Social media: opportunities for quality improvement and lessons for providers-a networked model for patient-centered care through digital engagement

Determinants of multimodal fake review generation in China's E-commerce platforms

This paper develops a theoretical model of determinants influencing multimodal fake review generation using the theories of signaling, actor-network, motivation, and human-environment interaction hypothesis. Applying survey data from users of China's three leading E-commerce platforms (Taobao, Jingdong, and Pinduoduo), we adopt structural equation modeling, machine learning technique, and Bayesian complex networks analysis to perform factor identification, path analysis, feature factor importance ranking, regime division, and network centrality analysis of full sample, male sample, and female sample to reach the following conclusions: (1) platforms' multimodal recognition and governance capabilities exert significant negative moderating effects on merchants' information behavior, while it shows no apparent moderating effect on users' information behavior; users' emotional venting, perceived value, reward mechanisms, and subjective norms positively influence multimodal fake review generation through perceptual behavior control; (2) feature factors of multimodal fake review generation can be divided into four regimes, i.e., regime 1 includes reward mechanisms and perceived social costs, indicating they are key feature factors of multimodal fake review generation; merchant perception impact is positioned in regime 2, signifying its pivotal role in multimodal fake review generation; regime 3 includes multimodal recognition and governance capabilities, supporting/disparaging merchants, and emotional venting; whereas user perception impact is positioned in regime 4, indicating its weaker influence on multimodal fake review generation; (3) both in full sample, male sample, and female sample, reward mechanisms play a crucial role in multimodal fake review generation; perceived value, hiring review control agency, multimodal recognition and governance capabilities exhibit a high degree of correlation; however, results of network centrality analysis also exhibit heterogeneity between male and female samples, i.e., male sample has different trends in closeness centrality values and betweenness centrality values than female sample. This indicates that determinants influencing multimodal fake review generation are complex and interconnected.

The Experiences of Stakeholders Using Social Media as a Tool for Health Service Design and Quality Improvement: A Scoping Review

BACKGROUND

Health organisations and stakeholders use social media for a range of functions, including engaging stakeholders in the design and quality improvement (QI) of services. Social media may help overcome some of the limitations of traditional stakeholder engagement methods. This scoping review explores the benefits, risks, barriers and enablers for using social media as a tool for stakeholder engagement in health service design and QI.

METHODS

The searches were conducted on 16 August 2022. Inclusion criteria were: studies of any health service stakeholders, in any health setting, where social media was used as a tool for service design or QI. Data was analysed using deductive content analysis. A committee of stakeholders provided input on research questions, data analysis and key findings.

RESULTS

61 studies were included. Benefits included improved organisational communication and relationship building. Risks/limitations included low quality of engagement and harms to users. Limited access and familiarity with social media were frequently reported barriers. Making discussions safe and facilitating access were common enablers.

CONCLUSION

The benefits, risks, barriers and enablers identified highlight the complexity of social media as an engagement tool for health service design and QI. Understanding these experiences may help implementers design more effective social media-based engagement activities.

Canadian Resources on Cannabis Use and Fertility, Pregnancy, and Lactation: Scoping Review

BACKGROUND

Cannabis use among reproductive-aged Canadians is increasing, but our understanding of its impacts on fertility, pregnancy, and breast milk is still evolving. Despite the availability of many web-based resources, informed decision-making and patient counseling are challenging for expectant families and providers alike.

OBJECTIVE

We aimed to conduct a scoping review of publicly available web-based Canadian resources to provide information on the effects of cannabis on fertility, pregnancy, and breast milk.

METHODS

Following PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews), we systematically searched 8 databases between January 1, 2010, and November 30, 2020, and web pages of 71 Canadian obstetrical, government, and public health organizations. We included English resources discussing the effects of cannabis on fertility, pregnancy, breastfeeding, or the exposed fetus and infant. Epidemiological characteristics, readability, and content information were extracted and summarized.

