scholarly journals Why do some inter-organisational collaborations in healthcare work when others do not? A realist review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Justin Avery Aunger ◽  
Ross Millar ◽  
Joanne Greenhalgh ◽  
Russell Mannion ◽  
Anne-Marie Rafferty ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Studies ◽  
Resource Sharing ◽  
Realist Review ◽  
Primary Data ◽  
Refined Theory ◽  
Policy And Practice ◽  
Healthcare Work ◽  
Partnership Synergy ◽  
Collaboration Types

Abstract Background Inter-organisational collaboration is increasingly prominent within contemporary healthcare systems. A range of collaboration types such as alliances, networks, and mergers have been proposed as a means to turnaround organisations, by reducing duplication of effort, enabling resource sharing, and promoting innovations. However, in practice, due to the complexity of the process, such efforts are often rife with difficulty. Notable contributions have sought to make sense of this area; however, further understanding is needed in order to gain a better understanding of why some inter-organisational collaborations work when others do not, to be able to more effectively implement collaborations in the future. Methods Realist review methodology was used with the intention of formulating context-mechanism-outcome configurations (CMOCs) to explain how inter-organisational collaborations work and why, combining systematic and purposive literature search techniques. The systematic review encompassed searches for reviews, commentaries, opinion pieces, and case studies on HMIC, MEDLINE, PsycINFO, and Social Policy and Practice databases, and further searches were conducted using Google Scholar. Data were extracted from included studies according to relevance to the realist review. Results Fifty-three papers were included, informing the development of programme theories of how, why, and when inter-organisational collaborations in healthcare work. Formulation of our programme theories incorporated the concepts of partnership synergy and collaborative inertia and found that it was essential to consider mechanisms underlying partnership functioning, such as building trust and faith in the collaboration to maximise synergy and thus collaborative performance. More integrative or mandated collaboration may lean more heavily on contract to drive collaborative behaviour. Conclusion As the first realist review of inter-organisational collaborations in healthcare as an intervention for improvement, this review provides actionable evidence for policymakers and implementers, enhancing understanding of mechanisms underlying the functioning and performing of inter-organisational collaborations, as well as how to configure the context to aid success. Next steps in this research will test the results against further case studies and primary data to produce a further refined theory. Systematic review registration PROSPERO CRD42019149009

scholarly journals Why do some inter-organisational collaborations in healthcare work when others do not? A realist review

2021 ◽  
Author(s):  
Justin Avery Aunger ◽  
Ross Millar ◽  
Joanne Greenhalgh ◽  
Russell Mannion ◽  
Anne Marie Rafferty ◽  
...  
Keyword(s):  
Case Studies ◽  
Resource Sharing ◽  
Realist Review ◽  
Primary Data ◽  
Refined Theory ◽  
Policy And Practice ◽  
Programme Theory ◽  
Healthcare Improvement ◽  
Healthcare Work ◽  
Partnership Synergy

Abstract Background Inter-organisational collaboration is increasingly prominent within contemporary healthcare systems. A range of collaboration types such as alliances, networks, and mergers have been proposed as a means to turnaround organisations, by reducing duplication of effort, enabling resource sharing, and promoting innovations. However, in practice, due to the complexity of the process, such efforts are often rife with difficulty. Notable contributions have sought to make sense of this area, however further understanding is needed in order to gain a better understanding of why some inter-organisational collaborations work when others do not, to be able to more effectively implement collaborations in the future. Methods Realist review methodology was used with the intention of formulating context-mechanism-outcome configurations (CMOCs) to explain how inter-organisational collaborations work and why., combining systematic and purposive literature search techniques . The systematic review encompassed searches for reviews, commentaries, opinion pieces and case studies on HMIC, Medline, PsycINFO, and Social Policy and Practice databases and further searches were conducted using Google Scholar. Data were extracted from included studies according to relevance to the realist review. Results Fifty-three papers were included, informing the development of programme theories of how, why, and when inter-organisational collaborations in healthcare work. Formulation of our programme theories incorporated the concepts of Partnership Synergy and Collaborative Inertia and found that it was essential to consider mechanisms underlying partnership functioning, such as building trust and faith in the collaboration to maximise synergy and thus collaborative performance. More integrative or mandated collaboration may lean more heavily on contract to drive collaborative behaviour. Conclusion As the first realist review of inter-organisational collaborations in healthcare as an intervention for improvement, this review provides actionable evidence for policymakers and implementers, enhancing understanding of mechanisms underlying the functioning and performing of inter-organisational collaborations, as well as how to configure the context to aid success. Next steps in this research will test the results against further case studies and primary data to produce a further refined theory. Review registration This review is registered at PROSPERO with ID CRD42019149009. Keywords Collaboration, partnership working, integration, healthcare, improvement, realist review, realist synthesis, context, programme theory, implementation

