1,038 research outputs found

    “Anyone can co-design?”: A case study synthesis of six experience-based co-design (EBCD) projects for healthcare systems improvement in New South Wales, Australia

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    Experience-based co-design (EBCD) is a quality improvement approach that is being used internationally to bring service users and health professionals together to improve healthcare experiences, systems and processes. Early evaluations and case studies of EBCD have shown promise in terms of improvements to experience and organisational processes, however challenges remain in participation around shared power and decision making, mobilisation for implementation, sustainment of improvements and measurement of outcomes. The objective of this case study was to explore the emergent issues in EBCD participation and implementation in six quality improvement projects conducted in mental health, rehabilitation, blood and bone marrow transplant, brain injury rehabilitation, urinary incontinence and intellectual disability settings by the Agency for Clinical Innovation (ACI), New South Wales, Australia (2015-2018). Methods: A two stage process of analysis was employed. The first stage involved a case to case synthesis using a variable-oriented approach. In this approach themes were identified within individual cases and compared across cases in workshops with all project leads. In the second stage the case themes were synthesised within an overarching thematic that was identified as the main challenge in effective participation and implementation in these EBCD projects. The results: themes identified in the first stage of analysis related to different methods for gathering experiences and the activities used for the co-design of improvements. Variability in service user participation within co-design workshops was also discussed. Four out of the six projects implemented improvements in full. The prominent thematic overarching all six EBCD cases was the need for guidance on capability development and co-design preparedness for all participants in co-design not only project leads. In conclusion, variability in EBCD implementation makes it difficult to identify which component parts are essential for improving experiences and services, and which of these lead to sustained changes and benefits for service users and health professionals. One way to address this is to develop a model for co-design capability and preparedness that is closely linked with a set of eight mechanisms that have been previously identified as essential to achieving change in healthcare improvement initiatives. Experience Framework This article is associated with the Innovation & Technology lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this len

    Applied Epidemiology during COVID-19 in Vietnam

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    This thesis presents projects I conducted between February 2020 to December 2021 to meet the competencies of the Master of Applied Epidemiology Program (MAE) of the Australian National University (ANU). During this period, I was employed at the Department of Communicable Disease Control of the National Institute of Hygiene and Epidemiology (NIHE) in Hanoi, Vietnam. Chapter 1 – Introduction. This chapter provides an overview of my field placement, describes how I met the different MAE requirements, and presents other side projects I have been involved in during my MAE that do not fall under the MAE competencies. Chapter 2 – Investigate an outbreak: In-flight transmission of SARS-CoV-2 in Vietnam: Results from an outbreak investigation and containment measures. This project covers the investigation of and response to an in-flight COVID-19 transmission event in Vietnam in March 2020. I took part in the investigations from the beginning which resulted in the publication of two journal articles: one on the in-depth investigation of the on-board transmission event (Journal Article 1), and another one describing the response activities to prevent community transmission (Journal Article 2). We found that one infectious passenger in business class very likely infected at least 12 other passengers during a 10-hour flight, many of whom were seated beyond the two-row/seat distance threshold that is usually used for contact tracing among airplane passengers. Timely, systematic and comprehensive contact tracing of all passengers and their close contacts was needed to prevent widespread community transmission. Chapter 3 – Analyze a public health dataset: Association of public health interventions and COVID19 incidence in Vietnam, January to December 2020. In this project I analyzed the relation between public health interventions and COVID-19 incidence in Vietnam over the course of 2020, which culminated in the publication of Journal Article 3. This analysis, which was the first of its kind in Vietnam and the region, identified important associations between the timing of public health interventions and changes in the reproductive number of SARSCoV-2. Chapter 4 – Evaluate a surveillance system: After action review of the COVID-19 surveillance system in Quang Ninh Province, Vietnam in 2020. For this project I conducted a Literature Review on the World Health Organization (WHO)’s After Action Review (AAR) toolkit, and used it to evaluate the effectiveness of the surveillance system in Quang Ninh province, Vietnam in preventing and controlling COVID-19. This evaluation, presented as a Final Report in this chapter, was part of a WHO-funded initiative to learn lessons from the COVID19 response in Vietnam. While central coordination and adaptive capacity during the emergency were identified as strengths, my evaluation also provides important recommendations on how to improve the surveillance system in Quang Ninh province, in particular through improved integration of different data systems and communication channels between health jurisdictions of Quang Ninh’s healthcare system. Chapter 5 – Design an epidemiological project: User-generated online information in response to a COVID-19 outbreak in Vietnam in July – September 2020. In this project I investigated so-called ‘infodemics’ related to a COVID-19 outbreak in Da Nang province, Vietnam between July and September 2020 by applying content analysis and semantic network analysis to publicly available user-generated information from the internet. I conducted two separate analyses: one on ‘infodemics’ related to COVID-19 incidence and mortality, which resulted in Submitted Article Manuscript 1; and another on ‘infodemics’ in relation to public health interventions, which resulted in Submitted Article Manuscript 2. Findings showed that public awareness and perceptions were highly correlated with the evolution of COVID-19 incidence and mortality (at first) during the outbreak, while misinformation and unverified information related to public health interventions that were implemented in response to the outbreak were also prevalent. Chapter 6 – Other MAE requirements. In this chapter I report on other MAE requirements which I completed during my fellowship, namely the publication of a Lay Audience Report, the Lesson From The Field, and the Teaching Experienc

