The challenge of integrating eHealth into healthcare; a systematic literature review on structure, process and outcomes (Donabedian model) (Preprint)

2021 ◽  
Author(s):  
Rosian Tossaint ◽  
Anke Versluis ◽  
Niels Chavannes ◽  
Esther Talboom ◽  
Marise Kasteleyn
Keyword(s):  
Literature Review ◽  
Human Resources ◽  
Care Process ◽  
Organisational Structure ◽  
Outcome Indicators ◽  
Daily Care ◽  
Care Processes ◽  
Process And Outcome ◽  
Structure Category ◽  
Inner Setting

BACKGROUND Healthcare organisations increasingly work with eHealth. However, the integration of eHealth into regular healthcare is challenging. It requires organisations to change the way they work. The organisation’s structure and care processes need to be adapted to ensure that eHealth supports the attainment of the desired outcomes. OBJECTIVE The aims of this study were to investigate whether there are identifiable indicators in the structure, process and outcome categories related to a successful integration of eHealth in regular healthcare, and to investigate which indicators of structure and process are related to outcome indicators. METHODS A systematic literature review was conducted, using Donabedian’s Structure-Process-Outcome framework (SPO), to identify indicators that are related to the integration of eHealth into healthcare organisations. Data extraction sheets were designed to provide an overview of the study characteristics, the eHealth characteristics, and the indicators. The extracted indicators were organised into themes and subthemes of the structure, process and outcome categories. RESULTS Eleven studies were included, covering a variety of study designs, diseases and eHealth tools. All studies identified structure, process and outcome indicators that were potentially related to the integration of eHealth. The number of indicators found in structure, process, outcomes was respectively 175, 84, and 88. The themes with the most-noted indicators and their mutual interaction were the inner setting (51 indicators, 16 interactions), care receiver (40 indicators, 11 interactions) and technology (38 indicators, 12 interactions) themes, all three in the structure category, the healthcare actions theme (38 indicators, 15 interactions) in the process category and the efficiency theme (30 indicators, 15 interactions) in the outcome category. In-depth examination showed four most-reported indicators, namely indicator ‘deployment of human resources’ (n=11) of the inner setting theme in the structure category, the ‘ease of use’ (n=16) and ‘technical issue’ (n=10) indicators, both in the technology theme within the structure category, and the ‘health logistics’ (n=26) indicator in the efficiency theme within the outcome category. CONCLUSIONS This study showed that three principles are important for the successful integration of eHealth into healthcare. First, the role of the care receiver needs to be incorporated into the organisational structure and daily care process. Second, the technology must be well attuned to the organisational structure and daily care process. Third, the deployment of human resources in the daily care processes needs to be aligned with the desired end results. Not adhering to these points could negatively affect the organisation, daily process, or the end results.

Role of Human Resources in Change

2015 ◽  
pp. 216-229
Author(s):  
Mürşide Özgeldi
Keyword(s):  
Performance Evaluation ◽  
Literature Review ◽  
Human Resources ◽  
Organisational Change ◽  
Training And Development ◽  
Organisational Structure ◽  
The People ◽  
Strategic Element ◽  
Human Resources Strategies

Due to rapid, continuous and radical changes, today, the environment becomes more and more unpredictable and unclear. Thus, in order to be successful and continue to exist organisations are to live with the change, predict, benefit from and manage it. Organisational change could be defined as the process or existing organisational structure and operations as well as the effort to change the behaviours of the most members in the organisation to a great extent. It could also be said that change related issues are mostly about people and the success of the change depends on the attitudes and behaviours of the people and the Human Resources strategies, policies and operations developed considering the need of the change. The HR issues such as planning, staffing, performance evaluation, training and development, price and appraisal, motivation, culture, communication, involvement and commitment are all related to the areas in which change is needed. It could be said that HR is a strategic element in change and should be proactive. This chapter is on the role of HR in change. Change itself, the human characteristics of change, the importance and the role of HR in change, the literature review of some HR models used in change and what HR should do in change will be summarised.

