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Martin CL, Austin RR, Alexander S, Britt-Lalich M, Lee K, Monsen KA. Discovering Patterns in the Corpus of Omaha System Evidence-Based Guidelines: A Descriptive Visualization Analysis. Comput Inform Nurs 2024; 42:1-10. [PMID: 38194509 DOI: 10.1097/cin.0000000000001093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Affiliation(s)
- Christie L Martin
- Author Affiliations: School of Nursing, University of Minnesota (Drs Martin, Austin, and Monsen, and Ms Britt-Lalich), Minneapolis; College of Nursing, The University of Alabama in Huntsville (Dr Alexander); and University of Missouri (Dr Lee), Columbia
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Brick R, Hekman DJ, Werner NE, Rodakowski J, Cadmus-Bertram L, Fields B. Health system and patient-level factors associated with multidisciplinary care and patient education among hospitalized, older cancer survivors. PEC INNOVATION 2023; 3:100192. [PMID: 37502427 PMCID: PMC10369477 DOI: 10.1016/j.pecinn.2023.100192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023]
Abstract
Objective The purpose of this study was to examine system- and patient-level factors associated with the number of healthcare disciplines involved in delivery of patient education among hospitalized older cancer survivors. Methods We used electronic health record (EHR) data from a single institution documenting patient education among hospitalized older patients (≥65 years) with a history of cancer between 9/1/2018 and 10/1/2019. We used parametric ordinal logistic regression to assess the number of healthcare disciplines involved in documented education activities. Results The sample (n = 446) was predominantly male, White, and on average 74 years old. Adjusting for patient and system-level variables, men and larger department units had higher odds of receiving education from fewer healthcare disciplines. Patients with a history of breast or prostate cancer and longer lenths of stay had lower odds of receiving patient education from fewer healthcare disciplines. Conclusion Hospital size, severity of illness, and cancer type are associated with delivery of multidisciplinary education in this sample. Innovation EHR provides an opportunity to identify patterns in patient education among cancer survivors. Future research should investigate provider perspectives of the findings to inform provider- and system-level strategies to improve patient education.
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Affiliation(s)
- Rachelle Brick
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, 9609 Medical Center Dr, Rockville, MD 20850, USA
| | - Daniel J. Hekman
- University of Wisconsin-Madison, Department of Emergency Medicine, 600 Highland Avenue Madison, WI 53792, USA
| | - Nicole E. Werner
- Indiana University, Department of Health & Wellness Design, 1025 E 7 St, Bloomington, IN 47405, USA
| | - Juleen Rodakowski
- University of Pittsburgh, Department of Occupational Therapy, Bridgeside Point I, 100 Technology Drive, Pittsburgh, PA 15219, USA
| | - Lisa Cadmus-Bertram
- University of Wisconsin-Madison, Department of Kinesiology, 2170 Medical Sciences Center, 1300 University Avenue, Madison, WI 53706, USA
| | - Beth Fields
- University of Wisconsin-Madison, Department of Kinesiology, 2170 Medical Sciences Center, 1300 University Avenue, Madison, WI 53706, USA
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Ndateba I, Wong ST, Beaumier J, Burge F, Martin-Misener R, Hogg W, Wodchis W, McGrail K, Johnston S. Primary care practice characteristics associated with team functioning in primary care settings in Canada: A practice-based cross-sectional survey. J Interprof Care 2022; 37:352-361. [PMID: 35880781 DOI: 10.1080/13561820.2022.2099359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Team-based care is recognized as a foundational building block of high-performing primary care. The purpose of this study was to identify primary care practice characteristics associated with team functioning and examine whether there is relationship between team composition or size and team functioning. We sought to answer the following research questions: (1) are primary care practice characteristics associated with team functioning; and (2) does team composition or size influence team functioning. This cross-sectional correlational study was conducted in Fraser East, British Columbia, Eastern Ontario Health Unit, Ontario and Central Zone, Nova Scotia in Canada. Data were collected from primary care practices using an organization survey and the Team Climate Inventory (TCI) as a measure team functioning. The independent variables of interest were: physicians' payment model, internal clinic meetings to discuss clinical issues, care coordination through informal and ad hoc exchange, care coordination through electronic medical records and sharing clinic mission, values and objectives among health professionals. Potentially confounding variables were as follows: team size, composition, and practice panel size. A total of 63 practices were included in these analyses. The overall mean score of team climate was 73 (SD: 10.75) out of 100. Regression analyses showed that care coordination through human interaction and sharing the practice's mission, values, and objectives among health professionals were positively associated with higher functioning teams. Care coordination through electronic medical records and larger team size were negatively associated with team climate. This study provides baseline data on what practice characteristics are associated with highly functioning teams in Canada.