scholarly journals Why do some inter-organisational collaborations in healthcare work when others do not? A realist review

2020 ◽  
Author(s):  
Justin Avery Aunger ◽  
Ross Millar ◽  
Joanne Greenhalgh ◽  
Russell Mannion ◽  
Anne Marie Rafferty ◽  
...  
Keyword(s):  
Case Studies ◽  
Resource Sharing ◽  
Realist Review ◽  
Primary Data ◽  
Refined Theory ◽  
Policy And Practice ◽  
Initial Trust ◽  
Middle Range ◽  
Healthcare Work ◽  
Theory Review

Abstract BackgroundInter-organisational collaboration is increasingly prominent within contemporary healthcare systems. A range of collaboration types such as alliances, networks, and mergers have been proposed as a means to turnaround organisations, by reducing duplication of effort, and enabling resource sharing, greater influence, and novel innovations. However, in practice, due to the complexity of the process, such efforts are often rife with difficulty. Notable contributions have sought to make sense of this area, however further understanding is needed in order to gain a better understanding of why some inter-organisational collaborations work when others do not, to be able to more effectively implement collaborations in the future.MethodsRealist review methodology was used, combining systematically searched papers and purposively searched ‘middle-range’ theories. The systematic review encompassed searches for reviews, commentaries, opinion pieces and case studies on HMIC, Medline, PsychINFO, and Social Policy and Practice databases and further searches were conducted using Google Scholar. Data were extracted from included studies according to relevance to the realist review.ResultsThirty-eight systematically-identified studies were included, in addition to twelve purposively-identified papers, informing the development of programme theories of how, why, and when partnerships in healthcare work. The findings led to the proposal of programme theories formulated as context-mechanism-outcome configurations, which outline what outcomes may be expected when partnerships are attempted in differing contexts. We found that it was essential to consider mechanisms underlying partnership functioning, such as building trust and faith in the collaboration, in a context of strong initial trust, to enable maximal synergy and thus collaborative performance.ConclusionAs the first realist review of inter-organisational collaborations in healthcare as an intervention for improvement, this review provides actionable evidence for policymakers and implementers, enhancing understanding of mechanisms underlying the functioning and performing of inter-organisational collaborations, as well as configuring context and entry point to aid success. Next steps in this research will test the results against further case studies and primary data to produce a further refined theory. Review registrationThis review is registered at PROSPERO with ID CRD42019149009.

scholarly journals Prevalence of retinopathy in prediabetes: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040997
Author(s):  
Varo Kirthi ◽  
Paul Nderitu ◽  
Uazman Alam ◽  
Jennifer Evans ◽  
Sarah Nevitt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diabetic Retinopathy ◽  
Data Extraction ◽  
Meta Analysis ◽  
International Diabetes Federation ◽  
Current Data ◽  
Risk Of Bias ◽  
Fundus Photography ◽  
Primary Data ◽  
Cochrane Library

