scholarly journals 82 This is My Child: Piloting and Evaluating a Special Needs Screening Tool for Pediatric Emergency

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e34-e34
Author(s):  
William Craig ◽  
Christopher Kilmer ◽  
David Nicholas ◽  
Mandi Newton ◽  
Lonnie Zwaigenbaum
Keyword(s):  
Focus Groups ◽  
Special Needs ◽  
Healthcare Providers ◽  
Pediatric Emergency ◽  
Health Care Team ◽  
Autism Spectrum ◽  
Ease Of Use ◽  
Healthcare Team ◽  
Waiting Room ◽  
Provider Perspectives

Abstract Background Parents of children with developmental disabilities (DD) including autism spectrum disorder (ASD) or behavioural conditions can be reluctant to inform the medical team of their child’s diagnosis during a visit to the pediatric Emergency Department (PED). Knowing the child’s sensitivities and needs, however, could make it easier for the healthcare team to provide the best possible care. A one-page tool, “This is My Child”, was developed to bridge this gap. Objectives Evaluate the ease of use, benefit to child’s care, and overall acceptance of “This is My Child” from parental and health provider perspectives. Design/Methods “This is My Child” was modified from an inpatient tool which helped communication between staff and children with ASD and their families. Developed with input from PED healthcare providers, the tool entailed ten questions pertinent to children who have communication and sensory processing challenges, as well as a prompt for additional comments. Families were recruited in the waiting room, and the study was open to all who were willing to participate. The completed tool was attached to the front of the ED chart prior to the child being seen. At the end of the ED visit, parents and treating healthcare providers completed a questionnaire evaluating the tool. Recruitment was deemed complete once 30 children with a prior diagnosis of a developmental/behavioural condition had been enrolled. Following analysis of the questionnaires, focus groups were held with participating ED healthcare providers. Results Of 336 study participants recruited, 199 parents, 225 physicians and 135 nurses returned questionnaires. The large majority of parents, physicians and nurses indicated ‘Strongly or Somewhat Agreed’ that the tool was easy to understand. However, only 18% of physicians and 29% of nurses, yet 76% of parents, felt that the tool should be used for all children seen in the PED. This discrepancy between health care team and parental opinion was explored in the focus groups. Healthcare providers noted that the tool was beneficial in cases where unique developmental needs were reported. Concern was raised given the tool’s perceived lack of relevance for children without special needs, as well as additional staff work for tool utilization. Conclusion This easy to use form was welcomed by families, but less so by physicians. Work is ongoing to integrate these perspectives.

Parent and health care provider perspectives related to disclosure of autism spectrum disorder in pediatric emergency departments

Autism ◽  
2016 ◽  
Vol 20 (8) ◽  
pp. 986-994 ◽  
Author(s):  
Barbara Muskat ◽  
Andrea Greenblatt ◽  
David B Nicholas ◽  
Savithiri Ratnapalan ◽  
Justine Cohen-Silver ◽  
...  
Keyword(s):  
Health Care ◽  
Autism Spectrum Disorder ◽  
Health Care Provider ◽  
Care Provider ◽  
Emergency Departments ◽  
Pediatric Emergency ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Provider Perspectives

scholarly journals Adaptation of a mobile health platform to the needs of cystic fibrosis patients, caregivers, and clinicians in the United States (Preprint)

2020 ◽  
Author(s):  
Sarah B. Rutland ◽  
Rikard Palmer Bergquist ◽  
Andreas Hager ◽  
Robin Geurs ◽  
Cathy Mims ◽  
...  
Keyword(s):  
United States ◽  
Cystic Fibrosis ◽  
Focus Groups ◽  
Mobile Health ◽  
Healthcare Providers ◽  
The United States ◽  
Standards Of Care ◽  
Healthcare Team ◽  
Daily Care ◽  
Clinic Visits

