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Science of healthcare delivery

Matthew P Smeltzer, Fedoria E Rugless, Bianca M Jackson, Courtney L Berryman, Nicholas R Faris, Meredith A Ray, Meghan Meadows, Anita A Patel, Kristina S Roark, Satish K Kedia, Margaret M DeBon, Fayre J Crossley, Georgia Oliver, Laura M McHugh, Willeen Hastings, Orion Osborne, Jackie Osborne, Toni Ill, Mark Ill, Wynett Jones, Hyo K Lee, Raymond S Signore, Roy C Fox, Jingshan Li, Edward T Robbins, Kenneth D Ward, Lisa M Klesges, Raymond U Osarogiagbon
Background: Responsible for 25% of all US cancer deaths, lung cancer presents complex care-delivery challenges. Adoption of the highly recommended multidisciplinary care model suffers from a dearth of good quality evidence. Leading up to a prospective comparative-effectiveness study of multidisciplinary vs. serial care, we studied the implementation of a rigorously benchmarked multidisciplinary lung cancer clinic. Methods: We used a mixed-methods approach to conduct a patient-centered, combined implementation and effectiveness study of a multidisciplinary model of lung cancer care...
February 2018: Translational Lung Cancer Research
Sagaren Govender, Cecile N Gerwel Proches, Abdulla Kader
Background: Four public hospitals in South Africa, which render both specialized and nonspecialized services to thousands of patients, were examined to determine the impact of leadership on health care service delivery. These hospitals were inundated by various problems that were impacting negatively on health care service delivery. Purpose: This research study aimed to gain a comprehensive understanding of the challenges, complexities and constraints facing public health care in KwaZulu-Natal (KZN) and to examine leadership as a strategy to enhance healthcare service delivery with a particular focus on four regional hospitals in the KZN Province...
2018: Journal of Multidisciplinary Healthcare
A Klin, W Jones
The future of neurodevelopmental medicine has the potential of situating child neurology at the forefront of a broad-based public health effort to optimize neurodevelopmental outcomes of children born with high-prevalence and diverse genetic, pre- and peri-natal, and environmental burdens compromising early brain development and leading to lifetime disabilities. Building on advancements in developmental social neuroscience and in implementation science, this shift is already occurring in the case of emblematic neurodevelopmental disorders such as autism...
March 1, 2018: Revista de Neurologia
J Sumankuuro, J Crockett, S Wang
OBJECTIVES: Maternal and neonatal healthcare outcomes in Sub-Saharan Africa (SSA) remain poor despite decades of different health service delivery interventions and stakeholder investments. Qualitative studies have attributed these results, at least in part, to sociocultural beliefs and practices. Thus there is a need to understand, from an overarching perspective, how these sociocultural beliefs affect maternal and neonatal health (MNH) outcomes. STUDY DESIGN: A qualitative meta-synthesis of primary studies on cultural beliefs and practices associated with maternal and neonatal health care was carried out, incorporating research conducted in any country within SSA, using data from men, women and health professionals gathered through focus group discussions, structured and semistructured interviews...
March 1, 2018: Public Health
Richard J Pugh, Amy Ellison, Kate Pye, Christian P Subbe, Chris M Thorpe, Nazir I Lone, Andrew Clegg
BACKGROUND: For healthcare systems, an ageing population poses challenges in the delivery of equitable and effective care. Frailty assessment has the potential to improve care in the intensive care setting, but applying assessment tools in critical illness may be problematic. The aim of this systematic review was to evaluate evidence for the feasibility and reliability of frailty assessment in critical care. METHODS: Our primary search was conducted in Medline, Medline In-process, EMBASE, CINAHL, PsycINFO, AMED, Cochrane Database of Systematic Reviews, and Web of Science (January 2001 to October 2017)...
February 26, 2018: Critical Care: the Official Journal of the Critical Care Forum
Echezona E Ezeanolue, William Nii Ayitey Menson, Dina Patel, Gregory Aarons, Ayodotun Olutola, Michael Obiefune, Patrick Dakum, Prosper Okonkwo, Bola Gobir, Timothy Akinmurele, Anthea Nwandu, Hadiza Khamofu, Bolanle Oyeledun, Muyiwa Aina, Andy Eyo, Obinna Oleribe, Ikoedem Ibanga, John Oko, Chukwuma Anyaike, John Idoko, Muktar H Aliyu, Rachel Sturke
BACKGROUND: Despite being disproportionately burdened by preventable diseases than more advanced countries, low- and middle-income countries (LMICs) continue to trail behind other parts of the world in the number, quality and impact of scholarly activities by their health researchers. Our strategy at the Nigerian Implementation Science Alliance (NISA) is to utilise innovative platforms that catalyse collaboration, enhance communication between different stakeholders, and promote the uptake of evidence-based interventions in improving healthcare delivery...
