scholarly journals Barriers and Enablers for Artificial Intelligence in Dental Diagnostics: A Qualitative Study

2021 ◽  
Vol 10 (8) ◽  
pp. 1612
Author(s):  
Anne Müller ◽  
Sarah Marie Mertens ◽  
Gerd Göstemeyer ◽  
Joachim Krois ◽  
Falk Schwendicke
Keyword(s):  
Artificial Intelligence ◽  
Content Analysis ◽  
Qualitative Study ◽  
Theoretical Domains Framework ◽  
Decision Makers ◽  
Provider Communication ◽  
Snowball Sampling ◽  
Medical Decisions ◽  
Barriers And Enablers ◽  
Patient Provider Communication

The present study aimed to identify barriers and enablers for the implementation of artificial intelligence (AI) in dental, specifically radiographic, diagnostics. Semi-structured phone interviews with dentists and patients were conducted between the end of May and the end of June 2020 (convenience/snowball sampling). A questionnaire developed along the Theoretical Domains Framework (TDF) and the Capabilities, Opportunities and Motivations influencing Behaviors model (COM-B) was used to guide interviews. Mayring’s content analysis was employed to point out barriers and enablers. We identified 36 barriers, conflicting themes or enablers, covering nine of the fourteen domains of the TDF and all three determinants of behavior (COM). Both stakeholders emphasized chances and hopes for AI. A range of enablers for implementing AI in dental diagnostics were identified (e.g., the chance for higher diagnostic accuracy, a reduced workload, more comprehensive reporting and better patient–provider communication). Barriers related to reliance on AI and responsibility for medical decisions, as well as the explainability of AI and the related option to de-bug AI applications, emerged. Decision-makers and industry may want to consider these aspects to foster implementation of AI in dentistry.

scholarly journals Barriers and enablers to effective interprofessional teamwork in the operating room: A qualitative study using the Theoretical Domains Framework

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249576
Author(s):  
Nicole Etherington ◽  
Joseph K. Burns ◽  
Simon Kitto ◽  
Jamie C. Brehaut ◽  
Meghan Britton ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Operating Room ◽  
Positive Emotions ◽  
Quality Care ◽  
Theoretical Domains Framework ◽  
Snowball Sampling ◽  
Team Members ◽  
Barriers And Enablers ◽  
Interprofessional Teamwork ◽  
Call Night

Background Effective teamwork is critical for safe, high-quality care in the operating room (OR); however, teamwork interventions have not consistently resulted in the expected gains for patient safety or surgical culture. In order to optimize OR teamwork in a targeted and evidence-based manner, it is first necessary to conduct a comprehensive, theory-informed assessment of barriers and enablers from an interprofessional perspective. Methods This qualitative study was informed by the Theoretical Domains Framework (TDF). Volunteer, purposive and snowball sampling were conducted primarily across four sites in Ontario, Canada and continued until saturation was reached. Interviews were recorded, transcribed, and de-identified. Directed content analysis was conducted in duplicate using the TDF as the initial coding framework. Codes were then refined whereby similar codes were grouped into larger categories of meaning within each TDF domain, resulting in a list of domain-specific barriers and enablers. Results A total of 66 OR healthcare professionals participated in the study (19 Registered Nurses, two Registered Practical Nurses, 17 anaesthesiologists, 26 surgeons, two perfusionists). The most frequently identified teamwork enablers included people management, shared definition of teamwork, communication strategies, positive emotions, familiarity with team members, and alignment of teamwork with professional role. The most frequently identified teamwork barriers included others’ personalities, gender, hierarchies, resource issues, lack of knowledge of best practices for teamwork, negative emotions, conflicting norms and perceptions across professions, being unfamiliar with team members, and on-call/night shifts. Conclusions We identified key factors influencing OR teamwork from an interprofessional perspective using a theoretically informed and systematic approach. Our findings reveal important targets for future interventions and may ultimately increase their effectiveness. Specifically, achieving optimal teamwork in the OR may require a multi-level intervention that addresses individual, team and systems-level factors with particular attention to complex social and professional hierarchies.

