Challenges in Inpatient Care Coordinators’ Clinical Workflow and Opportunities in Designing a Health IT Solution (Preprint)

2020 ◽  
Author(s):  
Danny T.Y. Wu ◽  
Paul Murdock ◽  
Scott Vennemeyer ◽  
Sarah Salomone ◽  
Keyin Jin ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Travel Time ◽  
Inpatient Care ◽  
Qualitative Interviews ◽  
Critical Role ◽  
Structured Interviews ◽  
Clinical Workflow ◽  
Mixed Methods Approach ◽  
Event Logs ◽  
Care Coordinators

BACKGROUND Inpatient care coordinators (ICCs) play a critical role in case management and care transition because they address patient needs by referring them to available services and facilities prior to discharge. ICCs tend to spend a significant amount of time reviewing patient charts and documenting the cases using Electronic Health Record (EHR) systems. However, significant knowledge gaps exist regarding their clinical workflow and potential use of health information technology to improve work efficiency and job satisfaction. OBJECTIVE We aimed to address the gap by answering the research questions: 1) what is a typical day of an inpatient care coordinator? 2) what challenges exist in terms of their care delivery and documentation activities? and 3) what patterns in the EHR event logs reinforce our findings from the qualitative interviews? In addition, we aimed to demonstrate the feasibility of our novel mixed-method approach to study clinical workflow. METHODS A mixed-methods approach was developed and employed to understand ICCs workflow patterns and identify existing barriers to workflow. This approach involved data collection from semi-structured interviews and EHR event logs to construct a generalizable picture of all ICC workflow at the University of Cincinnati Medical Center (UCMC). The study consisted of 12 qualitative interviews with ICCs at UCMC, and their EHR event logs for one month. The qualitative interviews were analyzed using thematic analysis and the event logs were analyzed using statistical and pattern analysis. RESULTS We identified three major workflow barriers faced by ICCs: long travel time, heavy documentation load, and suboptimal communication. The event logs provided empirical evidence to support the workflow barriers identified during the semi-structured interviews, especially in travel time and documentation load. CONCLUSIONS ICC workflow has several inefficiencies. We recommend a mobile-based informatics solution with streamlined, intelligent, and EHR-linked documentation support. Our mixed-methods approach can be applied to other clinical settings and healthcare institutions. CLINICALTRIAL NA

Management of e-resources in academic libraries in Ghana: Copyright implications

IFLA Journal ◽  
2021 ◽  
pp. 034003522110271
Author(s):  
Theresa L Adu ◽  
Thomas B van der Walt
Keyword(s):  
Distance Education ◽  
Mixed Methods ◽  
Distance Learning ◽  
Academic Libraries ◽  
Online Courses ◽  
Qualitative Interviews ◽  
Digital Resources ◽  
Mixed Methods Approach ◽  
Sequential Mixed Methods ◽  
Library Staff

This study investigated the copyright issues surrounding the management of e-resources in academic libraries in Ghana. Forty-seven library staff and head librarians from four academic libraries were engaged using questionnaires and qualitative interviews in a sequential mixed-methods approach to generate data for this study. The findings indicate that in all four institutions copyright issues arose with the provision of distance learning, online courses and e-reserves services. All the respondents stated that they or their colleagues had had faculty ask questions on copyright issues. However, the professional librarians indicated that the library was not consulted and the instructors for online courses or distance education programmes did not cooperate with librarians; rather, the department posting the materials made the decisions on copyright regarding the usage of digital resources for distance learning, online courses or e-reserves. This does not augur well for the management of copyright of e-resources in academic libraries in Ghana.

The Path to Adulthood: A Mixed-Methods Approach to the Exploration of the Experiences of Unaccompanied Minors in Portugal

2021 ◽  
Author(s):  
Carla Moleiro ◽  
Sandra Roberto
Keyword(s):  
Young Adults ◽  
Mixed Methods ◽  
Residential Care ◽  
Host Country ◽  
Qualitative Interviews ◽  
Autobiographical Narratives ◽  
Unaccompanied Minors ◽  
Mixed Methods Approach ◽  
Age Of Majority ◽  
The Voice

Abstract Unaccompanied minors who reach the age of majority often experience this transition as a complex stage. Insecurity and helplessness may arise and, in some cases, survival without the support of the institutions and services that previously protected them as minors in the host country may mean becoming at risk for social exclusion. The objective of the present study was to characterize unaccompanied minors in Portugal (N = 67) and understand the processes of transition into the age of majority, using a mixed-methods approach. Quantitative (survey) and qualitative (interviews on autobiographical narratives) methodologies were used as a means of acknowledging the voice of minors/young adults in their trajectories and experiences. Two groups were included, with minors (in residential care) and youths who had already reached adulthood (living independently). Results illustrate diverse reasons for arrival in Portugal and distinct strengths and struggles in the integration experiences, with both positive and negative aspects being identified in the transition to autonomy.

