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McNiff MM, Hawkins S, Haase B, Bullivant J, McIver T, Mitelman O, Emery N, Tasca G, Voermans N, Diaz-Manera J. Facioscapulohumeral Muscular Dystrophy European Patient Survey: Assessing Patient Reported Disease Burden and Preferences in Clinical Trial Participation. J Neuromuscul Dis 2024; 11:459-472. [PMID: 38277300 DOI: 10.3233/jnd-230171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
Background Facioscapulohumeral muscular dystrophy (FSHD) is a genetic disorder characterized by progressive muscle weakness leading to permanent disability. There are no curative treatments, however, there are several upcoming clinical trials testing new therapies in FSHD. Objective This study aimed to explore the disease burden and patient preferences of people with FSHD to ensure that clinical trials can be designed to include outcome measures that are relevant and important to patients. Methods A survey was developed with a steering committee clinicians and physiotherapists with relevant experience in the disease, patient representatives, a registry expert and industry consultants. Themes of the survey included; participant demographics, disease progression and impact on function, factors encouraging or discouraging clinical trial participation, and positive outcomes of a clinical trial. Results 1147 participants responded to the online survey, representing 26 countries across Europe and a range of disease severities. The study highlighted the key symptoms causing concern for FSHD patients - muscle weakness and mobility issues - reflecting what participants want targeted for future therapies. The need for clear information and communication throughout clinical trials was emphasised. Factors most encouraging trial participation included access to new investigational therapies, access to trial results and benefits for the FSHD community. Factors most discouraging trial participation included travel related issues and fear of side effects. Conclusions The results from this study identify the patient reported burden of FSHD and should provide researchers and industry with areas of therapeutic research that would be meaningful to patients, as well as supporting the development of patient centric outcome measures in clinical trials.
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Affiliation(s)
- Megan M McNiff
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Sheila Hawkins
- FSHD Europe, Radboud University Medical Centre, Department of Neurology, HB Nijmegen, TheNetherlands
| | - Bine Haase
- FSHD Europe, Radboud University Medical Centre, Department of Neurology, HB Nijmegen, TheNetherlands
| | - Joanne Bullivant
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Tammy McIver
- F. Hoffmann-La Roche Ltd, PD Data Sciences, Welwyn Garden City, UK
| | | | - Nicholas Emery
- The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - Giorgio Tasca
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
- Unità Operativa Complessa di Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Nicol Voermans
- FSHD Europe, Radboud University Medical Centre, Department of Neurology, HB Nijmegen, TheNetherlands
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jordi Diaz-Manera
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
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Westerink HJ, Oirbans T, Garvelink MM, van Uden-Kraan CF, Zouitni O, Bart HAJ, van der Wees PJ, van der Nat PB. Barriers and facilitators of meaningful patient participation at the collective level in healthcare organizations: A systematic review. Health Policy 2023; 138:104946. [PMID: 38000333 DOI: 10.1016/j.healthpol.2023.104946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/20/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023]
Abstract
INTRODUCTION Collective patient participation, such as patient participation in policy making, has become increasingly important to achieve high-quality care. However, there is little knowledge on how to let patients participate in a meaningful manner at this level. The aim of this systematic literature review was to provide an overview of barriers, facilitators, and associated impact of collective patient participation. METHODS PubMed and EMBASE were searched until May 2023 for studies that evaluated collective patient participation. Study characteristics, methods for patient participation, barriers and facilitators, and impact (if measured) of patient participation were extracted from the articles. RESULTS We included 59 articles. Identified barriers and facilitators of collective patient participation were grouped into five categories: (1) preconditions for patient participation, (2) strategy for patient participation, (3) preparation of patients and staff for patient participation, (4) support for patients and staff during patient participation, and (5) evaluation of patient participation. Impact of patient participation was reported in 34 included studies at three levels: quality of care and research, the team and organization, and the participants themselves. Only three studies reported quantitative outcomes. CONCLUSION Interestingly, similar challenges were experienced during a period of twenty years, indicating that little progress has been made in structuring patient participation. Our overview of barriers and facilitators will therefore help to improve and structure collective patient participation.
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Affiliation(s)
- Henrike J Westerink
- Department of Value Improvement, St. Antonius Hospital, Nieuwegein, Utrecht, The Netherlands; Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Tom Oirbans
- Department of Value Improvement, St. Antonius Hospital, Nieuwegein, Utrecht, The Netherlands; Department of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mirjam M Garvelink
- Department of Value Improvement, St. Antonius Hospital, Nieuwegein, Utrecht, The Netherlands
| | | | - Ouisam Zouitni
- Client Council, St. Antonius Hospital, Nieuwegein, Utrecht, The Netherlands
| | - Hans A J Bart
- Independent patient advocate (former policymaker for the Netherlands Patients Federation, now retired)
| | - Philip J van der Wees
- Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Paul B van der Nat
- Department of Value Improvement, St. Antonius Hospital, Nieuwegein, Utrecht, The Netherlands; Scientific Center for Quality of Healthcare (IQ healthcare), Radboud University Medical Center, Nijmegen, The Netherlands
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Braund H, Dalgarno N, Chan-Nguyen S, Digby G, Haji F, O'Riordan A, Appireddy R. Exploring Patient Advisors' Perceptions of Virtual Care Across Canada: Qualitative Phenomenological Study. J Med Internet Res 2023; 25:e45215. [PMID: 37995127 PMCID: PMC10704306 DOI: 10.2196/45215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 06/19/2023] [Accepted: 07/31/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND While virtual care services existed prior to the emergence of COVID-19, the pandemic catalyzed a rapid transition from in-person to virtual care service delivery across the Canadian health care system. Virtual care includes synchronous or asynchronous delivery of health care services through video visits, telephone visits, or secure messaging. Patient advisors are people with patient and caregiving experiences who collaborate within the health care system to share insights and experiences in order to improve health care. OBJECTIVE This study aimed to understand patient advisors' perceptions related to virtual care and potential impacts on health care quality. METHODS We adopted a phenomenological approach, whereby we interviewed 20 participants who were patient advisors across Canada using a semistructured interview protocol. The protocol was developed by content experts and medical education researchers. The interviews were audio-recorded, transcribed verbatim, and analyzed thematically. Data collection stopped once thematic saturation was reached. The study was conducted at Queen's University, Kingston, Ontario. We recruited 20 participants from 5 Canadian provinces (17 female participants and 3 male participants). RESULTS Six themes were identified: (1) characteristics of effective health care, (2) experiences with virtual care, (3) modality preferences, (4) involvement of others, (5) risks associated with virtual care encounters, and (6) vulnerable populations. Participants reported that high-quality health care included building relationships and treating patients holistically. In general, participants described positive experiences with virtual care during the pandemic, including greater efficiency, increased accessibility, and that virtual care was less stressful and more patient centered. Participants comparing virtual care with in-person care reported that time, scheduling, and content of interactions were similar across modalities. However, participants also shared the perception that certain modalities were more appropriate for specific clinical encounters (eg, prescription renewals and follow-up appointments). Perspectives related to the involvement of family members and medical trainees were positive. Potential risks included miscommunication, privacy concerns, and inaccurate patient assessments. All participants agreed that stakeholders should be proactive in applying strategies to support vulnerable patients. Participants also recommended education for patients and providers to improve virtual care delivery. CONCLUSIONS Participant-reported experiences of virtual care encounters were relatively positive. Future work could focus on delivering training and resources for providers and patients. While initial experiences are positive, there is a need for ongoing stakeholder engagement and evaluation to improve patient and caregiver experiences with virtual care.
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Affiliation(s)
- Heather Braund
- Office of Professional Development and Educational Scholarship, Health Sciences, Queen's University, Kingston, ON, Canada
| | - Nancy Dalgarno
- Office of Professional Development and Educational Scholarship, Health Sciences, Queen's University, Kingston, ON, Canada
| | - Sophy Chan-Nguyen
- Department of Family Medicine, Queen's University, Kingston, ON, Canada
| | - Geneviève Digby
- Division of Respirology, Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Faizal Haji
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Anne O'Riordan
- Division of Neurology, Department of Medicine, Queen's University, Kingston, ON, Canada
| | - Ramana Appireddy
- Division of Neurology, Department of Medicine, Queen's University, Kingston, ON, Canada
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Kimminau KS, Jernigan C, Krebill H, Douglas S, Peltzer J, Hamilton-Reeves J, Chen RC, Jensen R. Roadmap to engagement: Bringing patient partners into cancer research and beyond. J Clin Transl Sci 2023; 7:e178. [PMID: 37654779 PMCID: PMC10465315 DOI: 10.1017/cts.2023.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 07/16/2023] [Accepted: 07/20/2023] [Indexed: 09/02/2023] Open
Abstract
The University of Kansas Cancer Center (KU Cancer Center) initiated an engagement program to leverage the lived experience of individuals and families with cancer. KU Cancer Center faculty, staff, and patient partners built an infrastructure to achieve a patient-designed, patient-led, and research-informed engagement program called Patient and Investigator Voices Organizing Together (PIVOT). This special communication offers an engagement roadmap that can be replicated, scaled, and adopted at other cancer centers and academic health systems. PIVOT demonstrates that collaboration among academic leaders, investigators, and people with a lived experience yields a patient-centered, vibrant environment that enriches the research enterprise.
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Affiliation(s)
- Kim S. Kimminau
- Department of Family and Community Medicine, University of Missouri-Columbia, Columbia, MO, USA
| | - Cheryl Jernigan
- University of Kansas Cancer Center, University of Kansas School of Medicine, Kansas City, KS, USA
| | | | - Sara Douglas
- Patient Advocacy and Engagement Talaris Therapeutics, Louisville, KY, USA
| | - Jill Peltzer
- University of Kansas School of Nursing, Kansas City, KS, USA
| | - Jill Hamilton-Reeves
- KU Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Ronald C. Chen
- Department of Radiation Oncology, University of Kansas Cancer Center, Kansas City, KS, USA
| | - Roy Jensen
- University of Kansas Cancer Center, University of Kansas School of Medicine, Kansas City, KS, USA
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Rollston RL, Gallogly W, Lynch-Coffey A, Hoffman L, Clear B. Implementation of a Novel Telehealth Patient Advisory Council. J Patient Exp 2023; 10:23743735231184692. [PMID: 37441274 PMCID: PMC10334017 DOI: 10.1177/23743735231184692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023] Open
Abstract
Patient engagement in healthcare delivery processes has been increasingly emphasized in recent years, which can be accomplished in part by Patient Advisory Councils (PACs). Although well-established in brick-and-mortar facilities, the use of PACs in pure telehealth settings is limited. Bicycle Health, a digital health organization that provides biopsychosocial treatment of opioid use disorder (OUD) via telehealth, sought to increase patient engagement regarding care delivery and innovation, ultimately launching a telehealth Patient Advisory Council. Herein we discuss implementation challenges and iterative changes to address each challenge. Key learnings include the following: Patients with OUD are often subject to significant stigma, including by healthcare professionals. This is a key factor to consider when recruiting and engaging patients; trust building is key and can help to overcome both perceived and actual stigma.Inclusion of core staff persons who have lived experience with the respective health condition-in this case, OUD-is beneficial.Utilizing a formal framework, such as the Model for Improvement (utilized widely by the Institute for Healthcare Improvement), to guide improvement work is helpful for providing structure to feedback conversations, though this framework should be presented to patients in accessible language.
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Sagen JS, Smedslund G, Simonsen AE, Habberstad A, Kjeken I, Dagfinrud H, Moe RH. Patient engagement in the development and delivery of healthcare services: a systematic scoping review. BMJ Open Qual 2023; 12:e002309. [PMID: 37369560 PMCID: PMC10577732 DOI: 10.1136/bmjoq-2023-002309] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Patient engagement (PE) is required to improve future healthcare services. PE in the development and delivery of healthcare services is likely to be complex but is scarcely described. OBJECTIVES The objective of this scoping review was to summarise primary studies on mesolevel PE regarding structure, process and outcomes. More specifically, the aim was to explore barriers and facilitators to successful PE, how persons are engaged in the process and summarise reported consequences. METHOD A systematic scoping review was conducted, searching the MEDLINE, EMBASE, Cochrane and PsycINFO databases. Primary studies, published between 7 July 2005 and 4 October 2022, were considered for inclusion. Two reviewers extracted data about PE (eg, attributes of PE settings, facilitators and barriers, and outcomes to PE) and the first author coded the extracted data into structural, processual and outcome themes. RESULTS Of 8588 identified records, 37 studies were eligible. Most of the included studies were conducted in Europe (n=19; 51%) and North America (n=13; 35%). Structures that ensure sufficient stakeholder representativeness and PE knowledge through education may facilitate the PE process further, regardless of the environmental setting. Interpersonal relationships with uneven power dynamics were reported as noteworthy processual barriers to meaningful PE, while clearly described roles and tasks were reported as important facilitators. In contrast to hard outcomes with operationalised PE effects, the most noteworthy outcomes of PE were reported as soft processual consequences such as patient representatives improving their self-esteem and feeling valued. CONCLUSIONS Unfortunately, there is a dearth of studies exploring hard and operationalised PE outcomes on healthcare services and patients receiving healthcare. The PE process may be facilitated by dedicated finances to PE education and by ensuring sufficient stakeholder representativeness.
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Affiliation(s)
- Joachim Støren Sagen
- NKRR, Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
- Oslo Metropolitan University, Faculty of Health Sciences, Oslo, Norway
| | - Geir Smedslund
- NKRR, Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| | | | - Andreas Habberstad
- The Norwegian Federation of Organisations of Disabled People, Oslo, Norway
| | - Ingvild Kjeken
- NKRR, Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
- Oslo Metropolitan University, Faculty of Health Sciences, Oslo, Norway
| | - Hanne Dagfinrud
- NKRR, Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
- University of Oslo, Faculty of Medicine, Oslo, Norway
| | - Rikke Helene Moe
- NKRR, Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
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Silvola S, Restelli U, Bonfanti M, Croce D. Co-Design as Enabling Factor for Patient-Centred Healthcare: A Bibliometric Literature Review. CLINICOECONOMICS AND OUTCOMES RESEARCH 2023; 15:333-347. [PMID: 37220481 PMCID: PMC10200122 DOI: 10.2147/ceor.s403243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 04/21/2023] [Indexed: 05/25/2023] Open
Abstract
Service design and in particular co-design are approaches able to align with the need of healthcare contexts of value-based and patient-centered processing through a participatory design of services. The purpose of this study is to identify the characteristics of co-design and its applicability to the reengineering of healthcare services, as well as to detect the peculiarities of the application of this approach in different geographical contexts. The methodology applied for the review, Systematic Literature Network Analysis (SLNA), combines qualitative and quantitative perspectives. In detail, the analysis applied the paper citation networks and the co-word network analysis to detect the main research trends over time and to identify the most relevant publications. The results of the analysis highlight the backbone of literature on the application of co-design in healthcare as well as the advantages and the critical factors of the approach. Three main literature streams emerged concerning the integration of the approach at meso and micro level, the implementation of co-design at mega and macro level, and the impacts on non-clinical related outcomes. Moreover, the findings underline differences in co-design in terms of impacts and success factors in developed countries and economies in transition or developing countries. The analysis shows the potentially added value of the application of a participatory approach to the design and redesign of healthcare services both at different levels of the healthcare organization and in the contexts of developed countries and economies in transition or developing countries. The evidence also highlights potentialities and critical success factors of the application of co-design in healthcare services redesign.
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Affiliation(s)
- Sofia Silvola
- LIUC - Università Cattaneo, Castellanza, VA, Italy
- Department of Public Health Medicine, School of Health System & Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Umberto Restelli
- LIUC - Università Cattaneo, Castellanza, VA, Italy
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Davide Croce
- LIUC - Università Cattaneo, Castellanza, VA, Italy
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Racine N, Greer K, Dimitropoulos G, Collin-Vézina D, Henderson JL, Madigan S. Youth engagement in child maltreatment research: Gaps, barriers, and approaches. CHILD ABUSE & NEGLECT 2023; 139:106127. [PMID: 36907118 DOI: 10.1016/j.chiabu.2023.106127] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 02/11/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
Youth engagement in research, which involves meaningfully collaborating with youth as full partners in the research process, has contributed to improved research collaborations, enhanced youth participation, and increased motivation for researchers to address scientific questions relevant to youth. Engaging youth as partners in the research process is especially needed in the field of child maltreatment due to the high prevalence of maltreatment, its poor association with health outcomes, and the disempowerment that can occur following exposure to child maltreatment. Although evidence-based approaches for youth engagement in research have been established and applied in other areas such as mental health services, youth engagement in child maltreatment research has been limited. This is particularly disadvantageous to youth exposed to maltreatment as their voices remain absent from research priorities, which contributes to a discrepancy between the research topics that are relevant to youth and those that are pursued by the research community. Using a narrative review approach, we provide an overview of the potential for youth engagement within the field of child maltreatment research, identify barriers to youth engagement, provide trauma-informed strategies for engaging youth in the context of research, and review existing trauma-informed models for youth engagement. This discussion paper suggests that youth engagement in research can contribute to improvements in the design and delivery of mental health care services for youth exposed to traumatic experiences and should be prioritized in future research endeavors. Moreover, it is essential for youth who have historically experienced systemic violence to be engaged and have a voice in research that has the potential to impact policy and practice.
