Expert Advisory Groups: Exploring the Sensemaking Process During a Public Health Crisis Response

<p>Crisis sensemaking research has focused mainly on acute crises such as wildfires or industrial accidents, with crisis response being approximately under 72 hours. However, there is limited research on long duration crisis sensemaking for crisis response that may be several weeks, months, or even years. This research study aims to explore long duration crisis sensemaking during a public health crisis. During the crisis response period, key decision makers (KDMs) face a plethora of challenges, including being inundated with information, with varying levels of quality and relevance, or not having the right kind of information. They may rely on an Expert Advisory Group (EAG) to advise on the scientific/medical aspect of the disease. The EAG is comprised of specialists such as infectious disease physicians, infection prevention and control practitioners, epidemiologists, and public health physicians. The 2003 SARS outbreak in Toronto, Canada, was the context for this research. Participants were recruited who served as members of the Ontario SARS Scientific Advisory Committee (OSSAC) or were stakeholders during the crisis. Among their duties, these experts were tasked to write directives (mandated protocols) that govern all aspects of hospital life, from patient transfers, to cleaning. Data was collected in multiple forms, including: public inquiry reports, meeting minutes, newspaper articles, and interviews. Following a constructivist grounded theory strategy, I conducted several iterations of data collection and analysis. The findings include a conceptual framework of EAG social sensemaking through a long duration crisis, depicting the sequential process of a stream of sensemaking (the creation and revision of one directive). A second conceptual framework on the information dynamics of long duration social sensemaking reflects the learning over the course of the crisis period. Finally, a third conceptual framework on the regulation of expert advisory group sensemaking as a balance between the knowns and unknowns in the greater health system is presented.</p>

Expert Advisory Groups: Exploring the Sensemaking Process During a Public Health Crisis Response

<p>Crisis sensemaking research has focused mainly on acute crises such as wildfires or industrial accidents, with crisis response being approximately under 72 hours. However, there is limited research on long duration crisis sensemaking for crisis response that may be several weeks, months, or even years. This research study aims to explore long duration crisis sensemaking during a public health crisis. During the crisis response period, key decision makers (KDMs) face a plethora of challenges, including being inundated with information, with varying levels of quality and relevance, or not having the right kind of information. They may rely on an Expert Advisory Group (EAG) to advise on the scientific/medical aspect of the disease. The EAG is comprised of specialists such as infectious disease physicians, infection prevention and control practitioners, epidemiologists, and public health physicians. The 2003 SARS outbreak in Toronto, Canada, was the context for this research. Participants were recruited who served as members of the Ontario SARS Scientific Advisory Committee (OSSAC) or were stakeholders during the crisis. Among their duties, these experts were tasked to write directives (mandated protocols) that govern all aspects of hospital life, from patient transfers, to cleaning. Data was collected in multiple forms, including: public inquiry reports, meeting minutes, newspaper articles, and interviews. Following a constructivist grounded theory strategy, I conducted several iterations of data collection and analysis. The findings include a conceptual framework of EAG social sensemaking through a long duration crisis, depicting the sequential process of a stream of sensemaking (the creation and revision of one directive). A second conceptual framework on the information dynamics of long duration social sensemaking reflects the learning over the course of the crisis period. Finally, a third conceptual framework on the regulation of expert advisory group sensemaking as a balance between the knowns and unknowns in the greater health system is presented.</p>

Developing the first pan-Canadian survey on patient engagement in patient safety

Background Patient safety is a worldwide problem, and the patient contribution to mitigate the risk of patient harm is now recognized as a cornerstone to its solution. In order to understand the nature of integrating patients into patient safety and healthcare organizations and to monitor their integration, a Canadian survey tool has been co-constructed by patients, researchers and the Canadian Patient Safety Institute (CPSI). This questionnaire has been adapted from the French version of the patient engagement (PE) in patient safety (PS) questionnaire created for the province of Quebec, Canada. Methodology The pan-Canadian PE in PS survey tool was developed in a five-step process: (1) a literature review and revision of the initial tool developed in the province of Quebec; (2) translation of the French questionnaire into an English version tool; (3) creation of a Canadian expert advisory group; (4) adaptation of the English version tool based on feedback from the expert advisory group (assessment and development of the construct’s dimensions, wording assessment and adaptation for pan-Canadian use, technical testing of the online platform for the survey); and (5) pilot testing and pre-validation of the tool before pan-Canadian use. Results and conclusion Eight pan-Canadian PE in PS surveys were completed from five Canadian provinces by the expert advisory group and six surveys were completed during the pilot project by participants from different provinces in Canada. This survey tool comprises 5 sections: (1) demographic identification of the participants (Q1 to Q5); (2) general questions (Q6 to Q17); (3) the patient engagement process (experience level of participants and organizational incentives for PE in general) (Q18 to Q33); (4) PE in PS processes, such as current activities, strategies, structures, resources and factors (Q34 to Q67); and (5) the context and impact of PE in PS initiatives in Canadian healthcare organizations (CHOs) (Q68 to Q75), including outcome identification, improvement mechanisms and strategies, evaluation mechanisms, and indicators.

