scholarly journals Patient Engagement and its Evaluation Tools – Current Challenges and Future Directions Comment on "Metrics and Evaluation Tools for Patient Engagement in Healthcare Organization- and System-Level Decision-Making: A Systematic Review"

2019 ◽  
Vol 8 (6) ◽  
pp. 378-380 ◽  
Author(s):  
Samira Abbasgholizadeh Rahimi ◽  
Hervé Tchala Vignon Zomahoun ◽  
France Légaré
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Psychometric Properties ◽  
Patient Engagement ◽  
Delivery Systems ◽  
Healthcare Organization ◽  
System Level ◽  
Evaluation Tools ◽  
High Quality ◽  
Future Directions

Considering the growing recognition of the importance of patient engagement in healthcare decisions, research and delivery systems, it is important to ensure high quality and efficient patient engagement evaluation tools. In this commentary, we will first highlight the definition and importance of patient engagement. Then we discuss the psychometric properties of the patient engagement evaluation tools identified in a recent review on patient engagement in healthcare organization- and system-level decision-making. Lastly, we suggest future directions for patient engagement and its evaluation tools.

scholarly journals Metrics of Patient, Public, Consumer, and Community Engagement in Healthcare Systems: How Should We Define Engagement, What Are We Measuring, and Does It Matter for Patient Care? Comment on "Metrics and Evaluation Tools for Patient Engagement in Healthcare Organization- and System-Level Decision-Making: A Systematic Review"

2018 ◽  
Vol 8 (1) ◽  
pp. 49-50
Author(s):  
Zackary Berger
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Patient Care ◽  
Clinical Outcomes ◽  
Patient Engagement ◽  
Clinical Care ◽  
Healthcare Systems ◽  
System Level ◽  
Patient Representatives ◽  
Conceptual Foundations

In a rigorous systematic review, Dukhanin and colleagues categorize metrics and evaluative tools of the engagement of patient, public, consumer, and community in decision-making in healthcare institutions and systems. The review itself is ably done and the categorizations lead to a useful understanding of the necessary elements of engagement, and a suite of measures relevant to implementing engagement in systems. Nevertheless, the question remains whether the engagement of patient representatives in institutional or systemic deliberations will lead to improved clinical outcomes or increased engagement of individual patients themselves in care. Attention to the conceptual foundations of patient engagement would help make this systematic review relevant to the clinical care of patients.

scholarly journals Determining the influence of intervention characteristics on implementation success requires reliable and valid measures: Results from a systematic review

2021 ◽  
Vol 2 ◽  
pp. 263348952199419
Author(s):  
Cara C Lewis ◽  
Kayne Mettert ◽  
Aaron R Lyon
Keyword(s):  
Systematic Review ◽  
Psychometric Properties ◽  
Systematic Reviews ◽  
Quality Measures ◽  
Measure Development ◽  
Relative Advantage ◽  
Design Quality ◽  
High Quality ◽  
Evidence Strength

Background: Despite their inclusion in Rogers’ seminal diffusion of innovations theory, few implementation studies empirically evaluate the role of intervention characteristics. Now, with growing evidence on the role of adaptation in implementation, high-quality measures of characteristics such as adaptability, trialability, and complexity are needed. Only two systematic reviews of implementation measures captured those related to the intervention or innovation and their assessment of psychometric properties was limited. This manuscript reports on the results of eight systematic reviews of measures of intervention characteristics with nuanced data regarding a broad range of psychometric properties. Methods: The systematic review proceeded in three phases. Phase I, data collection, involved search string generation, title and abstract screening, full text review, construct assignment, and citation searches. Phase II, data extraction, involved coding psychometric information. Phase III, data analysis, involved two trained specialists independently rating each measure using PAPERS (Psychometric And Pragmatic Evidence Rating Scales). Results: Searches identified 16 measures or scales: zero for intervention source, one for evidence strength and quality, nine for relative advantage, five for adaptability, six for trialability, nine for complexity, and two for design quality and packaging. Information about internal consistency and norms was available for most measures, whereas information about other psychometric properties was most often not available. Ratings for psychometric properties fell in the range of “poor” to “good.” Conclusion: The results of this review confirm that few implementation scholars are examining the role of intervention characteristics in behavioral health studies. Significant work is needed to both develop new measures (e.g., for intervention source) and build psychometric evidence for existing measures in this forgotten domain. Plain Language Summary Intervention characteristics have long been perceived as critical factors that directly influence the rate of adopting an innovation. It remains unclear the extent to which intervention characteristics including relative advantage, complexity, trialability, intervention source, design quality and packaging, evidence strength and quality, adaptability, and cost impact implementation of evidence-based practices in behavioral health settings. To unpack the differential influence of these factors, high quality measures are needed. Systematic reviews can identify measures and synthesize the data regarding their quality to identify gaps in the field and inform measure development and testing efforts. Two previous reviews identified measures of intervention characteristics, but they did not provide information about the extent of the existing evidence nor did they evaluate the host of evidence available for identified measures. This manuscript summarizes the results of nine systematic reviews (i.e., one for each of the factors listed above) for which 16 unique measures or scales were identified. The nuanced findings will help direct measure development work in this forgotten domain.