RESULTS

A total of 183 resources met our inclusion criteria. Resources included content for public audiences (163/183, 89.1%) and health care providers (HCPs; 31/183, 16.9%). The resources were authored by national-level (46/183, 25.1%), provincial or territorial (65/183, 35.5%), and regional (72/183, 39.3%) organizations. All provinces and territories had at least one resource attributed to them. The majority (125/183, 68.3%) were written at a >10 grade reading level, and a few (7/183, 3.8%) were available in languages other than English or French. The breadth of content on fertility (55/183, 30.1%), pregnancy (173/183, 94.5%), and breast milk or breastfeeding (133/183, 72.7%) varied across resources. Common themes included citing a need for more research into the effects of cannabis on reproductive health and recommending that patients avoid or discontinue cannabis use. Although resources for providers were consistent in recommending patient counseling, resources targeting the public were less likely to encourage seeking advice from HCPs (23/163, 14.1%).

CONCLUSIONS

Canadian resources consistently identify that there is no known safe amount of cannabis that can be consumed in the context of fertility, pregnancy, and breastfeeding. Areas of improvement include increasing readability and language accessibility and encouraging bidirectional communication between HCPs and patients.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.1136/bmjopen-2020-045006.

Social Media as a Tool for Consumer Engagement in Hospital Quality Improvement and Service Design: Barriers and Enablers for Implementation

BACKGROUND

Social media can be used to engage consumers in hospital service design and quality improvement (QI) activities, however its uptake may be limited by a lack of guidance to support implementation. This article presents the perceived barriers and enablers in using social media for consumer engagement derived from an interview study with public hospital stakeholders.

METHODS

Semi-structured interviews with 26 Australian hospital service providers and consumer representatives. Data were analysed using a deductive content analysis method.

RESULTS

Data were collected between October 2019 and April 2020. Facebook was the platform most commonly used for consumer engagement activities. Barriers and enablers to social media-based consumer engagement were identified. The barrier themes were (1) fears and concerns; (2) lack of skills and resources for social media engagement; (3) lack of organisational processes and support; and (4) problems with social media platforms and the changing social media landscape. The enabler themes were: (1) hospitals facilitating access and use; (2) making discussions safe; (3) cultivating a social media community; and (4) building on success.

CONCLUSION

Using social media to facilitate consumer engagement in hospital service design and QI activities is feasible and acceptable to service providers and consumers. Hospitals and their executives can create a supportive environment for social media-based engagement activities through developing clear governance systems and providing training and support to all users. Consumers need to be involved in co-designing social media-based activities and determining which forms of engagement are accessible and acceptable. For some consumers and service providers, barriers such as a lack of resources and distrust of social media companies might mean that social media-based engagement will be less acceptable for them. Because of this it is important that hospitals provide complementary methods of engagement (eg, face-to-face) alongside social media-based methods.

Do Health Care Providers Pay Attention to Sharing Hospital Patient Safety Incidents Through Social Media in Saudi Arabia?

PURPOSE

The aim of this study was to find out if health care providers in Saudi Arabia used social media to share the safety incidents that occurred in hospitals.

PARTICIPANTS AND METHODS

To carry out this study, we conducted a survey using a valid and reliable questionnaire that was distributed through WhatsApp groups by means of a link to a sample of 450 health care providers in Saudi Arabia. The response rate was 33.55%, and 151 respondents answered the questionnaire. The survey was carried out in January 2019. The data were analyzed using basic descriptive statistics.

RESULTS

More than half of the respondents (54%) were female, and 68% of them were younger than 40 years. Also, 42% of the participants had a bachelor's degree, and 57% were working in the health care quality field. The participants used the following social media: WhatsApp (21%), Twitter (17%), YouTube (15%), Snapchat (13%), LinkedIn (12%), and Instagram (12%). They used these networks for education and professional development (24%), networking (23%), self-promotion (16%), employment (15%), sharing incidents that affect patient safety (11%), and health promotion (11%). Besides, 60% of the participants reported safety incidents that occurred in hospitals, and 72% of them did not agree to share these incidences through social media. In addition, 82% of participants thought that social networks were beneficial to obtain knowledge about quality of patient care.

