Quality of patient, family, caregiver and public engagement in decision-making in healthcare systems: a scoping review protocol

IntroductionTo advance person- and family-centred healthcare, government initiatives have supported the engagement of patients and family caregivers in decision-making in healthcare systems. There is, however, no consensus on how to define success for such initiatives. This scoping review aims to identify the key elements for defining the quality of patient and family caregiver engagement in decision-making across the engagement domains (individual, community/organisation, system) of British Columbia’s healthcare system. We will use those elements to develop a conceptual evaluation framework.Methods and analysisThis scoping review follows Arskey and O’Malley’s methodology. (1) The research question was identified through team discussions. (2) Articles for data source will be identified using a librarian-informed search strategy for seven bibliographic databases as well as grey literature sources. (3) Selected articles will be relevant to the evaluation of patient and family caregiver engagement in healthcare systems. (4) Two researchers will independently extract data into predefined and emerging categories. (5) The researchers will reconcile and organise the identified elements. The research team’s collective perspective will then refine the elements, and select, interpret and summarise the results. (6) Persons from key stakeholder groups will be consulted to refine the emergent conceptual framework.Ethics and disseminationWe will seek ethics approval for the stakeholder consultation. This study follows an integrated knowledge translation approach. The results will inform evaluation of the Patients as Partners Initiative of the British Columbia Ministry of Health, and will be disseminated as a scientific article, a research brief, and presentations at conferences and stakeholder meetings.

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Psychosocial and quality of life impact of scars in the surgical, traumatic and burn populations: a scoping review protocol

BMJ Open ◽

10.1136/bmjopen-2017-021289 ◽

2019 ◽

Vol 9 (6) ◽

pp. e021289

Author(s):

Natalia Ziolkowski ◽

Simon C Kitto ◽

Dahn Jeong ◽

Jennifer Zuccaro ◽

Thomasin Adams-Webber ◽

...

Keyword(s):

Quality Of Life ◽

Scoping Review ◽

Research Question ◽

Grey Literature ◽

Psychosocial Health ◽

Emotional Disturbances ◽

Study Selection ◽

Life Impact ◽

Methodological Considerations

IntroductionDespite the fact that millions of scars affect individuals annually, little is known about their psychosocial impact and overall quality of life (QOL) on individuals. Scars from multiple aetiologies may cause psychiatric and emotional disturbances, can limit physical functioning and increase costs to the healthcare system. The purpose of this protocol is to describe the methodological considerations that will guide the completion of a scoping review that will summarise the extent, range and nature of psychosocial health outcomes and QOL of scars of all aetiologies.Methods and analysisA modified Arksey and O’Malley (2005) framework will be completed, namely having ongoing consultation between experts from the beginning of the process, then (1) identifying the research question/s, (2) identifying the relevant studies from electronic databases and grey literature, with (3) study selection and (4) charting of data by two independent coders, and (5) collating, summarising and reporting data. Experts will include a health information specialist (TAW), scar expert (JSF), scoping review consultant (SCK), as well as at least two independent coders (NZ, AM).Ethics and disseminationEthics approval will not be sought for this scoping review. We plan to disseminate this research through publications, presentations and meetings with relevant stakeholders.

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Themes for evaluating the quality of initiatives to engage patients and family caregivers in decision-making in healthcare systems: a scoping review

BMJ Open ◽

10.1136/bmjopen-2021-050208 ◽

2021 ◽

Vol 11 (10) ◽

pp. e050208

Author(s):

Clayon B Hamilton ◽

Maryam Dehnadi ◽

M Elizabeth Snow ◽

Nancy Clark ◽

Michelle Lui ◽

...

