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Sadeghi S, Mahani F, Amiri P, Alamdari S, Khalili D, Saadat N, Ebadi SA, Mahdavi Hazaveh AR, Shahrzad MK, Azizi F. Barriers Toward the National Program for Prevention and Control of Diabetes in Iran: A Qualitative Exploration. Int J Health Policy Manag 2022; 12:6908. [PMID: 36300256 PMCID: PMC10125058 DOI: 10.34172/ijhpm.2022.6908] [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] [Received: 11/02/2021] [Accepted: 09/19/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Despite the achievements of the national program for the prevention and control of diabetes (NPPCD) over the past two decades, the available evidence indicates a high prevalence of this disease in Iran. This qualitative study aims to investigate barriers to the NPPCD by pursuing the perspectives of relevant policy-makers, planners, and healthcare workers. METHODS A grounded theory approach was used to analyze participants' perceptions and experiences. Semi-structured interviews (n=23) and eight focus groups (n=109) were conducted with relevant policy-makers, planners, and healthcare workers in charge of Iran's national diabetes management program. Of the 132 participants, ages ranged from 25 to 56 years, and 53% were female. Constant comparative analysis of the data was conducted manually, and open, axial, and selective coding was applied to the data. RESULTS Two main themes emerged from data analysis: implementation barriers and inefficient policy-making/ planning. Insufficient financial resources, staff shortage and insufficient motivation, inadequate knowledge of some healthcare workers, and defects in the referral system were recognized as the NPPCD implementation barriers. Inappropriate program prioritizing, the lack of or poor intersectoral collaboration, and the lack of an effective evaluation system were the inefficient policy-making/planning problems. CONCLUSION Current results highlighted that inefficient policy-making and planning have led to several implementation problems. Moreover, the key strategies to promote this program are prioritizing the NPPCD, practical intersectoral collaboration, and utilizing a more efficient evaluation system to assess the program and staff performance.
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Affiliation(s)
- Sohila Sadeghi
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Endocrinology & Metabolism, Internal Medicine, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mahani
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahram Alamdari
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Navid Saadat
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Alireza Ebadi
- Department of Endocrinology & Metabolism, Internal Medicine, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Reza Mahdavi Hazaveh
- Ministry of Health and Medical Education, Center for Non-communicable Disease Control, Tehran, Iran
| | - Mohammad Karim Shahrzad
- Internal Medicine and Endocrinology Shohada Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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van Elten HJ, Sülz S, van Raaij EM, Wehrens R. Big Data Health Care Innovations: Performance Dashboarding as a Process of Collective Sensemaking. J Med Internet Res 2022; 24:e30201. [PMID: 35191847 PMCID: PMC8905474 DOI: 10.2196/30201] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/10/2021] [Accepted: 12/15/2021] [Indexed: 12/21/2022] Open
Abstract
Big data is poised to revolutionize health care, and performance dashboards can be an important tool to manage big data innovations. Dashboards show the progress being made and provide critical management information about effectiveness and efficiency. However, performance dashboards are more than just a clear and straightforward representation of performance in the health care context. Instead, the development and maintenance of informative dashboards can be more productively viewed as an interactive and iterative process involving all stakeholders. We refer to this process as dashboarding and reflect on our learnings within a large European Union–funded project. Within this project, multiple big data applications in health care are being developed, piloted, and scaled up. In this paper, we discuss the ways in which we cope with the inherent sensitivities and tensions surrounding dashboarding in such a dynamic environment.