BACKGROUND Cystic fibrosis (CF) is an inherited chronic condition that requires extensive daily care and quarterly clinic visits with a multidisciplinary care team. The limited exchange of information outside of the quarterly clinic visits impedes optimal disease self-management, patient engagement, and shared decision-making. OBJECTIVE This study adapted a mobile health (mHealth) application originally developed in Sweden to the needs of people with CF, their caregivers, and healthcare providers in the United States, and tested it as a platform for sharing patient-generated health data (PGHD) with the CF healthcare team. METHODS Focus groups with CF healthcare providers, adolescents with CF, and caregivers of children and adolescents with CF were conducted to determine what modifications were necessary. Focus group data were analyzed using a thematic analysis, and emergent themes were ranked according to desirability and technical feasibility. The mHealth platform was then modified to meet the identified needs and preferences, and the flow of PGHD to a secure REDCap database was tested. Protocols for data management and clinical follow-up were also developed. RESULTS Five focus groups with 21 participants were conducted. Recommended modifications pertained to all functionalities of the mHealth platform, including tracking of symptoms, treatments, and activities of daily care; creating and organizing medication lists and setting up reminders; generating reports for the healthcare team; language and presentation; sharing and privacy; as well as settings and accounts. Overall, healthcare providers recommended changes to align the mHealth platform with U.S. standards of care, people with CF and their caregivers requested to track more disease symptoms and clinical outcomes, and both groups suggested the inclusion of a mental health tracker as well as more detailed response options and precise language. Beta-testers of the modified platform reported issues related to translatability to U.S. environment and various bugs. CONCLUSIONS This study demonstrated the importance of identifying the needs and preferences of target users and stakeholders before adopting existing mHealth solutions. All relevant perspectives, including those of clinicians, patients, and caregivers, should be thoroughly considered in order to meet both end-user needs and evidence-based practice recommendations. CLINICALTRIAL NCT03910881

scholarly journals Using Multidisciplinary Focus Groups to Inform the Development of mI SMART: A Nurse-Led Technology Intervention for Multiple Chronic Conditions

2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Jennifer A. Mallow ◽  
Laurie A. Theeke ◽  
Elliott Theeke ◽  
Brian K. Mallow
Keyword(s):  
Focus Groups ◽  
Chronic Conditions ◽  
Healthcare Providers ◽  
Multiple Chronic Conditions ◽  
Healthcare Team ◽  
User Friendliness ◽  
Team Members ◽  
Outcomes Of Care ◽  
Care Technology ◽  
Improve Access

Used as integrated tools, technology may improve the ability of healthcare providers to improve access and outcomes of care. Little is known about healthcare teams’ preferences in using such technology. This paper reports the findings from focus groups aimed at evaluating a newly developed primary care technology platform. Focus groups were completed in academic, outpatient, and community settings. Focus groups were attended by 37 individuals. The participants included professionals from multiple disciplines. Both prescribing (N=8) and nonprescribing healthcare team members (n=21) completed the focus groups and survey. The majority were practicing for more than 20 years (44.8%) in an outpatient clinic (62%) for 20–40 hours per week (37.9%). Providers identified perceived obstacles of patient use as ability, willingness, and time. System obstacles were identified as lack of integration, lack of reimbursement, and cost. The positive attributes of the developed system were capability for virtual visits, readability, connectivity, user-friendliness, ability to capture biophysical measures, enhanced patient access, and incorporation of multiple technologies. Providers suggested increasing capability for biophysical and symptom monitoring for more common chronic conditions. Technology interventions have the potential to improve access and outcomes but will not be successful without the input of users.

scholarly journals ‘There isn’t a checklist in the world that’s got that on it’: Special needs teachers’ opinions on the assessment and teaching priorities of pupils on the autism spectrum