Keyword(s):

Decision Making ◽

Family Caregivers ◽

Scoping Review ◽

Healthcare Quality ◽

Healthcare Systems ◽

Decision Making Process ◽

Journal Articles ◽

Rich Description ◽

Literature Reviews

ObjectiveTo 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.MethodsWe 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.ResultsOf 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.ConclusionsThe 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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Quality indicators for clinical care of patients with hypertension: scoping review protocol

BMJ Open ◽

10.1136/bmjopen-2018-026167 ◽

2019 ◽

Vol 9 (7) ◽

pp. e026167

Author(s):

Hanevi Djasri ◽

Sekar Laras ◽

Adi Utarini

Keyword(s):

Quality Indicators ◽

Scoping Review ◽

Medical Information ◽

Clinical Care ◽

Research Question ◽

Grey Literature ◽

Healthcare Research ◽

Health Coverage ◽

Medical Subject Headings

IntroductionCardiovascular diseases impose significant financial impact on countries implementing universal health coverage (UHC). Hypertension is a primary disease that will lead to more severe conditions without adequate clinical care. The quality of its clinical care must be well assessed in order to measure the effective coverage of people with hypertension in UHC. This study aims to identify indicators that can be used to measure the quality of clinical care provided to patients with hypertension in healthcare facilities.Methods and analysisThis review will be conducted using the six stages of the scoping review method: identifying the research question, searching for relevant studies, selecting studies, charting the data, collating, summarising and reporting the results, and conducting consultation exercises. The review will include all quality indicators used for clinical care of patients with hypertension at any healthcare facility. All research designs will be included. Search strategies are developed using the medical subject headings and keywords related to hypertension and quality indicators. Several electronic databases, that is, MEDLINE, Cochrane, Scopus and Web of Science, including clinical-guideline databases from Agency for Healthcare Research and Quality, National Institute for Health and Care Excellence, National Health Service Evidence and Medical Information Network Distribution Service, and also grey literature will be used. Two researchers will screen the titles and abstracts and review the full text of selected articles to determine the final inclusion. The results will be summarised quantitatively, using numerical counts, and qualitatively, using thematic analysis. The data extraction will include a complete list and detailed profile of all indicators. Stakeholder consultation will be conducted at the beginning and after preliminary results to translate findings to the potential knowledge users.Ethical considerations and disseminationReviews of published articles are considered secondary analysis and do not need ethical approval. The findings will be disseminated through various strategies, such as policy briefs, conferences, peer-reviewed journals, and on selected websites relevant to the subject.Study statusData collection for the scoping review will include publications up to May 2019, and the analysis will start in June 2019.

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Group practice impacts on patients, physicians and healthcare systems: a scoping review

BMJ Open ◽

10.1136/bmjopen-2020-041579 ◽

2021 ◽

Vol 11 (1) ◽

pp. e041579

Author(s):

Terry Zwiep ◽

San (Hilalion) Ahn ◽

Jamie Brehaut ◽

Fady Balaa ◽

Daniel I McIsaac ◽

...

Keyword(s):

Interpersonal Relationships ◽

Scoping Review ◽

Research Question ◽

Descriptive Analysis ◽

Final Analysis ◽

Healthcare Systems ◽

Group Practice ◽

Advantages And Disadvantages ◽

Group Practices

ObjectiveTo identify the advantages and disadvantages that group practices have on patients, physicians and healthcare systems.Study designA scoping review was performed based on the methodology proposed by Arksey and O’Malley, and refined by Levac et al. Titles and abstracts were screened by two reviewers. A quantitative analysis was performed to assess the type, year and region of publication, as well as the population studied. A qualitative descriptive analysis was performed to identify common themes.Study settingMEDLINE, EMBASE and Cochrane databases were searched from database inception to October 2018 for papers which assessed outcomes relevant to the research question.ResultsOur search strategy returned 2408 papers and 98 were included in the final analysis. Most papers were from the USA, were surveys and assessed physician outcomes. Advantages of group practices for patients included improved satisfaction and quality of care. Studies of physicians reported improved quality of life and income, while disadvantages included increased stress due to poor interpersonal relationships. Studies of healthcare systems reported improved efficiency and better utilisation of resources.ConclusionsGroup practices have many benefits for patients and physicians. However, further work needs to be done assessing patient outcomes and establishing the elements that make a group practice successful.

