scholarly journals How to foster successful implementation of a patient reported experience measurement in the disability sector: an example of developing strategies in co-creation

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Marjolein van Rooijen ◽  
Anneke van Dijk-de Vries ◽  
Stephanie Lenzen ◽  
Ruth Dalemans ◽  
Albine Moser ◽  
...  
Keyword(s):  
Implementation Strategies ◽  
Implementation Process ◽  
Successful Implementation ◽  
Participatory Action ◽  
Policy And Practice ◽  
Link Type ◽  
Tailored Implementation ◽  
Patient Reported ◽  
Strategy Changes ◽  
The Impact

Abstract Background The integrated uptake of patient-reported experience measures, using outcomes for the micro, meso and macro level, calls for a successful implementation process which depends on how stakeholders are involved in this process. Currently, the impact of stakeholders on strategies to improve the integrated use is rarely reported, and information about how stakeholders can be engaged, including care-users who are communication vulnerable, is limited. This study illustrates the impact of all stakeholders on developing tailored implementation strategies and provides insights into supportive conditions to involve care-users who are communication vulnerable. Methods With the use of participatory action research, implementation strategies were co-created by care-users who are communication vulnerable (n = 8), professionals (n = 12), management (n = 6) and researchers (n = 5) over 9 months. Data collection consisted of audiotapes, reports, and researchers’ notes. Conventional content analysis was performed. Results The impact of care-users concerned the strategies’ look and feel, understandability and relevance. Professionals influenced impact on how to use strategies and terminology. The impact of management was on showing the gap between policy and practice, and learning from previous improvement failures. Researchers showed impact on analysis, direction of strategy changes and translating academic and development experience into practice. The engagement of care-users who are communication vulnerable was supported, taking into account organisational issues and the presentation of information. Conclusions The impact of all engaged stakeholders was identified over the different levels strategies focused on. Care-users who are communication vulnerable were valuable engaged in co-creation implementation strategies by equipping them to their needs and routines, which requires adaptation in communication, delimited meetings and a safe group environment. Trial registration Reviewed by the Medical Ethics Committee of Zuyderland-Zuyd (METCZ20190006). NL7594 registred at https://www.trialregister.nl/.

scholarly journals What Is Good Advance Care Planning According to Hospitalized Palliative Patients and Their Families? An Explorative Study

2020 ◽  
Vol 35 (4) ◽  
pp. 236-242
Author(s):  
Birgit Vanderhaeghen ◽  
Inge Bossuyt ◽  
Johan Menten ◽  
Peter Rober
Keyword(s):  
Advance Care Planning ◽  
Implementation Strategies ◽  
Implementation Process ◽  
Relevant Information ◽  
Successful Implementation ◽  
Care Planning ◽  
Hospital Practice ◽  
Recall Procedure ◽  
Advance Care ◽  
Palliative Patients

Background: Advance care planning is not well implemented in Belgian hospital practice. In order to obtain successful implementation, implementation theory states that the adopters should be involved in the implementation process. This information can serve as a basis for creating better implementation strategies. Aim: For this study, we asked hospitalized palliative patients and their families what they experienced as good advance care planning. Methods: Twenty-nine interviews were taken from patients and families, following the Tape Assisted Recall procedure of Elliot. These interviews were analyzed using content analysis based on grounded theory. To improve reliability, 3 independent external auditors audited the analysis. Results: Results show that hospitalized palliative patients and families want to have advance care planning communication about treatment and care throughout their disease and about different aspects: social, psychological, physical, practical, and medical. They prefer to have these conversations with their supervising physician. They report 4 important goals of advance care planning communication: establishing a trustful relationship with the physician, in which they feel the involvement of the physician; giving and receiving relevant information for the decision process, making a personal decision about which treatment and care are preferred; and finding consensus between the preferred decision of the physician, the patient and the family concerning the treatment and care policy. Conclusion: This study can contribute to advance care planning implementation in hospital practice because it gives in insight into which elements in advance care planning patients and families experience as necessary and when advance care planning is necessary to them.

scholarly journals A qualitative exploration of Bahrain and Kuwait herbal medicine registration systems: policy implementation and readiness to change

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Azhar H. Alostad ◽  
Douglas T. Steinke ◽  
Ellen I. Schafheutle
Keyword(s):  
Classification System ◽  
Policy Development ◽  
Readiness To Change ◽  
Implementation Process ◽  
Arab Countries ◽  
Successful Implementation ◽  
Registration System ◽  
Regulatory Policies ◽  
Registration Process ◽  
The Impact

