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Hanley R, Collett J. The positioning information that should be provided to caregivers of adults with a physical disability on supply of custom-contoured seating, a Delphi study. Disabil Rehabil Assist Technol 2024:1-9. [PMID: 39034870 DOI: 10.1080/17483107.2024.2382287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 07/13/2024] [Indexed: 07/23/2024]
Abstract
PURPOSE This research aims to identify information that is important to provide on supply of custom-contoured seating. The way this information would be best communicated is also of interest. A two-round e-Delphi study was utilised to explore consensus. A panel of stakeholders from Ireland including experts in positioning clients in custom-contoured seating and caregivers were recruited. The first round consisted of open-ended questions and was analysed using thematic analysis. The second round employed a rating technique and 7-point Likert scale. Consensus was set a priori at 70% agreement. The way information should be communicated and by whom was rated in order of preference. MATERIALS AND METHODS Fifteen participants were recruited, nine clinicians and four caregivers. Fifty-two statements under six themes (transfers = 10, positioning = 22, pressure care = 4, general use = 4, post-supply follow-up = 8, functional activity = 4) were generated in round 1 by 13/15 participants. Round 2 was completed by 10/15. 49/52 statements reached consensus and were deemed important. The ways information should be communicated and by whom was identified. Caregivers want individualised information whereas clinicians preferred a more generic approach. RESULTS AND CONCLUSIONS There was a high degree of consensus on what information is required to support caregivers. The topics demonstrate the extensive information that should be provided. The preferred delivery method for primary caregivers was hands-on training with the opportunity to practice and take videos. Stakeholders differed in how they would prefer information delivered. Further research should evaluate the method of delivering training and its effectiveness.
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Affiliation(s)
- Ruth Hanley
- Assistive Technology and Specialised Seating Department, Central Remedial Clinic, Limerick, Ireland
| | - Johnny Collett
- Faculty of Health and Life Sciences, Centre for Movement, Occupational and Rehabilitation Sciences, Oxford Brookes University, Oxford, UK
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Bugdol M. Quality Objectives in Standardized Quality Management Systems. Qual Manag Health Care 2024; 33:200-205. [PMID: 37651588 DOI: 10.1097/qmh.0000000000000426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
BACKGROUND AND OBJECTIVES The effectiveness of a quality management system consistent with the ISO 9001 standard depends on how quality objectives are established and pursued. The aims of this article are to identify quality objectives in selected certified organizations providing medical services, assess their compliance with the requirements of the ISO 9001 standard, and determine factors influencing such objectives. METHODS The first theoretical part of the article is based on a systematic literature review. The empirical part contains an analysis of documentation related to quality management systems and conducted audits. The data were collected during 42 quality management system audits conducted in 16 health care organizations in the years 2015-2020. Uncategorized interviews were conducted with quality management system representatives. The data were verified by interviews with 6 management system auditors having at least 15 years' experience in auditing health care organizations. The assessment of the methodological correctness is based on the ISO 9001:2015 standard criteria. RESULTS The most frequently formulated quality objectives include improving customer satisfaction, task-based objectives related to planned works, improvements, and development of new medical services. The quality objectives fulfill the requirements of the ISO 9001 standard. However, they are not ambitious. The most significant factors influencing the processes of goal setting are economic (financial incentives, available resources for modernization), social (community needs), and managerial (the scope of performed analyses, the quality of the audit process, and the calculation of necessary effort). CONCLUSIONS Health care organizations need to pursue more ambitious objectives, intensify the use of performed medical analyses, and integrate quality objectives into management remuneration systems.
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Affiliation(s)
- Marek Bugdol
- Author Affiliation: Institute of Economics, Finance and Management, Jagiellonian University in Kraków, Kraków, Poland
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Pradeau C, Estival S, Postal V, Laurier V, Maugard C, Isner-Horobeti ME, Mourre F, Krasny-Pacini A. A pilot rating system to evaluate the quality of goal attainment scales used as outcome measures in rehabilitation. Neuropsychol Rehabil 2024:1-32. [PMID: 38805592 DOI: 10.1080/09602011.2024.2343150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/01/2024] [Indexed: 05/30/2024]
Abstract
Goal Attainment Scaling (GAS) is a method for writing person-centred approach evaluation scales that can be used as an outcome measure in clinical or research settings in rehabilitation. To be used in a research setting, it requires a high methodological quality approach. The aim of this study was to explore the feasibility and reliability of the GAS quality rating system, to ensure that GAS scales used as outcome measures are valid and reliable. Secondary objectives were: (1) to compare goal attainment scores' reliability according to how many GAS levels are described in the scale; and (2) to explore if GAS scorings are influenced by who scores goal attainment. The GAS scales analysed here were set collaboratively by 57 cognitively impaired adults clients and their occupational therapist. Goals had to be achieved within an inpatient one-month stay, during which clients participated in an intervention aimed at improving planning skills in daily life. The GAS quality rating system proved to be feasible and reliable. Regarding GAS scores, interrater reliability was higher when only three of the five GAS levels were described, i.e., "three milestone GAS" (0.74-0.92), than when all five levels were described (0.5-0.88), especially when scored by the clients (0.5 -0.88).
