scholarly journals Implementation challenges to patient safety in Guatemala: a mixed methods evaluation

2021 ◽  
pp. bmjqs-2020-012552
Author(s):  
Bria J Hall ◽  
Melany Puente ◽  
Angie Aguilar ◽  
Isabelle Sico ◽  
Monica Orozco Barrios ◽  
...  
Keyword(s):  
Patient Safety ◽  
Mixed Methods ◽  
Qualitative Interviews ◽  
Successful Implementation ◽  
Programme Implementation ◽  
Middle Income ◽  
Factors Affecting ◽  
Implementation Challenges ◽  
Safety Programme ◽  
Patient Centredness

BackgroundLittle is known about factors affecting implementation of patient safety programmes in low and middle-income countries. The goal of our study was to evaluate the implementation of a patient safety programme for paediatric care in Guatemala.MethodsWe used a mixed methods design to examine the implementation of a patient safety programme across 11 paediatric units at the Roosevelt Hospital in Guatemala. The safety programme included: (1) tools to measure and foster safety culture, (2) education of patient safety, (3) local leadership engagement, (4) safety event reporting systems, and (5) quality improvement interventions. Key informant staff (n=82) participated in qualitative interviews and quantitative surveys to identify implementation challenges early during programme deployment from May to July 2018, with follow-up focus group discussions in two units 1 year later to identify opportunities for programme modification. Data were analysed using thematic analysis, and integrated using triangulation, complementarity and expansion to identify emerging themes using the Consolidated Framework for Implementation Research. Salience levels were reported according to coding frequency, with valence levels measured to characterise the degree to which each construct impacted implementation.ResultsWe found several facilitators to safety programme implementation, including high staff receptivity, orientation towards patient-centredness and a desire for protocols. Key barriers included competing clinical demands, lack of knowledge about patient safety, limited governance, human factors and poor organisational incentives. Modifications included use of tools for staff recognition, integration of education into error reporting mechanisms and designation of trained champions to lead unit-based safety interventions.ConclusionImplementation of safety programmes in low-resource settings requires recognition of facilitators such as staff receptivity and patient-centredness as well as barriers such as lack of training in patient safety and poor organisational incentives. Embedding an implementation analysis during programme deployment allows for programme modification to enhance successful implementation.

scholarly journals Factors Affecting the Successful Implementation of Cloud and IoT - A Study on IT and Business Leaders

2019 ◽  
pp. 366-396
Author(s):  
Jipson George Thoomkuzhy ◽  
Mohammed Nazeh
Keyword(s):  
Cloud Computing ◽  
Information Integration ◽  
Business Leaders ◽  
Successful Implementation ◽  
Dynamic Information ◽  
Factors Affecting ◽  
Implementation Challenges ◽  
Share Data ◽  
The Internet Of Things ◽  
Day By Day

The Internet of Things (IoT) is turning into the following Internet-related transformation. It enables billions of gadgets to be associated and speak with one another to share data that enhances the nature of our day-by-day lives. Then again, Cloud Computing gives on-request, helpful and versatile system get to which makes it conceivable to share computing assets, without a doubt, this, thus, empowers dynamic information integration from different information sources. There are numerous issues hindering the fruitful implementation of both Cloud and IoT. The integration of Cloud Computing with the IoT is the best path on which to defeat these issues. The huge number of assets accessible on the Cloud can be greatly helpful for the IoT, while the Cloud can acquire attention to enhance its impediments with true protests in a more powerful and dispersed way. This paper gives to the various factors that affect the integration of the Cloud into the IoT by featuring the integration advantages and implementation challenges. This paper mainly focus on a study which was conducted on various IT and business leaders.

scholarly journals Mixed-methods, descriptive and observational cohort study examining feeding and growth patterns among low birthweight infants in India, Malawi and Tanzania: the LIFE study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e048216
Author(s):  
Linda Vesel ◽  
Lauren Spigel ◽  
Jnanindra Nath Behera ◽  
Roopa M Bellad ◽  
Leena Das ◽  
...  
Keyword(s):  
Cohort Study ◽  
Mixed Methods ◽  
Low Birthweight ◽  
Ethics Committees ◽  
Observational Cohort Study ◽  
Growth Patterns ◽  
Programme Implementation ◽  
Middle Income ◽  
Life Study ◽  
Observational Cohort

IntroductionEnding preventable deaths of newborns and children under 5 will not be possible without evidence-based strategies addressing the health and care of low birthweight (LBW, <2.5 kg) infants. The majority of LBW infants are born in low- and middle-income countries (LMICs) and account for more than 60%–80% of newborn deaths. Feeding promotion tailored to meet the nutritional needs of LBW infants in LMICs may serve a crucial role in curbing newborn mortality rates and promoting growth. The Low Birthweight Infant Feeding Exploration (LIFE) study aims to establish foundational knowledge regarding optimal feeding options for LBW infants in low-resource settings throughout infancy.Methods and analysisLIFE is a formative, multisite, observational cohort study involving 12 study facilities in India, Malawi and Tanzania, and using a convergent parallel, mixed-methods design. We assess feeding patterns, growth indicators, morbidity, mortality, child development and health system inputs that facilitate or hinder care and survival of LBW infants.Ethics and disseminationThis study was approved by 11 ethics committees in India, Malawi, Tanzania and the USA. The results will be disseminated through peer-reviewed publications and presentations targeting the global and local research, clinical, programme implementation and policy communities.Trial registration numbersNCT04002908 and CTRI/2019/02/017475.