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Affiliation(s)
- Hilco J van Elten
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, Netherlands
| | - Sandra Sülz
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, Netherlands
| | - Erik M van Raaij
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, Netherlands.,Rotterdam School of Management, Erasmus University, Rotterdam, Netherlands
| | - Rik Wehrens
- Erasmus School of Health Policy & Management, Erasmus University, Rotterdam, Netherlands
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Bangalore Sathyananda R, de Rijk A, Manjunath U, Krumeich A, van Schayck CP. Primary health Centres' performance assessment measures in developing countries: review of the empirical literature. BMC Health Serv Res 2018; 18:627. [PMID: 30092842 PMCID: PMC6085632 DOI: 10.1186/s12913-018-3423-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 07/26/2018] [Indexed: 11/10/2022] Open
Abstract
Background It is universally accepted that primary healthcare is essential for achieving public health and that assessment of its performance is critical for continuous improvement. The World Health Organization’s (WHO’s) framework for performance assessment is a comprehensive global standard, but difficult to apply in developing countries because of financial and data constraints. This study aims to review the empirical literature on measures for Primary Health Centre (PHC) performance assessment in developing countries, and compare them for comprehensiveness with the aspects described by the WHO Framework. Methods Research articles published in English scientific journals between January 1979 and October 2016 were reviewed systematically. The reporting quality of the article and the quality of the measures were assessed with instruments adapted for the purpose of this study. Data was categorized and described. Results Fifteen articles were included in the study out of 4359 articles reviewed. Nine articles used quantitative methods, one article used qualitative methods exclusively and five used mixed methods. Fourteen articles had a good description of the measurement properties. None of the articles presented validity tests of the measures but eleven articles presented measures that were well established. Mostly studies included components of personnel competencies (skilled/ non-skilled) and centre performance (patient satisfaction/cost /efficiency). Conclusions In comparison to the WHO framework, the measures in the articles were limited in scope as they did not represent all service components of PHCs. Hence, PHC performance assessment should include system components along with relevant measures of personnel performance beyond knowledge of protocols. Existing measures for PHC performance assessment in developing countries need to be validated and concise measures for neglected aspects need to be developed. Electronic supplementary material The online version of this article (10.1186/s12913-018-3423-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- R Bangalore Sathyananda
- Department of Primary Care, CAPHRI, Maastricht University, Maastricht, The Netherlands. .,, Present address: No 18, 3rd Main, 1stCross, Navodaya Layout, Shakambari Nagar, Sarakki, J P Nagar 1st Phase, Bengaluru, Karnataka, 560070, India.
| | - A de Rijk
- Department of Social Medicine, research institute CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - U Manjunath
- Institute of Health Management Research, Bangalore, India
| | - A Krumeich
- Department of Health Ethics and Society, research institute CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - C P van Schayck
- Department of Primary Care, CAPHRI, Maastricht University, Maastricht, The Netherlands
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Vafaee Najar A, Pooya A, Alizadeh Zoeram A, Emrouznejad A. Assessing the Relative Performance of Nurses Using Data Envelopment Analysis Matrix (DEAM). J Med Syst 2018; 42:125. [PMID: 29855730 DOI: 10.1007/s10916-018-0974-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 05/18/2018] [Indexed: 10/16/2022]
Abstract
Assessing employee performance is one of the most important issue in healthcare management services. Because of their direct relationship with patients, nurses are also the most influential hospital staff who play a vital role in providing healthcare services. In this paper, a novel Data Envelopment Analysis Matrix (DEAM) approach is proposed for assessing the performance of nurses based on relative efficiency. The proposed model consists of five input variables (including type of employment, work experience, training hours, working hours and overtime hours) and eight output variables (the outputs are amount of hours each nurse spend on each of the eight activities including documentation, medical instructions, wound care and patient drainage, laboratory sampling, assessment and control care, follow-up and counseling and para-clinical measures, attendance during visiting and discharge suction) have been tested on 30 nurses from the heart department of a hospital in Iran. After determining the relative efficiency of each nurse based on the DEA model, the nurses' performance were evaluated in a DEAM format. As results the nurses were divided into four groups; superstars, potential stars, those who are needed to be trained effectively and question marks. Finally, based on the proposed approach, we have drawn some recommendations to policy makers in order to improve and maintain the performance of each of these groups. The proposed approach provides a practical framework for hospital managers so that they can assess the relative efficiency of nurses, plan and take steps to improve the quality of healthcare delivery.