Leadership in a time of financial crisis: what do we want from our leaders?

2015 ◽  
Vol 36 (5) ◽  
pp. 612-627 ◽  
Author(s):  
Arlene Haddon ◽  
Catherine Loughlin ◽  
Corinne McNally
Keyword(s):  
Mixed Methods ◽  
Mixed Method ◽  
Sex Role ◽  
Qualitative Interviews ◽  
Crisis Leadership ◽  
Organizational Crisis ◽  
Content Type ◽  
Mixed Methods Approach ◽  
Nuanced Understanding ◽  
Method Approach

Purpose – The purpose of this paper is to gain a nuanced understanding of what employees want from leaders in an organizational crisis context. Design/methodology/approach – The authors use a mixed methods approach to explore employee leadership preferences during organizational crisis and non-crisis times using the Multi Factor Leadership Questionnaire (Avolio and Bass, 2004), and qualitative interviews. The authors also investigate sex roles using the Bem Sex Role Inventory (Bem, 1981). Findings – The mixed method approach reveals some potential limitations in how leadership is typically measured. The qualitative findings highlight employees’ expectations of leaders to take action quickly while simultaneously engaging in continuous communication with employees during crisis. None of the components of transformational leadership encapsulate this notion. Originality/value – The mixed methods approach is novel in the crisis leadership literature. Had the authors relied solely on the quantitative measures, the importance of continuous communication during crisis would not have been apparent. As a result of this approach, the findings suggest that widely used and accepted measures of leadership may not adequately capture leadership in a crisis context. This is timely as it aligns with current literature which questions the way this construct is operationalized (Van Knippenberg and Sitkin, 2013).

Who Creates Microtransactions : The Production Context of Video Game Monetization

2021 ◽  
Author(s):  
Lies van Roessel ◽  
Jan Švelch
Keyword(s):  
Content Analysis ◽  
Mixed Methods ◽  
Data Analysis ◽  
Frequency Analysis ◽  
Video Game ◽  
Job Descriptions ◽  
Structured Interviews ◽  
Game Development ◽  
Mixed Methods Approach ◽  
Roles And Responsibilities

Despite a growing academic interest in in-game monetization, much less attention has been paid to the production context of microtransactions. With this chapter, we aim to address this gap by focusing on the roles and responsibilities related to video game monetization. We answer the titular question of this chapter using a mixed methods approach, combining semi-structured interviews, content analysis of job descriptions, and frequency analysis of in-game credits. Results suggest that monetization responsibilities are both being integrated into various existing roles, including game designers or product managers, but also spawn new dedicated roles of monetization specialists. Monetization as a game development task is closely related to data analysis and only inconsistently appears in in-game credits.

scholarly journals Implementing the Aseptic Non Touch Technique (ANTT®) clinical practice framework for aseptic technique: a pragmatic evaluation using a mixed methods approach in two London hospitals

2017 ◽  
Vol 19 (1) ◽  
pp. 6-15 ◽  
Author(s):  
Simon Clare ◽  
Stephen Rowley
Keyword(s):  
Clinical Practice ◽  
Mixed Methods ◽  
Infection Prevention ◽  
Self Report ◽  
Healthcare Associated Infection ◽  
Structured Interviews ◽  
Aseptic Technique ◽  
Mixed Methods Approach ◽  
Practice Framework ◽  
Mean Compliance

Background: Aseptic technique is an important infection prevention competency for protecting patients from healthcare-associated infection (HAI). Healthcare providers using the Aseptic Non Touch Technique (ANTT®) aseptic technique have demonstrated reduced variability and improved compliance with aseptic technique. Objectives: The primary aim of this study is to determine whether standardizing aseptic technique for invasive IV procedures, using the ANTT® - Clinical Practice Framework (CPF), increases staff compliance with the infection prevention actions designed to achieve a safe and effective aseptic technique, and whether this is sustainable over time. Methods: A pragmatic evaluation using a mixed-methods approach consisting of an observational audit of practice, a self-report survey and structured interviews with key stakeholders. Compliance with aseptic technique before and after the implementation of ANTT® was measured by observation of 49 registered healthcare professionals. Results: Mean compliance with competencies was 94%; each component of practice was improved over baseline: hand hygiene = 63% ( P ≤ 0.001); glove use = 14% ( P ≤ 0.037); Key-Part protection = 54% ( P ≤ 0.001); a non-touch technique = 45% ( P ≤ 0.001); Key-Part cleaning = 82% ( P ≤ 0.001); and aseptic field management = 80% ( P ≤ 0.001). Conclusions: Results show implementation of ANTT® improved compliance with the prerequisite steps for safe and effective aseptic technique as defined by the ANTT®-CPF. Improvements in compliance were sustained over four years.