Abstract Background The Kuwaiti drug regulatory authority (DRA) lack a structured classification system for the assessment of imported herbal medicines (HMs), which leads to ambiguity in the registration process. This study aimed to examine the policy development and implementation process in an established HM registration system (Bahrain) and harness lessons to inform recommendations for a suitable HM classification system and explore implementation readiness in Kuwait. Methods A sequential study design was chosen, with data collected in Bahrain (case 1), recommendations formed and readiness for implementation explored subsequently in Kuwait (case 2). With ethics and DRA approval in place, data sources were documentary review of regulatory policies, direct observations of HMs registration processes, and semi-structured interviews with twenty three key officials involved in the HMs registration processes. Data from all three sources were analysed thematically and findings triangulated. Results The classification policy in Bahrain was found to be based on evidence and extensive stakeholder engagement, resulting in a clear and organised HM registration process. The availability of HMs classification policies in other DRAs, officials’ dedication and teamwork, and support by higher authority, were identified as the main facilitators in policy development and successful implementation. Barriers were the diversity of HM classifications worldwide, a lack of staff and resultant workload, and lack of training. Proposed recommendations for Kuwait were to adopt a clear definition of what constituted HMs, and to introduce a Traditional Herbal Registration based on this definition and the product’s characteristics. Interviews in Kuwait showed that almost all participants were in favour of the proposed recommendations and were in support of timely implementation. Interviewees anticipated that consistency in the HM registration process would be the main benefit, increasing reviewer’s confidence in making regulatory decisions. Interviewees also identified potential challenges which may impede successful implementation, including staff shortages, resistance to change by internal and external stakeholders, and the impact of cultural and traditional ways of working. Conclusions Insights into the HM policy development and implementation process in Bahrain, and exploration of Kuwait’s readiness to implement resultant recommendations informed an effective implementation process for a well-designed HMs policy for Kuwait and other Arab countries.

scholarly journals What Do Secondary Schools Need to Create Healthier Canteens? The Development of an Implementation Plan

2021 ◽  
Vol 9 ◽  
Author(s):  
Irma J. Evenhuis ◽  
Ellis L. Vyth ◽  
Femke van Nassau ◽  
Lydian Veldhuis ◽  
Marjan J. Westerman ◽  
...  
Keyword(s):  
Secondary Schools ◽  
Online Community ◽  
Implementation Strategies ◽  
Policy And Practice ◽  
Online Questionnaire ◽  
Implementation Plan ◽  
Online Tool ◽  
Tailored Implementation ◽  
School Canteen ◽  
Expert Meeting

Introduction: The Netherlands Nutrition Centre developed guidelines to improve the availability and accessibility of healthier food products in Dutch canteens. This paper describes the development of an implementation plan to facilitate implementation of Guidelines for Healthier Canteens in Dutch secondary schools.Materials and Methods: In cooperation with stakeholders (i.e., school/caterer managers/employees, school canteen advisors, researchers) and based on theory, we developed an implementation plan in three steps. First, we identified factors that impede/facilitate stakeholders to create a healthier school canteen during 14 interviews. Second, 25 experts discussed and prioritized these identified factors in an expert meeting. Third, we translated these factors into tools to be included in the implementation plan, by making use of behavior change taxonomies and evidence-based implementation strategies.Results: The plan aims to support stakeholders in implementing healthier school canteens and consists of five tools: (1) tailored advice based on an online questionnaire to assess schools' and stakeholders' context and the Canteen Scan (i.e., an online tool to assess the availability and accessibility of food/drink products); (2) communication materials with information and examples; (3) online community for support by sharing experiences/questions; (4) digital newsletter as reminder/support; (5) fact sheet with students' needs/wishes to tailor the canteen.Discussion: This study illustrates how collaboration between science, policy and practice resulted in a tailored implementation plan aimed to support schools to adhere to school canteen policy. This development serves as a good example for researchers, health promotion policymakers, and practitioners how to create an implementation plan that fits the needs of stakeholders.

