scholarly journals The Swiss Learning Health System: a national initiative supporting evidence-informed decision-making

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Mantwill ◽  
T Kasper Wicki ◽  
S Boes
Keyword(s):  
Decision Making ◽  
Health System ◽  
Research Policy ◽  
Informed Decision ◽  
Supporting Evidence ◽  
Informed Decision Making ◽  
Policy And Practice ◽  
Learning Health System ◽  
Learning Cycles ◽  
Swiss Health

Abstract Issue Over the last years, there has been an ever-increasing interest in how to promote and support uptake of evidence and evidence-informed decision-making in health-systems related policy and practice. However, only few efforts have been made that aim at fully leveraging the knowledge and expertise of bigger networks to address this issue more comprehensively. Description of the problem Also, in Switzerland, the need to address this matter has been increasingly emphasized by actors in the health system. In particular, the lack of comprehensive coordination efforts in the field of health services research, and subsequent knowledge translation activities, has been stressed. Results In response, the Swiss Learning Health System (SLHS) was established as a nationwide project in 2017, currently involving 10 academic partners. One of the overarching objectives of the SLHS is to bridge research, policy, and practice by providing an infrastructure that supports learning cycles. Learning cycles enable the continuous integration of evidence into policy and practice by: continuously identifying issues relevant to the health system, systemizing relevant evidence, presenting potential courses of action, and revising and reshaping responses. Key features of learning cycles in the SLHS include the development of policy/evidence briefs that serve as a basis for official stakeholder dialogues, which are structured dialogues during which the best course of action is discussed and evaluated. Issues that are identified to be further pursued are monitored for potential implementation and eventually evaluated to inform new learning cycles and to support continuous learning within the system. Lessons The SLHS is an important mechanism to institutionalize learning cycles within the Swiss health system by leveraging the expertise and knowledge of a comprehensive network, going beyond individual initiatives, and to respond effectively to newly occurring health system challenges. Key messages The Swiss Learning Health System is the first nationwide project that aims to establish learning cycles that support evidence-informed decision-making in health-system-related policy and practice. The Swiss Learning Health System is an infrastructure that supports the continuous flow of evidence into policy and practice, providing a mechanism to respond to occurring health system challenges.

scholarly journals Profile of Productivity and Equity in Health Resource Generation: Policy Implications of Iran’s Health Transformation Plan

2020 ◽  
Author(s):  
Vahid Yazdi-Feyzabadi ◽  
Mohammad Hossein Mehrolhassani ◽  
Mostafa Amini-Rarani
Keyword(s):  
Decision Making ◽  
Education Research ◽  
Health Services ◽  
Human Resources ◽  
Health System ◽  
Informed Decision ◽  
Policy Implications ◽  
Informed Decision Making ◽  
Scientific Authority ◽  
Resource Generation

Resource generation in health system provides mechanisms for training efficient and effective workforce and supplies facilities and equipment for delivering health services. Iran’s Health Transformation Plan is one of the major reforms implemented in 2014 designed to realize the scientific authority of the country among the countries in the region in horizon 2025 (Solar Year 1404). Therefore, the state of function of resource generation in the areas of education, research, and infrastructure suitable for provision of health services may provide valuable policy implications for informed decision-making. Therefore, the status of resource generation in the areas of education, research and infrastructure (focusing on human resources and medicine as two expensive and effective drivers) from the lens of productivity and equity can provide invaluable policy implications for informed decision-making. The function of resource generation in the three areas of education, research, and infrastructures of human resources and medicine in health system encounters many challenges in terms of productivity and equity. In this perspective paper, besides assessing these challenges in the light of available research evidence, it has been tried to identify these and aimed to suggest several policy recommendations in these areas for improving evidence-based policymaking. 

scholarly journals The National Collaborating Centre for Methods and Tools (NCCMT): Supporting evidence-informed decision-making in public health in Canada