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Affiliation(s)
- Innocent Ndateba
- School of Nursing, University of British Columbia, Vancouver, Canada.,Centre for Health Services and Policy Research, University of British Columbia, Vancouver, Canada
| | - Sabrina T Wong
- School of Nursing, University of British Columbia, Vancouver, Canada.,Centre for Health Services and Policy Research, University of British Columbia, Vancouver, Canada
| | - Jonathan Beaumier
- School of Nursing, University of British Columbia, Vancouver, Canada.,Centre for Health Services and Policy Research, University of British Columbia, Vancouver, Canada
| | | | | | - William Hogg
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Walter Wodchis
- University of Toronto, Institute of Health Policy, Management and Evaluation, Toronto, Canada
| | - Kimberlyn McGrail
- Centre for Health Services and Policy Research, University of British Columbia, Vancouver, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Sharon Johnston
- Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
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Zaher S, Otaki F, Zary N, Al Marzouqi A, Radhakrishnan R. Effect of introducing interprofessional education concepts on students of various healthcare disciplines: a pre-post study in the United Arab Emirates. BMC MEDICAL EDUCATION 2022; 22:517. [PMID: 35780117 PMCID: PMC9250223 DOI: 10.1186/s12909-022-03571-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 06/21/2022] [Indexed: 05/04/2023]
Abstract
BACKGROUND The value of interprofessional education (IPE) in nurturing healthcare professionals, and in shaping their professional identities, and their attitudes towards interdisciplinary teamwork and collaboration is established in the literature. IPE is an emerging concept in the Middle East and North Africa (MENA) region and is new to the United Arab Emirates (UAE). To date, the applicability and feasibility of IPE and of the corresponding collaborative practice in MENA countries remain largely unexamined. PURPOSE To investigate the effect of one of the first experiences of IPE in the UAE, which was purposefully designed in alignment with the principles of the Situated Learning Theory (SLT), on the readiness for interprofessional learning and collaboration among students of various healthcare disciplines in the UAE. METHODS A pre-post intervention quantitative research design was adopted for this study. The intervention focused on communication skills, and consisted of 2 tailor-made case-based scenarios. A total of 90 students (40 medical, 16 nursing, 16 pharmacy, and 18 physiotherapy), spread across two sessions (1 session per academic year across 2 academic years), took part in the IPE intervention. Readiness for Interprofessional Learning Scale (RIPLS) was used as the pre- and post- intervention assessments; aggregate data was analyzed using SPSS. RESULTS Of those who participated in the intervention (across both rounds), 77 participants responded to the pre-assessment (85. 6%) and 84 responded to the post-assessment (93. 3%). The IPE intervention under investigation significantly increased the level of readiness to engage in cross-disciplinary learning and collaboration among participating health professions' students. In terms of the subscales, the participants' openness to engage in teamwork was raised and their professional identity was fostered. Yet, no statistical significance around clarity of roles and responsibilities was detected. CONCLUSION The findings of this study encourage other universities in the MENA region to adopt IPE to improve future health professionals' capacity to develop shared understanding and mutual respect within cross-disciplinary teams. This, ultimately, feeds into improved quality of care and patient outcomes.