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

PLoS ONE ◽  
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.

scholarly journals Measuring the effects of a personalized music intervention on agitated behaviors among nursing home residents with dementia: design features for cluster-randomized adaptive trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ellen M. McCreedy ◽  
Roee Gutman ◽  
Rosa Baier ◽  
James L. Rudolph ◽  
Kali S. Thomas ◽  
...  
Keyword(s):  
Nursing Home ◽  
Real World ◽  
Implementation Strategies ◽  
Trial Registration ◽  
World Health ◽  
Secondary Outcome ◽  
Link Type ◽  
Cluster Randomized ◽  
The Impact ◽  
Adaptive Trial

Abstract Background Agitated and aggressive behaviors (behaviors) are common in nursing home (NH) residents with dementia. Medications commonly used to manage behaviors have dangerous side effects. NHs are adopting non-pharmacological interventions to manage behaviors, despite a lack of effectiveness evidence and an understanding of optimal implementation strategies. We are conducting an adaptive trial to evaluate the effects of personalized music on behaviors. Adaptive trials may increase efficiency and reduce costs associated with traditional RCTs by learning and making modifications to the trial while it is ongoing. Methods We are conducting two consecutive parallel cluster-randomized trials with 54 NHs in each trial (27 treatment, 27 control). Participating NHs were recruited from 4 corporations which differ in size, ownership structure, geography, and residents’ racial composition. After randomization, there were no significant differences between the NHs randomized to each trial with respect to baseline behaviors, number of eligible residents, degree of cognitive impairment, or antipsychotic use. Agitated behavior frequency is assessed via staff interviews (primary outcome), required nursing staff conducted resident assessments (secondary outcome), and direct observations of residents (secondary outcome). Between the two parallel trials, the adaptive design will be used to test alternative implementation strategies, increasingly enroll residents who are likely to benefit from the intervention, and seamlessly conduct a stage III/IV trial. Discussion This adaptive trial allows investigators to estimate the impact of a popular non-pharmaceutical intervention (personalized music) on residents’ behaviors, under pragmatic, real-world conditions testing two implementation strategies. This design has the potential to reduce the research timeline by improving the likelihood of powered results, increasingly enrolling residents most likely to benefit from intervention, sequentially assessing the effectiveness of implementation strategies in the same trial, and creating a statistical model to reduce the future need for onsite data collection. The design may also increase research equity by enrolling and tailoring the intervention to populations otherwise excluded from research. Our design will inform pragmatic testing of other interventions with limited efficacy evidence but widespread stakeholder adoption because of the real-world need for non-pharmaceutical approaches. {2a} Trial registration ClinicalTrials.govNCT03821844. Registered on January 30, 2019. This trial registration meets the World Health Organization (WHO) minimum standard.

scholarly journals Implementing a resource list management system in an academic library

2015 ◽  
Vol 33 (2) ◽  
pp. 210-223 ◽  
Author(s):  
Richard Cross
Keyword(s):  
Management System ◽  
Academic Library ◽  
Implementation Process ◽  
Resource Discovery ◽  
Virtual Learning Environment ◽  
Library Services ◽  
Successful Implementation ◽  
Content Type ◽  
Dynamic Relationship ◽  
The Impact

Purpose – The purpose of this paper is to review the key components of the introduction of a new resource list management system (RLMS) at Nottingham Trent University (NTU) using the Aspire application from Talis Education. It explains the key service goals; the implementation milestones; the main technical challenges which needed to be addressed; and the dynamic relationship between the rollout of the RLMS and existing selection, acquisition and resource delivery processes. Design/methodology/approach – This evidence in this paper is drawn from the experiences of the NTU RLMS project group, which involved colleagues from Libraries and Learning Resources, Information Systems and the Virtual Learning Environment (VLE) teams at the university. It draws on both qualitative evaluations and quantitative assessments of adoption and use by academics, students and library staff; and the internal mechanisms of project review. Findings – This paper concludes that the successful technical implementation of a cloud-based mission-critical service for academics and students depends on a successful collaboration between library, VLE and technical teams; and reaffirms that a hosted RLMS service still requires the deployment of local technical expertise. It is essential (although not always straightforward) to try to anticipate the impact that the introduction of a new RLMS will have on existing processes (inside the library and without). Ultimately, however, the successful implementation of an RLMS is dependent on securing its adoption by both academics and students; not least by ensuring that the application meets their needs. Although it is not a technical prerequisite, the prospect of a successful implementation of an RLMS is greatly improved when working with the grain of a supportive institutional policy environment. Originality/value – Interest in “next-generation” resource list systems which can address the needs of students, academics and library services is likely to increase sharply in the next few years, as library services seek to align both resource spend and resource discovery more closely than ever with the student experience around “directed reading”. The experiences of an “early adopter” implementer of an RLMS highlight some of the key prerequisites and significant operational decisions, and provide a number of insights for those about to embark on a similar implementation process.

scholarly journals Prospective evaluation of the impact of stress, anxiety, and depression on household income among young women with early breast cancer from the Young and Strong trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Erin E. Cook ◽  
Shoshana M. Rosenberg ◽  
Kathryn J. Ruddy ◽  
William T. Barry ◽  
Mary Greaney ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Household Income ◽  
The United States ◽  
Anxiety And Depression ◽  
Link Type ◽  
Patient Reported ◽  
Household Incomes ◽  
Prospective Longitudinal ◽  
The Impact