IntroductionThere is growing evidence of a higher than expected prevalence of retinopathy in prediabetes. This paper presents the protocol of a systematic review and meta-analysis of retinopathy in prediabetes. The aim of the review is to estimate the prevalence of retinopathy in prediabetes and to summarise the current data.Methods and analysisThis protocol is developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. A comprehensive electronic bibliographic search will be conducted in MEDLINE, EMBASE, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Scholar and the Cochrane Library. Eligible studies will report prevalence data for retinopathy on fundus photography in adults with prediabetes. No time restrictions will be placed on the date of publication. Screening for eligible studies and data extraction will be conducted by two reviewers independently, using predefined inclusion criteria and prepiloted data extraction forms. Disagreements between the reviewers will be resolved by discussion, and if required, a third (senior) reviewer will arbitrate.The primary outcome is the prevalence of any standard features of diabetic retinopathy (DR) on fundus photography, as per International Clinical Diabetic Retinopathy Severity Scale (ICDRSS) classification. Secondary outcomes are the prevalence of (1) any retinal microvascular abnormalities on fundus photography that are not standard features of DR as per ICDRSS classification and (2) any macular microvascular abnormalities on fundus photography, including but not limited to the presence of macular exudates, microaneurysms and haemorrhages. Risk of bias for included studies will be assessed using a validated risk of bias tool for prevalence studies. Pooled estimates for the prespecified outcomes of interest will be calculated using random effects meta-analytic techniques. Heterogeneity will be assessed using the I2 statistic.Ethics and disseminationEthical approval is not required as this is a protocol for a systematic review and no primary data are to be collected. Findings will be disseminated through peer-reviewed publications and presentations at national and international meetings including Diabetes UK, European Association for the Study of Diabetes, American Diabetes Association and International Diabetes Federation conferences.PROSPERO registration numberCRD42020184820.

scholarly journals Multilingualism in Vanuatu: Four case studies

2021 ◽  
pp. 136700692110231
Author(s):  
Mary Walworth ◽  
Amy Dewar ◽  
Thomas Ennever ◽  
Lana Takau ◽  
Iveth Rodriguez
Keyword(s):  
Case Studies ◽  
Primary Data ◽  
Small Scale ◽  
Language History ◽  
Speech Communities ◽  
The Pacific ◽  
Historical Processes ◽  
The Social ◽  
Original Contribution ◽  
B Mobility

Each of the 65 inhabited islands of Vanuatu hosts its own unique linguistic environment in which varying degrees of multilingualism are found. This paper defines various types of small-scale multilingual settings in Vanuatu and explores what sociohistorical factors have led to them. This paper is based on first-hand observations and primary data collected by the authors in four locations in the Pacific Island nation of Vanuatu since 2016: two neighboring villages of Emae Island (Makatu and Tongamea), North Malekula, and on Maewo Island. The assessments of multilingualism in these examples from Vanuatu were qualitative, based on observations of sociolinguistic practices in each of these areas, as well as data from language history and language use surveys carried out in each place. Through defining and comparing the types of multilingualism present in the four case studies, we identify patterns in the social and historical processes that lead to various kinds of multilingualism: (a) interaction of linguistic and sociocultural identities and (b) mobility of both individuals and entire speech communities. The examples described in this paper are used to highlight the diversity of multilingualism found in Vanuatu and to explore how their differing linguistic environments and histories have contributed to their varying degrees of multilingualism. This paper makes an original contribution to knowledge about the small-scale multilingual situations in Vanuatu, offering descriptions of previously undocumented and endangered multilingual environments. Through an examination of the sociocultural motivations for multilingualism, alongside historical migrations of speaker groups and marked sociolinguistic identities, this paper contributes to research on why and how small-scale multilingualism can develop. Furthermore, this paper provides the foundation for future, more rigorous investigations into the small-scale multilingual situations of this highly understudied region.

scholarly journals A living WHO guideline on drugs to prevent covid-19

BMJ ◽  
2021 ◽  
pp. n526
Author(s):  
François Lamontagne ◽  
Thomas Agoritsas ◽  
Reed Siemieniuk ◽  
Bram Rochwerg ◽  
Jessica Bartoszko ◽  
...  
Keyword(s):  
Systematic Review ◽  
Guideline Development ◽  
Meta Analysis ◽  
World Health ◽  
Policy And Practice ◽  
Assessment Development ◽  
Research Priority ◽  
Health Organization ◽  
Almost All ◽  
Drug Interventions

