What maximizes the effectiveness and implementation of technology-based interventions to support healthcare professional practice? A systematic literature review

Background Technological support may be crucial in optimizing healthcare professional practice and improving patient outcomes. A focus on electronic health records has left other technological supports relatively neglected. Additionally, there has been no comparison between different types of technology-based interventions, and the importance of delivery setting on the implementation of technology-based interventions to change professional practice. Consequently, there is a need to synthesise and examine intervention characteristics using a methodology suited to identifying important features of effective interventions, and the barriers and facilitators to implementation. Three aims were addressed: to identify interventions with a technological component that are successful at changing professional practice, to determine if and how such interventions are theory-based, and to examine barriers and facilitators to successful implementation. Methods A literature review informed by realist review methods was conducted involving a systematic search of studies reporting either: (1) behavior change interventions that included technology to support professional practice change; or (2) barriers and facilitators to implementation of technological interventions. Extracted data was quantitative and qualitative, and included setting, target professionals, and use of Behaviour Change Techniques (BCTs). The primary outcome was a change in professional practice. A thematic analysis was conducted on studies reporting barriers and facilitators of implementation. Results Sixty-nine studies met the inclusion criteria; 48 (27 randomized controlled trials) reported behavior change interventions and 21 reported practicalities of implementation. The most successful technological intervention was decision support providing healthcare professionals with knowledge and/or person-specific information to assist with patient management. Successful technologies were more likely to operationalise BCTs, particularly “instruction on how to perform the behavior”. Facilitators of implementation included aligning studies with organisational initiatives, ensuring senior peer endorsement, and integration into clinical workload. Barriers included organisational challenges, and design, content and technical issues of technology-based interventions. Conclusions Technological interventions must focus on providing decision support for clinical practice using recognized behavior change techniques. Interventions must consider organizational context, clinical workload, and have clearly defined benefits for improving practice and patient outcomes

Ethical Approaches to Mandating Influenza Vaccinations for Local Health Department Workforce in Georgia

Background: The seasonal influenza illness occurs every year in the United States during the cooler months from October to April, sometimes lasting longer. Although certain populations are more susceptible to this condition, data have shown that otherwise healthy individuals have experienced alarming rates of morbidity and mortality associated with these infections. Despite the CDC’s recommendation for influenza vaccination for all HCWs, compliance have been lagging among local health departments’ workforce. This practice arguably exposes a wide cross section of the U.S. population to the flu, while being served in these facilities. The utilitarian approach provides a framework to examine the ethical implications to the public of mandating influenza vaccination for these employees. Methods: A systematic review of peer-reviewed literature was conducted to address the following research questions: 1) Do local public health departments in Georgia mandate annual influenza vaccinations?  2) What are the ethical considerations for mandating influenza vaccinations for public health employees? and 3) What are the ethical considerations for mandating influenza vaccinations for the community? Twenty-five articles were included in the review. Results: Descriptive analysis shows that there is no mandatory vaccination policy in place for state or local departments in health in the state of Georgia. Most of the literature available relates to policy implementation within acute or long-term care facilities. A systematic review of mandatory influenza vaccination for public health workers focused on four areas: theoretical approaches to increase influenza vaccination coverage and support of, opposition to, and alternative strategies for influenza vaccinations. Conclusions: The utilitarian approach is sufficient for the influenza vaccination policy- making strategies and in the ethical approaches of mandating influenza vaccinations for local health department workforce in Georgia if need be, for vaccination targets are to be achieved

Blueprint for the Dissemination of Evidence-Based Practices in Health Care

Proposes strategies for better dissemination of best practices through quality improvement campaigns, including campaigns aligned with adopting organizations' goals, practical implementation tools and guides, and networks to foster learning opportunities

How Did COVID-19 Affect Education and What Can Be Learned Moving Forward?

