scholarly journals Designing Integrated Approaches to Support People with Multimorbidity: Key Messages from Systematic Reviews, Health System Leaders and Citizens

2016 ◽  
Vol 12 (2) ◽  
pp. 91-104 ◽  
Author(s):  
Michael Wilson ◽  
John Lavis ◽  
Francois-Pierre Gauvin
Keyword(s):  
Health System ◽  
Systematic Reviews ◽  
System Leaders ◽  
Integrated Approaches

PP22 How Do Health System Leaders Use Evidence To Inform Action?

2018 ◽  
Vol 34 (S1) ◽  
pp. 74-75
Author(s):  
Matthew D Mitchell ◽  
C Michael White ◽  
Jeanne-Marie Guise ◽  
Lionel Bañez ◽  
Craig Umscheid ◽  
...  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Process Improvement ◽  
Systematic Reviews ◽  
Predictive Analytics ◽  
Structured Interview ◽  
Healthcare Research ◽  
System Quality ◽  
Study Results ◽  
System Leaders

Introduction:The US Agency for Healthcare Research and Quality (AHRQ) Evidence-based Practice Center (EPC) program sponsors the development of systematic reviews to inform clinical policy and practice. The EPC program sought to better understand how health systems identify and use this evidence.Methods:Representatives from eleven EPCs, the EPC Scientific Resource Center, and AHRQ developed a semi-structured interview script to query a diverse group of nine Key Informants (KIs) involved in health system quality, safety and process improvement about how they identify and use evidence. Interviews were transcribed and qualitatively summarized into key themes.Results:All KIs reported that their organizations have either centralized quality, safety, and process improvement functions within their system, or they have partnerships with other organizations to conduct this work. There was variation in how evidence was identified, with larger health systems having medical librarians and central bureaus to gather and disseminate information and smaller systems having local chief medical officers or individual clinicians do this work. KIs generally prefer guidelines, especially those with treatment algorithms, because they are actionable. They like systematic reviews because they efficiently condense study results and reconcile conflicting data. They prefer information from systematic reviews to be presented as short digestible summaries with the full report available on demand. KIs preferred systematic reviews from reputable entities and those without commercial bias. Some of the challenges KIs reported include how to resolve conflicting evidence, the generalizability of evidence to local needs, determining whether the evidence is up-to-date, and the length of time required to generate reviews. The topics of greatest interest included predictive analytics, high-value care, advance care planning, and care coordination. To increase awareness of AHRQ EPC reviews, KIs suggest alerting people at multiple levels in a health-system when new evidence reports are available and making reports easier to find in common search engines.Conclusions:Systematic reviews are valued by health system leaders. To be most useful they should be easy to locate and available in different formats targeted to the needs of different audiences.

Health system decision makers' feedback on summaries and tools supporting the use of systematic reviews: a qualitative study

2014 ◽  
Vol 10 (3) ◽  
pp. 337-359 ◽  
Author(s):  
Moriah E Ellen ◽  
John N Lavis ◽  
Michael G Wilson ◽  
Jeremy Grimshaw ◽  
R Brian Haynes ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health System ◽  
Systematic Reviews ◽  
Decision Makers

scholarly journals Re-imagining Research: A Bold Call, but Bold Enough? Comment on "Experience of Health Leadership in Partnering with University-Based Researchers in Canada: A Call to ‘Re-Imagine’ Research"

2019 ◽  
Author(s):  
Bev J. Holmes
Keyword(s):  
Health System ◽  
Health Systems ◽  
Research Area ◽  
Evidence Use ◽  
Health System Change ◽  
Health Leadership ◽  
System Leaders ◽  
Change Projects ◽  
High Level ◽  
Partnership Models

