A systematic review of patient prioritization tools in non-emergency healthcare services

Abstract Background Patient prioritization is a strategy used to manage access to healthcare services. Patient prioritization tools (PPT) contribute to supporting the prioritization decision process, and to its transparency and fairness. Patient prioritization tools can take various forms and are highly dependent on the particular context of application. Consequently, the sets of criteria change from one context to another, especially when used in non-emergency settings. This paper systematically synthesizes and analyzes the published evidence concerning the development and challenges related to the validation and implementation of PPTs in non-emergency settings. Methods We conducted a systematic mixed studies review. We searched evidence in five databases to select articles based on eligibility criteria, and information of included articles was extracted using an extraction grid. The methodological quality of the studies was assessed by using the Mixed Methods Appraisal Tool. The article selection process, data extraction, and quality appraisal were performed by at least two reviewers independently. Results We included 48 studies listing 34 different patient prioritization tools. Most of them are designed for managing access to elective surgeries in hospital settings. Two-thirds of the tools were investigated based on reliability or validity. Inconclusive results were found regarding the impact of PPTs on patient waiting times. Advantages associated with PPT use were found mostly in relationship to acceptability of the tools by clinicians and increased transparency and equity for patients. Conclusions This review describes the development and validation processes of PPTs used in non-urgent healthcare settings. Despite the large number of PPTs studied, implementation into clinical practice seems to be an open challenge. Based on the findings of this review, recommendations are proposed to develop, validate, and implement such tools in clinical settings. Systematic review registration PROSPERO CRD42018107205

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A Systematic Review of Patient Prioritization Tools in Non-Emergency Healthcare Services

10.21203/rs.3.rs-29776/v1 ◽

2020 ◽

Author(s):

Julien Dery ◽

Angel Ruiz ◽

François Routhier ◽

Valérie Bélanger ◽

André Côté ◽

...

Keyword(s):

Systematic Review ◽

Selection Process ◽

Data Extraction ◽

Waiting Times ◽

Healthcare Services ◽

Process Data ◽

Eligibility Criteria ◽

Published Evidence ◽

Patient Prioritization ◽

The Impact

Abstract Background: Patient prioritization is a strategy used to manage access to healthcare services. Patient prioritization tools (PPT) contribute to supporting the prioritization decision process, and to its transparency and fairness. Patient prioritization tools can take various forms and are highly dependent on the particular context of application. Consequently, the sets of criteria change from one context to another, especially when used in non-emergency settings. This paper systematically synthesizes and analyzes the published evidence concerning the development and challenges related to the validation and implementation of PPTs in non-emergency settings. Methods: We conducted a systematic mixed studies review. We searched evidence in five databases to select articles based on eligibility criteria, and information of included articles was extracted using an extraction grid. The methodological quality of the studies was assessed by using the Mixed Methods Appraisal Tool. The article selection process, data extraction, and quality appraisal were performed by at least two reviewers independently. Results: We included 47 studies listing 33 different patient prioritization tools. Most of them are designed for managing access to elective surgeries in hospital settings. Two thirds of the tools were investigated based on reliability or validity. Inconclusive results were found regarding the impact of PPTs on patient waiting times. Advantages associated with PPT use were found mostly in relationship to acceptability of the tools by clinicians and increased transparency and equity for patients. Conclusions: This review describes the development and validation processes of PPTs used in non-urgent healthcare settings. Despite the large number of PPTs studied, implementation into clinical practice seems to be an open challenge. Based on the findings of this review, recommendations are proposed to develop, validate, and implement such tools in clinical settings. Systematic review registration: PROSPERO CRD42018107205

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A systematic review of patient prioritization tools in non-emergency healthcare services

10.21203/rs.3.rs-29776/v2 ◽

2020 ◽

Author(s):

Julien Dery ◽

Angel Ruiz ◽

François Routhier ◽

Valérie Bélanger ◽

André Côté ◽

...