CONCLUSIONS

The findings of this research showed that most health care providers in Saudi Arabia considered that safety incidents that occur in hospitals should not be shared through social media because they affect the policies and privacy of hospitals, patients, and personnel. However, most of the respondents believed that social media could contribute to improving the quality of patient attention and thought that WhatsApp and Twitter could be the most useful social media for these purposes.

Impact of Service Quality on In-Patients' Satisfaction, Perceived Value, and Customer Loyalty: A Mixed-Methods Study from a Developing Country

PURPOSE

Recent literature on healthcare quality demands more contextualized and patient-perspective research, as models from developed countries are not suitable for developing countries. Moreover, research on private healthcare services in Vietnam has long been underestimated by academia, but it has significant economic and commercial value. Hence, this study explores the dimensions of service quality in private healthcare and how they impact in-patient satisfaction, perceived value, and customer loyalty in Vietnam.

METHODS

This mixed-method study had a sample size of five inpatients for the qualitative phase and 368 inpatients for the quantitative phase from hospitals in Vietnam. The qualitative analysis explores service quality dimensions in private healthcare and incorporates them with the literature to develop a conceptual model. The quantitative phase tests the relationship between each construct in the conceptual model via structural equation modeling.

RESULTS

The four dimensions of service quality were emotion, function, social influence, and trust. Most of these dimensions have a significant impact on customer perceived value and satisfaction. However, emotion does not significantly influence customer perceived value, and function does not considerably impact customer satisfaction. In addition, social influence is an underrepresented variable in the service quality literature, but it has the most substantial impact on customer perceived value and customer satisfaction. The quantitative results also confirm that customer satisfaction and customer perceived value significantly impact customer loyalty (word-of-mouth and revisit intention); however, customer perceived value does not significantly impact customer satisfaction.

CONCLUSION

The study suggests that private healthcare providers and the government in Vietnam should allocate resources to improve service quality. Practitioners should invest in social branding and e-services to reach out to their customers. Future research should focus on a cost-benefit analysis and compare the effectiveness of service quality dimensions on customer behavioral intention.

The risks and benefits of using social media to engage consumers in service design and quality improvement in Australian public hospitals: findings from an interview study of key stakeholders

BACKGROUND

Engaging consumers - patients, families, carers and community members who are current or potential service users - in the planning, design, delivery, and improvement of health services is a requirement of public hospital accreditation in Australia. There is evidence of social media being used for consumer engagement in hospitals internationally, but in Australia this use is uncommon and stakeholders' experiences have not been investigated. The aim of the study was to explore the experiences and beliefs of key Australian public hospital stakeholders around using social media as a consumer engagement tool. This article focuses on the study findings relating to methods, risks, and benefits of social media use.

METHODS

Semi-structured interviews were conducted with Australian public hospital stakeholders in consumer representative, consumer engagement/patient experience, communications or quality improvement roles. Qualitative data were analysed using a deductive content analysis method. An advisory committee of consumer and service provider stakeholders provided input into the design and conduct of this study.

RESULTS

Twenty-six Australian public hospital service providers and consumers were interviewed. Participants described social media being used to: recruit consumers for service design and quality improvement activities; as an online space to conduct consultations or co-design; and, to gather feedback and patient experience data. The risks and benefits discussed by interview participants were grouped into five themes: 1) overcoming barriers to engagement, 2) consumer-initiated engagement; 3) breadth vs depth of engagement, 4) organisational transparency vs control and 5) users causing harm.

CONCLUSIONS

Social media can be used to facilitate consumer engagement in hospital service design and quality improvement. However, social media alone is unlikely to solve broader issues commonly experienced within health consumer engagement activities, such as tokenistic engagement methods, and lack of clear processes for integrating consumer and patient feedback into quality improvement activities.