94 Short-term use of therapeutic opioids for children and future opioid use disorders: A systematic review and qualitative study of decision-maker information needs

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e68-e68
Author(s):  
Malema Ahrari ◽  
Samina Ali ◽  
Michele Dyson ◽  
Lisa Hartling
Keyword(s):  
Systematic Review ◽  
Qualitative Study ◽  
Information Needs ◽  
Policy Decision ◽  
Decision Makers ◽  
Snowball Sampling ◽  
Opioid Use ◽  
Short Term ◽  
Short Term Exposure ◽  
Evidence Summary

Abstract Primary Subject area Emergency Medicine - Paediatric Background Healthcare visits, hospitalizations, and deaths due to opioid-related harms continue to rise for children, despite an overall decline in opioid prescriptions. Decision-makers (including patients and families, clinicians, and policy-makers) require high quality syntheses to inform decisions regarding opioid use. Previous research has found that how systematic review (SR) results are presented may influence uptake by decision-makers. Evidence summaries are appealing to decision-makers as they provide key messages in a succinct manner. Objectives 1) To conduct an SR examining the association between short-term therapeutic exposure to opioids in children and development of opioid use disorder, and 2) To gain perspectives from policy decision-makers on the usability and presentation of results through the form of an evidence summary. Design/Methods We conducted an SR following methods recommended by Cochrane. A medical librarian conducted a comprehensive search and two authors were involved in study selection, data extraction and quality assessment. Studies were eligible if they reported primary research in English or French, and study participants had therapeutic exposure to opioids before age 18 years. Results were described narratively. Decision makers were recruited through purposive and snowball sampling methods, and they participated in interviews to discuss an evidence summary based on the SR. Interviews were transcribed and data were analyzed using content analysis. Ethics approval was obtained for the qualitative study. Results Nineteen American studies involving 47,191,990 participants were included. One study demonstrated that short-term therapeutic exposure may be associated with opioid abuse. Four others showed an association without specifying duration of exposure. Fourteen studies provided information on prevalence or incidence of opioid misuse following therapeutic exposure, median 27.8% [interquartile range 21.4% – 30.7%]; notably, 12 of them did not specify duration of therapeutic exposure. Identified risk factors were contradictory and remain unclear. Decision makers had mixed preferences for the presentation of evidence, depending on their degree of involvement in research versus practice. A majority preferred having methods and key characteristics of studies included in the first page of the evidence summary. They noted that the summary should not be text-heavy and details should be appended. Conclusion A number of studies suggest there is an association between lifetime therapeutic opioid use (unknown duration) and future nonmedical opioid use; however, there is limited evidence to determine whether short-term exposure is specifically associated with these outcomes. Policy and decision-makers prefer a succinct evidence summary for this SR, with study-specific details provided as an appendix. PROSPERO Registration: 122681.

The Role of Patient–Provider Communication in Engagement and Re-engagement in HIV Treatment in Bamako, Mali: A Qualitative Study

2017 ◽  
Vol 23 (2) ◽  
pp. 129-143 ◽  
Author(s):  
Emily A. Hurley ◽  
Steven A. Harvey ◽  
Peter J. Winch ◽  
Mariam Keita ◽  
Debra L. Roter ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Hiv Treatment ◽  
Provider Communication ◽  
Patient Provider Communication

scholarly journals The Way of Implementing the New Accreditation Standards at Shahid Motahhari Educational Center in Marvdasht City: A Qualitative Study

2019 ◽  
Author(s):  
Hasan Jafari ◽  
Abbass YazdanPanah ◽  
Abdolreza Akbari
Keyword(s):  
Content Analysis ◽  
Qualitative Study ◽  
Human Resources ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Effective Factors ◽  
Accreditation Standards ◽  
Conventional Content Analysis ◽  
Lack Of Commitment ◽  
The Way

Background: One of the ways through which the quality of the hospital services can be improved is the accreditation, and most of the countries have launched their own accreditation system as a strategy to improve services. The aim of this research was to investigate the way of implementing the accreditation programs at Shahid Motahhari educational center in Marvdasht city. Methods: The current study was qualitative with conventional content analysis which was conducted by using the semi-structured interviews with eight officials and employees of Marvdasht Shahid Motahhari Medical Education Center in 2017. Purposeful sampling was done in this study and the next stage; the snowball sampling method was used to select the desired samples. Data were gathered to reach the data saturation point, and conventional content analysis was done to analyze the research data. Results: Two main themes and nineteen sub-themes were obtained through the nine categories. Self-confidence in the team, sense of superiority and achievement, all units’ coordination, accurate and scientific coherent supervision and management, and considering the book of standards as a guiding factor are among the strengths of this research.Poor management of programs, lack of proper context while running the program, lack of proper training, lack of financial and human resources, lack of commitment and interest in implementing the program among different groups were main identified barriers of the program. Conclusion: The effective factors on the implementation of the accreditation standards in the healthcarecenters should be identified. Besides, planning effective education, continued monitoring and assessing, creating suitable contexts of financial and human resources,consolidating the strengths and using the available potentials can be effective factors in line with the implemetation of accreditation standards.   Keywords: Accreditation, Hospital, Qualitative study, Evaluation

scholarly journals “There Are Still a Lot of Things that I Need”: A Qualitative Study Exploring Opportunities to Improve the Health Services of First Nations People with Arthritis seen at an On-reserve Outreach Rheumatology Clinic

