scholarly journals Strategies for developing and implementing a rheumatoid arthritis healthcare quality framework: a thematic analysis of perspectives from arthritis stakeholders

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043759
Author(s):  
Claire Barber ◽  
Diane Lacaille ◽  
Marc Hall ◽  
Victoria Bohm ◽  
Linda C Li ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Focus Groups ◽  
Thematic Analysis ◽  
Outcome Measurement ◽  
Healthcare Providers ◽  
Healthcare Quality ◽  
Quality Measurement ◽  
Measurement Development ◽  
Business World ◽  
Measurement Framework

ObjectivesTo obtain stakeholder perspectives to inform the development and implementation of a rheumatoid arthritis (RA) healthcare quality measurement framework.DesignQualitative study using thematic analysis of focus groups and interviews.SettingArthritis stakeholders from across Canada including healthcare providers, persons living with RA, clinic managers and policy leaders were recruited for the focus groups and interviews.ParticipantsFifty-four stakeholders from nine provinces.InterventionsQualitative researchers led each focus group/interview using a semistructured guide; the digitally recorded data were transcribed verbatim. Two teams of two coders independently analysed the transcripts using thematic analysis.ResultsPerspectives on the use of different types of measurement frameworks in healthcare were obtained. In particular, stakeholders advocated for the use of existing healthcare frameworks over frameworks developed in the business world and adapted for healthcare. Persons living with RA were less familiar with specific measurement frameworks, however, they had used existing online public forums for rating their experience and quality of healthcare provided. They viewed a standardised framework as potentially useful for assisting with monitoring the care provided to them individually. Nine guiding principles for framework development and 13 measurement themes were identified. Perceived barriers identified included access to data and concerns about how measures in the framework were developed and used. Effective approaches to framework implementation included having sound knowledge translation strategies and involving stakeholders throughout the measurement development and reporting process. Clinical models of care and health policies conducive to outcome measurement were highlighted as drivers of successful measurement initiatives.ConclusionThese important perspectives will be used to inform a healthcare quality measurement framework for RA.

Development of a Patient-centered Quality Measurement Framework for Measuring, Monitoring, and Optimizing Rheumatoid Arthritis Care in Canada

2020 ◽  
pp. jrheum.200688
Author(s):  
Claire E.H. Barber ◽  
Karen L. Then ◽  
Victoria Bohm ◽  
Marc Hall ◽  
Deborah A. Marshall ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Access To Care ◽  
Outcome Measurement ◽  
Quality Measurement ◽  
System Level ◽  
Patient Centered ◽  
Strategic Objectives ◽  
Early Access ◽  
Measurement Framework ◽  
Care And Treatment

Objective The aim of this study was to develop a patient-centered quality measurement framework to address a predefined vision statement and 7 strategic objectives for rheumatoid arthritis (RA) care that was developed in prior qualitative work with arthritis stakeholders. Methods One hundred forty-seven RA-related performance measures (PMs) were identified from a systematic review. A candidate list of 26 PMs meeting predefined criteria and addressing the strategic objectives previously defined was then assessed during a 3-round (R) modified Delphi. Seventeen panelists with expertise in RA, quality measurement, and/or lived experience with RA rated each PM on a 1–9 scale based on the items of importance, feasibility, and priority for inclusion in the framework during R1 and R3, with a moderated discussion in R2. PMs with median scores ≥ 7 on all 3 items without disagreement were included in the final set, which then underwent public comment. Results Twenty-one measures were included in the final framework (15 PMs from the Delphi and 6 published system-level measures on access to care and treatment). The measures included 4 addressing early access to care and timely diagnosis, 12 evidence-based care for RA and related comorbidities, 1 addressing patient participation as an informed partner in care, and 4 on patient outcomes. Conclusion The proposed framework builds upon existing measures capturing early access to care and treatment in RA and adds important PMs to promote high-quality RA care and outcome measurement. In the next phase, the authors will test the framework in clinical practice in addition to addressing certain areas where no suitable PMs were identified.

Priorities for High Quality Care in Rheumatoid Arthritis: Results of Patient, Health Professional, and Policymaker Perspectives

2020 ◽  
pp. jrheum.201044
Author(s):  
Claire E. H. Barber ◽  
Diane Lacaille ◽  
Marc Hall ◽  
Victoria Bohm ◽  
Linda C. Li ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Qualitative Analysis ◽  
Focus Groups ◽  
Quality Care ◽  
Structured Interview ◽  
High Quality ◽  
Strategic Objectives ◽  
High Quality Care ◽  
Measurement Framework ◽  
Vision Statement