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Affiliation(s)
- Nicole Racine
- University of Ottawa, 136 Jean-Jacques Lussier, Ottawa, ON K1N 6N5, Canada; Children's Hospital of Eastern Ontario Research Institute.
| | - Katelyn Greer
- University of Calgary, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada
| | - Gina Dimitropoulos
- University of Calgary, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada; Alberta Children's Hospital Research Institute, 3330 Hospital Dr. NW, 3B2X9 Calgary, AB, Canada
| | - Delphine Collin-Vézina
- School of Social Work, McGill University, 3506 University Street, Room 321A, Montreal, QC H3A 2A7, Canada
| | - J L Henderson
- Centre for Addiction and Mental Health, 80 Workman Way, Toronto, ON M5J 1H4, Canada; University of Toronto, Toronto, Ontario, Canada
| | - Sheri Madigan
- University of Calgary, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada; Alberta Children's Hospital Research Institute, 3330 Hospital Dr. NW, 3B2X9 Calgary, AB, Canada
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Kung A, Li DG, Lavery JA, Narang B, Diamond L. Characteristics of Cancer Hospitals with Written Language Access Policies. J Immigr Minor Health 2023; 25:282-290. [PMID: 36136231 PMCID: PMC10276971 DOI: 10.1007/s10903-022-01399-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 11/24/2022]
Abstract
Patients with limited English proficiency receive worse care due to communication barriers. Little is known about which cancer hospitals have written language access policies addressing bilingual clinicians. We conducted a cross-sectional survey of healthcare organizations, matching survey data to American Hospital Association Survey and American Community Survey data. We analyzed characteristics associated with hospitals having bilingual clinician policies. The response rate was 71% (127/178). Many hospitals (53 [42%]) did not have written policies on bilingual clinicians. Having bilingual clinicians available at the hospital was associated with having a written policy on bilingual clinicians, while being an NCORP site was associated with not having a written policy on bilingual clinicians. Patient demographic characteristics were not associated with hospitals having written policies on bilingual clinicians. A substantial proportion of cancer hospitals do not have policies that cover language use by bilingual clinicians, particularly at NCORP sites. Having written policies on bilingual clinicians has the potential to mitigate cancer disparities by facilitating accountability, improving communication, and reducing errors.
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Affiliation(s)
- Alina Kung
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Diane G Li
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jessica A Lavery
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Bharat Narang
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lisa Diamond
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.
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Merner B, Schonfeld L, Virgona A, Lowe D, Walsh L, Wardrope C, Graham-Wisener L, Xafis V, Colombo C, Refahi N, Bryden P, Chmielewski R, Martin F, Messino NM, Mussared A, Smith L, Biggar S, Gill M, Menzies D, Gaulden CM, Earnshaw L, Arnott L, Poole N, Ryan RE, Hill S. Consumers' and health providers' views and perceptions of partnering to improve health services design, delivery and evaluation: a co-produced qualitative evidence synthesis. Cochrane Database Syst Rev 2023; 3:CD013274. [PMID: 36917094 PMCID: PMC10065807 DOI: 10.1002/14651858.cd013274.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Partnering with consumers in the planning, delivery and evaluation of health services is an essential component of person-centred care. There are many ways to partner with consumers to improve health services, including formal group partnerships (such as committees, boards or steering groups). However, consumers' and health providers' views and experiences of formal group partnerships remain unclear. In this qualitative evidence synthesis (QES), we focus specifically on formal group partnerships where health providers and consumers share decision-making about planning, delivering and/or evaluating health services. Formal group partnerships were selected because they are widely used throughout the world to improve person-centred care. For the purposes of this QES, the term 'consumer' refers to a person who is a patient, carer or community member who brings their perspective to health service partnerships. 'Health provider' refers to a person with a health policy, management, administrative or clinical role who participates in formal partnerships in an advisory or representative capacity. This QES was co-produced with a Stakeholder Panel of consumers and health providers. The QES was undertaken concurrently with a Cochrane intervention review entitled Effects of consumers and health providers working in partnership on health services planning, delivery and evaluation. OBJECTIVES 1. To synthesise the views and experiences of consumers and health providers of formal partnership approaches that aimed to improve planning, delivery or evaluation of health services. 2. To identify best practice principles for formal partnership approaches in health services by understanding consumers' and health providers' views and experiences. SEARCH METHODS We searched MEDLINE, Embase, PsycINFO and CINAHL for studies published between January 2000 and October 2018. We also searched grey literature sources including websites of relevant research and policy organisations involved in promoting person-centred care. SELECTION CRITERIA We included qualitative studies that explored consumers' and health providers' perceptions and experiences of partnering in formal group formats to improve the planning, delivery or evaluation of health services. DATA COLLECTION AND ANALYSIS Following completion of abstract and full-text screening, we used purposive sampling to select a sample of eligible studies that covered a range of pre-defined criteria, including rich data, range of countries and country income level, settings, participants, and types of partnership activities. A Framework Synthesis approach was used to synthesise the findings of the sample. We appraised the quality of each study using the CASP (Critical Appraisal Skill Program) tool. We assessed our confidence in the findings using the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach. The Stakeholder Panel was involved in each stage of the review from development of the protocol to development of the best practice principles. MAIN RESULTS We found 182 studies that were eligible for inclusion. From this group, we selected 33 studies to include in the final synthesis. These studies came from a wide range of countries including 28 from high-income countries and five from low- or middle-income countries (LMICs). Each of the studies included the experiences and views of consumers and/or health providers of partnering in formal group formats. The results were divided into the following categories. Contextual factors influencing partnerships: government policy, policy implementation processes and funding, as well as the organisational context of the health service, could facilitate or impede partnering (moderate level of confidence). Consumer recruitment: consumer recruitment occurred in different ways and consumers managed the recruitment process in a minority of studies only (high level of confidence). Recruiting a range of consumers who were reflective of the clinic's demographic population was considered desirable, particularly by health providers (high level of confidence). Some health providers perceived that individual consumers' experiences were not generalisable to the broader population whereas consumers perceived it could be problematic to aim to represent a broad range of community views (high level of confidence). Partnership dynamics and processes: positive interpersonal dynamics between health providers and consumers facilitated partnerships (high level of confidence). However, formal meeting formats and lack of clarity about the consumer role could constrain consumers' involvement (high level of confidence). Health providers' professional status, technical knowledge and use of jargon were intimidating for some consumers (high level of confidence) and consumers could feel their experiential knowledge was not valued (moderate level of confidence). Consumers could also become frustrated when health providers dominated the meeting agenda (moderate level of confidence) and when they experienced token involvement, such as a lack of decision-making power (high level of confidence) Perceived impacts on partnership participants: partnering could affect health provider and consumer participants in both positive and negative ways (high level of confidence). Perceived impacts on health service planning, delivery and evaluation: partnering was perceived to improve the person-centredness of health service culture (high level of confidence), improve the built environment of the health service (high level of confidence), improve health service design and delivery e.g. facilitate 'out of hours' services or treatment closer to home (high level of confidence), enhance community ownership of health services, particularly in LMICs (moderate level of confidence), and improve consumer involvement in strategic decision-making, under certain conditions (moderate level of confidence). There was limited evidence suggesting partnering may improve health service evaluation (very low level of confidence). Best practice principles for formal partnering to promote person-centred care were developed from these findings. The principles were developed collaboratively with the Stakeholder Panel and included leadership and health service culture; diversity; equity; mutual respect; shared vision and regular communication; shared agendas and decision-making; influence and sustainability. AUTHORS' CONCLUSIONS Successful formal group partnerships with consumers require health providers to continually reflect and address power imbalances that may constrain consumers' participation. Such imbalances may be particularly acute in recruitment procedures, meeting structure and content and decision-making processes. Formal group partnerships were perceived to improve the physical environment of health services, the person-centredness of health service culture and health service design and delivery. Implementing the best practice principles may help to address power imbalances, strengthen formal partnering, improve the experiences of consumers and health providers and positively affect partnership outcomes.
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Affiliation(s)
- Bronwen Merner
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Lina Schonfeld
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Ariane Virgona
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Dianne Lowe
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
- Child and Family Evidence, Australian Institute of Family Studies, Melbourne, Australia
| | - Louisa Walsh
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Cheryl Wardrope
- Clinical Governance, Metro South Hospital and Health Service, Eight Mile Plains, Australia
| | | | - Vicki Xafis
- The Sydney Children's Hospitals Network, Sydney, Australia
| | - Cinzia Colombo
- Laboratory for medical research and consumer involvement, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Nora Refahi
- Consumer Representative, Melbourne, Australia
| | - Paul Bryden
- Consumer Representative, Caboolture, Australia
| | - Renee Chmielewski
- Planning and Patient Experience, The Royal Victorian Eye and Ear Hospital, East Melbourne, Australia
| | | | | | | | - Lorraine Smith
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Susan Biggar
- Consumer Representative, Melbourne, Australia
- Australian Health Practitioner Regulation Agency (AHPRA), Melbourne, Australia
| | - Marie Gill
- Gill and Wilcox Consultancy, Melbourne, Australia
| | - David Menzies
- Chronic Disease Programs, South Eastern Melbourne Primary Health Network, Heatherton, Australia
| | - Carolyn M Gaulden
- Detroit Wayne County Authority Health Residency Program, Michigan State University, Providence Hospital, Southfield, Michigan, USA
| | | | | | - Naomi Poole
- Strategy and Innovation, Australian Commission on Safety and Quality in Health Care, Sydney, Australia
| | - Rebecca E Ryan
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Bundoora, Australia
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11
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Crane ME, Purtle J, Becker SJ. Amplifying consumers as partners in dissemination and implementation science and practice. IMPLEMENTATION RESEARCH AND PRACTICE 2023; 4:26334895231205894. [PMID: 37936968 PMCID: PMC10571676 DOI: 10.1177/26334895231205894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023] Open
Abstract
Background This Viewpoint argues for consumers (people with lived experience and their families) to be amplified as key partners in dissemination and implementation science and practice. Method We contend that consumer opinion and consumer demand can be harnessed to influence practitioners and policymakers. Results Amplifying consumers' voices can improve the fit of evidence-based interventions to the intended end user. We offer recommendations of frameworks to engage consumers in the dissemination and implementation of health interventions. We discuss the primary types of evidence consumers may rely upon, including testimonials and lived experience. Conclusions Our intention is for this Viewpoint to continue the momentum in dissemination and implementation science and practice of engaging consumers in our work.
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Affiliation(s)
- Margaret E. Crane
- Department of Psychology, Temple University, Philadelphia, PA, USA
- Department of Psychiatry and Human Behavior Warren Alpert Medical School, Brown University, Providence, RI, USA
- Department of Public Health Policy & Management, New York University School of Global Public Health, New York, NY, USA
| | - Jonathan Purtle
- Department of Public Health Policy & Management, New York University School of Global Public Health, New York, NY, USA
| | - Sara J. Becker
- Institute for Public Health and Medicine, Northwestern Feinberg School of Medicine, Chicago, IL, USA
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12
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Shapiro M, Renly S, Maiorano A, Young J, Medina E, Neinstein A, Odisho AY. Digital Health at Enterprise Scale: An Evaluation Framework for Selecting Patient Facing Software in a Digital First Health System (Preprint). JMIR Form Res 2022; 7:e43009. [PMID: 37027184 PMCID: PMC10131984 DOI: 10.2196/43009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/19/2023] [Accepted: 01/24/2023] [Indexed: 01/26/2023] Open
Abstract
The digital transformation of our health care system will require not only digitization of existing tools but also a redesign of our care delivery system and collaboration with digital partners. Traditional patient journeys are reactive to symptom presentation and delayed by health care system-centric scheduling, leading to poor experience and avoidable adverse outcomes. Patient journeys will be reimagined to a digital health pathway that seamlessly integrates various care experiences from telemedicine, remote monitoring, to in-person clinic visits. Through centering the care delivery around the patients, they can have more delightful experiences and enjoy the quality of standardized condition pathways and outcomes. To design and implement digital health pathways at scale, enterprise health care systems need to develop capabilities and partnerships in human-centered design, operational workflow, clinical content management, communication channels and mechanisms, reporting and analytics, standards-based integration, security and data management, and scalability. Using a human-centered design methodology, care pathways will be built upon an understanding of the unmet needs of the patients to have a more enjoyable experience of care with improved clinical outcomes. To power this digital care pathway, enterprises will choose to build or partner for clinical content management to operationalize up-to-date, best-in-class pathways. With this clinical engine, this digital solution will engage with patients through multimodal communication modalities, including written, audio, photo, or video, throughout the patient journey. Leadership teams will review reporting and analytics functions to track that the digital care pathways will be iterated to improve patient experience, clinical metrics, and operational efficiency. On the backend, standards-based integration will allow this system to be built in conjunction with the electronic medical record and other data systems to provide safe and efficient use of the digital care solution. For protecting patient information and compliance, a security and data management strategy is critical to derisking breeches and preserving privacy. Finally, a framework of technical scalability will allow digital care pathways to proliferate throughout the enterprise and support the entire patient population. This framework empowers enterprise health care systems to avoid collecting a fragmented series of one-off solutions but develop a sustainable concerted roadmap to the future of proactive intelligent patient care.
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Affiliation(s)
- Martin Shapiro
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Sondra Renly
- Center for Digital Health Innovation, University of California, San Francisco, San Francisco, CA, United States
| | - Ali Maiorano
- Center for Digital Health Innovation, University of California, San Francisco, San Francisco, CA, United States
| | - Jerry Young
- Center for Digital Health Innovation, University of California, San Francisco, San Francisco, CA, United States
| | - Eli Medina
- Center for Digital Health Innovation, University of California, San Francisco, San Francisco, CA, United States
| | - Aaron Neinstein
- Center for Digital Health Innovation, University of California, San Francisco, San Francisco, CA, United States
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Anobel Y Odisho
- Center for Digital Health Innovation, University of California, San Francisco, San Francisco, CA, United States
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13
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Sagen J, Børøsund E, Simonsen AE, Habberstad A, Kjeken I, Dagfinrud H, Moe RH. Organisation, influence, and impact of patient advisory boards in rehabilitation institutions-an explorative cross-sectional study. BMC Musculoskelet Disord 2022; 23:738. [PMID: 35915435 PMCID: PMC9343240 DOI: 10.1186/s12891-022-05678-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 07/20/2022] [Indexed: 11/15/2022] Open
Abstract
Background Patient participation is highlighted as an important facilitator for patient-centered care. Patient participation organised as patient advisory boards (PABs) is an integral part of health care institutions in Norway. More knowledge is needed on how PAB representatives experience patient engagement (PE) with regard to organisation, influence, and impact. The objective was to describe how PAB representatives experience their tasks, roles, and impact on decision-making processes and service delivery in the setting of rehabilitation institutions. Methods PAB representatives recruited from rehabilitation institutions completed the Norwegian version of the generic Public and Patient Engagement evaluation tool (Norwegian abbreviation EBNOR). EBNOR is tested for reliability and validity with good results and comprises 35 items within four main domains, policies and practices, participatory culture, collaboration, and influence and impact that provide responses about PE-levels. The domain items are scored from “strongly disagree” to “strongly agree” on a five-point scale, in addition to a don’t know category. Items in the domain “influence and impact” are scored from “never” to “all of the time” on a four-point scale. Categorical data were summarized using frequencies and percentages, and response categories were collapsed into three PE-levels: barrier, intermediate, and facilitating level. Free-text responses were analysed according to principles of manifest content analysis, summed up, and used to elaborate the results of the scores. Results Of the 150 contacted PAB representatives, 47 (32%) consented to participate. The results showed that approximately 75% agreed that the organisation as a whole was strengthened as a result of patient participation. Four out of five domains were scored indicating a facilitating level; policies and practices (53%), participatory culture (53%), collaboration and common purpose (37%), and final thoughts (63%). The modal score in the domain influence and impact was in the intermediate PE-level (44%). Of a total of 34 codes from free text analyses, barriers to PE were coded 26 times, and PE facilitators were coded 8 times. Conclusions The findings indicate that most PAB representatives are satisfied with how rehabilitation institutions organise their PAB, but they still experience their impact as limited.
Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05678-y.
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Affiliation(s)
- Joachim Sagen
- Oslo Metropolitan University, St. Olavs plass, P.O. Box 4, NO-0130, Oslo, Norway.
| | - Elin Børøsund
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Andreas Habberstad
- The Norwegian Federation of Organisations of Disabled People, Oslo, Norway
| | - Ingvild Kjeken
- Norwegian National Advisory Unit On Rehabilitation in Rheumatology, Oslo, Norway
| | - Hanne Dagfinrud
- Norwegian National Advisory Unit On Rehabilitation in Rheumatology, Oslo, Norway
| | - Rikke Helene Moe
- Norwegian National Advisory Unit On Rehabilitation in Rheumatology, Oslo, Norway
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14
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Usher S, Denis JL. Exploring expectations and assumptions in the public and patient engagement literature: A meta-narrative review. PATIENT EDUCATION AND COUNSELING 2022; 105:2683-2692. [PMID: 35459528 DOI: 10.1016/j.pec.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 04/02/2022] [Accepted: 04/04/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Public and patient engagement (PPE) is increasingly recognized in policy statements as essential to achieving transformation towards patient-centred, value-based, integrated care. Despite extensive research over two decades, important gaps and questions remain around how the efforts invested in engagement drive the changes needed to meet these objectives. METHODS We conducted a meta-narrative review of systematic and scoping reviews to understand persistent difficulties and uncertainties in this research domain. Thirty-eight reviews looking at studies of PPE in care, healthcare organizations and systems were appraised. We synthesized the expectations of PPE that prompted each review, the guiding ideas about how PPE comes about, main findings and the questions and gaps they raise. RESULTS Four storylines are found in reviews: 1. Terminology is inconsistent and concepts are weak; 2. Outcomes of care can be improved 3. Influence on healthcare delivery and design is uncertain; 4. Characteristics of engagement efforts are consequential. DISCUSSION AND PRACTICE IMPLICATIONS Three assumptions underlie these storylines and appear as barriers to practice and research; alternative approaches based on collaborative governance and theories of change are proposed to understand and support engagement with transformative potential.
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Affiliation(s)
- Susan Usher
- École Nationale D'administration Publique, 4750 Henri Julien, Montréal, Québec H2T 2C8, Canada.
| | - Jean-Louis Denis
- École de Santé Publique, Université de Montréal, 7101 ave du Parc, Montréal, Québec H3N 1X9, Canada
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15
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Zwaiman A, da Luz LT, Perrier L, Hacker Teper M, Strauss R, Harth T, Haas B, Nathens AB, Gotlib Conn L. The involvement of trauma survivors in hospital-based injury prevention, violence intervention and peer support programs: A scoping review. Injury 2022; 53:2704-2716. [PMID: 35773023 DOI: 10.1016/j.injury.2022.06.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/26/2022] [Accepted: 06/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Despite decades-long involvement of trauma survivors in hospital-based program delivery, their roles and impact on trauma care have not been previously described. We aimed to characterize the literature on trauma survivor involvement in hospital-based injury prevention, violence intervention and peer support programs to map what is currently known and identify future research opportunities. METHODS A scoping review was conducted following the Joanna Briggs Institute (JBI) methodology. Articles were identified through electronic databases and gray literature. Included articles described hospital-based injury prevention programs, violence intervention programs and peer support programs that involved trauma survivors leveraging their injury experiences to counsel others. Studies were screened and data were abstracted in duplicate. Data were synthesized generally and by program type. RESULTS Thirty-six published articles and four program reports were included. Peer support programs were described in 21 articles, mainly involving trauma survivors as mentors or peer supporters. Peer support programs' most commonly reported outcome was participant satisfaction (n = 6), followed by participant self-efficacy (n = 5), depression (n = 4), and community integration (n = 3). Eleven injury prevention studies were included, all involving trauma survivors as speakers in youth targeted programs. Injury prevention studies commonly reported outcomes of participants' risk behaviors and awareness (n = 9). Violence intervention programs were included in four articles involving trauma survivors as intervention counsellors. Recidivism rate was the most commonly reported outcome (n = 3). Variability exists across and within program types when reporting on involved trauma survivors' gender, age, selection and training, duration of involvement and number of survivors involved. Outcomes related to trauma survivors' own experiences and the impacts to them of program involvement were under-studied. CONCLUSIONS Significant opportunity exists to fill current knowledge gaps in trauma survivors' involvement in trauma program delivery. There is a need to describe more fully who involved trauma survivors are to inform the development of effective future interventions.
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Affiliation(s)
- Ashley Zwaiman
- University of Toronto, 27 King's College Cir, Toronto, ON M5S 1A1 Canada
| | - Luis T da Luz
- Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON M4N 3M5 Canada
| | - Laure Perrier
- University Health Network, 190 Elizabeth St, Toronto, ON M5G 2C4, Canada
| | | | - Rachel Strauss
- Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON M4N 3M5 Canada
| | - Tamara Harth
- Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, ON M4N 3M5 Canada
| | - Barbara Haas
- Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON M4N 3M5 Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, 5 College St 4th Floor, Toronto, ON M5T 3M6 Canada
| | - Avery B Nathens
- Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON M4N 3M5 Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, 5 College St 4th Floor, Toronto, ON M5T 3M6 Canada
| | - Lesley Gotlib Conn
- Sunnybrook Research Institute, 2075 Bayview Ave, Toronto, ON M4N 3M5 Canada; Institute of Health Policy, Management, and Evaluation, University of Toronto, 5 College St 4th Floor, Toronto, ON M5T 3M6 Canada.
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16
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Lewis KB, Peter N, Graham ID, Kothari A. Engaging people with lived experience on advisory councils of a national not-for-profit: an integrated knowledge translation case study of Heart & Stroke Mission Critical Area Councils. Health Res Policy Syst 2022; 20:56. [PMID: 35606768 PMCID: PMC9125970 DOI: 10.1186/s12961-022-00863-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 05/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background In 2018, the Heart and Stroke Foundation of Canada transformed its approach to organizational strategic planning and priority-setting. The goal was to generate impact from bench to bedside to community, to improve the health of Canadians. It engaged researchers, clinician scientists, health systems leaders, and community members including people with lived experience (PWLE) on six Mission Critical Area (MCA) councils, each of which was co-chaired by a researcher or clinician scientist and a person with lived experience. Together, council members were tasked with providing advice to Heart & Stroke about the most relevant and impactful priorities of our time. The aim of this research was to explore the value of the MCA councils to Heart & Stroke, and to council members themselves. The research questions focused on understanding the process of managing and participating on the councils, the challenges and outcomes. Methods Using an integrated knowledge translation approach, we conducted a case study with developmental evaluation over a 2-year time period (2018–2020). We collected qualitative data from various sources (Heart & Stroke team responsible for managing the councils, council co-chairs, council members, and key informants). We collected documents and analysed them for contextual background. Results Participants noted that the MCA councils continuously evolved over the 2 years in various ways: from an uncertain direction to a concrete one, better integrating the voice of PWLE, and increased cohesiveness within and across MCA councils. This evolution was achieved in parallel with successes and challenges at three levels: the MCA councils and its members, Heart & Stroke, and Canadians. The MCA councils were disbanded in 2020, yet learnings, developments, initiatives and established partnerships remain as their legacy. Conclusions Heart & Stroke’s intended objectives for the MCA councils, to promote engagement and dialogue among community members including PWLE, clinician scientists, and researchers, and to provide advice into Heart & Stroke’s strategic renewal process, were achieved. This collaborative structure and process for PWLE engagement within a community of multidisciplinary clinician scientists and researchers is possible yet requires flexibility, commitment to stakeholder relationship management, and considerable resources. These findings may be helpful for other not-for-profit and funding organizations interested in engaging the public and other stakeholders into their organizational activities. Supplementary Information The online version contains supplementary material available at 10.1186/s12961-022-00863-w.
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Affiliation(s)
- Krystina B Lewis
- School of Nursing, Faculty of Health Sciences, University of Ottawa, University of Ottawa Heart Institute, Ottawa, Canada.
| | - Nedra Peter
- Schulich School of Medicine and Dentistry, Western University, London, Canada
| | | | - Ian D Graham
- School of Epidemiology and Public Health, School of Nursing, Ottawa University, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Anita Kothari
- School of Health Studies, Western University, London, Canada
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17
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Salvalaggio G, Ferguson L, Brooks HL, Campbell S, Gladue V, Hyshka E, Lam L, Morris H, Nixon L, Springett J. Impact of health system engagement on the health and well-being of people who use drugs: a realist review protocol. Syst Rev 2022; 11:66. [PMID: 35418306 PMCID: PMC9008896 DOI: 10.1186/s13643-022-01938-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 03/28/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Although community-level benefits of health system engagement (i.e., health service planning, delivery, and quality improvement, engaged research and evaluation, and collaborative advocacy) are well established, individual-level impacts on the health and well-being of community members are less explored, in particular for people who use or have used illegal drugs (PWUD). Capacity building, personal growth, reduced/safer drug use, and other positive outcomes may or may not be experienced by PWUD involved in engagement activities. Indeed, PWUD may also encounter stigma and harm when interacting with healthcare and academic structures. Our objective is to uncover why, how, and under what circumstances positive and negative health outcomes occur during health system engagement by PWUD. METHODS We propose a realist review approach due to its explanatory lens. Through preliminary exploration of literature, lived experience input, and consideration of formal theories, an explanatory model was drafted. The model describes contexts, mechanisms, and health outcomes (e.g., mental health, stable/safer drug use) involved in health system engagement. The explanatory model will be tested against the literature and iteratively refined against formal theories. A participatory lens will also be used, wherein PWUD with lived experience of health system engagement will contribute throughout all stages of the review. DISCUSSION We believe this is the first realist review to explore the contextual factors and underlying mechanisms of health outcomes for PWUD who participate in health system engagement. A thorough understanding of the relevant literature and theoretical underpinnings of this process will offer insights and recommendations to improve the engagement processes of PWUD.
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Affiliation(s)
- Ginetta Salvalaggio
- Department of Family Medicine, University of Alberta, 6-10 University Terrace, Edmonton, AB, T6G 2T4, Canada.
| | - Lawrence Ferguson
- Faculty of Medicine & Dentistry, University of Alberta, 8440 112 St. NW, Edmonton, AB, T6G 2R7, Canada
| | - Hannah L Brooks
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-87 Ave. NW, Edmonton, AB, T6G 1C9, Canada
| | - Sandra Campbell
- John W. Scott Health Sciences Library, University of Alberta, 2K3.28 Mackenzie Centre, Edmonton, AB, T6G 2R7, Canada
| | - Vanessa Gladue
- Alberta Alliance Who Educate and Advocate Responsibly, 10116 105 Ave. NW, Edmonton, AB, T5H 0K2, Canada
| | - Elaine Hyshka
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-87 Ave. NW, Edmonton, AB, T6G 1C9, Canada
| | - Linda Lam
- Department of Family Medicine, University of Alberta, 6-10 University Terrace, Edmonton, AB, T6G 2T4, Canada
| | - Heather Morris
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-87 Ave. NW, Edmonton, AB, T6G 1C9, Canada
| | - Lara Nixon
- Department of Family Medicine, University of Calgary, G012 Health Sciences Centre, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| | - Jane Springett
- Centre for Healthy Communities, School of Public Health, University of Alberta, 3-289 Edmonton Clinic Health Academy 11405-87 Ave. NW, Edmonton, AB, T6G 1C9, Canada
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18
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Bartlett R, Robinson T, Anand J, Negussie F, Simons Smith J, Boyle JA. Empathy and journey mapping the healthcare experience: a community-based participatory approach to exploring women's access to primary health services within Melbourne's Arabic-speaking refugee communities. ETHNICITY & HEALTH 2022; 27:584-600. [PMID: 32116007 DOI: 10.1080/13557858.2020.1734780] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 02/11/2020] [Indexed: 06/10/2023]
Abstract
Objectives: This community-based participatory research focused on physical and social barriers to healthcare for refugee women in Melbourne, Australia.Design: Women from non-English speaking backgrounds explored the meaning and impact of their health journeys through group surveys, Photovoice and GIS go-alongs. This empathy-building research also explored acceptability, desirability and feasibility of mHealth solutions to improve access to primary healthcare services.Results: Refugee women reported low utilisation of preventive healthcare services including limited awareness of cervical or breast screening.Conclusions: Phone ownership and health information searches online indicate mHealth solutions are feasible and acceptable to improve healthcare access, literacy and autonomy within this population.
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Affiliation(s)
- Rebeccah Bartlett
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, Australia
| | - Tracy Robinson
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, Australia
- School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Orange, Australia
| | - Jennifer Anand
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Fekir Negussie
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Jessica Simons Smith
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Jacqueline A Boyle
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, Australia
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19
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Masterson D, Areskoug Josefsson K, Robert G, Nylander E, Kjellström S. Mapping definitions of co-production and co-design in health and social care: A systematic scoping review providing lessons for the future. Health Expect 2022; 25:902-913. [PMID: 35322510 PMCID: PMC9122425 DOI: 10.1111/hex.13470] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 11/22/2021] [Accepted: 02/21/2022] [Indexed: 11/28/2022] Open
Abstract
Objectives This study aimed to explore how the concepts of co‐production and co‐design have been defined and applied in the context of health and social care and to identify the temporal adoption of the terms. Methods A systematic scoping review of CINAHL with Full Text, Cochrane Central Register of Controlled Trials, MEDLINE, PsycINFO, PubMed and Scopus was conducted to identify studies exploring co‐production or co‐design in health and social care. Data regarding date and conceptual definitions were extracted. From the 2933 studies retrieved, 979 articles were included in this review. Results A network map of the sixty most common definitions and—through exploration of citations—eight definition clusters and a visual representation of how they interconnect and have informed each other over time are presented. Additional findings were as follows: (i) an increase in research exploring co‐production and co‐design in health and social care contexts; (ii) an increase in the number of new definitions during the last decade, despite just over a third of included articles providing no definition or explanation for their chosen concept; and (iii) an increase in the number of publications using the terms co‐production or co‐design while not involving citizens/patients/service users. Conclusions Co‐production and co‐design are conceptualized in a wide range of ways. Rather than seeking universal definitions of these terms, future applied research should focus on articulating the underlying principles and values that need to be translated and explored in practice. Patient and Public Contribution The search strategy and pilot results were presented at a workshop in May 2019 with patient and public contributors and researchers. Discussion here informed our next steps. During the analysis phase of the review, informal discussions were held once a month with a patient who has experience in patient and public involvement. As this involvement was conducted towards the end of the review, we agreed together that inclusion as an author would risk being tokenistic. Instead, acknowledgements were preferred. The next phase involves working as equal contributors to explore the values and principles of co‐production reported within the most common definitions.
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Affiliation(s)
- Daniel Masterson
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Kristina Areskoug Josefsson
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Department of Behavioural Science, Oslo Metropolitan University, Oslo, Norway.,Faculty of Health Studies, VID Specialized University, Oslo, Norway
| | - Glenn Robert
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
| | | | - Sofia Kjellström
- Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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20
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Benson M, Albanese A, Bhatia KP, Cavillon P, Cuffe L, König K, Reinhard C, Graessner H. Development of a patient journey map for people living with cervical dystonia. Orphanet J Rare Dis 2022; 17:130. [PMID: 35313909 PMCID: PMC8935780 DOI: 10.1186/s13023-022-02270-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/20/2022] [Indexed: 01/18/2023] Open
Abstract
Background Patient journey maps are increasingly used as a tool that enables healthcare providers to refine their service provision to best meet patient needs. We developed a cervical dystonia patient journey map (CDPJM) that describes the holistic patient experience from pre-diagnosis through to long-term treatment. Methods The CDPJM was developed in 2 stages; a patient survey (open questions and multichoice) of 15 patients with CD was conducted to inform the design of the CDPJM, which was then refined and validated by an expert-patient focus group. Results Qualitative analysis of the patient survey supported five key stages of the patient journey: symptom onset, diagnosis and therapeutic relationship with healthcare professionals, initiation of care for CD, start of CD treatment, and living with treated CD. Following symptom onset, survey respondents described having multiple visits to their family doctor who prescribed strong pain killers and muscle relaxants and referred their patient to up to 10 different specialists for diagnosis. Over half (53.3%) of respondents had received ≥ 1 misdiagnosis. Respondents reported relief at having a diagnosis but a lack of understanding of the prognosis and treatment options; 46.7% said their neurologist did not spend enough time addressing their concerns. Survey respondents reported using a variety of alternative sources of information, including the internet (86.7%), self-help groups (66.7%) and information leaflets provided by health care professionals (60.0%). While botulinum toxin (BoNT) was consistently discussed as the main treatment option, some neurologists also mentioned physiotherapy, counselling, and other complementary approaches. However, patients were often left to seek complementary services themselves. Patients reported a ‘rollercoaster’ of relief with BoNT treatment with symptoms (and subsequent impact on daily life) returning towards the end of an injection cycle. “When BoNT works well I can return to an almost normal life … when the injections stop working so well, I have to rest more and avoid going to work and experience life restrictions.” Conclusions We present the first patient journey map for CD that can be used to guide local service mapping and to compare current provision with what patients say they want and need. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02270-4.
