Using knowledge translation for quality improvement: an interprofessional education intervention to improve thromboprophylaxis among medical inpatients

Introduction: Historically, community hospitals have had few options for meaningful treatment of patients presenting with acute stroke. As expertise grows in the administration of thrombolytics, primary stroke centers (PSC) fulfill an important role in the reduction of morbidity and mortality related to stroke. It is important for the PSC to partner with Emergency Medical Services (EMS) to change historical perceptions of the quality of PSC care. Education may improve teamwork and increase awareness of the PSC, thereby increasing their utilization in EMS disposition decisions. Objective: The objective of this study is to report the impact of an education intervention on PSC bypass decisions. Methods: The electronic patient care record database from a North Carolina county EMS system was queried as a quality improvement analysis from January 1, 2012 to February 28, 2016. This included 19 months prior to the education intervention, the year during the education intervention, and 19 months after the education intervention. All primary patient transports with Stroke/CVA, or suspected TIA as the primary or secondary impression were included. Interfacility transports were excluded. The recorded call location was determined to either be inside or outside the PSC service area. The hospital the patient was transported to was also recorded. Results: During the pre-intervention phase 222 patients were identified, 48 of which originated in the PSC service area. Of those 48 patients, 16 bypassed the PSC (33.3%). In the post-intervention phase, 94 of 269 total patients were in PSC service area. Only 12 bypasses occurred (12.8%) which is a reduction of 61.7% in PSC bypass compared to the pre-intervention phase. Conclusion: The period following a combined hospital/EMS educational intervention showed significant reduction in PSC bypass.

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Challenges associated with delivering education to patients after heart surgery.

10.32920/ryerson.14636412 ◽

2021 ◽

Author(s):

Suzanne Fredericks ◽

Aaron Bechtold

Keyword(s):

Patient Education ◽

Knowledge Translation ◽

Hospital Discharge ◽

Heart Surgery ◽

Education Intervention ◽

Intervention Delivery ◽

Teaching Interaction ◽

Valvular Replacement ◽

Heart Bypass

The purpose of this report is to provide a detailed description of the challenges that arose throughout the implementation of an individualized patient education intervention delivered to patients during their home recovery following heart surgery. The intervention was delivered at two points in time by telephone to patients following heart bypass and/or valvular replacement. The individualized patient education intervention was found to be effective in reducing the rate and number of complications developed during the first three months following hospital discharge. However, throughout the implementation of this intervention, specific challenges arose that included: onset of symptoms that interfered with intervention delivery, patient’s request for information beyond the scope of the teaching interaction, and the need to provide continued support to the therapist. These challenges were addressed throughout the course of the study and the strategies are currently being implemented into the planned knowledge translation activities associated with this intervention.

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A delirium prevalence audit and a pre and post evaluation of an interprofessional education intervention to increase staff knowledge about delirium in older adults

BMC Nursing ◽

10.1186/s12912-021-00692-2 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Beverley Ewens ◽

Karla Seaman ◽

Lisa Whitehead ◽

Amanda Towell-Barnard ◽

Michelle Young

Keyword(s):

Interprofessional Education ◽

Assessment Tool ◽

Subscale Score ◽

Adverse Outcomes ◽

Education Intervention ◽

Chi Square ◽

Delirium Assessment ◽

Post Evaluation ◽

Significant Difference ◽

Level Of Knowledge

Abstract Background Delirium is more prevalent in older people and estimated to occur in up to 50% of the hospital population. Delirium comprises a spectrum of behaviours, including cognitive and attention deficits, and fluctuating levels of consciousness, often associated with an underlying physiological disturbance. Delirium has been increasingly associated with adverse outcomes. Although often preventable or can at least be mitigated, delirium may not be a standard part of assessment and thus may not be recognized in the early stages when it is most likely to be treated successfully. The aim of this study was to evaluate the level of knowledge of delirium amongst clinicians caring for patients at high risk of developing delirium and to determine whether education can improve clinical assessment of delirium. Methods Two hundred and forty-six case notes were audited before and 149 were reviewed after the education intervention and implementation of a delirium screening tool. Clinicians at the hospital were invited to complete a questionnaire on knowledge of delirium. The questionnaire was based on a validated tool which contained 39 questions about delirium. The questionnaire also contained 28 questions on delirium knowledge. Additional questions were included to gather demographic information specific to the hospital. Descriptive statistics, chi square and independent t-tests were conducted to test for differences in knowledge between the pre and post periods. The Squire Checklist Reporting Guidelines for Quality Improvement Studies informed the preparation of the manuscript. Results The audit demonstrated that the use of a cognitive assessment tool overall increased from 8.5% in pre education to 43% in the post education period. One hundred and fifty-nine staff completed the questionnaire in total, 118 the pre and 41 post. The knowledge subscale score was high pre and post education and no statistically significant difference was observed. The greatest increase in knowledge was related to knowledge of the risk factors subscale. The increase in knowledge (6.8%) was statistically significant. Conclusion An interprofessional approach to delirium education was effective in not only increasing awareness of the factors associated with this syndrome but also increased the use of a delirium assessment tool.

