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Journal of Registry Management 2022Integration of screening data into routine cancer surveillance systems can create more robust data systems to inform cancer prevention and control activities. Currently,...
INTRODUCTION
Integration of screening data into routine cancer surveillance systems can create more robust data systems to inform cancer prevention and control activities. Currently, state central cancer registries do not routinely collect breast and cervical cancer screening data as part of state cancer surveillance activities. Florida conducted a pilot study involving: (1) linkage of breast and cervical cancer screening data from the Florida Breast and Cervical Cancer Early Detection Program (FBCCEDP) from 2009 to 2021 to the Florida Cancer Data System (FCDS) database to capture screening data for matched cancer cases in the FCDS; and (2) evaluation of the feasibility of developing a population-based breast and cervical cancer screening surveillance system by capturing electronic screening data from private health care providers.
METHODS
In 2018, the FCDS worked with the Florida Department of Health to identify data partners for the 5-year cancer screening pilot project funded by the Centers for Disease Control and Prevention. Engagement of project partners required extensive review of available screening data; data standards and formatting; data transmission schedules and methods; and processing procedures. The FCDS developed a database to integrate multiple source data sets into a single database whereby linkage to the central cancer registry could be performed.
RESULTS
The FCDS worked with Suncoast Health Systems, a clinical practice in the Hillsborough region of Florida, and the FBCCEDP to evaluate data availability, standardization of data sets, and data submission schedules for the pilot project. Extensive meetings and data reviews were conducted with both partners in the first phase of the project. The FCDS developed automated data processing procedures to integrate the data into a single cancer screening database and then linked records to the central cancer registry data set.
DISCUSSION
Registry collaboration with the FBCCEDP and Suncoast team on data quality and standardization has produced positive results. The project required extensive review of data and produced many lessons learned for development of a cancer screening surveillance system. Our pilot project depended on partnership building, commitment to data quality, and consistency in data submission practices.
Topics: Female; Humans; Pilot Projects; Florida; Early Detection of Cancer; Uterine Cervical Neoplasms; Breast Neoplasms
PubMed: 37260814
DOI: No ID Found -
Annals of the Academy of Medicine,... Feb 2021Globally, cervical cancer is the fourth most common cancer in women, with about 85% occurring in low-middle income countries (LMIC) and an age-standardised incidence...
INTRODUCTION
Globally, cervical cancer is the fourth most common cancer in women, with about 85% occurring in low-middle income countries (LMIC) and an age-standardised incidence rate of more than 15 per 100,000. It is largely preventable through HPV vaccination and cervical cancer screening. In Singapore, 18% of the foreign domestic workforce hail from Indonesia, the Philippines, Myanmar, and India. However, there is no data on preinvasive cervical disease and cervical cancer in foreign domestic workers (FDWs) and the aim of this pilot programme is to determine the baseline screen positive rate of high-grade intraepithelial in this population.
METHODS
A total of 322 FDWs were offered HPV screening through the Helping Our Helper (HOH) pilot programme. Data from this pilot programme were analysed and reported using simple descriptive statistics.
RESULTS
Out of the 322 FDWs who registered for HPV screening, 68.6% participated. There was a 22.2% screen-positive rate; 10% of those who screened positive for high-risk HPV had histologically confirmed high-grade cervical intraepithelial neoplasia. This result is similar to other data on cervical cancer screening in Singaporeans. This pilot project screened less than 1% of the eligible FDWs in Singapore.
DISCUSSION
The findings of this pilot programme suggest that there is public health value in providing cervical cancer screening to FDWs. Improving cervical cancer screening by increasing awareness and including routine cervical cancer screening as part of the employment medical examination should be studied.
Topics: Early Detection of Cancer; Female; Humans; India; Indonesia; Mass Screening; Philippines; Pilot Projects; Singapore; Uterine Cervical Neoplasms
PubMed: 33733256
DOI: 10.47102/annals-acadmedsg.2020293 -
BMC Health Services Research Dec 2017For national and local leaders to achieve universal health coverage, a new approach or technique to gathering evidence and understanding the contexts that influence the...