Objective To elucidate the essential elements of high-quality rheumatoid arthritis (RA) care in order to develop a vision statement and a set of strategic objectives for a national RA quality framework. Methods Focus groups and interviews were conducted by experienced qualitative researchers using a semi-structured interview or focus group guide with healthcare professionals, patients, clinic managers, healthcare leaders and policy makers to obtain their perspectives on elements essential to RA care. Purposive sampling provided representation of stakeholder types and regions. Recorded data was transcribed verbatim. Two teams of 2 coders independently analyzed the de-identified transcripts using thematic analysis. Strategic objectives and the vision statement were drafted based on the overarching themes from the qualitative analysis and finalized by a working group. Results A total of 54 stakeholders from 9 Canadian provinces participated in the project (3 focus groups and 19 interviews). Seven strategic objectives were derived from the qualitative analysis representing the following themes: 1) early access and timeliness of care, 2) evidence-informed high-quality care for the ongoing management of RA and comorbidities, 3) availability of patient self-management tools and educational materials for shared decision-making, 4) multidisciplinary care, 5) patient outcomes, and 6) patient experience and satisfaction with care, and 7) Equity, which emerged as an overarching theme. The ultimate vision obtained was “Ensuring patient-centered, high quality care for people living with rheumatoid arthritis”. Conclusion The seven strategic objectives identified highlight priorities for RA quality of care to be used in developing the National RA Quality Measurement Framework.

Development of an online transdisciplinary student wellbeing bundle: a thematic analysis (Preprint)

2020 ◽  
Author(s):  
Jena Buchan ◽  
Bonnie Clough ◽  
Jonathan Munro ◽  
Tatjana Ewais ◽  
Jaime Wallis ◽  
...  
Keyword(s):  
Focus Groups ◽  
Thematic Analysis ◽  
Personal Growth ◽  
Professional Staff ◽  
Self Awareness ◽  
Online Student ◽  
Student Wellbeing ◽  
Community Connectedness ◽  
Emerging Themes ◽  
Further Development

BACKGROUND The consequences of burnout for tertiary students across the health professions are well documented and include higher rates of mental health challenges, suicide, alcoholism, and relationship problems. As a key stakeholder in University-offered wellbeing services and support, it is desirable for students to hold a central role in development of such resources, particularly given effectiveness relies on student uptake. Hence there is a compelling need to develop a student-driven approach to promote wellbeing in the tertiary setting at individual, curricula, and systems levels. OBJECTIVE Based on this need, an online student-focused platform was developed using a bottom-up approach to support participant-driven enhancement of wellbeing and resilience to counteract burnout. This study reports on the development of the initial online “Student Bundle”, providing a foundation to inform the design of more locally based approaches to improve wellness and prevent burnout. METHODS Students and academic and professional staff from Griffith University Health groups were invited to participate in a series of focus groups. Sessions sought to collect information on desired structure, resources and overall content of the Student Bundle, with a thematic analysis undertaken to identify emerging themes. RESULTS Focus groups were conducted separately with staff (n=17) and students (n=7). Six main themes in relation to the development of the bundle emerged: Communication/Engagement; Accessibility/Flexibility; Professional practice; Community; Awareness; and Opportunity for personal growth. Stakeholders emphasized a bundle should be engaging and proactive to address wellbeing issues, incorporate aspects linked to professional identity and foster community, connectedness and self-awareness, providing an opportunity for growth. CONCLUSIONS Our research has revealed significant needs in relation to how an online student-focused wellbeing bundle could be delivered and what it could provide. Findings from this study will be used to guide further development and implementation of a multimodal, interactive student wellbeing bundle.

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 Development of a hybrid sleep and physical activity improvement intervention for adults with osteoarthritis-related pain and sleep disturbance: a focus group study with potential users

2021 ◽  
pp. 204946372110260
Author(s):  
Daniel Whibley ◽  
Kevin Stelfox ◽  
Alasdair L Henry ◽  
Nicole KY Tang ◽  
Anna L Kratz
Keyword(s):  
Physical Activity ◽  
Pain Management ◽  
Focus Groups ◽  
Thematic Analysis ◽  
Sleep Disturbances ◽  
Physical Activity Intervention ◽  
Focus Group Study ◽  
Intervention Component ◽  
Beneficial Impact ◽  
Improvement Intervention

Objective: Suboptimal sleep and physical activity are common among people living with osteoarthritis (OA) and simultaneous improvements in both may have a beneficial impact on pain. This study aimed to gather perspectives of people living with OA on important aspects to incorporate in a hybrid sleep and physical activity improvement intervention for OA pain management. Design: Qualitative study using two rounds of two focus groups. Setting and participants: Focus groups were conducted with adults living with OA-related chronic pain and sleep disturbances. Eighteen people attended focus groups in January 2020 and, of these, 16 attended subsequent focus groups in February 2020. Methods: Discussion at the first round of focus groups informed generation of prototype intervention materials that were shared, discussed and refined at the second round of focus groups. Thematic analysis was used to identify themes and sub-themes from the data. Results: Three themes, each with three sub-themes, were identified: facilitators of engagement with the intervention (sub-themes: motivational language, accountability and education); barriers to engagement (sub-themes: suboptimal interaction with healthcare practitioners, recording behaviour as burdensome/disruptive and uncertainty about technique) and characteristics of a physical activity intervention component (sub-themes: tailored, sustainable and supported). Conclusion: We have identified important aspects to incorporate into the design and delivery of a hybrid sleep and physical activity improvement intervention for OA pain management. Insights will be incorporated into intervention materials and protocols, with feasibility and acceptability assessed in a future study.

