Predicting and testing a silo-free delivery system

2018 ◽  
Vol 31 (5) ◽  
pp. 200-205 ◽  
Author(s):  
Eileen Florence Pepler ◽  
Joy Pridie ◽  
Steve Brown
Keyword(s):  
Support Groups ◽  
Community Support ◽  
Evidence Based ◽  
Policy Makers ◽  
New Ways Of Working ◽  
Working Together ◽  
Increasing Demand ◽  
Time To Learn ◽  
Free Environment ◽  
Future Population

Given the scale and complexity of the challenge of addressing the aging population, increasing demand for complex and integrated care, this article sets out potential opportunities to predict a future without silos, based on international learnings. Examining another country’s health and delivery systems, it is interesting to see the similarities and differences, so we offer some reflections applicable to Canada. These models are breaking down the silos. Imagine a setting where you could collaboratively co-design scenarios, debate, refine policy, and predict future population needs. Using a transformation lab setting, governments and policy-makers, providers, patients, families, and community support groups could collaboratively take the time to learn new ways of working together in a risk-free environment before becoming accountable for delivering targeted outcomes. It is time to implement provincial transformation labs to test local strategies and operational plans to co-design scenarios, use simulation, and test the choices using evidence-based tools.

Evidence-Based Policy in the Real World: A Cautionary View

2018 ◽  
Vol 678 (1) ◽  
pp. 180-191 ◽  
Author(s):  
Adam Gamoran
Keyword(s):  
Real World ◽  
Evidence Based ◽  
Policy And Practice ◽  
High Quality ◽  
Policy Makers ◽  
High Quality Evidence ◽  
Growing Body ◽  
Increasing Demand ◽  
Quality Evidence

The evidence movement has attended more to improving the supply of evidence than to increasing demand, so even as rigorous evidence production has increased, the use of evidence remains all too rare. A growing body of research indicates that the quality of relationships between researchers, policy-makers, and intermediaries plays a central role in whether rigorous evidence informs decisions in policy and practice. Creating structures to support such relationships remains a major challenge. Yet even when high-quality evidence is used, the intended benefits may not ensue because of broader challenges in society at large. Consequently, we should temper our expectations for the benefits of evidence-based policymaking, but not give up the effort.

A LOOK INTO THE HISTORY OF THE PREPARATION OF LOCAL PROFESSIONALS IN THE INDUSTRY

2019 ◽  
Vol 26 (2) ◽  
pp. 4-8
Author(s):  
Toshkentboy Pardaev ◽  
◽  
Zhavli Tursunov
Keyword(s):  
Evidence Based ◽  
Local Policy ◽  
Soviet Government ◽  
Policy Makers ◽  
History Of

In the article : In the second half of the 20 century the process of preparation of local experts in South Uzbekistan industry changes in this field a clear evidence-based analysis of the problematic processes that resulted from the discriminatory policy toward the Soviet government-dominated local policy makers

scholarly journals ‘Somebody stuck me in a bag of sand’: Lived experiences of the altered and uncomfortable body after stroke

2021 ◽  
pp. 026921552110007
Author(s):  
Hannah Stott ◽  
Mary Cramp ◽  
Stuart McClean ◽  
Ailie Turton
Keyword(s):  
Support Groups ◽  
Phenomenological Study ◽  
Community Support ◽  
Phenomenological Approach ◽  
The Body ◽  
Stroke Survivors ◽  
Post Stroke ◽  
Personal Perceptions ◽  
Psychological Sense ◽  
Qualitative Phenomenological

Objective: This study explored stroke survivors’ experiences of altered body perception, whether these perceptions cause discomfort, and the need for clinical interventions to improve comfort. Design: A qualitative phenomenological study. Setting: Participants’ homes. Participants: A purposive sample of 16 stroke survivors were recruited from community support groups. Participants (median: age 59; time post stroke >2 years), were at least six-months post-stroke, experiencing motor or sensory impairments and able to communicate verbally. Interventions: Semi-structured, face-to-face interviews were analysed using an interpretive phenomenological approach and presented thematically. Results: Four themes or experiences were identified: Participants described (1) a body that did not exist; (2) a body hindered by strange sensations and distorted perceptions; (3) an uncontrollable body; and (4) a body isolated from social and clinical support. Discomfort was apparent in a physical and psychological sense and body experiences were difficult to comprehend and communicate to healthcare staff. Participants wished for interventions to improve their comfort but were doubtful that such treatments existed. Conclusion: Indications are that altered body perceptions cause multifaceted physical and psychosocial discomfort for stroke survivors. Discussions with patients about their personal perceptions and experiences of the body may facilitate better understanding and management to improve comfort after stroke.

scholarly journals The Deterministic Evolution Of Illicit Drug Consumption Within a Given Population

2018 ◽  
Vol 62 ◽  
pp. 139-157 ◽  
Author(s):  
Yusra Bibi Ruhomally ◽  
Nabeelah Banon Jahmeerbaccus ◽  
Muhammad Zaid Dauhoo
Keyword(s):  
Drug Users ◽  
Illicit Drug ◽  
Drug Consumption ◽  
Dynamic Evolution ◽  
Evidence Based ◽  
Relative Importance ◽  
Epidemic Threshold ◽  
Drug Usage ◽  
Policy Makers ◽  
Reproduction Numbers

