scholarly journals Implementation of a Digitally Enabled Care Pathway (Part 2): Qualitative Analysis of Experiences of Health Care Professionals

10.2196/13143 ◽  
2019 ◽  
Vol 21 (7) ◽  
pp. e13143 ◽  
Author(s):  
Alistair Connell ◽  
Georgia Black ◽  
Hugh Montgomery ◽  
Peter Martin ◽  
Claire Nightingale ◽  
...  
Keyword(s):  
Health Care ◽  
At Risk ◽  
Early Detection ◽  
Real Time ◽  
Health Care Professionals ◽  
Care Pathway ◽  
Digital Technologies ◽  
Response Team ◽  
Working Practices ◽  
The Impact

Background One reason for the introduction of digital technologies into health care has been to try to improve safety and patient outcomes by providing real-time access to patient data and enhancing communication among health care professionals. However, the adoption of such technologies into clinical pathways has been less examined, and the impacts on users and the broader health system are poorly understood. We sought to address this by studying the impacts of introducing a digitally enabled care pathway for patients with acute kidney injury (AKI) at a tertiary referral hospital in the United Kingdom. A dedicated clinical response team—comprising existing nephrology and patient-at-risk and resuscitation teams—received AKI alerts in real time via Streams, a mobile app. Here, we present a qualitative evaluation of the experiences of users and other health care professionals whose work was affected by the implementation of the care pathway. Objective The aim of this study was to qualitatively evaluate the impact of mobile results viewing and automated alerting as part of a digitally enabled care pathway on the working practices of users and their interprofessional relationships. Methods A total of 19 semistructured interviews were conducted with members of the AKI response team and clinicians with whom they interacted across the hospital. Interviews were analyzed using inductive and deductive thematic analysis. Results The digitally enabled care pathway improved access to patient information and expedited early specialist care. Opportunities were identified for more constructive planning of end-of-life care due to the earlier detection and alerting of deterioration. However, the shift toward early detection also highlighted resource constraints and some clinical uncertainty about the value of intervening at this stage. The real-time availability of information altered communication flows within and between clinical teams and across professional groups. Conclusions Digital technologies allow early detection of adverse events and of patients at risk of deterioration, with the potential to improve outcomes. They may also increase the efficiency of health care professionals’ working practices. However, when planning and implementing digital information innovations in health care, the following factors should also be considered: the provision of clinical training to effectively manage early detection, resources to cope with additional workload, support to manage perceived information overload, and the optimization of algorithms to minimize unnecessary alerts.

scholarly journals Survey on Acceptance of Passive Technology Monitoring for Early Detection of Cognitive Impairment

2020 ◽  
pp. 9-15
Author(s):  
Sylvia Josephy-Hernandez ◽  
Catherine Norise ◽  
Jee-young Han ◽  
Kara M. Smith
Keyword(s):  
Health Care ◽  
Early Detection ◽  
Health Care Professionals ◽  
Public Perception ◽  
Health Care Systems ◽  
Smartphone Application ◽  
Ethical Implications ◽  
The Usa ◽  
The Impact ◽  
Digital Biomarkers

<b><i>Introduction:</i></b> Digital biomarkers may act as a tool for early detection of changes in cognition. It is important to understand public perception of technologies focused on monitoring cognition to better guide the design of these tools and inform patients appropriately about the associated risks and benefits. Health care systems may also play a role in the clinical, legal, and financial implications of such technologies. <b><i>Objective:</i></b> To evaluate public opinion on the use of passive technology for monitoring cognition. <b><i>Methods:</i></b> This was a one-time, Internet-based survey conducted in English and Spanish. <b><i>Results:</i></b> Within the English survey distributed in the USA (<i>n</i> = 173), 58.1% of respondents would be highly likely to agree to passive monitoring of cognition via a smartphone application. Thirty-eight percent of those with a higher degree of experience with technology were likely to agree to monitoring versus 20% of those with less experience with technology (<i>p</i> = 0.003). Sixty-two percent of non-health-care professionals were likely to agree to monitoring versus 45% of health-care workers (<i>p</i> = 0.012). There were significant concerns regarding privacy (<i>p</i> &#x3c; 0.01). We compared the surveys answered in Spanish in Costa Rica via logistic regression (<i>n</i> = 43, total <i>n</i> = 216), adjusting for age, education level, health-care profession, owning a smartphone, experience with technology, and perception of cognitive decline. Costa Rican/Spanish-speaking respondents were 7 times more likely to select a high probability of agreeing to such a technology (<i>p</i> &#x3c; 0.01). English-speaking respondents from the USA were 5 times more likely to be concerned about the impact on health insurance (<i>p</i> = 0.001) and life insurance (<i>p</i> = 0.01). <b><i>Conclusions:</i></b> Understanding public perception and ethical implications should guide the design of digital biomarkers for cognition. Privacy and the health-care system in which the participants take part are 2 major factors to be considered. It is the responsibility of researchers to convey the ethical and legal implications of cognition monitoring.