For national and local leaders to achieve universal health coverage, a new approach or technique to gathering evidence and understanding the contexts that influence the outcome of a study and goes beyond the quantitative results of clinical trials and pilot projects is important. The Doris Duke Charitable Foundation's African Health Initiative (AHI) was designed to produce this type of knowledge through embedding implementation research into Population Health Implementation and Training (PHIT) partnership projects in five countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) with the goal of improving primary health care and population health. In Ghana, this integration of research into implementation has contributed to the successful testing, adaptation and implementation of the Community-based Health Planning and Services (CHPS) model (The Navrongo Pilot Project), with results from the AHI-funded work informing national scale-up of effective practices. Further application of implementation science methods and frameworks to study cross-project lessons also produced the evidence needed by national and local decision makers on how and why different intervention components were successful and where and how local context drove implementation and adaptation. Cross-project research also identified effective approaches across diverse settings for building capacity for data-driven improvement, coaching and mentoring clinicians and researchers, developing locally appropriate interventions to reduce neonatal mortality, and integrating implementation research to inform local implementers and researchers in more effective strategies to strengthen health systems and improve health services and population health. Evidence has already shown the potential for this type of work to accelerate regional learning and spread of successful interventions to achieve targeted health goals more efficiently, better enabling countries to achieve the ambitious, but important, U.N. Sustainable Development Goals.
Topics: Africa; Biomedical Research; Capacity Building; Delivery of Health Care; Humans; Infant; Infant Mortality; Insurance, Health; Pilot Projects; Primary Health Care; Quality Improvement; Universal Health Insurance
PubMed: 29297396
DOI: 10.1186/s12913-017-2663-8 -
Canadian Family Physician Medecin de... Oct 2007PROBLEM ADDRESSED Family physicians are not adequately following the 2002 Osteoporosis Canada guidelines for providing optimal care to patients with osteoporosis. (Randomized Controlled Trial)
Randomized Controlled Trial
UNLABELLED
PROBLEM ADDRESSED Family physicians are not adequately following the 2002 Osteoporosis Canada guidelines for providing optimal care to patients with osteoporosis.
OBJECTIVE OF PROGRAM
The Canadian Quality Circle (CQC) pilot project was developed to assess the feasibility of the CQC project design and to gather information for implementing a national study of quality circles (QCs). The national study would assess whether use ofQCs could improve family physicians' adherence to the osteoporosis guidelines.
PROGRAM DESCRIPTION
The pilot project enrolled 52 family physicians and involved 7 QCs. The project had 3 phases: training and baseline data collection, educational intervention and follow-up data collection, and sessions on implementing strategies for care.
CONCLUSION
Findings from the pilot study showed that the CQC project was well designed and well received. Use of QCs appeared to be feasible for transferring knowledge and giving physicians an opportunity to analyze work-related problems and develop solutions to them.
Topics: Aged; Canada; Family Practice; Feasibility Studies; Female; Guideline Adherence; Humans; Middle Aged; Osteoporosis; Pilot Projects; Program Evaluation; Quality Assurance, Health Care
PubMed: 17934033
DOI: No ID Found -
Journal of Health Organization and... Feb 2021A performance-based financing (PBF) pilot project was implemented in 2011 in Burkina Faso. After more than five years of implementation (data collection in 2016), the...
PURPOSE
A performance-based financing (PBF) pilot project was implemented in 2011 in Burkina Faso. After more than five years of implementation (data collection in 2016), the project's sustainability was not guaranteed. This study's objective is to assess this project's sustainability in 2016 by identifying the presence/absence of different determinants of sustainability according to the conceptual framework of Seppey (2017).
DESIGN/METHODOLOGY/APPROACH
It uses a case study approach using in-depth interviews with various actors at the local, district/regional and national levels. Participants ( = 37) included health practitioners, management team members, implementers and senior members of health directions. A thematic analysis based on the conceptual framework was conducted, as well as an inductive analysis.
FINDINGS
Results show the project's sustainability level was weak according to an unequal presence of sustainability's determinants; some activities are being maintained but not fully routinised. Discrepancies between the project and the context's values appeared to be important barriers towards sustainability. Project's ownership by key stakeholders also seemed superficial despite the implementers' leadership towards its success. The project's objective towards greater autonomy for health centres was also directly confronting the Burkinabe's hierarchical health system.
ORIGINALITY/VALUE
This study reveals many fits and misfits between a PBF project and its context affecting its ability to sustain activities through time. It also underlines the importance of using a conceptual framework in implementing and evaluating interventions. These results could be interesting for decision-makers and implementers in further assessing PBF projects elsewhere.
Topics: Data Collection; Humans; Leadership; Pilot Projects; Reimbursement, Incentive
PubMed: 33533207
DOI: 10.1108/JHOM-04-2020-0137 -
BMC Medical Education Mar 2022Feedback is essential to medical education. Although the need for effective feedback delivery is well known, more recent focus is on understanding and strengthening the...
BACKGROUND
Feedback is essential to medical education. Although the need for effective feedback delivery is well known, more recent focus is on understanding and strengthening the faculty-trainee relationship within which the feedback process is carried out. The authors developed and implemented a combined resident-faculty feedback workshop within a psychiatry residency training program to enhance participants' understanding of challenges residents and faculty experience with the feedback process.
