scholarly journals ‘An exploration of stakeholder involvement in decision-making: a qualitative study of commissioning for alcohol services’

2020 ◽  
Author(s):  
hayley Alderson ◽  
Eileen Kaner ◽  
David Hunter ◽  
Amy O'Donnell ◽  
Angela Bate
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Focus Groups ◽  
Health Care Policy ◽  
Service Providers ◽  
Stakeholder Involvement ◽  
Fluid Environment ◽  
Key Issues ◽  
Perceived Involvement ◽  
The Impact

Abstract Background: The concept of providing individuals with a ‘voice’ via stakeholder involvement has been advocated within English health care policy for several decades. Stakeholder involvement encourages people affected by an issue to contribute to planning and decision making regarding treatment and care, inclusive of providers and recipients of care. This paper explores stakeholder involvement within the commissioning of public health alcohol services and illustrates whether stakeholders perceived that meaningful involvement had taken place. Methods: We conducted a qualitative case study, inclusive of in-depth interviews with 10 Alcohol commissioners, 11 alcohol service providers and 6 general practitioners plus three facilitated focus groups with 31 alcohol service users. All interviews and focus groups were audio-recorded and data were transcribed verbatim. Thematic analysis drawing on Arnstein’s theory was used to discuss key issues related to participants involvement which are illuminated using direct quotes. Results: Overall findings suggest that most participants were aware of and could name various methods of stakeholder involvement, methods varied from formal strategically imposed mechanisms to innovative opportunities. We found that strategic mechanisms of involvement focused on collating data to help construct a national picture regarding service delivery. Using Arnstein’s ladder to illustrate the extent of stakeholder involvement, the majority of the participants perceived involvement to occur at the level of informing or consultation implying a level of tokenism. In addition, the impact of stakeholder involvement is not systematically monitored making it hard to identify the impact that involvement methods have had. Conclusion: This paper has shown a lack of consistency regarding the opportunities within the commissioning process for stakeholder involvement to influence service design and delivery. It is essential within public health that a deeper understanding is generated of who stakeholders are within this complex and fluid environment and to develop a clearer understanding of the different roles that stakeholders can play within the entire commissioning process in order to maximise its utility. Future commissioning guidance also needs to reflect more dimensionality than ladders of involvement currently afford.

scholarly journals Dual MD–MPH Degree Students in the United States: Moving the Medical Workforce Toward Population Health

2021 ◽  
pp. 003335492097842
Author(s):  
Jo Marie Reilly ◽  
Christine M. Plepys ◽  
Michael R. Cousineau
Keyword(s):  
Public Health ◽  
United States ◽  
Population Health ◽  
Health Care Policy ◽  
The United States ◽  
Extensive Literature ◽  
Master Of Public Health ◽  
Telephone Interviews ◽  
Public Health Training ◽  
The Impact

Objective A growing need exists to train physicians in population health to meet the increasing need and demand for physicians with leadership, health data management/metrics, and epidemiology skills to better serve the health of the community. This study examines current trends in students pursuing a dual doctor of medicine (MD)–master of public health (MPH) degree (MD–MPH) in the United States. Methods We conducted an extensive literature review of existing MD–MPH databases to determine characteristics (eg, sex, race/ethnicity, MPH area of study) of this student cohort in 2019. We examined a trend in the MD community to pursue an MPH career, adding additional public health and health care policy training to the MD workforce. We conducted targeted telephone interviews with 20 admissions personnel and faculty at schools offering MD–MPH degrees in the United States with the highest number of matriculants and graduates. Interviews focused on curricula trends in medical schools that offer an MD–MPH degree. Results No literature describes the US MD–MPH cohort, and available MD–MPH databases are limited and incomplete. We found a 434% increase in the number of students pursuing an MD–MPH degree from 2010 to 2018. The rate of growth was greater than the increase in either the number of medical students (16%) or the number of MPH students (65%) alone. Moreover, MD–MPH students as a percentage of total MPH students more than tripled, from 1.1% in 2010 to 3.6% in 2018. Conclusions As more MD students pursue public health training, the impact of an MPH degree on medical school curricula, MD–MPH graduates, and MD–MPH career pursuits should be studied using accurate and comprehensive databases.

