scholarly journals Effectiveness of Anti-Corruption Agencies in East Africa: Kenya, Tanzania and Uganda

2016 ◽  
Keyword(s):  
Best Practices ◽  
East Africa ◽  
National Level ◽  
Evidence Based ◽  
African Union ◽  
Strategic Positioning ◽  
Public Servants ◽  
Laws And Policies ◽  
National Ownership ◽  
Current Report

With reportedly over USD50 billion lost annually through graft and illicit practices, combating corruption in Africa has been challenging. However, laws and policies at the continental, regional and national levels have been promulgated and enacted by African leaders. These initiatives have included the establishment of anti-corruption agencies mandated to tackle graft at national level, as well as coordinate bodies at regional and continental levels to ensure the harmonisation of normative standards and the adoption of best practices in the fight against corruption. Yet, given the disparity between the apparent impunity enjoyed by public servants and the anti-corruption rhetoric of governments in the region, the effectiveness of these agencies is viewed with scepticism. This continent-wide study of anti-corruption agencies aims to gauge their relevance and effectiveness by assessing their independence, mandate, available resources, national ownership, capacities and strategic positioning. These surveys include evidence-based recommendations calling for stronger, more relevant and effective institutions that are directly aligned to regional and continental anti-corruption frameworks, such as the African Union Convention on Preventing and Combating Corruption (AUCPCC), which the three countries in this current report Kenya, Tanzania and Uganda have all ratified.

Human Factors Considerations for Patients: A Cursory Review of Telehealth Guidelines

2021 ◽  
Vol 65 (1) ◽  
pp. 943-947
Author(s):  
Sarah A. Powers ◽  
Kimberly N. Perry ◽  
Amanda J. Ashdown ◽  
Matthew Pacailler ◽  
Mark W. Scerbo
Keyword(s):  
Best Practices ◽  
Human Factors ◽  
Healthcare Providers ◽  
Evidence Based ◽  
Environmental Requirements ◽  
Laws And Policies

During the COVID-19 pandemic, changes to telehealth laws and policies enabled more patients to meet with their healthcare providers remotely. The rapid implementation of telehealth has resulted in providers and patients interacting remotely with few existing standards or guidelines. Additionally, a cursory search of telehealth guidelines for patients revealed overly broad recommendations related to technology, security, and environmental requirements. Although researchers have recommended some human factors considerations for guidelines, these recommendations were rarely implemented in the guidelines we reviewed. Therefore, human factors professionals can contribute further by implementing best practices for telehealth appointments to create evidence-based standardized guidelines. Some initial areas to focus on include accessibility for patients, overcoming typical telehealth barriers, and addressing a wider diversity of patients.

Differences for managing mother’s own milk for very preterm infants across 11 European countries

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Rodrigues ◽  
J Zeitlin ◽  
E Wilson ◽  
L Toome ◽  
M Cuttini ◽  
...  
Keyword(s):  
Intensive Care ◽  
Best Practices ◽  
Neonatal Intensive Care ◽  
National Level ◽  
European Countries ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Mother’S Own Milk

Abstract Background There is an ongoing debate about the best practices to handle mother's own milk (MOM) for infants born very preterm (VPT, ≤32 weeks of gestation), specifically to prevent the human cytomegalovirus (HCMV) transmission and bacterial contamination of expressed MOM. Thus, we aimed to compare practices for managing MOM for VPT infants in European neonatal intensive care units (NICUs). Methods Data were collected as part of the EPICE (Effective Perinatal Intensive Care in Europe) study which explored the use of evidence-based practices for the care of VPT infants in 11 European countries. Structured questionnaires were sent to the head of all participating NICUs with at least 10 VPT admissions. Of the eligible 135 NICUs, 134 replied. Results A written protocol for breastfeeding/human milk use was available in 91% of the NICUs. Overall, 34% used human bank milk for all VPT infants whose mothers did not express and 56% reported using fresh MOM without restrictions regarding minimum gestational age, birth weight or risk of HCMV transmission (country range: 0-100%). In 22% of units all VPT infants received MOM pasteurized (country range: 0-73%). HCMV serology on all mothers who express their milk was not required in 71% of units (country range: 7-100%). Among NICUs that performed HCMV serology, 3% provided untreated fresh MOM and 23.5% formula in the case of positive mothers. Systematic bacteriological analyses of MOM were not performed in 76% NICUs (country range: 29-100%) while less than 10% did it for the first milk feeding, 7% every week and 8% with another frequency. Conclusions There are large variations in managing MOM across countries, which could reflect differences in regulations or guidelines, and among the same country NICUs, revealing that different options can operate locally. This variability suggests substantial differences in attitudes about what constitutes best practices among European neonatologists. Key messages We found significant differences across and within European countries for managing MOM for VPT infants suggesting lack of strong recommendations at the international and national level. There is wide variation in what European neonatologists consider best practices. To guide practice and not jeopardise VPT infants from MOM we need strong evidence-based data.

