scholarly journals Answering questions posed by health system stakeholders using linked administrative health data at the Institute for Clinical Evaluative Sciences (ICES)

2017 ◽  
Vol 1 (1) ◽  
Author(s):  
Erika A. Yates ◽  
Marian J. Vermeulen ◽  
Refik Saskin ◽  
Charles J. Victor ◽  
Alison P. Paprica ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health System ◽  
Health Care Providers ◽  
Health Data ◽  
Fiscal Year ◽  
Care Providers ◽  
Administrative Health Data ◽  
Research Findings ◽  
Linked Administrative Health Data

ABSTRACTObjectivesThere is a growing need to broaden access to administrative health data in order to support decision making and planning by health system stakeholders. An initiative funded by the Ontario Ministry of Health and Long-Term Care, the Applied Health Research Question (AHRQ) portfolio leverages the linked administrative health data holdings and the scientific and clinical expertise at ICES to answer questions generated by stakeholders that will have a direct impact on health care policy, planning or practice. ApproachEligible requesters include government ministries, health care providers and planners. Requests detail the purpose of the research question, the related scientific literature, and the planned use and intended impact of the research findings. An internal review team meets monthly to adjudicate; requests demonstrably needing research findings rapidly are adjudicated on an ad hoc basis. Eligible requests are those that aim to inform evidence-based decision making, do not advocate for a particular answer and are feasible in terms of data availability. All projects are reviewed by the internal privacy office to ensure that use of the administrative health data is in accordance with both data sharing agreements and legislation governing use of personal health information. At no cost to the requesting organization, ICES scientists and research staff formulate the analysis plan, conduct the analysis and prepare the research product (data tables, a slide deck and/or a written report); and, may opt to publish noteworthy findings. All research products must be cleared for risk of re-identification prior to being shared externally. ResultsRequests have steadily increased from 43 submissions in fiscal year 2012/13, to 59 in 2014/15 and 74 to date in 2015/16. In fiscal year 2014/15, provincial government and government agencies were the most frequent requesters (39%), followed by hospitals and other health care providers (19%), disease advocacy groups (12%) and professional associations (10%). Requests include assessment of health care utilization; health system performance and evaluation; and chronic disease prevalence and treatment. Time to complete reports varies from 5 days to 24 months, depending on project complexity and requirements. Requesters report that AHRQ research findings have influenced decision-making, policy development and health care practice; and have inspired future research. ConclusionThis initiative demonstrates the value and feasibility of using the linked administrative health data to answer questions to meet the unique needs of health planners and policymakers, and presents an opportunity for collaboration beyond the academic research community.

scholarly journals Multi-level considerations for optimal implementation of long-acting injectable antiretroviral therapy to treat people living with HIV: perspectives of health care providers participating in phase 3 trials

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andrea Mantsios ◽  
Miranda Murray ◽  
Tahilin S. Karver ◽  
Wendy Davis ◽  
Noya Galai ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health System ◽  
Health Care Providers ◽  
The United States ◽  
Provider Communication ◽  
Care Providers ◽  
Patient Provider Communication ◽  
Multi Level ◽  
Long Acting

Abstract Background Long-acting injectable antiretroviral therapy (LA ART) has been shown to be non-inferior to daily oral ART, with high patient satisfaction and preference to oral standard of care in research to date, and has recently been approved for use in the United States and Europe. This study examined the perspectives of health care providers participating in LA ART clinical trials on potential barriers and solutions to LA ART roll-out into real world settings. Methods This analysis draws on two data sources: (1) open-ended questions embedded in a structured online survey of 329 health care providers participating in the ATLAS-2 M trial across 13 countries; and (2) in-depth interviews with 14 providers participating in FLAIR/ ATLAS/ATLAS-2 M trials in the United States and Spain. Both assessments explored provider views and clinic dynamics related to the introduction of LA ART and were analyzed using thematic content analysis. The Consolidated Framework for Implementation Research (CFIR) was drawn on as the conceptual framework underpinning development of a model depicting study findings. Results Barriers and proposed solutions to LA ART implementation were identified at the individual, clinic and health system levels. Provider perceptions of patient level barriers included challenges with adhering to frequent injection appointments and injection tolerability. Proposed solutions included patient education, having designated staff for clinic visit retention, and clinic flexibility with appointment scheduling. The main provider concern was identifying appropriate candidates for LA ART; proposed solutions focused on patient provider communication and decision making. Clinic level barriers included the need for additional skilled individuals to administer injections, shifts in workflow as demand increases and the logistics of cold-chain storage. Proposed solutions included staff hiring and training, strategic planning around workflow and logistics, and the possibility of offering injections in other settings, including the home. Health system level barriers included cost and approvals from national regulatory bodies. Potential solutions included governments subsidizing treatment, ensuring cost is competitive with oral ART, and offering co-pay assistance. Conclusions Results suggest the importance of multi-level support systems to optimize patient-provider communication and treatment decision-making; clinic staffing, workflow, logistics protocols and infrastructure; and cost-related factors within a given health system.