We study the NERA model that describes the dynamic evolution of illicit drug usage in a population. The model consists of nonusers (N) and three categories of drug users: the experimental (E) category, the recreational (R) category and the addict (A) category. Two epidemic threshold term known as the reproduction numbers, R0 and μ are defined and derived. Sensitivity analysis of R0 on the parameters are performed in order to determine their relative importance to illicit drug prevalence. The local and global stability of the equilibrium states are also analysed. We also prove that a transcritical bifurcation occurs at R0 = 1. It is shown that an effective campaign of prevention can help to fight against the prevalence of illicit drug consumption. We demonstrate persistence when R0 > 1 and conditions for the extinction of drug consumption are also established. Numerical simulations are performed to verify our model. Our results show that the NERA model can assist policy makers in targeting prevention for maximum effectiveness and can be used to adopt evidence-based policies to better monitor and quantify drug use trends.

scholarly journals Qualitative Evidence Synthesis: Where Are We at?

2021 ◽  
Vol 20 ◽  
pp. 160940692199327
Author(s):  
Kate Flemming ◽  
Jane Noyes
Keyword(s):  
Qualitative Research ◽  
Systematic Reviews ◽  
Evidence Synthesis ◽  
Synthesis Methods ◽  
Qualitative Evidence Synthesis ◽  
Policy Makers ◽  
Qualitative Evidence ◽  
Health And Social Care ◽  
Method Paper ◽  
Increasing Demand

Qualitative evidence syntheses (QES) have increased in prominence and profile over the last decade as a discrete set of methodologies to undertake systematic reviews of primary qualitative research in health and social care and in education. The findings from a qualitative evidence synthesis can enable a richer interpretation of a particular phenomenon, set of circumstances, or experiences than single primary qualitative research studies can achieve. Qualitative evidence synthesis methods were developed in response to an increasing demand from health and social professionals, policy makers, guideline developers and educationalists for review evidence that goes beyond “what works” afforded by systematic reviews of effectiveness. The increasing interest in the synthesis of qualitative research has led to methodological developments documented across a plethora of texts and journal articles. This “State of the Method” paper aims to bring together these methodological developments in one place, contextualizing advances in methods with exemplars to support readers in making choices in approach to a synthesis and aid understanding. The paper clarifies what a “qualitative evidence synthesis” is and explores its role, purpose and development. It details the kind of questions a QES can explore, the processes associated with a QES, including the methods for synthesis. The rational and methods for integrating a QES with systematic reviews of effectiveness are also detailed. Finally approaches reporting and recognition of what a “good” or rigorous QES look like are provided.

scholarly journals Development of a Consumer Engagement Framework

2016 ◽  
Vol 11 (1) ◽  
pp. 46-49
Author(s):  
Lucylynn Lizarondo ◽  
Kate Kennedy ◽  
Debra Kay
Keyword(s):  
Healthcare Professionals ◽  
Evidence Based Practice ◽  
International Association ◽  
Model Development ◽  
Evidence Based ◽  
Strategic Partnerships ◽  
Consumer Engagement ◽  
Policy Makers ◽  
Australian Health ◽  
Group Experience

Objective: The purpose of this project was to develop a Consumer Engagement Model to plan for effective baby boomer engagement to inform policy makers in the healthcare system. This is the first stage of that process. Design: Initial model development for healthcare systems based on literature review and author group experience in evidence-based practice and research, and consumer advocacy and engagement. Setting and population: South Australian health and community service systems, and healthcare professionals that work with baby boomers. Findings: To develop an evidence-based Consumer Engagement Plan, it is recommended that policy makers undertake the four steps outlined in this document to design a question, determine consumer and community segments and scope of engagement, determine the breadth and depth of engagement and address the implications, assess risk and develop strategic partnerships to ensure the Plan is evidencebased,reasonable and achievable. Conclusions: We believe this process provides a framework for planning consumer engagement and for implementation, monitoring, evaluation and review of consumer engagement for policy excellence. We propose to undertake a validation of the model thus populating the model with examples of practice-based strategies and revising the model accordingly. Abbreviations: EBP – Evidence-Based Practice; IAP2 – International Association of Public Participation; PIO – Patient Intervention and Outcome.

scholarly journals Psychiatry in the future

2004 ◽  
Vol 28 (8) ◽  
pp. 277-278
Author(s):  
Frank Holloway
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Evidence Based Medicine ◽  
Cochrane Collaboration ◽  
Routine Clinical Practice ◽  
Evidence Based ◽  
Policy Makers ◽  
The Future ◽  
The Cochrane Collaboration ◽  
Based Medicine