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Affiliation(s)
- Shroque Zaher
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
- Division of Pathology, Al Qassimi Hospital, Sharjah, United Arab Emirates.
| | - Farah Otaki
- Strategy and Institutional Excellence, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Nabil Zary
- Institute for Excellence in Health Professions Education, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Amina Al Marzouqi
- College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Rajan Radhakrishnan
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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Zhao S, Du R, He Y, He X, Jiang Y, Zhang X. Elements of chronic disease management service system: an empirical study from large hospitals in China. Sci Rep 2022; 12:5693. [PMID: 35383275 PMCID: PMC8982312 DOI: 10.1038/s41598-022-09784-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 03/28/2022] [Indexed: 02/08/2023] Open
Abstract
At present, more patients suffer from multiple chronic diseases. However, the hospital's existing chronic disease management is carried out according to the department. This means that a patient needs to go to more than one department for a chronic disease treatment. Therefore, this study proposes 6 dimensions (organizational management, medical service support, medical service, community alliance, self-management support, management information system) and 36 questions, to help evaluate the current chronic disease management system in China's large third-class hospitals. In this study, 143 survey samples from doctors and nurses were collected. A principal component analysis was used to extract three key elements of chronic disease management service delivery system (service management organization, management information system, medical core service). Then, multiple regression was used to establish the relationship model between the overall performance of the system and the main elements. Three key service nodes of the system (medical specialist support, patient tracking management and personalized intervention) were determined according to the weight of the regression model. The regression coefficients of the above three main elements show a similar impact on the overall performance of the system, but the key service nodes under each major element have relative differences, including medical specialist support, patient tracking management and personalized intervention. Finally, to establish a chronic disease management system with multiple departmental continuous care for chronic diseases, it is necessary to improve the chronic disease management system from three aspects of medical specialty support, patient tracking management and personalized intervention. This paper proposes corresponding improvement strategies.
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Affiliation(s)
- Shuzhen Zhao
- West China School of Nursing/Outpatient Department, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Renjie Du
- Business School of Sichuan University, Chengdu, 610065, China
| | - Yanhua He
- West China School of Nursing/Outpatient Department, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xiaoli He
- West China School of Nursing/Outpatient Department, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yaxin Jiang
- West China School of Nursing/Outpatient Department, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xinli Zhang
- Business School of Sichuan University, Chengdu, 610065, China.
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Factors influencing sustainability and scale-up of rural primary healthcare memory clinics: perspectives of clinic team members. BMC Health Serv Res 2022; 22:148. [PMID: 35120516 PMCID: PMC8814777 DOI: 10.1186/s12913-022-07550-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 01/24/2022] [Indexed: 12/03/2022] Open
Abstract
Background The aging of rural populations contributes to growing numbers of people with dementia in rural areas. Despite the key role of primary healthcare in rural settings there is limited research on effective models for dementia care, or evidence on sustaining and scaling them. The purpose of this study was to identify factors influencing sustainability and scale-up of rural primary care based memory clinics from the perspective of healthcare providers involved in their design and delivery. Methods Participants were members of four interdisciplinary rural memory clinic teams in the Canadian province of Saskatchewan. A qualitative cross-sectional and retrospective study design was conducted. Data were collected via 6 focus groups (n = 40) and 16 workgroup meetings held with teams over 1 year post-implementation (n = 100). An inductive thematic analysis was used to identify themes. Results Eleven themes were identified (five that influenced both sustainability and scale-up, three related to sustainability, and three related to scale-up), encompassing team, organizational, and intervention-based factors. Factors that influenced both sustainability and scale-up were positive outcomes for patients and families, access to well-developed clinic processes and tools, a confident clinic leader-champion, facilitation by local facilitators and the researchers, and organizational and leadership support. Study findings revealed the importance of particular factors in the rural context, including facilitation to support team activities, a proven ready-to-use model, continuity of team members, and mentoring. Conclusions Interdisciplinary models of dementia care are feasible in rural settings if the right conditions and supports are maintained. Team-based factors were key to sustaining and scaling the innovation. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07550-0.