METHODS
The one-hour workshop consisted of small group activities and large group discussions, focused on (i) feedback challenges for both residents and faculty and (ii) potential ways to address identified challenges. Participants completed pre-and post-workshop questionnaires to rate their level of understanding of, and answer open-ended questions regarding, feedback challenges. Mixed-methods assessment of questionnaire responses examined quantitative rating changes from pre- to post-workshop, as well as emergent qualitative themes from the open-ended responses.
RESULTS
From a pool of 30 workshop participants, 26 completed each of the pre- and post-workshop questionnaires. Overall, participants were satisfied with the programming. Important considerations for the feedback process were (i) specific/constructive/timely feedback, (ii) meeting logistical/administrative feedback requirements, (iii) setting norms/expectations of effective/routine feedback, and (iv) relational/emotional considerations surrounding feedback. It appeared both faculty and residents were able to increase perspective taking about how the other group perceived the feedback process.
CONCLUSIONS
This pilot project is one of the first to examine a joint resident-faculty workshop focused on understanding how faculty and residents can interact to better understand each other's perspective on the feedback process. Further work in this area is needed to identify common misperceptions and design programming to help correct them. Further research is also needed to examine the impact of such programming on the feedback process.
Topics: Faculty, Medical; Formative Feedback; Humans; Internship and Residency; Pilot Projects; Students, Medical
PubMed: 35317809
DOI: 10.1186/s12909-022-03253-6 -
Globalization and Health Apr 2020In 2016-2017, Vietnam's Ministry of Health (MoH) implemented an event-based surveillance (EBS) pilot project in six provinces as part of Global Health Security Agenda...
BACKGROUND
In 2016-2017, Vietnam's Ministry of Health (MoH) implemented an event-based surveillance (EBS) pilot project in six provinces as part of Global Health Security Agenda (GHSA) efforts. This manuscript describes development and design of tools for monitoring and evaluation (M&E) of EBS in Vietnam.
METHODS
A strategic EBS framework was developed based on the EBS implementation pilot project's goals and objectives. The main process and outcome components were identified and included input, activities, outputs, and outcome indicators. M&E tools were developed to collect quantitative and qualitative data. The tools included a supervisory checklist, a desk review tool, a key informant interview guide, a focus group discussion guide, a timeliness form, and an online acceptability survey. An evaluation team conducted field visits for assessment of EBS 5-9 months after implementation.
RESULTS
The quantitative data collected provided evidence on the number and type of events that were being reported, the timeliness of the system, and the event-to-signal ratio. The qualitative and subjective data collected helped to increase understanding of the system's field utility and acceptance by field staff, reasons for non-compliance with established guidelines, and other factors influencing implementation.
CONCLUSIONS
The use of M&E tools for the EBS pilot project in Vietnam provided data on signals and events reported, timeliness of reporting and response, perceptions and opinions of implementers, and fidelity of EBS implementation. These data were valuable for Vietnam's MoH to understand the function of the EBS program, and the success and challenges of implementing this project in Vietnam.
Topics: Disease Outbreaks; Epidemiological Monitoring; Global Health; Humans; Pilot Projects; Surveys and Questionnaires; Vietnam
PubMed: 32354353
DOI: 10.1186/s12992-020-00567-2 -
WMJ : Official Publication of the State... Dec 2022Primary care physicians are overburdened with growing complexities and increasing expectations for primary care visits. To meet expectations, primary care physicians...
BACKGROUND
Primary care physicians are overburdened with growing complexities and increasing expectations for primary care visits. To meet expectations, primary care physicians must multitask during visits and spend extra hours in the office for charting, billing, and documentation. This impacts the physician's quality of life and may affect the quality of patient care. Many of the administrative tasks performed by physicians could, alternatively, be performed by nonphysician staff, leading to the adoption of team-based collaborative models.
METHODS
Mayo Clinic Health System piloted a team-based collaborative model in a small physician practice in Osseo, Wisconsin, where which staff could be trained quickly and efficiently. The model used medical assistants/licensed practical nurses (MA/LPN) to partner with primary care physicians during a patient visit. The LPN/MA, under physician supervision, ordered and monitored pending orders/labs, coordinated patient care, provided after-visit educational needs, and communicated other urgent messages to team members.
RESULTS
After 6 months, a comparison of pre- and posttrial data showed improved staff and patient satisfaction, decreased physician administrative work, and no cost-effectiveness improvement. Screening of medical conditions in the elderly improved, but no change was noted with chronic disease metrics.
