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BMJ Open Quality Apr 2022Hand hygiene is a fundamental action which is simple, inexpensive and an effective tool in reducing hospital-acquired infections, yet compliance remains low in...
BACKGROUND
Hand hygiene is a fundamental action which is simple, inexpensive and an effective tool in reducing hospital-acquired infections, yet compliance remains low in healthcare settings. In 2014, Changi General Hospital embarked on a pilot project to improve hand hygiene compliance in a pilot ward with the intention to eventually spread a multifaceted set of interventions hospital wide.
METHODS
A before and after interventional study of a pilot project. Hand hygiene data collection was through direct observations by auditors using WHO monitoring standards and techniques based on the five-moment model.
SETTING
A medical ward in an acute hospital in Singapore.
RESULTS
Overall hand hygiene compliance improved from a median of 53% in 2015 to 80% by end of 2017. Hand hygiene compliance of doctors increased from 43% to 60% (p=0.00), nurses from 62% to 89% (p=0.014) and allied health staff from 67% to 83% (p=0.002).
CONCLUSIONS
A multifaceted set of interventions developed by the project team was effective in improving hand hygiene compliance of doctors, nurses and allied health staff.
Topics: Cross Infection; Hand Hygiene; Hospitals; Humans; Physicians; Pilot Projects
PubMed: 35393292
DOI: 10.1136/bmjoq-2021-001659 -
Applied Clinical Informatics Aug 2021Pilot-testing is important in standards development because it facilitates agile navigation of the gap between needs for and use of standards in real-world settings and...
BACKGROUND
Pilot-testing is important in standards development because it facilitates agile navigation of the gap between needs for and use of standards in real-world settings and can reveal the practicalities of implementation. As the implementation and use of health data standards are usually more complicated than anticipated, the Office of the National Coordinator for Health Information Technology (ONC) routinely oversees and organizes relevant pilot projects.
OBJECTIVES
This article provides an in-depth look into a sample of ONC's standards-focused pilot projects to (1) inform readers of the complexities of developing, implementing, and advancing standards and (2) guide those seeking to evaluate new standards through pilot projects.
METHODS
The ONC's approach to conducting pilot projects begins with identifying a clinical care need, research requirement, or policy outcome that is not well supported by existing standards through a landscape review. ONC then selects a testing approach based on the identified need and maturity of relevant standards. Next, ONC identifies use cases and sites to pilot-test the relevant standard. Once complete, ONC publishes a report that informs subsequent projects and standards development.
RESULTS
Pilot projects presented here are organized into three categories related to their demonstrated focus and related approach: (1) improving standards for presenting and sharing clinical genetic data, (2) accelerating the development and implementation of new standards, and (3) facilitating clinical data reuse. Each project illustrates the pilot approach from inception to next steps, capturing the role of collaboration among standards development organizations, stakeholders, and end-users to ensure standards are practical and fit for purpose.
CONCLUSION
The ONC approach identifies implementation difficulties prior to broader adoption and use of standards, and provides insight into the steps needed to scale use of standards. The ONC's organization of pilot projects serves as a natural accelerator for building communities of practice, often providing a well-connected beneficiary of lessons learned.
Topics: Medical Informatics; Pilot Projects
PubMed: 34380169
DOI: 10.1055/s-0041-1731677 -
BMC Geriatrics Jan 2023In 2015, a plan for integrated care was launched by the Belgium government that resulted in the implementation of 12 integrated care pilot project across Belgium. The...
BACKGROUND
In 2015, a plan for integrated care was launched by the Belgium government that resulted in the implementation of 12 integrated care pilot project across Belgium. The pilot project Zorgzaam Leuven consists of a multidisciplinary local consortium aiming to bring lasting change towards integrated care for the region of Leuven. This study aims to explore experiences and perceptions of stakeholders involved in four transitional care actions that are part of Zorgzaam Leuven.
METHODS
This qualitative case study is part of the European TRANS-SENIOR project. Four actions with a focus on improving transitional care were selected and stakeholders involved in those actions were identified using the snow-ball method. Fourteen semi-structured interviews were conducted and inductive thematic analysis was performed.
