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VP205 Implementing Electronic Records In Ambulances
- Alison Porter, Sarah Black, Jeremy Dale, David Fitzpatrick, Robert Harris-Mayes, Robin Lawrenson, Ronan Lyons, Suzanne Mason, Zoe Morrison, Pauline Mountain, Henry Potts, Niro Siriwardena, Nigel Rees, Helen Snooks, Victoria Williams
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- Journal:
- International Journal of Technology Assessment in Health Care / Volume 33 / Issue S1 / 2017
- Published online by Cambridge University Press:
- 12 January 2018, p. 246
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- Article
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INTRODUCTION:
Increasingly, ambulance services offer alternatives to transfer to the emergency department (ED), when this is better for patients. The introduction of electronic health records (EHR) in ambulance services is encouraged by national policy across the United Kingdom (UK) but roll-out has been variable and complex.
Electronic Records in Ambulances (ERA) is a two-year study which aims to investigate and describe the opportunities and challenges of implementing EHR and associated technology in ambulances to support a safe and effective shift to out of hospital care, including the implications for workforce in terms of training, role and clinical decision-making skills.
METHODS:Our study includes a scoping review of relevant issues and a baseline assessment of progress in all UK ambulance services in implementing EHR. These will inform four in-depth case studies of services at different stages of implementation, assessing current usage, and examining context.
RESULTS:The scoping review identified themes including: there are many perceived potential benefits of EHR, such as improved safety and remote diagnostics, but as yet little evidence of them; technical challenges to implementation may inhibit uptake and lead to increased workload in the short term; staff implementing EHR may do so selectively or devise workarounds; and EHR may be perceived as a tool of staff surveillance.
CONCLUSIONS:Our scoping review identified some complex issues around the implementation of EHR and the relevant challenges, opportunities and workforce implications. These will help to inform our fieldwork and subsequent data analysis in the case study sites, to begin early in 2017. Lessons learned from the experience of implementing EHR so far should inform future development of information technology in ambulance services, and help service providers to understand how best to maximize the opportunities offered by EHR to redesign care.
seven - Cultural justice and addressing ‘social exclusion’: a case study of a Single Regeneration Budget project in Blackbird Leys, Oxford
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- By Zoë Morrison
- Edited by Rob Imrie, Mike Raco
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- Book:
- Urban Renaissance?
- Published by:
- Bristol University Press
- Published online:
- 20 January 2022
- Print publication:
- 21 May 2003, pp 139-162
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Summary
Introduction
How do we address the social injustices of deprivation and social polarisation? These are issues the New Labour government is currently addressing through the concept of ‘social exclusion’, and through social exclusion policies such as the Single Regeneration Budget (SRB). In this chapter, I want to assess how successful this concept and these policies may be. In particular, I am interested in whether or not New Labour's social exclusion policy successfully addresses cultural aspects of injustice and social exclusion.
Cultural injustice refers to a lack of respect and recognition of certain people and groups in society (Fraser, 1995). It can be distinguished from economic injustice, which, by contrast, involves the unfair distribution of economic resources (such as money) among people and groups. These are important concepts to define, because I assume in this chapter that addressing injustices of poverty and social polarisation, and thereby addressing social exclusion, involves dealing with both cultural and economic aspects of social justice. If ‘social inclusion’ is to be achieved, both economic and cultural aspects of injustice must be taken into account. In this chapter, then, I argue that while ‘social exclusion’ itself is a multidimensional concept, promising to encompass both economic and cultural aspects of injustice and exclusion, its use in current British social exclusion discourse and policy can in fact be seen to perpetuate and reproduce, rather than successfully address, cultural aspects of injustice.
First, the chapter examines the concept of social exclusion, and its political use in discourse by government in contemporary Britain. It also critically evaluates the British social exclusion discourse, and argues that it fails to take into account issues of cultural justice. The chapter then looks at how this translates to policies in place, through a case study of a social exclusion policy project in Blackbird Leys, Oxford. Through a detailed, qualitative study of the processes of a ‘community capacity building’ project there, funded through Round Five of the SRB, I find that cultural justice is, again, not sufficiently taken into account. Indeed, I find that harmful stereotypes about Blackbird Leys are even reproduced by this policy, and local people are disrespected within, and excluded from, the very processes of a policy that is aiming to achieve social inclusion.