Abstract: The COVID-19 pandemic drastically impacted the educational sector on a global front. A plethora of research has been conducted to better understand the effects that the pandemic had on education as a whole, including investigations into different topics (e.g., school closures, e-teaching and learning, mental and physical health), populations (e.g., students, teachers), and levels of education (e.g., school, higher education). To summarize the available literature on education during the pandemic both qualitatively and quantitatively, many systematic reviews and meta-analyses have begun to emerge. With the present systematic meta-review, we aimed to synthesize and combine this existing database to derive broader and more comprehensive insights that can aid educational stakeholders. We summarize and evaluate 43 systematic reviews, four meta-analyses, and eight combined systematic reviews and meta-analyses published until November 2022 to provide a comprehensive narrative of how this crisis affected education and what can be learned moving forward

Patient Generated Health Data: Framework for Decision Making

Patient information is a major part of healthcare decision making. Although currently scattered due to multiple sources and diverse formats, decision making can be improved if the patient information is readily available in a unified manner. Mobile technologies can improve decision making by integrating patient information from multiple sources. This study explores how patient generated health data (PGHD) from multiple sources can lead to improved healthcare decision making. A semi-systematic review is conducted to analyze research articles for transparency, clarity, and complete reporting. We conceptualize the data generated by healthcare professional as primarily from EHR/EMR and the data generated by patient as primarily from mobile apps and wearables. Eight themes led to the development of Convergence Model for Patient Data (CMPD). A framework was developed to illustrate several scenarios, to identify quality and timeliness requirements in mobile healthcare environment, and to provide necessary decision support

Employee health and well-being in the circular economy context:a systematic literature review

Abstract. In this era of high global business competition and resource depletion, the call for a new economic model is getting louder. In such a condition, the concept of circular economy (CE) has gone one step further to analyze its potentiality to address the recent business and economic sustainable developments and thus gained strong ground for adoption. In addition to the material resources, human labor is, indeed, an important input for the production process of products or services. However, there has been little study made on human labor or human factors as vital resources in the context of the circular economy. The purpose of this review is to explore how human issues are considered in the circular economy context by studying the existing literature. Thus, the focus is on employee well-being, occupational safety & health, employment issues, and human resource management. PRISMA tool was used for the systematic review. The review of articles shows that human issues were not directly the topic of interest for most of the researchers studying the perspectives of a circular economy. However, some issues related to this thesis came up in their studies. Thus, the current literature indicates the fact that the existing abilities of the employees, their skills, policies for workplace safety, and employee health issues are not in compliance with the progressive trend of CE adoption by different industries. In these regards, special employee training to build required skills, specific workplace safety measures, strong policies and regulations by government and other authorities are recommended to incorporate in circular business model to pursue the true effectiveness of circular economy

Cognitive barriers during monitoring-based commissioning of buildings

Monitoring-based commissioning (MBCx) is a continuous building energy management process used to optimize energy performance in buildings. Although monitoring-based commissioning (MBCx) can reduce energy waste by up to 20%, many buildings still underperform due to issues such as unnoticed system faults and inefficient operational procedures. While there are technical barriers that impede the MBCx process, such as data quality, the focuses of this paper are the non-technical, behavioral and organizational, barriers that contribute to issues initiating and implementing MBCx. In particular, this paper discusses cognitive biases, which can lead to suboptimal outcomes in energy efficiency decisions, resulting in missed opportunities for energy savings. This paper provides evidence of cognitive biases in decisions during the MBCx process using qualitative data from over 40 public and private sector organizations. The results describe barriers resulting from cognitive biases, listed in descending order of occurrence, including: risk aversion, social norms, choice overload, status quo bias, information overload, professional bias, and temporal discounting. Building practitioners can use these results to better understand potential cognitive biases, in turn allowing them to establish best practices and make more informed decisions. Researchers can use these results to empirically test specific decision interventions and facilitate more energy efficient decisions

The Effects of Education with Healthcare Providers on Low Vision Assistive Devices and their Ability to Improve Self-Care Skills