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Affiliation(s)
- Charles Pradeau
- Pôle de Médecine Physique et de Réadaptation, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut Universitaire de Réadaptation Clemenceau (IURC) Strasbourg, Strasbourg cedex, France
| | - Severine Estival
- Laboratoire Interdisciplinaire des Sciences du Numérique, CNRS, Université Paris-Saclay, Orsay, France
| | - Virginie Postal
- Laboratoire de Psychologie EA4139, Université de Bordeaux, Bordeaux, France
| | | | | | - Marie-Eve Isner-Horobeti
- Pôle de Médecine Physique et de Réadaptation, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut Universitaire de Réadaptation Clemenceau (IURC) Strasbourg, Strasbourg cedex, France
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg University"Mitochondrie, stress oxydant et protection musculaire", Bordeaux, France
| | - Fabien Mourre
- Hôpital Marin APHP, Unité Prader-Willi, Hendaye, France
| | - Agata Krasny-Pacini
- Pôle de Médecine Physique et de Réadaptation, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- Institut Universitaire de Réadaptation Clemenceau (IURC) Strasbourg, Strasbourg cedex, France
- Strasbourg Translational Neuroscience and Psychiatry, Inserm, Université de Strasbourg, Strasbourg, France
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Ryan AK, Miller L, Rose TA, Johnston LM. Child-led goal setting and evaluation tools for children with a disability: A scoping review. Dev Med Child Neurol 2024. [PMID: 38760984 DOI: 10.1111/dmcn.15959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/25/2024] [Accepted: 04/22/2024] [Indexed: 05/20/2024]
Abstract
AIM To examine child-led goal setting and evaluation tools and approaches for children with a disability or developmental delay. METHOD Six databases were searched for studies that included population (children aged less than 18 years with disability or developmental delay); construct (child-led goal setting tool or approach); and context (developmental therapy or rehabilitation). The utility of tools and approaches across the goal setting and evaluation process was investigated using abductive content analysis. RESULTS Fifty articles met the inclusion criteria. Three approaches and four tools for child-led goal setting and evaluation were identified. No studies reported the clinimetric properties of tools specifically for child self-respondents. Qualitative analysis revealed six distinct goal phases in which tools and approaches were used, which were synthesized into a new framework for child-led goal setting and evaluation titled DECIDE: Direct children to goal setting; Elicit goal topics and priorities; Construct a goal statement; Indicate baseline goal performance; Develop an action plan to address the goal; and Evaluate goal progress after the intervention. INTERPRETATION Children actively participated in goal setting and evaluation across six DECIDE goal phases. Further clinimetric information is required to support use of goal setting and evaluation tools with child self-respondents. Future research should emphasize the development of multi-phase goal setting tools and approaches for diverse populations of children.
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Affiliation(s)
- Aisling K Ryan
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Laura Miller
- School of Allied Health, Australian Catholic University, Brisbane, Queensland, Australia
| | - Tanya A Rose
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Leanne M Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
- Children's Health Queensland Hospital and Health Services, Brisbane, Queensland, Australia
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Ohno K, Oi R, Harada A, Tomori K, Sawada T. Response Shifts in the Canadian Occupational Performance Measure: A Convergent Mixed-Methods Study. Am J Occup Ther 2024; 78:7803205100. [PMID: 38709675 DOI: 10.5014/ajot.2024.050487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024] Open
Abstract
IMPORTANCE A response shift (RS) is a phenomenon in which there is an individual perceptual gap between pre and post assessments. RS effects were not considered in the Canadian Occupational Performance Measure (COPM) development process. OBJECTIVE To detect the effects of RS on the COPM. DESIGN Convergent mixed-methods research. SETTING Subacute rehabilitation hospital in Japan. PARTICIPANTS Nineteen adult patients with a range of neurological and musculoskeletal conditions recruited from a subacute rehabilitation hospital. OUTCOMES AND MEASURES In the qualitative analysis, patients' perceptions regarding occupation identified by the COPM were compared between the initial assessment (Time 1 [T1]) and a reassessment (Time 2 [T2]). In the quantitative study, patients were asked to re-rate the occupations in which the RS had occurred, giving feedback on their perceptions at T1 (T2'). The difference between T2 and T2' was calculated to clarify the magnitude of the RS. RESULTS Of the 19 patients, 18 had an RS in at least one occupation. The RS effects were classified into five categories: Replacing, Adding, Reducing, Unspecified, and Embodiment. Ninety occupations were extracted from all the patients, and 46 (51.1%) were affected by RS. The percentages of occupations for which the change in score due to RS exceeded the minimal clinically important difference (±2 points) was 26.1% (12 of 46) for COPM-Performance scores and 30.4% (14 of 46) for COPM-Satisfaction scores. CONCLUSIONS AND RELEVANCE Diverse RS effects have been identified in the COPM, which also affect score interpretation. Plain-Language Summary: The Canadian Occupational Performance Measure has a potential measurement bias that is due to a response shift in which there is an individual perceptual gap between pre and post assessments. The results of this study reveal a need to establish more accurate measurement methods to reduce the impact of response shifts on COPM scores.
