Papers by Eilish McAuliffe
Human Resources for Health, Sep 4, 2014
Background: Irish medical students have a long and proud history of embarking on international he... more Background: Irish medical students have a long and proud history of embarking on international health electives (IHEs) to broaden their experience in the developing world. Although there are many opinions in the literature about IHEs, there is a dearth of empirical research that explores the experience and the value of these experiences to medical students. Most students who participate in these IHEs from Irish medical schools are members of student IHE societies, which are entirely run by students themselves. There are varying levels of preparation and interaction with the medical schools in planning these experiences. This study explores the experiences of a sample of students who completed IHEs in 2012. Methods: This qualitative study used anonymized one-on-one interviews with medical students in Irish medical schools who completed IHEs to developing countries in 2012. Students were recruited using online noticeboards of student societies and e-mail. Purposive sampling was used to find students from different medical schools, some who had travelled with medical student IHE societies and others who had travelled independently. Seven male and seven female students participated. Interviews were conducted until saturation was reached. Data were then analyzed thematically. Results: The main themes identified were the perceived benefits of IHEs, the difficulties experienced with the distribution of charitable donations, the emotional impact on the students of participating in the IHEs, awareness of scope of practice by students, and issues with the current structure of IHEs. Conclusions: The informal relationship that currently exists between student societies and the medical schools results in poor accountability and reporting requirements on IHEs. Clearer guidelines and identification of learning outcomes for students would be helpful. The findings are relevant to medical students internationally.
HRB Open Research, 2018
Background: The Assisted Decision-Making (ADM) (Capacity) Act 2015 was enacted by Dáil Éireann in... more Background: The Assisted Decision-Making (ADM) (Capacity) Act 2015 was enacted by Dáil Éireann in December 2015. The purpose of the act, as it applies to healthcare, is to promote the autonomy of persons in relation to their treatment choices, to enable them to be treated according to their will and preferences, and to provide healthcare professionals with important information about persons and their choices in relation to treatment. In practice, those patients with cognitive impairment, particularly dementia, and those with complex needs requiring composite decisions present the greatest challenge to healthcare professionals practicing in accordance with this legislation. Patients with complex needs requiring multifaceted decisions are often over 70 years of age and present in acute hospitals experiencing some form of cognitive impairment. Objectives: The aim of this project is to develop an educational tool which will promote understanding of ADM among healthcare professionals wo...
BMC Health Services Research
Background COVID-19 has challenged health services throughout the world in terms of hospital capa... more Background COVID-19 has challenged health services throughout the world in terms of hospital capacity and put staff and vulnerable populations at risk of infection. In the face of these challenges, many health providers have implemented remote patient monitoring (RPM) of COVID-19 patients in their own homes. However systematic reviews of the literature on these implementations have revealed wide variations in how RPM is implemented; along with variations in particulars of RPM reported on, making comparison and evaluation difficult. A review of reported items is warranted to develop a framework of key items to enhance reporting consistency. The aims of this review of remote monitoring for COVID-19 patients are twofold: (1) to facilitate comparison between RPM implementations by tabulating information and values under common domains. (2) to develop a reporting framework to enhance reporting consistency. Method A review of the literature for RPM for COVID-19 patients was conducted foll...
Irish Medical Journal, May 31, 2021
Aims To determine changes in mental health (MH) attendance at Emergency Departments (ED) by child... more Aims To determine changes in mental health (MH) attendance at Emergency Departments (ED) by children aged five to 15 during the COVID-19 pandemic. Methods Analysis of MH presentations during the first year of the pandemic compared with prior year for three public paediatric EDs serving the greater Dublin area with a paediatric population of 430,000. Results Overall, ED attendance during the 12 months to 28th February 2021 was 34.3% below prior year, while MH presentations were 8.9% above prior year. MH attendances initially decreased by 26.8% (2020: 303; 2019: 414) during the first four months of the pandemic (March to June), lower than the corresponding decrease of 47.9% for presentations for any reason (2020: 11,530; 2019: 22,128). However, MH presentations increased by 52.4% in July and August (2020: 218; 2019: 143), and by 45.6% in September to December (2020: 552 ;2019: 379), dropping 28.1% below prior year in January (2021: 87; 2020: 121) before returning to prior year levels in February 2021 (2021: 107; 2020: 106). Conclusion Following the initial COVID-19 lockdown, ED presentations by children for acute MH care increased significantly over prior year, with this increase sustained throughout 2020. Long-term stressors linked to the pandemic may be leading to chronic MH problems, warranting increased funding of MH services as part of the response to COVID-19.Health Research Boar
BMC Health Services Research, 2021
Background COVID-19 has impacted the context in which healthcare staff and teams operate and this... more Background COVID-19 has impacted the context in which healthcare staff and teams operate and this has implications for quality improvement (QI) work. Contrary to the usual ambivalent relationship staff have with QI work, there have been examples of unprecedented staff engagement in implementing rapid changes during the pandemic indicating a change in important underlying factors that impact staff involvement in QI. The purpose of this study is to explore staff perspectives about how experience and skills of QI methods supported them in implementing innovative practices during COVID-19. Methods This is a qualitative narrative study based on narrative interviews to collect healthcare staff stories of implementing rapid change. The stories were identified through social media (Twitter) and a national health magazine issued by the Irish health service. Twenty staff members participated in the interviews. Interviews were audio recorded, transcribed, and anonymised. A four-step thematic a...