Keyword(s):

Systematic Review ◽

Selection Process ◽

Data Extraction ◽

Waiting Times ◽

Healthcare Services ◽

Process Data ◽

Eligibility Criteria ◽

Published Evidence ◽

Patient Prioritization ◽

The Impact

Abstract Background. Patient prioritization is a strategy used to manage access to healthcare services. Patient prioritization tools (PPT) contribute to supporting the prioritization decision process, and to its transparency and fairness. Patient prioritization tools can take various forms and are highly dependent on the particular context of application. Consequently, the sets of criteria change from one context to another, especially when used in non-emergency settings. This paper systematically synthesizes and analyzes the published evidence concerning the development and challenges related to the validation and implementation of PPTs in non-emergency settings.Methods. We conducted a systematic mixed studies review. We searched evidence in five databases to select articles based on eligibility criteria, and information of included articles was extracted using an extraction grid. The methodological quality of the studies was assessed by using the Mixed Methods Appraisal Tool. The article selection process, data extraction, and quality appraisal were performed by at least two reviewers independently.Results. We included 48 studies listing 34 different patient prioritization tools. Most of them are designed for managing access to elective surgeries in hospital settings. Two thirds of the tools were investigated based on reliability or validity. Inconclusive results were found regarding the impact of PPTs on patient waiting times. Advantages associated with PPT use were found mostly in relationship to acceptability of the tools by clinicians and increased transparency and equity for patients.Conclusions. This review describes the development and validation processes of PPTs used in non-urgent healthcare settings. Despite the large number of PPTs studied, implementation into clinical practice seems to be an open challenge. Based on the findings of this review, recommendations are proposed to develop, validate, and implement such tools in clinical settings.Systematic review registration: PROSPERO CRD42018107205

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The impact of decision aids in patients with colorectal cancer: a systematic review

BMJ Open ◽

10.1136/bmjopen-2018-028379 ◽

2019 ◽

Vol 9 (9) ◽

pp. e028379 ◽

Cited By ~ 4

Author(s):

Jenaya Goldwag ◽

Priscilla Marsicovetere ◽

Peter Scalia ◽

Heather A Johnson ◽

Marie-Anne Durand ◽

...

Keyword(s):

Colorectal Cancer ◽

Systematic Review ◽

Cancer Treatment ◽

Data Extraction ◽

Decision Aids ◽

Case Series ◽

Cochrane Library ◽

Eligibility Criteria ◽

The Impact ◽

Colorectal Cancer Treatment

ObjectivesOur aim was to conduct a systematic review of the literature to determine the impact of patient decision aids (PDA) on patients facing treatment decisions for colorectal cancer.DesignSystematic review.Data sourcesSources included Embase, Medline, Web of Science, CINAHL and the Cochrane Library from inception to June, 20, 2019.Eligibility criteriaWe included randomised controlled trials (RCTs), cohort studies, mixed methods and case series in which a PDA for colorectal cancer treatment was used. Qualitative studies were excluded from our review.Data extraction and synthesisFollowing execution of the search strategy by a medical librarian, two blinded independent reviewers identified articles for inclusion. Two blinded reviewers were also responsible for data extraction, risk of bias and study quality assessments. Any conflict in article inclusion or extraction was resolved by discussion.ResultsOut of 3773 articles identified, three met our inclusion criteria: one RCT, one before-and-after study and one mixed-method study. In these studies, the use of a PDA for colorectal cancer treatment was associated with increased patient knowledge, satisfaction and preparation for making a decision. On quality assessment, two of three studies were judged to be of low quality.ConclusionA paucity of evidence exists on the effect of PDA for colorectal cancer treatment with existing evidence being largely of low quality. Further investigation is required to determine the effect of decision aids for colorectal cancer treatment as well as reasons for the lack of PDA development and implementation in this area.Prospero registration numberCRD42018095153.

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The impacts of and outcomes from telehealth delivered in prisons: A systematic review

PLoS ONE ◽

10.1371/journal.pone.0251840 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0251840

Author(s):

Esther Jie Tian ◽

Sooraj Venugopalan ◽

Saravana Kumar ◽

Matthew Beard

Keyword(s):

Systematic Review ◽

Best Practice ◽

Selection Process ◽

Implementation Process ◽

Healthcare Services ◽

Evidence Base ◽

Conventional Care ◽

Local Context ◽

Successful Implementation ◽

The Impact

Background While the delivery of healthcare services within prison systems is underpinned by different models, access to timely and optimal healthcare is often constrained by multifaceted factors. Telehealth has been used as an alternative approach to conventional care. To date, much of the focus has been on evaluation of telehealth interventions within certain geographical contexts such as rural and remote communities. Therefore, the aim of this systematic review was to synthesise the evidence base to date for the impacts of, and outcomes from, telehealth delivered in prisons. Methods This systematic review was underpinned by best practice in the conduct and reporting of systematic reviews. A systematic search was conducted to reinforce the literature selection process. The modified McMaster Critical Appraisal Tool was used to assess the methodological quality of the included studies. A narrative synthesis of the study outcomes was undertaken. Results Twenty-nine quantitative studies were included. Telehealth interventions were greatly varied in terms of types of healthcare services, implementation process and intervention parameters. Methodological concerns such as rigour in data collection and analysis, and psychometric properties of outcome measures were commonly identified. Process-related outcomes and telehealth outcomes were the two overarching categories identified. Conclusion This systematic review provides mixed evidence on the impact of, and outcomes from, telehealth in prisons. While the evidence base does highlight some positive impacts of telehealth, which at the least, is as effective as conventional care while achieving patient satisfaction, it is also important to consider the local context and drivers that may influence what, when and how telehealth services are provided. Addressing critical factors throughout the lifecycle of telehealth is equally important for successful implementation and sustainability.