Background: Results of a study by Casten et al., (2005) confirmed low rates of use of devices and services for low vision by the older adult. Older adults with low vision are receptive to using low vision resources but are often unaware of them (Lighthouse International, 2021). Casten et al. (2005) further suggested that the lack of services or use of devices may be due to a lack of awareness of health care professionals. Low vision assistive devices (LVAD), whether high or low tech, or mainstream, can help maximize a client’s vision so that they can perform everyday tasks more easily and with less frustration (Duffy, 2017) and increase the likelihood of being able to age in place. Purpose: The purpose of this research was to educate practitioners on the effectiveness of interventions and pieces of assistive technology within the occupational therapy scope of practice to improve performance in daily activities at home for older adults with low vision. Theoretical Framework: This capstone was supported by the Adult Learning theory and The Conceptual Model of Occupational Therapy in Low Vision (Schoessow, 2010). These theories interact equally to support education on LVAD so that a person with low vision can function as independently as possible. Methods: This project was designed and implemented to provide professional development on current LVAD and local community resources to home health practitioners to increase their knowledge. The project was completed though a professional development module to inform practitioners of the most current best practices to help those with low vision remain as independent as possible with self-care skills in the home and community environments. Before and after the professional development module, pre and post survey data were collected to evaluate the participants’ knowledge level of identification of low vision client’s and the use of LVAD and resources and determine the change in their knowledge after the module. The goal of the professional development in-service was to not only increase the participants’ knowledge of LVAD and resources but also to reinforce occupational therapy’s role with this population. Results: This capstone project was conducted with eleven healthcare practitioners to provide education on LVAD, interventions and resources to healthcare practitioners with focus on the home care setting. Quantitative analysis of the data revealed that the objectives of the study were met. Mean scores improved from the pre to posttest, where pre-test questions ranged from 1.82 to 2.91 and the post-test questions ranged from 3.73 to 4.45, for an average of 2.14 or 42.8%. The participant responses to the open-ended questions were positive and indicated understanding and growth in realm of LVAD, interventions, and resources. Based on these findings, the educational presentation provided to home healthcare clinicians was found to increase home care clinicians’ knowledge of LVAD, interventions and resources. Conclusion: This researcher found evidence connecting this study to the past literature involving LVAD, interventions and resources. The capstone objectives were met by the participants’ demonstration of knowledge and perceptions and finally educating practitioners about the realm of low vision. This capstone helps to fill a gap in the literature involving the need for greater education on low vison

Economic aspects of delivering primary care services: an evidence synthesis to inform policy and research priorities

Policy Points The 2018 Declaration of Astana reemphasized the importance of primary health care and its role in achieving universal health coverage. While there is a large amount of literature on the economic aspects of delivering primary care services, there is a need for more comprehensive overviews of this evidence. In this article, we offer such an overview. Evidence suggests that there are several strategies involving coverage, financing, service delivery, and governance arrangements which can, if implemented, have positive economic impacts on the delivery of primary care services. These include arrangements such as worker task-shifting and telemedicine. The implementation of any such arrangements, based on positive economic evidence, should carefully account for potential impacts on overall health care access and quality. There are many opportunities for further research, with notable gaps in evidence on the impacts of increasing primary care funding or the overall supply of primary care services. Context: The 2018 Declaration of Astana reemphasized the importance of primary health care and its role in achieving universal health coverage. To strengthen primary health care, policymakers need guidance on how to allocate resources in a manner that maximizes its economic benefits. Methods: We collated and synthesized published systematic reviews of evidence on the economic aspects of different models of delivering primary care services. Building on previous efforts, we adapted existing taxonomies of primary care components to classify our results according to four categories: coverage, financing, service delivery, and governance. Findings: We identified and classified 109 reviews that met our inclusion criteria according to our taxonomy of primary care components: coverage, financing, service delivery, and governance arrangements. A significant body of evidence suggests that several specific primary care arrangements, such as health workers' task shifting and telemedicine, can have positive economic impacts (such as lower overall health care costs). Notably absent were reviews on the impact of increasing primary care funding or the overall supply of primary care services. Conclusions: There is a great opportunity for further research to systematically examine the broader economic impacts of investing in primary care services. Despite progress over the last decade, significant evidence gaps on the economic implications of different models of primary care services remain, which could help inform the basis of future research efforts

Paying for Quality: Understanding and Assessing Physician Pay-for-Performance Initiatives

Reviews the structure, prevalence, measurement issues, perception, and impact of current quality incentive programs, and discusses how much and under what circumstances they will improve quality of care. Includes descriptions of select programs