Are we measuring what matters in health technology assessment of disease management? Systematic literature review

2006 ◽  
Vol 22 (1) ◽  
pp. 47-57 ◽  
Author(s):  
Lotte Steuten ◽  
Bert Vrijhoef ◽  
Hans Severens ◽  
Frits van Merode ◽  
Cor Spreeuwenberg
Keyword(s):  
Disease Management ◽  
Literature Review ◽  
Health Technology Assessment ◽  
Systematic Literature Review ◽  
Technology Assessment ◽  
Health Technology ◽  
Substantial Part ◽  
Outcome Indicators ◽  
Process And Outcome ◽  
Process And Outcome Indicators

Objectives:An overview was produced of indicators currently used to assess disease management programs and, based on these findings, provide a framework regarding sets of indicators that should be used when taking the aims and types of disease management programs into account.Methods:A systematic literature review was performed.Results:Thirty-six studies met the inclusion criteria. It appeared that a link between aims of disease management and evaluated structure, process, as well as outcome indicators does not exist in a substantial part of published studies on disease management of diabetes and asthma/chronic obstructive pulmonary disease, especially when efficiency of care is concerned. Furthermore, structure indicators are largely missing from the evaluations, although these are of major importance for the interpretation of outcomes for purposes of decision-making. Efficiency of disease management is mainly evaluated by means ofprocessindicators; the use ofoutcomeindicators is less common. Within a framework, structure, process, and outcome indicators for effectiveness and efficiency are recommended for each type of disease management program.Conclusions:The link between aims of disease management and evaluated structure, process, and outcome indicators does not exist in a substantial part of published studies on disease management. The added value of this study mainly lies in the development of a framework to guide the choice of indicators for health technology assessment of disease management.

scholarly journals Quality indicators for in-hospital geriatric co-management programmes: a systematic literature review and international Delphi study

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e020617 ◽  
Author(s):  
Bastiaan Van Grootven ◽  
Lynn McNicoll ◽  
Daniel A Mendelson ◽  
Susan M Friedman ◽  
Katleen Fagard ◽  
...  
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Delphi Study ◽  
Western Europe ◽  
Outcome Indicators ◽  
Process And Outcome ◽  
Stay Time ◽  
The Usa ◽  
Level Of Agreement ◽  
Process And Outcome Indicators

ObjectiveTo find consensus on appropriate and feasible structure, process and outcome indicators for the evaluation of in-hospital geriatric co-management programmes.DesignAn international two-round Delphi study based on a systematic literature review (searching databases, reference lists, prospective citations and trial registers).SettingWestern Europe and the USA.ParticipantsThirty-three people with at least 2 years of clinical experience in geriatric co-management were recruited. Twenty-eight experts (16 from the USA and 12 from Europe) participated in both Delphi rounds (85% response rate).MeasuresParticipants rated the indicators on a nine-point scale for their (1) appropriateness and (2) feasibility to use the indicator for the evaluation of geriatric co-management programmes. Indicators were considered appropriate and feasible based on a median score of seven or higher. Consensus was based on the level of agreement using the RAND/UCLA Appropriateness Method.ResultsIn the first round containing 37 indicators, there was consensus on 14 indicators. In the second round containing 44 indicators, there was consensus on 31 indicators (structure=8, process=7, outcome=16). Experts indicated that co-management should start within 24 hours of hospital admission using defined criteria for selecting appropriate patients. Programmes should focus on the prevention and management of geriatric syndromes and complications. Key areas for comprehensive geriatric assessment included cognition/delirium, functionality/mobility, falls, pain, medication and pressure ulcers. Key outcomes for evaluating the programme included length of stay, time to surgery and the incidence of complications.ConclusionThe indicators can be used to assess the performance of geriatric co-management programmes and identify areas for improvement. Furthermore, the indicators can be used to monitor the implementation and effect of these programmes.

scholarly journals The Origin of Variation in Primary Care Process and Outcome Indicators

Medicine ◽  
2015 ◽  
Vol 94 (31) ◽  
pp. e1314 ◽  
Author(s):  
Juan F. Orueta ◽  
Arturo García-Alvarez ◽  
Gonzalo Grandes ◽  
Roberto Nuño-Solinís
Keyword(s):  
Primary Care ◽  
Care Process ◽  
Outcome Indicators ◽  
Process And Outcome ◽  
Process And Outcome Indicators

E-health and diabetes care

2007 ◽  
Vol 13 (1_suppl) ◽  
pp. 22-23 ◽  
Author(s):  
Nora Ekroos ◽  
Kari Jalonen
Keyword(s):  
Literature Review ◽  
Health Knowledge ◽  
Care Process ◽  
Process Data ◽  
Case Study Methodology ◽  
Quantitative Evidence ◽  
Basic Care ◽  
Care Processes ◽  
Patient Provider Communication ◽  
Multiple Case