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Mapping evidence of nurses’ attitudes toward older adults in Africa: a scoping review protocol

Systematic Reviews ◽

10.1186/s13643-021-01575-y ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Esther L. Wanko Keutchafo ◽

Jane Kerr ◽

Mary A. Jarvis ◽

Desmond Kuupiel

Keyword(s):

Older Adults ◽

Nursing Students ◽

Scoping Review ◽

Research Question ◽

Grey Literature ◽

Future Research ◽

African Countries ◽

Eligibility Criteria ◽

Students Attitudes

Abstract Background Culture influences nurses’ attitudes towards caring for older adults. Additionally, nursing students’ perceptions and attitudes towards older adults affect their behavior, possibly their career choices and/or the quality of care provided to older adults after graduation. In the context of lower–middle-income countries with a faster growing older adults population compared to upper income countries, the improvement of the quality care, inclusive of nurses’ attitudes towards older adults, is one of the strategies for strengthening nursing and midwifery in Africa. Furthermore, examining nurses and nursing students’ attitudes towards older adults will answer the United Nations’ call for more data to understand the needs and the status of older adults in Africa. Methods This scoping review will be guided by Arksey and O’Malley’s framework. The search will be performed using Scopus, PubMed databases, Academic search complete, CINAHL with full text, Education source, Health source: Nursing/Academic Edition, with words related to the topic. The reviewers will also use Google Scholar and the reference lists of the relevant articles. Primary studies and grey literature addressing the research question will be included. The search process will include a first stage where two reviewers will perform the title screening and the removal of duplicates, followed by a parallel abstract screening according to eligibility criteria. The second stage will involve the reading of full articles and the exclusion of articles, in accordance with the eligibility criteria. Data will be collated by two reviewers independently and parallel, using a predetermined data extraction form. Discrepancies will involve a third reviewer. The Mixed Methods Appraisal Tool, version 2018 will be used to assess the quality of the data of eligible articles. A narrative approach containing summary tables and graphs will facilitate synthesis. Discussion The review will provide insight into nurses' and nursing students’ attitudes towards older adults in African countries. The outcomes will guide future research, practice, and education in nursing.

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A scoping review of registry captured indicators for evaluating quality of critical care in ICU

Journal of Intensive Care ◽

10.1186/s40560-021-00556-6 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Issrah Jawad ◽

Sumayyah Rashan ◽

Chathurani Sigera ◽

Jorge Salluh ◽

Arjen M. Dondorp ◽

...

Keyword(s):

Critical Care ◽

Scoping Review ◽

Health Care Quality ◽

Grey Literature ◽

Healthcare Providers ◽

Evidence Base ◽

Patient Reported Outcome ◽

Care Quality ◽

Patient Reported

Abstract Background Excess morbidity and mortality following critical illness is increasingly attributed to potentially avoidable complications occurring as a result of complex ICU management (Berenholtz et al., J Crit Care 17:1-2, 2002; De Vos et al., J Crit Care 22:267-74, 2007; Zimmerman J Crit Care 1:12-5, 2002). Routine measurement of quality indicators (QIs) through an Electronic Health Record (EHR) or registries are increasingly used to benchmark care and evaluate improvement interventions. However, existing indicators of quality for intensive care are derived almost exclusively from relatively narrow subsets of ICU patients from high-income healthcare systems. The aim of this scoping review is to systematically review the literature on QIs for evaluating critical care, identify QIs, map their definitions, evidence base, and describe the variances in measurement, and both the reported advantages and challenges of implementation. Method We searched MEDLINE, EMBASE, CINAHL, and the Cochrane libraries from the earliest available date through to January 2019. To increase the sensitivity of the search, grey literature and reference lists were reviewed. Minimum inclusion criteria were a description of one or more QIs designed to evaluate care for patients in ICU captured through a registry platform or EHR adapted for quality of care surveillance. Results The search identified 4780 citations. Review of abstracts led to retrieval of 276 full-text articles, of which 123 articles were accepted. Fifty-one unique QIs in ICU were classified using the three components of health care quality proposed by the High Quality Health Systems (HQSS) framework. Adverse events including hospital acquired infections (13.7%), hospital processes (54.9%), and outcomes (31.4%) were the most common QIs identified. Patient reported outcome QIs accounted for less than 6%. Barriers to the implementation of QIs were described in 35.7% of articles and divided into operational barriers (51%) and acceptability barriers (49%). Conclusions Despite the complexity and risk associated with ICU care, there are only a small number of operational indicators used. Future selection of QIs would benefit from a stakeholder-driven approach, whereby the values of patients and communities and the priorities for actionable improvement as perceived by healthcare providers are prioritized and include greater focus on measuring discriminable processes of care.

