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Evaluation and Program Planning Apr 2017The purpose of this scoping review was to identify promising factors that underpin effective health promotion collaborations, measurement approaches, and evaluation... (Review)
Review
The purpose of this scoping review was to identify promising factors that underpin effective health promotion collaborations, measurement approaches, and evaluation practices. Measurement approaches and evaluation practices employed in 14 English-language articles published between January 2001 and October 2015 were considered. Data extraction included research design, health focus of the collaboration, factors being evaluated, how factors were conceptualized and measured, and outcome measures. Studies were methodologically diverse employing either quantitative methods (n=9), mixed methods (n=4), or qualitative methods (n=1). In total, these 14 studies examined 113 factors, 88 of which were only measured once. Leadership was the most commonly studied factor but was conceptualized differently across studies. Six factors were significantly associated with outcome measures across studies; leadership (n=3), gender (n=2), trust (n=2), length of the collaboration (n=2), budget (n=2) and changes in organizational model (n=2). Since factors were often conceptualized differently, drawing conclusions about their impact on collaborative functioning remains difficult. The use of reliable and validated tools would strengthen evaluation of health promotion collaborations and would support and enhance the effectiveness of collaboration.
Topics: Cooperative Behavior; Health Promotion; Humans; Leadership; Program Evaluation; Reproducibility of Results; Research Design
PubMed: 27915114
DOI: 10.1016/j.evalprogplan.2016.11.013 -
Clinical Pharmacology and Therapeutics May 2019Medicines Adaptive Pathways to Patients (MAPPs) seeks to foster access to novel beneficial treatments for the right patient groups at the earliest appropriate time in... (Review)
Review
Medicines Adaptive Pathways to Patients (MAPPs) seeks to foster access to novel beneficial treatments for the right patient groups at the earliest appropriate time in the product life-span, in a sustainable fashion. We summarize the MAPPs engagement process and critical questions to be asked at each milestone of the product life-span. These considerations are of relevance for regulatory and access pathways that strive to address the "evidence vs. access" conundrum.
Topics: Drug Approval; Drugs, Investigational; Health Services Accessibility; Humans; Patient Selection; Risk Assessment; Time Factors
PubMed: 29901216
DOI: 10.1002/cpt.1121 -
The Journal of Thoracic and... May 2019
Topics: Cardiac Surgical Procedures; Delivery of Health Care, Integrated; Heart Valve Diseases; Heart Valves; Hospital Administration; Humans; Leadership; Marketing of Health Services; Minimally Invasive Surgical Procedures; Patient Care Team; Patient Safety; Patient Selection; Program Development; Program Evaluation; Quality Indicators, Health Care; Risk Assessment; Workload
PubMed: 30470541
DOI: 10.1016/j.jtcvs.2018.10.037 -
British Journal of Anaesthesia Apr 2013There is a growing literature on the relationship between team processes and clinical performance. The purpose of this review is to summarize these articles and examine... (Meta-Analysis)
Meta-Analysis Review
There is a growing literature on the relationship between team processes and clinical performance. The purpose of this review is to summarize these articles and examine the impact of team process behaviours on clinical performance. We conducted a literature search in five major databases. Inclusion criteria were: English peer-reviewed papers published between January 2001 and May 2012, which showed or tried to show (i) a statistical relationship of a team process variable and clinical performance or (ii) an improvement of a performance variable through a team process intervention. Study quality was assessed using predefined quality indicators. For every study, we calculated the relevant effect sizes. We included 28 studies in the review, seven of which were intervention studies. Every study reported at least one significant relationship between team processes or an intervention and performance. Also, some non-significant effects were reported. Most of the reported effect sizes were large or medium. The study quality ranged from medium to high. The studies are highly diverse regarding the specific team process behaviours investigated and also regarding the methods used. However, they suggest that team process behaviours do influence clinical performance and that training results in increased performance. Future research should rely on existing theoretical frameworks, valid, and reliable methods to assess processes such as teamwork or coordination and focus on the development of adequate tools to assess process performance, linking them with outcomes in the clinical setting.