CONCLUSIONS
Data showed improved staff and patient satisfaction, decreased physician clerical burden, increased appointment slots, mixed clinical outcomes, and did not demonstrate cost-effectiveness. The authors recommend that similar models be conducted in large settings to see if these results are reproducible.
Topics: Humans; Aged; Pilot Projects; Quality of Life; Patient Care; Wisconsin; Primary Health Care
PubMed: 36637843
DOI: No ID Found -
BMC Health Services Research Jul 2022Globally, 19 million children have preventable vision impairment simply because refractive and eye health services are inaccessible to most of them. In Zambia,...
BACKGROUND
Globally, 19 million children have preventable vision impairment simply because refractive and eye health services are inaccessible to most of them. In Zambia, approximately 50,000 school children need spectacle provision. The School-based Eye Health Programme (SEHP) has been identified worldwide as a proven strategy to address childhood blindness. Given its great benefits, the Zambian government intends to scale up the programme. This scalability assessment aims to identify and evaluate the essential components of an effective SEHP, determine roles, assess existing capacities within user organisations, identify environmental facilitating and inhibiting factors, and estimate the minimum resources necessary for the scaling up and their proposed scale-up strategies.
METHODS
Five elements (innovation, user organisation, resource team, environment, and strategies for horizontal and vertical scaling-up) were assessed guided by the ExpandNet-WHO Nine Steps for Developing a Scaling-Up Strategy. Literature review on proven strategies to reduce childhood blindness and the credibility of SEHP implemented in resource-limited settings, document review on the pilot project, questionnaires, and stakeholders' interviews were conducted to collect data for this assessment. Subsequently, twenty questions in the Worksheets for Developing a Scaling-up Strategy were used to report the assessment outcome systematically.
RESULTS
Additional components of SEHP incorporated in Zambia's model enhanced the innovation's credibility and relevance. The resource team was relatively competent in the pilot project, and the same team will be employed during the scaling-up. Potential change in political parties, the lack of supply chain, and unstable financial support were identified as inhibiting factors. The objectives of SEHP were aligned with the National Eye Health Strategic Plan 2017-2021, which supports the institutionalisation of the SEHP into the existing School Health and Nutrition Programme. For the pace of expansion, replicating SEHP to another district rather than a province will be more realistic.
CONCLUSION
Scaling up a comprehensive SEHP in Zambia is feasible if sufficient funding is available. Additionally, the pace must be adapted to the local context to ensure that every component within the SEHP is intact.
Topics: Blindness; Child; Health Promotion; Humans; Pilot Projects; Schools; Zambia
PubMed: 35879794
DOI: 10.1186/s12913-022-08350-2 -
European Journal of Pediatrics Mar 2022In daily paediatrics, drugs are commonly used off-label, as they are not approved for children. Approval is lacking because the required clinical studies were limited to...
In daily paediatrics, drugs are commonly used off-label, as they are not approved for children. Approval is lacking because the required clinical studies were limited to adults in the past. Without clinical studies, evidence-based recommendations for drug use in children are limited. Information on off-label drug dosing in children can be found in different handbooks, databases and scientific publications but the dosing recommendations can differ considerably. To improve safety and efficacy of drugs prescribed to children and to assist the prescribers, stakeholders in Swiss paediatrics started a pilot project, supported by the Federal Office of Public Health, with the aim to create a database, providing healthcare professionals with so called "harmonised" dosage recommendations based on the latest available scientific evidence and best clinical practice. A standardised process for dosage harmonisation between paediatric experts was defined, guided and documented in an electronic tool, developed for this purpose. As proof of principle, a total of 102 dosage recommendations for 30 different drugs have been nationally harmonised in the pilot phase considering the current scientific literature and the approval of the most experienced national experts in the field.Conclusion: This approach paved the way for unified national dosage recommendations for children. Reaching the project's milestones fulfilled the prerequisites for funding and starting regular operation of SwissPedDose in 2018. Since then, the database was extended with recommendations for 100 additional drugs. What is Known: • Prescribing off-label is a common practice among paediatricians, as many drugs are still not authorised for use in children. • Some countries developed national drug formularies providing off-label dosage recommendations. What is New: • Comparison of published dosage recommendations in known drug handbooks and online databases show substantial differences and heterogeneity, revealing the need for harmonisation. • The design of a tool for standardised harmonisation of dosage recommendations, based on information collected on currently applied dosages, latest scientific evidence and the approval of experts.
Topics: Adult; Child; Databases, Pharmaceutical; Drug Labeling; Humans; Off-Label Use; Pediatrics; Pilot Projects; Switzerland
PubMed: 34739591
DOI: 10.1007/s00431-021-04304-8