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Affiliation(s)
- Ali Vafaee Najar
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Pooya
- Department of Management, Faculty of Economics & Administrative Sciences, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Ali Alizadeh Zoeram
- Department of Management, Faculty of Economics & Administrative Sciences, Ferdowsi University of Mashhad, and Researcher at ACECR: Academic Center for Education, Culture and Research-Khorasan Razavi, Mashhad, Iran.
| | - Ali Emrouznejad
- Department of Operations & Information Management, Aston Business School, Aston University, Birmingham, UK
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Gerhard-Szep S, Güntsch A, Pospiech P, Söhnel A, Scheutzel P, Wassmann T, Zahn T. Assessment formats in dental medicine: An overview. GMS JOURNAL FOR MEDICAL EDUCATION 2016; 33:Doc65. [PMID: 27579365 PMCID: PMC5003142 DOI: 10.3205/zma001064] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 03/24/2016] [Accepted: 05/09/2016] [Indexed: 05/25/2023]
Abstract
AIM At the annual meeting of German dentists in Frankfurt am Main in 2013, the Working Group for the Advancement of Dental Education (AKWLZ) initiated an interdisciplinary working group to address assessments in dental education. This paper presents an overview of the current work being done by this working group, some of whose members are also actively involved in the German Association for Medical Education's (GMA) working group for dental education. The aim is to present a summary of the current state of research on this topic for all those who participate in the design, administration and evaluation of university-specific assessments in dentistry. METHOD Based on systematic literature research, the testing scenarios listed in the National Competency-based Catalogue of Learning Objectives (NKLZ) have been compiled and presented in tables according to assessment value. RESULTS Different assessment scenarios are described briefly in table form addressing validity (V), reliability (R), acceptance (A), cost (C), feasibility (F), and the influence on teaching and learning (EI) as presented in the current literature. Infoboxes were deliberately chosen to allow readers quick access to the information and to facilitate comparisons between the various assessment formats. Following each description is a list summarizing the uses in dental and medical education. CONCLUSION This overview provides a summary of competency-based testing formats. It is meant to have a formative effect on dental and medical schools and provide support for developing workplace-based strategies in dental education for learning, teaching and testing in the future.
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Affiliation(s)
- Susanne Gerhard-Szep
- Goethe-Universität, Carolinum Zahnärztliches Universitäts-Institut gGmbH, Poliklinik Zahnerhaltungskunde, Frankfurt am Main, Deutschland
| | - Arndt Güntsch
- Marquette University School of Dentistry, Department of Surgical Sciences, Milwaukee, USA und Universitätsklinikum Jena, Zentrum für Zahn-, Mund- und Kieferheilkunde, Jena, Deutschland
| | - Peter Pospiech
- Universität Würzburg, Poliklinik für Zahnärztliche Prothetik, Würzburg, Deutschland
| | - Andreas Söhnel
- Universitätsmedizin Greifswald, Poliklinik für Zahnärztliche Prothetik, Alterszahnheilkunde und medizinischer Werkstoffkunde, Greifswald, Deutschland
| | - Petra Scheutzel
- Universitätsklinikum Münster, Poliklinik für Prothetische Zahnmedizin & Biomaterialien, Münster, Deutschland
| | - Torsten Wassmann
- Universitätsmedizin Göttingen, Poliklinik für Zahnärztliche Prothetik, Göttingen, Deutschland
| | - Tugba Zahn
- Goethe-Universität, Carolinum Zahnärztliches Universitäts-Institut gGmbH, Poliklinik für Zahnärztliche Prothetik, Frankfurt am Main, Deutschland
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Kvas A, Seljak J. A competency-based performance appraisal for nurse leaders. OBZORNIK ZDRAVSTVENE NEGE 2016. [DOI: 10.14528/snr.2016.50.1.90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction: An employee performance appraisal is used internationally to improve employee performance, productivity, efficiency and effectiveness in nursing care. The purpose of the study was to assess the performance and efficiency of nurse leaders at all levels of leadership, identify deficient areas for each individual leader and propose improvements.
Methods: Two surveys were conducted in 15 Slovenian public hospitals. The sample from the first survey included 1311 nurses who assessed the level of competencies of their immediate superiors. The sample from the second survey included 236 nurse leaders. Data envelopment analysis is used in this study to develop a model of practice outputs and inputs to help identify the most efficient nurse leaders.
Results: Significant differences exist in the performance appraisal among the leaders in nursing. A total of 203 (86 %) nurse leaders are defined as inefficient and could improve their leadership performance. On average, inefficient leaders could improve their behaviour most in the areas of generic leadership competencies (by 51.7 %) and interprofessional relationships (by 47.7 %).
Discussion and conclusion: The areas with the worst performance are generic leadership competencies and interprofessional relationships where also the most significant improvements are possible. Nurse leaders and hospital managers can use the analysis results to determine in which areas the leaders in their organisation should improve the levels of their competencies.