    The Electronic Health Record Scorecard: A Measure of Utilization and Communication Skills

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    As the adoption rate of electronic health records (EHRs) in the United States continues to grow, both providers and patients will need to adapt to the reality of a third actor being present during the visit encounter. The purpose of this project is to provide insight on “best” practice patterns for effective communication and efficient use of the EHR in the clinical practice setting. Through the development of a comprehensive scorecard, this project assessed current status of EHR use and communication skills among health care providers in various clinical practice settings. Anticipated benefits of this project are increased comfortability in interfacing with the EHR and increased satisfaction on the part of the provider as well as the patient. Serving as a benchmark, this assessment has the potential to help guide future health information technology development, training, and education for both students and health care providers

    Annual Report, 2006-2007

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    Flight test evaluation of an RAF high altitude partial pressure protective assembly

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    A partial pressure suit was evaluated during tests in an F-104 and F-15 as a protective garment for emergency descents. The garment is an pressure jerkin and modified anti-g suit combined with an oronasal mask. The garment can be donned and doffed at the aircraft to minimize thermal buildup. The oronasal mask was favored by the pilots due to its immobility on the face during high g-loading. The garment was chosen to provide optimum dexterity for the pilot, which is not available in a full pressure suit, while protecting the pilot at altitudes up to 18,288 meters, during a cabin decompression, and subsequent aircraft descent. During cabin decompressions in the F-104 and F-15, cabin pressure altitude was measured at various aircraft angles of attack, Mach numbers, and altitudes to determine the effect of the aerodynamic slipstream on the cabin altitude

    Implementing strategies in consumer and community engagement in health care: Results of a large-scale, scoping meta-review

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    © 2014 Sarrami-Foroushani et al.; licensee BioMed Central Ltd. Background: There is growing recognition of the importance of the active involvement of consumers and community members in health care. Despite the long history of consumer and community engagement (CCE) research and practice, there is no consensus on the best strategies for CCE. In this paper, we identify various dimensions of CCE-related strategies and offer a practical model to assist policy-makers, practitioners and researchers. Methods: We undertook a large-scale, scoping meta-review and searched six databases using a list of nine medical subject headings (MeSH) and a comprehensive list of 47 phrases. We identified and examined a total of 90 relevant systematic reviews. Results: Identified reviews show that although there is a significant body of research on CCE, the development of the field is hindered by a lack of evidence relating to specific elements of CCE. They also indicate a diverse and growing enterprise, drawing on a wide range of disciplinary, political and philosophical perspectives and a mix of definitions, targets, approaches, strategies and mechanisms. CCE interventions and strategies aim to involve consumers, community members and the public in general, as well as specific sub-groups, including children and people from culturally and linguistically diverse backgrounds. Strategies for CCE vary in terms of their aim and type of proposed activity, as do the methods and tools which have been developed to support them. Methods and tools include shared decision making, use of decision aids, consumer representation, application of electronic and internet-based facilities, and peer support. The success of CCE is dependent on both the approach taken and contextual factors, including structural facilitators such as governmental support, as well as barriers such as costs, organisational culture and population-specific limitations. Conclusions: The diversity of the field indicates the need to measure each component of CCE. This meta-review provides the basis for development of a new eight stage model of consumer and community engagement. This model emphasises the importance of clarity and focus, as well as an extensive evaluation of contextual factors within specific settings, before the implementation of CCE strategies, enabling those involved in CCE to determine potential facilitators and barriers to the process

    Behavior change techniques to promote healthcare professionals' eHealth competency : A systematic review of interventions