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21
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Anderson NN, Dong K, Baker GR, Moody L, Scane K, Urquhart R, Wodchis WP, Gagliardi AR. Impacts of patient and family engagement in hospital planning and improvement: qualitative interviews with patient/family advisors and hospital staff. BMC Health Serv Res 2022; 22:360. [PMID: 35303884 PMCID: PMC8932199 DOI: 10.1186/s12913-022-07747-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 03/08/2022] [Indexed: 11/30/2022] Open
Abstract
Background Patient engagement (PE) in hospital planning and improvement is widespread, yet we lack evidence of its impact. We aimed to identify benefits and harms that could be used to assess the impact of hospital PE. Methods We interviewed hospital-affiliated persons involved in PE activities using a qualitative descriptive approach and inductive content analysis to derive themes. We interpreted themes by mapping to an existing framework of healthcare performance measures and reported themes with exemplar quotes. Results Participants included 38 patient/family advisors, PE managers and clinicians from 9 hospitals (2 < 100 beds, 4 100 + beds, 3 teaching). Benefits of PE activities included 9 impacts on the capacity of hospitals. PE activities involved patient/family advisors and clinicians/staff in developing and spreading new PE processes across hospital units or departments, and those involved became more adept and engaged. PE had beneficial effects on hospital structures/resources, clinician staff functions and processes, patient experience and patient outcomes. A total of 14 beneficial impacts of PE were identified across these domains. Few unintended or harmful impacts were identified: overextended patient/family advisors, patient/family advisor turnover and clinician frustration if PE slowed the pace of planning and improvement. Conclusions The 23 self reported impacts were captured in a Framework of Impacts of Patient/Family Engagement on Hospital Planning and Improvement, which can be used by decision-makers to assess and allocate resources to hospital PE, and as the basis for ongoing research on the impacts of hospital PE and how to measure it. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07747-3.
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Affiliation(s)
- Natalie N Anderson
- Toronto General Hospital Research Institute, University Health Network, 200 Elizabeth Street, 13EN-228, M5G2C4, Toronto, Canada
| | - Kelly Dong
- Faculty of Medicine, University of Toronto, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.,Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - G Ross Baker
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Lesley Moody
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Kerseri Scane
- Patient Partnerships, University Health Network, Toronto, Canada
| | - Robin Urquhart
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Walter P Wodchis
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Anna R Gagliardi
- Toronto General Hospital Research Institute, University Health Network, 200 Elizabeth Street, 13EN-228, M5G2C4, Toronto, Canada.
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22
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Aboumatar H, Pitts S, Sharma R, Das A, Smith BM, Day J, Holzhauer K, Yang S, Bass EB, Bennett WL. Patient engagement strategies for adults with chronic conditions: an evidence map. Syst Rev 2022; 11:39. [PMID: 35248149 PMCID: PMC8898416 DOI: 10.1186/s13643-021-01873-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 12/17/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Patient and family engagement (PFE) has been defined as a partnership between patients, families, and health care providers to achieve positive health care outcomes. There is evidence that PFE is critical to improving outcomes. We sought to systematically identify and map the evidence on PFE strategies for adults with chronic conditions and identify areas needing more research. METHODS We searched PubMed, CINAHL, EMBASE, and Cochrane, January 2015 to September 2021 for systematic reviews on strategies for engaging patients with chronic conditions and their caregivers. From each review, we abstracted search dates, number and type of studies, populations, interventions, and outcomes. PFE strategies were categorized into direct patient care, health system, and community-policy level strategies. We found few systematic reviews on strategies at the health system, and none at the community-policy level. In view of this, we also searched for original studies that focused on PFE strategies at those two levels and reviewed the PFE strategies used and study findings. RESULTS We found 131 reviews of direct patient care strategies, 5 reviews of health system strategies, and no reviews of community-policy strategies. Four original studies addressed PFE at the health system or community-policy levels. Most direct patient care reviews focused on self-management support (SMS) (n = 85) and shared decision-making (SDM) (n = 43). Forty-nine reviews reported positive effects, 35 reported potential benefits, 37 reported unclear benefits, and 4 reported no benefits. Health system level strategies mainly involved patients and caregivers serving on advisory councils. PFE strategies with the strongest evidence focused on SMS particularly for patients with diabetes. Many SDM reviews reported potential benefits especially for patients with cancer. DISCUSSION Much more evidence exists on the effects of direct patient care strategies on PFE than on the effects of health system or community-policy strategies. Most reviews indicated that direct patient care strategies had positive effects or potential benefits. A limitation of this evidence map is that due to its focus on reviews, which were plentiful, it did not capture details of individual interventions. Nevertheless, this evidence map should help to focus attention on gaps that require more research in efforts to improve PFE.
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Affiliation(s)
- Hanan Aboumatar
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA.
| | - Samantha Pitts
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA
| | - Ritu Sharma
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Asar Das
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Brandon M Smith
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jeff Day
- Department of Art as Applied to Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Katherine Holzhauer
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA
| | - Sejean Yang
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA
| | - Eric B Bass
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA.,Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Wendy L Bennett
- Department of Medicine, Division of General Internal Medicine, Johns Hopkins University School of Medicine, 750 East Pratt Street 15th Floor, Baltimore, MD, 21202, USA
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23
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Olden HA, Santarossa S, Murphy D, Johnson CC, Kippen KE. Bridging the Patient Engagement Gap in Research and Quality Improvement Utilizing the Henry Ford Flexible Engagement Model. J Patient Cent Res Rev 2022; 9:35-45. [PMID: 35111881 PMCID: PMC8772608 DOI: 10.17294/2330-0698.1828] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
PURPOSE This paper was intended to share a flexible engagement model (FEM) for organizing a structure to obtain patient input regarding health care operations and research, provide greater detail on recruitment, retention, and dissemination strategies, and demonstrate successes and potential applications in other health care settings. METHODS Utilizing a pragmatic approach, the Patient-Engaged Research Center (PERC) at Henry Ford Health System developed the FEM, a 7-step process to introduce interested patients/caregivers to the patient advisor program and to follow up with placements. PERC developed a meeting evaluation to measure participant satisfaction. Retention and dissemination methods to keep participants consistently engaged included monthly email blasts, an annual patient advisor retreat, and inviting patient advisors to attend/present at local and national conferences. RESULTS As of January 2020, the program had 419 patient advisors. Almost 50% self-reported as Caucasian and 31% as African American; 73% were women, and most were 45-74 years of age. Recruitment methods proved effective, as 85% of advisors were initially engaged through print and digital marketing. Mean advisor orientation workshop evaluation scores regarding content, facilitators, and logistics were high, with all 4.5 or higher on a Likert scale of 1 (strongly negative) to 5 (strongly positive). CONCLUSIONS Given the FEM's flexible nature and adaptability, PERC has been successful in effectively leveraging the patient voice and experiences in research and health care delivery. Further research could investigate the model's generalizability, return on investment, and how to formally embed its methodology institutionally.
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Affiliation(s)
- Heather A Olden
- Patient-Engaged Research Center, Department of Public Health Sciences, Henry Ford Health System, Detroit, MI
| | - Sara Santarossa
- Patient-Engaged Research Center, Department of Public Health Sciences, Henry Ford Health System, Detroit, MI
| | - Dana Murphy
- Patient-Engaged Research Center, Department of Public Health Sciences, Henry Ford Health System, Detroit, MI
| | - Christine C Johnson
- Patient-Engaged Research Center, Department of Public Health Sciences, Henry Ford Health System, Detroit, MI
| | - Karen E Kippen
- Patient-Engaged Research Center, Department of Public Health Sciences, Henry Ford Health System, Detroit, MI
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24
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Manolios E, Braoudé I, Jean E, Huppert T, Verneuil L, Revah-Levy A, Sibeoni J. Disclosing Child Sexual Abuse to a Health Professional: A Metasynthesis. Front Psychiatry 2022; 13:788123. [PMID: 35747100 PMCID: PMC9211373 DOI: 10.3389/fpsyt.2022.788123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 05/12/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Sexual abuse is a major public health problem. Its disclosure to a health professional could help to reduce its impact on survivors' lives. The objective of this metasynthesis, combining a systematic review and an analysis of the qualitative studies, was to explore the qualitative literature concerning the experience of a survivor disclosing sexual violence experienced in childhood to a health professional, from the perspective of both. METHODS AND DATA SOURCES We used four databases and two journals (Medline, PsycINFO, EMBASE, and SSCI, and the Journal of Sexual Abuse and Child Abuse and Neglect) to identify studies concerning this disclosure of sexual abuse to healthcare professionals from the point of view of the survivors and the health professionals. After assessing the methodological quality of the articles with the "Critical Appraisal Skills Program (CASP)," we conducted a thematic analysis of the data extracted during the review. RESULTS This review includes 20 articles, covering the data of 612 participants: 291 who were adults at the time of the study but abused in childhood, 152 minors, 14 parents of adolescents, and 155 healthcare professionals. Two themes emerged from the analysis: (1) the disclosure as experienced by the professionals, and (2) the disclosure as experienced by the survivors. CONCLUSION Our results show that survivors had a diachronic approach to the experience of disclosure. They suggest a change over time in how survivors experience disclosure: relief and release were seen only among the adult participants, at a distance from - long after - the disclosure. This study made it possible to identify new perspectives for research in the field of child psychiatry and to formulate concrete clinical proposals, in particular, by applying the principle of patient experts to involve now-adult survivors in training and increase the awareness of the healthcare professionals concerned.
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Affiliation(s)
- Emilie Manolios
- ECSTRA Team, UMR-1153, Inserm, Universiteì de Paris, Paris, France.,AP-HP, Service de Psychiatrie et Addictologie de l'Adulte et du Sujet Âgé, Hôpital Européen Georges-Pompidou, Paris, France
| | - Ilan Braoudé
- ECSTRA Team, UMR-1153, Inserm, Universiteì de Paris, Paris, France.,Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, Argenteuil, France
| | - Elise Jean
- ECSTRA Team, UMR-1153, Inserm, Universiteì de Paris, Paris, France.,Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, Argenteuil, France
| | - Thomas Huppert
- Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, Argenteuil, France
| | - Laurence Verneuil
- ECSTRA Team, UMR-1153, Inserm, Universiteì de Paris, Paris, France.,Pôle Précarité, GHU Paris Psychiatrie and Neurosciences, Paris, France
| | - Anne Revah-Levy
- ECSTRA Team, UMR-1153, Inserm, Universiteì de Paris, Paris, France.,Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, Argenteuil, France
| | - Jordan Sibeoni
- ECSTRA Team, UMR-1153, Inserm, Universiteì de Paris, Paris, France.,Service Universitaire de Psychiatrie de l'Adolescent, Argenteuil Hospital Centre, Argenteuil, France
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25
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Choukair D, Lee-Kirsch MA, Berner R, Grasemann C, Hiort O, Hauck F, Klein C, Druschke D, Hoffmann GF, Burgard P. Der klinische Versorgungspfad zur multiprofessionellen Versorgung seltener Erkrankungen in der Pädiatrie – Ergebnisse aus dem Projekt TRANSLATE-NAMSE. Monatsschr Kinderheilkd 2021. [DOI: 10.1007/s00112-021-01378-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Zusammenfassung
Hintergrund
Seltene Erkrankungen (SE) manifestieren sich ganz überwiegend im Kindes- und Jugendalter, sind heterogen, multisystemisch, haben meist einen chronischen Verlauf und stellen eine große Herausforderung für alle Beteiligten dar. Finanziert durch den Innovationsfonds des G‑BA hatte das Versorgungsprojekt TRANSLATE-NAMSE das Ziel, Vorschläge zur besseren Versorgung von Menschen mit SE zu entwickeln und zu erproben.
Fragestellung
Für Patienten aller Altersgruppen mit einer Verdachtsdiagnose aus einer von 5 Gruppen definierter Indikatorerkrankungen (seltene Anämien, Endokrinopathien, Autoinflammationserkrankungen, primäre Immundefekte und Stoffwechselerkrankungen) sollte ein generischer Versorgungspfad entwickelt werden, der den Weg von der Konfirmationsdiagnostik bis hin zur Langzeitbetreuung dieser Patienten abbildet.
Methodik
Der Versorgungspfad wurde als allgemeines Ablaufschema dargelegt; die Prozessschritte wurden in eine Checkliste übertragen, inhaltlich ausformuliert und an 6 universitären Standorten an 587 Personen mit der Verdachtsdiagnose einer Indikatorerkrankungen erprobt.
Ergebnisse
Für 369 (62,9 %) Fälle mit der Verdachtsdiagnose einer Indikatorerkrankung konnte eine Diagnose gestellt werden, davon in 25,2 % mit innovativer genetischer Diagnostik; 104 (17,7 %) Verdachtsdiagnosen erwiesen sich als falsch-positiv; 114 (19,4 %) Fälle blieben ungeklärt. An Fallkonferenzen zur multiprofessionellen Versorgung nahmen im Median 4 Spezialisten teil. Die Versorgung (Diagnoseeröffnung, Schulung, Beratung, Information) begann im Median am Tag des Diagnostikergebnisses. In einer externen Evaluation erwies sich die Zufriedenheit der Sorgeberechtigten mit dem Versorgungspfad als hoch.
Schlussfolgerungen
Im bisher in Deutschland einzigartigen TRANSLATE-NAMSE-Projekt wurde ein Versorgungspfad für SE in der Pädiatrie entwickelt und erfolgreich erprobt. Zur Verstetigung dieser Versorgungsform ist eine auskömmliche Finanzierung in der Regelversorgung anzustreben.
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26
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Nordlind A, Sundqvist AS, Anderzén-Carlsson A, Almblad AC, Ängeby K. How paediatric departments in Sweden facilitate giving children a voice on their experiences of healthcare: A cross-sectional study. Health Expect 2021; 25:384-393. [PMID: 34856647 PMCID: PMC8849245 DOI: 10.1111/hex.13396] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/17/2021] [Accepted: 11/07/2021] [Indexed: 11/28/2022] Open
Abstract
Background In January 2020, the United Nations Convention on the Rights of the Child was incorporated into Swedish law. According to Swedish regulations, patients are to be given the opportunity to participate in quality improvement. Sometimes, the patients are children who have the right to be heard on matters concerning them, such as their experience of a hospital visit. Objective This study aimed to describe how Swedish paediatric departments facilitate children's voices on their healthcare experiences and how their perspectives are taken into account in quality improvement work. Methods This study has a descriptive cross‐sectional design. Data were collected using a study‐specific survey sent by e‐mail to all the heads of the paediatric departments in Sweden, with both inpatient and outpatient care. The response rate was 74% (28 of 38 departments). Results The results demonstrated a variation in questionnaires used and to whom they were targeted; less than half of the participating departments reported having had questionnaires aimed at children. The results also indicated a major variation in other working methods used to allow children to voice their experiences in Swedish paediatric departments. The results indicate that the national co‐ordination in facilitating the children's rights to be heard on their experiences in healthcare organisations can be improved. Conclusion Further research is required to ascertain which method is the most practically effective in paediatric departments, in what way children prefer to be heard regarding their experience of and perspectives on healthcare, and what questions need to be asked. A validated national patient‐reported experience measure developed with and aimed at children could provide them with equal opportunities to voice their experiences in healthcare, regardless of their diagnoses or which paediatric department they visit.