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The Influence of applied pressure on the seated person and the prediction of early discomfort – protocol for a systematic review

International Journal of Occupational and Environmental Safety ◽

10.24840/2184-0954_003.001_0008 ◽

2019 ◽

Vol 3 (1) ◽

pp. 77-83

Author(s):

Marko Cvetkovic ◽

J. Duarte ◽

Denise Soares ◽

J. Santos Baptista

Keyword(s):

Systematic Review ◽

Soft Tissues ◽

Negative Impact ◽

Selection Process ◽

Data Extraction ◽

Applied Pressure ◽

Critical Values ◽

Process Data ◽

Design Characteristics ◽

Meta Analyses

Sitting comfortably in a vehicle, office or at home, besides design characteristics, requires excellent physical support of the material to the exposed body segments. An uncomfortable seat can cause well-known pain such as lower back pain, which is nowadays become as "chronical" pain among all the seated workers. This systematic review protocol is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) Statement and presents a methodology to find possible evidence of critical values of the applied pressure which can cause a negative impact on the soft tissues of the seated person. Furthermore, if it is possible to correlate obtained critical values with the time spent in the sitting position. Based on this, the main databases (Scopus, PubMed and Science Direct) will be searched using the same keywords combination for all of them. Afterwards, articles selection process, data extraction, and validation will be approved independently by the reviewers and collected data will be summarized in a spreadsheet table. Outcomes of the selected articles will be examined in the details and will be analyzed in order to extract the main results.

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Technology-based Health Solutions for Cancer Caregivers to Better Shoulder the Impact of COVID-19: A Systematic Review Protocol

10.21203/rs.3.rs-66218/v1 ◽

2020 ◽

Author(s):

Zhaohui Su ◽

Dean McDonnell ◽

Bin Liang ◽

Jennifer Kue ◽

Xiaoshan Li ◽

...

Keyword(s):

Systematic Review ◽

Digital Health ◽

A Priori ◽

Healthcare Services ◽

Daily Basis ◽

Eligibility Criteria ◽

Healthcare Needs ◽

Cancer Caregivers ◽

Meta Analyses ◽

The Impact

Abstract Background Cancer patients are particularly vulnerable to COVID-19, partially owing to their compromised immune systems and curbed or cut cancer healthcare services caused by the pandemic. As a result, cancer caregivers may have to shoulder triple crises: the COVID-19 pandemic, pronounced healthcare needs from the patient, and elevated need for care from within. While technology-based health interventions have the potential to address unique challenges cancer caregivers face amid COVID-19, limited insights are available. Thus, to bridge this gap, we aim to identify technology-based interventions designed for cancer caregivers and report the characteristics and effects of these interventions concerning the distinctive challenges cancer caregivers face amid COVID-19. Additionally, this paper will present practical insights into the diverse intervention approaches that can assist in the delivery of digital health solutions for cancer caregivers amid and beyond COVID-19.Methods A systematic review of the literature will be conducted in PubMed, PsycINFO, CINAHL, and Scopus in September, 2020. Articles that center on technology-based interventions for cancer caregivers will be included in the review. The search strategy was developed in consultation with an academic librarian who is experienced in systematic review studies. Titles, abstracts, and full-text articles will be screened against eligibility criteria developed a priori. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures will be followed for the reporting process.Results NA—This is a protocol study.Conclusions COVID-19 has uprooted cancer care as we know it. Due to barriers introduced by the COVID-19 pandemic, such as medical resources rationing, cancer caregivers often have to step up to address patients' healthcare needs and wants. This, in turn, will exert substantial stress on informal caregivers, above and beyond COVID-19-related burdens the general public shoulders on a daily basis. Findings of this study can shed light on evidence-based and practical solutions cancer caregivers can utilize to mitigate the unique challenges they face amid COVID-19. Furthermore, results of this study will also offer valuable insights for researchers who aim to develop interventions for cancer caregivers in the context of COVID-19. In addition, we also expect to be able to identify areas for improvement that need to be addressed in order for health experts to more adequately help cancer caregivers weather the storm of global health crises like COVID-19 and beyond.Study Protocol Registration: PROSPERO CRD42020196301

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Technology-based Health Solutions for Cancer Caregivers to Better Shoulder the Impact of COVID-19: A Systematic Review Protocol

10.21203/rs.3.rs-66218/v2 ◽

2021 ◽

Author(s):

Zhaohui Su ◽

Dean McDonnell ◽

Bin Liang ◽

Jennifer Kue ◽

Xiaoshan Li ◽

...