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Scoping review of mental health in prisons through the COVID-19 pandemic

BMJ Open ◽

10.1136/bmjopen-2020-046547 ◽

2021 ◽

Vol 11 (5) ◽

pp. e046547

Author(s):

Luke Johnson ◽

Kerry Gutridge ◽

Julie Parkes ◽

Anjana Roy ◽

Emma Plugge

Keyword(s):

Mental Health ◽

Scoping Review ◽

Grey Literature ◽

Well Being ◽

Health Impact ◽

Poor Quality ◽

Eligibility Criteria ◽

Prison Staff ◽

The Impact

ObjectiveTo examine the extent, nature and quality of literature on the impact of the COVID-19 pandemic on the mental health of imprisoned people and prison staff.DesignScoping review.Data sourcesPubMed, Embase, CINAHL, Global Health, Cochrane, PsycINFO, PsychExtra, Web of Science and Scopus were searched for any paper from 2019 onwards that focused on the mental health impact of COVID-19 on imprisoned people and prison staff. A grey literature search focused on international and government sources and professional bodies representing healthcare, public health and prison staff was also performed. We also performed hand searching of the reference lists of included studies.Eligibility criteria for selection of studiesAll papers, regardless of study design, were included if they examined the mental health of imprisoned people or prison staff specifically during the COVID-19 pandemic. Imprisoned people could be of any age and from any countries. All languages were included. Two independent reviewers quality assessed appropriate papers.ResultsOf 647 articles found, 83 were eligible for inclusion, the majority (58%) of which were opinion pieces. The articles focused on the challenges to prisoner mental health. Fear of COVID-19, the impact of isolation, discontinuation of prison visits and reduced mental health services were all likely to have an adverse effect on the mental well-being of imprisoned people. The limited research and poor quality of articles included mean that the findings are not conclusive. However, they suggest a significant adverse impact on the mental health and well-being of those who live and work in prisons.ConclusionsIt is key to address the mental health impacts of the pandemic on people who live and work in prisons. These findings are discussed in terms of implications for getting the balance between infection control imperatives and the fundamental human rights of prison populations.

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Usability Methods and Attributes Reported in Usability Studies of Mobile Apps for Health Care Education: Protocol for a Scoping Review

JMIR Research Protocols ◽

10.2196/19072 ◽

2020 ◽

Vol 9 (8) ◽

pp. e19072

Author(s):

Susanne Grødem Johnson ◽

Thomas Potrebny ◽

Lillebeth Larun ◽

Donna Ciliska ◽

Nina Rydland Olsen

Keyword(s):

Health Care ◽

Scoping Review ◽

Mobile Apps ◽

Research Question ◽

Grey Literature ◽

Research Area ◽

Research Field ◽

Learning Technologies ◽

Health Care Education ◽

Care Education

Background E-learning technologies, including mobile apps, are used to a large extent in health care education. Mobile apps can provide extendable learning environments and motivate students for adaptive and collaborative learning outside the classroom context. Developers should design practical, effective, and easy-to-use mobile apps. Usability testing is an important part of app development in order to understand if apps meet the needs of users. Objective The aim of this study is to perform a scoping review of usability methods and attributes reported in usability studies of mobile apps for health care education. Methods The scoping review is guided by the methodological framework developed by Arksey & O’Malley and further developed by Levac et al and Kahlil et al. The stages we will follow are as follows: (1) identifying the research question; (2) identifying relevant studies; (3) selecting studies; (4) charting the data; and (5) summarizing and reporting the results. We have developed two research questions to meet the aim of the study, which are as follows: (1) What usability methods are used to evaluate the usability of mobile apps for health care education? and (2) What usability attributes are reported in the usability studies of mobile apps for health care education? We will apply a comprehensive search of the literature, including 10 databases, a reference search, and a search for grey literature. Two review authors will independently screen articles for eligibility. Results The initial electronic database searches were completed in March 2019. The literature search identified 14,297 unique references. Following title and abstract screening, the full texts of 369 records were obtained. The scoping review is expected to be completed in spring 2021. Conclusions We expect the overview of usability methods and attributes reported in usability studies of mobile apps for health care education to contribute to the knowledge base for researchers and developers. It will give an overview of the research field and provide researchers and developers with relevant and important information on the usability research area, including highlighting possible research gaps. International Registered Report Identifier (IRRID) DERR1-10.2196/19072