scholarly journals How Effective Is Youth Volunteering as an Employment Strategy? A Mixed Methods Study of England

Sociology ◽  
2020 ◽  
Vol 54 (4) ◽  
pp. 763-781
Author(s):  
Bryony Hoskins ◽  
Pauline Leonard ◽  
Rachel Wilde
Keyword(s):  
Mixed Methods ◽  
Citizenship Education ◽  
Qualitative Interviews ◽  
Longitudinal Survey ◽  
Mixed Methods Study ◽  
Short Term ◽  
Mixed Methods Approach ◽  
Negative Effect ◽  
Support Policy ◽  
The Relationship

Volunteering is routinely advocated in British policy as a key mechanism for young people to gain employment, but with little evidence of its viability as a strategy. Indeed, the limited research in this area suggests the link is weak and that access to good quality volunteering is differentiated along class lines. This article draws on a mixed methods approach, using survey data from the Citizenship Education Longitudinal Survey and qualitative interviews, to analyse the relationship between youth volunteering and employment. It finds that volunteering is not unequivocally beneficial for employment, particularly if it does not offer career-related experience or is imposed rather than self-initiated. It can even have a negative effect on employment. Furthermore, social class mediates access to volunteering opportunities most likely to convert into employment. We conclude there is little evidence to support policy assumptions that, in the short term, volunteering has a positive relationship to paid employment.

scholarly journals Effects of training podiatrists to use imagery-based motivational interviewing when treating people with diabetes-related foot disease: a mixed-methods pilot study

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Tracey Kaczmarek ◽  
Jaap J. Van Netten ◽  
Peter A. Lazzarini ◽  
David Kavanagh
Keyword(s):  
Job Satisfaction ◽  
Mixed Methods ◽  
Pilot Study ◽  
Motivational Interviewing ◽  
Qualitative Interviews ◽  
Self Care ◽  
Substantial Effect ◽  
Subjective Experiences ◽  
Structured Interviews ◽  
Foot Disease

Abstract Background Self-care in diabetes related foot disease (DFD) is challenging and contributes to poor outcomes. Motivational Interviewing (MI) can engage people in self-care and modifying it by integrating imagery may further improve its outcomes. No previous studies have trained podiatrists in using MI to address DFD self-care. This was the first study on training podiatrists to conduct imagery-based motivational interviewing (MI) when treating people with DFD, and to examine impacts on MI related skills, job satisfaction and subjective experiences in a mixed-methods pilot study. Methods Eleven recruited podiatrists (median age: 35 years, 9 female and 2 male) received two 4-h training sessions, and three received subsequent mentoring. MI and imagery skills were rated using validated tools during two clinical sessions per participant at baseline, and 2- and 12-weeks post-training. Job satisfaction was assessed at baseline and 12 weeks. Semi-structured interviews at 12 weeks were analysed using the framework approach. Results Significant improvements over time (p = .006–.044) with substantial effect sizes (η2 = .50–.67) were found in three of four global MI related communication skills and two of four MI behaviours. However, effects on these indices were not sustained to 12 weeks, and imagery was rarely used. Job satisfaction was high at baseline and unchanged at follow-up (p = 0.34, η2 = .100). In qualitative interviews, MI training and skills were valued, but significant challenges in using MI when treating people with DFD were reported. Conclusion Training podiatrists in MI may have potential but more training, observation and mentoring appear needed to obtain sustained communication changes in practice.

scholarly journals Investigating Mobile Banking Continuance Intention: A Mixed-Methods Approach

2021 ◽  
Vol 2021 ◽  
pp. 1-17
Author(s):  
Imdadullah Hidayat-ur-Rehman ◽  
Arshad Ahmad ◽  
Muhammad Nauman Khan ◽  
Shamsul Anuar Mokhtar
Keyword(s):  
Mixed Methods ◽  
Conceptual Model ◽  
Emerging Market ◽  
Qualitative Interviews ◽  
Perceived Usefulness ◽  
Mobile Banking ◽  
Mixed Methods Approach ◽  
Perceived Security ◽  
Managerial Implications ◽  
Security Concerns