Abstract Background Young women with breast cancer tend to report lower quality of life and higher levels of stress than older women with breast cancer, and this may have implications for other psychosocial factors including finances. We sought to determine if stress, anxiety, and depression at diagnosis were associated with changes in household income over 12-months in young women with breast cancer in the United States. Methods This study was a prospective, longitudinal cohort study comprised of women enrolled in the Young and Strong trial. Of the 467 women aged 18–45 newly diagnosed with early-stage breast cancer enrolled in the Young and Strong trial from 2012 to 2013, 356 (76%) answered income questions. Change in household income from baseline to 12 months was assessed and women were categorized as having lost, gained, maintained the same household income <$100,000, or maintained household income ≥$100,000. Patient-reported stress, anxiety, and depression were assessed close to diagnosis at trial enrollment. Adjusted multinomial logistic regression models were used to compare women who lost, gained, or maintained household income ≥$100,000 to women who maintained the same household income <$100,000. Results Although most women maintained household income ≥$100,000 (37.1%) or the same household income <$100,000 (32.3%), 15.4% lost household income and 15.2% gained household income. Stress, anxiety, and depression were not associated with gaining or losing household income compared to women maintaining household incomes <$100,000. Women with household incomes <$50,000 had a higher risk of losing household income compared to women with household incomes ≥$50,000. Women who maintained household incomes ≥$100,000 were less likely to report financial or insurance problems. Among women who lost household income, 56% reported financial problems and 20% reported insurance problems at 12 months. Conclusions Baseline stress, anxiety, and depression were not associated with household income changes for young women with breast cancer. However, lower baseline household income was associated with losing household income. Some young survivors encounter financial and insurance problems in the first year after diagnosis, and further support for these women should be considered. Trial registration Clinicaltrials.gov, NCT01647607; date registered: July 23, 2012.

scholarly journals Clinicians’ knowledge and attitudes towards patient reported outcomes in colorectal cancer care – insights from qualitative interviews

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nora Tabea Sibert ◽  
Christoph Kowalski ◽  
Holger Pfaff ◽  
Simone Wesselmann ◽  
Clara Breidenbach
Keyword(s):  
Colorectal Cancer ◽  
Cancer Care ◽  
Patient Reported Outcomes ◽  
Qualitative Content Analysis ◽  
Qualitative Interviews ◽  
Implementation Strategies ◽  
Clinical Staff ◽  
Successful Implementation ◽  
Patient Reported ◽  
Clinical Benefits

Abstract Introduction Patient-reported outcomes (PROs) can be used in cancer care to monitor patients’ disease-related symptoms and functional status. However, successful implementation of such instruments is only possible if clinical staff are convinced of the clinical benefits. It is therefore crucial to investigate the attitudes of clinical staff to PROs in routine cancer care. Methods Semi-structured, guideline-based interviews were held with 12 clinicians working in certified colorectal cancer centers in Germany who are taking part in an observational study on PROs (five surgeons, two oncologists, one psycho-oncologist, two oncological care nurses, one stoma therapist, and one physician assistant) in order to investigate firstly, how clinicians describe PRO instruments (“wording”); and secondly, the clinicians’ general attitude toward PROs. A qualitative content analysis according to Kuckartz was performed. Results The wording used to describe PROs was not consistent. Statements on attitudes toward PROs were very heterogeneous and were therefore categorized into “(rather) positive” and “(rather) negative.” The principal advantages of PROs mentioned by participants included broader, structured knowledge about patients and treatment, as well as relevance for patients. Subcategories for (rather) negative attitudes included statements expressing doubts about the questionnaires and “no need for PROs.” Discussion The clinicians participating mainly expressed fairly positive attitudes toward PROs. However, they had little knowledge about PROs in general and the interviews therefore mainly reflect their expectations and assumptions about them. These initial impressions may be regarded as providing a basis for future implementation strategies and for training of clinicians on how to use PROs in routine cancer care.

scholarly journals Update to the study protocol for an implementation-effectiveness trial comparing two education strategies for improving the uptake of noninvasive ventilation in patients with severe COPD exacerbation

