scholarly journals Determinants for the use and de-implementation of low-value care in health care: a scoping review

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Hanna Augustsson ◽  
Sara Ingvarsson ◽  
Per Nilsen ◽  
Ulrica von Thiele Schwarz ◽  
Irene Muli ◽  
...  
Keyword(s):  
Health Care ◽  
Scoping Review ◽  
Empirical Studies ◽  
Implementation Strategies ◽  
Considerable Proportion ◽  
Journal Articles ◽  
Health Care Settings ◽  
Scientific Databases ◽  
Full Text Review ◽  
English Articles

Abstract Background A considerable proportion of interventions provided to patients lack evidence of their effectiveness. This implies that patients may receive ineffective, unnecessary or even harmful care. However, despite some empirical studies in the field, there has been no synthesis of determinants impacting the use of low-value care (LVC) and the process of de-implementing LVC. Aim The aim was to identify determinants influencing the use of LVC, as well as determinants for de-implementation of LVC practices in health care. Methods A scoping review was performed based on the framework by Arksey and O’Malley. We searched four scientific databases, conducted snowball searches of relevant articles and hand searched the journal Implementation Science for peer-reviewed journal articles in English. Articles were included if they were empirical studies reporting on determinants for the use of LVC or de-implementation of LVC. The abstract review and the full-text review were conducted in duplicate and conflicting decisions were discussed until consensus was reached. Data were charted using a piloted data charting form and the determinants were inductively coded and categorised in an iterative process conducted by the project group. Results In total, 101 citations were included in the review. Of these, 92 reported on determinants for the use of LVC and nine on determinants for de-implementation. The studies were conducted in a range of health care settings and investigated a variety of LVC practices with LVC medication prescriptions, imaging and screening procedures being the most common. The identified determinants for the use of LVC as well as for de-implementation of LVC practices broadly concerned: patients, professionals, outer context, inner context, process and evidence and LVC practice. The results were discussed in relation to the Consolidated Framework for Implementation Research. Conclusion The identified determinants largely overlap with existing implementation frameworks, although patient expectations and professionals’ fear of malpractice appear to be more prominent determinants for the use and de-implementation of LVC. Thus, existing implementation determinant frameworks may require adaptation to be transferable to de-implementation. Strategies to reduce the use of LVC should specifically consider determinants for the use and de-implementation of LVC. Registration The review has not been registered.

A Scoping Review of Telehealth-Assisted Case Management for Chronic Illnesses

2021 ◽  
pp. 019394592110089
Author(s):  
Jee Young Joo ◽  
Megan F. Liu
Keyword(s):  
Health Care ◽  
Case Management ◽  
Scoping Review ◽  
Access To Health Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Management Practice ◽  
Empirical Studies ◽  
Chronic Illnesses ◽  
Future Research

This scoping review aimed to examine telehealth-assisted case management for chronic illnesses and assess its overall impact on health care delivery. Guided by the PRISMA statement, this review included 36 empirical studies published between 2011 and 2020. This study identified three weaknesses and four strengths of telehealth-assisted case management. While the weaknesses were negative feelings about telehealth, challenges faced by patients in learning and using telehealth devices, and increased workload for case managers, the strengths included efficient and timely care, increased access to health care services, support for patients’ satisfaction, and cost savings. Future research can be designed and conducted for overcoming the weaknesses of telehealth-assisted case management. Additionally, the strengths identified by this review need to be translated from research into case management practice for chronic illness care. This review not only describes the value of such care strategy, but also provides implications for future nursing practice and research.

scholarly journals Usability and utility of eHealth for physical activity counselling in primary health care: a scoping review

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Apichai Wattanapisit ◽  
Titiporn Tuangratananon ◽  
Sanhapan Wattanapisit
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Primary Health Care ◽  
Scoping Review ◽  
Health Behaviours ◽  
Cochrane Library ◽  
Technical Problems ◽  
Primary Health ◽  
Wide Range ◽  
Full Text Review

