scholarly journals Integration Intrapreneurship: Implementing Innovation in a Public Healthcare Organisation

2021 ◽  
Author(s):  
Perrin Moss ◽  
Nicole Hartley ◽  
Trevor Russell
Keyword(s):  
Large Scale ◽  
Organizational Context ◽  
Healthcare Organization ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
Healthcare Organisation ◽  
Healthcare Outcomes ◽  
Community Healthcare ◽  
Project Echo ◽  
New Business

Abstract Aim: As global events impact the way organisations operate and innovate in response to regional, workforce and consumer needs, the concept of intrapreneurism is attracting growing interest from policymakers and executives, particularly within the healthcare sector. The aim of this study was to capture the key learnings from the implementation of a telementoring pilot, to understand how intrapreneurship can embed innovation within an established organization to effect more integrated healthcare.Purpose: A qualitative approach was used with a phenomenological lens to explore the key learnings of the Project ECHO® (Extension for Community Healthcare Outcomes) pilot implementation to provide an understanding of what the project team’s strategies and tactics were during the process of embedding a new business innovation. The implementation and piloting of Project ECHO®, a telementoring model, in a large-scale public healthcare organization in Queensland, Australia was investigated as an exemplar of integration intrapreneurship. Findings: Through an inductive approach, this qualitative study found the implementation of the Project ECHO® pilot had specific dimensions and strategies/tactics which were exemplars of intrapreneurism. The organizational context and workforce characteristics described in this study presented new knowledge of how intrapreneurs implemented an innovation to address fragmentation of healthcare service delivery, professional isolation and instances of low-value care. This research contributes to a better understanding of the strategic and tactical approaches to implementing intrapreneurial innovations within a public healthcare organization, with learnings that can be adapted by intrapreneurs in other contexts.

Managers do it their way: How managers act in a decentralised healthcare services provider organisation – a mixed methods study

2021 ◽  
pp. 095148482110654
Author(s):  
Mikael Ohrling ◽  
Sara Tolf ◽  
Karin Solberg-Carlsson ◽  
Mats Brommels
Keyword(s):  
Content Analysis ◽  
Service Delivery ◽  
Healthcare Delivery ◽  
Healthcare Services ◽  
Management Model ◽  
Public Healthcare ◽  
Healthcare Organisation ◽  
Programme Theory ◽  
Local Conditions ◽  
Community Healthcare

Purpose: Decentralisation is considered a way to get managers more committed and more prone to respond to local needs. This study analyses how managers perceive a decentralised management model within a large public healthcare delivery organisation in Sweden. Design/methodology/approach: A programme theory evaluation was performed applying direct content analysis to in-depth interviews with healthcare managers. Balance score card data were used in a blinded comparative content analysis to explore relations between performance and how the delegated authority was perceived and used by the managers. Findings: Managers’ perceptions of the decentralised management model supported its intentions to enable the front-line to make decisions to better meet customer needs and flexibly adapt to local conditions. The managers appreciated and used their delegated authority. Central policies and control on human resources and investments were accepted as those are to the benefit of the whole organisation. Leadership development and organisation-wide improvement programmes were of support. Units showing high organisational performance had proactive managers, although differences in manager perceptions across units were small. Originality: This, one of the first of its kind, study of a decentralisation in service delivery organisation shows a congruence between the rationale of a management model, the managers’ perceptions of the authority and accountability as well as management practises. These observations stemming from a large public primary and community healthcare organisation has not, to our knowledge, been reported and provide research-informed guidance on decentralisation as one strategy for resolving challenges in healthcare service delivery organisations.

scholarly journals A Protocol for a Comprehensive Monitoring and Evaluation Framework With a Compendium of Tools to Assess Quality of Project ECHO (Extension for Community Healthcare Outcomes) Implementation Using Mixed Methods, Developmental Evaluation Design

2021 ◽  
Vol 9 ◽  
Author(s):  
Smita Ghosh ◽  
Brenna M. Roth ◽  
Irene Massawe ◽  
Emmanuel Mtete ◽  
Jacob Lusekelo ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Appreciative Inquiry ◽  
Monitoring And Evaluation ◽  
Evaluation Framework ◽  
Assessment Tools ◽  
Healthcare Outcomes ◽  
Developmental Evaluation ◽  
Evaluation Design ◽  
Community Healthcare ◽  
Project Echo

