scholarly journals Implementation of a client-accessible and multidisciplinary youth health record in the Netherlands; a mixed-methods process evaluation

2021 ◽  
Author(s):  
Janine Benjamins ◽  
Jan-Gerrit Duinkerken ◽  
Gerlinde Jordaan ◽  
Rianne Koster ◽  
Romay Canfijn ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Process Evaluation ◽  
Information Needs ◽  
Electronic Patient Record ◽  
Complex Interventions ◽  
Implementation Process ◽  
Project Planning ◽  
Patient Record ◽  
User Friendliness ◽  
Working Processes

Abstract Background: Client-accessible patient records potentially contribute to patient-centered care by facilitating shared decision-making, enhancing interdisciplinary collaboration, and promoting patient’s autonomy. To achieve this, three Dutch organizations providing ‘care for youth’ developed an electronic patient record (EPR-Youth). EPR-Youth supports working processes of all three organizations and is fully accessible for adolescents and for parents of children aged 0-16 years. Co-creation was chosen as implementation approach for this e-Health intervention that not only intervenes with technology (hardware) but also transforms working processes (orgware) and professional behavior (software). Objective: to investigate the implementation process of EPR-Youth and to determine barriers and facilitators.Methods: a mixed methods design was used. To guide the process evaluation, Pfadenhauers’ Context and Implementation of Complex Interventions framework and Proctor’s theoretic framework on implementation were used to define implementation outcomes and describe setting and context. Target groups were parents, adolescents, professionals using EPR-Youth, and all stakeholders in the implementation process.Results: Barriers in the implementation process of EPR-Youth were the complexity of collaboration between stakeholders and the lack of clarity about leadership and project planning. Facilitating factors were clarifying the vision, setting deadlines, and a pioneering spirit.Acceptability of the client-portal was high among all users. Adoption of the client-portal was highest among parents of children aged 0-3 years and among higher educated parents.Professionals’ doubts about user-friendliness and about the match with vision and working processes were partly due to lack of knowledge of all system functionalities. Conclusion: The implementation of EPR-Youth, the first Dutch electronic patient record facilitating both preventive child health and youth care, was successful on ‘hardware’ level. To complete implementation on ‘software’ and ‘orgware’ level, client information needs attention, as well as training of professionals. Further research is needed to gain insight into barriers to access the client-portal. Although co-creation was an essential ingredient to reach project goals, situational leadership with more direction at the start and room for disruption is needed to guide this process.

scholarly journals The development and process evaluation of the ACTION study: A person-centred communication intervention targeting nurse assistants in home care for older persons

2019 ◽  
Author(s):  
Tanja Gustafsson ◽  
Annelie J Sundler ◽  
Elisabeth Lindberg ◽  
Pernilla Karlsson ◽  
Hanna Maurin Söderholm
Keyword(s):  
Health Care ◽  
Home Care ◽  
Process Evaluation ◽  
Educational Intervention ◽  
Older Persons ◽  
Complex Interventions ◽  
Implementation Process ◽  
Ageing Population ◽  
Web Based ◽  
The Web

Abstract Background A rapidly ageing population challenges the health care system in general and home care services in particular. Communication is a cornerstone of person-centred care. However, little research has been conducted on how to improve communication between health care professionals and older persons in home care contexts, despite research showing the importance of such interactions. The increasing demands on how to best and efficiently improve competence in health professionals is the reason why the ACTION intervention was conducted. This paper aims to describe the development and process evaluation of an educational intervention for nurse assistants (NAs) in home care and highlights the potential of self-directed web-based learning as well as the pitfalls of conducting complex interventions in home care. Methods A web-based educational intervention focusing on person-centred communication was developed that targeted NAs in home care for older persons. Twenty-seven NAs from two units in Sweden were recruited, and 23 NAs were offered the educational intervention. Data were collected from multiple sources before, during and after the intervention and were analysed using quantitative and qualitative methods. Data were extracted from the web platform and analysed to determine the NAs´ engagement in the intervention. Additionally, interviews, evaluation forms and field notes were used to evaluate the feasibility of the intervention. Results The main findings suggest that web-based education seems to be an appropriate strategy in the home care context. The majority of the NAs (91%) participated in full or in part in the intervention. During the implementation process, some adaptions were required to fit the local circumstances regarding technical support, scheduling, and the design of the lectures. The NAs perceived the format to be easy to use and flexible and appreciated the stepwise modules. The content was perceived as valuable. Conclusions Our findings show that the benefits of the web-based educational intervention included the short and focused lectures as well as its accessibility. Challenges with the implementation process included gaining access to the NAs and motivating and involving the NAs. This study emphasizes the environmental support needed to successfully conduct complex interventions, including physical, organizational and cultural aspects.