scholarly journals Quality in crisis: a systematic review of the quality of health systems in humanitarian settings

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Keely Jordan ◽  
Todd P. Lewis ◽  
Bayard Roberts
Keyword(s):  
Systematic Review ◽  
Health System ◽  
Health Systems ◽  
Point Of Care ◽  
System Level ◽  
System Quality ◽  
High Quality ◽  
Humanitarian Settings ◽  
Quality Health

Abstract Background There is a growing concern that the quality of health systems in humanitarian crises and the care they provide has received little attention. To help better understand current practice and research on health system quality, this paper aimed to examine the evidence on the quality of health systems in humanitarian settings. Methods This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The context of interest was populations affected by humanitarian crisis in low- and middle- income countries (LMICs). We included studies where the intervention of interest, health services for populations affected by crisis, was provided by the formal health system. Our outcome of interest was the quality of the health system. We included primary research studies, from a combination of information sources, published in English between January 2000 and January 2019 using quantitative and qualitative methods. We used the High Quality Health Systems Framework to analyze the included studies by quality domain and sub-domain. Results We identified 2285 articles through our search, of which 163 were eligible for full-text review, and 55 articles were eligible for inclusion in our systematic review. Poor diagnosis, inadequate patient referrals, and inappropriate treatment of illness were commonly cited barriers to quality care. There was a strong focus placed on the foundations of a health system with emphasis on the workforce and tools, but a limited focus on the health impacts of health systems. The review also suggests some barriers to high quality health systems that are specific to humanitarian settings such as language barriers for refugees in their host country, discontinued care for migrant populations with chronic conditions, and fears around provider safety. Conclusion The review highlights a large gap in the measurement of quality both at the point of care and at the health system level. There is a need for further work particularly on health system measurement strategies, accountability mechanisms, and patient-centered approaches in humanitarian settings.

scholarly journals The Iowa Gambling Task (IGT) in Brazil: a systematic review

2013 ◽  
Vol 35 (3) ◽  
pp. 160-170 ◽  
Author(s):  
André Rutz ◽  
Amer Cavalheiro Hamdan ◽  
Melissa Lamar
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Psychometric Properties ◽  
Subject Matter ◽  
Iowa Gambling Task ◽  
Total Sample ◽  
Test Administration ◽  
Gambling Task ◽  
Diverse Range ◽  
Cultural Variables

Background: Decision-making is a complex, multidimensional cognitive function that requires the choice between two or more options and also the predictive analysis of its consequences. One of the tools most widely used to assess decision-making in neuropsychological research is the Iowa Gambling Task (IGT). Objective: To conduct a systematic review of articles reporting empirical IGT studies based in Brazil. Method: Articles were obtained from multiple journal databases including ISI Web of Knowledge, Scopus, SciELO, LILACS, and Scholar Google. Results: Thirty-six studies were included in this review and divided into four categories according to main subject matter (psychiatry & personality; demographic & cultural variables; medical/clinic; and psychometric properties & test administration standardization). In general, there was a significant growth in research employing IGT (Χ² = 17.6, df = 5, p = 0.0003), but this growth was restricted to a few geographic areas of Brazil. The psychiatry & personality subject matter was the most abundant, accounting for 14 publications (39% of the total sample). Conclusion: Since its first adaptation to Brazilian Portuguese in 2006, a growing interest in decision-making as measured by the IGT can be observed, with psychiatry & personality topics representing a large portion of the scientific inquiry to date. Nevertheless, in order to extend the initial results of Brazilian IGT decision-making research, more studies are necessary - across a more diverse range of topics, including demographic & cultural variables, and psychometric properties & test administration standardization, the areas least studied -, as is the dissemination of the IGT to more regions of the country.