scholarly journals The challenge of bringing evidence in decision-making for public health emergencies: can preparedness reach out to HTA?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C E Chronaki ◽  
A Miglietta
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Policy Development ◽  
Digital Health ◽  
Resource Planning ◽  
Public Health Emergency ◽  
Evidence Based ◽  
Public Health Emergencies ◽  
The Impact ◽  
Evidence Based Decision Making

Abstract Evidence-based decision-making is central to public health. Implementing evidence-informed actions is most challenging during a public health emergency as in an epidemic, when time is limited, scientific uncertainties and political pressures tend to be high, and reliable data is typically lacking. The process of including data for preparedness and training for evidence-based decision making in public health emergencies is not systematic and is complicated by many barriers as the absence of common digital tools and approaches for resource planning and update of response plans. Health Technology Assessment (HTA) is used with the aim to improve the quality and efficiency of public health interventions and to make healthcare systems more sustainable. Many of today's public health crises are also cross-border, and countries need to collaborate in a systematic and standardized way in order to enhance interoperability to share data and to plan coordinated response. Digital health tools have an important role to play in this setting, facilitating use of knowledge about the population that can potentially affected by the crisis within and across regional and national borders. To strengthen the impact of scientific evidence on decision-making for public health emergency preparedness and response, it is necessary to better define and align mechanisms through which interdisciplinary evidence feeds into decision-making processes during public health emergencies and the context in which these mechanisms operate. Activities and policy development in the HTA network could inform this process. The objective of this presentation is to identify barriers for evidence-based decision making during public health emergencies and discuss how standardization in digital health and HTA processes may help overcome these barriers leading to more effective coordinated and evidence-based public health emergency response.

scholarly journals Key issues in co-creation with stakeholders when research problems are complex

2019 ◽  
Vol 15 (3) ◽  
pp. 423-435 ◽  
Author(s):  
Gabriele Bammer
Keyword(s):  
International Association ◽  
Stakeholder Involvement ◽  
Research Programme ◽  
Extensive Literature ◽  
Multiple Stakeholders ◽  
Stakeholder Groups ◽  
Complex Problems ◽  
Research Problems ◽  
Key Issues ◽  
The Impact

The extensive literature on research co-creation is mostly based on problems being treated as clearly defined and solvable. What is the impact on co-creation when problems are complex, with the following characteristics: difficult to delimit, contested definitions, multiple uncertainties and unresolvable unknowns, constraints on what can be done, and no perfect solution? Co-creation on such problems requires a research mindset that appreciates that stakeholders have an essential role in making complexity evident and that limiting stakeholder involvement also limits the ability to understand and effectively act on complex problems. The Integration and Implementation Sciences (i2S) framework is introduced as a way to systematically take into account multiple stakeholders with multiple relevant inputs. In addition, one specific tool, the research-relevant modified International Association for Public Participation (IAP2) spectrum, is described as a way of exploring stakeholder engagement. For complex problems this modified spectrum can be used to describe different ways of including stakeholders, to reflect on appropriate forms of engagement, as well as to take into account both level of researcher control and different categories of stakeholder groups. A research programme examining the feasibility of prescribing pharmaceutical heroin as a treatment for heroin dependence stimulated thinking about co-creation on complex problems and is used as a practice example to illustrate the points covered.

Consumer empowerment in insurance

2018 ◽  
Vol 36 (6) ◽  
pp. 1073-1097 ◽  
Author(s):  
Pascal Buehler ◽  
Peter Maas
Keyword(s):  
Decision Making ◽  
Self Efficacy ◽  
Service Providers ◽  
Time Lag ◽  
Decision Making Process ◽  
Consumer Empowerment ◽  
Content Type ◽  
Perceived Performance ◽  
Performance Risk ◽  
The Impact