February 12, 2018: Health Research Policy and Systems
Andrea C Tricco, Wasifa Zarin, Patricia Rios, Vera Nincic, Paul A Khan, Marco Ghassemi, Sanober Diaz, Ba' Pham, Sharon E Straus, Etienne V Langlois
BACKGROUND: It is unclear how to engage a wide range of knowledge users in research. We aimed to map the evidence on engaging knowledge users with an emphasis on policy-makers, health system managers, and policy analysts in the knowledge synthesis process through a scoping review. METHODS: We used the Joanna Briggs Institute guidance for scoping reviews. Nine electronic databases (e.g., MEDLINE), two grey literature sources (e.g., OpenSIGLE), and reference lists of relevant systematic reviews were searched from 1996 to August 2016...
February 12, 2018: Implementation Science: IS
Aaron R Lyon, Kelly Whitaker, Jill Locke, Clayton R Cook, Kevin M King, Mylien Duong, Chayna Davis, Mark D Weist, Mark G Ehrhart, Gregory A Aarons
BACKGROUND: Integrated healthcare delivered by work groups in nontraditional service settings is increasingly common, yet contemporary implementation frameworks typically assume a single organization-or organizational unit-within which system-level processes influence service quality and implementation success. Recent implementation frameworks predict that inter-organizational alignment (i.e., similarity in values, characteristics, activities related to implementation across organizations) may facilitate the implementation of evidence-based practices (EBP), but few studies have evaluated this premise...
February 7, 2018: Implementation Science: IS
Chrisanne Wilks, Erik Krisle, Kimberly Westrich, Kristina Lunner, David Muhlestein, Robert Dubois
BACKGROUND: Optimized medication use involves the effective use of medications for better outcomes, improved patient experience, and lower costs. Few studies systematically gather data on the actions accountable care organizations (ACOs) have taken to optimize medication use. OBJECTIVES: To (a) assess how ACOs optimize medication use; (b) establish an association between efforts to optimize medication use and achievement on financial and quality metrics; (c) identify organizational factors that correlate with optimized medication use; and (d) identify barriers to optimized medication use...
May 30, 2017: Journal of Managed Care & Specialty Pharmacy
Florian R Schroeck, Nicholas Smith, Jeremy B Shelton
Implementation science is a rapidly developing field dedicated to the scientific investigation of strategies to facilitate improvements in healthcare delivery. These strategies have been shown in several settings to lead to more complete and sustained change. In this essay, we discuss how refined surveillance recommendations for non-muscle-invasive bladder cancer, which involve a complex interplay between providers, healthcare facilities, and patients, could benefit from use of implementation strategies derived from the growing literature of implementation science...
January 26, 2018: Urologic Oncology
Pragashnie Govender, Verusia Chetty, Deshini Naidoo, Ntsikelelo Pefile
BACKGROUND: The Integrated Decentralized Training (i-DecT) project was created to address the current need for health care in South Africa among resource poor climates in rural and periurban settings. The University of KwaZulu-Natal (UKZN) in South Africa has embarked on a program within the School of Health Sciences (SHS) to decentralize the clinical learning platform in order to address this disparity. Framed in a pragmatic stance, this proposal is geared towards informing the roll out of decentralized clinical training (DCT) within the province of KwaZulu-Natal...
January 25, 2018: JMIR Research Protocols
Bernadette Mazurek Melnyk, Lynn Gallagher-Ford, Cindy Zellefrow, Sharon Tucker, Laurel Van Dromme, Bindu Koshy Thomas
BACKGROUND: Even though multiple positive outcomes are the result of evidence-based care, including improvements in healthcare quality, safety, and costs, it is not consistently delivered by clinicians in healthcare systems throughout the world. AIMS: In an attempt to accelerate the implementation of evidence-based practice (EBP) across the United States, an invitational Interprofessional National EBP Forum to determine major priorities for the advancement of EBP was held during the launch of the newly established Helene Fuld Health Trust National Institute for Evidence-Based Practice in Nursing and Healthcare at The Ohio State University College of Nursing...