Best Practices for Data Visualization: Creating and Evaluating a Report for an Evidence-Based Fall Prevention Program (Preprint)

2018 ◽  
Author(s):  
Srijesa Khasnabish ◽  
Zoe Burns ◽  
Madeline Couch ◽  
Mary Mullin ◽  
Randall Newmark ◽  
...  
Keyword(s):  
Literature Review ◽  
Best Practices ◽  
Implementation Science ◽  
Data Visualization ◽  
Systematic Literature Review ◽  
Fall Prevention ◽  
Prevention Program ◽  
Evidence Based ◽  
Data Display ◽  
Fall Prevention Program

BACKGROUND Data visualization experts have identified core principles to follow when creating visual displays of data that facilitate comprehension. Such principles can be applied to creating effective reports for clinicians that display compliance with quality improvement protocols. A basic tenet of implementation science is continuous monitoring and feedback. Applying best practices for data visualization to reports for clinicians can catalyze implementation and sustainment of new protocols. OBJECTIVE To apply best practices for data visualization to create reports that clinicians find clear and useful. METHODS First, we conducted a systematic literature review to identify best practices for data visualization. We applied these findings and feedback collected via a questionnaire to improve the Fall TIPS Monthly Report (FTMR), which shows compliance with an evidence-based fall prevention program, Fall TIPS (Tailoring Interventions for Patient Safety). This questionnaire was based on the requirements for effective data display suggested by expert Stephen Few. We then evaluated usability of the FTMR using a 15-item Health Information Technology Usability Evaluation Scale (Health-ITUES). Items were rated on a 5-point Likert scale from strongly disagree (1) to strongly agree (5). RESULTS The results of the systematic literature review emphasized that the ideal data display maximizes the information communicated while minimizing the cognitive efforts involved with data interpretation. Factors to consider include selecting the correct type of display (e.g. line vs bar graph) and creating simplistic reports. The qualitative and quantitative evaluations of the original and final FTMR revealed improved perceptions of the visual display of the reports and their usability. Themes that emerged from the staff interviews emphasized the value of simplified reports, meaningful data, and usefulness to clinicians. The mean (SD) rating on the Health-ITUES scale when evaluating the original FTMR was 3.86 (0.19) and increased to 4.29 (0.11) when evaluating the revised FTMR (Mann Whitney U Test, z=-12.25, P<0.001). CONCLUSIONS Best practices identified through a systematic review can be applied to create effective reports for clinician use. The lessons learned from evaluating FTMR perceptions and measuring usability can be applied to creating effective reports for clinician use in the context of other implementation science projects.

scholarly journals Engaging Multidisciplinary Stakeholders to Drive Shared Decision-Making in Oncology

2018 ◽  
Vol 34 (1) ◽  
pp. 29-31 ◽  
Author(s):  
Gabrielle Rocque ◽  
Ellen Miller-Sonnet ◽  
Alan Balch ◽  
Carrie Stricker ◽  
Josh Seidman ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Best Practices ◽  
Shared Decision Making ◽  
Best Practice ◽  
Care Delivery ◽  
Evidence Based ◽  
Shared Decision ◽  
Oncology Practice ◽  
Development And Validation

Although recognized as best practice, regular integration of shared decision-making (SDM) approaches between patients and oncologists remains an elusive goal. It is clear that usable, feasible, and practical tools are needed to drive increased SDM in oncology. To address this goal, we convened a multidisciplinary collaborative inclusive of experts across the health-care delivery ecosystem to identify key principles in designing and testing processes to promote SDM in routine oncology practice. In this commentary, we describe 3 best practices for addressing challenges associated with implementing SDM that emerged from a multidisciplinary collaborative: (1) engagement of diverse stakeholders who have interest in SDM, (2) development and validation of an evidence-based SDM tool grounded within an established conceptual framework, and (3) development of the necessary roadmap and consideration of the infrastructure needed for engendering patient engagement in decision-making. We believe these 3 principles are critical to the success of creating SDM tools to be utilized both within and outside of clinical practice. We are optimistic that shared use across settings will support adoption of this tool and overcome barriers to implementing SDM within busy clinical workflows. Ultimately, we hope that this work will offer new perspectives on what is important to patients and provide an important impetus for leveraging patient preferences and values in decision-making.

scholarly journals Evaluating the national multisite implementation of dialectical behaviour therapy in a community setting: A mixed methods approach

2019 ◽  
Author(s):  
Daniel Flynn ◽  
Mary Joyce ◽  
Conall Gillespie ◽  
Mary Kells ◽  
Michaela Swales ◽  
...  
Keyword(s):  
Mixed Methods ◽  
National Level ◽  
Team Leader ◽  
Barriers And Facilitators ◽  
Future Research ◽  
Evidence Based ◽  
Community Settings ◽  
Team Leaders ◽  
Implementation Framework ◽  
Mixed Methods Approach