Abstract Clinical question What is the role of drugs in preventing covid-19? Why does this matter? There is widespread interest in whether drug interventions can be used for the prevention of covid-19, but there is uncertainty about which drugs, if any, are effective. The first version of this living guideline focuses on the evidence for hydroxychloroquine. Subsequent updates will cover other drugs being investigated for their role in the prevention of covid-19. Recommendation The guideline development panel made a strong recommendation against the use of hydroxychloroquine for individuals who do not have covid-19 (high certainty). How this guideline was created This living guideline is from the World Health Organization (WHO) and provides up to date covid-19 guidance to inform policy and practice worldwide. Magic Evidence Ecosystem Foundation (MAGIC) provided methodological support. A living systematic review with network analysis informed the recommendations. An international guideline development panel of content experts, clinicians, patients, an ethicist and methodologists produced recommendations following standards for trustworthy guideline development using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Understanding the new recommendation The linked systematic review and network meta-analysis (6 trials and 6059 participants) found that hydroxychloroquine had a small or no effect on mortality and admission to hospital (high certainty evidence). There was a small or no effect on laboratory confirmed SARS-CoV-2 infection (moderate certainty evidence) but probably increased adverse events leading to discontinuation (moderate certainty evidence). The panel judged that almost all people would not consider this drug worthwhile. In addition, the panel decided that contextual factors such as resources, feasibility, acceptability, and equity for countries and healthcare systems were unlikely to alter the recommendation. The panel considers that this drug is no longer a research priority and that resources should rather be oriented to evaluate other more promising drugs to prevent covid-19. Updates This is a living guideline. New recommendations will be published in this article and signposted by update notices to this guideline. Readers note This is the first version of the living guideline for drugs to prevent covid-19. It complements the WHO living guideline on drugs to treat covid-19. When citing this article, please consider adding the update number and date of access for clarity.

Grassroots Archive Collection at CDRCSL

2021 ◽  
pp. 107780042110146
Author(s):  
Yunxiang Yan ◽  
Tian Li ◽  
Yanjie Huang
Keyword(s):  
Social Sciences ◽  
Qualitative Research ◽  
Case Studies ◽  
Social Life ◽  
Primary Sources ◽  
Primary Data ◽  
Social Sciences And Humanities ◽  
Special Collection ◽  
Historical Truth ◽  
Written Materials

This article aims to introduce the value of grassroots archives at the Center for Data and Research on Contemporary Social Life (CDRCSL) at Fudan University for qualitative research in social sciences and humanities. This special collection includes written materials on various aspects of social life that are left outside the official archive system. We first introduce the types and features of the grassroots archives collection and then briefly review the values of these primary sources, illustrated by two examples. We conclude with brief discussion on some case studies based on the primary data from the CDRCSL collection and our reflection on the tension between the protection of subject privacy and preservation of historical truth.

scholarly journals Sustaining organizational culture change in health systems

2016 ◽  
Vol 30 (1) ◽  
pp. 2-30 ◽  
Author(s):  
Cameron David Willis ◽  
Jessie Saul ◽  
Helen Bevan ◽  
Mary Ann Scheirer ◽  
Allan Best ◽  
...  
Keyword(s):  
Organizational Culture ◽  
Cultural Change ◽  
Grey Literature ◽  
Realist Review ◽  
Policy And Practice ◽  
Content Type ◽  
Organizational Culture Change ◽  
Contextual Elements ◽  
Values And Beliefs ◽  
Guiding Principles

Purpose – The questions addressed by this review are: first, what are the guiding principles underlying efforts to stimulate sustained cultural change; second, what are the mechanisms by which these principles operate; and, finally, what are the contextual factors that influence the likelihood of these principles being effective? The paper aims to discuss these issues. Design/methodology/approach – The authors conducted a literature review informed by rapid realist review methodology that examined how interventions interact with contexts and mechanisms to influence the sustainability of cultural change. Reference and expert panelists assisted in refining the research questions, systematically searching published and grey literature, and helping to identify interactions between interventions, mechanisms and contexts. Findings – Six guiding principles were identified: align vision and action; make incremental changes within a comprehensive transformation strategy; foster distributed leadership; promote staff engagement; create collaborative relationships; and continuously assess and learn from change. These principles interact with contextual elements such as local power distributions, pre-existing values and beliefs and readiness to engage. Mechanisms influencing how these principles sustain cultural change include activation of a shared sense of urgency and fostering flexible levels of engagement. Practical implications – The principles identified in this review, along with the contexts and mechanisms that influence their effectiveness, are useful domains for policy and practice leaders to explore when grappling with cultural change. These principles are sufficiently broad to allow local flexibilities in adoption and application. Originality/value – This is the first study to adopt a realist approach for understanding how changes in organizational culture may be sustained. Through doing so, this review highlights the broad principles by which organizational action may be organized within enabling contextual settings.