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Affiliation(s)
- Anna Nordlind
- Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,Department of Paediatric Medicine, County Hospital Karlstad, Karlstad, Sweden
| | - Ann-Sofie Sundqvist
- Faculty of Medicine and Health, University Health Care Research Centre, Örebro University, Örebro, Sweden.,Department of Cardiothoracic and Vascular Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Agneta Anderzén-Carlsson
- Faculty of Medicine and Health, University Health Care Research Centre, Örebro University, Örebro, Sweden
| | - Ann-Charlotte Almblad
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Children Hospital and Emergency, Region Uppsala, Uppsala, Sweden
| | - Karin Ängeby
- Centre for Clinical Research, Region Värmland, Karlstad, Sweden.,School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.,Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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27
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Verma AA, Murray J, Greiner R, Cohen JP, Shojania KG, Ghassemi M, Straus SE, Pou-Prom C, Mamdani M. Mise en œuvre de l’apprentissage machine en santé. CMAJ 2021; 193:E1708-E1715. [PMID: 34750183 PMCID: PMC8584368 DOI: 10.1503/cmaj.202434-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Amol A Verma
- Réseau hospitalier Unity Health de Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Institut du savoir Li Ka Shing de l'Hôpital St. Michael (Verma, Straus, Pou-Prom, Mamdani); Département de médecine (Verma, Shojania, Straus, Mamdani) et Institut des politiques, de la gestion et de l'évaluation de la santé (Verma, Mamdani) et Département de statistique (Murray), Université de Toronto, Toronto, Ont.; Université de l'Alberta (Greiner); Institut d'intelligence machine de l'Alberta (Greiner), Edmonton, Alb.; Institut des algorithmes d'apprentissage de Montréal (Cohen), Montréal, Qc.; Centre pour l'amélioration de la qualité et la sécurité des patients (Shojania), Université de Toronto; Centre des sciences de la santé Sunnybrook (Shojania); Institut Vecteur (Ghassemi, Mamdani) et Département des sciences informatiques (Ghassemi); Faculté de pharmacie Leslie Dan (Mamdani), Université de Toronto, Toronto, Ont.; Département de radiologie, Université Stanford (Cohen), Stanford, Calif.
| | - Joshua Murray
- Réseau hospitalier Unity Health de Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Institut du savoir Li Ka Shing de l'Hôpital St. Michael (Verma, Straus, Pou-Prom, Mamdani); Département de médecine (Verma, Shojania, Straus, Mamdani) et Institut des politiques, de la gestion et de l'évaluation de la santé (Verma, Mamdani) et Département de statistique (Murray), Université de Toronto, Toronto, Ont.; Université de l'Alberta (Greiner); Institut d'intelligence machine de l'Alberta (Greiner), Edmonton, Alb.; Institut des algorithmes d'apprentissage de Montréal (Cohen), Montréal, Qc.; Centre pour l'amélioration de la qualité et la sécurité des patients (Shojania), Université de Toronto; Centre des sciences de la santé Sunnybrook (Shojania); Institut Vecteur (Ghassemi, Mamdani) et Département des sciences informatiques (Ghassemi); Faculté de pharmacie Leslie Dan (Mamdani), Université de Toronto, Toronto, Ont.; Département de radiologie, Université Stanford (Cohen), Stanford, Calif
| | - Russell Greiner
- Réseau hospitalier Unity Health de Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Institut du savoir Li Ka Shing de l'Hôpital St. Michael (Verma, Straus, Pou-Prom, Mamdani); Département de médecine (Verma, Shojania, Straus, Mamdani) et Institut des politiques, de la gestion et de l'évaluation de la santé (Verma, Mamdani) et Département de statistique (Murray), Université de Toronto, Toronto, Ont.; Université de l'Alberta (Greiner); Institut d'intelligence machine de l'Alberta (Greiner), Edmonton, Alb.; Institut des algorithmes d'apprentissage de Montréal (Cohen), Montréal, Qc.; Centre pour l'amélioration de la qualité et la sécurité des patients (Shojania), Université de Toronto; Centre des sciences de la santé Sunnybrook (Shojania); Institut Vecteur (Ghassemi, Mamdani) et Département des sciences informatiques (Ghassemi); Faculté de pharmacie Leslie Dan (Mamdani), Université de Toronto, Toronto, Ont.; Département de radiologie, Université Stanford (Cohen), Stanford, Calif
| | - Joseph Paul Cohen
- Réseau hospitalier Unity Health de Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Institut du savoir Li Ka Shing de l'Hôpital St. Michael (Verma, Straus, Pou-Prom, Mamdani); Département de médecine (Verma, Shojania, Straus, Mamdani) et Institut des politiques, de la gestion et de l'évaluation de la santé (Verma, Mamdani) et Département de statistique (Murray), Université de Toronto, Toronto, Ont.; Université de l'Alberta (Greiner); Institut d'intelligence machine de l'Alberta (Greiner), Edmonton, Alb.; Institut des algorithmes d'apprentissage de Montréal (Cohen), Montréal, Qc.; Centre pour l'amélioration de la qualité et la sécurité des patients (Shojania), Université de Toronto; Centre des sciences de la santé Sunnybrook (Shojania); Institut Vecteur (Ghassemi, Mamdani) et Département des sciences informatiques (Ghassemi); Faculté de pharmacie Leslie Dan (Mamdani), Université de Toronto, Toronto, Ont.; Département de radiologie, Université Stanford (Cohen), Stanford, Calif
| | - Kaveh G Shojania
- Réseau hospitalier Unity Health de Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Institut du savoir Li Ka Shing de l'Hôpital St. Michael (Verma, Straus, Pou-Prom, Mamdani); Département de médecine (Verma, Shojania, Straus, Mamdani) et Institut des politiques, de la gestion et de l'évaluation de la santé (Verma, Mamdani) et Département de statistique (Murray), Université de Toronto, Toronto, Ont.; Université de l'Alberta (Greiner); Institut d'intelligence machine de l'Alberta (Greiner), Edmonton, Alb.; Institut des algorithmes d'apprentissage de Montréal (Cohen), Montréal, Qc.; Centre pour l'amélioration de la qualité et la sécurité des patients (Shojania), Université de Toronto; Centre des sciences de la santé Sunnybrook (Shojania); Institut Vecteur (Ghassemi, Mamdani) et Département des sciences informatiques (Ghassemi); Faculté de pharmacie Leslie Dan (Mamdani), Université de Toronto, Toronto, Ont.; Département de radiologie, Université Stanford (Cohen), Stanford, Calif
| | - Marzyeh Ghassemi
- Réseau hospitalier Unity Health de Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Institut du savoir Li Ka Shing de l'Hôpital St. Michael (Verma, Straus, Pou-Prom, Mamdani); Département de médecine (Verma, Shojania, Straus, Mamdani) et Institut des politiques, de la gestion et de l'évaluation de la santé (Verma, Mamdani) et Département de statistique (Murray), Université de Toronto, Toronto, Ont.; Université de l'Alberta (Greiner); Institut d'intelligence machine de l'Alberta (Greiner), Edmonton, Alb.; Institut des algorithmes d'apprentissage de Montréal (Cohen), Montréal, Qc.; Centre pour l'amélioration de la qualité et la sécurité des patients (Shojania), Université de Toronto; Centre des sciences de la santé Sunnybrook (Shojania); Institut Vecteur (Ghassemi, Mamdani) et Département des sciences informatiques (Ghassemi); Faculté de pharmacie Leslie Dan (Mamdani), Université de Toronto, Toronto, Ont.; Département de radiologie, Université Stanford (Cohen), Stanford, Calif
| | - Sharon E Straus
- Réseau hospitalier Unity Health de Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Institut du savoir Li Ka Shing de l'Hôpital St. Michael (Verma, Straus, Pou-Prom, Mamdani); Département de médecine (Verma, Shojania, Straus, Mamdani) et Institut des politiques, de la gestion et de l'évaluation de la santé (Verma, Mamdani) et Département de statistique (Murray), Université de Toronto, Toronto, Ont.; Université de l'Alberta (Greiner); Institut d'intelligence machine de l'Alberta (Greiner), Edmonton, Alb.; Institut des algorithmes d'apprentissage de Montréal (Cohen), Montréal, Qc.; Centre pour l'amélioration de la qualité et la sécurité des patients (Shojania), Université de Toronto; Centre des sciences de la santé Sunnybrook (Shojania); Institut Vecteur (Ghassemi, Mamdani) et Département des sciences informatiques (Ghassemi); Faculté de pharmacie Leslie Dan (Mamdani), Université de Toronto, Toronto, Ont.; Département de radiologie, Université Stanford (Cohen), Stanford, Calif
| | - Chloé Pou-Prom
- Réseau hospitalier Unity Health de Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Institut du savoir Li Ka Shing de l'Hôpital St. Michael (Verma, Straus, Pou-Prom, Mamdani); Département de médecine (Verma, Shojania, Straus, Mamdani) et Institut des politiques, de la gestion et de l'évaluation de la santé (Verma, Mamdani) et Département de statistique (Murray), Université de Toronto, Toronto, Ont.; Université de l'Alberta (Greiner); Institut d'intelligence machine de l'Alberta (Greiner), Edmonton, Alb.; Institut des algorithmes d'apprentissage de Montréal (Cohen), Montréal, Qc.; Centre pour l'amélioration de la qualité et la sécurité des patients (Shojania), Université de Toronto; Centre des sciences de la santé Sunnybrook (Shojania); Institut Vecteur (Ghassemi, Mamdani) et Département des sciences informatiques (Ghassemi); Faculté de pharmacie Leslie Dan (Mamdani), Université de Toronto, Toronto, Ont.; Département de radiologie, Université Stanford (Cohen), Stanford, Calif
| | - Muhammad Mamdani
- Réseau hospitalier Unity Health de Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Institut du savoir Li Ka Shing de l'Hôpital St. Michael (Verma, Straus, Pou-Prom, Mamdani); Département de médecine (Verma, Shojania, Straus, Mamdani) et Institut des politiques, de la gestion et de l'évaluation de la santé (Verma, Mamdani) et Département de statistique (Murray), Université de Toronto, Toronto, Ont.; Université de l'Alberta (Greiner); Institut d'intelligence machine de l'Alberta (Greiner), Edmonton, Alb.; Institut des algorithmes d'apprentissage de Montréal (Cohen), Montréal, Qc.; Centre pour l'amélioration de la qualité et la sécurité des patients (Shojania), Université de Toronto; Centre des sciences de la santé Sunnybrook (Shojania); Institut Vecteur (Ghassemi, Mamdani) et Département des sciences informatiques (Ghassemi); Faculté de pharmacie Leslie Dan (Mamdani), Université de Toronto, Toronto, Ont.; Département de radiologie, Université Stanford (Cohen), Stanford, Calif.
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Charlot M, Carolan K, Gawuga C, Freeman E, Sprague Martinez L. Patient powered research: an approach to building capacity for a hardly reached patient population to engage in cancer research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2021; 7:74. [PMID: 34702359 PMCID: PMC8547568 DOI: 10.1186/s40900-021-00317-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/15/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Participating in clinical trials is a metric of high-quality cancer care and improves survival. However, Black individuals with cancer are less likely to be enrolled in clinical trials and experience a disproportionate burden of cancer mortality compared to Whites. Patient-engaged research is one potential strategy to address racial inequities in clinical trials, but little is known about best practices for engaging Black individuals and communities impacted by cancer in research partnerships. METHODS We used a community engaged research approach to establish a patient advisory council (PAC) representative of the patient population served by a safety net hospital cancer center. We outline the process of establishing the PAC and the lessons learned. RESULTS The inaugural PAC included 7 members representative of the cancer center's patient demographics. PAC members developed a patient centered vision, mission and action plan. PAC and community-academic research partners experienced the transformative power of centering the lived experiences of patients of color to promote health equity in cancer research. CONCLUSION Establishing a patient advisory council at a safety net hospital cancer care center provided a platform for engaging a hardly reached population in patient centered research.
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Affiliation(s)
- Marjory Charlot
- Division of Oncology, University of North Carolina School of Medicine, Houpt Physicians Office Building, 170 Manning Drive, 3rd Floor, Chapel Hill, NC, 27599, USA.
- University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA.
| | - Kelsi Carolan
- University of Connecticut School of Social Work, Hartford, CT, USA
- Boston University School of Social Work, Boston, MA, USA
| | - Cyrena Gawuga
- Macro Department, Boston University School of Social Work, Boston, MA, USA
| | - Elmer Freeman
- Center for Community Health Education Research and Service, Inc., Boston, MA, USA
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29
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Hamilton CB, Dehnadi M, Snow ME, Clark N, Lui M, McLean J, Mamdani H, Kooijman AL, Bubber V, Hoefer T, Li LC. Themes for evaluating the quality of initiatives to engage patients and family caregivers in decision-making in healthcare systems: a scoping review. BMJ Open 2021; 11:e050208. [PMID: 34635521 PMCID: PMC8506891 DOI: 10.1136/bmjopen-2021-050208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To identify the key themes for evaluating the quality of initiatives to engage patients and family caregivers in decision-making across the organisation and system domains of healthcare systems. METHODS We conducted a scoping review. Seven databases of journal articles were searched from their inception to June 2019. Eligible articles were literature reviews published in English and provided useful information for determining aspects of engaging patients and family caregivers in decision-making to evaluate. We extracted text under three predetermined categories: structure, process and outcomes that were adapted from the Donabedian conceptual framework. These excerpts were then independently open-coded among four researchers. The subsequent themes and their corresponding excerpts were summarised to provide a rich description of each theme. RESULTS Of 7747 unique articles identified, 366 were potentially relevant, from which we selected the 42 literature reviews. 18 unique themes were identified across the three predetermined categories. There were six structure themes: engagement plan, level of engagement, time and timing of engagement, format and composition, commitment to support and environment. There were four process themes: objectives, engagement approach, communication and engagement activities. There were eight outcome themes: decision-making process, stakeholder relationship, capacity development, stakeholder experience, shape policy/service/programme, health status, healthcare quality, and cost-effectiveness. CONCLUSIONS The 18 themes and their descriptions provide a foundation for identifying constructs and selecting measures to evaluate the quality of initiatives for engaging patients and family caregivers in healthcare system decision-making within the organisation and system domains. The themes can be used to investigate the mechanisms through which relevant initiatives are effective and investigate their effectiveness.
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Affiliation(s)
- Clayon B Hamilton
- Evaluation and Research Services, Fraser Health Authority, Surrey, British Columbia, Canada
- Primary Care Division, Ministry of Health, Victoria, British Columbia, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Arthritis Research Canada, Vancouver, British Columbia, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Maryam Dehnadi
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - M Elizabeth Snow
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Centre for Health Evaluation and Outcomes Sciences, Vancouver, British Columbia, Canada
| | - Nancy Clark
- Faculty of Human and Social Development, University of Victoria, Victoria, British Columbia, Canada
| | - Michelle Lui
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Janet McLean
- Family Caregivers of British Columbia, Victoria, British Columbia, Canada
| | - Hussein Mamdani
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Allison L Kooijman
- Patient Voices Network, BC Patient Safety and Quality Council, Vancouver, British Columbia, Canada
- School of Interdisciplinary Studies, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vikram Bubber
- Patient Voices Network, BC Patient Safety and Quality Council, Vancouver, British Columbia, Canada
| | - Tammy Hoefer
- BC Patient Safety and Quality Council, Vancouver, British Columbia, Canada
| | - Linda C Li
- Arthritis Research Canada, Vancouver, British Columbia, Canada
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
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30
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LoRusso S, Eichinger K, Higgs K, Lewis L, Walker M, Albert J, Langer M, Tawil R, Statland JM, Kimminau KS. A Roadmap to Patient Engagement: Facioscapulohumeral Muscular Dystrophy and the ReSolve Clinical Trial. Neurol Clin Pract 2021; 11:e722-e726. [PMID: 34840889 PMCID: PMC8610524 DOI: 10.1212/cpj.0000000000001074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/08/2021] [Indexed: 11/15/2022]
Abstract
We describe our efforts to overcome barriers to patient engagement in facioscapulohumeral muscular dystrophy (FSHD) and offer a roadmap that can be replicated in other rare neurologic disorders. We implemented an engagement plan during Clinical Trial Readiness to Solve Barriers to Drug Development for FSHD (ReSolve), an 18-month, multisite, observational study of individuals with FSHD. Elements of our engagement plan included conducting focus groups during protocol development, patient involvement on the ReSolve external advisory committee, creation of a patient advisory committee, and collaboration with patient advocacy groups. Patient feedback led to adaptations in the study protocol and to changes in recruitment and retention methods. Patient engagement ensures that the patient voice contributes to multiple aspects of trial design and implementation. Our engagement efforts exemplify how collaboration with patients and families can be accomplished in FSHD and the resultant roadmap process may be replicable in other rare neurologic diseases.