Information Retrieval in Medicine: The Visual and the Invisible (Information Retrieval im Gesundheitswesen: Das Visuelle und das Unsichtbare)

2006 ◽  
Vol 48 (1) ◽  
Author(s):  
Floris Wiesman ◽  
Arie Hasman ◽  
Loes Braun ◽  
Jaap van den Herik
Keyword(s):  
Information Retrieval ◽  
Domain Knowledge ◽  
Information Needs ◽  
Electronic Patient Record ◽  
Software Agent ◽  
Patient Record ◽  
Full Control ◽  
The Invisible

SummaryEspecially in knowledge-rich domains such as medicine perfect access to the literature is essential for professionals. Unfortunately, especially in knowledge-rich domains it is difficult to achieve perfect access: it is too difficult and too time consuming for users to formulate queries that yield the maximum of relevant documents and a minimum of non-relevant ones. The paper first discusses the challenges of information retrieval in medicine and various existing approaches. To address the challenges two completely opposite approaches are presented. The first supports the user by means of metabrowsing: a visual way of depicting the relations between domain concepts and documents. Metabrowsing relieves the user from the formulation of queries, while leaving him in full control. The second approach aims to minimize the interaction with the user. Information needs and queries are autonomously and proactively formulated by a software-agent who remains invisible to the user. The agent uses the electronic patient record of a particular patient and domain knowledge. As a result, the agent provides the doctor with literature that is relevant with respect to the patient at hand.

The process of establishing Discovery College in Melbourne

2018 ◽  
Vol 22 (4) ◽  
pp. 187-194 ◽  
Author(s):  
Liza Hopkins ◽  
Andrew Foster ◽  
Lara Nikitin
Keyword(s):  
Mental Health ◽  
Mixed Methods ◽  
Process Evaluation ◽  
Service Management ◽  
Implementation Process ◽  
Youth Mental Health ◽  
Initial Tension ◽  
Content Type ◽  
Outcomes Evaluation ◽  
College Staff

Purpose The purpose of this paper is to understand and inform the development and implementation of a newly established Discovery College (a youth-focused Recovery College). It also aims to contribute to a broader understanding of the benefits and barriers to establishing Recovery Colleges. Design/methodology/approach The overall study took a mixed-methods approach to the evaluation of Discovery College, including a qualitative process evaluation component as well as a mixed-methods outcomes evaluation. This paper reports on the findings of the process evaluation, which undertook key informant interviews with a range of stakeholders in the implementation process. Findings A total of 16 themes emerged from the qualitative data, which were then clustered into four main areas: establishing Discovery College, organisational context, nature of Discovery College and service transformation. Implementation was reported as both feasible and effective. Initial tension between fidelity to the model and a pragmatic approach to action was negotiated during implementation and through an ability of staff to tolerate uncertainty, enabled by the efforts and support of senior service management and college staff. Originality/value Recovery Colleges co-designed and implemented in youth mental health services are a recent development in the field of mental health care and very little has previously been published regarding the feasibility, effectiveness and acceptability of youth-focused Recovery Colleges. This paper is one of the first to assess the barriers and enablers to the implementation of Discovery College within a clinical youth mental health service.

scholarly journals Role of Individual Motivations and Privacy Concerns in the Adoption of German Electronic Patient Record Apps—A Mixed-Methods Study

2021 ◽  
Vol 18 (18) ◽  
pp. 9553
Author(s):  
Richard Henkenjohann
Keyword(s):  
Mixed Methods ◽  
Electronic Health Record ◽  
Large Scale ◽  
Electronic Patient Record ◽  
Mixed Methods Study ◽  
Patient Record ◽  
Health Record ◽  
Potential Benefits ◽  
Electronic Health ◽  
External Mandates

Germany’s electronic patient record (“ePA”) launched in 2021 with several attempts and years of delay. The development of such a large-scale project is a complex task, and so is its adoption. Individual attitudes towards an electronic health record are crucial, as individuals can reject opting-in to it and making any national efforts unachievable. Although the integration of an electronic health record serves potential benefits, it also constitutes risks for an individual’s privacy. With a mixed-methods study design, this work provides evidence that different types of motivations and contextual privacy antecedents affect usage intentions towards the ePA. Most significantly, individual motivations stemming from feelings of volition or external mandates positively affect ePA adoption, although internal incentives are more powerful.