BMJ Open, 2020
ObjectivesThe first aim of this study was to quantify the difficulty level of clinical research P... more ObjectivesThe first aim of this study was to quantify the difficulty level of clinical research Patient Information Leaflets/Informed Consent Forms (PILs/ICFs) using validated and widely used readability criteria which provide a broad assessment of written communication. The second aim was to compare these findings with best practice guidelines.DesignRetrospective, quantitative analysis of clinical research PILs/ICFs provided by academic institutions, pharmaceutical companies and investigators.SettingPILs/ICFs which had received Research Ethics Committee approval in the last 5 years were collected from Ireland and the UK.InterventionNot applicable.Main outcome measuresPILs/ICFs were evaluated against seven validated readability criteria (Flesch Reading Ease, Flesh Kincaid Grade Level, Simplified Measure of Gobbledegook, Gunning Fog, Fry, Raygor and New Dale Chall). The documents were also scored according to two health literacy-based criteria: the Clear Communication Index (CCI) and...
Background Hospital avoidance during the COVID-19 pandemic has been reported with a significant d... more Background Hospital avoidance during the COVID-19 pandemic has been reported with a significant decrease in attendance at emergency departments among paediatric populations with potential increased morbidity and mortality outcomes. The present study sought to understand parents’ experiences of healthcare during the initial public health stages of the COVID-19 pandemic.Methods A cross-sectional survey of parents of children under the age of 16 (N = 1044). The survey collected demographic information to profile parents and children, capture relevant health information such as pre-existing conditions and/or chronic illness or disability, and health service usage during the pandemic. Descriptive statistics, chi-square tests and regression analyses were used to determine the factors that influenced avoidance and hesitancy. Results23% of parents stated that they were much more hesitant to access health services upon implementation of the initial public health restrictions. Parents with a ...
HRB Open Research, 2020
Background:Measures introduced to delay the spread of COVID-19 may result in avoidance of emergen... more Background:Measures introduced to delay the spread of COVID-19 may result in avoidance of emergency departments (EDs) for non-COVID related illness. Clinicians and medical representative bodies such as the Irish Association for Emergency Medicine (IAEM) have expressed concern that some patients may not seek timely urgent medical intervention. Evidence from previous epidemics found that hospital avoidance during outbreaks of MERS and SARS was common. While ED attendance returned to normal following SARS and MERS, both outbreaks lasted 2-3 months. As the COVID-19 pandemic is forecast to extend into 2021, little is known about the impact COVID-19 will have on paediatric attendance at EDs as the pandemic evolves.Aims: This project aims to assess the impact of COVID-19 on paediatric emergency healthcare utilisation, to understand how the health seeking behaviour of parents may have altered due to the pandemic, and to identify how any barriers to accessing care can be removed. Methods: A...
BMJ Open, 2019
IntroductionScaling-up is essential to ensure universal access of effective health interventions.... more IntroductionScaling-up is essential to ensure universal access of effective health interventions. Scaling-up is a complex process, which occurs across diverse systems and contexts with no one-size-fits-all approach. To date, little attention has been paid to the process of scaling-up in how to make adaptations for local fit. The aim of this research is to develop theory on what actions can be used to make adaptations to health interventions for local fit when scaling-up across diverse contexts that will have practical application for implementers involved in scaling-up.Methods and analysisGiven the complexity of this subject, a realist review methodology was selected. Specifically, realist review emphasises an iterative, non-linear process, whereby the review is refined as it progresses. The identification of how the context may activate mechanisms to achieve outcomes is used to generate theories on what works for whom in what circumstances. This protocol will describe the first com...