Topics: Behavior; Clinical Competence; Communication; Data Collection; Data Interpretation, Statistical; Leadership; Patient Care Team; Research Design; Treatment Outcome
PubMed: 23454826
DOI: 10.1093/bja/aes513 -
Medical Care Jun 2012To review literature on the impact of The Food and Drug Administration (FDA) drug risk communications on medication utilization, health care services use, and health... (Review)
Review
OBJECTIVE
To review literature on the impact of The Food and Drug Administration (FDA) drug risk communications on medication utilization, health care services use, and health outcomes.
DATA SOURCES
The authors searched MEDLINE and the Web of Science for manuscripts published between January 1990 and November 2010 that included terms related to drug utilization, the FDA, and advisories or warnings. We manually searched bibliographies and works citing selected articles and consulted with experts to guide study selection.
STUDY SELECTION
Studies were included if they involved an empirical analysis evaluating the impact of an FDA risk communication.
DATA EXTRACTION
We extracted the drug(s) analyzed, relevant FDA communication(s), data source, analytical method, and main outcome(s) assessed.
RESULTS
Of the 1432 records screened, 49 studies were included. These studies covered 16 medicines or therapeutic classes; one third examined communications regarding antidepressants. Most used medical or pharmacy claims and a few rigorously examined patient-provider communication, decision making, or risk perceptions. Advisories recommending increased clinical or laboratory monitoring generally led to decreased drug use, but only modest, short-term increases in monitoring. Communications targeting specific subpopulations often spilled over to other groups. Repeated or sequential advisories tended to have larger but delayed effects and decreased incident more than prevalent use. Drug-specific warnings were associated with particularly large decreases in utilization, although the magnitude of substitution within therapeutic classes varied across clinical contexts.
CONCLUSIONS
Although some FDA drug risk communications had immediate and strong impacts, many had either delayed or had no impact on health care utilization or health behaviors. These data demonstrate the complexity of using risk communication to improve the quality and safety of prescription drug use, and suggest the importance of continued assessments of the effect of future advisories and label changes. Identifying factors that are associated with rapid and sustained responses to risk communications will be important for informing future risk communication efforts.
Topics: Communication; Drug Interactions; Drug Monitoring; Drug Utilization; Drug-Related Side Effects and Adverse Reactions; Health Behavior; Health Knowledge, Attitudes, Practice; Health Services; Humans; Patient Selection; Risk Assessment; Risk Management; United States; United States Food and Drug Administration
PubMed: 22266704
DOI: 10.1097/MLR.0b013e318245a160 -
Journal of Healthcare Engineering 2017This paper studies the real-life problems of outpatient clinics having the multiple objectives of minimizing resource overtime, patient waiting time, and waiting area...
This paper studies the real-life problems of outpatient clinics having the multiple objectives of minimizing resource overtime, patient waiting time, and waiting area congestion. In the clinic, there are several patient classes, each of which follows different treatment procedure flow paths through a multiphase and multiserver queuing system with scarce staff and limited space. We incorporate the stochastic factors for the probabilities of the patients being diverted into different flow paths, patient punctuality, arrival times, procedure duration, and the number of accompanied visitors. We present a novel two-stage simulation-based heuristic algorithm to assess various tactical and operational decisions for optimizing the multiple objectives. In stage I, we search for a resource allocation plan, and in stage II, we determine a block appointment schedule by patient class and a service discipline for the daily operational level. We also explore the effects of the separate strategies and their integration to identify the best possible combination. The computational experiments are designed on the basis of data from a study of an ophthalmology clinic in a public hospital. Results show that our approach significantly mitigates the undesirable outcomes by integrating the strategies and increasing the resource flexibility at the bottleneck procedures without adding resources.