scholarly journals Factors influencing general practitioners decisions to refer Paediatric patients to the emergency department: a systematic review and narrative synthesis

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Ciara Conlon ◽  
Emma Nicholson ◽  
Beatriz Rodríguez-Martin ◽  
Roisin O’Donovan ◽  
Aoife De Brún ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Emergency Department ◽  
Paediatric Patient ◽  
General Practitioners ◽  
Clinical Decision Making ◽  
System Level ◽  
Clinical Factors ◽  
Paediatric Patients ◽  
The Impact

Abstract Background Clinical guidelines are integral to a general practitioner’s decision to refer a paediatric patient to emergency care. The influence of non-clinical factors must also be considered. This review explores the non-clinical factors that may influence general practitioners (GPs) when deciding whether or not to refer a paediatric patient to the Emergency Department (ED). Methods A systematic review of peer-reviewed literature published from August 1980 to July 2019 was conducted to explore the non-clinical factors that influence GPs’ decision-making in referring paediatric patients to the emergency department. The results were synthesised using a narrative approach. Results Seven studies met the inclusion criteria. Non-clinical factors relating to patients, GPs and health systems influence GPs decision to refer children to the ED. GPs reported parents/ caregivers influence, including their perception of severity of child’s illness, parent’s request for onward referral and GPs’ appraisal of parents’ ability to cope. Socio-economic status, GPs’ aversion to risk and system level factors such as access to diagnostics and specialist services also influenced referral decisions. Conclusions A myriad of non-clinical factors influence GP referrals of children to the ED. Further research on the impact of non-clinical factors on clinical decision-making can help to elucidate patterns and trends of paediatric healthcare and identify areas for intervention to utilise resources efficiently and improve healthcare delivery.

scholarly journals Co-production as an Emerging Methodology for Developing School-Based Health Interventions with Students Aged 11–16: Systematic Review of Intervention Types, Theories and Processes and Thematic Synthesis of Stakeholders’ Experiences

2020 ◽  
Author(s):  
Hayley Reed ◽  
Danielle Couturiaux ◽  
Marianne Davis ◽  
Amy Edwards ◽  
Edward Janes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Target Population ◽  
Health Interventions ◽  
System Level ◽  
Empirical Literature ◽  
Bibliographic Databases ◽  
Individual Level ◽  
Thematic Synthesis ◽  
School Based

AbstractCo-production affords an intervention’s target population the opportunity to participate in intervention theory decision-making during the development process. This addresses the over-reliance on developing interventions through academic theories which can be devoid of contextual understanding and result in challenges to implementing school-based health programmes. There is an emergent empirical literature on co-producing school-based health interventions, but an understanding of appropriate theoretical types and processes and stakeholders’ experiences is lacking. Through the conduct of a systematic review, this study seeks to understand the types and underlying theories and processes for co-production in school-based health interventions with students aged 11–16. A thematic synthesis explored stakeholders’ experiences of the different types of co-production. A systematic search of five electronic bibliographic databases, citation tracking of included studies, and consultation with an expert international panel were employed. Of 27,433 unique papers, 30 papers representing 22 studies were retained to describe types, and 23 papers of 18 studies used to synthesise stakeholders’ experiences. Three types were identified: external, individual-level, and system-level capacity-building. Whilst this review showed variability in co-production types, stakeholders involved and processes, shared functions were identified. Students’, school staff, facilitators’ and researchers’ experiences in terms of acceptability, feasibility and undertaking decision-making are discussed. Recommendations for conceptualising and reporting co-production and process evaluations of co-produced school-based health interventions are highlighted.

scholarly journals Delving Into the Details of Evaluating Public Engagement Initiatives Comment on "Metrics and Evaluation Tools for Patient Engagement in Healthcare Organization- and System-Level Decision-Making: A Systematic Review"

