The relationship between baseline Organizational Readiness to Change Assessment subscale scores and implementation of hepatitis prevention services in substance use disorders treatment clinics: a case study

<p>Abstract</p> <p>Background</p> <p>The Organizational Readiness to Change Assessment (ORCA) is a measure of organizational readiness for implementing practice change in healthcare settings that is organized based on the core elements and sub-elements of the Promoting Action on Research Implementation in Health Services (PARIHS) framework. General support for the reliability and factor structure of the ORCA has been reported. However, no published study has examined the utility of the ORCA in a clinical setting. The purpose of the current study was to examine the relationship between baseline ORCA scores and implementation of hepatitis prevention services in substance use disorders (SUD) clinics.</p> <p>Methods</p> <p>Nine clinic teams from Veterans Health Administration SUD clinics across the United States participated in a six-month training program to promote evidence-based practices for hepatitis prevention. A representative from each team completed the ORCA evidence and context subscales at baseline.</p> <p>Results</p> <p>Eight of nine clinics reported implementation of at least one new hepatitis prevention practice after completing the six-month training program. Clinic teams were categorized by level of implementation-high (n = 4) versus low (n = 5)-based on how many hepatitis prevention practices were integrated into their clinics after completing the training program. High implementation teams had significantly higher scores on the patient experience and leadership culture subscales of the ORCA compared to low implementation teams. While not reaching significance in this small sample, high implementation clinics also had higher scores on the research, clinical experience, staff culture, leadership behavior, and measurement subscales as compared to low implementation clinics.</p> <p>Conclusions</p> <p>The results of this study suggest that the ORCA was able to measure differences in organizational factors at baseline between clinics that reported high and low implementation of practice recommendations at follow-up. This supports the use of the ORCA to describe factors related to implementing practice recommendations in clinical settings. Future research utilizing larger sample sizes will be essential to support these preliminary findings.</p

Integration in primary community care networks (PCCNs): examination of governance, clinical, marketing, financial, and information infrastructures in a national demonstration project in Taiwan

Background. Taiwan's primary community care network (PCCN) demonstration project, funded by the Bureau of National Health Insurance on March 2003, was established to discourage hospital shopping behavior of people and drive the traditional fragmented health care providers into cooperate care models. Between 2003 and 2005, 268 PCCNs were established. This study profiled the individual members in the PCCNs to study the nature and extent to which their network infrastructures have been integrated among the members (clinics and hospitals) within individual PCCNs. Methods. The thorough questionnaire items, covering the network working infrastructures - governance, clinical, marketing, financial, and information integration in PCCNs, were developed with validity and reliability confirmed. One thousand five hundred and fifty-seven clinics that had belonged to PCCNs for more than one year, based on the 2003-2005 Taiwan Primary Community Care Network List, were surveyed by mail. Nine hundred and twenty-eight clinic members responded to the surveys giving a 59.6 % response rate. Results. Overall, the PCCNs' members had higher involvement in the governance infrastructure, which was usually viewed as the most important for establishment of core values in PCCNs' organization design and management at the early integration stage. In addition, it found that there existed a higher extent of integration of clinical, marketing, and information infrastructures among the hospital-clinic member relationship than those among clinic members within individual PCCNs. The financial infrastructure was shown the least integrated relative to other functional infrastructures at the early stage of PCCN formation. Conclusion. There was still room for better integrated partnerships, as evidenced by the great variety of relationships and differences in extent of integration in this study. In addition to provide how the network members have done for their initial work at the early stage of network forming in this study, the detailed surveyed items, the concepts proposed by the managerial and theoretical professionals, could be a guide for those health care providers who have willingness to turn their business into multi-organizations. © 2007 Lin; licensee BioMed Central Ltd.published_or_final_versio

F-2(D(3)) measurements at ZEUS

Results on the diffractive structure function F-2(D(3)) in deep inelastic neutral current positron-proton scattering (DIS) have been obtained by the ZEUS collaboration using two different methods. Diffractive interactions are selected by either requiring a small, not exponentially suppressed invariant hadronic mass M-X in the main detector or by detecting a fast proton in the ZEUS leading proton spectrometer (LPS). The results of the two methods are compared

Recent photoproduction results from ZEUS

Recent results for inclusive jet cross sections, dijet cross sections and dijet angular distributions are compared with NLO perturbative QCD calculations. The observation of isolated high PT photons (prompt photons) is also reported

Event shape analysis of multihadronic final states in deep inelastic rapidity gap events at HERA

A global event shape analysis of the multihadronic final states observed in deep inelastic scattering (DIS) with a large forward rapidity gap (LRG) is performed in the range Q(2) greater than or equal to 5 GeV2, 160 GeV less than or equal to W less than or equal to 250 GeV and eta(max) less than or equal to 1.8. Particular emphasis is paid to the dependence of these variables, measured in the gamma*-pomeron rest frame, upon M-X, the mass of the hadronic final state. With increasing M-X the multihadronic final states become planar. The broadening effects exhibited by the data can be described by including a gluon density in models where the pomeron has a partonic structure or alternatively by considering a direct coupling of the pomeron to quark and gluon pairs

Leading baryons at low x(L) in DIS and photoproduction at ZEUS

Results obtained by the ZEUS collaboration on leading baryon production in the proton fragmentation region are presented. The reaction gamma p --> NX, with N a proton or a neutron, is examined both at low and high photon virtuality

Searches at HERA for excited fermions, contact interactions, a heavy neutrino, and: a HERA excess?

Results are presented on a number of searches for new physics in ep collisions at HERA using the ZEUS and HI detectors. Limits are presented on the production of elicited fermions, contact interactions, as well as a heavy right handed neutrino and W-R boson. Also presented are ZEUS results on the excess of events at high x and Q(2)

Fragmentation functions at ZEUS

The scaled momentum spectra of final state charged hadrons produced in Deep Inelastic Scattering in the ranges 10 < Q(2) < 1280 GeV2 and 6 . 10(-4) < x(Bjorken) < 5 . 10(-2) have been measured in the current region of the Breit frame using the ZEUS detector. The evolution with Q(2) of the scaled momentum, x(p) = 2p(Breit)/Q, has been investigated and preliminary results are presented which show evidence for scaling violations and support for the universality of quark fragmentation

D* and J/psi inelastic photoproduction at HERA

Cross sections of D* and J/Psi inelastic photoproduction were measured by the ZEUS detector at HERA collider. Comparisons of the data with calculations in NLO pQCD and SHA QCD approaches were made