Women in Cardiology: Role of Social Media in Advocacy

Digital and social media have transformed the field of medicine. They are powerful tools that academic and non-academic physicians and healthcare providers are using to influence others, promote ideas, obtain knowledge, disseminate research and communicate with others. The history of advocacy for women in medicine and the role of social media in influencing the choice of women to choose Cardiology as a career and its role in advocacy for Women in Cardiology (WIC) have been reviewed. It has changed the way cardiologists learn, educate, and interact with each other. Social media has proven especially useful in advocating for WIC, but whether it can help improve the numbers of female doctors going into Cardiology remains to be seen. In addition to encouraging women to pursue cardiology, social media has drawn attention to key women's rights issues affecting practicing female cardiologists.

YouTube as a Source of Information on Epidural Steroid Injection

Objective

With the advance of the internet, social media platforms have become a major source of medical information. We assessed the reliability, quality, and usefulness of the most-viewed YouTube videos of epidural steroid injection (ESI).

Methods

A search was conducted on YouTube on February 13, 2020, using the keywords “epidural injection,” “epidural steroid injection,” “epidural transforaminal injection,” and “epidural transforaminal steroid injection.” The top 50 most-viewed videos were assessed with a modified DISCERN scale (mDISCERN) and a Global Quality Scale (GQS). Further, the usefulness of information in each video was evaluated.

Results

Only 22% of videos contained information with high reliability, and these were produced by hospitals or physicians. None of the videos provided by media organizations and patients were reliable. As for information quality, only 34% were moderate to excellent quality. Even of the videos produced by hospitals or physicians, approximately half were of generally poor or poor quality. Regarding the usefulness of information, although 76% were assessed to contain useful information, 8% had misleading information. Particularly, four of these videos contained misleading information, and three were provided by patients who experienced ESI.

Conclusion

YouTube is a platform where medical information is actively shared and widespread. Here, we found that the reliability and quality of videos were low even when these were produced by hospitals or physicians. Further, the quality tended to be much lower when it was provided by media organizations or patients. Future efforts by physicians and professional societies to improve the reliability and quality of medical content are necessary.

The use of social media as a tool for stakeholder engagement in health service design and quality improvement: A scoping review

Background

Health-related social media use is common but few health organisations have embraced its potential for engaging stakeholders in service design and quality improvement (QI). Social media may provide new ways to engage more diverse stakeholders and conduct health design and QI activities.

Objective

To map how social media is used by health services, providers and consumers to contribute to service design or QI activities.

Methods

The scoping review was undertaken using the Joanna Briggs Institute methodology. An advisory committee of stakeholders provided guidance throughout the review. Inclusion criteria were studies of any health service stakeholders, in any health setting, where social media was used as a tool for communications which influenced or advocated for changes to health service design or delivery. A descriptive numerical summary of the communication models, user populations and QI activities was created from the included studies, and the findings were further synthesised using deductive qualitative content analysis.

Results

40 studies were included. User populations included organisations, clinical and non-clinical providers, young people, people with chronic illness/disability and First Nations people. Twitter was the most common platform for design and QI activities. Most activities were conducted using two-way communication models. A typology of social media use is presented, identifying nine major models of use.

Conclusion

This review identifies the ways in which social media is being used as a tool to engage stakeholders in health service design and QI, with different models of use appropriate for different activities, user populations and stages of the QI cycle.

The Use of Social Media by Healthcare Quality Personnel in Saudi Arabia

Purpose

The objective of this research was to investigate the use of social media for educational purposes by healthcare quality personnel in Saudi Arabia. Participants and Methods. A cross-sectional design study was carried out with 78 healthcare quality employees working in different hospitals in Saudi Arabia. The survey was distributed through WhatsApp, and the data were collected during November 2019. The results were analyzed and expressed in percentages using basic statistic tools.