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    Introduction: The use of eHealth is rapidly ->increasing; however, many healthcare professionals have insufficient eHealth competency. Consequently, interventions addressing eHealth competency might be useful in fostering the effective use of eHealth. Objective: Our systematic review aimed to identify and evaluate the behavior change techniques applied in interventions to promote healthcare professionals' eHealth competency. Methods: We conducted a systematic literature review following the Joanna Briggs Institute's Manual for Evidence Synthesis. Published quantitative studies were identified through screening PubMed, Embase, and CINAHL. Two reviewers independently performed full-text and quality assessment. Eligible interventions were targeted to any healthcare professional and aimed at promoting eHealth capability or motivation. We synthesized the interventions narratively using the Behavior Change Technique Taxonomy v1 and the COM-B model. Results: This review included 32 studies reporting 34 heterogeneous interventions that incorporated 29 different behavior change techniques. The interventions were most likely to improve the capability to use eHealth and less likely to enhance motivation toward using eHealth. The promising techniques to promote both capability and motivation were action planning and participatory approach. Information about colleagues' approval, emotional social support, monitoring emotions, restructuring or adding objects to the environment, and credible source are techniques worth further investigation. Conclusions: We found that interventions tended to focus on promoting capability, although motivation would be as crucial for competent eHealth performance. Our findings indicated that empathy, encouragement, and usercentered changes in the work environment could improve eHealth competency as a whole. Evidence-based techniques should be favored in the development of interventions, and further intervention research should focus on nurses and multifaceted competency required for using different eHealth systems and devices.Peer reviewe

    The use of a proficiency-based clinical tool in the evaluation of clinical knowledge and skills in the athletic training setting

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    Context. Athletic training clinical education has changed significantly since the Commission on Accreditation of Athletic Training Education (CAATE) became the accrediting body for the profession. One of the changes is to require proficiency in both didactic knowledge and clinical performance through evaluation. Clinical education studies are evident and methods of teaching and learning are explored frequently, however little is known about the connection of athletic training students\u27 didactic performance and clinical proficiency competencies with on the field experiences. Objective. The purpose of this study was to create a clinical proficiency evaluation tool as a means to evaluate an athletic training student\u27s clinical skills. Design. The design of this study was a correlation study to note the relationship between GPAs, clinical performance evaluation grades, proficiency grades and the score obtained on the clinical proficiency evaluation tool. Setting. One Division I Mid-Atlantic University with a CAATE-accredited undergraduate athletic training program. Participants. This study included fifteen senior undergraduate athletic training students (6 males and 9 females) with a mean age of 22.5+/-1.5 years. This was a sample of convenience based on availability. Participants included in this study were required to be in their third year in the athletic training program and in good standing in order to graduate at the end of their final semester. The individuals had successfully completed all sophomore, junior, and first semester senior course and proficiency work with a minimum of proficient scores. Exclusion criteria included senior students in any other curriculum other than athletic training, individuals in the athletic training program but not in their third year, and individuals who had not scored at least proficient in all the proficiencies through the Fall semester of 2009. Intervention. Senior athletic training students were asked to participate in this study, and upon agreement were required to fill out the necessary informed consent paperwork and FERPA forms giving the examiner permission to access their individual scholastic files since acceptance into the athletic training education program through the fall 2009 semester. The students completed the clinical proficiency evaluation tool, which is based upon video scenarios within the established clinical proficiency and competency requirements of the athletic training education program. The tool consists of pictures, questions, situations, and video scenarios that students could experience in the athletic training setting. While viewing the tool, the students completed a 50 item multiple choice test. Upon completion of the examination, answer sheets were collected, and results were recorded. Main Outcome Measures. Based on the results, athletic training students\u27 clinical site grades will correlate highly with the grades obtained from the clinical proficiency evaluation tool, and athletic training students\u27 clinical site grades will improve over the course of each semester. Results. From the possible 16 senior students athletic training students, 15 individuals (n=15) submitted the required material for a participation rate of 93.75%. The mean GPA was 3.40+/-.33. As sophomore students, the mean score for their clinical evaluation grades is 90.2% +/-3.1%. As juniors, the mean clinical evaluation grade is 92.7%+/-4.5%, and as seniors, the mean clinical evaluation grade is 91.4% +/-5.7%. Clinical proficiency score results showed a mean of 88.2% +/-3.0%, and ranged from a minimum of 85.0% and a maximum score of a 93.0%. Results of the clinical proficiency evaluation tool had a mean of 63.1% +/-5.8%, and scores ranged from a minimum of 48% to a maximum score of 72%. Strong correlational relationships were found between the junior year clinical evaluation grades and GPA (r =.639, P=.010), clinical proficiency grades and GPA (r =.711, P=.003), as well as clinical proficiency grades and the junior year clinical evaluation grades (r =.754, P=.001). Conclusion. This study shows a strong correlation between GPA and clinical performance evaluation grades, and a moderate correlation between proficiency grades and the clinical proficiency evaluation tool. The clinical proficiency evaluation tool may have some areas of correlation and significance in accordance to the grades and scores already being obtained by programs. Information obtained in this study could be used by individual athletic training education programs to evaluate clinical proficiencies near the end of the athletic training student\u27s senior year
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