scholarly journals Implications and Recommendations From a Project ECHO Series on Aging With IDD

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 434-434
Author(s):  
Jenni Mathews ◽  
Faith Helm

Abstract Ongoing evaluations of innovative educational programs provide opportunities for quality improvement. This paper reports results from a Project ECHO series on lifelong IDD and dementia. Participant responses (n = 85) were collected from spoke sites in various settings across the US. Using a 5-point (5 very effective) Likert scale, data were collected from assessment items on 4 didactic presentations and 5 case studies representing essential components of the ECHO model. Overall scores by spoke sites for satisfaction with the didactic and case presentations ranged from 3.94 to 4.94; relevance of case studies to the work setting ranged from 4.0 to 4.75. Knowledge gain questions showed consistently positive directionality. As a result of their participation, spokes rated intent to provide better care for patients (57% to 88%), train staff (62% to 81%), and educate family/caregivers (57% to 88%). Implications of findings for the application of quality improvement methods are discussed.

Author(s):  
Louçã Francisco ◽  
Ash Michael

Chapter 7 describes the origins of the Chicago School and its successful projection into the hearts and minds of the global ruling class. Working chronologically, there is a description of how this program took root in Chicago and how some of its central figures, Friedman and Harberger, undertook a hemispheric campaign to capture both academic and government institutions. A history of the deregulation movement in the US and case studies of Mexico, Chile, Argentina, and Brazil highlight the breadth and depth of the campaign. The chapter closes in Europe where the neoliberal insurgency faced more-developed social states. Its success varied in Britain, France, and Germany.


2021 ◽  
Vol 34 (1) ◽  
Author(s):  
Greta Kaluzeviciute

AbstractSystematic case studies are often placed at the low end of evidence-based practice (EBP) due to lack of critical appraisal. This paper seeks to attend to this research gap by introducing a novel Case Study Evaluation-tool (CaSE). First, issues around knowledge generation and validity are assessed in both EBP and practice-based evidence (PBE) paradigms. Although systematic case studies are more aligned with PBE paradigm, the paper argues for a complimentary, third way approach between the two paradigms and their ‘exemplary’ methodologies: case studies and randomised controlled trials (RCTs). Second, the paper argues that all forms of research can produce ‘valid evidence’ but the validity itself needs to be assessed against each specific research method and purpose. Existing appraisal tools for qualitative research (JBI, CASP, ETQS) are shown to have limited relevance for the appraisal of systematic case studies through a comparative tool assessment. Third, the paper develops purpose-oriented evaluation criteria for systematic case studies through CaSE Checklist for Essential Components in Systematic Case Studies and CaSE Purpose-based Evaluative Framework for Systematic Case Studies. The checklist approach aids reviewers in assessing the presence or absence of essential case study components (internal validity). The framework approach aims to assess the effectiveness of each case against its set out research objectives and aims (external validity), based on different systematic case study purposes in psychotherapy. Finally, the paper demonstrates the application of the tool with a case example and notes further research trajectories for the development of CaSE tool.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 681-681
Author(s):  
Regina Shih

Abstract The prevalence of caregiving for an adult or child with special needs has increased significantly in the past five years (from 18.2% to over 21.3%), driven by an increase in the prevalence of caring for a family member or friend aged 50 and older. At the same time, care recipients have greater health and functional needs that necessitate care from others in comparison to 2015. These new 2020 data from the Caregiving in the US Survey by the National Alliance for Caregiving suggests that not only are more American adults taking on the role of caregiver, but they are doing so for increasingly complex care situations. This paper addresses the prevalence of caregiving including the demographics of family caregivers, relationship between the caregiver and the care recipient, health conditions of the care recipient, and living situations of care recipients and their caregivers.


2021 ◽  
Vol 10 (2) ◽  
pp. e000839
Author(s):  
Heather Cassie ◽  
Vinay Mistry ◽  
Laura Beaton ◽  
Irene Black ◽  
Janet E Clarkson ◽  
...  

ObjectivesEnsuring that healthcare is patient-centred, safe and harm free is the cornerstone of the NHS. The Scottish Patient Safety Programme (SPSP) is a national initiative to support the provision of safe, high-quality care. SPSP promotes a coordinated approach to quality improvement (QI) in primary care by providing evidence-based methods, such as the Institute for Healthcare Improvement’s Breakthrough Series Collaborative methodology. These methods are relatively untested within dentistry. The aim of this study was to evaluate the impact to inform the development and implementation of improvement collaboratives as a means for QI in primary care dentistry.DesignA multimethod study underpinned by the Theoretical Domains Framework and the Kirkpatrick model. Quantitative data were collected using baseline and follow-up questionnaires, designed to explore beliefs and behaviours towards improving quality in practice. Qualitative data were gathered using interviews with dental team members and practice-based case studies.ResultsOne hundred and eleven dental team members completed the baseline questionnaire. Follow-up questionnaires were returned by 79 team members. Twelve practices, including two case studies, participated in evaluation interviews. Findings identified positive beliefs and increased knowledge and skills towards QI, as well as increased confidence about using QI methodologies in practice. Barriers included time, poor patient and team engagement, communication and leadership. Facilitators included team working, clear roles, strong leadership, training, peer support and visible benefits. Participants’ knowledge and skills were identified as an area for improvement.ConclusionsFindings demonstrate increased knowledge, skills and confidence in relation to QI methodology and highlight areas for improvement. This is an example of partnership working between the Scottish Government and NHSScotland towards a shared ambition to provide safe care to every patient. More work is required to evaluate the sustainability and transferability of improvement collaboratives as a means for QI in dentistry and wider primary care.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 690-690
Author(s):  
Erin Kent