RESULTS
Professionals appreciated to be involved in the decision making early onwards either by proposing own initiatives or by providing their input in shaping actions. Improved team spirit and community feeling with other health care professionals (HCPs) was reported to reduce communication barriers and was perceived to benefit both patients and professionals. The actions provided supportive tools and various learning opportunities that participants acknowledged. Technical shortcomings (e.g. lack of integrated patient records) and financial and political support were identified as key challenges impeding the sustainable implementation of the transitional care actions.
CONCLUSION
The pilot project Zorgzaam Leuven created conditions that triggered work motivation for HCPs. It supported the development of multidisciplinary care partnerships at the local level that allowed early involvement and increased collaboration, which is crucial to successfully improve transitional care for vulnerable patients.
Topics: Humans; Belgium; Pilot Projects; Transitional Care; Qualitative Research; Delivery of Health Care, Integrated; Perception
PubMed: 36690954
DOI: 10.1186/s12877-023-03746-z -
Global Health, Science and Practice Mar 2021Community clinics (CCs) staffed by community health workers (CHWs) represent an effort of the Government of Bangladesh to strengthen the grassroots provision of primary...
BACKGROUND
Community clinics (CCs) staffed by community health workers (CHWs) represent an effort of the Government of Bangladesh to strengthen the grassroots provision of primary health care services and to accelerate progress in achieving universal health coverage. The Improving Community Health Workers (ICHWs) Project of Save the Children piloted a CC-centered health service (CCHS) model that strengthened community and local government engagement, harmonized the work of different CHW cadres who were working in the same catchment area of each CC, and improved the accountability of CHWs and the CC to the local community.
METHODS
We describe the process for developing and implementing the CCHS model in 6 unions in Barishal District where the model was piloted and provide some early qualitative and quantitative findings pertaining to the model's effectiveness. Data were collected from CCs in the 6 pilot unions and 6 other unions that served as a control. Qualitative data were collected from the intervention area during the pre-pilot (October 2017-September 2018) and pilot phase (October 2018-September 2019). Document review, key informant interviews, and focus group discussions were also conducted. Maternal and child health service utilization data were extracted from the government health information system in both the intervention and control areas.
RESULTS
Community group meetings ensured engagement with local government authorities and supported resource mobilization. There was greater coordination of work among CHWs and increased motivation of CHWs to better serve their clients. The analysis showed that the increase in maternal health consultations was substantially greater in the intervention area than in the control area, as was the number of referrals for higher-level care.
CONCLUSION
The CCHS model as applied in this pilot project is effective in engaging local key stakeholders, increasing CHW capacity, and improving client satisfaction. The model demonstrated that a community health system can be strengthened by a comprehensive approach that engages communities and local government officials and that harmonizes the work of CHWs.
Topics: Bangladesh; Child; Community Health Services; Community Health Workers; Humans; Pilot Projects; Primary Health Care; Qualitative Research
PubMed: 33727329
DOI: 10.9745/GHSP-D-20-00466 -
BMC Cancer Aug 2022This analysis presents the outcomes of the operations of the National Cancer Network (NCN) pilot project in Lower Silesian Voivodeship, Poland, for lung cancer for the...
The pilot project of the National Cancer Network in Poland: Assessment of the functioning of the National Cancer Network and results from quality indicators for lung cancer (2019-2021).
BACKGROUND
This analysis presents the outcomes of the operations of the National Cancer Network (NCN) pilot project in Lower Silesian Voivodeship, Poland, for lung cancer for the period of 2019-2021. The results concerning measures of the quality of medical processes were analysed.
METHODS
Twenty-one measures used to gauge the quality of oncological care for lung cancer were assessed. Data collection and processing for the purpose of calculating the measures were carried out as part of the NCN pilot project based on the Regulation of the Ministry of Health enacted on 13 December 2018. The measures were calculated at the Voivodeship Coordination Center, and the data were derived from the centres included in the network in the area of the analysed voivodeship.