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Ossenberg C, Dalton M, Henderson A. Validation of the Australian Nursing Standards Assessment Tool (ANSAT): A pilot study. NURSE EDUCATION TODAY 2016; 36:23-30. [PMID: 26296544 DOI: 10.1016/j.nedt.2015.07.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 06/16/2015] [Accepted: 07/05/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Workplace-based learning and assessment are essential elements of all nursing education programs. There is, however, limited evidence of validity and reliability available regarding assessment instruments, based on the professional competency standards for nursing in Australia. OBJECTIVE The aims of this project were to advance the assessment properties of a new instrument, the Australian Nursing Standards Assessment Tool (ANSAT) and investigate the acceptability of this instrument when applied to the evaluation of the professional competence of nursing students in authentic practice settings. METHODS A validation study of ANSAT was conducted by 23 clinical assessors from two universities, completing 220 instruments for second and third year undergraduate nursing students undertaking clinical placement in an authentic practice setting. 'Think Aloud' interviews and a post-test survey provided additional data to determine the validity and acceptability of the ANSAT. The pilot study occurred in parallel with completion of existing university assessment instruments. RESULTS Principal components analysis extracted one factor: professional practice competence. Comparison of total instrument scores between year levels demonstrated a significant difference in each of the clinical domains (p=0.000), suggesting that the instrument is sensitive to differing levels of performance across different year levels. The ANSAT demonstrated high internal consistency with a Cronbach's alpha coefficient of 0.976. Post-test evaluation completed by assessors demonstrated high usability and acceptability for use in common practice settings. DISCUSSION Results of the pilot study provided preliminary support for the ANSAT instrument. It is recommended that testing of the instrument be undertaken on a larger cohort to ensure the generalisability of the findings to other nursing populations. CONCLUSION There is a need for valid and reliable instruments that assess the performance of nursing in the authentic practice setting. With the addition of supportive behavioural cues, the ANSAT enables clarity, consistency and collaboration in workplace-based assessment.
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Affiliation(s)
| | - Megan Dalton
- School of Human, Health and Social Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Amanda Henderson
- Princess Alexandra Hospital, Woolloongabba, Queensland, Australia; Griffith Health, Griffith University, Queensland, Australia
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Yanes AF, McElroy LM, Abecassis ZA, Holl J, Woods D, Ladner DP. Observation for assessment of clinician performance: a narrative review. BMJ Qual Saf 2015; 25:46-55. [PMID: 26424762 DOI: 10.1136/bmjqs-2015-004171] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 09/13/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND Video recorded and in-person observations are methods of quality assessment and monitoring that have been employed in high risk industries. In the medical field, observations have been used to evaluate the quality and safety of various clinical processes. This review summarises studies utilising video recorded or in-person observations for assessing clinician performance in medicine and surgery. METHODS A search of MEDLINE (PubMed) was conducted using a combination of medical subject headings (MeSH) terms. Articles were included if they described the use of in-person or video recorded observations to assess clinician practices in three categories: (1) teamwork and communication between clinicians; (2) errors and weaknesses in practice; and (3) compliance and adherence to interventions or guidelines. RESULTS The initial search criteria returned 3215 studies, 223 of which were identified for full text review. A total of 69 studies were included in the final set of literature. Observations were most commonly used in data dense and high risk environments, such as the emergency department or operating room. The most common use was for assessing teamwork and communication factors. CONCLUSIONS Observations are useful for the improvement of healthcare delivery through the identification of clinician lapses and weaknesses that affect quality and safety. Limitations of observations include the Hawthorne effect and the necessity of trained observers to capture and analyse the notes or videos. The comprehensive, subtle and sensitive information observations provided can supplement traditional quality assessment methods and inform targeted interventions to improve patient safety and the quality of care.