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Affiliation(s)
- Kanta Ohno
- Kanta Ohno, PhD, is Assistant Professor, Department of Rehabilitation, School of Health Science, Tokyo University of Technology, Tokyo, Japan;
| | - Riho Oi
- Riho Oi, BOT, is Occupational Therapist, Department of Occupational Therapy, Gotanda Rehabilitation Hospital, Tokyo, Japan
| | - Ai Harada
- Ai Harada, BOT, is Occupational Therapist, Department of Occupational Therapy, Shizuoka Tokushukai Hospital, Shizuoka, Japan
| | - Kounosuke Tomori
- Kounosuke Tomori, PhD, is Professor, Department of Rehabilitation, School of Health Science, Tokyo University of Technology, Tokyo, Japan
| | - Tatsunori Sawada
- Tatsunori Sawada, PhD, is Professor, Department of Rehabilitation, School of Health Science, Tokyo University of Technology, Tokyo, Japan
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Guo L, Lin C, Qu J. A Specific, Measurable, Achievable, Relevant, Timed (SMART) Nursing Project Reduces Anxiety, Depression, and Post-Traumatic Stress Disorder in Parents of Childhood or Adolescent Osteosarcoma Patients. TOHOKU J EXP MED 2024; 262:229-238. [PMID: 38220170 DOI: 10.1620/tjem.2023.j107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Specific, measurable, achievable, relevant, timed (SMART) principle improves the nursing utility by setting individual goals for participants and helping them to achieve these goals. Our study intended to investigate the impact of a SMART nursing project on reducing mental stress and post-traumatic stress disorder (PTSD) in parents of childhood or adolescent osteosarcoma patients. In this randomized, controlled study, 66 childhood or adolescent osteosarcoma patients and 126 corresponding parents were enrolled and divided into SMART or normal care (NC) groups at a 1:1 ratio. All parents received a 3-month corresponding intervention and a 6-month interview. Our study revealed that the self-rating anxiety scale score at the 3rd month (M3) (P < 0.05) and the 6th month (M6) (P < 0.01), and anxiety rate at M3 (P < 0.05) and M6 (P < 0.05) were lower in parents in SMART group vs. NC group. The self-rating depression scale score at M3 and M6, and depression rate at M3 and M6 were lower in parents in SMART group vs. NC group (all P < 0.05). Impact of events scale-revised score at the 1st month (M1) (P < 0.05), M3 (P < 0.05), and M6 (P < 0.01) were lower in parents in SMART group vs. NC group. By subgroup analyses, the SMART nursing project showed better impacts on decreasing anxiety, depression, and PTSD in parents with an undergraduate education or above than in those with a high school education or less. Conclusively, SMART nursing project reduces anxiety, depression, and PTSD in parents of childhood or adolescent osteosarcoma patients, which is more effective in those with higher education.
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Affiliation(s)
- Libo Guo
- Department of Orthopedic Surgery, Harbin Medical University Cancer Hospital
| | - Chunna Lin
- Department of Nursing, Jixi People's Hospital
| | - Jinrong Qu
- Department of Orthopedics, First Affiliated Hospital, Heilongjiang University of Chinese Medicine
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Shkurka E, Child H, Balls J, Melkhuln E, Carter L, Compton V, Marscheider R, McConnell R, Meenaghan S, Milburn N, Nugent G, Peabody G, Rimmer L. Early rehabilitation and mobilisation of neonatal and paediatric extracorporeal membrane oxygenation patients: A UK and Ireland consensus document. Perfusion 2024; 39:174-181. [PMID: 36240012 DOI: 10.1177/02676591221132676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Despite increasing early rehabilitation and mobilisation (ERM) in paediatric intensive care, current evidence for ERM of neonatal and paediatric patients receiving extracorporeal membrane oxygenation (ECMO) is limited. The proposed benefits of ERM in neonatal and paediatric ECMO patients are multifaceted, including reduced immobility related issues and maintenance of functional ability. However, ECMO presents additional safety and logistical challenges, and currently there are no published neonatal or paediatric guidelines. A consensus document was developed to provide guidance for ERM with neonatal and paediatric ECMO patients. The document was developed by specialist physiotherapists from nine ECMO centres within the UK and Ireland, together with the UK Paediatric Critical Care Society ECMO group and members of the multidisciplinary team. The document covers key considerations and practicalities for completing ERM in this population including, acuity level measurement, activity level guidance, safety and risk assessment, and goal setting. Risk assessment and safety checklist bedside tools are also included and designed to be adapted as required to meet specific unit policies and protocols.
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Affiliation(s)
- Emma Shkurka
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Hannah Child
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Jennie Balls
- Royal Brompton and Harefield NHS Trust, London, UK
| | - Ellie Melkhuln
- Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Lee Carter
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | | | | | - Rachel McConnell
- The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | | | - Natalie Milburn
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | | | - Gemma Peabody
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Laura Rimmer
- Alder Hey Children's NHS Foundation Trust, Liverpool, UK
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Ayupe KMA, Dias IMBC, Cazeiro APM, de Campos AC, Longo E. Rehabilitation Practices Delivered by Physical and Occupational Therapists to Brazilian Children With Congenital Zika Syndrome: A Cross-Sectional Study. GLOBAL HEALTH, SCIENCE AND PRACTICE 2023; 11:e2300219. [PMID: 38123996 PMCID: PMC10749651 DOI: 10.9745/ghsp-d-23-00219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Congenital Zika syndrome (CZS) is a health condition that has affected the development of thousands of children in Brazil. Because it is a new condition, its understanding is an ongoing process. Therefore, it is important to know the rehabilitation interventions being delivered to improve the functioning of these children. We aimed to describe the practices of physical therapists (PTs) and occupational therapists (OTs) who provide follow-up care for children with CZS in Brazil. METHODS This cross-sectional study included PTs and OTs who assist children with CZS in Brazil. An online questionnaire was used to verify the participants' personal characteristics and professional work environment, as well as the rehabilitation programs they implemented in Brazil for children with CZS. Data were analyzed using descriptive statistics. RESULTS A total of 116 professionals (79 PT and 37 OT) who work mainly in public health services (81.9%) participated in the study. Of these, 24.1% plan interventions based on reading scientific articles, 66.4% did not report using the biopsychosocial model, 52.6% do not perform any assessments before starting an intervention, 31.9% use neurodevelopmental treatment, and 22.4% use sensorimotor stimulation interventions. The majority of the interventions are delivered 1 to 2 times a week, lasting up to 1 hour. CONCLUSIONS Professional training and knowledge translation strategies are needed to implement evidence-based practices and improve the quality of rehabilitation programs for Brazilian children with CZS.