2021 ◽  
Vol 47 (56) ◽  
pp. 292-296
Author(s):  
Heather Husson ◽  
Claire Howarth ◽  
Sarah Neil-Sztramko ◽  
Maureen Dobbins
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Informed Decision ◽  
Decision Makers ◽  
Supporting Evidence ◽  
Informed Decision Making ◽  
Public Health Response ◽  
The Public ◽  
Public Health Infrastructure ◽  
Health Response

The National Collaborating Centre for Methods and Tools (NCCMT) is part of a network of six National Collaborating Centres for Public Health (NCC) created in 2005 by the federal government following the severe acute respiratory syndrome (SARS) epidemic to strengthen public health infrastructure in Canada. The work of the NCCMT, to support evidence-informed decision-making (EIDM) in public health in Canada, is accomplished by curating trustworthy evidence, building competence to use evidence and accelerating change in EIDM. Ongoing engagement with its target audiences ensures NCCMT’s relevance and ability to respond to evolving public health needs. This has been particularly critical during the coronavirus disease 2019 (COVID-19) pandemic, which saw NCCMT pivot its activities to support the public health response by conducting rapid reviews on priority questions identified by decision-makers from federal to local levels as well as create and maintain a national repository of in-progress or completed syntheses. These efforts, along with partnering with the COVID-19 Evidence Network to support Decision-Making (COVID-END), sought to reduce duplication, increase coordination of synthesis efforts and support decision-makers to use the best available evidence in decision-making. Data from website statistics illustrate the successful uptake of these initiatives across Canada and internationally.

scholarly journals What supports do health system organizations have in place to facilitate evidence-informed decision-making? a qualitative study

2013 ◽  
Vol 8 (1) ◽  
Author(s):  
Moriah E Ellen ◽  
Gregory Léon ◽  
Gisèle Bouchard ◽  
John N Lavis ◽  
Mathieu Ouimet ◽  
...  
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Health System ◽  
Informed Decision ◽  
Informed Decision Making

scholarly journals PEAC Events: identification of Predictable, Expensive, Avoidable, and Cardinal events within a learning health system.

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
David Whyatt ◽  
Matthew Yap ◽  
Matthew Tuson ◽  
Mei Ruu Kok ◽  
Berwin Turlach ◽  
...  
Keyword(s):  
Mental Health ◽  
Service Delivery ◽  
Health System ◽  
Targeted Delivery ◽  
Hospital Admissions ◽  
Research Policy ◽  
Access To Health Services ◽  
Policy And Practice ◽  
Learning Health System ◽  
The Impact

ABSTRACT ObjectivesThe objectives of this project are to identify patients that can be recruited into specific interventions and the optimisation of the delivery of such interventions, in order to improve access to health services, equity of service delivery, and patient outcomes.ApproachThe entire linked Western Australian Data Collections from 2002-2015 (including population-wide hospital admissions, emergency department presentations, cancer registry records, mental health care, maternity records, and mortality records) were examined. To identify patients at risk, a definition of a ‘PEAC’ event was developed. This acronym reflects the following criteria for such events. First, the event should ‘predictable’, i.e. either able to be easily predicted, or able to predict subsequent poor patient outcomes (for example, death). Second, the event should be ‘expensive’, i.e. be associated with significantly increased levels of individual healthcare utilisation and/or mortality. Third, the impact of the event should be ‘avoidable’, i.e. an evidence-based intervention should exist that may delay or completely avoid the event, or reduce its sequelae. Fourth, the event should be ‘cardinal’, which in this context indicates that the event should be clearly and unambiguously defined and recognisable, and specific enough to assign an effective intervention. Once PEAC events were identified, geospatial and predictive modelling of future events were then used to inform clinical service delivery, alongside appropriate return-on-investment analysis to support intervention. Finally, the entire process was embedded within a learning health system, linking research, policy, and practice, to drive ongoing improvement.ResultsExemplar PEAC events will be described, including hospital admission events associated with chronic disease, mental health, and dental/oral health. The predictability of such events in individuals using statistical models fitted to the available administrative datasets will be presented, along with the sequelae of such events in terms of healthcare use and mortality. The optimisation of delivering interventions targeting PEAC events will be described, along with the process of translating findings into policy and practice within the context of a learning health system.ConclusionThe identification of PEAC events allows for targeted delivery of healthcare interventions in a manner that not only optimises access, equity, and outcomes, but also permits ongoing improvement of the health system.