Abstract Background The implementation of evidence-based interventions for borderline personality disorder in community settings is important given that individuals with this diagnosis are often extensive users of both inpatient and outpatient mental health services. Although work in this area is limited, previous studies have identified facilitators and barriers to successful DBT implementation. This study seeks to expand on previous work by evaluating a coordinated implementation of DBT in community settings at a national level. The Consolidated Framework for Implementation Research (CFIR) [1] provided structural guidance for this national level coordinated implementation.Methods A mixed methods approach was utilised to explore the national multi-site implementation of DBT from the perspective of team leaders and therapists who participated in the coordinated training and subsequent implementation of DBT. Qualitative interviews with DBT team leaders ( n = 8) explored their experiences of implementing DBT in their local service and was analysed using content analysis. Quantitative surveys from DBT therapists ( n = 74) examined their experience of multiple aspects of the implementation process including orienting the system, and preparations and support for implementation. Frequencies of responses were calculated. Written qualitative feedback was analysed using content analysis.Results Five themes were identified from the interview data: team formation, implementation preparation, client selection, service level challenges and team leader role. Participants identified team size and support for the team leader as key points for consideration in DBT implementation. Key challenges encountered were the lack of system support to facilitate phone coaching and a lack of allocated time to focus on DBT. Implementation facilitators included having dedicated team members and support from management.Conclusions The barriers and facilitators identified in this study are broadly similar to those reported in previous research. Barriers and facilitators were identified across several domains of the CFIR and are consistent with a recently published DBT implementation Framework [2]. Future research should pay particular attention to the domain of characteristics of individuals involved in DBT implementation. The results highlight the importance of a mandated service plan for the coordinated implementation of an evidence-based treatment in a public health service.

scholarly journals Development of an assessment and intervention protocol for postpartum hemorrhage in the mainland of China: an evidence-based method and Delphi consult

2019 ◽  
Vol 6 (4) ◽  
pp. 285-291
Author(s):  
Ying Liu ◽  
Ya-Jing Fan ◽  
Wei Zhuang ◽  
Qun Huang
Keyword(s):  
Best Practices ◽  
Delphi Method ◽  
Postpartum Hemorrhage ◽  
Selection Criteria ◽  
Evidence Based ◽  
Early Assessment ◽  
Modified Delphi ◽  
Intervention Protocol ◽  
The Mainland Of China ◽  
Assessment Questionnaire

Abstract Objective Postpartum hemorrhage (PPH) is a leading cause of maternal death. Although guidelines have been updated, those with detailed protocols are limited for nursing practice. This study aims at establishing an early assessment and intervention protocol as a toolkit for PPH for midwives and obstetrical nurses. Methods Employing the evidence-based method, a systematic Internet search of guidelines was conducted and appraisal of literatures was conducted with AGREE system and Oxman-Guyatt Overview Quality Assessment Questionnaire (OQAQ), according to which a protocol draft was therefore developed. Then, a two-round modified Delphi method was utilized to reach a consensus of the protocol built on best practices. Selection criteria for each intervention measure included consensus level with a threshold of 70%, mean of importance (M) >3.5, and coefficient of variation (CV) <0.25. Reliability of experts’ opinion was calculated by positive coefficient and authoritative coefficient. Items without consistency were enlisted in the second-round consult. When all items met the selection criteria, the protocol would be finally formulated. Results A 122-measure protocol was established, including prevention, assessment, and intervention of PPH. With a panel of 14 experts participated in the consult, the positivity coefficient was 0.93 and 1.00 for two rounds, respectively, and the authority coefficient was 0.88. After a two-round consult and revision of the draft, the final program was formulated, containing 5 first-level indexes and 14 second-level indexes with a total item of 120. Conclusions The PPH protocol, based on high-quality evidences, was formulated with a two-round Delphi method, which can provide insight for midwives and obstetrical nurses to effectively deal with PPH.

scholarly journals Rethinking Streets for Physical Distancing

2021 ◽  
Author(s):  
Marc Schlossberg ◽  
◽  
Rebecca Lewis ◽  
Aliza Whalen ◽  
Clare Haley ◽  
...  
Keyword(s):  
Best Practices ◽  
Case Studies ◽  
Evidence Based ◽  
The Third ◽  
Spatial Equity ◽  
Outdoor Space ◽  
Primary Output ◽  
Page Book

This report summarizes the primary output of this project, a book of COVID-era street reconfiguration case studies called Rethinking Streets During COVID-19: An Evidence-Based Guide to 25 Quick Redesigns for Physical Distancing, Public Use, and Spatial Equity. COVID-era needs have accelerated the process that many communities use to make street transformations due to: a need to remain physically distanced from others outside our immediate household; a need for more outdoor space close to home in every part of every community to access and enjoy; a need for more space to provide efficient mobility for essential workers in particular; and a need for more space for local businesses as they try to remain open safely. This project is the third in a series of NITC-supported case study books on best practices in street reconfigurations for more active, sustainable, and in this case, COVID-supportive uses. The full, 154-page book is available for free download from the National Institute for Transportation and Communities (NITC).

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