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Affiliation(s)
- Kennea Martins Almeida Ayupe
- Department of Integrated Health Education, Center for Health Sciences, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil.
| | - Ianka Maria Bezerra Cunha Dias
- Postgraduate Program in Rehabilitation Sciences, Universidade Federal do Rio Grande do Norte, Faculty of Health Sciences of Trairi, Santa Cruz, Rio Grande do Norte, Brazil
| | | | - Ana Carolina de Campos
- Postgraduate Program in Physical Therapy, Universidade Federal do São Carlos, São Carlos, São Paulo, Brazil
| | - Egmar Longo
- Postgraduate Program in Rehabilitation Sciences, Universidade Federal do Rio Grande do Norte, Faculty of Health Sciences of Trairi, Santa Cruz, Rio Grande do Norte, Brazil
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Jakubietz RG, Giunta RE, Jakubietz MG, König S. [Goal-setting in Plastic Surgery using the SMART principle]. HANDCHIR MIKROCHIR P 2023; 55:450-456. [PMID: 37918819 DOI: 10.1055/a-2157-0946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023] Open
Abstract
INTRODUCTION The process of continuous acquisition of surgical expertise is a key element in registrar training. The principle of active, self-directed learning, which is regularly applied in medical school, can also be used to gain surgical expertise in registrar training. METHODS Surgical training can be compared to acquiring expertise in music or sport, where both intellectual and manual capabilities are required. Specific training principles, including analysis, goal setting, practice and reflection on the process, are commonly encountered in these fields. Smart goal setting is preferred in order to ensure compliance and a successful strategy. This can also be used in plastic surgery training. APPLICATION Surgical principles as well as partial or complete surgical procedures can be practiced using the smart principle. The fragmentation of a larger task into smaller units allows rapid acquisition of surgical expertise without impeding patient safety. DISCUSSION Surgical training today happens in a setting caught between economic and medicolegal challenges. The reduction of case load requires simulation practice as well as self-directed learning - which has been shown to improve outcomes. The smart principle allows distinct goal setting which can improve compliance of the student and increase success. As this form of learning is not intuitive to all individuals, supervisors and mentor can support trainees in the acquisition of surgical expertise using this principle.
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Affiliation(s)
- Rafael G Jakubietz
- Klinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie, Universitätsklinikum Würzburg Chirurgische Klinik 2, Würzburg, Germany
| | - Riccardo E Giunta
- Abteilung für Handchirurgie, Plastische Chirurgie und Ästhetische Chirurgie Klinikum der Ludwig-Maximilians Universität München, München, Germany
| | - Michael G Jakubietz
- Klinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie, Universitätsklinikum Würzburg Chirurgische Klinik 2, Würzburg, Germany
| | - Sarah König
- Institut für Medizinische Lehre und Ausbildungsforschung, Universitätsklinikum Würzburg Bereich A, Würzburg, Germany
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Waisman-Nitzan M, Ivzori Y, Anaby D. Promoting Participation-Focused Practices in Inclusive Educational Settings: Stakeholders' Perspectives Following a Knowledge Translation Initiative. Am J Occup Ther 2023; 77:7706205050. [PMID: 37922537 DOI: 10.5014/ajot.2023.050262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
IMPORTANCE Available participation-focused interventions (e.g., the Pathways and Resources for Engagement and Participation intervention [PREP]), are not well integrated into practice, indicating a knowledge-to-practice gap. OBJECTIVE To explore the perspectives of school-based (SB) occupational therapists and occupational therapy managers following knowledge translation (KT) programs for facilitating participation-based practices in inclusive education. DESIGN This was an implementation qualitative study. After taking part in KT programs for implementing PREP, which were tailored to the needs and contexts of each stakeholder group, occupational therapists participated in focus groups, and occupational therapy managers responded to open-ended survey questions. A content analysis was done separately for each group, then integrated and organized according to the Participation-focused KT (P-KT) framework. SETTING Inclusive educational setting. PARTICIPANTS Seven occupational therapists working in inclusive schools and 39 occupational therapy managers. RESULTS We identified 10 themes addressing the micro, meso, and macro levels of the P-KT framework across the two groups. Five themes, common to all participants, addressed micro (e.g., setting participation-focused goals) and meso (e.g., school-PREP fit) levels. Macro-level themes were addressed by managers only (e.g., anchoring PREP to existing policy of the Israeli Ministry of Education). CONCLUSIONS AND RELEVANCE Targeting different stakeholders at the micro and meso levels of the educational system can initiate a shift in practice toward a focus on participation. KT intersectoral initiatives at the macro level (e.g., targeting community services and local policies), and engaging other stakeholders (e.g., students, families, and educators), are required to ensure the sustainability of participation-based practices. What This Article Adds: The authors present two knowledge translation programs that target both occupational therapists and managers in the educational system. The programs promote a shift in school-based occupational therapy services toward a focus on participation and environment.