Topics: Algorithms; Ambulatory Care Facilities; Appointments and Schedules; Computer Simulation; Decision Making; Efficiency, Organizational; Hospitals, Public; Humans; Models, Organizational; Ophthalmology; Outpatients; Patient Selection; Probability; Resource Allocation; Stochastic Processes; Time Factors
PubMed: 29104748
DOI: 10.1155/2017/9034737 -
Anaesthesia May 2011
Topics: Ambulatory Surgical Procedures; Anesthesia; Anesthesia Recovery Period; Documentation; Emergencies; Hospital Units; Humans; Length of Stay; Patient Selection; United Kingdom; Workforce
PubMed: 21418041
DOI: 10.1111/j.1365-2044.2011.06651.x -
The Milbank Quarterly Dec 2010The mixed results of success among QI initiatives may be due to differences in the context of these initiatives. (Review)
Review
CONTEXT
The mixed results of success among QI initiatives may be due to differences in the context of these initiatives.
METHODS
The business and health care literature was systematically reviewed to identify contextual factors that might influence QI success; to categorize, summarize, and synthesize these factors; and to understand the current stage of development of this research field.
FINDINGS
Forty-seven articles were included in the final review. Consistent with current theories of implementation and organization change, leadership from top management, organizational culture, data infrastructure and information systems, and years involved in QI were suggested as important to QI success. Other potentially important factors identified in this review included: physician involvement in QI, microsystem motivation to change, resources for QI, and QI team leadership. Key limitations in the existing literature were the lack of a practical conceptual model, the lack of clear definitions of contextual factors, and the lack of well-specified measures.
CONCLUSIONS
Several contextual factors were shown to be important to QI success, although the current body of literature lacks adequate definitions and is characterized by considerable variability in how contextual factors are measured across studies. Future research should focus on identifying and developing measures of context tied to a conceptual model that examines context across all levels of the health care system and explores the relationships among various aspects of context.
Topics: Attitude of Health Personnel; Diffusion of Innovation; Group Processes; Health Services Research; Humans; Information Systems; Leadership; Models, Theoretical; Motivation; Organizational Culture; Organizational Innovation; Outcome Assessment, Health Care; Program Evaluation; Quality Assurance, Health Care; Quality Improvement; Research Design; Total Quality Management
PubMed: 21166868
DOI: 10.1111/j.1468-0009.2010.00611.x -
Journal of Clinical Pathology.... 1969
Topics: Autoanalysis; Complement Fixation Tests; Electronic Data Processing; Humans; Laboratories; Methods; Organization and Administration; Serologic Tests; Syphilis Serodiagnosis
PubMed: 5272507
DOI: 10.1136/jcp.s2-3.1.14 -
BMJ Open Dec 2017Tailoring health information to the needs of individuals has become an important part of modern health communications. Tailoring has been addressed by researchers from... (Review)
Review
INTRODUCTION
Tailoring health information to the needs of individuals has become an important part of modern health communications. Tailoring has been addressed by researchers from different disciplines leading to the emergence of a wide range of approaches, making the newcomers confused. In order to address this, a comprehensive overview of the field with the indications of research gaps, tendencies and trends will be helpful. As a result, a systematic protocol was outlined to conduct a scoping review within the field of computer-based health information tailoring.
METHODS AND ANALYSIS
This protocol is based on the York's five-stage framework outlined by Arksey and O'Malley. A field-specific structure was defined as a basis for undertaking each stage. The structure comprised three main aspects: , and . Five leading databases were searched: PubMed, Scopus, Science Direct, EBSCO and IEEE and a broad search strategy was used with less strict inclusion criteria to cover the breadth of evidence. Theoretical frameworks were used to develop the data extraction form and a rigorous approach was introduced to identify the categories from data. Several explanatory-descriptive methods were considered to analyse the data, from which some were proposed to be employed for the first time in scoping studies.
ETHICS AND DISSEMINATION
This study investigates the breadth and depth of existing literature on computer-tailoring and as a secondary analysis, does not require ethics approval. We anticipate that the results will identify research gaps and novel ideas for future studies and provide direction to combine methods from different disciplines. The research findings will be submitted for publication to relevant peer-reviewed journals and conferences targeting health promotion and patient education.
Topics: Health Promotion; Health Services Needs and Demand; Humans; Medical Records Systems, Computerized; Patient Education as Topic; Research Design
PubMed: 29284722
DOI: 10.1136/bmjopen-2017-019215