scholarly journals Facilitators and Barriers to Recruiting Ambulatory Oncology Practices Into a Large Multisite Study: Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Milisa Manojlovich ◽  
Louise Bedard ◽  
Jennifer J Griggs ◽  
Michaella McBratnie ◽  
Kari Mendelsohn-Victor ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Mixed Methods ◽  
Data Collection ◽  
Human Subjects ◽  
Implementation Process ◽  
Lessons Learned ◽  
Quality Improvement Collaborative ◽  
Ambulatory Oncology ◽  
Oncology Care ◽  
Facilitators And Barriers

BACKGROUND Practice-based research is essential to generate the data necessary to understand outcomes in ambulatory oncology care. Although there is an increased interest in studying ambulatory oncology care, given the rising patient volumes and complexity in those settings, little guidance is available on how best to recruit ambulatory oncology practices for research. OBJECTIVE This paper aimed to describe the facilitators and barriers to recruiting ambulatory oncology practices into a large multisite study. METHODS Using a mixed methods design, we sought to recruit 52 ambulatory oncology practices that have participated in a state-wide quality improvement collaborative for the quantitative phase. We used 4 domains of the Consolidated Framework for Implementation Research (CFIR) to describe facilitators and barriers to recruitment. RESULTS We successfully recruited 28 of the 52 collaborative-affiliated practices, collecting survey data from 2223 patients and 297 clinicians. <i>Intervention attributes</i> included multimodal outreach and training activities to assure high fidelity to the data collection protocol. The <i>implementation process</i> was enhanced through interactive training and practice-assigned champions responsible for data collection. <i>External context</i> attributes that facilitated practice recruitment included partnership with a quality improvement collaborative and the inclusion of a staff member from the collaborative in our team. Key opinion leaders within each practice who could identify challenges to participation and propose flexible solutions represented <i>internal context</i> attributes. We also reported lessons learned during the recruitment process, which included navigating diverse approaches to human subjects protection policies and understanding that recruitment could be a negotiated process that took longer than anticipated, among others. CONCLUSIONS Our experience provides other researchers with challenges to anticipate and possible solutions for common issues. Using the CFIR as a guide, we identified numerous recruitment barriers and facilitators and devised strategies to enhance recruitment efforts. In conclusion, researchers and clinicians can partner effectively to design and implement research protocols that ultimately benefit patients who are increasingly seeking care in ambulatory practices.

scholarly journals Facilitators and Barriers to Recruiting Ambulatory Oncology Practices Into a Large Multisite Study: Mixed Methods Study

JMIR Cancer ◽  
10.2196/14476 ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. e14476 ◽  
Author(s):  
Milisa Manojlovich ◽  
Louise Bedard ◽  
Jennifer J Griggs ◽  
Michaella McBratnie ◽  
Kari Mendelsohn-Victor ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Mixed Methods ◽  
Data Collection ◽  
Human Subjects ◽  
Implementation Process ◽  
Lessons Learned ◽  
Quality Improvement Collaborative ◽  
Ambulatory Oncology ◽  
Oncology Care ◽  
Facilitators And Barriers