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Affiliation(s)
- Michal Waisman-Nitzan
- Michal Waisman-Nitzan, PhD, BOT, is Research and Teaching Fellow, Occupational Therapy Department, University of Haifa, Haifa, Israel;
| | - Yonat Ivzori
- Yonat Ivzori, PhD, BOT, is Researcher and Lecturer, Occupational Therapy Department, Zefat Academic College, Zefat, Israel, and Researcher and Lecturer, Special Education Department, Oranim College of Education, Kiryat Tiv'on, Israel
| | - Dana Anaby
- Dana Anaby, PhD, BOT, is Associate Professor, School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
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11
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Bain K, Bombria SD, Chapparo CJ, Donelly M, Heard R, Treacy S. Goal attainment of children with cerebral palsy participating in multi-modal intervention. Child Care Health Dev 2023; 49:1066-1075. [PMID: 36977609 DOI: 10.1111/cch.13117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 02/21/2023] [Accepted: 03/13/2023] [Indexed: 03/30/2023]
Abstract
AIM We aimed to determine if there was a significant difference in the functional performance of family requested daily tasks by a heterogeneous group of children with cerebral palsy following a programme of neuro-developmental treatment and in comparison to a randomly control group. BACKGROUND There are considerable challenges in conducting research into the functional performance of children with cerebral palsy. These include the highly heterogeneous nature of the population group, poor ecological and treatment fidelity, floor and ceiling effects in assessments, and insensitivity to the diverse functional needs and goals of children and families. Therapists and families identified functional goals and specified all aspects of performance details for each goal on five point goal attainment scales. Children with cerebral palsy were assigned randomly to treatment and alternate treatment groups. Children were video recorded attempting to perform targeted functional skills at pre-test, post-pest and follow-up. Videos were recorded and rated by expert clinicians blind to experimental condition. RESULTS After the first round of target intervention and alternate treatment had been completed, a significant difference in the goal attainment was noted between the control group and the treatment group at the post test, indicating that intervention was associated with a higher level of goal attainment than that attained by the control group (p = 0.0321) with a large effect size. CONCLUSIONS The study provided evidence of an effective way to investigate and to enhance the available motor capacity of children with moderate to severe cerebral palsy during participation in requested daily task performance, as reflected in goal attainment. Goal attainment scales were a reliable measure that was able to be used to detect changes in functional goals among a highly heterogeneous population group with individualized goals that were meaningful to each child and family.
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Affiliation(s)
- Kathryn Bain
- Southern Cross University, East Lismore, New South Wales, Australia
| | | | | | - Michelle Donelly
- Southern Cross University, East Lismore, New South Wales, Australia
| | - Robert Heard
- The University of Sydney, Camperdown, New South Wales, Australia
| | - Sue Treacy
- Southern Cross University, East Lismore, New South Wales, Australia
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Novak I, Te Velde A, Hines A, Stanton E, Mc Namara M, Paton MCB, Finch-Edmondson M, Morgan C. Rehabilitation Evidence-Based Decision-Making: The READ Model. FRONTIERS IN REHABILITATION SCIENCES 2022; 2:726410. [PMID: 36188787 PMCID: PMC9397823 DOI: 10.3389/fresc.2021.726410] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/08/2021] [Indexed: 12/31/2022]
Abstract
Evidence-based practice is the foundation of rehabilitation for maximizing client outcomes. However, an unacceptably high number of ineffective or outdated interventions are still implemented, leading to sub-optimal outcomes for clients. This paper proposes the Rehabilitation Evidence bAsed Decision-Making (READ) Model, a decision-making algorithm for evidence-based decision-making in rehabilitation settings. The READ Model outlines a step-by-step layered process for healthcare professionals to collaboratively set goals, and to select appropriate interventions. The READ Model acknowledges the important multi-layered contributions of client's preferences and values, family supports available, and external environmental factors such as funding, availability of services and access. Healthcare professionals can apply the READ Model to choose interventions that are evidence-based, with an appropriate mode, dose, and with regular review, in order to achieve client's goals. Two case studies are used to demonstrate application of the READ Model: cerebral palsy and autism spectrum disorder. The READ Model applies the four central principles of evidence-based practice and can be applied across multiple rehabilitation settings.
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Affiliation(s)
- Iona Novak
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Anna Te Velde
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Ashleigh Hines
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Emma Stanton
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Maria Mc Namara
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Madison C B Paton
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Megan Finch-Edmondson
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Catherine Morgan
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, NSW, Australia
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13
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Ogbeiwi O. Theoretical frameworks for project goal‐setting: A qualitative case study of an organisational practice in Nigeria. Int J Health Plann Manage 2022; 37:2328-2344. [DOI: 10.1002/hpm.3471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/26/2021] [Accepted: 03/21/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Osahon Ogbeiwi
- Faculty of Health Studies University of Bradford Bradford UK
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14
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Wakabayashi H, Yoshimura Y, Maeda K, Fujiwara D, Nishioka S, Nagano A. Goal setting for nutrition and body weight in rehabilitation nutrition: position paper by the Japanese Association of Rehabilitation Nutrition (secondary publication). J Gen Fam Med 2022; 23:77-86. [PMID: 35261854 PMCID: PMC8888801 DOI: 10.1002/jgf2.509] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 10/24/2021] [Indexed: 12/29/2022] Open
Abstract
The most important nutrition goals in rehabilitation nutrition are improving function and quality of life, and they are useful to set body weight goals to further improve these aspects. In this paper, we clarified our position, as the Japanese Association of Rehabilitation Nutrition, on body weight goal setting. Body weight goals should be SMART (Specific, Measurable, Achievable, Realistic/Relevant, and Timed). The standard amount of energy accumulation/deficit needed to gain/lose 1 kg body weight is 7500 kcal. In other words, if the nutrition goal is set at 1 kg body weight gain per month, daily energy accumulation can be calculated as approximately 250 kcal. It is necessary to reconcile the rehabilitation goal setting, the content, quantity, and quality of physical activity and exercise therapy, and the patient's general condition and intentions to set nutrition goals. Body weight goal setting is more variable than rehabilitation goal setting, and it is important to confirm the degree of achievement through rehabilitation nutrition monitoring.