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Effects of a Virtual Interprofessional Education Intervention on Health Professions Learners Enrolled in Post-Graduate Education Programs

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2021.07.623 ◽

2021 ◽

Vol 102 (10) ◽

pp. e53

Author(s):

Raine Osborne ◽

Kristen Hicks-Roof ◽

David McInnes ◽

Jackie Osborne

Keyword(s):

Graduate Education ◽

Interprofessional Education ◽

Health Professions ◽

Education Intervention ◽

Education Programs ◽

Post Graduate

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Paving the way for electronic patient-centered measurement in team-based primary care: an integrated knowledge translation approach (Preprint)

10.2196/preprints.33584 ◽

2021 ◽

Author(s):

Selena Davis ◽

Marcy Antonio ◽

Mindy Smith ◽

Paul Burgener ◽

Danielle C. Lavallee ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Health Care ◽

Quality Improvement ◽

Knowledge Translation ◽

Mental Health Care ◽

Integrated Knowledge Translation ◽

Care Pathways ◽

Patient Portal ◽

Integrated Knowledge

BACKGROUND Patient-centred measurement (PCM) aims to improve overall quality of care through the collection and sharing of patients’ values and perspectives. Yet, the use of PCM in care team decisions remains limited. Integrated knowledge translation (IKT) offers a collaborative, adaptive approach to explore best practices for incorporating PCM into primary care practices by involving knowledge users, including patients and providers, in the exploratory process. OBJECTIVE (i) test the feasibility of using patient-generated data (PGD) in team-based care; (ii) describe use of these data for team-based mental health care; and (iii) summarize patient and provider care experiences with PCM. METHODS We conducted a multi-methods exploratory study in a rural team-based primary care clinic using IKT to co-design, implement and evaluate use of PCM in team-based mental health care. Care pathways, workflows, and quality improvement activities were iteratively adjusted to improve integration efforts. Patient and provider experiences were evaluated using individual interviews relating use of PCM and patient portal in practice. All meeting notes, interview summaries, and emails were analyzed to create a narrative evaluation. RESULTS During co-design, a care workflow was developed for incorporating electronically-collected PGD from the patient portal into the electronic medical record (EMR), and customized educational tools and resources were added. During implementation, care pathways and patient workflows for PCM were developed. Patients found portal use easy, educational, and validating, but data entries were not used during care visits. Providers saw the portal as extra work and lack of portal/EMR integration was a major barrier. The IKT approach was invaluable for addressing workflow changes and understanding ongoing barriers to PCM use and quality improvement. CONCLUSIONS Although the culture towards PCM is changing, use of PCM during care was not successful. Patients felt validated and supported through portal use and could be empowered to bring these data to their visits. Training, modeling, and adaptable PCM methods are needed before PCM can be integrated into routine care.

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Improving pneumococcal vaccination rates of medical inpatients in urban Nepal using quality improvement measures

BMJ Quality Improvement Reports ◽

10.1136/bmjquality.u212047.w4835 ◽

2016 ◽

Vol 5 (1) ◽

pp. u212047.w4835 ◽

Cited By ~ 2

Author(s):

Allison Bock ◽

Kathan Chintamaneni ◽

Lisa Rein ◽

Tifany Frazer ◽

Gyan Kayastha ◽

...

Keyword(s):

Quality Improvement ◽

Pneumococcal Vaccination ◽

Vaccination Rates ◽

Medical Inpatients ◽

Improvement Measures

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The use of theories, frameworks, or models in knowledge translation studies in healthcare settings in China: a scoping review protocol

Systematic Reviews ◽

10.1186/s13643-020-01567-4 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Junqiang Zhao ◽

Xuejing Li ◽

Lijiao Yan ◽

Yamei Yu ◽

Jiale Hu ◽

...

Keyword(s):

Quality Improvement ◽

Knowledge Translation ◽

Scoping Review ◽

Qualitative Content Analysis ◽

Critical Role ◽

Reporting Quality ◽

Open Science ◽

Eligibility Criteria ◽

Research And Practice ◽

Healthcare Settings

Abstract Background Knowledge translation (KT) theories, frameworks, and models (TFMs) can help guide and explain KT processes, and facilitate the evaluation of implementation outcomes. They play a critical role in conducting KT research and practice. Currently, little is known about the usage of TFMs in KT in Chinese healthcare settings. The aim of this scoping review is to identify which TFMs had been used for KT in healthcare settings in China, and how these TFMs were used. Methods The protocol for this scoping review is in accordance with the Arksey and O’Malley framework and further enhanced by the recommendations suggested by Levac et al. We will search 8 databases (4 Chinese and 4 English) to identify relevant studies. Four reviewers (2 for Chinese, 2 for English) will independently screen studies based on the eligibility criteria. The basic characteristic of studies and the TFMs utilization (i.e., what, why, and how) will be extracted. Methodological quality and reporting quality will be assessed using the Mixed Method Appraisal Tool (MMAT) and the Standards for Reporting Implementation Studies (StaRI) (or Standards for Quality Improvement Reporting Excellence, SQUIRE 2.0 for quality improvement studies), respectively. All the retrieved TFMs will be categorized into Nilsen’s classifications of TFMs for KT research. We will employ the qualitative content analysis approach to summarize how these TFMs have been used, and the rationale. A consultation will be conducted through a 1-h interactive virtual meeting with an expert panel of knowledge users. Discussion By conducting this scoping review, we expect to gain a comprehensive and in-depth understanding of why and how TFMs have been used in KT research and practice in China, and to identify gaps and provide recommendations for more efficient and meaningful use of TFMs in the future. Systematic review registration This review has been registered with the Open Science Framework (10.17605/OSF.IO/8NXAM).

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