45. Education at distance: Broadcasting ECG rounds to Southeastern Ontario (BESO Project). An innovative approach for teaching electrocardiography

2007 ◽  
Vol 30 (4) ◽  
pp. 51 ◽  
Author(s):  
A. Baranchuk ◽  
G. Dagnone ◽  
P. Fowler ◽  
M. N. Harrison ◽  
L. Lisnevskaia ◽  
...  
Keyword(s):  
Health Care ◽  
Real Time ◽  
Digital Signal ◽  
Teaching Methodology ◽  
Care Providers ◽  
Long Distance ◽  
Medicine Clerkship ◽  
Time Problem ◽  
The Impact ◽  
Ecg Interpretation

Electrocardiography (ECG) interpretation is an essential skill for physicians as well as for many other health care professionals. Continuing education is necessary to maintain these skills. The process of teaching and learning ECG interpretation is complex and involves both deductive mechanisms and recognition of patterns for different clinical situations (“pattern recognition”). The successful methodologies of interactive sessions and real time problem based learning have never been evaluated with a long distance education model. To evaluate the efficacy of broadcasting ECG rounds to different hospitals in the Southeastern Ontario region; to perform qualitative research to determine the impact of this methodology in developing and maintaining skills in ECG interpretation. ECG rounds are held weekly at Kingston General Hospital and will be transmitted live to Napanee, Belleville, Oshawa, Peterborough and Brockville. The teaching methodology is based on real ECG cases. The audience is invited to analyze the ECG case and the coordinator will introduce comments to guide the case through the proper algorithm. Final interpretation will be achieved emphasizing the deductive process and the relevance of each case. An evaluation will be filled out by each participant at the end of each session. Videoconferencing works through a vast array of internet LANs, WANs, ISDN phone lines, routers, switches, firewalls and Codecs (Coder/Decoder) and bridges. A videoconference Codec takes the analog audio and video signal codes and compresses it into a digital signal and transmits that digital signal to another Codec where the signal is decompressed and retranslated back into analog video and audio. This compression and decompression allows large amounts of data to be transferred across a network at close to real time (384 kbps with 30 frames of video per second). Videoconferencing communication works on voice activation so whichever site is speaking has the floor and is seen by all the participating sites. A continuous presence mode allows each site to have the same visual and audio involvement as the host site. A bridged multipoint can connect between 8 and 12 sites simultaneously. This innovative methodology for teaching ECG will facilitate access to developing and maintaining skills in ECG interpretation for a large number of health care providers. Bertsch TF, Callas PW, Rubin A. Effectiveness of lectures attended via interactive video conferencing versus in-person in preparing third-year internal medicine clerkship students for clinical practice examinations. Teach Learn Med 2007; 19(1):4-8. Yellowlees PM, Hogarth M, Hilty DM. The importance of distributed broadband networks to academic biomedical research and education programs. Acad Psychaitry 2006;30:451-455

scholarly journals Building capacity for implementation—the KT Challenge

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Agnes T. Black ◽  
Marla Steinberg ◽  
Amanda E. Chisholm ◽  
Kristi Coldwell ◽  
Alison M. Hoens ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Qualitative Data ◽  
Practice Change ◽  
Evidence Based ◽  
Science Literature ◽  
Health Care Settings ◽  
Improvement Programs ◽  
The Impact

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity, and practice change. Methods The evaluation used a mixed-methods retrospective pre-post design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, 6 months into implementation, and at the end of the 2-year funded projects) to measure KT capacity (knowledge, skills, and confidence) and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analyzed using non-parametric statistics. Results Participants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. Conclusions The KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.