In an era of evidence-based medicine, policy-makers and researchers are preoccupied by the task of ensuring that advances in research are implemented in routine clinical practice. This preoccupation has spawned a small but growing research industry of its own, with the development of resources such as the Cochrane Collaboration database and journals such as Evidence-Based Mental Health. In this paper, I adopt a philosophically quite unfashionable methodology – introspection – to address the question: how has research affected my practice?

scholarly journals Multifunctionality of agriculture, public policies and scientific evidences: Some critical issues of contemporary controversies

2010 ◽  
Vol 4 (1-2) ◽  
pp. 53-58 ◽  
Author(s):  
Catherine Laurent ◽  
Marielle Berriet-Solliec ◽  
Marc Kirsch ◽  
Pierre Labarthe ◽  
AurélieT AurélieTrouvé
Keyword(s):  
Decision Making ◽  
Theoretical Models ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Policy Makers ◽  
Science And Policy ◽  
Public Policy Analysis ◽  
Critical Issues ◽  
The Status ◽  
New Situation

Various theoretical models of public policy analysis are used to treat situations of decision-making in which public deciders have to take into account the multifunctionality of agriculture. For some, science-society relations are not really problematical. Others acknowledge the current attempts of these policy-makers to find adequate scientific knowledge, and the difficulties they encounter. These difficulties stem partly from the very content of knowledge produced by research. Could other modes of production be more efficient? The status of the knowledge produced by these approaches is a subject of debate. Bridging the divide between science and policy more effectively is not only a question of knowledge brokerage.Accessibility and reliability of the existing evidences are also problems to be addressed. The debates around evidence-based practices may provide some landmarks in this new situation although they also emphasize the limits of the tools that can be built for this purpose.  

scholarly journals Reflections: The Responsibility of Doctoral Nurses to Lead a Change in Practice

Aquichan ◽  
2021 ◽  
Vol 21 (2) ◽  
pp. 1-8
Author(s):  
Elizabeth A Rosser
Keyword(s):  
Strategic Change ◽  
Critical Mass ◽  
Leadership Skills ◽  
Thinking Skills ◽  
Evidence Base ◽  
Critical Thinking Skills ◽  
Evidence Based ◽  
Training Experience ◽  
New Ways Of Working ◽  
Quality Of Patient Care

This paper aims to consider the responsibilities of doctoral nurses to lead changes in practice through a very personal reflection of over 52 years in nursing. The reflective learning moves from an early training experience where I learned to ‘do’ to becoming a nursing professor with a doctoral qualification and an ‘evidence-based doer.’ The change witnessed has been considerable. As the highest educated professional, I have learned that doctoral nurses are responsible for leading and directly influencing clinical practice, either as a practitioner, an educator, or a researcher. They are capable of encouraging the development of critical thinking skills and helping practitioners to be curious, take risks with ideas, identify gaps in the evidence base, and be creative in their problem-solving. If the strategic vision for nurses globally is to provide the best quality of patient care, then evidence-based practice is key to leading from the head, hand, and heart. Doctoral nurses understand the patient benefits of a high staff-to-patient ratio and having a critical mass of university qualified nurses and must strive to influence policy to this effect. As each country, particularly in Latin America, develops a critical mass of doctorally qualified nurses, then they can harness their innovation, create new ways of working, attract them back into practice, and strengthen their political voice to lead strategic change. Doctoral nurses must develop their leadership skills and their confidence to lead. They have a responsibility to realise their potential and identify the opportunities to really make a difference.

scholarly journals Critical Appraisal on the Selection Criteria for Evidence-based Healthcare

2021 ◽  
Author(s):  
Paulo Cesar Morales Mayer ◽  
Caroline Amélia Gonçalves ◽  
Franz Porzsolt
Keyword(s):  
Cervical Cancer ◽  
Clinical Trials ◽  
Selection Criteria ◽  
Human Subjects ◽  
Evidence Based ◽  
Inclusion Criteria ◽  
Pragmatic Trials ◽  
Exclusion Criteria ◽  
Policy Makers ◽  
Evidence Based Healthcare

Abstract Background: Evidence-Based healthcare deals basically with published clinical trials to guide the decision making on what treatment to use for any specific conditions.Aims: The present paper assessed the inclusion and exclusion criteria used in clinical trials of cervical cancer aiming at establishing a clear distinction between each criterion.Methods: We performed a bibliographical search in pubmed with the terms cervical cancer and treatment or therapy filtered for clinical trials with human subjects for the last ten years. A total of 30 papers were used extracting and classifying the inclusion and exclusion category according to the characteristic they described. Results: We found no clear parameter to establish which criteria could exclusively serve as inclusion or exclusion across the papers, about 56% of the categories identified were found either listed as inclusion or exclusion criteria or even as both in some cases.Conclusions: The key issue of selection criteria is not in its form but in its function, the first point to consider is if the trial is experimental (focused on efficacy and proof of principle) or observational (pragmatic trials, focused on effectiveness and real world conditions). We suggest, inclusion criteria should be broad, focused on the investigated condition; exclusion criteria should apply only to the subset of this “included” population, and do not take part in observational studies. These conclusions do not serve only for researchers but should affect practitioners and policy makers to correctly compare the results of investigated treatment.

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