Patient registries from the view of health policy

2014 ◽  
Vol 155 (19) ◽  
pp. 729-731 ◽  
Author(s):  
Ildikó Kissné Horváth
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Policy ◽  
Health Care Providers ◽  
Health Care Quality ◽  
Health Data ◽  
Care Quality ◽  
Care Providers ◽  
Critical Importance ◽  
Disease Registries

Integrated health data management and disease registries which are able to support evidence-based decision making are of critical importance for health policy. Data provided by disease registries are used for the development of health strategy, planning of preventive activities, capacity-building in health care provision, improving health care quality, and planning clinical trials. Disease registries monitoring epidemiology, natural history of diseases, treatment outcomes and the detection of adverse reactions are requested not only by policy-makers, but public health authorities and health care providers, too. Registries for rare diseases are of critical importance for developing network between reference centres and developing and evaluating new drugs. Data and information need for decision-making in public services and the protection of health data of individuals require a careful balance that needs to be taken into account when considering disease registries. Orv. Hetil., 2014, 155(19), 729–731.

scholarly journals Improving Communications With Patients and Families in Geriatric Care. The How, When, and What

2021 ◽  
Vol 8 ◽  
pp. 237437352110340
Author(s):  
Shirley Chien-Chieh Huang ◽  
Alden Morgan ◽  
Vanessa Peck ◽  
Lara Khoury
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Family Caregivers ◽  
Health Care Providers ◽  
Tertiary Care ◽  
Care Providers ◽  
Telephone Interviews ◽  
Written Information ◽  
Geriatric Unit ◽  
Patient Health

There has been little published literature examining the unique communication challenges older adults pose for health care providers. Using an explanatory mixed-methods design, this study explored patients’ and their family/caregivers’ experiences communicating with health care providers on a Canadian tertiary care, inpatient Geriatric unit between March and September 2018. In part 1, the modified patient–health care provider communication scale was used and responses scored using a 5-point scale. In part 2, one-on-one telephone interviews were conducted and responses transcribed, coded, and thematically analyzed. Thirteen patients and 7 family/caregivers completed part 1. Both groups scored items pertaining to adequacy of information sharing and involvement in decision-making in the lowest 25th percentile. Two patients and 4 family/caregivers participated in telephone interviews in part 2. Interview transcript analysis resulted in key themes that fit into the “How, When, and What” framework outlining the aspects of communication most important to the participants. Patients and family/caregivers identified strategic use of written information and predischarge family meetings as potentially valuable tools to improve communication and shared decision-making.

scholarly journals Plain Language Summary: Opioid Prescribing for Analgesia After Common Otolaryngology Operations

2021 ◽  
Vol 164 (4) ◽  
pp. 704-711
Author(s):  
Samantha Anne ◽  
Sandra A. Finestone ◽  
Allison Paisley ◽  
Taskin M. Monjur
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Clinical Practice ◽  
Pain Management ◽  
Health Care Providers ◽  
Clinical Practice Guideline ◽  
Shared Decision ◽  
Care Providers ◽  
Plain Language ◽  
Opioid Prescribing

This plain language summary explains pain management and careful use of opioids after common otolaryngology operations. The summary applies to patients of any age who need treatment for pain within 30 days after having a common otolaryngologic operation (having to do with the ear, nose, or throat). It is based on the 2021 “Clinical Practice Guideline: Opioid Prescribing for Analgesia After Common Otolaryngology Operations.” This guideline uses available research to best advise health care providers, and it includes recommendations that are explained in this summary. Recommendations may not apply to every patient but can be used to facilitate shared decision making between patients and their health care providers.

scholarly journals A Survey of Family Planning Training, Knowledge, and Practices Among Health Care Providers Within the Military Health System at Joint Base Lewis–McChord

2018 ◽  
Vol 184 (5-6) ◽  
pp. e394-e399 ◽  
Author(s):  
Elizabeth I Deans ◽  
Alison L Batig ◽  
Sarah Cordes ◽  
Alicia N Scribner ◽  
Peter E Nielsen ◽  
...  
Keyword(s):  
Health Care ◽  
Family Planning ◽  
Health System ◽  
Health Care Providers ◽  
Care Providers ◽  
Military Health System ◽  
Military Health ◽  
The Military

The public’s trust and information brokers in health care, public health and research