Improving Coded Data Entry by an Electronic Patient Record System

1996 ◽  
Vol 35 (02) ◽  
pp. 108-111 ◽  
Author(s):  
F. Puerner ◽  
H. Soltanian ◽  
J. H. Hohnloser
Keyword(s):  
Phase I ◽  
Electronic Patient Record ◽  
Data Entry ◽  
Discharge Summary ◽  
Patient Record ◽  
Phase Iii ◽  
Electronic Patient Record System ◽  
Record System ◽  
Data Encoding ◽  
Discharge Summaries

AbstractData are presented on the use of a browsing and encoding utility to improve coded data entry for an electronic patient record system. Traditional and computerized discharge summaries were compared: during three phases of coding ICD-9 diagnoses phase I, no coding; phase II, manual coding, and phase III, computerized semiautomatic coding. Our data indicate that (1) only 50% of all diagnoses in a discharge summary are encoded manually; (2) using a computerized browsing and encoding utility this percentage may increase by 64%; (3) when forced to encode manually, users may “shift” as much as 84% of relevant diagnoses from the appropriate coding section to other sections thereby “bypassing” the need to encode, this was reduced by up to 41 % with the computerized approach, and (4) computerized encoding can improve completeness of data encoding, from 46 to 100%. We conclude that the use of a computerized browsing and encoding tool can increase data quality and the percentage of documented data. Mechanisms bypassing the need to code can be avoided.

Uncertainty about cellulitis and unmet patient information needs: a mixed methods study

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697349
Author(s):  
Anna Lalonde ◽  
Emma Teasdale ◽  
Ingrid Muller ◽  
Joanne Chalmers ◽  
Peter Smart ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Information Needs ◽  
Qualitative Data ◽  
Information Provision ◽  
Mixed Methods Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Face To Face ◽  
Patient Information Needs ◽  
History Of

BackgroundCellulitis is a common painful infection of the skin and underlying tissues that recurs in approximately a third of cases. Patients’ ability to recover from cellulitis or prevent recurrence is likely to be influenced by their understanding of the condition.AimTo explore patients’ perceptions of cellulitis and their information needs.MethodMixed methods study comprising semi-structured, face-to-face interviews and cross-sectional survey, recruiting through primary care, secondary care and advertising. Adults aged 18 or over with a history of cellulitis (first or recurrent) were invited to complete a survey, take part in an interview or both. Qualitative data was analysed thematically.ResultsThirty interviews were conducted between August 2016 and July 2017. Qualitative data revealed low prior awareness of cellulitis, uncertainty around diagnosis, concern/surprise at the severity of cellulitis, and perceived insufficient information provision. People were surprised they had never heard of the condition and that they had not received advice or leaflets giving self-care information. Some sought information from the internet and found this bewildering. Two hundred and forty surveys were completed (response rate 17%). These showed that, while most people received information on the treatment of cellulitis (60.0%, n = 144), they reported receiving no information about causes (60.8%, n = 146) or prevention of recurrence (73.3%, n = 176).ConclusionThere is a need for provision of basic information for people with cellulitis, particularly being informed of the name of their condition, how to manage acute episodes, and how to reduce risk of recurrence.

scholarly journals Mixed-methods process evaluation of SafeTea: a multimedia campaign to prevent hot drink scalds in young children and promote burn first aid

2020 ◽  
pp. injuryprev-2020-043909
Author(s):  
Laura Elizabeth Cowley ◽  
C Verity Bennett ◽  
Isabelle Brown ◽  
Alan Emond ◽  
Alison Mary Kemp
Keyword(s):  
Social Media ◽  
Mixed Methods ◽  
Young Children ◽  
Process Evaluation ◽  
Behavioural Change ◽  
First Aid ◽  
Multifaceted Intervention ◽  
Media Content ◽  
Educational Videos ◽  
The Uk