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Affiliation(s)
- Hidetaka Wakabayashi
- Department of Rehabilitation MedicineTokyo Women's Medical University HospitalTokyoJapan
| | - Yoshihiro Yoshimura
- Center for Sarcopenia and Malnutrition ResearchKumamoto Rehabilitation HospitalKumamotoJapan
| | - Keisuke Maeda
- Department of Geriatric MedicineNational Center for Geriatrics and GerontologyObuJapan
| | - Dai Fujiwara
- Department of Rehabilitation MedicineSaka General HospitalShiogamaJapan
| | - Shinta Nishioka
- Department of Clinical Nutrition and Food ServicesNagasaki Rehabilitation HospitalNagasakiJapan
| | - Ayano Nagano
- Department of NursingNishinomiya Kyoritsu Neurosurgical HospitalNishinomiyaJapan
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15
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Lin D, Zhang SJ, Lin LL, Qi SY, Gong M, Li SB, Zhang J. The use of goal attainment scaling in the acupuncture of children with intellectual disability. WORLD JOURNAL OF TRADITIONAL CHINESE MEDICINE 2022. [DOI: 10.4103/2311-8571.351509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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Matérne M, Frank A, Arvidsson P. The utility of goal attainment scaling in evaluating a structured water dance intervention for adults with profound intellectual and multiple disabilities. Heliyon 2021; 7:e07902. [PMID: 34504979 PMCID: PMC8417330 DOI: 10.1016/j.heliyon.2021.e07902] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/24/2021] [Accepted: 08/27/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Adults with profound intellectual and multiple disabilities (PIMD) have problems to be actively involved in essential life activities that affect their health. The aim of this study was to explore the utility of goal attainment scaling (GAS) in evaluating an intervention for adults with PIMD, and to describe how the GAS goals were set according to the International Classification of Functioning, Disability and Health (ICF) domains of body function as well as activity and participation. METHOD As part of an aquatic intervention (Structured water dance), 28 adults with PIMD received GAS goals which were adapted to their individual needs and which the intervention could affect. RESULT Twenty of the goals were formulated within the ICF Activity/Participation domain and eight within the Body Functions domains. On average, participants improved by 1.25 levels on the five-level GAS scales. CONCLUSION GAS can be a useful tool for setting and evaluating individualized and meaningful goals, in body functions as well as in activity and participation, related to a healthpromoting activity for adults with PIMD.
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Affiliation(s)
- Marie Matérne
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, SE 70185 Örebro, Sweden
- School of Law, Psychology and Social Work, Örebro University, Sweden
| | - André Frank
- Center for Adult Habilitation, Region Örebro County, Örebro, Sweden
| | - Patrik Arvidsson
- Region Gävleborg, Centre for Research & Development, Region Gävleborg, Sweden
- Centre for Augmentative and Alternative Communication, University of Pretoria, Pretoria, South Africa
- CHILD, Swedish Institute for Disability Research, Jönköping University, Sweden
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17
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Metzler MJ, Haspels E, Brunton L, Andersen J, Pritchard L, Herrero M, Hodge J, Kirton A. Goals of children with unilateral cerebral palsy in a brain stimulation arm rehabilitation trial. Dev Med Child Neurol 2021; 63:584-591. [PMID: 33368181 DOI: 10.1111/dmcn.14763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 01/10/2023]
Abstract
AIM To explore relationships between category classifications for children's rehabilitation goals, outcomes, and participant characteristics. METHOD Children with hemiparetic cerebral palsy due to perinatal stroke rated self-selected goals with the Canadian Occupational Performance Measure (COPM) and completed the Assisting Hand Assessment (AHA) and Box and Block Test (BBT), at baseline and 6 months, in a randomized, controlled 10-day neuromodulation rehabilitation trial using repetitive transcranial magnetic stimulation. Goals were classified with the Canadian Model of Occupational Performance and Engagement and the International Classification of Functioning, Disability and Health. Analysis included standard linear regression. RESULTS Data for 45 participants (mean age 11y 7mo, SD 3y 10mo, range 6-19y, 29 males, 16 females) on 186 goals were included. Self-care goal percentage corresponded with baseline BBT by age (standardized ß=-0.561, p=0.004). Leisure goal percentage corresponded with baseline BBT (standardized ß=0.419, p=0.010). AHA change corresponded with productivity goals (standardized ß=0.327, p=0.029) and age (standardized ß=0.481, p=0.002). COPM change corresponded with baseline COPM and age by AHA change (p<0.05). INTERPRETATION Younger children with lower motor function were more likely to select self-care goals while those with better function tended to select leisure goals. Functional improvement corresponded with older age and productivity goals. COPM change scores reflected functional improvement among older children. Children chose functionally and developmentally appropriate goals. Consequently, children should be free to set goals that matter to them. WHAT THIS PAPER ADDS Children in a brain stimulation trial chose divergent upper extremity functional goals. Younger children with lower ability chose more self-care goals. Children with higher ability chose more leisure goals. Older children's goal ratings reflected objective functional motor gains. Children chose goals appropriate to their function and level of development.