Keyword(s):

Systematic Review ◽

A Priori ◽

Healthcare Services ◽

Eligibility Criteria ◽

Healthcare Needs ◽

Protocol Registration ◽

Review Protocol ◽

Cancer Caregivers ◽

Meta Analyses ◽

The Impact

Abstract Background: Cancer patients are particularly vulnerable to COVID-19, partially owing to their compromised immune systems and curbed or cut cancer healthcare services caused by the pandemic. As a result, cancer caregivers may have to shoulder triple crises: the COVID-19 pandemic, pronounced healthcare needs from the patient, and elevated need for care from within. While technology-based health interventions have the potential to address unique challenges cancer caregivers face amid COVID-19, limited insights are available. Thus, to bridge this gap, we aim to identify technology-based interventions designed for cancer caregivers and report the characteristics and effects of these interventions concerning cancer caregivers' distinctive challenges amid COVID-19. Methods: A systematic search of the literature will be conducted in PubMed, PsycINFO, CINAHL, and Scopus from the database inception to the end of March, 2021. Articles that center on technology-based interventions for cancer caregivers will be included in the review. The search strategy will be developed in consultation with an academic librarian who is experienced in systematic review studies. Titles, abstracts, and full-text articles will be screened against eligibility criteria developed a priori. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures will be followed for the reporting process. Conclusions: COVID-19 has upended cancer care as we know it. Findings of this study can shed light on evidence-based and practical solutions cancer caregivers can utilize to mitigate the unique challenges they face amid COVID-19. Furthermore, results of this study will also offer valuable insights for researchers who aim to develop interventions for cancer caregivers in the context of COVID-19. In addition, we also expect to be able to identify areas for improvement that need to be addressed in order for health experts to more adequately help cancer caregivers weather the storm of global health crises like COVID-19 and beyond. Study Protocol Registration: PROSPERO CRD42020196301

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Impact of transitional care interventions on hospital readmissions in older medical patients: a systematic review

BMJ Open ◽

10.1136/bmjopen-2020-040057 ◽

2021 ◽

Vol 11 (1) ◽

pp. e040057

Author(s):

Lisa Fønss Rasmussen ◽

Louise Bang Grode ◽

Jeppe Lange ◽

Ishay Barat ◽

Merete Gregersen

Keyword(s):

Systematic Review ◽

Methodological Quality ◽

Transitional Care ◽

Selection Process ◽

Hospital Readmissions ◽

Cochrane Library ◽

Medical Patients ◽

Process Data ◽

Readmission Rates ◽

The Impact

ObjectivesTo identify and synthesise available evidence on the impact of transitional care interventions with both predischarge and postdischarge elements on readmission rates in older medical patients.DesignA systematic review.MethodInclusion criteria were: medical patients ≥65 years or mean age in study population of ≥75 years; interventions were transitional care interventions between hospital and home with both predischarge and postdischarge components; outcome was hospital readmissions. Studies were excluded if they: included other patient groups than medical patients, included patients with only one diagnosis or patients with only psychiatric disorders. PubMed, The Cochrane Library, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Web of Science were searched from January 2008 to August 2019. Study selection at title level was undertaken by one author; the remaining selection process, data extraction and methodological quality assessment were undertaken by two authors independently. A narrative synthesis was performed, and effect sizes were estimated.ResultWe identified 1951 records and included 11 studies: five randomised trials, four non-randomised controlled trials and two pre–post cohort studies. The 11 studies represent 15 different interventions and 29 outcome results measuring readmission rates within 7–182 days after discharge. Twenty-two of the 29 outcome results showed a drop in readmission rates in the intervention groups compared with the control groups. The most significant impact was seen when interventions were of high intensity, lasted at least 1 month and targeted patients at risk. The methodological quality of the included studies was generally poor.ConclusionTransitional care interventions reduce readmission rates among older medical patients although the impact varies at different times of outcome assessment. High-quality studies examining the impact of interventions are needed, preferably complimented by a process evaluation to refine and improve future interventions.PROSPERO registration numberCRD42019121795.