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Sibbald SL, Paciocco S, Fournie M, Van Asseldonk R, Scurr T. Continuing to enhance the quality of case study methodology in health services research. Healthc Manage Forum 2021; 34:291-296. [PMID: 34227408 PMCID: PMC8392758 DOI: 10.1177/08404704211028857] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Case study methodology has grown in popularity within Health Services Research (HSR). However, its use and merit as a methodology are frequently criticized due to its flexible approach and inconsistent application. Nevertheless, case study methodology is well suited to HSR because it can track and examine complex relationships, contexts, and systems as they evolve. Applied appropriately, it can help generate information on how multiple forms of knowledge come together to inform decision-making within healthcare contexts. In this article, we aim to demystify case study methodology by outlining its philosophical underpinnings and three foundational approaches. We provide literature-based guidance to decision-makers, policy-makers, and health leaders on how to engage in and critically appraise case study design. We advocate that researchers work in collaboration with health leaders to detail their research process with an aim of strengthening the validity and integrity of case study for its continued and advanced use in HSR.
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Affiliation(s)
- Shannon L. Sibbald
- Faculty of Health Sciences, Western University, London, Ontario, Canada
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- The Schulich Interfaculty Program in Public Health, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Stefan Paciocco
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Meghan Fournie
- Faculty of Health Sciences, Western University, London, Ontario, Canada
| | | | - Tiffany Scurr
- Faculty of Health Sciences, Western University, London, Ontario, Canada
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Paciocco S, Kothari A, Licskai CJ, Ferrone M, Sibbald SL. Evaluating the implementation of a chronic obstructive pulmonary disease management program using the Consolidated Framework for Implementation Research: a case study. BMC Health Serv Res 2021; 21:717. [PMID: 34289847 PMCID: PMC8293496 DOI: 10.1186/s12913-021-06636-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/14/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a prevalent chronic disease that requires comprehensive approaches to manage; it accounts for a significant portion of Canada's annual healthcare spending. Interprofessional teams are effective at providing chronic disease management that meets the needs of patients. As part of an ongoing initiative, a COPD management program, the Best Care COPD program was implemented in a primary care setting. The objectives of this research were to determine site-specific factors facilitating or impeding the implementation of a COPD program in a new setting, while evaluating the implementation strategy used. METHODS A qualitative case study was conducted using interviews, focus groups, document analysis, and site visits. Data were deductively analyzed using the Consolidated Framework for Implementation Research (CFIR) to assess the impact of each of its constructs on Best Care COPD program implementation at this site. RESULTS Eleven CFIR constructs were determined to meaningfully affect implementation. Five were identified as the most influential in the implementation process. Cosmopolitanism (partnerships with other organizations), networks and communication (amongst program providers), engaging (key individuals to participate in program implementation), design quality and packaging (of the program), and reflecting and evaluating (throughout the implementation process). A peer-to-peer implementation strategy included training of registered respiratory therapists (RRT) as certified respiratory educators and the establishment of a communication network among RRTs to discuss experiences, collectively solve problems, and connect with the program lead. CONCLUSIONS This study provides a practical example of the various factors that facilitated the implementation of the Best Care COPD program. It also demonstrates the potential of using a peer-to-peer implementation strategy. Focusing on these factors will be useful for informing the continued spread and success of the Best Care COPD program and future implementation of other chronic care programs.
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Affiliation(s)
- Stefan Paciocco
- Health and Rehabilitation Sciences, Western University, London, Canada
| | - Anita Kothari
- School of Health Studies, Faculty of Health Sciences, Western University, London, Canada
| | - Christopher J Licskai
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | | | - Shannon L Sibbald
- School of Health Studies, Faculty of Health Sciences, Department of Family Medicine, Schulich School of Medicine and Dentistry, The Schulich Interfaculty Program in Public Health, Schulich School of Medicine and Dentistry, Western University, London, Canada.
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