Purpose The purpose of this paper is to enhance the understanding of consumer empowerment in the relationship between consumers and service providers. It draws on self-efficacy theory to conceptualize consumer empowerment and explain the impact on perceived performance risk in insurance decision making. Design/methodology/approach This study employs data collected from an online survey involving 487 consumers in Switzerland, who recently decided on an insurance service. A structural equation model quantifies both the psychological effects on consumers’ perception of insurance services and behavioral effects on their decision-making process. Findings Perceived consumer empowerment is conceptualized by perceived self-efficacy and perceived controllability. Both have a significant impact on perceived performance risk, while the former is partially mediated by the preference to delegate the decision to a surrogate. Moreover, customers’ involvement in the purchase process moderates both the direct and indirect effect of perceived self-efficacy on perceived performance risk. Research limitations/implications The results are based on consumers’ perceptions from a single country. Furthermore, consumers’ perceptions were surveyed with a time lag after the decision-making process. To increase rigor, perceptions should be collected during decision making. Practical implications Results show that consumer empowerment can be employed as a risk reduction strategy. Consumers with self-efficacy and controllability beliefs perceive significantly less performance risk; however, practitioners should consider that consumers are also motivated to make decisions independently rather than delegating their decisions. Furthermore, consumer empowerment depends on consumer will. For largely indifferent consumers, empowerment does not affect risk or decision delegation preference. Originality/value The study is among the few empirical works to examine the effects of consumer empowerment on the consumer-service provider relationship on an individual level. Furthermore, applying consumer empowerment in relationship marketing implies a shift in research focus to the question of how consumers construe decision-making situations rather than objectively measuring the state of consumer relationship.

Implementation of 3D printing and the effect on decision making in logistics management

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Stefan Hecker
Keyword(s):  
Decision Making ◽  
3D Printing ◽  
Service Providers ◽  
Logistics Management ◽  
Service Development ◽  
Content Type ◽  
Disruptive Technologies ◽  
Logistics Service ◽  
Service Portfolio ◽  
The Impact

PurposeFrom a synthesis of literature, the purpose of this paper is to present a conceptual service development methodology showing the impact of 3D printing as a disruptive technology to the service portfolio. The methodology is designed to support practitioners and academics in better understanding the impact of disruptive technologies may have to the service portfolio and participate in the technology.Design/methodology/approachA literature review is conducted and based on these findings a conceptual framework has been developed.FindingsThe design of a methodology for the development of 3D printing services is used to evaluate the disruption potential of 3D printing and to implement the technology in the service portfolio of a logistics service provider. The disruption potential of 3D printing influences a logistics manager by make to order decisions. In addition, it could be proven the service portfolio was diversified.Research limitations/implicationsLiterature directly dealing with technology-based service development for decision making in logistics management is rare and thus the methodology is built on insights, compiled from the distinct research areas. Further research should be performed on this nascent topic.Practical implicationsLogistics service providers may use the developed methodology to revise their service portfolio by the consideration of disruptive technologies, in order to reduce strategic misdecisions regarding the range of services.Originality/valueThis paper looks specifically at decision making for implementing disruptive technologies to the service portfolio.

scholarly journals MANAJEMEN MUTU TERPADU DI PESANTREN

2021 ◽  
Vol 15 (2) ◽  
pp. 195-226
Author(s):  
Siti Aimah
Keyword(s):  
Quality Management ◽  
Service Providers ◽  
Stakeholder Involvement ◽  
Boarding School ◽  
Quality Standards ◽  
Customer Expectations ◽  
Implementation Evaluation ◽  
Quality Culture ◽  
Analysis Technique ◽  
The Impact

The purpose of this study is to find; planning, implementation, evaluation, follow-up, characteristics and impacts of quality standards on the application of integrated quality management in Pondok Pesantren Darussalam Blokagung and Pondok Pesantren Modern Al-Kautsar Banyuwangi. This study uses a qualitative approach to the data collection techniques used that are: observation, interviews and documentation. The data analysis technique uses interactive three models that are: data reduction, data presentation, conclusion drawing. The results of this research: first, the pattern of MMT application in pesantren is influenced by the typology of the education system used, but substantially has the same pattern of organizing, planning, implementing, monitoring and innovation. The pattern formed a cycle that repeated itself in the implementation of quality activities with the control of the person responsible for quality in collaboration with all stakeholders in the Islamic boarding school, especially the organizers of the managed educational activities; second, characteristics of MMT in pesantren that is focus on customers in providing satisfaction, total stakeholder involvement both internal and external in organizing quality activities, quality standards that are in line with customer desires, commitment of pesantren education service providers in supporting the improvement of quality culture, continuous improvement through improving quality standards in line with increasing customer expectations and innovation values ​​of the quality of the pesantren so that the public is increasingly in demand,  prospective students and users, the integration of education and dual graduation is now increasingly in demand by the community; third the impact of implementing integrated quality management in pesantren is improvement of quality culture that triggers public appeal, to register their children in Islamic boarding schools and increasing number of students in pesantren, the increasing recognition of the quality (education) of pesantren in the community.

