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The European Journal of General Practice Dec 2018In the course of our supervisory work over the years, we have noticed that qualitative research tends to evoke a lot of questions and worries, so-called frequently asked...
In the course of our supervisory work over the years, we have noticed that qualitative research tends to evoke a lot of questions and worries, so-called frequently asked questions (FAQs). This series of four articles intends to provide novice researchers with practical guidance for conducting high-quality qualitative research in primary care. By 'novice' we mean Master's students and junior researchers, as well as experienced quantitative researchers who are engaging in qualitative research for the first time. This series addresses their questions and provides researchers, readers, reviewers and editors with references to criteria and tools for judging the quality of qualitative research papers. The second article focused on context, research questions and designs, and referred to publications for further reading. This third article addresses FAQs about sampling, data collection and analysis. The data collection plan needs to be broadly defined and open at first, and become flexible during data collection. Sampling strategies should be chosen in such a way that they yield rich information and are consistent with the methodological approach used. Data saturation determines sample size and will be different for each study. The most commonly used data collection methods are participant observation, face-to-face in-depth interviews and focus group discussions. Analyses in ethnographic, phenomenological, grounded theory, and content analysis studies yield different narrative findings: a detailed description of a culture, the essence of the lived experience, a theory, and a descriptive summary, respectively. The fourth and final article will focus on trustworthiness and publishing qualitative research.
Topics: Data Collection; Grounded Theory; Humans; Primary Health Care; Qualitative Research; Research Design; Research Personnel; Sample Size
PubMed: 29199486
DOI: 10.1080/13814788.2017.1375091 -
Journal of Health Organization and... Feb 2020The importance of hospital board engagement in the work of governing healthcare quality has been demonstrated in the literature. Research into influences on effective... (Comparative Study)
Comparative Study
PURPOSE
The importance of hospital board engagement in the work of governing healthcare quality has been demonstrated in the literature. Research into influences on effective corporate governance has traditionally focused on board architecture. Emerging research is bringing to light the importance of governance dynamics. This paper contributes to emerging research through highlighting how communication and leadership underpin effective engagement in governing healthcare quality.
DESIGN/METHODOLOGY/APPROACH
A comparative case study of eight Australian public hospitals was undertaken involving document review, interviews and observations. Case studies were allocated into high- or low-engagement categories based on evidence of governance processes being undertaken, in order to compare and contrast influencing factors. Thematic analysis was undertaken to explore how communication and leadership influence healthcare governance.
FINDINGS
Several key components of communication and leadership are shown to influence healthcare quality governance. Clear logical narratives in reporting, open communication, effective questioning and challenge from board members are important elements of communication found to influence engagement. Leadership that has a focus on healthcare excellence and quality improvement are aligned and promote effective meeting processes is also found to foster governance engagement. Effective engagement in these communication and leadership processes facilitate valuable reflexivity at the governance level.
PRACTICAL IMPLICATIONS
The findings highlight the way in which boards and senior managers can strengthen governance effectiveness through attention to key aspects of communication and leadership.
ORIGINALITY/VALUE
The case study approach allows the exploration of communication and leadership in greater depth than previously undertaken at the corporate governance level in the healthcare setting.
Topics: Australia; Communication; Databases, Factual; Delivery of Health Care; Hospitals, Public; Interviews as Topic; Leadership; Observation; Organizational Case Studies
PubMed: 32239875
DOI: 10.1108/JHOM-07-2019-0194 -
PM & R : the Journal of Injury,... Sep 2017Cancer and its treatments introduce various adverse effects that may affect survivors' physical, cognitive and psychological functioning. Frequently both tolerance to... (Review)
Review
Cancer and its treatments introduce various adverse effects that may affect survivors' physical, cognitive and psychological functioning. Frequently both tolerance to activity and exercise are affected as well. Rehabilitation providers should have substantive knowledge about the effect of cancer progression and common side effects associated with antineoplastic treatment to safely integrate rehabilitation interventions. Rehabilitation may mitigate loss of function and disability; however, these patients are among the most medically complex that providers treat. This report provides a focused review that synthesizes the current evidence regarding disease progression and oncology-directed treatment side effects within the context of safety considerations for rehabilitation interventions throughout the continuum of cancer care. Descriptive information regarding the evidence for precautions and contraindications is provided so that rehabilitation providers can promote a safe plan of rehabilitation care. It is incumbent upon but also challenging for rehabilitation providers to stay up to date on the many advances in cancer treatment, and there are many gaps in the literature regarding safety issues. Although further research is needed to inform care, this review provides clinicians with a framework to assess patients with the goal of safely initiating rehabilitation interventions.