Many articles over the last two decades have enumerated barriers to and facilitators for evidence use in health systems. Bowen et al’s article "Response to Experience of Health Leadership in Partnering with University-Based Researchers: A Call to ‘Re-imagine Research’" furthers the debate by focusing on an under-explored research area (health system design and health service organization) with an under-studied stakeholder group (health system leaders), by undertaking a broad program of research on partnerships, and, based on participant responses, by calling for re-imagining of research itself. In response to the claim that the research community is not providing expertise to this pressing issue in the health system, I provide four high level reasons: partnerships mean different things to different people, our language does not reflect the reality we want, our health systems have yet to fully embrace evidence use, and complexity is easier to talk about than act within. Bowen et al’s study, and their broader program of research, is well-placed to explore these issues further, helping identify appropriate researcher-health system leader partnership models for various health system change projects. Given the positive shifts identified in this study, and the knowledge that participants demonstrate about what needs to change, the time is right for bold action, re-imagining not only research, but healthcare, such that the production and use of evidence for better health is embraced and supported.

scholarly journals A Rapid Process for Identifying and Prioritizing Technology-Based Tools for Health System Implementation (Preprint)

2018 ◽  
Author(s):  
Emily R Dibble ◽  
Bradley E Iott ◽  
Allen J Flynn ◽  
Darren P King ◽  
Mark P MacEachern ◽  
...  
Keyword(s):  
Decision Making ◽  
Health System ◽  
Review Process ◽  
New Technology ◽  
Rapid Review ◽  
Current Evidence ◽  
Review Panel ◽  
Environmental Scan ◽  
System Leaders ◽  
Evidence Review

BACKGROUND Health system decisions to put new technologies into clinical practice require a rapid and trustworthy decision-making process informed by best evidence. OBJECTIVE This study aimed to present a rapid evidence review process that can be used to inform health system leaders and clinicians seeking to implement new technology tools to improve patient-clinician decision making and patient-oriented outcomes. METHODS The rapid evidence review process we pioneered involved 5 sequential subprocesses: (1) environmental scan, (2) expert panel recruitment, (3) host evidence review panel, (4) analysis, and (5) local validation panel. We conducted an environmental scan of health information technology (IT) literature to identify relevant digital tools in oncology care. We synthesized the recent literature using current evidence review methods, creating visual summaries for use by a national panel of experts. Panelists were taken through a 6-hour modified Delphi process to prioritize tools for implementation. Findings from the rapid evidence review panel were taken to a local validation panel for further rapid review during a 3-hour session. RESULTS Our rapid evidence review process shows promise for informing decision making by reducing the amount of time and resources needed to identify and prioritize adoption of IT tools. Despite evidence of improved patient outcomes, panelists had substantial concerns about implementing patient-reported outcome tracking tools, voicing concerns about liability, lack of familiarity with new technology, and additional time and workflow changes such tools would require. Instead, clinicians favored technologies that did not require clinician involvement. CONCLUSIONS Health system leaders can use the rapid evidence review process presented here to usefully inform local technology adoption, implementation, and use in practice.

scholarly journals The Role of Patient Navigators in Ambulatory Care: Overview of Systematic Reviews

2021 ◽  
Author(s):  
Hannah Budde ◽  
Gemma Williams ◽  
Juliane Winkelmann ◽  
Laura Pfirter ◽  
Claudia Bettina Maier
Keyword(s):  
Health Services ◽  
Health System ◽  
Ambulatory Care ◽  
Systematic Reviews ◽  
Patient Navigation ◽  
Transitional Care ◽  
Emergency Department Visits ◽  
Patient Navigators

Abstract Background: Patient navigators have been introduced across various countries to enable timely access to healthcare services and ensure completion of diagnosis and follow-up of care. There is an increasing amount of evidence on the positive effect of patient navigation for patients. The aim of this study was to analyse the evidence on patient navigation interventions in ambulatory care and to evaluate their effects on individuals and health system outcomes.Methods: An overview of reviews was conducted, based on a prespecified protocol. All patients in ambulatory care or transitional care setting were included in this review as long as it was related to the role of patient navigators. The study analysed all roles of patient navigators covering a wide range of health professionals such as physicians, nurses, pharmacists, social workers as well as lay health workers or community-based workers with no or very limited training. Studies including patient-related measures and health system-related outcomes were eligible for inclusion. A rigorous data collection was performed in multiple data bases. After reaching an inter-rater agreement, title and abstract screening was independently performed. Of an initial 8362 search results a total of 673 articles were eligible for full-text screening. An extraction form was used to analyse the nine included review.Results: Nine systematic reviews were included covering various patient navigation roles in cancer care, disease screening and transitional care. Seven systematic reviews primarily tailored services to ethnic minorities or other disadvantaged groups. Patient navigators performed tasks such as providing education and counselling, translations, home visits, outreach, scheduling of appointments and follow-up. Six reviews identified positive outcomes in expanding access to care, in particular for vulnerable patient groups. Two reviews on patient navigation in transitional care reported improved patient outcomes and hospital readmission rates and mixed evidence on quality of life and emergency department visits.Conclusions: Patient navigators have shown to expand access to screenings and health services for vulnerable patients or population groups who tend to underuse health services.