Abstract Background Physical activity (PA) counselling is an effective approach to promote PA in primary health care (PHC). Barriers to PA counselling in PHC include time constraints, lack of knowledge and skills of providers, and systemic barriers. Using electronic health (eHealth) has the potential to promote PA. This scoping review aimed to identify usability and utility of eHealth for tailored PA counselling introduced in PHC settings. Methods A scoping review included primary research articles. The authors systematically searched six databases (Cochrane Library, CINAHL Complete, Embase, PubMed, Scopus and Web of Science) from the inception of the databases. The search terms consisted of three search components: intervention (PA counselling), platform (eHealth), and setting (PHC). Additional articles were included through reference lists. The inclusion criteria were research or original articles with any study designs in adult participants. Results Of 2501 articles after duplicate removal, 2471 articles were excluded based on the title and abstract screening and full text review. A total of 30 articles were included for synthesis. The eHealth tools had a wide range of counselling domains as a stand-alone PA domain and multiple health behaviours. The included articles presented mixed findings of usability and utility of eHealth for PA counselling among patients and providers in PHC settings. Technical problems and the complexity of the programmes were highlighted as barriers to usability. The majority of articles reported effective utility, however, several articles stated unfavourable outcomes. Conclusions eHealth has the potential to support PA counselling in PHC. Facilitators and barriers to eHealth usability should be considered and adapted to particular settings and contexts. The utility of eHealth for promoting PA among patients should be based on the pragmatic basis to optimise resources.

Safe Care for Pediatric Patients: A Scoping Review Across Multiple Health Care Settings

2017 ◽  
Vol 57 (1) ◽  
pp. 62-75 ◽  
Author(s):  
Antonia Stang ◽  
Denise Thomson ◽  
Lisa Hartling ◽  
Jocelyn Shulhan ◽  
Megan Nuspl ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Scoping Review ◽  
Health Care Systems ◽  
Health Care Settings ◽  
Safety Concerns ◽  
Safety Research ◽  
Safety Interventions ◽  
Care Systems ◽  
Analytic Models

Children are particularly vulnerable to patient safety concerns due to pediatric-specific and general health care challenges. This scoping review identifies and describes the vulnerabilities of those aged 0 to 18 years to iatrogenic harm in various health care settings. Six databases were searched from 1991 to 2012. Primary studies were categorized using predetermined groupings. Categories were tallied and descriptive statistics were employed. A total of 388 primary studies exploring interventions that improved patient safety, deficiencies, or errors leading to safety concerns were included. The most common issues were medication (189 studies, 48.7%) and general medical (81 studies, 20.9%) errors. Sixty studies (15.5%) evaluated or described patient safety interventions, 206 studies (53.1%) addressed health care systems and technologies, 17 studies (4.4%) addressed caregiver perspectives and 20 studies (5.2%) discussed analytic models for patient safety. Further work is needed to ensure consistency of definitions in patient safety research to facilitate comparison and collation of results.

Lean bundles in health care: a scoping review

2019 ◽  
Vol 33 (4) ◽  
pp. 488-510 ◽  
Author(s):  
Ayman Bahjat Abdallah ◽  
Rasha Zuhair Alkhaldi
Keyword(s):  
Health Care ◽  
Scoping Review ◽  
Empirical Studies ◽  
Hospital Performance ◽  
Future Research ◽  
Just In Time ◽  
Original Research ◽  
Total Quality ◽  
Content Type ◽  
Literature Evidence

