scholarly journals Development of performance indicators for systems of urgent and emergency care in the Republic of Ireland. Update of a systematic review and consensus development exercise

2019 ◽  
Vol 1 ◽  
pp. 6 ◽  
Author(s):  
Siobhan Boyle ◽  
Rebecca Dennehy ◽  
Orla Healy ◽  
John Browne
Keyword(s):  
Systematic Review ◽  
Emergency Care ◽  
Performance Indicators ◽  
Online Survey ◽  
Urgent Care ◽  
Nominal Group ◽  
Consensus Development ◽  
Republic Of Ireland ◽  
Care Systems ◽  
The Republic

Objectives: To develop a set of performance indicators to monitor the performance of emergency and urgent care systems in the Republic of Ireland. Design: This study comprised of an update of a previously performed systematic review and a formal consensus development exercise. The literature search was conducted in PubMed and covered the period 2008 to 2014. The results of the review were used to inform a consensus group of 17 national experts on urgent and emergency care in Ireland. The consensus development exercise comprised an online survey followed by a face-to-face nominal group technique meeting. During this meeting participants had the opportunity to revise their preferences for different indicators after listening to the views of other group members. A final online survey was then used to confirm the preferences of participants. Results: Initial literature searches yielded 2339 article titles.  After further searches, sixty items were identified for full-text review. Following this review, fifty-seven were excluded. Three articles were identified for inclusion in the systematic review. These papers produced 42 unique indicators for consideration during the consensus development exercise. In total, 17 indicators had a median of greater than 7 following the meeting and met our pre-specified criterion for acceptable consensus. Discussion: Using this systematic review and nominal group consensus development exercise, we have identified a set of 17 indicators, which a consensus of different experts regard as potentially good measures of the performance of urgent and emergency care systems in Ireland. Pragmatic implications are discussed with reference to three subsequently performed original studies which used some of the indicators

scholarly journals Development of performance indicators for systems of urgent and emergency care in the Republic of Ireland: Systematic review and consensus development exercise

2018 ◽  
Vol 1 ◽  
pp. 6 ◽  
Author(s):  
Siobhan Boyle ◽  
Rebecca Dennehy ◽  
Orla Healy ◽  
John Browne
Keyword(s):  
Systematic Review ◽  
Emergency Care ◽  
Performance Indicators ◽  
Urgent Care ◽  
Nominal Group ◽  
Consensus Development ◽  
Republic Of Ireland ◽  
Full Text Review ◽  
Care Systems ◽  
The Republic

Objectives: To develop a set of performance indicators to monitor the performance of emergency and urgent care systems in the Republic of Ireland. Design: This study comprised of an update of a previously performed systematic review and a formal consensus development exercise. Results: Initial literature searches yielded 2339 article titles.  After further searches, sixty items were identified for full-text review. Following this review, fifty-seven were excluded. Three articles were identified for inclusion in the systematic review. These papers produced 42 unique indicators for consideration during the consensus development exercise. In total, 17 indicators had a median of greater than 7 following the meeting and met our pre-specified criterion for acceptable consensus. Discussion: Using this systematic review and nominal group consensus development exercise, we have identified a set of 17 indicators, which a consensus of different experts regard as potentially good measures of the performance of urgent and emergency care systems in Ireland.

scholarly journals Essential medicines for emergency care in Africa

2018 ◽  
Vol 35 (7) ◽  
pp. 412-419 ◽  
Author(s):  
Morgan C Broccoli ◽  
Jennifer L Pigoga ◽  
Mulinda Nyirenda ◽  
Lee Wallis ◽  
Emilie J Calvello Hynes
Keyword(s):  
Emergency Care ◽  
Online Survey ◽  
Care Delivery ◽  
Careful Consideration ◽  
Essential Medicines ◽  
Health Priorities ◽  
Consensus Process ◽  
Expert Review ◽  
District Hospitals ◽  
Care Systems

ObjectivesEssential medicines lists (EMLs) are efficient means to ensure access to safe and effective medications. The WHO has led this initiative, generating a biannual EML since 1977. Nearly all countries have implemented national EMLs based on the WHO EML. Although EMLs have given careful consideration to many public health priorities, they have yet to comprehensively address the importance of medicines for treating acute illness and injury.MethodsWe undertook a multistep consensus process to establish an EML for emergency care in Africa. After a review of existing literature and international EMLs, we generated a candidate list for emergency care. This list was reviewed by expert clinicians who ranked the medicines for overall inclusion and strength of recommendation. These medications and recommendations were then evaluated by an expert group. Medications that reached consensus in both the online survey and expert review were included in a draft emergency care EML, which underwent a final inperson consensus process.ResultsThe final emergency care EML included 213 medicines, 25 of which are not in the 2017 WHO EML, but were deemed essential for clinical practice by regional emergency providers. The final EML has associated recommendations of desirable or essential and is subdivided by facility level. Thirty-nine medicines were recommended for basic facilities, an additional 96 for intermediate facilities (eg, district hospitals) and an additional 78 for advanced facilities (eg, tertiary centres).ConclusionThe 25 novel medications not currently on the WHO EML should be considered by planners when making rational formularies for developing emergency care systems. It is our hope that these resource-stratified lists will allow for easier implementation and will be a useful tool for practical expansion of emergency care delivery in Africa.