Results

More than half of the participants (74.36%) were under 40 years old, and the gender was equally distributed among them. The participants used the following social media in decreasing order for educational purposes: YouTube, Twitter, LinkedIn, Snapchat, Instagram, and Facebook. The largest proportion of them employed YouTube, and the least used social media network was Facebook. The majority of them (58.87%) employed these platforms more than 3 hours daily. Most respondents (82%) agreed that social media can be used to educate on healthcare quality topics, and YouTube was the preferred platform for this goal. The reasons for using social media for professional purposes were networking (27%), education and professional development (24%), and health promotion (13%). Most of the responses considered that social media networks were somehow helpful and very helpful for improving knowledge about the profession (96.20%), improving creativity (90%), improving decision making (83.33%), improving critical skills (80.77%), and improving problem-solving abilities (79.49%).

Conclusion

The findings showed that a high percentage of the healthcare quality personnel in Saudi Arabia used social media for educational purposes, and the most used platform for this objective was YouTube. The results suggested that social media can be potentially useful to perceive healthcare quality in the Kingdom of Saudi Arabia.

Improving the Theoretical Understanding Toward Patient-Driven Health Care Innovation Through Online Value Cocreation: Systematic Review

Background

Patient participation in the health care domain has surged dramatically through the availability of digital health platforms and online health communities (OHCs). Such patient-driven service innovation has both potential and challenges for health care organizations. Over the last 5 years, articles have surfaced that focus on value cocreation in health care services and the importance of engaging patients and other actors in service delivery. However, a theoretical understanding of how to use OHCs for this purpose is still underdeveloped within the health care service ecosystem.

Objective

This paper aimed to introduce a theoretical discussion for better understanding of the potential of OHCs for health care organizations, in particular, for patient empowerment.

Methods

This literature review study involved a comprehensive search using 12 electronic databases (EMBASE, PsycINFO, Web of Science, Scopus, ScienceDirect, Medical Literature Analysis and Retrieval System Online, PubMed, Elton B Stephens Co [academic], Cumulative Index of Nursing and Allied Health Literature, Accelerated Information Sharing for Law Enforcement, Association for Computing Machinery, and Google Scholar) from 2013 to 2019. A total of 1388 studies were identified from the database search. After removing duplicates and applying inclusion criteria, we thematically analyzed 56 articles using the Braun and Clarke thematic analysis approach.

Results

We identified a list of 5 salient themes: communication extension, improved health literacy for patients and health care organizations, communication transparency with patients, informational and social support for patients, and patient empowerment in self-management. The most frequent theme was communication extension, which covers 39% (22/56) of the literature. This theme reported that an extension of communication between patients, caregivers, and physicians and organizations led to new opportunities to create value with minimal time and cost restrictions. Improved health literacy and communication transparency with patients were the second and third most frequent themes, respectively, covering 26% (15/56) and 25% (14/56) of the literature, respectively. The frequency of these themes indicated that the use of OHCs to generate new knowledge from patients’ interactions helped health care organizations to customize treatment plans and establish transparent and effective communication between health care organizations and patients. Furthermore, of the 56 studies, 13 (23%) and 10 (17%) studies contended the opportunity of using OHCs in terms of informational and emotional support and empowering patients in their self-management of diseases.

Conclusions

This review enables better understanding of the current state of the art of the online value cocreation and its potential for health care organizations. This study found that the opportunities for health care organizations through enhancement of patient participation and their cocreation of value in digital health platforms have been rapidly increasing. The identified gaps and opportunities in this study would identify avenues for future directions in modernized and more effective value-oriented health care informatics research.

What Are Diabetes Patients Versus Health Care Personnel Discussing on Social Media?

BACKGROUND

Use of social media is increasing rapidly, also in health care and diabetes. However, patients, health care personnel, and patient organizations discuss diabetes on social media very differently. This has led to a lack of common ground when these stakeholders communicate about diabetes and a gap in understanding one another's point of view. Social media have a potential for improved communication if each stakeholder group knows about, acknowledges, and accepts one another's perspective.

METHOD

We extracted and analyzed posts from three Norwegian Facebook groups representing patients, patients' organization, and health care personnel. Qualitative content analysis was done to find the distribution of main categories, followed by a thematic analysis of subcategories that were posted and discussed.