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Affiliation(s)
- Samantha LoRusso
- Department of Neurology (SL), Ohio State University Medical Center, Columbus, Ohio; Department of Neurology (KE. LL, RT), Strong Memorial Hospital, University of Rochester, Rochester, New York; Department of Neurology (KH, MW, JMS), University of Kansas Medical Center, Kansas City, Kansas; University of Missouri School of Medicine (KSK), Columbia, Missouri
| | - Katy Eichinger
- Department of Neurology (SL), Ohio State University Medical Center, Columbus, Ohio; Department of Neurology (KE. LL, RT), Strong Memorial Hospital, University of Rochester, Rochester, New York; Department of Neurology (KH, MW, JMS), University of Kansas Medical Center, Kansas City, Kansas; University of Missouri School of Medicine (KSK), Columbia, Missouri
| | - Kiley Higgs
- Department of Neurology (SL), Ohio State University Medical Center, Columbus, Ohio; Department of Neurology (KE. LL, RT), Strong Memorial Hospital, University of Rochester, Rochester, New York; Department of Neurology (KH, MW, JMS), University of Kansas Medical Center, Kansas City, Kansas; University of Missouri School of Medicine (KSK), Columbia, Missouri
| | - Leann Lewis
- Department of Neurology (SL), Ohio State University Medical Center, Columbus, Ohio; Department of Neurology (KE. LL, RT), Strong Memorial Hospital, University of Rochester, Rochester, New York; Department of Neurology (KH, MW, JMS), University of Kansas Medical Center, Kansas City, Kansas; University of Missouri School of Medicine (KSK), Columbia, Missouri
| | - Michaela Walker
- Department of Neurology (SL), Ohio State University Medical Center, Columbus, Ohio; Department of Neurology (KE. LL, RT), Strong Memorial Hospital, University of Rochester, Rochester, New York; Department of Neurology (KH, MW, JMS), University of Kansas Medical Center, Kansas City, Kansas; University of Missouri School of Medicine (KSK), Columbia, Missouri
| | - James Albert
- Department of Neurology (SL), Ohio State University Medical Center, Columbus, Ohio; Department of Neurology (KE. LL, RT), Strong Memorial Hospital, University of Rochester, Rochester, New York; Department of Neurology (KH, MW, JMS), University of Kansas Medical Center, Kansas City, Kansas; University of Missouri School of Medicine (KSK), Columbia, Missouri
| | - Michele Langer
- Department of Neurology (SL), Ohio State University Medical Center, Columbus, Ohio; Department of Neurology (KE. LL, RT), Strong Memorial Hospital, University of Rochester, Rochester, New York; Department of Neurology (KH, MW, JMS), University of Kansas Medical Center, Kansas City, Kansas; University of Missouri School of Medicine (KSK), Columbia, Missouri
| | - Rabi Tawil
- Department of Neurology (SL), Ohio State University Medical Center, Columbus, Ohio; Department of Neurology (KE. LL, RT), Strong Memorial Hospital, University of Rochester, Rochester, New York; Department of Neurology (KH, MW, JMS), University of Kansas Medical Center, Kansas City, Kansas; University of Missouri School of Medicine (KSK), Columbia, Missouri
| | - Jeffrey M Statland
- Department of Neurology (SL), Ohio State University Medical Center, Columbus, Ohio; Department of Neurology (KE. LL, RT), Strong Memorial Hospital, University of Rochester, Rochester, New York; Department of Neurology (KH, MW, JMS), University of Kansas Medical Center, Kansas City, Kansas; University of Missouri School of Medicine (KSK), Columbia, Missouri
| | - Kim S Kimminau
- Department of Neurology (SL), Ohio State University Medical Center, Columbus, Ohio; Department of Neurology (KE. LL, RT), Strong Memorial Hospital, University of Rochester, Rochester, New York; Department of Neurology (KH, MW, JMS), University of Kansas Medical Center, Kansas City, Kansas; University of Missouri School of Medicine (KSK), Columbia, Missouri
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Abstract
Surgical oncology is cancer care that focuses on using surgery to diagnose, stage, and treat cancer and is one of the main treatments for malignancy. Patients older than 65 years are generally considered geriatric. The incidence of cancer in geriatric patients is increasing annually. Candidacy for surgical intervention depends on factors such as cancer type, size, location, grade and stage of the tumor, and the patient's overall health status and age. Despite increasing agreement that age should not limit treatment options, geriatric patients tend to be undertreated. Cancer in geriatric patients has different features than in younger patients. As such, treatment options may be dissimilar in these 2 cohorts. Here, care of the geriatric patient undergoing surgical oncology interventions is discussed.
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Affiliation(s)
- Dalton Skipper
- Dalton Skipper is Manager of Education, Emory Healthcare, 1459 Montreal Rd MOB, Suite 210, Tucker, GA 30084
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Sumner J, Chong L, Bundele A, Wei Lim Y. Co-Designing Technology for Aging in Place: A Systematic Review. THE GERONTOLOGIST 2021; 61:e395-e409. [PMID: 32506136 PMCID: PMC8437501 DOI: 10.1093/geront/gnaa064] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES There is a growing interest to involve older adults in the co-design of technology to maintain their well-being and independence. What remains unknown is whether the beneficial effects of co-designed solutions are greater than those reported for non co-designed solutions. The aim of this study was to evaluate the effects and experiences of co-designed technology that support older adults to age in place. RESEARCH DESIGN AND METHODS We conducted a systematic review to (a) investigate the health and well-being outcomes of co-designed technology for older adults (≥60 years), (b) identify co-design approaches and contexts where they are applied, and (c) identify barriers and facilitators of the co-design process with older adults. Searches were conducted in MEDLINE, EMBASE, CINAHL, Science Citation Index (Web of Science), Scopus, OpenGrey, and Business Source Premiere. RESULTS We identified 14,649 articles and included 34 projects. Four projects reported health and well-being outcomes; the effects were inconsistent. Co-design processes varied greatly and in their intensity of older adult involvement. Common facilitators of and barriers to co-design included the building of relationships between stakeholders, stakeholder knowledge of problems and solutions, and expertise in the co-design methodology. DISCUSSION AND IMPLICATIONS The effect of co-designed technology on health and well-being was rarely studied and it was difficult to ascertain its impact. Future co-design efforts need to address barriers unique to older adults. Evaluation of the impact of co-designed technologies is needed and standardization of the definition of co-design would be helpful to researchers and designers.
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Affiliation(s)
- Jennifer Sumner
- Yong Loo Lin School of Medicine, Department of Medicine, National University of Singapore, Singapore
- Medical Affairs— Research Innovation & Enterprise, Alexandra Hospital, National University Health System, Singapore
| | - Lin Siew Chong
- Yong Loo Lin School of Medicine, Department of Medicine, National University of Singapore, Singapore
- Medical Affairs— Research Innovation & Enterprise, Alexandra Hospital, National University Health System, Singapore
| | - Anjali Bundele
- Medical Affairs— Research Innovation & Enterprise, Alexandra Hospital, National University Health System, Singapore
| | - Yee Wei Lim
- Yong Loo Lin School of Medicine, Department of Medicine, National University of Singapore, Singapore
- Medical Affairs— Research Innovation & Enterprise, Alexandra Hospital, National University Health System, Singapore
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Smith BM, Sharma R, Das A, Aboumatar H, Pitts SI, Day J, Holzhauer K, Bass E, Bennett WL. Patient and family engagement strategies for children and adolescents with chronic diseases: A review of systematic reviews. PATIENT EDUCATION AND COUNSELING 2021; 104:2213-2223. [PMID: 33678498 DOI: 10.1016/j.pec.2021.02.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 01/14/2021] [Accepted: 02/10/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Patient and family engagement is important for family-centered care, particularly for children and adolescents with chronic disease. We aimed to 1) identify available evidence from systematic reviews on engagement strategies used to help children, adolescents, and their caregivers manage chronic conditions, and 2) identify gaps in the literature. METHODS We searched PubMed and CINAHL from January 2015 to January 2020 for systematic reviews on patient and family engagement strategies in the pediatrics population (<18 years). Strategies were categorized by direct patient care, health system, and community policy levels. We excluded reviews if interventions were unidirectional or without comparison. RESULTS We identified 25 systematic reviews. Twenty-two evaluated direct patient care, with 14 (279 unique studies) exclusively in pediatrics and 8 (24 unique studies) that included pediatric results with adults. Three reviews (9 unique studies) evaluated health system strategies. Direct patient care reviews focused on self-management support (n = 16) and shared decisionmaking (n = 6). Asthma was the most frequently evaluated condition (n = 14). CONCLUSIONS AND PRACTICE IMPLICATIONS Engagement strategies for children and adolescents with chronic disease are focused on direct patient care, particularly for asthma. More research is needed to address engagement for broader populations, expanded outcomes, and at health system and community levels.
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Affiliation(s)
- Brandon M Smith
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, USA.
| | - Ritu Sharma
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Asar Das
- Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Hanan Aboumatar
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Samantha I Pitts
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Jeff Day
- Department of Art as Applied to Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Katherine Holzhauer
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Eric Bass
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Wendy L Bennett
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
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Verma AA, Murray J, Greiner R, Cohen JP, Shojania KG, Ghassemi M, Straus SE, Pou-Prom C, Mamdani M. Implementing machine learning in medicine. CMAJ 2021; 193:E1351-E1357. [PMID: 35213323 PMCID: PMC8432320 DOI: 10.1503/cmaj.202434] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Amol A Verma
- Unity Health Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Li Ka Shing Knowledge Institute of St. Michael's Hospital (Verma, Straus, Pou-Prom, Mamdani); Department of Medicine (Verma, Shojania, Straus, Mamdani) and Institute of Health Policy, Management, and Evaluation (Verma, Mamdani) and Department of Statistics (Murray), University of Toronto, Toronto, Ont.; University of Alberta (Greiner); Alberta Machine Intelligence Institute (Greiner), Edmonton, Alta.; Montreal Institute for Learning Algorithms (Cohen), Montréal, Que.; Centre for Quality Improvement and Patient Safety (Shojania), University of Toronto; Sunnybrook Health Sciences Centre (Shojania); Vector Institute (Ghassemi, Mamdani) and Department of Computer Science (Ghassemi); Leslie Dan Faculty of Pharmacy (Mamdani), University of Toronto, Toronto, Ont.; Department of Radiology, Stanford University (Cohen), Stanford, Calif.
| | - Joshua Murray
- Unity Health Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Li Ka Shing Knowledge Institute of St. Michael's Hospital (Verma, Straus, Pou-Prom, Mamdani); Department of Medicine (Verma, Shojania, Straus, Mamdani) and Institute of Health Policy, Management, and Evaluation (Verma, Mamdani) and Department of Statistics (Murray), University of Toronto, Toronto, Ont.; University of Alberta (Greiner); Alberta Machine Intelligence Institute (Greiner), Edmonton, Alta.; Montreal Institute for Learning Algorithms (Cohen), Montréal, Que.; Centre for Quality Improvement and Patient Safety (Shojania), University of Toronto; Sunnybrook Health Sciences Centre (Shojania); Vector Institute (Ghassemi, Mamdani) and Department of Computer Science (Ghassemi); Leslie Dan Faculty of Pharmacy (Mamdani), University of Toronto, Toronto, Ont.; Department of Radiology, Stanford University (Cohen), Stanford, Calif
| | - Russell Greiner
- Unity Health Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Li Ka Shing Knowledge Institute of St. Michael's Hospital (Verma, Straus, Pou-Prom, Mamdani); Department of Medicine (Verma, Shojania, Straus, Mamdani) and Institute of Health Policy, Management, and Evaluation (Verma, Mamdani) and Department of Statistics (Murray), University of Toronto, Toronto, Ont.; University of Alberta (Greiner); Alberta Machine Intelligence Institute (Greiner), Edmonton, Alta.; Montreal Institute for Learning Algorithms (Cohen), Montréal, Que.; Centre for Quality Improvement and Patient Safety (Shojania), University of Toronto; Sunnybrook Health Sciences Centre (Shojania); Vector Institute (Ghassemi, Mamdani) and Department of Computer Science (Ghassemi); Leslie Dan Faculty of Pharmacy (Mamdani), University of Toronto, Toronto, Ont.; Department of Radiology, Stanford University (Cohen), Stanford, Calif
| | - Joseph Paul Cohen
- Unity Health Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Li Ka Shing Knowledge Institute of St. Michael's Hospital (Verma, Straus, Pou-Prom, Mamdani); Department of Medicine (Verma, Shojania, Straus, Mamdani) and Institute of Health Policy, Management, and Evaluation (Verma, Mamdani) and Department of Statistics (Murray), University of Toronto, Toronto, Ont.; University of Alberta (Greiner); Alberta Machine Intelligence Institute (Greiner), Edmonton, Alta.; Montreal Institute for Learning Algorithms (Cohen), Montréal, Que.; Centre for Quality Improvement and Patient Safety (Shojania), University of Toronto; Sunnybrook Health Sciences Centre (Shojania); Vector Institute (Ghassemi, Mamdani) and Department of Computer Science (Ghassemi); Leslie Dan Faculty of Pharmacy (Mamdani), University of Toronto, Toronto, Ont.; Department of Radiology, Stanford University (Cohen), Stanford, Calif
| | - Kaveh G Shojania
- Unity Health Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Li Ka Shing Knowledge Institute of St. Michael's Hospital (Verma, Straus, Pou-Prom, Mamdani); Department of Medicine (Verma, Shojania, Straus, Mamdani) and Institute of Health Policy, Management, and Evaluation (Verma, Mamdani) and Department of Statistics (Murray), University of Toronto, Toronto, Ont.; University of Alberta (Greiner); Alberta Machine Intelligence Institute (Greiner), Edmonton, Alta.; Montreal Institute for Learning Algorithms (Cohen), Montréal, Que.; Centre for Quality Improvement and Patient Safety (Shojania), University of Toronto; Sunnybrook Health Sciences Centre (Shojania); Vector Institute (Ghassemi, Mamdani) and Department of Computer Science (Ghassemi); Leslie Dan Faculty of Pharmacy (Mamdani), University of Toronto, Toronto, Ont.; Department of Radiology, Stanford University (Cohen), Stanford, Calif
| | - Marzyeh Ghassemi
- Unity Health Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Li Ka Shing Knowledge Institute of St. Michael's Hospital (Verma, Straus, Pou-Prom, Mamdani); Department of Medicine (Verma, Shojania, Straus, Mamdani) and Institute of Health Policy, Management, and Evaluation (Verma, Mamdani) and Department of Statistics (Murray), University of Toronto, Toronto, Ont.; University of Alberta (Greiner); Alberta Machine Intelligence Institute (Greiner), Edmonton, Alta.; Montreal Institute for Learning Algorithms (Cohen), Montréal, Que.; Centre for Quality Improvement and Patient Safety (Shojania), University of Toronto; Sunnybrook Health Sciences Centre (Shojania); Vector Institute (Ghassemi, Mamdani) and Department of Computer Science (Ghassemi); Leslie Dan Faculty of Pharmacy (Mamdani), University of Toronto, Toronto, Ont.; Department of Radiology, Stanford University (Cohen), Stanford, Calif
| | - Sharon E Straus
- Unity Health Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Li Ka Shing Knowledge Institute of St. Michael's Hospital (Verma, Straus, Pou-Prom, Mamdani); Department of Medicine (Verma, Shojania, Straus, Mamdani) and Institute of Health Policy, Management, and Evaluation (Verma, Mamdani) and Department of Statistics (Murray), University of Toronto, Toronto, Ont.; University of Alberta (Greiner); Alberta Machine Intelligence Institute (Greiner), Edmonton, Alta.; Montreal Institute for Learning Algorithms (Cohen), Montréal, Que.; Centre for Quality Improvement and Patient Safety (Shojania), University of Toronto; Sunnybrook Health Sciences Centre (Shojania); Vector Institute (Ghassemi, Mamdani) and Department of Computer Science (Ghassemi); Leslie Dan Faculty of Pharmacy (Mamdani), University of Toronto, Toronto, Ont.; Department of Radiology, Stanford University (Cohen), Stanford, Calif
| | - Chloe Pou-Prom
- Unity Health Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Li Ka Shing Knowledge Institute of St. Michael's Hospital (Verma, Straus, Pou-Prom, Mamdani); Department of Medicine (Verma, Shojania, Straus, Mamdani) and Institute of Health Policy, Management, and Evaluation (Verma, Mamdani) and Department of Statistics (Murray), University of Toronto, Toronto, Ont.; University of Alberta (Greiner); Alberta Machine Intelligence Institute (Greiner), Edmonton, Alta.; Montreal Institute for Learning Algorithms (Cohen), Montréal, Que.; Centre for Quality Improvement and Patient Safety (Shojania), University of Toronto; Sunnybrook Health Sciences Centre (Shojania); Vector Institute (Ghassemi, Mamdani) and Department of Computer Science (Ghassemi); Leslie Dan Faculty of Pharmacy (Mamdani), University of Toronto, Toronto, Ont.; Department of Radiology, Stanford University (Cohen), Stanford, Calif
| | - Muhammad Mamdani
- Unity Health Toronto (Verma, Murray, Straus, Pou-Prom, Mamdani); Li Ka Shing Knowledge Institute of St. Michael's Hospital (Verma, Straus, Pou-Prom, Mamdani); Department of Medicine (Verma, Shojania, Straus, Mamdani) and Institute of Health Policy, Management, and Evaluation (Verma, Mamdani) and Department of Statistics (Murray), University of Toronto, Toronto, Ont.; University of Alberta (Greiner); Alberta Machine Intelligence Institute (Greiner), Edmonton, Alta.; Montreal Institute for Learning Algorithms (Cohen), Montréal, Que.; Centre for Quality Improvement and Patient Safety (Shojania), University of Toronto; Sunnybrook Health Sciences Centre (Shojania); Vector Institute (Ghassemi, Mamdani) and Department of Computer Science (Ghassemi); Leslie Dan Faculty of Pharmacy (Mamdani), University of Toronto, Toronto, Ont.; Department of Radiology, Stanford University (Cohen), Stanford, Calif.