scholarly journals User involvement in adolescents’ mental healthcare: protocol for a systematic review

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018800
Author(s):  
Petter Viksveen ◽  
Stig Erlend Bjønness ◽  
Siv Hilde Berg ◽  
Nicole Elizabeth Cardenas ◽  
Julia Rose Game ◽  
...  
Keyword(s):  
Systematic Review ◽  
Critical Appraisal ◽  
Research Evidence ◽  
Data Extraction ◽  
Mental Healthcare ◽  
User Involvement ◽  
Cochrane Collaboration ◽  
Research Literature ◽  
Primary Data ◽  
Evaluation Approach

IntroductionUser involvement has become a growing importance in healthcare. The United Nations state that adolescents have a right to be heard, and user involvement in healthcare is a legal right in many countries. Some research provides an insight into the field of user involvement in somatic and mental healthcare for adults, but little is known about user involvement in adolescents’ mental healthcare, and no overview of the existing research evidence exists.Methods and analysisThe aim of this systematic review is to provide an overview of existing research reporting on experiences with and the effectiveness and safety issues associated with user involvement for adolescents’ mental healthcare at the individual and organisational level. A systematic literature search and assessment of published research in the field of user involvement in adolescents’ mental healthcare will be carried out. Established guidelines will be used for data extraction (Cochrane Collaboration guidelines, Strengthening the Reporting of Observational studies in Epidemiology and Critical Appraisal Skills Programme (CASP)), critical appraisal (Cochrane Collaboration guidelines and Pragmatic-Explanatory Continuum Indicator Summary) and reporting of results (Preferred Reporting Items for Systematic reviews and Meta-Analyses, Consolidated Standards of Reporting Trials and CASP). Confidence in the research evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. Adolescents are included as coresearchers for the planning and carrying out of this systematic review. This systematic review will provide an overview of the existing research literature and thereby fill a knowledge gap. It may provide various stakeholders, including decision-makers, professionals, individuals and their families, with an overview of existing knowledge in an underexplored field of research.Ethics and disseminationEthics approval is not required for this systematic review as we are not collecting primary data. The results will be published in a peer-reviewed journal and at conference presentations and will be shared with stakeholder groups.

Nutrient and Food Intake of Indonesian Children Under 5 Years of Age: A Systematic Review

2021 ◽  
pp. 101053952110410
Author(s):  
Hesti Retno Budi Arini ◽  
Veni Hadju ◽  
Preetha Thomas ◽  
Megan Ferguson
Keyword(s):  
Systematic Review ◽  
Food Intake ◽  
Dietary Intake ◽  
Narrative Analysis ◽  
Fruits And Vegetables ◽  
Child Malnutrition ◽  
Micronutrient Deficiencies ◽  
Policy And Practice ◽  
Comprehensive Overview ◽  
Children Under 5

The Indonesian Government’s targets to reduce the prevalence of child malnutrition are unlikely to be met based on current progress. Adequate dietary intake is key to meeting these targets. This systematic review aimed to provide a comprehensive overview of the nutrient and food intake of Indonesian children under 5 years of age. Peer-reviewed and gray literature published between 2007 and 2019 were collected. Of 1500 records, 38 articles met the study inclusion criteria and a narrative analysis was conducted. Children under 5 years were reported to have ranging energy and macronutrient intakes, some with adequate protein intake. Micronutrient deficiencies, particularly iron, zinc, calcium, and vitamin C, were reported. Animal-source foods, fruits, and vegetables were consumed by children, but frequency and/or volume of consumption was low, and it is among the probable causes of micronutrient deficiency among children under 5 years. The absence of reporting micronutrient intake in the national survey limited evidence to inform nutrition-related policies. The implementation of a national micronutrient survey will be beneficial in informing policy and practice aimed at reducing the prevalence of child malnutrition in line with national targets, through improvement in dietary intake.

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