Background Practice-based research is essential to generate the data necessary to understand outcomes in ambulatory oncology care. Although there is an increased interest in studying ambulatory oncology care, given the rising patient volumes and complexity in those settings, little guidance is available on how best to recruit ambulatory oncology practices for research. Objective This paper aimed to describe the facilitators and barriers to recruiting ambulatory oncology practices into a large multisite study. Methods Using a mixed methods design, we sought to recruit 52 ambulatory oncology practices that have participated in a state-wide quality improvement collaborative for the quantitative phase. We used 4 domains of the Consolidated Framework for Implementation Research (CFIR) to describe facilitators and barriers to recruitment. Results We successfully recruited 28 of the 52 collaborative-affiliated practices, collecting survey data from 2223 patients and 297 clinicians. Intervention attributes included multimodal outreach and training activities to assure high fidelity to the data collection protocol. The implementation process was enhanced through interactive training and practice-assigned champions responsible for data collection. External context attributes that facilitated practice recruitment included partnership with a quality improvement collaborative and the inclusion of a staff member from the collaborative in our team. Key opinion leaders within each practice who could identify challenges to participation and propose flexible solutions represented internal context attributes. We also reported lessons learned during the recruitment process, which included navigating diverse approaches to human subjects protection policies and understanding that recruitment could be a negotiated process that took longer than anticipated, among others. Conclusions Our experience provides other researchers with challenges to anticipate and possible solutions for common issues. Using the CFIR as a guide, we identified numerous recruitment barriers and facilitators and devised strategies to enhance recruitment efforts. In conclusion, researchers and clinicians can partner effectively to design and implement research protocols that ultimately benefit patients who are increasingly seeking care in ambulatory practices.

scholarly journals Mixed-Methods Research in a Complex Multisite VA Health Services Study: Variations in the Implementation and Characteristics of Chiropractic Services in VA

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Raheleh Khorsan ◽  
Angela B. Cohen ◽  
Anthony J. Lisi ◽  
Monica M. Smith ◽  
Deborah Delevan ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Data Collection ◽  
Mixed Methods Research ◽  
Implementation Process ◽  
Lessons Learned ◽  
Data Sources ◽  
Department Of Veterans Affairs ◽  
Policy And Practice ◽  
Trade Offs ◽  
The Us

Maximizing the quality and benefits of newly established chiropractic services represents an important policy and practice goal for the US Department of Veterans Affairs’ healthcare system. Understanding the implementation process and characteristics of new chiropractic clinics and the determinants and consequences of these processes and characteristics is a critical first step in guiding quality improvement. This paper reports insights and lessons learned regarding the successful application of mixed methods research approaches—insights derived from a study of chiropractic clinic implementation and characteristics, Variations in the Implementation and Characteristics of Chiropractic Services in VA (VICCS). Challenges and solutions are presented in areas ranging from selection and recruitment of sites and participants to the collection and analysis of varied data sources. The VICCS study illustrates the importance of several factors in successful mixed-methods approaches, including (1) the importance of a formal, fully developed logic model to identify and link data sources, variables, and outcomes of interest to the study’s analysis plan and its data collection instruments and codebook and (2) ensuring that data collection methods, including mixed-methods, match study aims. Overall, successful application of a mixed-methods approach requires careful planning, frequent trade-offs, and complex coding and analysis.

scholarly journals Quality Improvement in Juvenile Idiopathic Arthritis: a Mixed-methods Implementation Pilot of the CAPTURE-JIA Dataset

2022 ◽  
Author(s):  
Flora Mcerlane ◽  
Chris Anderson ◽  
Saskia Lawson-Tovey ◽  
Barbara Lee ◽  
Chris Lee ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Quality Improvement ◽  
Mixed Methods ◽  
Data Collection ◽  
Clinical Care ◽  
Data Collection Tool ◽  
Collection System ◽  
Electronic Data ◽  
Data Collection System ◽  
Electronic Data Collection