Purpose The purpose of this paper is to review original research on lean management (LM) in health care to identify potential research gaps and present recommendations for future research. The paper also discusses the current state of implementing LM practices in health care. In addition, it presents and highlights “lean bundles” imported from manufacturing, namely, total quality management (TQM), human resource management, just-in-time and total productive maintenance, as a potential implementation strategy of LM in hospitals to optimize overall health care performance. Design/methodology/approach The scoping review was conducted based on the guidelines specified by Arksey and O’Malley (2005). Relevant included studies were retrieved by searching various electronic databases. The PRISMA guidelines were applied to identify and select eligible studies. Findings The majority of previous studies used selected practices to measure LM in health care. In most cases, these practices reflected a narrow and biased view of LM. Lean bundles which comprehensively view LM and reflect all its aspects have rarely been discussed in the health care literature. Evidence about the contribution of lean bundles to hospital performance needs to be addressed in future studies. Practical implications This paper demonstrates the implementation of the four lean bundles in hospitals. It argues that, instead of adopting one dimension or selected practices of LM, hospitals viewing LM as a comprehensive multi-dimensional approach through the adoption of the four lean bundles are expected to maximize their performances. Originality/value This is one of the first works to comprehensively review and discuss lean bundles in the context of health care. It argues that the adoption of the four lean bundles by hospitals will enable them to yield the maximum LM performance benefits. In addition, a proposed survey questionnaire based on the literature review is provided to assist researchers in conducting future empirical studies.

scholarly journals Virtue and Care Ethics & Humanism in Medical Education: A Scoping Review

2021 ◽  
Author(s):  
David J. Doukas ◽  
David T. Ozar ◽  
Martina Darragh ◽  
Janet M. de Groot ◽  
Brian S. Carter ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Virtue Ethics ◽  
Scoping Review ◽  
Care Ethics ◽  
Health Professions ◽  
Health Professions Education ◽  
Exclusion Criteria ◽  
Health Ethics ◽  
English Articles

Abstract PURPOSE:This scoping review explores how virtue and care ethics are incorporated into health professions education and how these factors may relate to the development of humanistic patient care.METHOD:Our team identified citations in the literature emphasizing virtue ethics and care ethics (in PubMed, NLM Catalog, WorldCat, EthicsShare, EthxWeb, Globethics.net, Philosopher’s Index, and ProQuest Central) lending themselves to constructs of humanism curricula. Our exclusion criteria consisted of non-English articles, those not addressing virtue and care ethics and humanism in medical pedagogy, and those not addressing aspects of character in health ethics. We examined in a stepwise fashion whether citations: 1) Contained definitions of virtue and care ethics; 2) Implemented virtue and care ethics in health care curricula; and 3) Evidenced patient-directed caregiver humanism.RESULTS: 811 citations were identified, 88 intensively reviewed, and the final 25 analyzed in-depth. We identified multiple key themes with relevant metaphors associated with virtue/care ethics, curricula, and humanism education.CONCLUSIONS:This research sought to better understand how virtue and care ethics can potentially promote humanism and identified themes that facilitate and impede this mission.

scholarly journals Preferences of Older Immigrants in Nursing Care: A Scoping Review

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 265-265
Author(s):  
Huerrem Tezcan-Guentekin ◽  
Martina Roes ◽  
Viktoria Peters-Nehrenheim
Keyword(s):  
Health Care ◽  
Nursing Care ◽  
Scoping Review ◽  
Health Care Professionals ◽  
Literature Search ◽  
Health Care Settings ◽  
Older Immigrants ◽  
Need Of Care ◽  
Centered Care ◽  
Care Health

Abstract Background Worldwide, our societies are characterized by an increasing diversity, greatly contributed by immigrants. When in need of care older immigrants face various barriers and serious challenges in terms of unmet preferences. To provide person-centered care, health care professionals need to consider the personal background of immigrants to identify and assess their individual preferences. Objective To understand how preferences of older immigrants in nursing care are defined and how they can be assessed. Methods A scoping review will be conducted to identify and analyze preferences of older immigrants across health care settings. Preliminary results The literature search revealed that older immigrants in need of care define their preferences in terms of expectations and priorities. Differences among immigrants are related to the age of the person at the time of immigration, on cultural differences and/or on how the concepts of preferences in the country of origin is understood.

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