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Affiliation(s)
- Arianna F Yanes
- Transplant Outcomes Research Collaborative, Northwestern University, Chicago, Illinois, USA
| | - Lisa M McElroy
- Transplant Outcomes Research Collaborative, Northwestern University, Chicago, Illinois, USA Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Zachary A Abecassis
- Transplant Outcomes Research Collaborative, Northwestern University, Chicago, Illinois, USA
| | - Jane Holl
- Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Donna Woods
- Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Daniela P Ladner
- Transplant Outcomes Research Collaborative, Northwestern University, Chicago, Illinois, USA Center for Healthcare Studies, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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van de Ridder JMM, McGaghie WC, Stokking KM, ten Cate OTJ. Variables that affect the process and outcome of feedback, relevant for medical training: a meta-review. MEDICAL EDUCATION 2015; 49:658-73. [PMID: 26077214 DOI: 10.1111/medu.12744] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 07/29/2014] [Accepted: 02/04/2015] [Indexed: 05/11/2023]
Abstract
CONTEXT Feedback is considered important in medical education. The literature is not clear about the mechanisms that contribute to its effects, which are often small to moderate and at times contradictory. A variety of variables seem to influence the impact of feedback on learning. The aim of this study was to determine which variables influence the process and outcomes of feedback in settings relevant to medical education. METHODS A myriad of studies on feedback have been conducted. To determine the most researched variables, we limited our review to meta-analyses and literature reviews published in the period from January 1986 to February 2012. According to our protocol, we first identified features of the feedback process that influence its effects and subsequently variables that influence these features. We used a chronological model of the feedback process to categorise all variables found. RESULTS A systematic search of ERIC, PsycINFO and MEDLINE yielded 1101 publications, which we reduced to 203, rejecting papers on six exclusion criteria. Of these, 46 met the inclusion criteria. In our four-phase model, we identified 33 variables linked to task performance (e.g. task complexity, task nature) and feedback reception (e.g. self-esteem, goal-setting behaviour) by trainees, and to observation (e.g. focus, intensity) and feedback provision (e.g. form, content) by supervisors that influence the subsequent effects of the feedback process. Variables from all phases influence the feedback process and effects, but variables that influence the quality of the observation and rating of the performance dominate the literature. There is a paucity of studies addressing other, seemingly relevant variables. CONCLUSIONS The larger picture of variables that influence the process and outcome of feedback, relevant for medical education, shows many open spaces. We suggest that targeted studies be carried out to expand our knowledge of these important aspects of feedback in medical education.
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Affiliation(s)
| | - William C McGaghie
- Department of Medical Education, Feinberg School of Medicine Northwestern University, Chicago, Illinois, USA
| | - Karel M Stokking
- Department of Educational Sciences, Utrecht University, Utrecht, the Netherlands
| | - Olle T J ten Cate
- Center for Research and Development of Education, University Medical Centre Utrecht, School of Medical Sciences, Utrecht University, Utrecht, the Netherlands
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Lizarondo L, Grimmer K, Kumar S. Assisting allied health in performance evaluation: a systematic review. BMC Health Serv Res 2014; 14:572. [PMID: 25394559 PMCID: PMC4234851 DOI: 10.1186/s12913-014-0572-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 10/28/2014] [Indexed: 11/21/2022] Open
Abstract
Background Performance evaluation raises several challenges to allied health practitioners and there is no agreed approach to measuring or monitoring allied health service performance. The aim of this review was to examine the literature on performance evaluation in healthcare to assist in the establishment of a framework that can guide the measurement and evaluation of allied health clinical service performance. This review determined the core elements of a performance evaluation system, tools for evaluating performance, and barriers to the implementation of performance evaluation. Methods A systematic review of the literature was undertaken. Five electronic databases were used to search for relevant articles: MEDLINE, Embase, CINAHL, PsychInfo, and Academic Search Premier. Articles which focussed on any allied health performance evaluation or those which examined performance in health care in general were considered in the review. Content analysis was used to synthesise the findings from individual articles. Results A total of 37 articles were included in the review. The literature suggests there are core elements involved in performance evaluation which include prioritising clinical areas for measurement, setting goals, selecting performance measures, identifying sources of feedback, undertaking performance measurement, and reporting the results to relevant stakeholders. The literature describes performance evaluation as multi-dimensional, requiring information or data from more than one perspective to provide a rich assessment of performance. A range of tools or instruments are available to capture various perspectives and gather a comprehensive picture of health care quality. Conclusions Every allied health care delivery system has different performance needs and will therefore require different approaches. However, there are core processes that can be used as a framework to evaluate allied health performance. A careful examination of barriers to performance evaluation and subsequent tailoring of strategies to overcome these barriers should be undertaken to achieve the aims of performance evaluation. The findings of this review should inform the development of a standardised framework that can be used to measure and evaluate allied health performance. Future research should explore the utility and overall impact of such framework in allied health service delivery.