Abstract BackgroundA significant proportion of children and young people with juvenile idiopathic arthritis (JIA) do not achieve inactive disease during the first two years following diagnosis. Refinements to clinical care pathways have the potential to improve clinical outcomes but a lack of consistent and contemporaneous clinical data presently precludes standard setting and implementation of meaningful quality improvement programmes. This study was the first to pilot clinical data collection and analysis using the CAPTURE-JIA dataset, and to explore patient and clinician-reported feasibility and acceptability data.MethodsA multiphase mixed-methods approach enabled prospective collection of quantitative data to examine the feasibility and efficacy of dataset collection and of qualitative data informing the context and processes of implementation. An initial paper pilot informed the design of a bespoke electronic data collection system (the Agileware system), with a subsequent electronic pilot informing the final CAPTURE-JIA data collection tool. ResultsPaper collection of patient data was feasible but time-consuming in the clinical setting. Phase 1 paper pilot data (121 patients) identified three themes: problematic data items (14/62 data items received >40% missing data), formatting of data collection forms and a clinician-highlighted need for digital data collection, informing Phase 2 electronic data collection tool development. Patients and families were universally supportive of the collection and analysis of anonymised patient data to inform clinical care. No apparent preference for paper / electronic data collection was reported by families. Phase 3 electronic pilot data (38 patients) appeared complete and the system reported to be easy to use. Analysis of the study dataset and a dummy longitudinal dataset confirmed that all eleven JIA national audit questions can be answered using the electronic system. ConclusionsMulticentre CAPTURE-JIA data collection is feasible and acceptable, with a bespoke data collection system highlighted as the most satisfactory solution. The study is informing ongoing work towards a streamlined and flexible national paediatric data collection system to drive quality improvement in clinical care.

scholarly journals Introduction

2021 ◽  
Vol 24 (3-4) ◽  
pp. 285-304
Author(s):  
Alex J. Bellamy ◽  
Ivan Šimonović
Keyword(s):  
Mixed Methods ◽  
Data Collection ◽  
Case Studies ◽  
Evidence Base ◽  
Lessons Learned ◽  
Preventive Action ◽  
Concerted Effort ◽  
Multiple Sources ◽  
Multiple Stakeholders ◽  
Mixed Methods Approach

Abstract Atrocity prevention is a difficult and complex undertaking, one that needs concerted effort by multiple stakeholders to be successful. This article seeks to help bridge the acknowledged gap between the promise of atrocity prevention and its implementation by providing an introduction about lessons learned from various case studies. By doing so, it seeks to develop an evidence base of effective atrocity prevention efforts to benefit practitioners of atrocity prevention. To ensure the evaluation is as rigorous as possible, five principles were incorporated into the research. One, to apply a reasonableness test so as not to confuse association with causation. Two, use a mixed methods approach for data collection. Three, triangulate data with multiple sources. Four, validate data with participants and experts to determine a level of accuracy. And five, consider a counterfactual argument of what would have happened if the preventive action(s) had not occurred.

scholarly journals Implementation of the First US Sugar-Sweetened Beverage Tax in Berkeley, CA, 2015–2019

2020 ◽  
Vol 110 (9) ◽  
pp. 1429-1437 ◽  
Author(s):  
Jennifer Falbe ◽  
Anna H. Grummon ◽  
Nadia Rojas ◽  
Suzanne Ryan-Ibarra ◽  
Lynn D. Silver ◽  
...  
Keyword(s):  
Public Health ◽  
Public Support ◽  
Implementation Process ◽  
Food Prices ◽  
Lessons Learned ◽  
Sugar Sweetened Beverage ◽  
Excise Tax ◽  
Sweetened Beverage ◽  
Advisory Commissions ◽  
Facilitators And Barriers

Objectives. To identify lessons learned from implementation of the nation’s first sugar-sweetened beverage (SSB) excise tax in 2015 in Berkeley, California. Methods. We interviewed city stakeholders and SSB distributors and retailers (n = 48) from June 2015 to April 2017 and analyzed records through January 2019. Results. Lessons included the importance of thorough and timely communications with distributors and retailers, adequate lead time for implementation, advisory commissions for revenue allocations, and funding of staff, communications, and evaluation before tax collection begins. Early and robust outreach about the tax and programs funded can promote and sustain public support, reduce friction, and facilitate beverage price increases on SSBs only. No retailer reported raising food prices, indicating that Berkeley’s SSB tax did not function as a “grocery tax,” as industry claimed. Revenue allocations totaled more than $9 million for public health, nutrition, and health equity through 2021. Conclusions. The policy package, context, and implementation process facilitated translating policy into public health outcomes. Further research is needed to understand long-term facilitators and barriers to sustaining public health benefits of Berkeley’s tax and how those differ from facilitators and barriers in jurisdictions facing significant industry-funded repeal efforts.