scholarly journals Low levels of chemsex among men who have sex with men, but high levels of risk among men who engage in chemsex: analysis of a cross-sectional online survey across four countries

Sexual Health ◽  
2018 ◽  
Vol 15 (2) ◽  
pp. 144 ◽  
Author(s):  
Jamie Frankis ◽  
Paul Flowers ◽  
Lisa McDaid ◽  
Adam Bourne
Keyword(s):  
Northern Ireland ◽  
Drug Use ◽  
Online Survey ◽  
Illicit Drugs ◽  
Cross Sectional ◽  
Republic Of Ireland ◽  
Hiv Test ◽  
The Republic ◽  
Sex With Men ◽  
First Time

Background This paper establishes the prevalence of chemsex drug use among men who have sex with men (MSM), the extent to which these drugs are used in a sexual context, as well as their associated behaviours and circumstances of use. Methods: Data from a cross-sectional, online survey of 2328 MSM recruited via gay sociosexual media in Scotland, Wales, Northern Ireland and the Republic of Ireland were analysed. Results: While almost half (48.8%) of participants had ever taken illicit drugs, lifetime chemsex drug use was less common (18.0%) and far fewer reported chemsex drug use in the last year (8.2%) or last 4 weeks (3.0%). Just over one-quarter (27.1%) of men who used chemsex drugs in the last year reported no sexualised drug use, but almost three-quarters (72.9%) did. Only 6.1% of the whole sample reported sexualised chemsex drug use in the last year. The odds of reporting chemsex in the last year were significantly higher for men aged 36–45 years (AOR = 1.96), single men (AOR = 1.83), men who were HIV positive (AOR = 4.01), men who report high-risk sex (AOR = 4.46), being fisted (AOR = 7.77) or had sex in exchange for goods other than money (AOR = 4.7) in the last year and men who reported an HIV test in the last 3 months (AOR = 1.53). Discussion: Only a small proportion of MSM in Scotland, Wales, Northern Ireland and the Republic of Ireland reported chemsex, and, for the first time, it is demonstrated that not all chemsex drug use was sexualised. Nevertheless, MSM who engage in chemsex (MWEC) reported substantial sexual risk inequalities. These novel findings highlight several opportunities for intervention, particularly around the multiple vulnerabilities of MWEC, opportunities for early identification of those most vulnerable to chemsex-related harm and the potential to develop a specialised responsive patient pathway.

A profile of physiotherapy practice educators and practice tutors in the Republic of Ireland

2021 ◽  
Vol 41 (2) ◽  
pp. 193-199
Author(s):  
Anne O’Connor ◽  
Arlene McCurtin
Keyword(s):  
Online Survey ◽  
Learning Needs ◽  
Republic Of Ireland ◽  
Physiotherapy Practice ◽  
Student Supervision ◽  
University Support ◽  
The Republic ◽  
Model Of Practice ◽  
And Training ◽  
Practice Education

BACKGROUND: Limited evidence exists regarding practice educators’ and practice tutors’ experience of, and training in, student supervision in the physiotherapy workplace. This knowledge would inform universities of their learning needs and help to enhance the practice-based experience for physiotherapy students. OBJECTIVE: The aim of this study was to create a profile of physiotherapy practice educators’ and practice tutors’ student supervision experience, university support available to them during practice placement and training undertaken by them. This study was undertaken in the Republic of Ireland. METHODS: An online survey was designed and circulated via the Irish Society of Chartered Physiotherapists’ database of physiotherapy members. RESULTS: One hundred and ninety-two practice educators and 71 practice tutors participated. Findings indicate that the 1:1 model of practice education is the predominant model of practice education employed in the Republic of Ireland. 70% of practice educators currently receive support from a practice tutor. Fifty-five percent of practice educators undertake student supervision 2-3 times per year. However, 56% of practice educators and 48% of practice tutors had not undertaken training in student supervision in the year prior to the study. A decline was also noted in the uptake of student supervision among clinicians with 16–25 years clinical experience. CONCLUSION: This study provides an insightful profile of physiotherapy practice education in the Republic of Ireland. Findings are encouraging, with data highlighting that most practice educators are supported by practice tutors. Recommendations include the need for further investigation of the apparent decline in student supervision among experienced clinicians. Consideration of the learning needs of practice educators and practice tutors is encouraged as well as a review of the accessibility and flexibility of training resources provided.

scholarly journals A National Survey of attitudes to COVID-19 Digital Contact Tracing in the Republic of Ireland

2020 ◽  
Author(s):  
Michael Edmund O'Callaghan ◽  
Jim Buckley ◽  
Brian Fitzgerald ◽  
Kevin Johnson ◽  
John Laffey ◽  
...  
Keyword(s):  
National Survey ◽  
Large Scale ◽  
Online Survey ◽  
Contact Tracing ◽  
Republic Of Ireland ◽  
Software Applications ◽  
Adult Participants ◽  
Social Media Platforms ◽  
The Republic ◽  
The Government