Topics: Adult; Aged; Combined Modality Therapy; Disability Evaluation; Female; Humans; Male; Middle Aged; Neoplasms; Patient Safety; Patient Selection; Physical Therapy Modalities; Risk Assessment; Safety Management; Survivors
PubMed: 28942913
DOI: 10.1016/j.pmrj.2017.08.403 -
BMJ (Clinical Research Ed.) Aug 2017While the patient and public involvement (PPI) evidence base has expanded over the past decade, the quality of reporting within papers is often inconsistent, limiting...
While the patient and public involvement (PPI) evidence base has expanded over the past decade, the quality of reporting within papers is often inconsistent, limiting our understanding of how it works, in what context, for whom, and why. To develop international consensus on the key items to report to enhance the quality, transparency, and consistency of the PPI evidence base. To collaboratively involve patients as research partners at all stages in the development of GRIPP2. The EQUATOR method for developing reporting guidelines was used. The original GRIPP (Guidance for Reporting Involvement of Patients and the Public) checklist was revised, based on updated systematic review evidence. A three round Delphi survey was used to develop consensus on items to be included in the guideline. A subsequent face-to-face meeting produced agreement on items not reaching consensus during the Delphi process. 143 participants agreed to participate in round one, with an 86% (123/143) response for round two and a 78% (112/143) response for round three. The Delphi survey identified the need for long form (LF) and short form (SF) versions. GRIPP2-LF includes 34 items on aims, definitions, concepts and theory, methods, stages and nature of involvement, context, capture or measurement of impact, outcomes, economic assessment, and reflections and is suitable for studies where the main focus is PPI. GRIPP2-SF includes five items on aims, methods, results, outcomes, and critical perspective and is suitable for studies where PPI is a secondary focus. GRIPP2-LF and GRIPP2-SF represent the first international evidence based, consensus informed guidance for reporting patient and public involvement in research. Both versions of GRIPP2 aim to improve the quality, transparency, and consistency of the international PPI evidence base, to ensure PPI practice is based on the best evidence. In order to encourage its wide dissemination this article is freely accessible on and journal websites.
Topics: Checklist; Community Participation; Consensus; Cooperative Behavior; Delphi Technique; Diffusion of Innovation; Health Services Research; Humans; Program Development; Reproducibility of Results; Research Design
PubMed: 28768629
DOI: 10.1136/bmj.j3453 -
The Journal of Investigative Dermatology Jun 2015
Topics: Academic Medical Centers; Diffusion of Innovation; Humans; Models, Organizational; Research Design; Research Support as Topic; Translational Research, Biomedical; Universities
PubMed: 25964262
DOI: 10.1038/jid.2015.5 -
European Journal of Vascular and... Apr 2020
Topics: Biomedical Research; Quality Improvement; Registries; Vascular Surgical Procedures
PubMed: 32179003
DOI: 10.1016/j.ejvs.2020.02.014 -
American Journal of Physiology. Renal... Mar 2021The Vanderbilt O'Brien Kidney Center (VOKC) is one of the eight National Institutes of Health P30-funded centers in the United States. The mission of these core-based... (Review)
Review
The Vanderbilt O'Brien Kidney Center (VOKC) is one of the eight National Institutes of Health P30-funded centers in the United States. The mission of these core-based centers is to provide technical and conceptual support to enhance and facilitate research in the field of kidney diseases. The goal of the VOKC is to provide support to understand mechanisms and identify potential therapies for acute and chronic kidney disease. The services provided by the VOKC are meant to help the scientific community to have the right support and tools as well as to select the right animal model, statistical analysis, and clinical study design to perform innovative research and translate discoveries into personalized care to prevent, diagnose, and cure kidney disease. To achieve these goals, the VOKC has in place a program to foster collaborative investigation into critical questions of kidney disease, to personalize diagnosis and treatment of kidney disease, and to disseminate information about kidney disease and the benefits of VOKC services and research. The VOKC is complemented by state-of-the-art cores and an education and outreach program whose goals are to provide an educational platform to enhance the study of kidney disease, to publicize information about services available through the VOKC, and to provide information about kidney disease to patients and other interested members of the community. In this review, we highlight the major services and contributions of the VOKC.