2020 ◽  
pp. 174462952097290
Author(s):  
Melanie Howell ◽  
Jill Bradshaw ◽  
Peter E Langdon
Keyword(s):  
Data Analysis ◽  
Focus Groups ◽  
Special Needs ◽  
Content Validity ◽  
Development Process ◽  
Autism Spectrum ◽  
Barriers To Learning ◽  
Assessment Development ◽  
The World ◽  
Teacher Assessments

Two focus groups were conducted with special needs teachers to: (a) identify barriers to learning for autistic pupils, (b) consider broad assessment domains and specific skills or behaviours which teachers consider important for these pupils, and (c) give their opinions on teacher assessments. Data analysis resulted in six main themes: (a) barriers to learning, (b) teacher priorities for autistic pupils, (c) ways of overcoming barriers, (d) the concept of ‘true mastery’, (e) assessing the bigger picture, and (f) practicalities of assessment. Results showed that teachers have priorities for the pupils they know well and concerns about the assessments they regularly use. To ensure face and content validity of teacher assessments, and for assessments to be useful to and valued by the teachers who use them, it is recommended that teachers have opportunities to input during various aspects of the assessment development process.

scholarly journals GAINING INTERPROFESSIONAL COMPETENCE THROUGH A GERIATRICS CASE CONFERENCE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S151-S151
Author(s):  
Amber S McIlwain ◽  
Danielle Backus ◽  
Kristine Marcus ◽  
Jeff Fortner
Keyword(s):  
Interprofessional Education ◽  
Healthcare Providers ◽  
Core Competency ◽  
Healthcare Team ◽  
Case Conference ◽  
Her Family ◽  
Centered Care ◽  
Geriatric Disorder ◽  
Positive Response Rate ◽  
Care Conference

Abstract There is increased demand to provide health professions students with interprofessional education and practice experience. Interprofessional Case Conferences (ICC) allow students to work in teams to learn about different professions while exploring a topic through the lens of an interprofessional core competency. The goal of this particular ICC was to provide students an experience to witness and discuss team-based, person-centered care for a common geriatric disorder. The case was designed to develop the interprofessional competency of teams and teamwork. Students were divided into teams and observed live vignettes of a care conference involving an 80-year old female admitted to a rehabilitation facility following a hip fracture and replacement. Students witnessed how patients, families, and healthcare providers work together during a stressful time. After each vignette, students discussed questions related to miscommunications, motivations of the different actors involved, and how the healthcare team should respond. In the first offering, 93 students participated, increasing to 150 in the next year. Students completed a post-survey to determine if the session delivered a positive interprofessional experience. The average positive response rate was 92.5% (92-94%, n = 53) in year-1 and 93.5% (90-97%, n = 71) in year-2. By allowing students to witness a simulated live care conference, they had a tangible event to dissect instead of discussing hypotheticals. By discussing a geriatrics case in a rehabilitation setting, students witnessed how numerous healthcare professions coordinate care for a patient and her family, thereby demonstrating competence in teamwork.

scholarly journals A75 IMPLEMENTING A CIRRHOSIS ORDER SET: A QUALITATIVE ANALYSIS OF PROVIDER-IDENTIFIED BARRIERS AND FACILITATORS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 41-42
Author(s):  
E Johnson ◽  
M Carbonneau ◽  
D Campbell-Scherer ◽  
P Tandon ◽  
A Hyde
Keyword(s):  
Focus Groups ◽  
Gastrointestinal Disease ◽  
Pragmatic Trial ◽  
Healthcare Providers ◽  
Structured Interview ◽  
Barriers And Facilitators ◽  
Care Utilization ◽  
Implementation Barriers ◽  
Mortality And Morbidity ◽  
Order Set