Introduction: The United States Centers for Disease Control and Prevention (CDC), through U.S. President's Emergency Plan for AIDS Relief (PEPFAR), supports a third of all people receiving HIV care globally. CDC works with local partners to improve methods to find, treat, and prevent HIV and tuberculosis. However, a shortage of trained medical professionals has impeded efforts to control the HIV epidemic in Sub-Saharan Africa and Asia. The Project Extension for Community Healthcare Outcomes (ECHOTM) model expands capacity to manage complex diseases, share knowledge, disseminate best practices, and build communities of practice. This manuscript describes a practical protocol for an evaluation framework and toolkit to assess ECHO implementation.Methods and Analysis: This mixed methods, developmental evaluation design uses an appreciative inquiry approach, and includes a survey, focus group discussion, semi-structured key informant interviews, and readiness assessments. In addition, ECHO session content will be objectively reviewed for accuracy, content validity, delivery, appropriateness, and consistency with current guidelines. Finally, we offer a mechanism to triangulate data sources to assess acceptability and feasibility of the evaluation framework and compendium of monitoring and evaluation tools.Expected impact of the study on public health: This protocol offers a unique approach to engage diverse group of stakeholders using an appreciative inquiry process to co-create a comprehensive evaluation framework and a compendium of assessment tools. This evaluation framework utilizes mixed methods (quantitative and qualitative data collection tools), was pilot tested in Tanzania, and has the potential for contextualized use in other countries who plan to evaluate their Project ECHO implementation.

scholarly journals Exploring learners’ perspectives of a Project ECHO palliative care education curriculum in resource-limited settings in light of key learning theories

2020 ◽  
Author(s):  
Megan Doherty ◽  
Shokoufeh Modanloo ◽  
Emily Evans ◽  
Dennis Newhook ◽  
Doug Archibald
Keyword(s):  
Palliative Care ◽  
Focus Groups ◽  
Healthcare Providers ◽  
Learning Theories ◽  
Sociocultural Factors ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Specialist Care ◽  
Community Healthcare ◽  
Project Echo

Abstract Background: Project ECHO (Extension of Community Healthcare Outcomes) is a well-established telehealth educational platform developed to improve access to specialist care training in underserved areas. The objective of this study is to explore the learning experiences of participants in a Project ECHO targeting care providers in India and explore considerations for how ECHO programs could be modified to cater to the unique learning needs of individuals in low- and middle-income countries. Methods : We implemented a one-year Project ECHO on pediatric palliative care (ECHO PPC) targeting healthcare providers in India. The program consisted of 24 bi-weekly sessions (March 2018-February 2019) hosted by the Hyderabad Centre for Palliative Care in Hyderabad, India. Learners who attended at least 20% (5 sessions) were eligible to participate. Data related to demographic characteristics of ECHO PPC participants were collected. Four focus groups were conducted (February-April 2019) either online via videoconference or in person. Focus groups recordings were transcribed, coded and independently verified. The codes were then arranged into overarching themes.Results : Thirty-six learners were eligible and invited to participate in the study. Seventeen individuals completed the study. Following coding and analysis, two major themes and seven sub-themes were identified. The themes included: (1) Benefits of participation in ECHO PPC (creation of a community of practice; opportunity to exchange cultures, ideas and experiences; supportive role of the facilitator and peers; increased relevant knowledge and skills; and access to additional learning resources) and (2) Barriers to participation (difficulties with time and practice schedule management and language and sociocultural factors). Conclusion: The key principals of learning theories were incorporated into forming the Project ECHO conceptual model in this study. PPC Project ECHO facilitated community building, stimulated professional interest and additional learning outside of the program. However, addressing the barriers and challenges might likely enhance the success of the program in future.

Project ECHO: telementoring to educate and support prescribing of HIV pre-exposure prophylaxis by community medical providers

Sexual Health ◽  
2018 ◽  
Vol 15 (6) ◽  
pp. 601 ◽  
Author(s):  
Brian R. Wood ◽  
Maren S. Mann ◽  
Natalia Martinez-Paz ◽  
Kenton T. Unruh ◽  
Mary Annese ◽  
...  
Keyword(s):  
Healthcare Outcomes ◽  
Medical Providers ◽  
Prescribing Practices ◽  
Community Healthcare ◽  
Project Echo ◽  
Practitioner Knowledge ◽  
Health Practitioners ◽  
Exposure Prophylaxis ◽  
Community Practitioner