ObjectivesSafeTea is a multifaceted intervention delivered by community practitioners to prevent hot drink scalds to young children and improve parents’ knowledge of appropriate burn first aid. We adapted SafeTea for a national multimedia campaign, and present a mixed-methods process evaluation of the campaign.MethodsWe used social media, a website hosting downloadable materials and media publicity to disseminate key messages to parents/caregivers of young children and professionals working with these families across the UK. The SafeTea campaign was launched on National Burns Awareness Day (NBAD), October 2019, and ran for 3 months. Process evaluation measurements included social media metrics, Google Analytics, and quantitative and qualitative results from a survey of professionals who requested hard copies of the materials via the website.ResultsFindings were summarised under four themes: ‘reach’, ‘engagement’, ‘acceptability’ and ‘impact/behavioural change’. The launch on NBAD generated widespread publicity. The campaign reached a greater number of the target audience than anticipated, with over 400 000 views of the SafeTea educational videos. Parents and professionals engaged with SafeTea and expressed positive opinions of the campaign and materials. SafeTea encouraged parents to consider how to change their behaviours to minimise the risks associated with hot drinks. Reach and engagement steadily declined after the first month due to reduced publicity and social media promotion.ConclusionThe SafeTea campaign was successful in terms of reach and engagement. The launch on NBAD was essential for generating media interest. Future campaigns could be shorter, with more funding for additional social media content and promotion.

scholarly journals Barriers to implementing motivational interviewing in addiction treatment: A nominal group technique process evaluation

2021 ◽  
Vol 2 ◽  
pp. 263348952110184
Author(s):  
Melissa R Hatch ◽  
Kristine Carandang ◽  
Joanna C Moullin ◽  
Mark G Ehrhart ◽  
Gregory A Aarons
Keyword(s):  
Motivational Interviewing ◽  
Process Evaluation ◽  
Nominal Group Technique ◽  
Implementation Strategies ◽  
Implementation Process ◽  
Nominal Group ◽  
Management Level ◽  
Implementation Program ◽  
Ebp Implementation ◽  
Staff Level

Background: The successful implementation of evidence-based practices (EBPs) in real-world settings requires an adaptive approach and ongoing process evaluation and tailoring. Although conducting a needs assessment during the preparation phase of implementation is beneficial, it is challenging to predict all barriers to EBP implementation that may arise over the course of implementation and sustainment. This article describes a process evaluation that identified emergent and persistent barriers that impacted the implementation of an EBP across multiple behavioral health organizations and clinics. Methods: This study was conducted during the first cohort of a cluster randomized controlled trial testing the effectiveness of the Leadership and Organizational Change for Implementation (LOCI) strategy to implement motivational interviewing (MI) in substance use disorder treatment agencies and clinics. We used a modified nominal group technique (NGT) in which clinic leaders identified barriers faced during the implementation process. Barriers were categorized, then ranked and rated according to leaders’ perceptions of each barrier’s influence on implementation. The barriers were then contextualized through individual qualitative interviews. Results: Fifteen barriers were identified, grouped into staff-level barriers, management-level barriers, and implementation program barriers. Time and resistance to MI were rated as the most influential staff-level barriers. Among management-level barriers, time was also rated highest, followed by turnover and external contractual constraints. The most influential implementation barrier was client apprehension of recording for fidelity assessment and feedback. Individual interviews supported these findings and provided suggested adaptations for future implementation efforts. Conclusion: EBP implementation is an ongoing process whereby implementation strategies must be proactively and strategically tailored to address emergent barriers. This research described a process evaluation that was used to identify 15 emergent and/or persistent barriers related to staff, management, and the implementation program. Using implementation strategies that can be tailored and/or adapted to such emergent barriers is critical to implementation effectiveness. Plain Language Summary Unforeseen barriers often arise during the course of implementation. Conducting evaluations during implementation allows for tailoring the implementation strategy. As part of a larger study using the Leadership and Organizational Change for Implementation (LOCI) strategy to implement motivational interviewing (MI), we collected data from the first cohort of LOCI clinic leaders to identify barriers to MI implementation that persisted despite advanced planning and to understand unanticipated barriers that arose during implementation. Leaders identified 15 barriers faced during the implementation process that fell into three categories: staff-level barriers, management-level barriers, and implementation program barriers. The leaders ranked time as the most influential barrier at both the staff and management levels. Staff apprehension, resistance to MI implementation, and staff turnover were also of significant concern to leaders. Future implementation efforts may benefit from conducting a similar process evaluation during the implementation phase.

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