RESULTS

The patient organization's posts are the most equally distributed over the four main identified categories: scientific content, health care services, self-management, and diabetes awareness. The closed patient group's posts were dominated by self-management; the open diabetes nurses' group was dominated by diabetes awareness. The three social media groups differed substantially in what and how they posted and discussed within the main topics. The nurses' open group had percentage-wise both the most liked and commented post, and the posts on self-management had the highest average number of comments.

CONCLUSIONS

There is a big discrepancy in posted information and discussions on social media, between patient closed group, patient organization open group, and health care personnel open group. To reach the aim of using social media for better health, there is a need for more information of what is posted and discussed in the other groups, to harmonize and ensure safe and accurate dissemination of information.

Investigating inequities in hospital care among lesbian, gay, bisexual, and transgender (LGBT) individuals using social media

RATIONALE

Persons who identify as lesbian, gay, bisexual, and transgender (LGBT) face health inequities due to unwarranted discrimination against their sexual orientation or identity. An important contributor to LGBT health disparities is the inequitable or substandard care that LGBT individuals receive from hospitals.

OBJECTIVE

To investigate inequities in hospital care among LGBT patients using the popular social media platform Twitter.

METHOD

This study examined a dataset of Twitter communications (tweets) collected from February 2015 to May 2017. The tweets mentioned Twitter handles for hospitals (i.e., usernames for hospitals) and LGBT related terms. The topics discussed were explored to develop an LGBT position index referring to whether the hospital appears supportive or not supportive of LGBT rights. Results for each hospital were then compared to the Healthcare Equality Index (HEI), an established index to evaluate equity of hospital care towards LGBT patients.

RESULTS

In total, 1856 tweets mentioned LGBT terms representing 653 unique hospitals. Of these hospitals, 189 (28.9%) were identified as HEI leaders. Hospitals in the Northeast showed significantly greater support towards LGBT issues compared to hospitals in the Midwest. Hospitals deemed as HEI leaders had higher LGBT position scores compared to non-HEI leaders (p = 0.042), when controlling for hospital size and location.

CONCLUSIONS

This exploratory study describes a novel approach to monitoring LGBT hospital care. While these initial findings should be interpreted cautiously, they can potentially inform practices to improve equity of care and efforts to address health disparities among gender minority groups.

A web-based and mobile patient-centered ''microblog'' messaging platform to improve care team communication in acute care

Communication in acute care settings is fragmented and occurs asynchronously via a variety of electronic modalities. Providers are often not on the same page with regard to the plan of care. We designed and developed a secure, patient-centered "microblog" messaging platform that identifies care team members by synchronizing with the electronic health record, and directs providers to a single forum where they can communicate about the plan of care. The system was used for 35% of patients admitted to a medical intensive care unit over a 6-month period. Major themes in messages included care coordination (49%), clinical summarization (29%), and care team collaboration (27%). Message transparency and persistence were seen as useful features by 83% and 62% of respondents, respectively. Availability of alternative messaging tools and variable use by non-unit providers were seen as main barriers to adoption by 83% and 62% of respondents, respectively. This approach has much potential to improve communication across settings once barriers are addressed.

eHealth in Treatment of Offenders in Forensic Mental Health: A Review of the Current State

BACKGROUND

Treatment of offenders in forensic mental health is complex. Often, these in- or outpatients have low treatment motivation, suffer from multiple disorders, and have poor literacy skills. eHealth may be able to improve treatment outcomes because of its potential to increase motivation and engagement, and it can overcome the predominant one-size-fits-all approach by being tailored to individual patients.

OBJECTIVE

To examine its potential, this systematic review studies the way that eHealth has been used and studied in forensic mental health and identifies accompanying advantages and disadvantages for both patients and treatment, including effectiveness.

METHODS

A systematic search in Scopus, PsycINFO, and Web of Science was performed up until December 2017. Studies were included if they focused on technological interventions to improve the treatment of forensic psychiatric patients.