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Affiliation(s)
- Lucylynn Lizarondo
- International Centre for Allied Health Evidence, School of Health Sciences, University of South Australia, Adelaide, South Australia.
| | - Karen Grimmer
- International Centre for Allied Health Evidence, School of Health Sciences, University of South Australia, Adelaide, South Australia.
| | - Saravana Kumar
- International Centre for Allied Health Evidence, School of Health Sciences, University of South Australia, Adelaide, South Australia.
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Numminen O, Laine T, Isoaho H, Hupli M, Leino-Kilpi H, Meretoja R. Do educational outcomes correspond with the requirements of nursing practice: educators' and managers' assessments of novice nurses' professional competence. Scand J Caring Sci 2014; 28:812-21. [PMID: 24512685 PMCID: PMC4282483 DOI: 10.1111/scs.12115] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 12/28/2013] [Indexed: 11/29/2022]
Abstract
Objective This study evaluated weather educational outcomes of nurse education meet the requirements of nursing practice by exploring the correspondence between nurse educators' and nurse managers' assessments of novice nurses' professional competence. The purpose was to find competence areas contributing to the acknowledged practice–theory gap. Design A cross-sectional, comparative design using the Nurse Competence Scale was applied. Subjects The sample comprised nurse educators (n = 86) and nurse managers (n = 141). Methods Descriptive and inferential statistics were used in the data analysis. Main outcome measures Educators assessed novice nurses' competence to a significantly higher level than managers in all competence areas (p < 0.001). The biggest correspondence between educators' and mangers' assessments were in competencies related to immediate patient care, commitment to ethical values, maintaining professional skills and nurses' care of the self. The biggest differences were in competencies related to developmental and evaluation tasks, coaching activities, use of evidence-based knowledge and in activities which required mastering a comprehensive view of care situations. However, differences between educators' and managers' assessments were strongly associated with their age and work experience. Active and improved collaboration should be focused on areas in which the differences between educators' and managers' assessments greatly differ in ensuring novice nurses′ fitness for practice.
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Affiliation(s)
- Olivia Numminen
- Hospital District of Helsinki and Uusimaa, Corporate Headquarters, Helsinki, Finland
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Numminen O, Meretoja R, Isoaho H, Leino-Kilpi H. Professional competence of practising nurses. J Clin Nurs 2013; 22:1411-23. [DOI: 10.1111/j.1365-2702.2012.04334.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2012] [Indexed: 11/27/2022]
Affiliation(s)
- Olivia Numminen
- Corporate Headquarters; Hospital District of Helsinki and Uusimaa; Helsinki
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Traynor M, Stone K, Cook H, Gould D, Maben J. Disciplinary processes and the management of poor performance among UK nurses: bad apple or systemic failure? A scoping study. Nurs Inq 2013; 21:51-8. [DOI: 10.1111/nin.12025] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Michael Traynor
- School of Health and Education; Middlesex University; London UK
| | - Katie Stone
- Department of Palliative Care, Policy and Rehabilitation; King's College London; London UK
| | - Hannah Cook
- The School of Nursing, Midwifery and Social Work; The University of Manchester; Manchester UK
| | - Dinah Gould
- Cardiff School of Nursing and Midwifery Studies; Cardiff University; Cardiff UK
| | - Jill Maben
- National Nursing Research Unit; King's College London; London UK
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ATHLIN ELSY, LARSSON MARIA, SÖDERHAMN OLLE. A model for a national clinical final examination in the Swedish bachelor programme in nursing. J Nurs Manag 2011; 20:90-101. [DOI: 10.1111/j.1365-2834.2011.01278.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Data Envelopment Analysis Model for the Appraisal and Relative Performance Evaluation of Nurses at an Intensive Care Unit. J Med Syst 2010; 35:1039-62. [DOI: 10.1007/s10916-010-9570-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2009] [Accepted: 07/21/2010] [Indexed: 10/19/2022]