A study was designed to develop e-health knowledge in Finland, and create quantitative evidence of the benefits of e-health for productivity in the health-care process. First, a literature review was conducted. Then a multiple case study methodology was employed. This involves an interview study and a quantitative analysis of process data in order to understand the primary care processes concerning diabetes. Based on the results from the literature review, e-health has the potential to provide evidence-based, interactive tools to empower patient self-management, enhance practice/provider efficiency and work flow, and improve patient-provider communication. The effects of e-health in chronic disease management seem to be positive. Research is needed in order to evaluate the most efficient methods of handling routine communication and basic care online. We believe that e-health based services will offer effective ways of managing chronic diseases in future.

scholarly journals Making the Decision to Stay at Home: Developing a Community-Based Care Process Model for Aging in Place

2021 ◽  
Vol 18 (11) ◽  
pp. 5987
Author(s):  
Katarina Galof ◽  
Zvone Balantič
Keyword(s):  
Older Adults ◽  
Human Resources ◽  
Policy Development ◽  
Process Model ◽  
Empirical Work ◽  
Care Process ◽  
Research Approach ◽  
Community Based ◽  
Decision To Stay ◽  
At Home

The care of older adults who wish to spend their old age at home should be regulated in every country. The purpose of this article is to illustrate the steps for developing a community-based care process model (CBCPM), applied to a real-world phenomenon, using an inductive, theory-generative research approach to enable aging at home. The contribution to practice is that the collaboration team experts facilitate the application of the process in their own work as non-professional human resources. This means that each older adult is his or her own case study. Different experts and non-experts can engage in the process of meeting needs as required. The empirical work examined the number of levels and steps required and the types of human resources needed. The proposed typology of the CBCPM for older adults can provide insight, offer a useful framework for future policy development, and evaluate pilots at a time when this area of legislation is being implemented.

scholarly journals The use of the Nursing Activities Score in clinical settings: an integrative review

2015 ◽  
Vol 49 (spe) ◽  
pp. 147-156 ◽  
Author(s):  
Joanie Lachance ◽  
Frédéric Douville ◽  
Clémence Dallaire ◽  
Katia Grillo Padilha ◽  
Maria Cecilia Gallani
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Care Quality ◽  
Clinical Settings ◽  
Framework Structure ◽  
Inclusion Criteria ◽  
Delivery Method ◽  
Process And Outcome ◽  
Structure Category ◽  
Quality Framework

ABSTRACT Objective analyze how studies have approached the results obtained from the application of the Nursing Activities Score (NAS) based on Donabedian’s model of healthcare organization and delivery. Method CINAHL and PubMed databases were searched for papers published between 2003 and March 2015. Results 36 articles that met the inclusion criteria were reviewed and double-coded by three independent coders and analyzed based on the three elements of Donabedian’s health care quality framework: structure, process and outcome. The most frequently addressed, but not always tested, variables were those that fell into the structure category. Conclusion variables that fell into the process category were used less frequently. Beside NAS, the most frequently used variables in the outcome category were mortality and length of stay. However, no study used a quality framework for healthcare or NAS to evaluate costs, and it is recommended that further research should explore this approach.

scholarly journals EMPLOYEE PERFORMANCE MODELS: COMPETENCE, COMPENSATION AND MOTIVATION (HUMAN RESOURCES LITERATURE REVIEW STUDY)

2020 ◽  
Vol 2 (1) ◽  
pp. 185-198
Author(s):  
Muhammad Reza Putra ◽  
Gupron Gupron
Keyword(s):  
Literature Review ◽  
Human Resources ◽  
Employee Performance ◽  
Performance Models ◽  
Competence Motivation ◽  
Review Study ◽  
A Company

In a company, employees are one of the most important elements in achieving company goals. The performance of an employee is certainly influenced by several factors that a manager needs to know. Managers must know the strengths and weaknesses of each manager in order to maximize potential and minimize employee shortages. The factors that influence an employee's performance are motivation, compensation and competence. Motivation is needed by an individual because basically humans need encouragement or inducement in order to work better. Motivation is given as a way to improve employee performance to carry out their responsibilities. The different competencies of each employee are also a factor in the good and bad performance of an employee. The competence of each employee must be improved in order to achieve company goals. Compensation also affects an employee's performance. Compensation can be in the form of money or other facilities. Compensation is given as remuneration by the company to employees who have carried out their duties and responsibilities.

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