RESULTS
A total of 3,638 patients diagnosed with lung cancer were enrolled in the NCN pilot program during the analysed period. For 3 measures, out of 21, target values were obtained. For 2 measures, the values differed significantly from the assumed target value.
CONCLUSION
In our opinion, the NCN pilot study, as a test of the network's functioning, meets the assumed goal. The NCN assessment is based on, inter alia, analysis of the outcomes of oncological quality of care measures for lung cancer, and facilitates monitoring of the quality of medical services provided and the identification of areas for improvement. In addition, the pilot program, which will last until the end of 2022, will allow for further in-depth analysis regarding the network's limitations before implementing the system on a national scale in Poland. This will be the subject of further investigation.
Topics: Data Collection; Humans; Lung Neoplasms; Pilot Projects; Poland; Quality Indicators, Health Care
PubMed: 36045330
DOI: 10.1186/s12885-022-10020-9 -
Bulletin of the World Health... Jun 2023To determine whether the positive results of a single-district pilot project focused on rectal artesunate administration at the community level in Zambia could be...
OBJECTIVE
To determine whether the positive results of a single-district pilot project focused on rectal artesunate administration at the community level in Zambia could be replicated on a larger scale.
METHODS
In partnership with government, in 10 rural districts during 2018-2021 we: (i) trained community health volunteers to administer rectal artesunate to children with suspected severe malaria and refer them to a health facility; (ii) supported communities to establish emergency transport, food banks and emergency savings to reduce referral delays; (iii) ensured adequate drug supplies; (iv) trained health workers to treat severe malaria with injectable artesunate; and (v) monitored severe malaria cases and associated deaths via surveys, health facility data and a community monitoring system.
RESULTS
Intervention communities accessed quality-assured rectal artesunate from trained community health volunteers, and follow-on treatment for severe malaria from health workers. Based on formal data from the health management information system, reported deaths from severe malaria reduced significantly from 3.1% (22/699; 95% confidence interval, CI: 2.0-4.2) to 0.5% (2/365; 95% CI: 0.0-1.1) in two demonstration districts, and from 6.2% (14/225; 95% CI: 3.6-8.8) to 0.6% (2/321; 95% CI: 0.0-1.3) in eight scale-up districts.
CONCLUSION
Despite the effects of the coronavirus disease, our results confirmed that pre-referral rectal artesunate administered by community health volunteers can be an effective intervention for severe malaria among young children. Our results strengthen the case for wider expansion of the pre-referral treatment in Zambia and elsewhere when combined with supporting interventions.
Topics: Child; Humans; Child, Preschool; Artesunate; Antimalarials; Zambia; Artemisinins; Pilot Projects; Malaria; Community Health Workers
PubMed: 37265679
DOI: 10.2471/BLT.22.289181 -
The Lancet. Planetary Health Sep 2023Inequity in access to urban greenspaces might contribute to health disparities in the USA via multiple pathways. Academic medical centres can promote health equity in... (Review)
Review
Inequity in access to urban greenspaces might contribute to health disparities in the USA via multiple pathways. Academic medical centres can promote health equity in their surrounding communities by partnering with community organisations to improve greenspace access in urban environments. Academic medical centres are also uniquely positioned to advance health-equity leadership among the next generation of doctors through medical-education initiatives; of particular importance is that medical professionals are involved in advocating for the expansion of greenspace access due to its direct relationship with human health and wellness. Furthermore, by focusing educational, research, and service endeavours on addressing the most important health issues within their communities, institutions could allocate some of their resources towards community greening as a form of preventive health investment. This Personal View describes our medical-student-led pilot project Philadelphia Towards Racial and Environmental Equity (Philly TREEs) at the Perelman School of Medicine (University of Pennsylvania, Philadelphia, PA, USA), which aims to improve tree equity and community wellness in Philadelphia. We highlight this project to show how academic medical institutions can help cities to achieve urban tree-canopy goals in an equitable way through community partnership and address disparities in the environment and in health.