Abstract Background: Contact tracing remains a critical part of controlling the spread of COVID-19. Many countries have developed novel software applications (Apps) in an effort to augment traditional contact tracing methods. Aim: To conduct a national survey of the Irish population to examine barriers and levers to the use of a contact tracing App.Methods: Adult participants were invited to respond via an online survey weblink sent via email and messaging Apps and posted on our university website and on popular social media platforms. Results: A total of 8,088 responses were received, with all 26 counties of the Republic of Ireland represented. 54% of respondents said they would definitely download a contact tracing App, while 30% said they would probably download a contact tracing App. 95% of respondents identified at least one reason for them to download the App, with the most common reasons being the potential for the App to help family members and friends and a sense of responsibility to the wider community. 59% identified at least one reason not to download the App, with the most common reasons being fear that technology companies or the government might use the App technology for greater surveillance after the pandemic.Conclusion: Irish citizens surveyed express high levels of willingness to download a public health-backed App to augment contact tracing. Concerns raised regarding privacy and data security will be critical if the App is to achieve the large-scale adoption and ongoing use required for its effective operation.

scholarly journals Measuring health equity in emergency care using routinely collected data: a systematic review

2020 ◽  
Author(s):  
Kevin Morisod ◽  
Xhyljeta Luta ◽  
Joachim Marti ◽  
Jacques Spycher ◽  
Mary Malebranche ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care System ◽  
Administrative Data ◽  
Emergency Care ◽  
Health Care Systems ◽  
Health Care Equity ◽  
Care Systems ◽  
Ed Visits ◽  
Care System

Abstract Abstract Background : Achieving equity in health care remains a challenge for health care systems worldwide and marked inequities in access and quality of care persist. The performance assessment of health care systems is often limited to quality and efficiency indicators. Identifying indicators of health care equity is an important first step in integrating the concept of equity into assessments of health care system performance. Because emergency care serves as the interface between ambulatory and inpatient care, it is arguably an opportune setting in which to begin this process. Methods: We conducted a systematic review of administrative data-derived health care equity indicators and their association with socio-economic determinants of health (SEDH) in emergency care settings. Following PRISMA-Equity reporting guidelines, Ovid MEDLINE, EMBASE, PUBMED and Web of Science were searched for relevant studies. The outcomes of interest were indicators of health care equity and the associated SEDH they examine. Results: Among 29 studies identified, 14 equity indicators were identified and grouped into four categories that reflect the patient emergency care pathway. Total emergency department (ED) visits and ambulatory care sensitive condition-related ED visits were the two most frequently used equity indicators. The studies analysed equity based on seven SEDH: social deprivation, income, education level, social class, insurance coverage, health literacy and financial and non-financial barriers. Despite some conflicting results, all identified SEDH are associated with inequalities in access to and use of emergency care. Conclusion: The use of administrative data-derived indicators in combination with identified SEDH could improve the measurement of health care equity in emergency care settings across health care systems worldwide. Using a combination of indicators is likely to lead to a more comprehensive, well-rounded measurement of health care equity than using any one indicator in isolation. Though studies analysed focused on emergency care settings, it seems possible to extrapolate these indicators to measure equity in other areas of the health care system. Further studies elucidating root causes of health inequities in and outside the health care system are needed. .

scholarly journals Consensus-Derived Quality Performance Indicators for Neuroendocrine Tumour Care

2019 ◽  
Vol 8 (9) ◽  
pp. 1455
Author(s):  
Woodhouse ◽  
Pattison ◽  
Segelov ◽  
Singh ◽  
Parker ◽  
...  
Keyword(s):  
Performance Indicators ◽  
Online Survey ◽  
Neuroendocrine Tumour ◽  
Nominal Group Technique ◽  
Neuroendocrine Cells ◽  
Nominal Group ◽  
Pathology Report ◽  
Delphi Consensus ◽  
Consensus Process ◽  
Quality Performance

Quality performance indicators (QPIs) are used to monitor the delivery of cancer care. Neuroendocrine tumours (NETs) are a family of individually uncommon cancers that derive from neuroendocrine cells or their precursors, and can occur in most organs. There are currently no QPIs available for NETs and their heterogeneity makes QPI development difficult. CommNETs is a collaboration between NET clinicians, researchers and advocates in Canada, Australia and New Zealand. We created QPIs for NETs using a three-step consensus process. First, a multidisciplinary team used the nominal group technique to create candidates (n = 133) which were then curated into appropriateness statements (62 statements, 44 sub-statements). A two-stage modified RAND/UCLA Delphi consensus process was conducted: an online survey rated the statement appropriateness then the top-ranked statements (n = 20) were assessed in a face-to-face meeting. Finally, 10 QPIs met consensus criteria; documentation of primary site, proliferative index, differentiation, tumour board review, use of a structured pathology report, presence of distant metastasis, 5- and 10-year disease-free and overall survival. These NET QPIs will be trialed as a method to monitor and improve care for people with NETs and to facilitate international comparison.

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