2020 ◽  
Author(s):  
Adalberto Loyola-Sanchez ◽  
Ingris Pelaez-Ballestas ◽  
Lynden Crowshoe ◽  
Diane Lacaille ◽  
Rita Henderson ◽  
...  
Keyword(s):  
Qualitative Study ◽  
First Nations ◽  
Patient Navigator ◽  
Provider Communication ◽  
Health Providers ◽  
Model Of Care ◽  
Community Awareness ◽  
Patient Reported ◽  
Patient Provider Communication

Abstract Background Arthritis is a highly prevalent disease and leading cause of disability in the Indigenous population. A novel model of care consisting of a rheumatology outreach clinic in an on-reserve primary healthcare center has provided service to an Indigenous community in Southern Alberta since 2010. Despite quality assessments suggesting this model of care improves accessibility and is effective in meeting treatment targets, substantial improvements in patient-reported outcomes have not been realized. Therefore, the objective of this study was to explore the experiences of Indigenous persons with arthritis and healthcare providers involved in this model of care to inform the development of health service improvements that enhance patient outcomes.Methods This was a narrative-based qualitative study involving a purposeful sample of 32 individuals involved in the Indigenous rheumatology model of care. Semi-structured in-depth interviews were conducted to elicit experiences with the existing model of care and to encourage reflections on opportunities to improve it. A two-stage analysis was conducted. The first stage aimed to produce a narrative synthesis of sensitizing concepts through a dialogical method comparing people with arthritis and health providers’ narratives. The second stage involved a collective effort to crystalize these sensitizing concepts in specific recommendations to improve the quality of the current model of care. Triangulation, through participant checking and discussion among researchers, was used to increase the validity of the final recommendations.Results Ten Indigenous people with arthritis lived experience, 14 health providers and 8 administrative staff were interviewed. One main overarching theme was identified, which reflected the need to provide services that improve people’s functioning. Further, the following specific recommendations were identified: 1) enhancing patient-provider communication, 2) improving the continuity of the healthcare service, 3) increasing community awareness about the presence and negative impact of arthritis, and 4) increasing peer connections and support among people living with arthritis.Conclusions Improving the quality of the current Indigenous rheumatology model of care requires implementing strategies that improve functioning, patient-provider communication, continuity of care, community awareness and peer support. A community facilitator in a role of a patient navigator could facilitate the implementation of these strategies.

scholarly journals “There are still a lot of things that I need”: a qualitative study exploring opportunities to improve the health services of First Nations People with arthritis seen at an on-reserve outreach rheumatology clinic

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Adalberto Loyola-Sanchez ◽  
Ingris Pelaez-Ballestas ◽  
Lynden Crowshoe ◽  
Diane Lacaille ◽  
Rita Henderson ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health Services ◽  
First Nations ◽  
Provider Communication ◽  
Health Providers ◽  
Model Of Care ◽  
Community Awareness ◽  
Patient Reported ◽  
Patient Provider Communication

Abstract Background Arthritis is a highly prevalent disease and leading cause of disability in the Indigenous population. A novel model of care consisting of a rheumatology outreach clinic in an on-reserve primary healthcare center has provided service to an Indigenous community in Southern Alberta since 2010. Despite quality assessments suggesting this model of care improves accessibility and is effective in meeting treatment targets, substantial improvements in patient-reported outcomes have not been realized. Therefore, the objective of this study was to explore the experiences of Indigenous persons with arthritis and healthcare providers involved in this model of care to inform the development of health service improvements that enhance patient outcomes. Methods This was a narrative-based qualitative study involving a purposeful sample of 32 individuals involved in the Indigenous rheumatology model of care. In-depth interviews were conducted to elicit experiences with the existing model of care and to encourage reflections on opportunities to improve it. A two-stage analysis was conducted. The first stage aimed to produce a narrative synthesis of concepts through a dialogical method comparing people with arthritis and health providers’ narratives. The second stage involved a collective effort to synthesize concepts and propose specific recommendations to improve the quality of the current model of care. Triangulation, through participant checking and discussion among researchers, was used to increase the validity of the final recommendations. Results Ten Indigenous people with arthritis lived experience, 14 health providers and 8 administrative staff were interviewed. One main overarching theme was identified, which reflected the need to provide services that improve people’s physical and mental functioning. Further, the following specific recommendations were identified: 1) enhancing patient-provider communication, 2) improving the continuity of the healthcare service, 3) increasing community awareness about the presence and negative impact of arthritis, and 4) increasing peer connections and support among people living with arthritis. Conclusions Improving the quality of the current Indigenous rheumatology model of care requires implementing strategies that improve functioning, patient-provider communication, continuity of care, community awareness and peer support. A community-based provider who supports people while navigating health services could facilitate the implementation of these strategies.

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