Background Pre-exposure prophylaxis (PrEP) is an effective tool to prevent HIV infection for at-risk individuals, but access requires medical providers to be aware of and comfortable with prescribing PrEP. Project ECHO (Extension for Community Healthcare Outcomes) was started to support hepatitis C virus treatment in rural New Mexico, but has since expanded to train health practitioners to treat other medical conditions in other locations. Methods: In 2012, a Project ECHO telehealth program was launched to mentor community HIV practitioners in our region. In July 2015, quarterly PrEP didactics and monthly PrEP case discussions were incorporated into this program. The result was a pilot PrEP telementoring intervention. An initial nine-question survey assessed baseline community practitioner knowledge and attitudes towards PrEP, and a follow-up 16-item survey 2 years later assessed the effect of Project ECHO on PrEP knowledge, concerns and prescribing practices. Results: Twenty-four and 45 medical providers completed the baseline and follow-up surveys respectively. In follow-up, providers reported that Project ECHO participation helped them stay current on PrEP guidelines, improved knowledge, increased likelihood to prescribe PrEP and addressed most concerns about prescribing PrEP. One exception was continued concerns about cost and insurance access, which were addressed by adjusting the didactic curriculum. Many participants reported that the Project ECHO pilot PrEP telementoring intervention assisted them in disseminating PrEP knowledge to other medical providers in their region. Conclusions: It is feasible to incorporate PrEP training into Project ECHO distance telementoring programs as a tool to educate community practitioners and support PrEP prescribing.

Supporting and improving community health services—a prospective evaluation of ECHO technology in community palliative care nursing teams

2015 ◽  
Vol 9 (2) ◽  
pp. 202-208 ◽  
Author(s):  
Clare White ◽  
Sonja McIlfatrick ◽  
Lynn Dunwoody ◽  
Max Watson
Keyword(s):  
Palliative Care ◽  
Self Efficacy ◽  
Demographic Data ◽  
Healthcare Outcomes ◽  
Community Healthcare ◽  
Project Echo ◽  
Significant Difference ◽  
The Uk ◽  
Prospective Longitudinal ◽  
Care Nursing

IntroductionProject ECHO (Extension for Community Healthcare Outcomes) uses teleconferencing technology to support and train healthcare providers (HCPs) remotely, and has improved care across the USA. A 6-month pilot was trialled in a community palliative care nursing setting to determine if ECHO would be effective in the UK in providing education and support to community hospice nurses (CHN).MethodsThe pilot involved weekly 2 hour sessions of teaching and case-based discussions facilitated by hospice staff linking with nine teams of CHN using video conferencing technology. A mixed-methods prospective longitudinal cohort study was used to evaluate the pilot. Each CHN provided demographic data, and completed a written knowledge assessment and a self-efficacy tool before and after the pilot. Two focus groups were also performed after the pilot.Results28 CHNs completed the evaluation. Mean knowledge score improved significantly from 71.3% to 82.7% (p=0.0005) as did overall self-efficacy scores following the ECHO pilot. Pre-ECHO (p=0.036) and Retro-Pretest ECHO (p=0.0005) self-efficacy were significantly lower than post-ECHO. There was no significant difference between Pretest and Retro-Pretest ECHO self-efficacy (p=0.063). 96% recorded gains in learning, and 90% felt that ECHO had improved the care they provided for patients. 83% would recommend ECHO to other HCPs. 70% stated the technology used in ECHO had given them access to education that would have been hard to access due to geography.ConclusionsThis study supports the use of Project ECHO for CHNs in the UK by demonstrating how a 6-month pilot improved knowledge and self-efficacy. As a low-cost high-impact model, ECHO provides an affordable solution to addressing growing need.

scholarly journals Geriatric Workforce Enhancement Programs' Participation in the Nursing Home COVID Action Network

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 493-493
Author(s):  
Leland Waters ◽  
Nina Tumosa
Keyword(s):  
Nursing Home ◽  
Healthcare Providers ◽  
Health Resources ◽  
Healthcare Research ◽  
Nursing Facilities ◽  
Healthcare Outcomes ◽  
Community Healthcare ◽  
Project Echo ◽  
Action Network ◽  
The University

Abstract In late September, 2020, the Geriatric Workforce Enhancement Program’s (GWEP) Program Officer, at the Health Resources Services Administration (HRSA), alerted the 48 GWEPs about a nationwide initiative focusing specifically on the pandemic’s effect in nursing facilities. The ECHO Institute at the University of New Mexico negotiated a national contract with the Agency for Healthcare Research and Quality (AHRQ) to provide a nationwide educational intervention via the CARES Act Provider Relief Fund. The ECHO Institute recruited over 100 Training Centers as educational coordinators for the Project ECHO Nursing Home National COVID Action Network. Our Project Officer suggested that individual GWEPs participate in this effort and take the lead or provide geriatric educators for these Training Centers. Project ECHO (Extension for Community Healthcare Outcomes) is an innovative telementoring program that creates virtual learning communities, bringing together healthcare providers and subject matter experts using videoconference technology for brief presentations, and case-based learning, fostering an “all learn, all teach” approach. This symposium will describe the journeys that five GWEPs experienced becoming Training Centers, rapidly deploying a nursing home ECHO project, to support nursing home staff on best practices for protecting patients, staff, and visitors from coronavirus infection and spread. GWEPs from The University of Louisville, the University of North Carolina, the University of North Texas, the University of Rochester and The Virginia Geriatric Education Center’s two ECHO Hubs, joined the National COVID Action Network. This presentation will provide an overview of why GWEPs are well positioned to address emergent needs with short notice.