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Technology-based health solutions for cancer caregivers to better shoulder the impact of COVID-19: a systematic review protocol

Systematic Reviews ◽

10.1186/s13643-021-01592-x ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Zhaohui Su ◽

Dean McDonnell ◽

Bin Liang ◽

Jennifer Kue ◽

Xiaoshan Li ◽

...

Keyword(s):

Systematic Review ◽

A Priori ◽

Healthcare Services ◽

Eligibility Criteria ◽

Healthcare Needs ◽

Academic Librarian ◽

Review Protocol ◽

Cancer Caregivers ◽

Meta Analyses ◽

The Impact

Abstract Background Cancer patients are particularly vulnerable to COVID-19, partially owing to their compromised immune systems and curbed or cut cancer healthcare services caused by the pandemic. As a result, cancer caregivers may have to shoulder triple crises: the COVID-19 pandemic, pronounced healthcare needs from the patient, and elevated need for care from within. While technology-based health interventions have the potential to address unique challenges cancer caregivers face amid COVID-19, limited insights are available. Thus, to bridge this gap, we aim to identify technology-based interventions designed for cancer caregivers and report the characteristics and effects of these interventions concerning cancer caregivers' distinctive challenges amid COVID-19. Methods A systematic search of the literature will be conducted in PubMed, PsycINFO, CINAHL, and Scopus from the database inception to the end of March 2021. Articles that center on technology-based interventions for cancer caregivers will be included in the review. The search strategy will be developed in consultation with an academic librarian who is experienced in systematic review studies. Titles, abstracts, and full-text articles will be screened against eligibility criteria developed a priori. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedures will be followed for the reporting process. Conclusions COVID-19 has upended cancer care as we know it. Findings of this study can shed light on evidence-based and practical solutions cancer caregivers can utilize to mitigate the unique challenges they face amid COVID-19. Furthermore, results of this study will also offer valuable insights for researchers who aim to develop interventions for cancer caregivers in the context of COVID-19. In addition, we also expect to be able to identify areas for improvement that need to be addressed in order for health experts to more adequately help cancer caregivers weather the storm of global health crises like COVID-19 and beyond. Systematic review registration PROSPERO CRD42020196301

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Weaning from mechanical ventilation in people with neuromuscular disease: a systematic review

BMJ Open ◽

10.1136/bmjopen-2020-047449 ◽

2021 ◽

Vol 11 (9) ◽

pp. e047449

Author(s):

Saint Clair Gomes Bernardes Neto ◽

Rodrigo Torres-Castro ◽

Íllia Lima ◽

Vanessa R Resqueti ◽

Guilherme A F Fregonezi

Keyword(s):

Systematic Review ◽

Mechanical Ventilation ◽

Hospital Stay ◽

Neuromuscular Disease ◽

Data Extraction ◽

Invasive Mechanical Ventilation ◽

Eligibility Criteria ◽

Randomised Controlled ◽

The Impact ◽

Weaning Protocols

ObjectiveThis systematic review aimed in assessing the effects of different weaning protocols in people with neuromuscular disease (NMD) receiving invasive mechanical ventilation, identifying which protocol is the best and how different protocols can affect weaning outcome success, duration of weaning, intensive care unit (ICU) and hospital stay and mortality.DesignSystematic review.Data sourcesElectronic databases (MEDLINE, EMBASE, Web of Science and Scopus) were searched from January 2009 to August 2020.Eligibility criteria for selecting studiesRandomised controlled trials (RCTs) and non-RCT that evaluated patients with NMD (adults and children from 5 years old) in the weaning process managed with a protocol (pressure support ventilation; synchronised intermittent mandatory ventilation; continuous positive airway pressure; ‘T’ piece).Primary outcomeWeaning success.Secondary outcomesWeaning duration, ICU stay, hospital stay, ICU mortality, complications (pneumothorax, ventilation-associated pneumonia).Data extraction and synthesisTwo review authors assessed the titles and the abstracts for inclusion and reviewed the full texts independently.ResultsWe found no studies that fulfilled the inclusion criteria.ConclusionsThe absence of studies about different weaning protocols for patients with NMD does not allow concluding the superiority of any specific weaning protocol for patients with NMD or determining the impact of different types of protocols on other outcomes. The result of this review encourages further studies.PROSPERO registration numberCRD42019117393.

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