Abstract Background Cirrhosis is the leading cause of mortality and morbidity in individuals with gastrointestinal disease. Multiple care gaps exist for hospitalized patients with cirrhosis, resulting in high rates of re-hospitalization (e.g. 44% at 90 days in Alberta). The Cirrhosis Care Alberta (CCAB) is a 4-year multi-component pragmatic trial with an aim to reduce acute-care utilization by implementing an electronic order set and supporting education across eight hospital sites in Alberta. Aims As part of the pre-implementation evaluation, this qualitative study analyzed data from provider focus groups to identify barriers and facilitators to implementation. Methods We conducted focus groups at eight hospital sites with a total of 54 healthcare providers (3–12 per site). A semi-structured interview guide based upon constructs of the Consolidated Framework for Implementation Research (CFIR) and Normalization Process Theory (NPT) frameworks was used to guide the focus groups. Focus groups were recorded and transcribed verbatim. Data was analyzed thematically and inductively. Results Five major themes emerged across all eight sites: (i) understanding past implementation experiences, (ii) resource challenges, (iii) competing priorities among healthcare providers, (iv) system challenges, and (v) urban versus rural differences. Site-specific barriers included perceived lack of patient flow, time restraints, and concerns about the quality and quantity of past implementation interventions. Facilitators included passionate project champions, and an ample feedback process. Conclusions Focus groups were useful for identifying pre-implementation barriers and facilitators of an electronic orders set. Findings from this study are being refined to address the influence of COVID-19, and the data will be used to inform the intervention roll-out at each of the sites. Funding Agencies Alberta Innovates

scholarly journals Facilitators and barriers to the utilization of the ACT SMART Implementation Toolkit in community-based organizations: a qualitative study

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Aksheya Sridhar ◽  
Amy Drahota ◽  
Kiersten Walsworth
Keyword(s):  
Technology Acceptance ◽  
Technology Acceptance Model ◽  
Autism Spectrum ◽  
Ease Of Use ◽  
Science Literature ◽  
Community Based ◽  
Web Based ◽  
Community Based Organizations ◽  
Facilitators And Barriers ◽  
Acceptance Model

Abstract Background Evidence-based practices (EBPs) have been shown to improve behavioral and mental health outcomes for children diagnosed with autism spectrum disorder (ASD). Research suggests that the use of these practices in community-based organizations is varied; however, the utilization of implementation guides may bridge the gap between research and practice. The Autism Community Toolkit: Systems to Measure and Adopt Research-Based Treatments (ACT SMART) Implementation Toolkit is a web-based implementation toolkit developed to guide organization-based implementation teams through EBP identification, adoption, implementation, and sustainment in ASD community-based organizations. Methods This study examined the facilitators and barriers (collectively termed “determinants”) to the utilization of this toolkit, based on the perspectives of implementation teams at six ASD community-based organizations. Two independent coders utilized the adapted EPIS framework and the Technology Acceptance Model 3 to guide qualitative thematic analyses of semi-structured interviews with implementation teams. Results Salient facilitators (e.g., facilitation teams, facilitation meetings, phase-specific activities) and barriers (e.g., website issues, perceived lack of ease of use of the website, perceived lack of resources, inner context factors) were identified, highlighting key determinants to the utilization of this toolkit. Additionally, frequent determinants and determinants that differed across adapted EPIS phases of the toolkit were noted. Finally, analyses highlighted two themes: (a) Inner Context Determinants to use of the toolkit (e.g., funding) and (b) Innovation Determinants (e.g., all website-related factors), indicating an interaction between the two models utilized to guide study analyses. Conclusions Findings highlighted several factors that facilitated the utilization of this implementation guide. Additionally, findings identified key areas for improvement for future iterations of the ACT SMART Implementation Toolkit. Importantly, these results may inform the development, refinement, and utilization of implementation guides with the aim of increasing the uptake of EBPs in community-based organizations providing services to children with ASD and their families. Finally, these findings contribute to the implementation science literature by illustrating the joint use of the EPIS framework and Technology Acceptance Model 3 to evaluate the implementation of a web-based toolkit within community-based organizations.