The Use of and Attitude Towards Telehealth in Rural Communities

2007 ◽  
Vol 13 (3) ◽  
pp. 29 ◽  
Author(s):  
Emily Mauldon
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Routine Practice ◽  
Care Providers ◽  
Urban Hospital ◽  
Primary Health ◽  
The Impact ◽  
Rural Patients

This paper reports on the attitudes of a sample of health care providers towards the use of telehealth to support rural patients and integrate rural primary health and urban hospital care. Telehealth and other information technologies hold the promise of improving the quality of care for people in rural and remote areas and for supporting rural primary health care providers. While seemingly beneficial for rural patients, study participants believed that telehealth remains underused and poorly integrated into their practice. In general, participants thought that telehealth is potentially beneficial but places constraints on their activities, and few actually used it. Published literature usually reports either on the success of telehealth pilot projects or initiatives that are well resourced and do not reflect the constraints of routine practice, or has an international focus limiting its relevance to the Australian context. Because of the paucity of systematic and generalisable research into the effects of the routine use of telehealth to support rural patients, it is unclear why health care professionals choose to provide such services or the costs and benefits they incur in doing so. Research and policy initiatives continue to be needed to identify the impact of telehealth within the context of Australian primary health care and to develop strategies to support its use.

The Impact of the SAGE & THYME Foundation Level Workshop on Factors Influencing Communication Skills in Health Care Professionals

2014 ◽  
Vol 34 (1) ◽  
pp. 37-46 ◽  
Author(s):  
Michael Connolly ◽  
Joanne M. Thomas ◽  
Julie A. Orford ◽  
Nicola Schofield ◽  
Sigrid Whiteside ◽  
...  
Keyword(s):  
Health Care ◽  
Communication Skills ◽  
Health Care Professionals ◽  
Factors Influencing ◽  
The Impact

Industry First AI-Powered Fully Automated Safety Observation System Deployed to Global Offshore Fleet

2021 ◽  
Author(s):  
Nassima Brown ◽  
Adrian Brown ◽  
Abhijeet Degupta ◽  
Barry Quinn ◽  
Dustin Stringer ◽  
...  
Keyword(s):  
Real Time ◽  
Safety Culture ◽  
Safety Management ◽  
Digital Technologies ◽  
Observation System ◽  
Safety Program ◽  
Effective Application ◽  
Behavior Based ◽  
Global Operations ◽  
The Impact

Abstract As the oil and gas industry is facing tumultuous challenges, adoption of cutting-edge digital technologies has been accelerated to deliver safer, more efficient operations with less impact on the environment. While advanced AI and other digital technologies have been rapidly evolving in many fields in the industry, the HSE sector is playing catch-up. With the increasing complexity of risks and safety management processes, the effective application of data-driven technologies has become significantly harder, particularly for international organizations with varying levels of digital readiness across diverse global operations. Leaders are more cautious to implement solutions that are not fit-for purpose, due to concerns over inconsistencies in rolling out the program across international markets and the impact this may have on ongoing operations. This paper describes how the effective application of Artificial intelligence (AI) and Machine Learning (ML) technologies have been used to engineer a solution that fully digitizes and automates the end-to-end offshore behavior-based safety program across a global offshore fleet; optimizing a critical safety process used by many leading oil & gas organization to drive positive workplace safety culture. The complex safety program has been transformed into clear, efficient and automated workflow, with real-time analytics and live transparent dashboards which detail critical safety indicators in real time, aiding decision-making and improving operational performance. The novel behavior-based safety digital solution, referred to as 3C observation tool within Noble drilling, has been built to be fully aligned with the organization's safety management system requirements and procedures, using modern and agile tools and applications for fully scalability and easy deployment. It has been critical in sharpening the offshore safety observation program across global operations, resulting in a boost of the workforce engagement by 30%, and subsequently increasing safety awareness skill set attainment; improving overall offshore safety culture, all while reducing operating costs by up to 70% and cutting carbon footprint through the elimination of 15,000 manhours and half a million paper cards each year, when compared to previously used methods and workflows

Undiagnosed patients and patients at risk for COPD in primary health care: early detection with the support of non-physicians