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Affiliation(s)
- Megan J Metzler
- Department of Clinical Neurosciences, Alberta Children's Hospital, Calgary, AB, Canada.,Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Eva Haspels
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada.,Faculty of Science, University of Amsterdam, Amsterdam, the Netherlands
| | - Laura Brunton
- School of Physical Therapy, Western University, London, ON, Canada
| | - John Andersen
- Child Health, Glenrose Rehabilitation Hospital, Edmonton, AB, Canada.,Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Lesley Pritchard
- Department of Physical Therapy, University of Alberta, Edmonton, AB, Canada.,Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Mia Herrero
- Department of Clinical Neurosciences, Alberta Children's Hospital, Calgary, AB, Canada
| | - Jacquie Hodge
- Calgary Pediatric Stroke Program, University of Calgary, Calgary, AB, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Adam Kirton
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada.,Calgary Pediatric Stroke Program, University of Calgary, Calgary, AB, Canada.,Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Clinical Neuroscience, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Calgary, AB, Canada
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18
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Quality objectives in management systems – their attributes, establishment and motivational function. INTERNATIONAL JOURNAL OF QUALITY & RELIABILITY MANAGEMENT 2021. [DOI: 10.1108/ijqrm-05-2020-0173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe aim of this paper is to show the ways of setting quality objectives, their attributes and the conditions under which they can perform a motivational function.Design/methodology/approachCollecting relevant data, the authors used the results of previous research and theoretical assumptions concerning quality objectives. Subsequently, they carried out a survey and exemplification research based on participatory observations, document content analysis and interviews.FindingsGoals are set mainly by top management, but the communication process itself is insufficient; the needs of system users are not taken into account. In the opinion of the employees, quality objectives are measurable and objective, although not very ambitious. For quality objectives to fulfil a motivational function, they should be objective and measurable. Also, the allocation of tasks among employees needs to be fair. Furthermore, quality objectives have to play a greater role in remuneration systems.Originality/valueThis paper is one of the first publications on the role and function of quality objectives. Its advantage is that it defines the conditions under which such objectives can have a motivational effect and encourage employees to pursue the improvement of their products and services.
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Transition to Multidisciplinary Pediatric Telerehabilitation during the COVID-19 Pandemic: Strategy Development and Implementation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041484. [PMID: 33557395 PMCID: PMC7914913 DOI: 10.3390/ijerph18041484] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/27/2021] [Accepted: 01/31/2021] [Indexed: 02/01/2023]
Abstract
Telerehabilitation offers a unique solution for continuity of care in pediatric rehabilitation under physical distancing. The major aims of this study were to: (1) describe the development of telerehabilitation usage guidelines in a large hospital in Israel, and to (2) evaluate the implementation of telerehabilitation from the perspectives of healthcare practitioners and families. An expert focus group developed guidelines which were disseminated to multidisciplinary clinicians. Following sessions, clinicians filled The Clinician Evaluation of Telerehabilitation Service (CETS), a custom-built feedback questionnaire on telerehabilitation, and parents completed the client version of the Therapist Presence Inventory (TPI-C) and were asked to rate the effectiveness of sessions on an ordinal scale. Four goals of telerehabilitation sessions were defined: (1) maintenance of therapeutic alliance, (2) provision of parental coping strategies, (3) assistance in maintaining routine, and (4) preventing functional deterioration. Principal Components Analysis was used for the CETS questionnaire and the relationships of CETS and TPI-C with child’s age and the type of session were evaluated using Spearman’s correlations and the Kruskal–Wallis H test. In total, sixty-seven telerehabilitation sessions, with clients aged 11.31 ± 4.8 years, were documented by clinicians. Three components (child, session, parent) explained 71.3% of the variance in CETS. According to therapists, their ability to maintain the therapeutic alliance was generally higher than their ability to achieve other predefined goals (p < 0.01). With younger children, the ability to provide feedback to the child, grade treatment difficulty and provide coping strategies to the parents were diminished. Families perceived the therapist as being highly present in therapy regardless of treatment type. These results demonstrate a potential framework for the dissemination of telerehabilitation services in pediatric rehabilitation.
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Sibley C, Ayers C, King B, Browning T, Kwon JK. Decreasing Patient Dwell Times for Outpatient Cardiac Nuclear Medicine Studies: The Benefits of SMART Goals, Scope Limitations, and Society Guidelines in Quality Improvement. Curr Probl Diagn Radiol 2020; 49:333-336. [PMID: 32321661 DOI: 10.1067/j.cpradiol.2020.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 02/03/2020] [Accepted: 02/25/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND We describe a quality improvement project to improve patient dwell times for outpatient cardiac nuclear medicine exams. Preliminary data indicated that the mean patient dwell time was about 270 minutes. Our specific, measurable, achievable, relevant, and time-bound goal was to reduce patient dwell times for outpatient pharmacologically stressed cardiac nuclear medicine exams by 60 minutes over the course of 2 months. METHODS An interdisciplinary team was formed which used staff interviews and workflow observation to create a cause and effect diagram as well as a process map. Review of the national guidelines for cardiac nuclear medicine exams identified rest and stress intervals as intervention targets. A new protocol was designed and implemented. RESULTS The mean patient dwell time was improved from 270 to 184 minutes. CONCLUSIONS Overall, we found that a clear specific, measurable, achievable, relevant, and time-bound goal, limited scope, and national guideline review allowed for a successful quality improvement project.