scholarly journals Evaluation of an anti-stigma campaign related to common mental disorders in rural India: a mixed methods approach

2016 ◽  
Vol 47 (3) ◽  
pp. 565-575 ◽  
Author(s):  
P. K. Maulik ◽  
S. Devarapalli ◽  
S. Kallakuri ◽  
A. Tewari ◽  
S. Chilappagari ◽  
...  
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Help Seeking ◽  
Common Mental Disorders ◽  
Qualitative Interviews ◽  
Social Contact ◽  
Future Research ◽  
Post Intervention ◽  
Middle Income ◽  
Major Barrier

BackgroundStigma related to mental health is a major barrier to help-seeking resulting in a large treatment gap in low- and middle-income countries (LMIC). This study assessed changes in knowledge, attitude and behaviour, and stigma related to help-seeking among participants exposed to an anti-stigma campaign.MethodThe campaign, using multi-media interventions, was part of the SMART Mental Health Project, conducted for 3 months, across 42 villages in rural Andhra Pradesh, in South India. Mixed-methods evaluation was conducted in two villages using a pre-post design.ResultsA total of 1576 and 2100 participants were interviewed, at pre- and post-intervention phases of the campaign. Knowledge was not increased. Attitudes and behaviours improved significantly (p < 0.01). Stigma related to help-seeking reduced significantly (p < 0.05). Social contact and drama were the most beneficial interventions identified during qualitative interviews.ConclusionThe results showed that the campaign was beneficial and led to improvement of attitude and behaviours related to mental health and reduction in stigma related to help-seeking. Social contact was the most effective intervention. The study had implications for future research in LMIC.

scholarly journals Teaching patient safety in global health: lessons from the Duke Global Health Patient Safety Fellowship

2019 ◽  
Vol 4 (1) ◽  
pp. e001220 ◽  
Author(s):  
Bria E Johnston ◽  
Randall Lou-Meda ◽  
Sindy Mendez ◽  
Karen Frush ◽  
Judy Milne ◽  
...  
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Global Health ◽  
Low Income ◽  
Experiential Training ◽  
Middle Income ◽  
Implementation Challenges ◽  
Intensive Training ◽  
Middle Income Countries ◽  
Local Safety

Health systems in low-income and middle-income countries (LMICs) have a high burden of medical errors and complications, and the training of local experts in patient safety is critical to improve the quality of global healthcare. This analysis explores our experience with the Duke Global Health Patient Safety Fellowship, which is designed to train clinicians from LMICs in patient safety, quality improvement and infection control. This intensive fellowship of 3–4 weeks includes (1) didactic training in patient safety and quality improvement, (2) experiential training in patient safety operations, and (3) mentorship of fellows in their home institution as they lead local safety programmes. We have learnt several lessons from this programme, including the need to contextualise training to local needs and resources, and to focus training on building interdisciplinary patient safety teams. Implementation challenges include a lack of resources and data collection systems, and limited recognition of the role of safety in global health contexts. This report can serve as an operational guide for intensive training in patient safety that is contextualised to global health challenges.

scholarly journals Evaluation of a patient safety programme on Surgical Safety Checklist Compliance: a prospective longitudinal study

2018 ◽  
Vol 7 (3) ◽  
pp. e000362 ◽  
Author(s):  
Brigid M Gillespie ◽  
Emma L Harbeck ◽  
Joanne Lavin ◽  
Kyra Hamilton ◽  
Therese Gardiner ◽  
...  
Keyword(s):  
Patient Safety ◽  
Longitudinal Design ◽  
Programme Implementation ◽  
Prospective Longitudinal Study ◽  
Surgical Safety ◽  
Safety Programme ◽  
Incident Data ◽  
Surgical Teams ◽  
Prospective Longitudinal ◽  
The Impact

BackgroundSurgical Safety Checklists (SSC) have been implemented widely across 132 countries since 2008. Yet, despite associated reductions in postoperative complications and death rates, implementation of checklists in surgery remains a challenge. The aim of this study was to assess the impact of a patient safety programme over time on SSC use and incidence of clinical errors.DesignA prospective longitudinal design over three time points and a retrospective secondary analysis of clinical incident data was undertaken.MethodsWe implemented a patient safety programme over 4 weeks to improve surgical teams’ use of the SSC. We undertook structured observations to assess surgical teams’ checklist use before and after programme implementation and conducted a retrospective audit of clinical incident data 12 months before and 12 months following implementation of the programme.ResultsThere were significant improvements in the observed use of the SSC across all phases, particularly in sign-out where completion rates ranged from 79.3% to 94.5% (p<0.0001) following programme implementation. Across clinical incident audit periods, 33 019 surgical procedures were performed. Based on a subsample of 64 cases, clinical incidents occurred in 22/16 264 (0.13%) before implementation and 42/16 755 (0.25%) cases after implementation. The most predominant incident after programme implementation was inadequate tissue specimen labelling (23/42, 54.8%). Clinical incidents resulted in minimal or no harm to the patient.ConclusionsThe benefit in using a surgical checklist lies in the potential to enhance team communications and the promotion of a team culture in which safety is the priority.