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Bhutta ZA, Darmstadt GL, Haws RA, Yakoob MY, Lawn JE. Delivering interventions to reduce the global burden of stillbirths: improving service supply and community demand. BMC Pregnancy Childbirth 2009; 9 Suppl 1:S7. [PMID: 19426470 PMCID: PMC2679413 DOI: 10.1186/1471-2393-9-s1-s7] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Although a number of antenatal and intrapartum interventions have shown some evidence of impact on stillbirth incidence, much confusion surrounds ideal strategies for delivering these interventions within health systems, particularly in low-/middle-income countries where 98% of the world's stillbirths occur. Improving the uptake of quality antenatal and intrapartum care is critical for evidence-based interventions to generate an impact at the population level. This concluding paper of a series of papers reviewing the evidence for stillbirth interventions examines the evidence for community and health systems approaches to improve uptake and quality of antenatal and intrapartum care, and synthesises programme and policy recommendations for how best to deliver evidence-based interventions at community and facility levels, across the continuum of care, to reduce stillbirths. METHODS We systematically searched PubMed and the Cochrane Library for abstracts pertaining to community-based and health-systems strategies to increase uptake and quality of antenatal and intrapartum care services. We also sought abstracts which reported impact on stillbirths or perinatal mortality. Searches used multiple combinations of broad and specific search terms and prioritised rigorous randomised controlled trials and meta-analyses where available. Wherever eligible randomised controlled trials were identified after a Cochrane review had been published, we conducted new meta-analyses based on the original Cochrane criteria. RESULTS In low-resource settings, cost, distance and the time needed to access care are major barriers for effective uptake of antenatal and particularly intrapartum services. A number of innovative strategies to surmount cost, distance, and time barriers to accessing care were identified and evaluated; of these, community financial incentives, loan/insurance schemes, and maternity waiting homes seem promising, but few studies have reported or evaluated the impact of the wide-scale implementation of these strategies on stillbirth rates. Strategies to improve quality of care by upgrading the skills of community cadres have shown demonstrable impact on perinatal mortality, particularly in conjunction with health systems strengthening and facilitation of referrals. Neonatal resuscitation training for physicians and other health workers shows potential to prevent many neonatal deaths currently misclassified as stillbirths. Perinatal audit systems, which aim to improve quality of care by identifying deficiencies in care, are a quality improvement measure that shows some evidence of benefit for changes in clinical practice that prevent stillbirths, and are strongly recommended wherever practical, whether as hospital case review or as confidential enquiry at district or national level. CONCLUSION Delivering interventions to reduce the global burden of stillbirths requires action at all levels of the health system. Packages of interventions should be tailored to local conditions, including local levels and causes of stillbirth, accessibility of care and health system resources and provider skill. Antenatal care can potentially serve as a platform to deliver interventions to improve maternal nutrition, promote behaviour change to reduce harmful exposures and risk of infections, screen for and treat risk factors, and encourage skilled attendance at birth. Following the example of high-income countries, improving intrapartum monitoring for fetal distress and access to Caesarean section in low-/middle-income countries appears to be key to reducing intrapartum stillbirth. In remote or low-resource settings, families and communities can be galvanised to demand and seek quality care through financial incentives and health promotion efforts of local cadres of health workers, though these interventions often require simultaneous health systems strengthening. Perinatal audit can aid in the development of better standards of care, improving quality in health systems. Effective strategies to prevent stillbirth are known; gaps remain in the data, the evidence and perhaps most significantly, the political will to implement these strategies at scale.
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Affiliation(s)
- Zulfiqar A Bhutta
- Division of Maternal and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Gary L Darmstadt
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Rachel A Haws
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Joy E Lawn
- Saving Newborn Lives/Save the Children-US, Cape Town, South Africa
- International Perinatal Care Unit, Institute of Child Health, London, UK
- Health Systems Research Unit, Medical Research Council of South Africa, South Africa
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Hilarion P, Suñol R, Groene O, Vallejo P, Herrera E, Saura RM. Making performance indicators work: The experience of using consensus indicators for external assessment of health and social services at regional level in Spain. Health Policy 2009; 90:94-103. [PMID: 18829129 DOI: 10.1016/j.healthpol.2008.08.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2008] [Revised: 08/05/2008] [Accepted: 08/17/2008] [Indexed: 11/24/2022]
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