scholarly journals The Impact of Public Health Interventions on The First and Second Waves of COVID-19 in Trinidad And Tobago – A Simple Epidemic Model

2020 ◽  
Author(s):  
Loren De Freitas ◽  
Han-I Wang
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Trinidad And Tobago ◽  
Specific Treatment ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Support Methods ◽  
The Impact ◽  
Second Wave ◽  
Combined Interventions

Introduction The COVID-19 pandemic has resulted in more than 35 million confirmed cases worldwide. Currently, there is no specific treatment for the disease or available vaccine to reduce the spread of COVID-19. As such, countries rely on a range of public health interventions to assist in halting the spread of transmission. Caribbean countries have also adopted many public health interventions. In this paper, we use mathematical modelling to demonstrate the impact of public health interventions on the progression of COVID-19 in order to provide timely decision support. Methods A cohort Markov model, based on the concept of the SEIR model, was built to reflect the characteristics of the COVID-19 virus. Five possible public health interventions in the first wave and a projection of current second wave were simulated using the constructed model. Results The model results indicate that the strictest combined interventions of complete border closure and lockdown were the most effective with the number of deaths less than ten in the first wave. For the current second wave, it will take around 30 days for the pandemic to pass its peak after implementing the wearing of face masks policy. Conclusions This paper shows the impact of common public health interventions on the COVID-19 pandemic, using Trinidad and Tobago as an example. Such impacts may be useful in reducing delays in decision-making and improving compliance by populations. However, given the limitations associated with mathematical models, decision-making should be guided by economic assessments, infectious disease and public health expertise.

scholarly journals Differential impact of non-pharmaceutical public health interventions on COVID-19 epidemics in the United States

2020 ◽  
Author(s):  
Xiaoshuang Liu ◽  
Xiao Xu ◽  
Guanqiao Li ◽  
Xian Xu ◽  
Yuyao Sun ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Decision Making ◽  
The United States ◽  
School Closure ◽  
Health Interventions ◽  
Public Health Interventions ◽  
The Us ◽  
The Impact ◽  
Individualized Decision

Abstract The widespread pandemic of novel coronavirus disease 2019 (COVID-19) poses an unprecedented global health crisis. In the United States (US), different state governments have adopted various combinations of non-pharmaceutical public health interventions (NPIs) to mitigate the epidemic from February to April, 2020. Quantitative assessment on the effectiveness of NPIs is in great need to assist in guiding the individualized decision making for adjustment of interventions in the US and around the world. However, the impact of these approaches remain uncertain. Based on the reported cases, the effective reproduction number of COVID-19 epidemic for 50 states in the US was estimated. The measurement on the effectiveness of eight different NPIs was conducted by assessing risk ratios (RRs) between and NPIs through a generalized linear model (GLM). Different NPIs were found to have led to different levels of reduction in. Stay-at-home contributed approximately 51% (95% CI 46%-57%), gathering ban (more than 10 people) 19% (14%-24%), non-essential business closure 16% (10%-21%), declaration of emergency 13% (8%-17%), interstate travel restriction 11% (5%-16%), school closure 10% (7%-13%), initial business closure 10% (6%-14%), and gathering ban (more than 50 people) 6% (2%-11%). This retrospective assessment of NPIs on has shown that NPIs played critical roles on epidemic control in the US in the past several months. The quantitative results could guide individualized decision making for future adjustment of NPIs in the US and other countries for COVID-19 and other similar infectious diseases.

scholarly journals P563 Shared decision-making in pregnancy in inflammatory bowel disease: Design of a pregnancy in IBD decision aid (PIDA)