RESULTS

The search resulted in 50 studies in which eHealth was used for treatment purposes. Multiple types of studies and technologies were identified, such as virtual reality, web-based interventions, and videoconferencing. The results confirmed the benefits of technology, for example, the acquisition of unique information about offenders, effectiveness, and tailoring to specific characteristics, but indicated that these are not fully taken advantage of.

DISCUSSION

To overcome the barriers and obtain the benefits, eHealth has to have a good fit with patients and the forensic psychiatric context. It has to be seamlessly integrated in existing care and should not be added as an isolated element. To bridge the gap between the current situation and eHealth's potential, further research on development, implementation, and evaluation should be conducted.

eHealth for Patient Engagement: A Systematic Review

eHealth interventions are recognized to have a tremendous potential to promote patient engagement. To date, the majority of studies examine the efficacy of eHealth in enhancing clinical outcomes without focusing on patient engagement in its specificity. This paper aimed at reviewing findings from the literature about the use of eHealth in engaging patients in their own care process. We undertook a comprehensive literature search within the peer-reviewed international literature. Eleven studies met the inclusion criteria. eHealth interventions reviewed were mainly devoted to foster only partial dimensions of patient engagement (i.e., alternatively cognitive, emotional or behavioral domains related to healthcare management), thus failing to consider the complexity of such an experience. This also led to a great heterogeneity of technologies, assessed variables and achieved outcomes. This systematic review underlines the need for a more holistic view of patient needs to actually engage them in eHealth interventions and obtaining positive outcomes. In this sense, patient engagement constitute a new frontiers for healthcare models where eHealth could maximize its potentialities.

Dissemination of health-related research among scientists in three countries: access to resources and current practices

OBJECTIVES

In public health and clinical settings insufficient dissemination of evidence-based practices limits the reach of new discoveries to broad populations. This study aimed to describe characteristics of the dissemination process by researchers across three countries (Brazil, United Kingdom, and United States), explore how designing for dissemination practices has been used, and analyze factors associated with dissemination.

METHODS

A similar online survey was used to query researchers across the three countries; data were pooled to draw cross-country conclusions.

FINDINGS

This study identified similarities and differences between countries. Importance of dissemination to nonresearcher audiences was widely recognized as important; however, traditional academic venues were the main dissemination method. Several factors were associated with self-rated dissemination effort in the pooled sample, but these predictive factors (e.g., support and resources for dissemination) had low prevalence. Less than one-third of researchers rated their level of effort for dissemination as excellent. Respondents reported limited support and resources to make it easier for researchers who might want to disseminate their findings.

CONCLUSION

Though intentions show the importance of dissemination, researchers across countries lack supports to increase dissemination efforts. Additional resources and training in designing for dissemination along with improved partnerships could help bridge the research-practice gap.

Improving the quality of tracheostomy care

Educational aims

To understand the current challenges in the care of tracheostomy patients

To understand principles of quality improvement collaboration and how this can improve the quality of care for tracheostomy patients

Summary

The UK National Confidential Enquiry into Patient Outcomes and Death illustrates that there remains significant morbidity and mortality relating to patients with a tracheostomy, with much preventable harm. Challenges include the inherent complexity of the patient's underlying condition, wide variations in tracheostomy management, variable delivery of education for staff, patients and families, and difficult coordination of care between such a variety of individuals involved in performing, managing and ultimately removing tracheostomies.

Quality-improvement collaboratives are groups of institutions with a common purpose who work together to drive positive change. They help support clinicians in developing skills and teams necessary to design and sustain quality-improvement cycles. They are a cost-effective way of rapidly disseminating improvement strategies and engaging in shared learning across institutions around the world. The Global Tracheostomy Collaborative aims to improve quality of care and outcomes through five interdependent key drivers: coordinated multidisciplinary team care, education, institution-wide protocols, family and patient-centred care, and metrics and outcomes using a specifically designed database.