Developing the First Pan-Canadian Survey on Patient Engagement in Patient Safety

Background: Patient safety is a worldwide problem, and the patient contribution to mitigate the risk of patient harm is now recognized as a cornerstone to its solution. In order to understand the nature of integrating patients into patient safety and healthcare organizations and to monitor their integration, a Canadian survey tool has been co-constructed by patients, researchers and the Canadian Patient Safety Institute (CPSI). This questionnaire has been adapted from the French version of the patient engagement (PE) in patient safety (PS) questionnaire created for the province of Quebec, Canada. Methodology: The pan-Canadian PE in PS survey tool was developed in a five-step process: (1) a literature review and revision of the initial tool developed in the province of Quebec; (2) translation of the French questionnaire into an English version tool; (3) creation of a Canadian expert advisory group; (4) adaptation of the English version tool based on feedback from the expert advisory group (assessment and development of the construct’s dimensions, wording assessment and adaptation for pan-Canadian use, technical testing of the online platform for the survey); and (5) pilot testing and pre-validation of the tool before pan-Canadian use. Results and Conclusion: The pan-Canadian PE in PS survey tool comprises 5 sections: (1) demographic identification of the participants (Q1 to Q5); (2) general questions (Q6 to Q17); (3) the patient engagement process (experience level of participants and organizational incentives for PE in general) (Q18 to Q33); (4) PE in PS processes, such as current activities, strategies, structures, resources and factors (Q34 to Q67); and (5) the context and impact of PE in PS initiatives in Canadian healthcare organizations (CHOs) (Q68 to Q75), including outcome identification, improvement mechanisms and strategies, evaluation mechanisms, and indicators.

Developing The First Pan-Canadian Survey on Patient Engagement in Patient Safety

Background: Patient safety is a worldwide problem, and the patient contribution to mitigate the risk of patient harm is now recognized as a cornerstone to its solution. In order to understand the nature of integrating patients into patient safety and healthcare organizations and to monitor their integration, a Canadian survey tool has been co-constructed by patients, researchers and the Canadian Patient Safety Institute (CPSI). This questionnaire has been adapted from the French version of the patient engagement (PE) in patient safety (PS) questionnaire created for the province of Quebec, Canada. Methodology: The pan-Canadian PE in PS survey tool was developed in a five-step process: (1) a literature review and revision of the initial tool developed in the province of Quebec; (2) translation of the French questionnaire into English; (3) creation of a Canadian expert advisory group; (4) adaptation of the tool based on feedback from the expert advisory group (assessment and development of the construct’s dimensions, wording assessment and adaptation for pan-Canadian use, technical testing of the online platform for the survey); and (5) pilot testing and pre-validation of the tool before pan-Canadian use. Results and Conclusion: The pan-Canadian PE in PS survey tool comprises 5 sections: (1) demographic identification of the participants (Q1 to Q5); (2) general questions (Q6 to Q17); (3) the patient engagement process (experience level of participants and organizational incentives for PE in general) (Q18 to Q33); (4) PE in PS processes, such as current activities, strategies, structures, resources and factors (Q34 to Q67); and (5) the context and impact of PE in PS initiatives in Canadian healthcare organizations (CHOs) (Q68 to Q75), including outcome identification, improvement mechanisms and strategies, evaluation mechanisms, and indicators.

Advancing Stroke Recovery Through Improved Articulation of Nonpharmacological Intervention Dose

Dose articulation is a universal issue of intervention development and testing. In stroke recovery, dose of a nonpharmaceutical intervention appears to influence outcome but is often poorly reported. The challenges of articulating dose in nonpharmacological stroke recovery research include: (1) the absence of specific internationally agreed dose reporting guidelines; (2) inadequate conceptualization of dose, which is multidimensional; and (3) unclear and inconsistent terminology that incorporates the multiple dose dimensions. To address these challenges, we need a well-conceptualized and consistent approach to dose articulation that can be applied across stroke recovery domains to stimulate critical thinking about dose during intervention development, as well as promote reporting of planned intervention dose versus actually delivered dose. We followed the Design Research Paradigm to develop a framework that guides how to articulate dose, conceptualizes the multidimensional nature and systemic linkages between dose dimensions, and provides reference terminology for the field. Our framework recognizes that dose is multidimensional and comprised of a duration of days that contain individual sessions and episodes that can be active (time on task) or inactive (time off task), and each individual episode can be made up of information about length, intensity, and difficulty. Clinical utility of this framework was demonstrated via hypothetical application to preclinical and clinical domains of stroke recovery. The suitability of the framework to address dose articulation challenges was confirmed with an international expert advisory group. This novel framework provides a pathway for better articulation of nonpharmacological dose that will enable transparent and accurate description, implementation, monitoring, and reporting, in stroke recovery research.

In search of the data revolution: Has the official statistics paradigm shifted?

What distinguishes revolution from evolution? What events or movements in the world of official statistics have been sufficiently disruptive or transformational to deserve being called revolutionary? Using the definitions of data revolution put forward by the Independent Expert Advisory Group on a Data Revolution for Sustainable Development in their report A World that Counts to identify potential data revolutions and then deriving a framework to evaluate those definitions from Thomas Kuhn’s work The Structure of Scientific Revolutions, this paper investigates, through the lens of official statistics, whether there has been a data revolution or not.