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mihaela S. Stefan ◽  
Penelope S. Pekow ◽  
Christopher M. Shea ◽  
Ashley M. Hughes ◽  
Nicholas S. Hill ◽  
...  
Keyword(s):  
Study Design ◽  
Noninvasive Ventilation ◽  
Implementation Strategies ◽  
Inpatient Setting ◽  
Effectiveness Trial ◽  
Copd Exacerbation ◽  
Implementation Effectiveness ◽  
Link Type ◽  
The Impact ◽  
Severe Copd

Abstract Background There is strong evidence that noninvasive ventilation (NIV) improves the outcomes of patients hospitalized with severe COPD exacerbation, and NIV is recommended as the first-line therapy for these patients. Yet, several studies have demonstrated substantial variation in NIV use across hospitals, leading to preventable morbidity and mortality. In addition, prior studies suggested that efforts to increase NIV use in COPD need to account for the complex and interdisciplinary nature of NIV delivery and the need for team coordination. Therefore, our initial project aimed to compare two educational strategies: online education (OLE) and interprofessional education (IPE), which targets complex team-based care in NIV delivery. Due to the impact of the COVID-19 pandemic on recruitment and planned intervention, we had made several changes in the study design, statistical analysis, and implementation strategies delivery as outlined in the methods. Methods We originally proposed a two-arm, pragmatic, cluster, randomized hybrid implementation-effectiveness trial comparing two education strategies to improve NIV uptake in patients with severe COPD exacerbation in 20 hospitals with a low baseline rate of NIV use. Due to logistical constrains and slow recruitment, we changed the study design to an opened cohort stepped-wedge design with three steps which will allow the institutions to enroll when they are ready to participate. Only the IPE strategy will be implemented, and the education will be provided in an online virtual format. Our primary outcome will be the hospital-level risk-standardized NIV proportion for the period post-IPE training, along with the change in rate from the period prior to training. Aim 1 will compare the change over time of NIV use among patients with COPD in the step-wedged design. Aim 2 will explore the mediators’ role (respiratory therapist autonomy and team functionality) on the relationship between the implementation strategies and effectiveness. Finally, in Aim 3, through interviews with providers, we will assess the acceptability and feasibility of the educational training. Conclusion The changes in study design will result in several limitation. Most importantly, the hospitals in the three cohorts are not randomized as they enroll based on their readiness. Second, the delivery of the IPE is virtual, and it is not known if remote education is conducive to team building. However, this study will be among the first to test the impact of IPE in the inpatient setting carefully and may generalize to other interventions directed to seriously ill patients. Trial registration ClinicalTrials.govNCT04206735. Registered on December 20, 2019;

scholarly journals SYSTEMS FOR MONITORING TRENDS IN THE DEVELOPMENT OF DISTANCE LEARNING

2021 ◽  
pp. 58-65
Author(s):  
Э. Д. Алисултанова ◽  
А. Р. Магомадова ◽  
М. С-М. Мусаева
Keyword(s):  
Distance Education ◽  
Distance Learning ◽  
Implementation Process ◽  
Monitoring Systems ◽  
Successful Implementation ◽  
Global Pandemic ◽  
Pros And Cons ◽  
Training Courses ◽  
The Impact

В статье отражены актуальные проблемы, связанные с развитием дистанционного образования в России. В частном порядке были рассмотрены такие темы, как влияние текущей мировой пандемии, вызванной коронавирусом COVID-19, на ускоренное развитие дистанционного обучения, приведена статистика, были отмечены основные плюсы и минусы дистанционного образования в целом, приведена классификация основных функциональных элементов процесса реализации дистанционного обучения, дано понятие мониторинга, приведены примеры реализации систем мониторинга при помощи инструментов с открытым исходным кодом. Доказано, что для успешной реализации обучения на расстоянии необходимо взаимодействие преподавателя и студента, актуальное обновление обучающих курсов, поддержка единого веб-портала для выкладывания свежих материалов. В статье автор предложил пути и способы оптимизации процесса мониторинга систем, предоставив актуальную классификацию систем, а также пример входных данных, на основе которых делается статистика. The article reflects the current problems associated with the development of distance education in Russia. Topics such as the impact of the current global pandemic caused by the COVID-19 coronavirus on the accelerated development of distance learning were discussed in private, statistics were provided, the main pros and cons of distance education in general were noted, the classification of the main functional elements of the distance learning implementation process was given, the concept of monitoring was given, examples of the implementation of monitoring systems using open source tools were given. It was suggested that the most important component of the successful implementation of distance learning is the interaction of the teacher and the student, the actual updating of training courses, the support of a single web portal for posting fresh materials. In the article, the author proposed ways and means of optimizing the process of monitoring systems, providing an up-to-date classification of systems, as well as an example of input data on the basis of which statistics are made.

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