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Lim S, Morris H, Pizzirani B, Kajewski D, Lee WK, Skouteris H. Evaluating hospital tools and services that were co-produced with patients: A rapid review. Int J Qual Health Care 2021; 32:231-239. [PMID: 32222757 DOI: 10.1093/intqhc/mzaa020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 02/04/2020] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To describe the process and outcomes of services or products co-produced with patients in hospital settings. DATA SOURCES Database searches on Medline, CINAHL and Business Source between 2008 and 2019. STUDY SELECTION Studies that evaluate the products of co-production in hospital settings. DATA EXTRACTION Primary outcome is the individual and organizational outcomes resulting from co-production. Study characteristics, co-production process, level of engagement and intensity of engagement were also extracted. RESULTS OF DATA SYNTHESIS A total of 13 studies were included. Types of co-produced outputs were health services and care processes, tools and resources, and technology-based products, such as mobile application. Most studies engaged patients at a consultative or involvement level, with only four studies engaging patients as partners. Moderate-to-high acceptability and usability by patients and health services were reported for co-produced outputs. Organizational outcomes were also reported qualitatively as producing various positive effects, such as improved communication and diagnostic process. Positive patient outcomes were reported for co-produced outputs in qualitative (e.g. improved social support) and quantitative results (e.g. reduction of clinic wait time). No patient clinical outcomes were reported. CONCLUSION Co-produced outputs have moderate-to-high acceptability, usability or uptake. There is insufficient evidence on other organizational or patient outcomes due to the lack of reporting of outcomes in co-production. Future research should focus on the outcomes (i.e. effects on patients and health service providers), not just the output of co-production. This is critical to provide feedback to advance the knowledge and implementation of co-production.
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Affiliation(s)
- Siew Lim
- Monash Centre for Health Research and Implementation, Monash University, 43-51 Kanooka Grove, Clayton, Melbourne, VIC 3168, Australia
| | - Heather Morris
- Monash Centre for Health Research and Implementation, Monash University, 43-51 Kanooka Grove, Clayton, Melbourne, VIC 3168, Australia
| | - Bengianni Pizzirani
- Monash Centre for Health Research and Implementation, Monash University, 43-51 Kanooka Grove, Clayton, Melbourne, VIC 3168, Australia
| | - Duncan Kajewski
- Monash Centre for Health Research and Implementation, Monash University, 43-51 Kanooka Grove, Clayton, Melbourne, VIC 3168, Australia
| | - Wai Kit Lee
- Monash Centre for Health Research and Implementation, Monash University, 43-51 Kanooka Grove, Clayton, Melbourne, VIC 3168, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, Monash University, 43-51 Kanooka Grove, Clayton, Melbourne, VIC 3168, Australia
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Begasse de Dhaem O, Kiarashi J, Armand CE, Charleston L, Szperka CL, Lee YS, Rajapakse T, Seng EK, VanderPluym JH, Starling AJ. Ten Eleven things to facilitate participation of underrepresented groups in headache medicine research. Headache 2021; 61:951-960. [PMID: 34125956 PMCID: PMC10091268 DOI: 10.1111/head.14124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 04/01/2021] [Accepted: 04/05/2021] [Indexed: 12/17/2022]
Affiliation(s)
| | - Jessica Kiarashi
- Department of Neurology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Cynthia E Armand
- Department of Neurology, Albert Einstein College of Medicine, Montefiore Headache Center, Bronx, NY, USA
| | - Larry Charleston
- Department of Neurology and Ophthalmology, Michigan State University College of Human Medicine, East Lansing, MI, USA
| | - Christina L Szperka
- Department of Neurology, Children's Hospital of Philadelphia & Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Yeonsoo S Lee
- Department of Medicine, Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA
| | - Thilinie Rajapakse
- Department of Neurology, Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada
| | - Elizabeth K Seng
- Department of Psychology, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.,Department of Psychology, Albert Einstein College of Medicine, Bronx, NY, USA
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Missel M, Hansen MH, Petersson NB, Forman J, Højskov IE, Borregaard B. Transforming the experience of illness into action - Patient and spouses experiences of involvement in a patient and family advisory council. PATIENT EDUCATION AND COUNSELING 2021; 104:1481-1486. [PMID: 33257200 DOI: 10.1016/j.pec.2020.11.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 11/07/2020] [Accepted: 11/20/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The objective was to explore patients' and spouses' perception and attitudes towards participating in a patient and family advisory council. METHODS A qualitative study with interviews conducted within a phenomenological-hermeneutical frame, inspired by Ricoeur were conducted with current and former participants (patients and/or spouses) of a patient and family advisory council in Denmark. RESULTS In total, 16 participants were interviewed (12 former patients/four spouses) with a mean age of 68 (range 49-79) and 44 % women. After the analysis, perceptions and attitudes towards participating in a patient advisory council emerged in four themes; "Payback", "A personal invitation", "A safe and equal atmosphere", and "Sharing, caring, and healing". CONCLUSION Participants of an advisory council express a need for "paying it back" to the health care system. When being part of the advisory council, the participants expressed feeling a genuine engagement and interest from the health-care professionals - leading to a feeling of being equal and taken seriously. The advisory council increased the process of recovery by sharing narratives with peers. PRACTICAL VALUE Experiences of being part of an advisory council lead to an understanding of "why" former patients and spouses participate. This knowledge can help others to recruit members.
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Affiliation(s)
- Malene Missel
- Department of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Denmark
| | | | - Nadja Buch Petersson
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Denmark
| | - Jacqueline Forman
- Centre for Heart Valve Innovation, St. Pauls Hospital, Vancouver, Canada
| | - Ida Elisabeth Højskov
- Department of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Britt Borregaard
- Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Denmark; Department of Cardiology, Odense University Hospital, Denmark; University of Southern Denmark, 5000, Odense C, Denmark.
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Bolz-Johnson M, Kenny T, Le Cam Y, Hernando I. Our greatest untapped resource: our patients. J Community Genet 2021; 12:241-246. [PMID: 33884523 DOI: 10.1007/s12687-021-00524-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/23/2021] [Indexed: 11/24/2022] Open
Abstract
Healthcare is continually evolving to meet the changing needs of twenty-first century populations whilst striving to keeping pace with medical and technological advancements. Patients and clinicians remain the constants in this evolving environment, sitting at the cutting edge of new evidence and innovation and at the coalface of clinical services which need to address the increasingly challenging health priorities we face as a society. Patients and clinicians, positioned centre stage in this changing world, must adjust their relationships and partnerships to reduce the burden of illness and ensure that multifaceted care needs are all properly addressed. In rare diseases, this relationship between patients and professionals demands a new model of care, in which patients are active, valued partners in their own care and function not as 'enlightened self-interested' individuals but as experts by experience. The unique characteristics of rare diseases demand that care evolves beyond multidisciplinary team care to 'Networked-care', in which care is prescribed based upon the body of experience and expertise of a community of experts and patients (who are experts by experience). Healthcare models are being redrawn around a new norm of clinical practice based on true patient-clinical partnerships in care. A partnership with patients, when supported by proper investment, is a collaborative relationship that aligns both the medical and clinical perspectives of professionals with a holistic perspective of patients' life experiences. Such partnerships can (i) ensure that decisions around care and design of services are needs-led, (ii) reduce the fog of uncertainty that surrounds rare diseases, (iii) amplify the success of new discoveries, and (iv) create breakthrough innovations: in these ways, patient-clinical partnerships increase the efficiency and effectiveness of our work and build a more sustainable future for our healthcare services.
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Affiliation(s)
| | - Tom Kenny
- Square Root Thinking, Cologne, Germany
| | - Yann Le Cam
- EURORDIS - Rare Diseases Europe, Paris, France
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Jones AR, Tay CT, Melder A, Vincent AJ, Teede H. What Are Models of Care? A Systematic Search and Narrative Review to Guide Development of Care Models for Premature Ovarian Insufficiency. Semin Reprod Med 2021; 38:323-330. [PMID: 33684948 DOI: 10.1055/s-0041-1726131] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
No specific model of care (MoC) is recommended for premature ovarian insufficiency (POI), despite awareness that POI is associated with comorbidities requiring multidisciplinary care. This article aims to explore the definitions and central components of MoC in health settings, so that care models for POI can be developed. A systematic search was performed on Ovid Medline and Embase, and including gray literature. Unique definitions of MoC were identified, and thematic analysis was used to summarize the key component of MoC. Of 2,477 articles identified, 8 provided unique definitions of MoC, and 11 described components of MoC. Definitions differ in scope, focusing on disease, service, or system level, but a key feature is that MoC is operational, describing how care is delivered, as well as what that care is. Thematic analysis identified 42 components of MoC, summarized into 6 themes-stakeholder engagement, supporting integrated care, evidence-based care, defined outcomes and evaluation, behavior change methodology, and adaptability. Stakeholder engagement was central to all other themes. MoCs operationalize how best practice care can be delivered at a disease, service, or systems level. Specific MoC should be developed for POI, to improve clinical and process outcomes, translate evidence into practice, and use resources more efficiently.
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Affiliation(s)
- Alicia R Jones
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Victoria, Australia.,Department of Endocrinology, Monash Health, Victoria, Australia
| | - Chau T Tay
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Victoria, Australia.,Department of Endocrinology, Monash Health, Victoria, Australia
| | - Angela Melder
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Victoria, Australia.,Monash Partner's Academic Health Science Centre, Victoria, Australia
| | - Amanda J Vincent
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Victoria, Australia.,Department of Endocrinology, Monash Health, Victoria, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Victoria, Australia.,Department of Endocrinology, Monash Health, Victoria, Australia.,Monash Partner's Academic Health Science Centre, Victoria, Australia
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40
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Wahlberg KJ, Burnett M, Muthukrishnan P, Purcell K, Repp AB, van Eeghen C, Wahlberg EA, Kennedy AG. Partnering With Patients in a Quality Improvement Curriculum for Internal Medicine Residents. J Patient Exp 2021; 8:2374373521999604. [PMID: 34179411 PMCID: PMC8205409 DOI: 10.1177/2374373521999604] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Patient experience is a core component of the Institute for Healthcare Improvement Triple Aim for health care improvement. Although resident physicians must meet quality improvement (QI) competencies prior to graduation, QI training during residency may not adequately prepare residents to improve patient and family experience. We describe an active learning QI curriculum engaging 3 Patient and Family Advisors as partners alongside 15 resident physicians. This partnership proved to be a meaningful experience for both groups, with the development of mutual respect and insight into the contributions that patients and families bring to solving problems in health care quality.
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Affiliation(s)
- Kramer J Wahlberg
- The University of Vermont Larner College of Medicine, Burlington, VT, USA
| | - Maria Burnett
- The University of Vermont Larner College of Medicine, Burlington, VT, USA
| | | | - Kate Purcell
- The University of Vermont Medical Center, Burlington, VT, USA
| | - Allen B Repp
- The University of Vermont Larner College of Medicine, Burlington, VT, USA
| | | | | | - Amanda G Kennedy
- The University of Vermont Larner College of Medicine, Burlington, VT, USA
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Gagliardi AR, Martinez JPD, Baker GR, Moody L, Scane K, Urquhart R, Wodchis WP. Hospital capacity for patient engagement in planning and improving health services: a cross-sectional survey. BMC Health Serv Res 2021; 21:179. [PMID: 33632200 PMCID: PMC7908767 DOI: 10.1186/s12913-021-06174-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/11/2021] [Indexed: 12/30/2022] Open
Abstract
Background Patient engagement (PE) in planning or improving hospital facilities or services is one approach for improving healthcare delivery and outcomes. To provide evidence on hospital capacity needed to support PE, we described the attributes of hospital PE capacity associated with clinical quality measures. Methods We conducted a cross-sectional survey of general and specialty hospitals based on the Measuring Organizational Readiness for Patient Engagement framework. We derived a PE capacity index measure, and with Multiple Correspondence Analysis, assessed the association of PE capacity with hospital type, and rates of hand-washing, C. difficile infection rates and 30-day readmission. Results Respondents (91, 66.4%) included general: < 100 beds (48.4%), 100+ beds (27.5%), teaching hospitals (11.0%) and specialty (13.2%) hospitals. Most featured PE in multiple clinical and corporate departments. Most employed PE in a range of Planning (design/improve facilities 94.5%, develop strategic plans 87.9%), Evaluation/Quality Improvement (accreditation 91.2%, develop QI plans 90.1%) and Service Delivery activities (develop information/communication aids 92.3%). Hospitals enabled PE with multiple supports (median 12, range 0 to 25), most often: 76.9% strategic plan recognizes PE, 74.7% patient/family advisory council, and 69.2% pool of patient volunteers; and least often: 30.0% PE staff, 26.4% PE funding and 16.5% patient reimbursement or 3.3% compensation. Hospitals employed a range of less (inform, consult) and more (involve, partner) active modes of engagement. Two variables accounted for 29.6% of variance in hospital PE capacity index measure data: number of departments featuring PE and greater use of active engagement modes. PE capacity was not associated with general hospital type or clinical quality measures. Conclusions Hospitals with fewer resources can establish favourable PE conditions by deploying PE widely and actively engaging patients. Healthcare policy-makers, hospital executives and PE managers can use these findings to allocate PE resources. Future research should explore how PE modes and methods impact clinical outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06174-0.
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Affiliation(s)
- Anna R Gagliardi
- Toronto General Hospital Research Institute, University Health Network, 200 Elizabeth Street, 13EN-228, Toronto, M5G2C4, Canada.
| | | | - G Ross Baker
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Lesley Moody
- Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Kerseri Scane
- Patient Partnerships, University Health Network, Toronto, Canada
| | - Robin Urquhart
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Walter P Wodchis
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
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Rintell D, Heath D, Braga Mendendez F, Cross E, Cross T, Knobel V, Gagnon B, Turtle C, Cohen A, Kalmykov E, Fox J. Patient and family experience with transthyretin amyloid cardiomyopathy (ATTR-CM) and polyneuropathy (ATTR-PN) amyloidosis: results of two focus groups. Orphanet J Rare Dis 2021; 16:70. [PMID: 33557882 PMCID: PMC7869246 DOI: 10.1186/s13023-021-01706-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 01/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Transthyretin amyloidosis, or ATTR, is a progressive and debilitating rare proteopathy generally manifested as either transthyretin amyloid polyneuropathy (ATTR-PN) or transthyretin amyloid cardiomyopathy (ATTR-CM). Irrespective of the clinical presentation, affected patients manage a chronic and life-threatening condition that severely impacts their quality of life. Although the primary symptoms and diagnostic criteria for ATTR are increasingly being discussed in the medical literature, due in large part by continual advances in uncovering disease pathophysiology, there exists a surprising paucity of published data on the patient journey and family experience. In order to address this disparity, two focus groups, one for ATTR-CM and one for ATTR-PN, were convened and asked to describe the diagnostic process, symptoms, and impact on their own quality of life that was experienced from these rare and typically misdiagnosed illnesses. RESULTS Patients in both ATTR groups often underwent a long and difficult diagnostic odyssey characterized by seemingly nonspecific physical manifestations resulting in mismanagement and suboptimal care, inadequate interventions, and delays in establishing the correct diagnosis, which was integral to determining the specialized treatment they needed. Collectively, patients with ATTR-CM and patients with ATTR-PN reported a similar number of symptoms, but the type of symptoms varied. The ATTR-CM group identified intolerance to activity, inability to exercise, insomnia and fatigue as the most challenging symptoms. The ATTR-PN group identified fatigue, diarrhea/constipation and sensory deficits as the most difficult symptoms. In general, ATTR was reported to be highly stressful for both patients and their families. Spouses of patients with ATTR-CM were often in a caregiver role and reported experiencing considerable anxiety. Patients with ATTR-PN were stressed not only by the physical consequences of their illness, but also by its effects on their parents and other relatives, as well as concerns about children and grandchildren inheriting the disease-causing mutations associated with ATTR. Despite such challenges, family members are identified as an important resource of coping, motivation, inspiration and support. CONCLUSIONS Several steps can be taken to reduce the challenges and burdens of living with ATTR, including increased education for primary care physicians and specialists who unknowingly encounter ATTR, increased access to and ready availability of mental health services and support, and increased engagement with support groups and advocacy organizations. Input from patients and their representatives should guide clinical trials, increase the availability of genetic testing, and generate natural history and qualitative studies detailing patients' experience. Although each recommendation is impactful in itself, taken together they would jointly facilitate a shortened and ameliorated patient journey through more timely diagnosis and greater access to personalized medical care.