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Affiliation(s)
- Carson Sibley
- UT Southwestern Department of Radiology, Dallas, TX; Parkland Health and Hospital System, Dallas, TX.
| | - Camara Ayers
- UT Southwestern Department of Radiology, Dallas, TX
| | - Brent King
- UT Southwestern Department of Radiology, Dallas, TX; Parkland Health and Hospital System, Dallas, TX
| | - Travis Browning
- UT Southwestern Department of Radiology, Dallas, TX; Parkland Health and Hospital System, Dallas, TX
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21
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Establishment of Key Performance Indicators for Green Building Operations Monitoring—An Application to China Case Study. ENERGIES 2020. [DOI: 10.3390/en13040976] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Released green building evaluation standards for operation stage include a huge number of indicators, which are very comprehensive and systematic. However, the indicators of these standards are very complicated and a large amount of time and manpower are consumed for their evaluation. To evaluate the operational performance of green buildings more practically and efficiently, some studies collect the operational data for part of the indicators (mainly focusing on building energy performance, indoor environmental quality or occupant satisfaction), which are too rough to evaluate the performance of green building. This paper proposed a total of 27 key performance indicators (KPIs) for green building operations monitoring. The number of proposed indicators is much fewer than the evaluation standards, as well as suitable for long-term monitoring, which can dramatically reduce evaluation time and cost. On the other hand, the indicators involving Outdoor environmental quality, Indoor environmental quality, HVAC system, P&D system, Renewable energy system, Total resource consumption and User behavior, which are more comprehensive and systematic than the conventional monitoring studies for operational performance of green building. Firstly, an indicators library for operations monitoring of green building was established based on relevant standards and literature review in this field. Secondly, “SMART” principle and Delphi method were adopted to select the key performance indicators for green building operations monitoring. Different background experts regarding green building industry were chosen to screen the most relevant, accessible and measurable indicators. Subsequently, two projects in China were selected for case study of key performance indicators proposed in this paper for green building operations monitoring to validate the feasibility and advancement.
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22
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Nguyen L, Cross A, Rosenbaum P, Gorter JW. Use of the International Classification of Functioning, Disability and Health to support goal-setting practices in pediatric rehabilitation: a rapid review of the literature. Disabil Rehabil 2019; 43:884-894. [PMID: 31345067 DOI: 10.1080/09638288.2019.1643419] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The International Classification of Functioning, Disability and Health (referred to as the ICF) is the World Health Organization's framework for health. It can be used to identify goals that capture all aspects of a person's life and to inform clinical goal-setting processes. This review aims to report how healthcare providers are using the ICF framework to support goal-setting practices in pediatric rehabilitation services. METHODS A rapid review was conducted using scoping review principles in the following databases: CINAHL, Medline and PsycINFO. Key terms included: "ICF", "goal-setting" and "pediatrics". RESULTS Sixteen studies met the inclusion criteria. Three main themes emerged about the use of the ICF in pediatric rehabilitation: 1) match the content of goals to the ICF domains; 2) implement with existing tools for goal-setting; and 3) inform the development of new tools for goal-setting. Healthcare providers often use a combination of goal-setting tools. The SMART approach is used to frame goals, while the Canadian Occupational Performance Measure and Goal Attainment Scale have been used to document and evaluate goals. CONCLUSION The ICF framework can be used with current goal-setting practices and offers a common lens and language with which to facilitate collaborative goal-setting with families and healthcare providers.Implications for RehabilitationThe International Classification of Functioning, Disability and Health (ICF) provides a common framework and language to support collaborative goal-setting between families and healthcare providersDespite the opportunity for the ICF to be used as a framework with goal-setting approaches, to date the ICF has mainly been used to match the content of goals to ICF domains for documentation purposesThe ICF should be incorporated into the established clinical routines in order to promote its use among healthcare providersThe ICF can be used with existing goal-setting tools in clinical practice and to inform the ongoing development of new tools to support the goal-setting process in family-centred services.
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Affiliation(s)
- Linda Nguyen
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Andrea Cross
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.,Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
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Jarvis JM, Choong K, Khetani MA. Associations of Participation-Focused Strategies and Rehabilitation Service Use With Caregiver Stress After Pediatric Critical Illness. Arch Phys Med Rehabil 2019; 100:703-710. [PMID: 30578773 PMCID: PMC6435394 DOI: 10.1016/j.apmr.2018.11.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 11/10/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE(S) Determine the associations between having participation-focused strategies and receiving rehabilitation services in the pediatric intensive care unit (PICU) with caregiver stress over 6 months post-PICU discharge. DESIGN Substudy of a data from Wee-Cover, a prospective cohort study. SETTING Two PICU sites. PARTICIPANTS Caregivers (N=168) of children 1-17 years old admitted into a PICU for ≥48 hours. MAIN OUTCOME MEASURES Data were collected from caregivers at enrollment and 3 and 6 months post-PICU discharge. Caregiver stress was assessed using the Pediatric Inventory for Parents. Having strategies to support their child's participation in home-based activities was assessed using the Participation and Environment Measure (PEM). In PEM, caregivers report on strategies used to support their child's participation in home-based activities. Data were dichotomized (yes, no) to denote having participation-focused strategies and if their child received PICU rehabilitation services. Additional covariates were history of a preexisting condition, child age, length of PICU stay, and change in functional capacities at PICU discharge. RESULTS History of a preexisting condition, time, and change in functional capacities significantly predicted caregiver stress frequency and difficulty. The interaction of having strategies-by-rehabilitation-by-time significantly predicted caregiver stress frequency and difficulty. CONCLUSION(S) Results highlight the role of early rehabilitation and the importance of working with caregivers to develop participation-focused strategies to support their child's functioning post-PICU. Families of children with a preexisting condition or those who experience a decrease in function during a PICU stay are susceptible to higher levels of stress and may be a priority population to target for rehabilitation services.
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Affiliation(s)
- Jessica M Jarvis
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL
| | - Karen Choong
- Department of Pediatrics, Critical Care, Epidemiology and Biostatistics, McMaster University, Hamilton, ON
| | - Mary A Khetani
- Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL.
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