scholarly journals Lessons learned on the experienced facilitators and barriers of implementing a tailored VBHC model in a Dutch university hospital from a perspective of physicians and nurses

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e051764
Author(s):  
Dane Lansdaal ◽  
Femke van Nassau ◽  
Marije van der Steen ◽  
Martine de Bruijne ◽  
Marian Smeulers
Keyword(s):  
Patient Involvement ◽  
Implementation Process ◽  
Lessons Learned ◽  
University Hospital ◽  
Care Process ◽  
External Information ◽  
Health Records ◽  
Facilitators And Barriers ◽  
Implementation Methodology ◽  
Insight Into

ObjectiveThis study aims to obtain insight into experienced facilitators and barriers of implementing a tailored value-based healthcare (VBHC) model in a Dutch university hospital from a perspective of physicians and nurses.MethodA descriptive qualitative study with 12 physicians, nurses and managers of seven different care pathways who were involved in the implementation of a tailored VBHC methodology was conducted. Thematic content analysis was used to analyse the data guided by all factors of the Consolidated Framework for Implementation Research (CFIR).FindingsThe method designed for the implementation of a tailored VBHC methodology was appointed as a structured guide for the process. Throughout the implementation process, leadership and team dynamics were considered as important for the implementation to succeed. Also, sharing experiences with other value teams and the cooperation with external Information Technology (IT) teams in the hospital was mentioned as desirable. The involvement of patients, that is part of the VBHC methodology, was considered useful in the decision-making and improvement of the care process because it gave better insights in topics that are important for patients. The time-consuming nature of the implementation process was named as barrier to the VBHC methodology. On top of that, the shaping of the involvement of patients and the ongoing changes in departments were established as difficult. Finally, working with the Electronic Health Records and acquiring the necessary digital skills were considered to be often forgotten and, thus, hindering implementation.ConclusionClinical Healthcare organisations implementing a tailored VBHC methodology will benefit from the use of a structured implementation methodology, a well-led strong team and cooperation with (external) teams and patients. However, shaping patient involvement, alignment with other departments and attention to digitisation were seen as a most important concerns in implementation and require further attention.

Implementation of Automated Network-Level Crack Detection Processes in Maryland

2003 ◽  
Vol 1860 (1) ◽  
pp. 109-116 ◽  
Author(s):  
Jonathan L. Groeger ◽  
Peter Stephanos ◽  
Paul Dorsey ◽  
Mark Chapman
Keyword(s):  
Data Collection ◽  
Crack Detection ◽  
Implementation Process ◽  
Lessons Learned ◽  
Pavement Management ◽  
Pavement Management System ◽  
State Highway ◽  
Management Group ◽  
Detection Software ◽  
Insight Into

The Maryland State Highway Administration (MDSHA) has collected cracking data on its roadways for use in its pavement management system since 1984. Through much of this history the pavement cracking survey was performed yearly by teams of inspectors riding in vans. With the reengineering of the administration over the years, this process began to present serious resource and logistical problems. During the past 3 years, the MDSHA pavement management group has developed and implemented a state-of-the-art automated network-level crack detection process that is showing promising results. This process is based upon the use of the automated road analyzer (ARAN) data collection vehicle, Wisecrax crack detection software, and an intensive quality-control (QC) and quality-assurance (QA) procedure. The data collection and data processing tasks are all performed in house with MDSHA resources. An overview of the processes developed and implemented by MDSHA to conduct these surveys is provided. Also discussed are challenges and lessons learned during the implementation process. Presentation of this information will allow others to gain insight into the strengths and weaknesses of adopting such a system and promote information sharing among pavement data collection organizations. Overall, it is concluded that automated network-level crack detection is a workable and efficient tool. However, a strict QC-QA regime must be instituted in order to achieve consistent and repeatable results.

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