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S474-S475
Author(s):  
A J Williams ◽  
Y Leung ◽  
K O’Connor ◽  
V Huang
Keyword(s):  
Decision Making ◽  
Focus Groups ◽  
Disease Activity ◽  
Decision Aid ◽  
Negative Impact ◽  
Decision Aids ◽  
Mode Of Delivery ◽  
Surgical History ◽  
The Impact ◽  
In Pregnancy

Abstract Background A lack of IBD-specific reproductive knowledge has been associated with increased ‘voluntary childlessness’.Furthermore, a lack of patient and clinician knowledge may contribute to inappropriate medication changes during or after pregnancy that may lead to a flare of disease. Evidence exists for the benefit of decision aids to support decision-making in pregnancy in general, as well as in multiple other chronic disease; however, such a resource for pregnancy in IBD has not been identified. Methods Using International Patient Decision Aids Standards, we have commenced design of our Pregnancy in IBD Decision Aid (PIDA). A steering committee consisting of Canadian and Australian Healthcare professionals with an interest in IBD management in pregnancy, in addition to a patient representative was established. Initial patient and clinician focus groups were conducted. Themes prospectively chosen for discussion included inheritance, fertility, nutrition, medications, mode of delivery, breastfeeding, infant infections and vaccinations. We designed an electronic PIDA draft that incorporates individualised information (for example, type of IBD, pre-conception or pregnant, surgical history and current medications) in personalised decision-making. Further patient focus groups and interviews were conducted to obtain user opinion of the PIDA draft. Results In July 2017, patient and clinician focus groups were conducted at a Canadian site. Patient concerns regarding pregnancy included the impact of disease, previous surgical history on fertility, preterm delivery; the potential impact of current and past drug therapies on the fetus/ infant; and the negative impact of active disease on both maternal and fetal/infant health. Clinician concerns included the absence of pre-conception counselling and potential for lack of patient understanding about the impact of disease activity and IBD medication use in pregnancy. Patient feedback (n = 15) obtained through interviews at two Canadian and one Australian site regarding the current electronic PIDA draft was predominantly positive, with comments pertaining to the adequacy of content coverage, personalisation, readability and unbiased information presentation. Suggestions were made for inclusion of further content such as the impact of IBD on sexual function, expected laboratory changes and the timing of recommencement of medications post-partum. Conclusion The completion of pre and post-PIDA design focus groups and interviews affirmed the role for PIDA. Main decisions that were considered necessary to address included ideal timing of conception pending disease activity, management of medications and delivery methods. Ongoing user feedback is being obtained at Australian and Canadian sites currently.

scholarly journals THE EXAMINATION OF DETERMINANTS AND BARRIERS TO END-OF-LIFE DECISION MAKING AND PLANNING

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S236-S237
Author(s):  
Brittany E Gaines ◽  
Debra J Dobbs
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
End Of Life ◽  
Rural Areas ◽  
Hospice Care ◽  
Service Providers ◽  
Advance Care ◽  
End Of Life Decision ◽  
The Impact

Abstract As individuals are living longer, in many cases with chronic diseases, there is an increased focus on end-of-life (EOL) planning and decision making. This includes a broad spectrum of choices including advance care planning (ACP) and turning to palliative care or hospice care. Although there has been an increase in palliative and hospice care enrollment and ACP engagement over the past decade, participation remains low for certain subgroups of the population. The purpose of this symposium is to offer insight into reasons for these varying rates of engagement by exploring determinants and barriers to EOL decision making and planning and by examining caregiver knowledge of EOL decision making and planning from the service provider perspective. The first three studies examine various types of influences in EOL decision making and planning. Inoue and colleagues explore factors associated with the length of hospice stay, and Gaines and colleagues examine the impact of environmental characteristics in ACP. Ornstein and colleagues use Denmark registry data to assess the role of kinlessness at the time of death in EOL decision making and healthcare utilization. The final presentation by Noh and colleagues examines how service providers in rural areas perceive community residents’ knowledge of ACP and palliative care. The discussion following these presentations will compare findings across different forms of EOL decision making and planning, consider the impact of the varying methodological approaches used, and highlight implications of these works for potential interventions and policies related to EOL decision making and planning.

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