2019 ◽  
Vol 8 (4) ◽  
pp. 247-249
Author(s):  
Marion Danis
Keyword(s):  
Systematic Review ◽  
Health Policy ◽  
Public Engagement ◽  
Public Discourse ◽  
Public Support ◽  
System Level ◽  
Systematic Evaluation ◽  
Policy Decisions ◽  
Evaluation Tools ◽  
The Public

Initiatives to engage the public in health policy decisions have been widely endorsed and used, yet agreed upon methods for systematically evaluating the effectiveness of these initiatives remain to be developed. Dukhanin, Topazian, and DeCamp have thus developed a useful taxonomy of evaluation criteria derived from a systematic review of published evaluation tools that might serve as the basis for systematic evaluation. In considering the application of such a taxonomy, it is important to appreciate the political space in which health policy decisions occur. In this context, public engagement initiatives are likely to have a modest and unpredictable impact on policy decisions. Other goals, aside from influencing policy decisions, such as informing the public about issues, identifying the public’s values, enhancing public support for decisions, and promoting public discourse, are likely to be more feasible. While Dukanan and colleagues did not aim to do so, future efforts to align guidance for planning public engagement initiatives with evaluation tools would be useful to promote the success of public engagement initiatives.

scholarly journals Patient Portals Facilitating Engagement With Inpatient Electronic Medical Records: A Systematic Review (Preprint)

2018 ◽  
Author(s):  
Ronald Dendere ◽  
Christine Slade ◽  
Andrew Burton-Jones ◽  
Clair Sullivan ◽  
Andrew Staib ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Outcomes ◽  
Electronic Medical Records ◽  
Patient Engagement ◽  
Medical Records ◽  
Provider Communication ◽  
Patient Portals ◽  
High Quality ◽  
Patient Provider Communication

BACKGROUND Engaging patients in the delivery of health care has the potential to improve health outcomes and patient satisfaction. Patient portals may enhance patient engagement by enabling patients to access their electronic medical records (EMRs) and facilitating secure patient-provider communication. OBJECTIVE The aim of this study was to review literature describing patient portals tethered to an EMR in inpatient settings, their role in patient engagement, and their impact on health care delivery in order to identify factors and best practices for successful implementation of this technology and areas that require further research. METHODS A systematic search for articles in the PubMed, CINAHL, and Embase databases was conducted using keywords associated with patient engagement, electronic health records, and patient portals and their respective subject headings in each database. Articles for inclusion were evaluated for quality using A Measurement Tool to Assess Systematic Reviews (AMSTAR) for systematic review articles and the Quality Assessment Tool for Studies with Diverse Designs for empirical studies. Included studies were categorized by their focus on input factors (eg, portal design), process factors (eg, portal use), and output factors (eg, benefits) and by the valence of their findings regarding patient portals (ie, positive, negative, or mixed). RESULTS The systematic search identified 58 articles for inclusion. The inputs category was addressed by 40 articles, while the processes and outputs categories were addressed by 36 and 46 articles, respectively: 47 articles addressed multiple themes across the three categories, and 11 addressed only a single theme. Nineteen articles had high- to very high-quality, 21 had medium quality, and 18 had low- to very low-quality. Findings in the inputs category showed wide-ranging portal designs; patients’ privacy concerns and lack of encouragement from providers were among portal adoption barriers while information access and patient-provider communication were among facilitators. Several methods were used to train portal users with varying success. In the processes category, sociodemographic characteristics and medical conditions of patients were predictors of portal use; some patients wanted unlimited access to their EMRs, personalized health education, and nonclinical information; and patients were keen to use portals for communicating with their health care teams. In the outputs category, some but not all studies found patient portals improved patient engagement; patients perceived some portal functions as inadequate but others as useful; patients and staff thought portals may improve patient care but could cause anxiety in some patients; and portals improved patient safety, adherence to medications, and patient-provider communication but had no impact on objective health outcomes. CONCLUSIONS While the evidence is currently immature, patient portals have demonstrated benefit by enabling the discovery of medical errors, improving adherence to medications, and providing patient-provider communication, etc. High-quality studies are needed to fully understand, improve, and evaluate their impact.

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