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Affiliation(s)
| | - Dena Heath
- Amyloidosis Research Consortium, Newton, MA, USA
| | | | | | | | | | | | | | - Alan Cohen
- Eidos Therapeutics, San Francisco, CA, USA
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Tam L, Burns K, Barnes K. Responsibilities and capabilities of health engagement professionals (HEPs): Perspectives from HEPs and health consumers in Australia. Health Expect 2020; 24:111-120. [PMID: 33174668 PMCID: PMC7879552 DOI: 10.1111/hex.13155] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/06/2020] [Accepted: 10/22/2020] [Indexed: 01/30/2023] Open
Abstract
Background In Australia, the National Safety and Quality Health Service Standards (2012) stipulates that partnering with health consumers to improve health‐care experiences is one of the criteria health‐care organizations are assessed and accredited against. This standard has given rise to a role: health engagement professionals (HEPs). While there are no standard requirements for recruitment into this role, this study contributes to much needed research into understanding their responsibilities and capabilities, and their contributions to engagement outcomes. Methods Using a qualitative, interpretive approach, 16 HEPs and 15 health consumer representatives (who have experiences of interacting with HEPs) participated in an in‐depth phone interview in December 2019. We explored (a) the purposes of the role, (b) the responsibilities and work activities and (c) the capabilities required to carry out the responsibilities. Results Health engagement professionals are specialists in designing engagement mechanisms for health‐care organizations to co‐design health services with health consumers. They facilitate partnerships between health‐care organizations and health consumers. They play significant roles in listening to, facilitating understanding amongst different stakeholder groups (eg hospital management, health‐care workers and health consumers) and navigating the bureaucratic structures to influence outcomes. Four major responsibilities (advocacy, education, facilitation and administration) and four categories of capabilities (relational, communication, professional and personal) were identified. Conclusion A list of job responsibilities and desired capabilities of HEPs is provided to help health‐care organizations better understand the requirements for the role. This would help them decide how applicants to these roles would meet the requirements (eg experience of navigating bureaucratic systems).
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Affiliation(s)
- Lisa Tam
- School of Advertising, Marketing and Public Relations, Queensland University of Technology, Brisbane, Qld, Australia
| | - Kara Burns
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Logan, Qld, Australia
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Haesebaert J, Samson I, Lee-Gosselin H, Guay-Bélanger S, Proteau JF, Drouin G, Guimont C, Vigneault L, Poirier A, Sanon PN, Roch G, Poitras MÈ, LeBlanc A, Légaré F. "They heard our voice!" patient engagement councils in community-based primary care practices: a participatory action research pilot study. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:54. [PMID: 32974050 PMCID: PMC7507740 DOI: 10.1186/s40900-020-00232-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/14/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Patient engagement could improve the quality of primary care practices. However, we know little about effective patient engagement strategies. We aimed to assess the acceptability and feasibility of embedding advisory councils of clinicians, managers, patients and caregivers to conduct patient-oriented quality improvement projects in primary care practices. METHODS Using a participatory action research approach, we conducted our study in two non-academic primary care practices in Quebec City (Canada). Patient-experts (patients trained in research) were involved in study design, council recruitment and meeting facilitation. Advisory councils were each to include patients and/or caregivers, clinicians and managers. Over six meetings, councils would identify quality improvement priorities and plan projects accordingly. We assessed acceptability and feasibility of the councils using non-participant observations, audio-recordings and self-administered questionnaires. We used descriptive analyses, triangulated qualitative data and performed inductive thematic analysis. RESULTS Between December 2017 and June 2018, two advisory councils were formed, each with 11 patients (36% male, mean age 53.8 years), a nurse and a manager practising as a family physician (25% male, mean age 45 years). The six meetings per practice occurred within the study period with a mean of eight patients per meeting. Councils worked on two projects each: the first council on a new information leaflet about clinic organization and operation, and on communications about local public health programs; the second on methods to further engage patients in the practice, and on improving the appointment scheduling system. Median patient satisfaction was 8/10, and 66.7% perceived councils had an impact on practice operations. They considered involvement of a manager, facilitation by patient-experts, and the fostering of mutual respect as key to this impact. Clinicians and managers liked having patients as facilitators and the respect among members. Limiting factors were difficulty focusing on a single feasible project and time constraints. Managers in both practices were committed to pursuing the councils post-study. CONCLUSION Our results indicated that embedding advisory councils of clinicians, managers, patients and caregivers to conduct patient-oriented quality improvement projects in primary care practices is both acceptable and feasible. Future research should assess its transferability to other clinical contexts.
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Affiliation(s)
- Julie Haesebaert
- VITAM – Centre de recherche en santé durable, CIUSSS de la Capitale-Nationale, Pavillon Landry-Poulin, Room A-4574, 2525, chemin de la Canardière, Quebec City, Quebec G1J 0A4 Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec City, Quebec Canada
| | - Isabelle Samson
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec City, Quebec Canada
| | - Hélène Lee-Gosselin
- Department of Management, Faculty of Business Administration, Université Laval, Quebec City, Quebec Canada
| | - Sabrina Guay-Bélanger
- VITAM – Centre de recherche en santé durable, CIUSSS de la Capitale-Nationale, Pavillon Landry-Poulin, Room A-4574, 2525, chemin de la Canardière, Quebec City, Quebec G1J 0A4 Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec City, Quebec Canada
| | | | - Guy Drouin
- Clinic Manager, Quebec City, Quebec Canada
| | | | | | | | | | - Geneviève Roch
- Centre Hospitalier Universitaire de Québec – Université Laval Research Center, Hôpital Saint-François d’Assise, Quebec City, Quebec Canada
- Faculty of Nursing, Université Laval, Quebec City, Quebec Canada
| | - Marie-Ève Poitras
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Chicoutimi, Quebec Canada
| | - Annie LeBlanc
- VITAM – Centre de recherche en santé durable, CIUSSS de la Capitale-Nationale, Pavillon Landry-Poulin, Room A-4574, 2525, chemin de la Canardière, Quebec City, Quebec G1J 0A4 Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec City, Quebec Canada
| | - France Légaré
- VITAM – Centre de recherche en santé durable, CIUSSS de la Capitale-Nationale, Pavillon Landry-Poulin, Room A-4574, 2525, chemin de la Canardière, Quebec City, Quebec G1J 0A4 Canada
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec City, Quebec Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec City, Quebec Canada
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Hempstead SE, Fredkin K, Hovater C, Naureckas ET. Patient and Family Participation in Clinical Guidelines Development: The Cystic Fibrosis Foundation Experience. J Particip Med 2020; 12:e17875. [PMID: 33064090 PMCID: PMC7434055 DOI: 10.2196/17875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/30/2020] [Accepted: 05/06/2020] [Indexed: 01/14/2023] Open
Abstract
Patient and family participation in guideline development is neither standardized nor uniformly accepted in the guideline development community, despite the 2011 Institute of Medicine’s Guidelines We Can Trust and the Guideline International Network’s GIN-Public Toolkit recommendations. The Cystic Fibrosis Foundation has included patients and/or family members directly in guideline development since 2004. Over time, various strategies for increasing patient and family member participation have been implemented. Surveys of recent patient/family and clinical guidelines committee members have shown that inclusion of individuals with cystic fibrosis and their family members on guidelines committees has provided insight otherwise invisible to clinicians.
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Affiliation(s)
| | | | - Cade Hovater
- Community Advisor to the Cystic Fibrosis Foundation, Bethesda, MD, United States
| | - Edward T Naureckas
- Department of Pulmonary Medicine, University of Chicago, Chicago, IL, United States
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Ramazani S, Bayer ND, Gottfried JA, Wagner J, Leonard MS, Lynn J, Schriefer J. The Value of Family Advisors as Coleaders in Pediatric Quality Improvement Efforts: A Qualitative Theme Analysis. J Patient Exp 2020; 7:1708-1714. [PMID: 33457634 PMCID: PMC7786654 DOI: 10.1177/2374373520939827] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Engaging family advisors in pediatric quality improvement (QI) efforts is well-studied in intensive care but less understood in other settings. The purpose of this study was to assess the perceived impact of including a family advisor as a colead on a QI initiative that successfully improved the family-centered timing of routine morning blood tests performed on pediatric inpatients. Five structured written reflections from core QI team members were analyzed using inductive thematic analysis and 3 major themes were identified. The first found that a family advisor's presence from the beginning of a QI initiative helps inform project design. The second determined that family partners working with residents fostered a better shared understanding of the role of trainees and caregivers in improving the quality of care. The third found that a family partner is an effective change agent to enact practice improvement, support professional development, and enhance resident education. Our qualitative analysis showed that engaging a family advisor as a colead influenced the design, implementation, and post-intervention impact of the initiative and improved family-centered outcomes.
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Affiliation(s)
- Suzanne Ramazani
- Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY, USA
| | - Nathaniel D Bayer
- Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Jenna Wagner
- Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY, USA
| | - Michael S Leonard
- Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY, USA
| | - Justin Lynn
- Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY, USA
| | - Jan Schriefer
- Golisano Children's Hospital, University of Rochester Medical Center, Rochester, NY, USA
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Patients' Views About Patient Engagement and Representation in Healthcare Governance. J Healthc Manag 2020; 64:332-346. [PMID: 31498210 DOI: 10.1097/jhm-d-18-00152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
EXECUTIVE SUMMARY Health systems increasingly engage with patient representatives on their governance boards or with patient and family advisory councils to improve care delivery. Little is known about how general patients regard those engagement activities. The objective of this study was to assess the importance of patient representation. We mailed a survey to 31,687 Medicare beneficiaries attributed to a Medicare accountable care organization. We examined relationships between respondents' views and their health characteristics and performed thematic analysis on free-text responses. Among 3,061 respondents, the majority believed that having a patient representative (74.1%) or a patient council (74.0%) mattered "some" or "a lot." The main factors respondents considered in answering were that "patients deserve a voice" (64%) and "having a patient on the [governance] board increases my trust" in this organization (46%). Our analysis of free-text responses illuminated why patient representatives are important, keys to successful engagement, and reasons behind the skepticism. This study indicates that most patients believe representation in health system governance is important, and that realizing its potential requires engagement activities that improve general patients' awareness of, and interaction with, their representatives.
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48
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An electronic health record-based strategy to recruit for a Patient Advisory Council for Research: Implications for inclusion. J Clin Transl Sci 2020; 4:69-72. [PMID: 32257413 PMCID: PMC7103472 DOI: 10.1017/cts.2019.433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 10/04/2019] [Accepted: 10/15/2019] [Indexed: 01/19/2023] Open
Abstract
In 2017, the NYU Clinical and Translational Science Institute’s Recruitment and Retention Unit created a Patient Advisory Council for Research (PACR) to provide feedback on clinical trials and health research studies. We collaborated with our clinical research informatics team to generate a random sample of patients, based on the International Classification of Diseases, Tenth Revision codes and demographic factors, for invitation via the patient portal. This approach yielded in a group that was diverse with regard to age, race/ethnicity, sex, and health conditions. This report highlights the benefits and limitations of using an electronic health record-based strategy to identify and recruit members for a PACR.
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Chapman E, Haby MM, Toma TS, de Bortoli MC, Illanes E, Oliveros MJ, Barreto JOM. Knowledge translation strategies for dissemination with a focus on healthcare recipients: an overview of systematic reviews. Implement Sci 2020; 15:14. [PMID: 32131861 PMCID: PMC7057470 DOI: 10.1186/s13012-020-0974-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 02/17/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND While there is an ample literature on the evaluation of knowledge translation interventions aimed at healthcare providers, managers, and policy-makers, there has been less focus on patients and their informal caregivers. Further, no overview of the literature on dissemination strategies aimed at healthcare users and their caregivers has been conducted. The overview has two specific research questions: (1) to determine the most effective strategies that have been used to disseminate knowledge to healthcare recipients, and (2) to determine the barriers (and facilitators) to dissemination of knowledge to this group. METHODS This overview used systematic review methods and was conducted according to a pre-defined protocol. A comprehensive search of ten databases and five websites was conducted. Both published and unpublished reviews in English, Spanish, or Portuguese were included. A methodological quality assessment was conducted; low-quality reviews were excluded. A narrative synthesis was undertaken, informed by a matrix of strategy by outcome measure. The Health System Evidence taxonomy for "consumer targeted strategies" was used to separate strategies into one of six categories. RESULTS We identified 44 systematic reviews that describe the effective strategies to disseminate health knowledge to the public, patients, and caregivers. Some of these reviews also describe the most important barriers to the uptake of these effective strategies. When analyzing those strategies with the greatest potential to achieve behavioral changes, the majority of strategies with sufficient evidence of effectiveness were combined, frequent, and/or intense over time. Further, strategies focused on the patient, with tailored interventions, and those that seek to acquire skills and competencies were more effective in achieving these changes. In relation to barriers and facilitators, while the lack of health literacy or e-literacy could increase inequities, the benefits of social media were also emphasized, for example by widening access to health information for ethnic minorities and lower socioeconomic groups. CONCLUSIONS Those interventions that have been shown to be effective in improving knowledge uptake or health behaviors should be implemented in practice, programs, and policies-if not already implemented. When implementing strategies, decision-makers should consider the barriers and facilitators identified by this overview to ensure maximum effectiveness. PROTOCOL REGISTRATION PROSPERO: CRD42018093245.
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Affiliation(s)
| | - Michelle M. Haby
- Departamento de Ciencias Químico Biológicas, Universidad de Sonora, Hermosillo, Sonora Mexico
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC Australia
| | - Tereza Setsuko Toma
- Instituto de Saúde, Secretaria de Estado da Saúde de São Paulo, São Paulo, Brazil
| | | | | | - Maria Jose Oliveros
- Departamento de Medicina Interna, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile
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50
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Affiliation(s)
- Tara Kiran
- Department of Family and Community Medicine (Kiran, Tepper), St. Michael's Hospital; Department of Family and Community Medicine (Kiran, Tepper), University of Toronto; MAP Centre for Urban Health Solutions (Kiran), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; North York General Hospital (Tepper), North York, Ont.; Institute of Health Policy, Management, and Evaluation (Kiran, Tepper), University of Toronto; Ontario Health, Quality Business Unit (Kiran), Toronto, Ont.; CHILD-BRIGHT Network (Gavin), Montréal, Que.; Ontario Strategy for Patient-Oriented Research Support Unit (Gavin), Toronto, Ont.
| | - Joshua Tepper
- Department of Family and Community Medicine (Kiran, Tepper), St. Michael's Hospital; Department of Family and Community Medicine (Kiran, Tepper), University of Toronto; MAP Centre for Urban Health Solutions (Kiran), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; North York General Hospital (Tepper), North York, Ont.; Institute of Health Policy, Management, and Evaluation (Kiran, Tepper), University of Toronto; Ontario Health, Quality Business Unit (Kiran), Toronto, Ont.; CHILD-BRIGHT Network (Gavin), Montréal, Que.; Ontario Strategy for Patient-Oriented Research Support Unit (Gavin), Toronto, Ont
| | - Frank Gavin
- Department of Family and Community Medicine (Kiran, Tepper), St. Michael's Hospital; Department of Family and Community Medicine (Kiran, Tepper), University of Toronto; MAP Centre for Urban Health Solutions (Kiran), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; North York General Hospital (Tepper), North York, Ont.; Institute of Health Policy, Management, and Evaluation (Kiran, Tepper), University of Toronto; Ontario Health, Quality Business Unit (Kiran), Toronto, Ont.; CHILD-BRIGHT Network (Gavin), Montréal, Que.; Ontario Strategy for Patient-Oriented Research Support Unit (Gavin), Toronto, Ont
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