scholarly journals Identification and inclusion of gender factors in retrospective cohort studies: the GOING-FWD framework

2021 ◽  
Vol 6 (4) ◽  
pp. e005413
Author(s):  
Valeria Raparelli ◽  
Colleen M. Norris ◽  
Uri Bender ◽  
Maria Trinidad Herrero ◽  
Alexandra Kautzky-Willer ◽  
...  
Keyword(s):  
Outcome Measurement ◽  
Meta Analysis ◽  
Synthetic Data ◽  
Well Being ◽  
Pooled Analysis ◽  
Research Network ◽  
Local Analysis ◽  
Related Factors ◽  
Measurement Framework ◽  
Definition Of

Gender refers to the socially constructed roles, behaviours, expressions and identities of girls, women, boys, men and gender diverse people. Gender-related factors are seldom assessed as determinants of health outcomes, despite their powerful contribution. The Gender Outcomes INternational Group: to Further Well-being Development (GOING-FWD) project developed a standard five-step methodology applicable to retrospectively identify gender-related factors and assess their relationship to outcomes across selected cohorts of non-communicable chronic diseases from Austria, Canada, Spain, Sweden. Step 1 (identification of gender-related variables): Based on the gender framework of the Women Health Research Network (ie, identity, role, relations and institutionalised gender), and available literature for a certain disease, an optimal ‘wish-list’ of gender-related variables was created and discussed by experts. Step 2 (definition of outcomes): Data dictionaries were screened for clinical and patient-relevant outcomes, using the International Consortium for Health Outcome Measurement framework. Step 3 (building of feasible final list): a cross-validation between variables per database and the ‘wish-list’ was performed. Step 4 (retrospective data harmonisation): The harmonisation potential of variables was evaluated. Step 5 (definition of data structure and analysis): The following analytic strategies were identified: (1) local analysis of data not transferable followed by a meta-analysis combining study-level estimates; (2) centrally performed federated analysis of data, with the individual-level participant data remaining on local servers; (3) synthesising the data locally and performing a pooled analysis on the synthetic data and (4) central analysis of pooled transferable data. The application of the GOING-FWD multistep approach can help guide investigators to analyse gender and its impact on outcomes in previously collected data.

scholarly journals A methodology of healthcare quality measurement: a case study

2015 ◽  
Vol 588 ◽  
pp. 012027 ◽  
Author(s):  
F Pecoraro ◽  
D Luzi ◽  
M Cesarelli ◽  
F Clemente
Keyword(s):  
Healthcare Quality ◽  
Quality Measurement

scholarly journals Cigar-Smoking-Cessation Interest and Experience among Black Young Adults: A Semi-Structured In-Depth Interview Investigation

2021 ◽  
Vol 18 (14) ◽  
pp. 7309
Author(s):  
Aniruddh Ajith ◽  
Aaron Broun ◽  
Danielle A. Duarte ◽  
Bambi Jewett ◽  
Lilianna Phan ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Thematic Analysis ◽  
Financial Constraints ◽  
Qualitative Data ◽  
Smoking Prevalence ◽  
Healthcare Providers ◽  
Easy Access ◽  
Black African ◽  
Depth Interview ◽  
Cigar Smoking

Although Black/African American populations have high cigar-smoking prevalence, little is known about cigar-smoking cessation among this group. This study explored the perceptions and experiences of cigar-smoking cessation and assistance received from healthcare providers among forty Black young-adult cigar smokers (ages 21–29). Semi-structured in-depth phone interviews were transcribed and coded. Qualitative data were analyzed by using thematic analysis. Participants mostly smoked cigarillos, large cigars, and blunts. Overall, many regular cigarillo smokers reported interest in quitting eventually, while large-cigar and blunt smokers shared less interest in quitting because they perceived low harm from smoking these products. The reasons for cigar-smoking cessation were health concerns and financial constraints. Most of the participants who attempted to quit cigars did not use any cessation aids. The reasons for relapse included nicotine withdrawal, stress, and easy access. Additionally, most participants reported their healthcare providers did not ask whether they smoked cigars, and even when they knew, little assistance for cigar-smoking cessation was provided. Informing Black cigar smokers of the harm of cigar smoking and encouraging healthcare providers to screen for and assist with cigar-smoking cessation may alleviate the health burden of cigar smoking in this population.

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