Case study of a stepped-care psychological service for healthcare professionals working in critical care

2021 ◽  
Author(s):  
Connie Galati ◽  
Bronwyn Avard ◽  
Louise Ramsay
Keyword(s):  
Critical Care ◽  
Healthcare Professionals ◽  
Stepped Care ◽  
Psychological Service

scholarly journals A mixed methods multiple case study to evaluate the implementation of a care pathway for colorectal cancer surgery using extended normalization process theory

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
R. van Zelm ◽  
E. Coeckelberghs ◽  
W. Sermeus ◽  
A. Wolthuis ◽  
L. Bruyneel ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Healthcare Professionals ◽  
Care Pathway ◽  
Implementation Process ◽  
Colorectal Cancer Surgery ◽  
Protocol Adherence ◽  
Multiple Case ◽  
Specific Factors ◽  
Normalization Process

Abstract Background Specific factors that facilitate or prevent the implementation of enhanced recovery protocols for colorectal cancer surgery have been described in previous qualitative studies. This study aims to perform a concurrent qualitative and quantitative evaluation of factors associated with successful implementation of a care pathway (CP) for patients undergoing surgery for colorectal cancer. Methods This comparative mixed methods multiple case study was based on a sample of 10 hospitals in 4 European countries that implemented a specific CP and performed pre- and post-implementation measurements. In-depth post-implementation interviews were conducted with healthcare professionals who were directly involved. Primary outcomes included protocol adherence and improvement rate. Secondary outcomes included length of stay (LOS) and self-rated protocol adherence. The hospitals were ranked based on these quantitative findings, and those with the highest and lowest scores were included in this study. Qualitative data were summarized on a per-case basis using extended Normalization Process Theory (eNPT) as theoretical framework. The data were then combined and analyzed using joint display methodology. Results Data from 381 patients and 30 healthcare professionals were included. Mean protocol adherence rate increased from 56 to 62% and mean LOS decreased by 2.1 days. Both measures varied greatly between hospitals. The two highest-ranking hospitals and the three lowest-ranking hospitals were included as cases. Factors which could explain the differences in pre- and post-implementation performance included the degree to which the CP was integrated into daily practice, the level of experience and support for CP methodology provided to the improvement team, the intrinsic motivation of the team, shared goals and the degree of management support, alignment of CP development and hospital strategy, and participation of relevant disciplines, most notably, physicians. Conclusions Overall improvement was achieved but was highly variable among the 5 hospitals evaluated. Specific factors involved in the implementation process that may be contributing to these differences were conceptualized using eNPT. Multidisciplinary teams intending to implement a CP should invest in shared goals and teamwork and focus on integration of the CP into daily processes. Support from hospital management directed specifically at quality improvement including audit may likewise facilitate the implementation process. Trial registration NCT02965794. US National Library of Medicine, ClinicalTrials.gov. Registered 4 August 2014.

scholarly journals Methods for conducting international Delphi surveys to optimise global participation in core outcome set development: a case study in gastric cancer informed by a comprehensive literature review

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Bilal Alkhaffaf ◽  
Jane M. Blazeby ◽  
Aleksandra Metryka ◽  
Anne-Marie Glenny ◽  
Ademola Adeyeye ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Literature Review ◽  
Healthcare Professionals ◽  
Vascular Malformations ◽  
Methodological Approach ◽  
Core Outcome Set ◽  
Core Outcome ◽  
Comprehensive Literature Review ◽  
International Participation