scholarly journals Going Beyond Panaceas: The Diversity of Land Observatory Forms in Africa

Land ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. 70 ◽  
Author(s):  
Quentin Grislain ◽  
Jeremy Bourgoin ◽  
Ward Anseeuw ◽  
Perrine Burnod ◽  
Eva Hershaw ◽  
...  
Keyword(s):  
Decision Making ◽  
Participant Observation ◽  
Video Conferencing ◽  
Analytical Framework ◽  
Informed Decision ◽  
Informed Decision Making ◽  
Information Production ◽  
Dynamic Data ◽  
Ex Post ◽  
Ex Ante

In recent decades, mechanisms for observation and information production have proliferated in an attempt to meet the growing needs of stakeholders to access dynamic data for the purposes of informed decision-making. In the land sector, a growing number of land observatories are producing data and ensuring its transparency. We hypothesize that these structures are being developed in response to the need for information and knowledge, a need that is being driven by the scale and diversity of land issues. Based on the results of a study conducted on land observatories in Africa, this paper presents existing and past land observatories on the continent and proposes to assess their diversity through an analysis of core dimensions identified in the literature. The analytical framework was implemented through i) an analysis of existing literature on land observatories, ii) detailed assessments of land observatories based on semi-open interviews conducted via video conferencing, iii) fieldwork and visits to several observatories, and iv) participant observation through direct engagement and work at land observatories. We emphasize that the analytical framework presented here can be used as a tool by land observatories to undertake ex-post self-evaluations that take the observatory’s trajectory into account, or in the case of proposed new land observatories, to undertake ex-ante analyses and design the pathway towards the intended observatory.

scholarly journals A referral aid for smoking cessation interventions in primary care: study protocol for a randomized controlled trial

2021 ◽  
Vol 22 ◽  
Author(s):  
Daniëlle N. Zijlstra ◽  
Jean W.M. Muris ◽  
Catherine Bolman ◽  
J. Mathis Elling ◽  
Vera E.R.A. Knapen ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Making ◽  
Smoking Cessation ◽  
Cost Effectiveness ◽  
Structural Equation ◽  
Controlled Trial ◽  
Linear Regression Analysis ◽  
Informed Decision ◽  
Equation Modeling ◽  
Informed Decision Making

Abstract Background: To expedite the use of evidence-based smoking cessation interventions (EBSCIs) in primary care and to thereby increase the number of successful quit attempts, a referral aid was developed. This aid aims to optimize the referral to and use of EBSCIs in primary care and to increase adherence to Dutch guidelines for smoking cessation. Methods: Practice nurses (PNs) will be randomly allocated to an experimental condition or control condition, and will then recruit smoking patients who show a willingness to quit smoking within six months. PNs allocated to the experimental condition will provide smoking cessation guidance in accordance with the referral aid. Patients from both conditions will receive questionnaires at baseline and after six months. Cessation effectiveness will be tested via multilevel logistic regression analyses. Multiple imputations as well as intention to treat analysis will be performed. Intervention appreciation and level of informed decision-making will be compared using analysis of (co)variance. Predictors for appreciation and informed decision-making will be assessed using multiple linear regression analysis and/or structural equation modeling. Finally, a cost-effectiveness study will be conducted. Discussion: This paper describes the study design for the development and evaluation of an information and decision tool to support PNs in their guidance of smoking patients and their referral to EBSCIs. The study aims to provide insight into the (cost) effectiveness of an intervention aimed at expediting the use of EBSCIs in primary care.

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