Distance Delivery of Function-Based Skill Training for Providers in Rural Settings

2021 ◽  
pp. 875687052110423
Author(s):  
Abby Hodges ◽  
Jaclyn D. Joseph ◽  
Phillip S. Strain
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Challenging Behavior ◽  
Skill Training ◽  
Healthcare Outcomes ◽  
Community Healthcare ◽  
Small Communities ◽  
Project Echo ◽  
Assessment And Treatment ◽  
Behavioral Services

Children with diagnosed disabilities, teachers and classroom staff, and families living in rural areas have difficulty accessing any and all behavioral services, including parent training, due to a lack of providers, distance to clinics, cost of transportation, low income and/or inadequate health insurance, and confidentiality concerns from living in small communities. In this study, Project ECHO (Extension for Community Healthcare Outcomes) was used to train early childhood professionals on how to implement Prevent–Teach–Reinforce for Young Children, which is a step-by-step manualized approach to the assessment and treatment of challenging behavior that reflects a commitment to evidence-based practice. Results of the pilot study, study limitations, and future directions are discussed.

Building Capacity to Reduce Disparities in Diabetes

2012 ◽  
Vol 38 (3) ◽  
pp. 386-396 ◽  
Author(s):  
Kathleen Colleran ◽  
Erika Harding ◽  
Billie Jo Kipp ◽  
Andrea Zurawski ◽  
Barbara MacMillan ◽  
...  
Keyword(s):  
New Mexico ◽  
Community Health ◽  
Training Program ◽  
Health Workers ◽  
Positive Impact ◽  
Training Session ◽  
Healthcare Outcomes ◽  
Community Healthcare ◽  
Project Echo ◽  
Hands On

Purpose The purpose of this study is to determine whether an innovative interactive distance training program is an effective modality to train community health workers (CHWs) to become members of the diabetes health care team. The University of New Mexico Health Sciences Center has developed a rigorous diabetes training program for CHWs involving both distance and hands-on learning as part of Project ECHO™ (Extension for Community Healthcare Outcomes). Methods Twenty-three diverse CHW participants from across New Mexico were enrolled in the first training session. Participants completed surveys at baseline and at the end of the program. They attended a 3-day hands-on training session, followed by weekly participation in tele/video conferences for 6 months. Wilcoxon signed-rank statistics were used to compare pre- and posttest results. Results Participants demonstrated significant improvements in diabetes knowledge ( P = .002), diabetes attitudes ( P = .04) and confidence in both clinical and nonclinical skills ( P < .001 and P = .04, respectively). Additionally, during focus group discussions, participants reported numerous benefits from participation in the program. Conclusions Community health worker participation in the Project ECHO diabetes training program resulted in significant increases in knowledge, confidence, and attitudes in providing care to patients with diabetes. Studies are ongoing to determine whether the training has a positive impact on patient outcomes.

scholarly journals Extension for Community Healthcare Outcomes Uruguay: A New Strategy to Promote Best Primary Care Practice for Autism

2019 ◽  
Vol 6 ◽  
pp. 2333794X1983373 ◽  
Author(s):  
Gustavo Giachetto ◽  
Ana Laura Casuriaga ◽  
Anabella Santoro ◽  
Virginia Kanopa ◽  
Gabriela Garrido ◽  
...  
Keyword(s):  
Primary Care ◽  
Best Practice ◽  
Care Practice ◽  
Healthcare Outcomes ◽  
Self Perception ◽  
Community Healthcare ◽  
Project Echo ◽  
New Strategy ◽  
Primary Care Clinicians ◽  
Clinical Cases

Introduction. In Uruguay, the special care required for children with neurodevelopmental disorders presents difficulties including lack of access to specialists and rehabilitation services. Project ECHO (Extension for Community Healthcare Outcomes) connects primary care clinicians from remote areas to specialists to enable them to treat complex conditions through ongoing education and mentoring. Objective. To share the experience of the ECHO Autism program during the first 2 years of implementation. Methods. Analysis of ECHO Autism clinics from June 2015 to June 2017 including clinical cases presented participants’ self-perception of changes in skills and competences. Results. Twenty clinical cases were presented: mean age 4.5 years; 15 were males; and 17 with medical and psychiatric comorbidities. After ECHO Autism implementation, a statistically significant improvement in participants’ self-perception of skills and competences was observed. Conclusions. ECHO Autism in Uruguay is a meaningful approach to autism care and offers improved access to best practice care.

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