scholarly journals The effectiveness of evidence summaries on health policymakers and health system managers use of evidence from systematic reviews: a systematic review

2016 ◽  
Vol 11 (1) ◽  
Author(s):  
Jennifer Petkovic ◽  
Vivian Welch ◽  
Maria Helena Jacob ◽  
Manosila Yoganathan ◽  
Ana Patricia Ayala ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health System ◽  
Systematic Reviews ◽  
Evidence Summaries

From pilot project to system solution: innovation, spread and scale for health system leaders

BMJ Leader ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. 87-90 ◽  
Author(s):  
James Shaw ◽  
Joshua Tepper ◽  
Danielle Martin
Keyword(s):  
Health System ◽  
Pilot Project ◽  
Leadership Strategies ◽  
Health Innovations ◽  
Conceptual Clarity ◽  
System Solution ◽  
System Leaders ◽  
Broad Community

Promoting the scale and spread of effective health innovations requires dedicated action from health system leaders. In order to maximise the effects of leadership strategies to promote the spread and scale of health innovations, conceptual clarity and well-defined strategies are essential. In this commentary, we propose definitions of the concepts of ‘innovation’, ‘spread’ and ‘scale’, and explain how these concepts can be used by health system leaders to generate interest, excitement and commitment for specific innovations from a broad community of stakeholders. We then outline two strategies from the community organising literature that leaders can use to promote spread and scale.

scholarly journals A Narrative Review and Proposed Framework for Using Health System Data with Systematic Reviews to Support Decision-making

2020 ◽  
Vol 35 (6) ◽  
pp. 1830-1835 ◽  
Author(s):  
Jennifer S. Lin ◽  
M. Hassan Murad ◽  
Brian Leas ◽  
Jonathan R. Treadwell ◽  
Roger Chou ◽  
...  
Keyword(s):  
Decision Making ◽  
Health System ◽  
Systematic Reviews ◽  
Narrative Review ◽  
System Data ◽  
Health System Data ◽  
Support Decision Making

scholarly journals Use of EHR-Based Pediatric Quality Measures: Views of Health System Leaders and Parents

2019 ◽  
Vol 35 (2) ◽  
pp. 177-185
Author(s):  
David M. Hartley ◽  
Susannah Jonas ◽  
Daniel Grossoehme ◽  
Amy Kelly ◽  
Cassandra Dodds ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health System ◽  
Health Care Quality ◽  
Quality Measures ◽  
Care Quality ◽  
Quality Data ◽  
High Confidence ◽  
System Leaders ◽  
Using Data

Measures of health care quality are produced from a variety of data sources, but often, physicians do not believe these measures reflect the quality of provided care. The aim was to assess the value to health system leaders (HSLs) and parents of benchmarking on health care quality measures using data mined from the electronic health record (EHR). Using in-context interviews with HSLs and parents, the authors investigated what new decisions and actions benchmarking using data mined from the EHR may enable and how benchmarking information should be presented to be most informative. Results demonstrate that although parents may have little experience using data on health care quality for decision making, they affirmed its potential value. HSLs expressed the need for high-confidence, validated metrics. They also perceived barriers to achieving meaningful metrics but recognized that mining data directly from the EHR could overcome those barriers. Parents and HSLs need high-confidence health care quality data to support decision making.

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