scholarly journals Connected diagnostics to improve accurate diagnosis, treatment, and conditional payment of malaria services in Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shannen M. C. van Duijn ◽  
Angela K. Siteyi ◽  
Sherzel Smith ◽  
Emmanuel Milimo ◽  
Leon Stijvers ◽  
...  
Keyword(s):  
Clinical Performance ◽  
Healthcare Providers ◽  
Malaria Treatment ◽  
Sub Saharan Africa ◽  
Structured Interviews ◽  
National Guidelines ◽  
Private Providers ◽  
Provider Perspectives ◽  
Treatment Data ◽  
Sub Saharan

Abstract Background In sub-Saharan Africa, the material and human capacity to diagnose patients reporting with fever to healthcare providers is largely insufficient. Febrile patients are typically treated presumptively with antimalarials and/or antibiotics. Such over-prescription can lead to drug resistance and involves unnecessary costs to the health system. International funding for malaria is currently not sufficient to control malaria. Transition to domestic funding is challenged by UHC efforts and recent COVID-19 outbreak. Herewith we present a digital approach to improve efficiencies in diagnosis and treatment of malaria in endemic Kisumu, Kenya: Connected Diagnostics. The objective of this study is to evaluate the feasibility, user experience and clinical performance of this approach in Kisumu. Methods Our intervention was performed Oct 2017–Dec 2018 across five private providers in Kisumu. Patients were enrolled on M-TIBA platform, diagnostic test results digitized, and only positive patients were digitally entitled to malaria treatment. Data on socio-demographics, healthcare transactions and medical outcomes were analysed using standard descriptive quantitative statistics. Provider perspectives were gathered by 19 semi-structured interviews. Results In total 11,689 febrile patients were digitally tested through five private providers. Malaria positivity ranged from 7.4 to 30.2% between providers, significantly more amongst the poor (p < 0.05). Prescription of antimalarials was substantially aberrant from National Guidelines, with 28% over-prescription (4.6–63.3% per provider) and prescription of branded versus generic antimalarials differing amongst facilities and correlating with the socioeconomic status of clients. Challenges were encountered transitioning from microscopy to RDT. Conclusion We provide full proof-of-concept of innovative Connected Diagnostics to use digitized malaria diagnostics to earmark digital entitlements for correct malaria treatment of patients. This approach has large cost-saving and quality improvement potential.

scholarly journals The Oral Health Inequities between Special Needs Children and Normal Children in Asia: A Systematic Review and Meta-Analysis

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 410
Author(s):  
Valendriyani Ningrum ◽  
Abu Bakar ◽  
Tzong-Ming Shieh ◽  
Yin-Hwa Shih
Keyword(s):  
Oral Health ◽  
Special Needs ◽  
Meta Analysis ◽  
Autism Spectrum ◽  
Permanent Teeth ◽  
Cochrane Library ◽  
Special Needs Children ◽  
Normal Children ◽  
Children’S Oral Health ◽  
Care System

This meta-analysis aimed to analyze the oral health inequalities among special needs children during 2004–2019 in Asia to reveal the importance and the needs of establishing integrated and equitable special needs dentistry care system in Indonesia. PubMed, Scopus, Cochrane Library, Web of Science, and Wiley Online Library were systematically searched for full-text observational studies published from 1 January 2004 to 15 January 2020, in English in Asia. Studies that included children under 18 years of age with special needs and compared them to healthy controls were selected. Study quality was assessed using the Joanna Briggs Institute 2017 Critical Appraisal Checklist. Risk of bias was assessed using the ROBINS-E tool. The decayed, missing, and filled permanent teeth (DMFT) index indicated that special needs children who suffer from intellectual disability or autism spectrum disorder had significantly more caries than normal children (p < 0.001). The special needs children who had more caries than normal children lived in countries that had a high average DMFT value among 12 years old children (p < 0.001), and these two variables showed a positive correlation in meta-regression analysis (p < 0.001). Having an integrated and equitable care system and elevating children’s oral health are important to maintain special needs children’s oral health.

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