2003 ◽  
Vol 12 (3) ◽  
pp. 366-373 ◽  
Author(s):  
Hubertus J. M. Vrijhoef ◽  
Joseph P. M. Diederiks ◽  
Geertjan J. Wesseling ◽  
Constant P. Van Schayck ◽  
Cor Spreeuwenberg
Keyword(s):  
Health Care ◽  
At Risk ◽  
Primary Health Care ◽  
Early Detection ◽  
Primary Health ◽  
Patients At Risk

scholarly journals Efficacy of a brief online mindfulness-based intervention on the psychological well-being of health care professionals and trainees during the COVID-19 pandemic: A mixed method design

2021 ◽  
Vol 26 ◽  
Author(s):  
Iram Osman ◽  
Shaista Hamid ◽  
Veena S. Singaram
Keyword(s):  
South Africa ◽  
Health Care ◽  
Mixed Method ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Well Being ◽  
Personal Accomplishment ◽  
Intervention Analysis ◽  
Health Crisis ◽  
The Impact

Background: During the coronavirus disease 2019 (COVID-19) pandemic, health professionals were pushed to the front line of a global health crisis unprepared and resource constrained, which affected their mental well-being.Aim: This study aimed to investigate the effectiveness of a brief online mindfulness-based intervention (MBI) on stress and burnout for health professionals training and working in South Africa during the COVID-19 crisis.Setting: The context of the study is the overburdened, under-resourced health care system in South Africa during a global pandemic.Methods: A mixed method framework was adopted for this study. The quantitative data was analysed using descriptive analysis and the participants’ qualitative experiences were interpreted using interpretative phenomenological analysis.Results: Forty-seven participants took part in this study. The study found a statistically significant (p 0.05) reduction in stress levels and emotional exhaustion as well as an increase in mindful awareness and feelings of personal accomplishment after the intervention. The participants’ shared experiences were analysed in two parts. The pre-intervention analysis presented with central themes of loss of control and a sense of powerlessness because of COVID-19. The post-intervention analysis comprised themes of a sense of acquired control and empowerment through increased mindfulness.Conclusions: The study found that a brief online MBI can be associated with reduced levels of stress and burnout as well as an increased sense of control and empowerment, felt both personally and professionally, during a global crisis.Contribution: The impact of an online MBI for health care professionals amidst a pandemic has not been previously documented.

scholarly journals COVID-19 pandemic impact on dentists in Latin America’s epicenter: São-Paulo, Brazil

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256092
Author(s):  
Tatiane Fernandes Novaes ◽  
Maisa Camillo Jordão ◽  
Carlos Felipe Bonacina ◽  
André Oswaldo Veronezi ◽  
Carlos Ariel Rodrigues de Araujo ◽  
...  
Keyword(s):  
Health Care ◽  
Low Income ◽  
Health Care Professionals ◽  
Negative Impact ◽  
Sao Paulo ◽  
The State ◽  
Financial Impact ◽  
São Paulo ◽  
Ordinal Logistic Regression Analysis ◽  
The Impact

The state of São Paulo, Brazil, where more than 94.000 dentists are currently registered, has become the epicenter of COVID-19 in Latin America. The aim of this cross-sectional study was to evaluate the impact of COVID-19 pandemic on dentists in this state. A semi-structured questionnaire was sent via e-mail to 93.280 dentists with active registration in the Dental Council of São Paulo (CROSP). The impact of COVID-19 pandemic was assessed through questions related to demographic, socioeconomic, dental practice characteristics and personal protective equipment (PPE) use. Ordinal logistic regression analysis was performed to investigate the association between all the variables (p<0.05). Over 8 days, 2113 responses were received. Only 26.52% of the sample reported a low-income reduction (from 0–10%), while the majority of dentists reported a more negative financial impact, 35.6% with a reduction of more than 50% of their monthly income. Dentists who worked in the private sector and at the capital had a greater financial impact when compared to those of the public sector and countryside of the state (p<0.05). Furthermore, about 83% reported not having received any specific training to control the transmission of coronavirus in the health area. This study provides evidence of the negative impact of the COVID-19 pandemic on the routine of dentists in the state of São Paulo, Brazil. Hopefully, this study will help dental and other health care professionals to better understand the consequences of disease in dental settings and strengthen preparedness throughout the dental health care system.

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