2019 ◽  
Vol 33 (7/8) ◽  
pp. 929-948 ◽  
Author(s):  
Jodyn Platt ◽  
Minakshi Raj ◽  
Sharon L.R. Kardia
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health System ◽  
Information Sharing ◽  
Health Information ◽  
Health Care Providers ◽  
Care Providers ◽  
Content Type ◽  
The Public ◽  
Information Brokers

Purpose Nations such as the USA are investing in technologies such as electronic health records in order to collect, store and transfer information across boundaries of health care, public health and research. Health information brokers such as health care providers, public health departments and university researchers function as “access points” to manage relationships between the public and the health system. The relationship between the public and health information brokers is influenced by trust; and this relationship may predict the trust that the public has in the health system as a whole, which has implications for public trust in the system, and consequently, legitimacy of involved institutions, under circumstances of health information data sharing in the future. This paper aims to discuss these issues. Design/methodology/approach In this study, the authors aimed to examine characteristics of trustors (i.e. the public) that predict trust in health information brokers; and further, to identify the factors that influence trust in brokers that also predict system trust. The authors developed a survey that was administered to US respondents in 2014 using GfK’s nationally representative sample, with a final sample of 1,011 participants and conducted ordinary least squares regression for data analyses. Findings Results suggest that health care providers are the most trusted information brokers of those examined. Beliefs about medical deceptive behavior were negatively associated with trust in each of the information brokers examined; however, psychosocial factors were significantly associated with trust in brokers, suggesting that individual attitudes and beliefs are influential on trust in brokers. Positive views of information sharing and the expectation of benefits of information sharing for health outcomes and health care quality are associated with system trust. Originality/value This study suggests that demonstrating the benefits and value of information sharing could be beneficial for building public trust in the health system; however, trust in brokers of information are variable across the public; that is, knowledge, attitudes and beliefs are associated with the level of trust different individuals have in various health information brokers – suggesting that the need for a personalized approach to building trust.

scholarly journals Safe and Effective Prescription of Exercise in Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Rationale and Methods for an Integrated Knowledge Translation Study

2013 ◽  
Vol 20 (4) ◽  
pp. 281-284 ◽  
Author(s):  
Pat G Camp ◽  
W Darlene Reid ◽  
Cristiane Yamabayashi ◽  
Dina Brooks ◽  
Donna Goodridge ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Decision Making ◽  
Knowledge Translation ◽  
Pulmonary Disease ◽  
Health Care Providers ◽  
Chronic Obstructive ◽  
Care Providers ◽  
Comorbid Conditions ◽  
Obstructive Pulmonary Disease

BACKGROUND: Patients hospitalized with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) engage in low levels of activity, putting them at risk for relapse and future readmissions. There is little direction for health care providers regarding the parameters for safe exercise during an AECOPD that is effective for increasing activity tolerance before discharge from hospital, especially for patients with associated comorbid conditions.OBJECTIVE: To report the rationale for and methods of a study to develop evidence-informed care recommendations that guide health care providers in the assessment, prescription, monitoring and progression of exercise for patients hospitalized with AECOPD.METHODS: The present study was a multicomponent knowledge translation project incorporating evidence from systematic reviews of exercise involving populations with chronic obstructive pulmonary disease and/or common comorbidities. A Delphi process was then used to obtain expert opinion from clinicians, academics and patients to identify the parameters of safe and effective exercise for patients with AECOPD.RESULTS: Clinical decision-making tool(s) for patients and practitioners supported by a detailed knowledge dissemination, implementation and evaluation framework.CONCLUSION: The present study addressed an important knowledge gap: the lack of availability of parameters to guide safe and effective exercise prescription for hospitalized patients with AECOPD, with or without comorbid conditions. In the absence of such parameters, health care professionals may adopt an ‘activity as tolerated’ approach, which may not improve physical activity levels in their patients. The present study synthesizes the best available evidence and expert opinion, and will generate decision-making tools for use by patients and their health care providers.

Improving Health Care Provider Communication in End-of-Life Decision-Making

2017 ◽  
Vol 28 (2) ◽  
pp. 124-132 ◽  
Author(s):  
Tracey Wilson ◽  
Cathy Haut ◽  
Bimbola Akintade
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Critical Care ◽  
End Of Life ◽  
Health Care Providers ◽  
Care Providers ◽  
Improvement Project ◽  
Daunting Task ◽  
End Of Life Decision ◽  
Life Decision

Critical care providers are responsible for many aspects of patient care, primarily focusing on preserving life. However, nearly 40% of patients who are admitted to an adult critical care unit will not survive. Initiating a conversation about end-of-life decision-making is a daunting task. Often, health care providers are not trained, experienced, or comfortable facilitating these conversations. This article describes a quality improvement project that identified current views on end-of-life communication in the intensive care unit and potential barriers that obstruct open discussion, and offering strategies for improvement.

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