Factors Affecting The use Of Posbindu PTM Elderly In Medan Puskesmas Rantang Medan District Medan Petisah District In 2018

2020 ◽  
Vol 6 (1) ◽  
pp. 121-128
Author(s):  
Sri Natalia Ginting ◽  
Asriwati Asriwati ◽  
Anto Anto
Keyword(s):  
Mixed Methods ◽  
Factors Affecting

Penyakit tidak menular telah menjadi penyebab utama kematian secara global pada saat ini. Posbindu PTM merupakan suatu bentuk pelayanan yang melibatkan peran serta masyarakat melalui upaya promotif-preventif. Jenis penelitian adalah dengan pendekatan mixed methods dengan tujuan untuk mengetahui faktor yang memengaruhi terhadap pemanfaatan Posbindu PTM pada lansia di Wilayah Kerja Puskesmas Rantang Medan Kecamatan Medan Petisah dengan populasi penelitian adalah sebanyak 653 lansia dengan teknik sampel menggunakan accidental sampling sebanyak 87 lansia. Hasil penelitian menunjukkan bahwa pengetahuan memiliki sig-p 0,011 < 0,05, sikap sig-p 0,017 > 0,05, jarak tempuh sig-p 0,041 < 0,05, dukungan tenaga kesehatan sig-p 0,415 > 0,05 dan dukungan keluarga memilikisig-p 0,028 < 0,05. Kesimpulan ada pengaruh pengetahuan, sikap, jarak tempuh dan dukungan keluarga terhadap pemanfaatan Posbindu PTM pada lansia, sedangkan dukungan tenaga kesehatan tidak memiliki pengaruh terhadap pemanfaatan Posbindu PTM pada lansia. Penelitian ini diharapkan dapat menjadi bahan masukan atau informasi yang bermanfaat bagi Puskesmas, Dinas Kesehatan, maupun instansi lain terkait dengan pemanfaatan Posbindu PTM. Kata Kunci: Faktor yang Memengaruhi, Pemanfaatan Posbindu PTM, Lansi

scholarly journals Evaluating the success of the tele-pathology system in governmental hospitals in Kuwait: an explanatory sequential mixed methods design

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ali Jasem Buabbas ◽  
Tareq Mohammad ◽  
Adel K. Ayed ◽  
Hawraa Mallah ◽  
Hamza Al-Shawaf ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Mixed Methods ◽  
Support Services ◽  
User Satisfaction ◽  
Technical Support ◽  
Successful Implementation ◽  
System Quality ◽  
Mixed Methods Design ◽  
Telepathology System

Abstract Background Telepathology is the practice of reviewing and exchanging pathological images through telecommunication systems to obtain diagnoses remotely. Studying the factors that make such a system successful and favourable is important to ensure the merits of its implementation in clinical practice. Objective This study aims to evaluate the success of a telepathology system from the users’ perspectives, using specific evaluation criteria, namely: system quality, information quality, technical service quality, user satisfaction, and benefits. Methods A sequential explanatory mixed methods design was adopted in this study, which consists of two phases. Initially, a questionnaire was distributed via WhatsApp to all of the pathologists (total: 45) working at governmental hospitals in Kuwait. Followed by, semi-structured interviews with ten senior pathologists. Results Forty pathologists responded to the questionnaire, giving an 89% response rate. There were 42.5% of the respondents aged between 35–44 years old, and 52.5% were male. The quantitative results reveal that most of the respondents were satisfied with the quality of the telepathology system with a mean of 2.6025 (Standard Deviation (SD) = 0.47176), whereas they were dissatisfied with the quality of the information with a mean of 2.4100 (SD = 1.580) and the technical support services with a mean of 2.2750 (SD = 0.99535). In addition, there was disagreement on the benefits of telepathology in clinical practice among the pathologists with a mean of 2.4667 (SD = 0.77552). The qualitative results indicate that the lack of interest in and little experience with using the system were behind the general dissatisfaction of most of the respondents. All of the interviewees were satisfied with the performance of the telepathology system and considered it successful; however, the quality of the technical support services, including training workshops, was deemed deficient. Conclusion This study concluded that telepathology system in Kuwait is functioning well and has been successful in its implementation; however, pathologists are dissatisfied with it, mainly due to the deficient quality of the technical support services provided. In addition, the successful implementation of such advanced technologies requires careful steps to be taken on multiple levels: technical, organisational, and managerial. Recommendations were suggested.

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