January 16, 2018: Worldviews on Evidence-based Nursing
Anne-Sophie Yussif, Anyetei Lassey, Gabriel Yao-Kumah Ganyaglo, Eva J Kantelhardt, Heike Kielstein
BACKGROUND: In Ghana, adolescents represent 22% of the total population. The rates of adolescent pregnancies are high. Of all births registered in the country in 2014, 30% were by adolescents, and 14% of adolescents aged between 15 and 19 years had begun childbearing. Pregnancies and deliveries of adolescents are accompanied by more risks as compared to older women. The aim of the study was to explore the long-term effects of adolescent pregnancies on subsequent pregnancies and births and on the socioeconomic status of the women...
December 29, 2017: Reproductive Health
Marilyn M Lombardi, Regena G Spratling, Wei Pan, Susan E Shapiro
In an era of rising clinical costs and shrinking federal research dollars, the survival of the academic health center may depend on its capacity to cultivate high-impact innovations in care delivery on an accelerated basis. Yet, the health sciences literature offers little guidance regarding the key organizational determinants most likely to facilitate such innovation. We report on the conceptualization, development, and preliminary testing of a new 21-item Accelerated Healthcare Innovation Capacity scale for addressing that knowledge gap...
January 2018: Quality Management in Health Care
Michael Gardam, Leah Gitterman, Liz Rykert, Elisa Vicencio
Front-line ownership (FLO) is a complexity science-based approach to leading change initiatives that is built upon a foundation of Positive Deviance and the use of Liberating Structures to engage others. In this paper, we outline the use of FLO in four successful patient safety or quality improvement projects in four countries. While the underlying principles guiding the use of FLO were the same for each of these projects, project goals, the types of roles involved and how the projects evolved, spread and were sustained, varied considerably between settings...
2017: HealthcarePapers
Jennifer Webb, Asta Sorensen, Samantha Sommerness, Beth Lasater, Kamila Mistry, Leila Kahwati
BACKGROUND: The use of health information technology (IT) has been shown to promote patient safety in Labor and Delivery (L&D) units. The use of health IT to apply safety science principles (e.g., standardization) to L&D unit processes may further advance perinatal safety. METHODS: Semi-structured interviews were conducted with L&D units participating in the Agency for Healthcare Research and Quality's (AHRQ's) Safety Program for Perinatal Care (SPPC) to assess units' experience with program implementation...
December 19, 2017: BMC Medical Informatics and Decision Making
Dana C Crawford, Alexander A Morgan, Joshua C Denny, Bruce J Aronow, Steven E Brenner
Precision medicine research efforts both in basic science discovery and clinical implementation are well underway and promise to provide individualized preventions and treatments, improving overall health care delivery. To achieve these goals, advances in data capture and analysis are needed spanning different types of 'omic and clinical data. The efforts to enhance precise treatments for all may accentuate healthcare disparities unless specific challenges are identified and addressed. This session of the 2018 Pacific Symposium on Biocomputing presents the latest developments in this transdisciplinary research space of genomics, medicine, and population health...
2018: Pacific Symposium on Biocomputing
Iain Simpson
This industry update covers the period from 1 September through 30 September 2017, and is based on information sourced from company press releases, scientific literature, patents and various news websites. The month saw the US FDA approve three new molecular entities, Aliqopa (copanlisib dihydrochloride) (Bayer Healthcare); Solosec (secnidazole) (Symbiomix Therapeutics) and Verzenio (abemaciclib) (Eli Lilly and Co). Intarcia Therapeutics Inc. has its application for approval of a novel drug device combination of exenatide for the treatment of diabetes rejected by FDA but said that it will work to address the concerns and refile the application...
January 2018: Therapeutic Delivery
Manuel Lillo-Crespo, M Cristina Sierras-Davó, Rhoda MacRae, Kevin Rooney
PURPOSE: Frontline healthcare professionals are well positioned to improve the systems in which they work. Educational curricula, however, have not always equipped healthcare professionals with the skills or knowledge to implement and evaluate improvements. It is important to have a robust and standardized framework in order to evaluate the impact of such education in terms of improvement, both within and across European countries. The results of such evaluations will enhance the further development and delivery of healthcare improvement science (HIS) education...
2017: Journal of Educational Evaluation for Health Professions
Wynne E Norton, Amy E Kennedy, David A Chambers
BACKGROUND: Studying de-implementation-defined herein as reducing or stopping the use of a health service or practice provided to patients by healthcare practitioners and systems-has gained traction in recent years. De-implementing ineffective, unproven, harmful, overused, inappropriate, and/or low-value health services and practices is important for mitigating patient harm, improving processes of care, and reducing healthcare costs. A better understanding of the state-of-the-science is needed to guide future objectives and funding initiatives...
December 4, 2017: Implementation Science: IS
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