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Reducing Alert Fatigue by Sharing Low-Level Alerts With Patients and Enhancing Collaborative Decision Making Using Blockchain Technology: Scoping Review and Proposed Framework (MedAlert) (Preprint)

10.2196/preprints.22013 ◽

2020 ◽

Author(s):

Paul Kengfai Wan ◽

Abylay Satybaldy ◽

Lizhen Huang ◽

Halvor Holtskog ◽

Mariusz Nowostawski

Keyword(s):

Health Care ◽

Decision Making ◽

Scoping Review ◽

Health Care Quality ◽

Research Question ◽

Clinical Decision ◽

Care Quality ◽

Alert Fatigue ◽

Low Level ◽

Future Work

BACKGROUND Clinical decision support (CDS) is a tool that helps clinicians in decision making by generating clinical alerts to supplement their previous knowledge and experience. However, CDS generates a high volume of irrelevant alerts, resulting in alert fatigue among clinicians. Alert fatigue is the mental state of alerts consuming too much time and mental energy, which often results in relevant alerts being overridden unjustifiably, along with clinically irrelevant ones. Consequently, clinicians become less responsive to important alerts, which opens the door to medication errors. OBJECTIVE This study aims to explore how a blockchain-based solution can reduce alert fatigue through collaborative alert sharing in the health sector, thus improving overall health care quality for both patients and clinicians. METHODS We have designed a 4-step approach to answer this research question. First, we identified five potential challenges based on the published literature through a scoping review. Second, a framework is designed to reduce alert fatigue by addressing the identified challenges with different digital components. Third, an evaluation is made by comparing MedAlert with other proposed solutions. Finally, the limitations and future work are also discussed. RESULTS Of the 341 academic papers collected, 8 were selected and analyzed. MedAlert securely distributes low-level (nonlife-threatening) clinical alerts to patients, enabling a collaborative clinical decision. Among the solutions in our framework, Hyperledger (private permissioned blockchain) and BankID (federated digital identity management) have been selected to overcome challenges such as data integrity, user identity, and privacy issues. CONCLUSIONS MedAlert can reduce alert fatigue by attracting the attention of patients and clinicians, instead of solely reducing the total number of alerts. MedAlert offers other advantages, such as ensuring a higher degree of patient privacy and faster transaction times compared with other frameworks. This framework may not be suitable for elderly patients who are not technology savvy or in-patients. Future work in validating this framework based on real health care scenarios is needed to provide the performance evaluations of MedAlert and thus gain support for the better development of this idea. CLINICALTRIAL

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An assessment of scoping review reporting within paramedicine: A scoping review

Australasian Journal of Paramedicine ◽

10.33151/ajp.17.834 ◽

2020 ◽

Vol 17 ◽

Author(s):

Brett Williams ◽

Bronwyn Beovich

Keyword(s):

Scoping Review ◽

Literature Search ◽

Methodological Approach ◽

Grey Literature ◽

Specific Information ◽

Emergency Medical Service Personnel ◽

Scoping Reviews ◽

Scoping Studies ◽

Full Text Screening

Aim This study aimed to examine the quality of published paramedic scoping reviews against pre-existing frameworks to assess the extent to which they fulfil the requirements of this methodological approach. Subsequently, recommendations will be presented regarding improvements for future paramedic scoping reviews. Methods A scoping review was conducted guided by the PRISMA Extension for Scoping Reviews. A literature search was performed in six electronic databases as well as the grey literature to identify previous scoping reviews that focussed on paramedic or emergency medical service personnel. Relevant data were extracted from included articles and presented in narrative and tabular formats. Results The literature search initially identified 475 articles, of which 20 remained after title/abstract and full-text screening. There was a general increase in the number of studies published over time, the majority of articles (80%) had conducted their scoping review utilising published frameworks, and 75% of first authors were paramedics. Although many areas of these reports comply with published guidelines, there was an overall lack of consistency in the specific information included, the level of detail of that information, and the location of information within the reports. Conclusion All paramedic scoping studies should be reported with the use of a published framework to enable standardisation in the reporting, thus facilitating understanding, reproducibility, and utility. The PRISMA Extension for Scoping Reviews provides a checklist and thorough explanations of each step in the reporting process and is recommended for use with all future paramedic scoping reviews.

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