Topics: Animals; Biomedical Research; Community-Institutional Relations; Cooperative Behavior; Education, Professional; Health Education; Humans; Interdisciplinary Communication; Nephrology; Research Design; Tennessee
PubMed: 33356958
DOI: 10.1152/ajprenal.00452.2020 -
BMJ Health & Care Informatics Aug 2020Electronic medication systems (EMS) have been highly effective in reducing prescribing errors, but little research has investigated their effects on medication...
Changes in medication administration error rates associated with the introduction of electronic medication systems in hospitals: a multisite controlled before and after study.
BACKGROUND
Electronic medication systems (EMS) have been highly effective in reducing prescribing errors, but little research has investigated their effects on medication administration errors (MAEs).
OBJECTIVE
To assess changes in MAE rates and types associated with EMS implementation.
METHODS
This was a controlled before and after study (three intervention and three control wards) at two adult teaching hospitals. Intervention wards used an EMS with no bar-coding. Independent, trained observers shadowed nurses and recorded medications administered and compliance with 10 safety procedures. Observational data were compared against medication charts to identify errors (eg, wrong dose). Potential error severity was classified on a 5-point scale, with those scoring ≥3 identified as serious. Changes in MAE rates preintervention and postintervention by study group, accounting for differences at baseline, were calculated.
RESULTS
7451 administrations were observed (4176 pre-EMS and 3275 post-EMS). At baseline, 30.2% of administrations contained ≥1 MAE, with wrong intravenous rate, timing, volume and dose the most frequent. Post-EMS, MAEs decreased on intervention wards relative to control wards by 4.2 errors per 100 administrations (95% CI 0.2 to 8.3; p=0.04). Wrong timing errors alone decreased by 3.4 per 100 administrations (95% CI 0.01 to 6.7; p<0.05). EMS use was associated with an absolute decline in potentially serious MAEs by 2.4% (95% CI 0.8 to 3.9; p=0.003), a 56% reduction in the proportion of potentially serious MAEs. At baseline, 74.1% of administrations were non-compliant with ≥1 of 10 procedures and this rate did not significantly improve post-EMS.
CONCLUSIONS
Implementation of EMS was associated with a modest, but significant, reduction in overall MAE rate, but halved the proportion of MAEs rated as potentially serious.
Topics: Drug Administration Schedule; Efficiency, Organizational; Hospitals, Teaching; Humans; Medication Errors; Medication Systems, Hospital; Pharmaceutical Preparations
PubMed: 32796084
DOI: 10.1136/bmjhci-2020-100170 -
Journal of Neuro-ophthalmology : the... Sep 2020Supplemental Digital Content is Available in the Text. (Review)
Review
Supplemental Digital Content is Available in the Text.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Delivery of Health Care; Eye Diseases; Health Plan Implementation; Humans; Neurology; Ophthalmology; Pandemics; Patient Selection; Pneumonia, Viral; Remote Consultation; SARS-CoV-2; Telemedicine
PubMed: 32604249
DOI: 10.1097/WNO.0000000000001024 -
World Journal of Gastroenterology Mar 2016With the growing number of patients in need of liver transplantation, there is a need for adopting new and modifying existing allocation policies that prioritize... (Review)
Review
With the growing number of patients in need of liver transplantation, there is a need for adopting new and modifying existing allocation policies that prioritize patients for liver transplantation. Policy should ensure fair allocation that is reproducible and strongly predictive of best pre and post transplant outcomes while taking into account the natural history of the potential recipients liver disease and its complications. There is wide acceptance for allocation policies based on urgency in which the sickest patients on the waiting list with the highest risk of mortality receive priority. Model for end-stage liver disease and Child-Turcotte-Pugh scoring system, the two most universally applicable systems are used in urgency-based prioritization. However, other factors must be considered to achieve optimal allocation. Factors affecting pre-transplant patient survival and the quality of the donor organ also affect outcome. The optimal system should have allocation prioritization that accounts for both urgency and transplant outcome. We reviewed past and current liver allocation systems with the aim of generating further discussion about improvement of current policies.
Topics: Decision Support Techniques; Delivery of Health Care; Donor Selection; End Stage Liver Disease; Healthcare Disparities; Humans; Liver Transplantation; Models, Organizational; Patient Selection; Predictive Value of Tests; Risk Assessment; Risk Factors; Tissue Donors; Tissue and Organ Procurement; Treatment Outcome; Waiting Lists
PubMed: 26973389
DOI: 10.3748/wjg.v22.i10.2922