Topics: Humans; Schools, Medical; Philadelphia; Forestry; Health Equity; Health Promotion; Pilot Projects
PubMed: 37673548
DOI: 10.1016/S2542-5196(23)00173-0 -
AMIA ... Annual Symposium Proceedings.... 2021After the emergence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in 2019, identification of immune correlates of protection (CoPs) have become...
After the emergence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in 2019, identification of immune correlates of protection (CoPs) have become increasingly important to understand the immune response to SARS-CoV-2. The vast amount of preprint and published literature related to COVID-19 makes it challenging for researchers to stay up to date on research results regarding CoPs against SARS-CoV-2. To address this problem, we developed a machine learning classifier to identify papers relevant to CoPs and a customized named entity recognition (NER) model to extract terms of interest, including CoPs, vaccines, assays, and animal models. A user-friendly visualization tool was populated with the extracted and normalized NER results and associated publication information including links to full-text articles and clinical trial information where available. The goal of this pilot project is to provide a basis for developing real-time informatics platforms that can inform researchers with scientific insights from emerging research.
Topics: Animals; COVID-19; Humans; Pilot Projects; SARS-CoV-2
PubMed: 35308924
DOI: No ID Found -
Community Mental Health Journal Nov 2023Autistic people may have difficulties in finding and keeping a job. Studies highlight that only 34% of autistic people are employed compared to 54% of people with...
Social Skills and Cognitive Training to Support Work-Related Skills and Job Placement in a Group of Autistic Adults : Effectiveness of a Neuropsychological and Social Skills Intervention: A Case Series Study on a Pilot Program.
Autistic people may have difficulties in finding and keeping a job. Studies highlight that only 34% of autistic people are employed compared to 54% of people with disability. 58% of people with ASD have never had a job. Social cognition and cognitive strains may also have a significant impact on working life. The primary goal of our project is supporting autistic people through a training program focused on neuropsychological and social skills training to improve participant' job skills. Through an Individual Placement and Support model the project involved various Partners to guide, identify skills and interests, provide cognitive and psychological support for autistic people. Results highlighted neuropsychological training efficacy, especially in inhibitory control and good rate of employment status at the end of the project. Findings are encouraging and underline the importance of a multidisciplinary approach to support autistic people in their work life considering their expectations, needs and inclinations.
Topics: Humans; Adult; Autistic Disorder; Social Skills; Cognitive Training; Pilot Projects; Employment
PubMed: 37318671
DOI: 10.1007/s10597-023-01152-8 -
Journal of Public Health Management and... 2018Small area data are key to better understanding the complex relationships between environmental health, health outcomes, and risk factors at a local level. In 2014, the...
OBJECTIVE
Small area data are key to better understanding the complex relationships between environmental health, health outcomes, and risk factors at a local level. In 2014, the Centers for Disease Control and Prevention's National Environmental Public Health Tracking Program (Tracking Program) conducted the Sub-County Data Pilot Project with grantees to consider integration of sub-county data into the National Environmental Public Health Tracking Network (Tracking Network).
DESIGN
The Tracking Program and grantees developed sub-county-level data for several data sets during this pilot project, working to standardize processes for submitting data and creating required geographies. Grantees documented challenges they encountered during the pilot project and documented decisions.
RESULTS
This article covers the challenges revealed during the project. It includes insights into geocoding, aggregation, population estimates, and data stability and provides recommendations for moving forward.
CONCLUSION
National standards for generating, analyzing, and sharing sub-county data should be established to build a system of sub-county data that allow for comparison of outcomes, geographies, and time. Increasing the availability and accessibility of small area data will not only enhance the Tracking Network's capabilities but also contribute to an improved understanding of environmental health and informed decision making at a local level.
Topics: Data Systems; Environmental Monitoring; Florida; Geographic Mapping; Humans; Information Dissemination; Local Government; Maine; New York; Pilot Projects; Public Health; Washington; Wisconsin
PubMed: 29227419
DOI: 10.1097/PHH.0000000000000686