Abstract In 2020, ~1.8 million Americans are expected to be newly diagnosed with cancer, with approximately 70% of cases diagnosed over the age of 65. Cancer can have a ripple effect, impacting not just patients themselves, but their family caregivers. This presentation will provide an overview of the estimates of the number of family caregivers caring for individuals with cancer in the US, focusing on older patients, from several population-based data sources: Caregiving in the US 2020, the Health Information National Trends Survey (HINTS, 2017-2019), the Behavioral Risk Factors Surveillance System (BRFSS, 2015-2019), and the National Health and Aging Trends (NHATS) Survey. The presentation will compare features of the data sources to give a comprehensive picture of the state of cancer caregiving. In addition, the presentation will highlight what is known about the experiences of cancer caregivers, including caregiving characteristics, burden, unmet needs, and ideas for improving support for family caregivers.


2020 ◽  
Vol 12 (11) ◽  
pp. 4563
Author(s):  
Sangpil Ko ◽  
Pasi Lautala ◽  
Kuilin Zhang

Rail car availability and the challenges associated with the seasonal dynamics of log movements have received growing attentions in the Lake Superior region of the US, as a portion of rail car fleet is close to reaching the end of its service life. This paper proposes a data-driven study on the rail car peaking issue to explore the fleet of rail cars dedicated to being used for log movements in the region, and to evaluate how the number of cars affects both the storage need at the sidings and the time the cars are idled. This study is based on the actual log scale data collected from a group of forest companies in cooperation with the Lake State Shippers Association (LSSA). The results of our analysis revealed that moving the current log volumes in the region would require approximately 400–600 dedicated and shared log cars in ideal conditions, depending on the specific month. While the higher fleet size could move the logs as they arrive to the siding, the lower end would nearly eliminate the idling of rail cars and enable stable volumes throughout the year. However, this would require short-term storage and additional handling of logs at the siding, both elements that increase the costs for shippers. Another interesting observation was the fact that the reduction of a single day in the loading/unloading process (2.5 to 1.5 days) would eliminate almost 100 cars (20%) of the fleet without reduction in throughput.


Healthcare ◽  
2021 ◽  
Vol 8 ◽  
pp. 100432
Author(s):  
Leah Tuzzio ◽  
Catherine M. Meyers ◽  
Laura M. Dember ◽  
Corita R. Grudzen ◽  
Edward R. Melnick ◽  
...  

2020 ◽  
Vol 41 (S1) ◽  
pp. s41-s42
Author(s):  
Martin Evans ◽  
Rajiha Abubeker ◽  
Surafel Fentaw Dinku ◽  
Thuria Adem ◽  
Abera Abdeta ◽  
...  

Background: In July 2017, recognizing the threat that antimicrobial resistance poses to the population, the Ethiopian Public Health Institute (EPHI) launched the Ethiopia AMR Surveillance Network at 4 sentinel laboratories. Simultaneously, laboratory capacity building was initiated to ensure the reporting of quality laboratory data to the surveillance system. One initiative, Project ECHO (Extension for Community Healthcare Outcomes) was used to virtually connect subject matter experts with participating laboratories in remote settings to provide ongoing education and telementoring and to foster peer-to-peer learning and problem solving in microbiology. The 10-month project was supported by the Centers for Disease Control and Prevention (CDC) and the American Society for Microbiology (ASM).Methods: Biweekly 1-hour sessions were held by ASM for 2 sentinel sites, Tikur Anbessa Specialized Hospital and the EPHI Clinical Microbiology and Mycology Laboratory, using a videoconferencing platform. Each virtual session consisted of a didactic session, a case presentation by a participating laboratory, open discussion and feedback. Case presentations focused on technical challenges and problems encountered in the preanalytical, analytical, and postanalytical phases of microbiology testing. Experts from CDC and ASM provided feedback along with a summation of key learning objectives. Sessions were recorded and post session reports were shared with participants. To assess participants’ baseline knowledge, a comprehensive pretest was administered prior to the first session. The same instrument was administered as a posttest 2 weeks after the final session. Unstructured interviews were also conducted to assess participants’ perceptions of the value of ECHO to their work. Results: Mean pretest scores were 69.25% and the posttest scores were 71.04%, a difference of 1.79% (P = NS). Participant interviews revealed perceived benefits of ECHO participation to include enhanced critical thinking and problem resolution in microbiology, increased communication and improved working relationships between participating sites, and improved understanding and application of CLSI standards. As a result of Ethiopia’s participation in Project ECHO, 23 case presentations have been added to ECHO Box, a resource bank and web portal, which allows members of the ECHO community to share and access didactics, documents, and learning materials. Conclusions: Despite minimal difference between pretest and posttest scores, the Project ECHO experience of virtual case-based learning and collaborative problem solving has encouraged critical thinking, peer-to-peer learning, networking among participants, and has provided microbiologists with the resources for improved bacterial isolation, identification, and antibiotic susceptibility testing. The lessons learned could be applied as this project is expanded to additional laboratories in the AMR Surveillance Network.Funding: NoneDisclosures: None


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