Building on IS research, this study investigates m-banking continuance from an emerging market perspective. Using a mixed-methods approach, the study presents m-banking continuance phenomenon through an integrated model. Study 1 focuses on qualitative interviews of mobile banking users, whereas study 2 empirically tests the conceptual model derived from literature and the results of study 1. Study 1 reveals three additional constructs, perceived ubiquity, perceived autonomy, and perceived security concerns to the existing literature-based constructs. However, the results of study 2—a survey of 390 m-banking users—provide empirical evidence to support the hypotheses drawn in the proposed conceptual model. The results reveal that perceived ubiquity, perceived usefulness, satisfaction, facilitating conditions, perceived security concerns, and trust have emerged as significant direct influencers on m-banking continuance. Moreover, the study offers practical academic and managerial implications regarding m-banking.

scholarly journals Evaluation of a Case Management to Support Families With Children Diagnosed With Spinal Muscular Atrophy—Protocol of a Controlled Mixed-Methods Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Jana Willems ◽  
Erik Farin-Glattacker ◽  
Thorsten Langer
Keyword(s):  
Mixed Methods ◽  
Case Management ◽  
Muscular Atrophy ◽  
Healthcare Providers ◽  
Structured Interviews ◽  
Mixed Methods Approach ◽  
Management Intervention ◽  
Care Integration ◽  
Case Management Intervention

Background: Spinal muscular atrophy (SMA) is a rare neuromuscular disease characterized by degeneration of the anterior horn cells in the spinal cord, resulting in muscle atrophy, and proximal muscle weakness. SMA presents with a wide range of symptoms requiring multiple clinical specialists and therapists. Integrating care between disciplines can be challenging due to the dynamic course of the disease, and great distances between specialist centers and local providers. Insufficient care integration can lead to suboptimal quality of care and more difficulties for patients and families. This study aims to improve care integration through a Case Management intervention, and taking a mixed-methods approach, to evaluate its impact.Methods: An exploratory, controlled, two-armed study with baseline, post- and follow-up measurement and process evaluation is conducted to evaluate our intervention compared to usual care. Through a multi-perspective state analysis, we investigate the experiences of caregivers and healthcare providers concerning the actual healthcare quality of patients with SMA I and II. Semi-structured interviews and care diaries are used. We apply that data to conceive a tailored Case Management intervention supplemented by a digital platform. The intervention's effect is examined in comparison to a control group taking a mixed-methods approach. As primary endpoints, we investigate the caregivers' health-related quality of life and the quality of care integration. Secondary endpoints are the use of healthcare services (patients and caregivers) and costs. We assess the process quality from the perspectives of caregivers and healthcare providers through semi-structured interviews.Discussion: This is an exploratory, controlled study to assess the impact of a tailored Case Management intervention to improve the care of patients with SMA I and II. After the evaluation, results on feasibility, expected effect sizes, and process quality will be available. On this basis, future randomized controlled trials can be planned. If demonstrated beneficial, the experience gained within this study may also be valuable for care strategies in other regions and other (non-pediatric) patient groups with rare diseases and/or chronic, complex conditions.Clinical Trial registration:https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00018778, identifier: DRKS00018778.

scholarly journals Mixed Methods Research: A Comprehensive Approach for Study into the New Zealand Voluntary Carbon Market

2016 ◽  
Author(s):  
S Birchall ◽  
Maya Murphy ◽  
Markus Milne
Keyword(s):  
Mixed Methods ◽  
New Zealand ◽  
Mixed Methods Research ◽  
Qualitative Interviews ◽  
Carbon Market ◽  
Qualitative Inquiry ◽  
Wicked Problem ◽  
Research Approach ◽  
Data Sets ◽  
Mixed Methods Approach

Climate change and solutions to solving this wicked problem require a mixed methods research approach that draws on quantitative and qualitative inquiry together. The purpose of this article is to demonstrate the applicability (and effectiveness) of a mixed methods approach applied to research into the voluntary carbon market (VCM), a key path available for organisations electing to offset their carbon emissions, in New Zealand. The mixed methods approach included three unique data sets (quantitative documents, quantitative surveys, qualitative in-depth interviews), and was both explanatory (qualitative interviews built upon and contextualized the document analysis and survey results) and convergent (data sets were examined separately, then, as they represent different aspects of the same phenomenon, were combined for analysis). These complementary methods were used to gain a fuller picture of the evolution and institutional dynamics of the VCM field in order to produce a comprehensive case study.

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