Abstract Background Core outcome sets (COS) should be relevant to key stakeholders and widely applicable and usable. Ideally, they are developed for international use to allow optimal data synthesis from trials. Electronic Delphi surveys are commonly used to facilitate global participation; however, this has limitations. It is common for these surveys to be conducted in a single language potentially excluding those not fluent in that tongue. The aim of this study is to summarise current approaches for optimising international participation in Delphi studies and make recommendations for future practice. Methods A comprehensive literature review of current approaches to translating Delphi surveys for COS development was undertaken. A standardised methodology adapted from international guidance derived from 12 major sets of translation guidelines in the field of outcome reporting was developed. As a case study, this was applied to a COS project for surgical trials in gastric cancer to translate a Delphi survey into 7 target languages from regions active in gastric cancer research. Results Three hundred thirty-two abstracts were screened and four studies addressing COS development in rheumatoid and osteoarthritis, vascular malformations and polypharmacy were eligible for inclusion. There was wide variation in methodological approaches to translation, including the number of forward translations, the inclusion of back translation, the employment of cognitive debriefing and how discrepancies and disagreements were handled. Important considerations were identified during the development of the gastric cancer survey including establishing translation groups, timelines, understanding financial implications, strategies to maximise recruitment and regulatory approvals. The methodological approach to translating the Delphi surveys was easily reproducible by local collaborators and resulted in an additional 637 participants to the 315 recruited to complete the source language survey. Ninety-nine per cent of patients and 97% of healthcare professionals from non-English-speaking regions used translated surveys. Conclusion Consideration of the issues described will improve planning by other COS developers and can be used to widen international participation from both patients and healthcare professionals.

Physicians declining patient enrollment in a critical care trial: a case study in thromboprophylaxis

2013 ◽  
Vol 39 (12) ◽  
pp. 2115-2125 ◽  
Author(s):  
D. Cook ◽  
◽  
Y. Arabi ◽  
N. D. Ferguson ◽  
D. Heels-Ansdell ◽  
...  
Keyword(s):  
Critical Care ◽  
Patient Enrollment ◽  
Critical Care Trial

scholarly journals Machine learning in critical care: state-of-the-art and a sepsis case study

2018 ◽  
Vol 17 (S1) ◽  
Author(s):  
Alfredo Vellido ◽  
Vicent Ribas ◽  
Carles Morales ◽  
Adolfo Ruiz Sanmartín ◽  
Juan Carlos Ruiz Rodríguez
Keyword(s):  
Machine Learning ◽  
Critical Care ◽  
State Of The Art

scholarly journals MindTick: Case Study of a Digital System for Mental Health Clinicians to Monitor and Support Patients Outside Clinics

2021 ◽  
Author(s):  
Rebecca Perry ◽  
Lydia Oakey-Neate ◽  
John Fouyaxis ◽  
Sue Boyd-Brierley ◽  
Megan Wilkinson ◽  
...  
Keyword(s):  
Mental Health ◽  
Healthcare Service ◽  
Mobile App ◽  
Health Conditions ◽  
Mental Health Clinicians ◽  
Psychological Service ◽  
Mental Health Patients ◽  
Future Work ◽  
Roll Out

The current COVID-19 pandemic has highlighted the limitations of relying solely on in-person contact for diagnosis, monitoring and treatment of mental health conditions. Mobile health approaches can be used to monitor mental health patients remotely, but they are not properly integrated with existing models of healthcare service delivery. We present findings from a case study of a mobile app enabled cloud-based software program rolled out in a phone based psychological service to enable real-time/temporal monitoring. The program offered patients an app to record measures of symptoms in everyday contexts and provided clinicians with access to an accompanying dashboard to use information from the app to tailor treatments and monitor progress and ultimately facilitate earlier and personalised care decisions. Feedback related to implementation and utility was gathered from clinicians through a focus group conducted two months post-roll-out. Findings identified that the system is valuable and feasible, however implementation issues were identified. These are discussed in order to inform future work in this area to support the delivery of timely and responsive mental health care in the community.

scholarly journals The Electronic Patient Record as an Organizational Artifact

2011 ◽  
pp. 78-89 ◽  
Author(s):  
Pieter Toussaint ◽  
Marc Berg
Keyword(s):  
Electronic Patient Record ◽  
Healthcare Professionals ◽  
Research Effort ◽  
Patient Record ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Specific Research ◽  
Technological Bias

The research effort on Electronic Patient Records (EPRs) has rapidly increased in the last decade. Much of this research focussed on standardisation and technical realizations. We will describe such a research effort in this chapter and evaluate its success. Our main finding is that the lack of success of this specific research effort is mainly due to its technological bias. Although standards (both conceptual and technical) are important prerequisites for the realisation of an EPR, organisational issues are decisive for success. The role played by these organisational issues will be illustrated by analysing the findings of the case study presented in the chapter. We will argue that research on EPRs should be more focussed on the role of an EPR as an organisational artefact that coordinates the work of healthcare professionals, in order to lead to successful implementations.

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