BMJ, 2005
Editor-The recent UN prediction that its millennium development goals will be missed by a wide ma... more Editor-The recent UN prediction that its millennium development goals will be missed by a wide margin may stop the UN and its specialised agencies from adopting promethean goals they cannot hope to meet. 1 The G8 meeting is an opportunity to reexamine outmoded development principles. The Commission for Africa recommends a doubling of aid, reaching $75 billion (£41 billion; €112 billion) annually by 2015 and total debt forgiveness. 2 Of the $75 billion, 44% is directed towards health related millennium development goals. However, the findings of the World Bank and the International Policy Institute show that traditional development aid does not work (box). 3 4 From 1990 to mid-2005 official development aid was more than $1 trillion to developing countries. 5 At least an equal amount has been contributed by foundations, religious organisations, corporations, and private donors. Oil exports from Africa now account for 11% of the world's supply while Africa's foreign direct investment has risen sharply to 10.1% of gross domestic product in 2004. Yet, the prime minister, Tony Blair, found that "African poverty and stagnation is the greatest tragedy of our time." 2 The donor community does not lack money; its development concepts mean that increased aid will not eliminate global poverty but is more likely to increase it. 4 The US African Growth and Opportunity Act reduced barriers to trade, increased exports, created jobs, and expanded opportunities for Africans and Americans alike. It is also encouraging African governments to reform their economies. Last year US exports to sub-Saharan Africa increased by 25%, and America's imports from Africa rose by 88%. Development aid, like the Marshall Plan, should focus on economic growth rather than on social engineering programmes. Aid should be used to create things lacking in developing countries, rather than to consume things through high donor transaction costs. Let's get jobs, economic opportunities, and institutions of free societies for people in Africa by collaborating with its nations to foster an enabling environment that will make this possible-and bid a farewell to alms.
Bacci A, Bergstrom S: Meeting the need for emergency obstetric care in Mozambique: work performan... more Bacci A, Bergstrom S: Meeting the need for emergency obstetric care in Mozambique: work performance and histories of medical doctors and assistant medical officers trained for surgery Pereira, Cumbi, et al. ... S: Economic evaluation of surgically trained assistant medical officers in ...
Guiding change in the Irish health system This literature review was prepared by
Journal of Health Organization and Management
PurposeThe field of implementation science has emerged as a response to the challenges experience... more PurposeThe field of implementation science has emerged as a response to the challenges experienced in translating evidence-based practice and research findings to healthcare settings. Whilst the field has grown considerably in recent years, comparatively, there is a conspicuous lack of attention paid to the work of pre-implementation, that is, how we effectively engage with organisations to support the translation of research into practice. Securing the engagement and commitment of healthcare organisations and staff is key in quality improvement and organisational research. In this paper the authors draw attention to the pre-implementation phase, that is, the development of an amenable context to support implementation research.Design/methodology/approachDrawing from examples across an interdisciplinary group of health systems researchers working across a range of healthcare organisations, the authors present a reflective narrative viewpoint. They identify the principal challenges e...
International Journal of Environmental Research and Public Health, 2021
Background: Designing and implementing team interventions to improve quality and safety of care i... more Background: Designing and implementing team interventions to improve quality and safety of care in acute hospital contexts is challenging. There is little emphasis in the literature on how contextual conditions impact interventions or how specific active ingredients of interventions impact on team members’ reasoning and enact change. This realist evaluation helps to deepen the understanding of the enablers and barriers for effective team interventions in these contexts. Methods: Five previously developed initial programme theories were tested using case studies from two diverse hospital contexts. Data were collected from theory driven interviews (n = 19) in an Irish context and from previously conducted evaluative interviews (n = 16) in a US context. Data were explored to unpack the underlying social and psychological drivers that drove both intended and unintended outcomes. Patterns of regularity were identified and synthesised to develop middle-range theories (MRTs). Results: Elev...
Additional file 1. Key Terms & Boolean Operators.
This document is a PRISMA-P Checklist for a systematic review protocol entitled:<br><br&... more This document is a PRISMA-P Checklist for a systematic review protocol entitled:<br><br>"A protocol for a systematic review investigating factors influencing statistical planning, design, conduct, analysis and reporting of clinical trials". <br>This checklist illustrates that the protocol and systematic review will be conducted in accordance with the PRISMA guidelines (Moher et al., 2015)
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Papers by Eilish McAuliffe