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Srinivasan S, James SM, Kwek J, Black K, Taft AJ, Bateson D, Norman WV, Mazza D. What do Australian primary care clinicians need to provide long-acting reversible contraception and early medical abortion? A content analysis of a virtual community of practice. BMJ SEXUAL & REPRODUCTIVE HEALTH 2024:bmjsrh-2024-202330. [PMID: 38960413 DOI: 10.1136/bmjsrh-2024-202330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 06/04/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND Uptake of long-acting reversible contraception (LARC) is lower in Australia compared with other high-income countries, and access to early medical abortion (EMA) is variable with only 11% of general practitioners (GPs) providing EMA. The AusCAPPS (Australian Contraception and Abortion Primary Care Practitioner Support) Network is a virtual community of practice established to support GPs, nurses and pharmacists to provide LARC and EMA in primary care. Evaluating participant engagement with AusCAPPS presents an opportunity to understand clinician needs in relation to LARC and EMA care. METHODS Data were collected from July 2021 until July 2023. Numbers of online resource views on AusCAPPS were analysed descriptively and text from participant posts underwent qualitative content analysis. RESULTS In mid-2023 AusCAPPS had 1911 members: 1133 (59%) GPs, 439 (23%) pharmacists and 272 (14%) nurses. Concise point-of-care documents were the most frequently viewed resource type. Of the 655 posts, most were created by GPs (532, 81.2%), followed by nurses (88, 13.4%) then pharmacists (16, 2.4%). GPs most commonly posted about clinical issues (263, 49% of GP posts). Nurses posted most frequently about service implementation (24, 27% of nurse posts). Pharmacists posted most about health system and regulatory issues (7, 44% of pharmacist posts). CONCLUSIONS GPs, nurses and pharmacists each have professional needs for peer support and resources to initiate or continue LARC and EMA care, with GPs in particular seeking further clinical education and upskilling. Development of resources, training and implementation support may improve LARC and EMA provision in Australian primary care.
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Affiliation(s)
- Sonia Srinivasan
- SPHERE, NHMRC Centre of Research Excellence, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sharon Maree James
- SPHERE, NHMRC Centre of Research Excellence, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Joly Kwek
- SPHERE, NHMRC Centre of Research Excellence, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Kirsten Black
- Discipline of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine and Science, University of Sydney, Sydney, New South Wales, Australia
| | - Angela J Taft
- Judith Lumley Centre, La Trobe University College of Science Health and Engineering, Melbourne, Victoria, Australia
| | - Deborah Bateson
- Discipline of Obstetrics, Gynaecology and Neonatology, Faculty of Medicine and Science, University of Sydney, Sydney, New South Wales, Australia
- The Daffodil Centre, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Wendy V Norman
- Department of Family Practice, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
- Public Health, Environments and Society, London School of Hygiene and Tropical Medicine Faculty of Public Health and Policy, London, UK
| | - Danielle Mazza
- SPHERE, NHMRC Centre of Research Excellence, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Mazaheri E, Alavi M, Samouei R, Ashrafi-rizi H. Facilitating and Inhibiting Factors of Clinical Knowledge Sharing among Medical Specialists in University Hospitals. Int J Prev Med 2024; 14:132. [PMID: 38449689 PMCID: PMC10916407 DOI: 10.4103/ijpvm.ijpvm_143_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/06/2023] [Indexed: 03/08/2024] Open
Abstract
Background Clinical knowledge sharing (CKS) is one of the key points of knowledge management in the field of health and significantly increases the quality of care and patient safety. It also provides the achievement of an efficient system in hospitals and educational and treatment centers involved in clinical processes in order to make the best clinical decisions. The purpose of this research is to identify the factors that facilitate and inhibit CKS among medical specialists in the educational-treatment hospitals in Iran. Methods This was an applied qualitative study with the conventional content analysis method conducted in 2022. The data collection tool was a semi-structured interview. The participants were 13 medical specialists and sub-specialists working in educational-treatment hospitals of the country, who were selected by purposeful and snowball sampling. The method of data analysis was based on Graneheim and Lundman's five-step method, which was followed by codes, sub-categories, main categories, and classifications. Results After conducting the interviews and assessing their content, finally, 193 codes were extracted, which were identified in two general classification of facilitating and inhibiting factors with 92 and 101 concepts, respectively. Facilitating factors in the three main categories of "education in the context of culture, society and university", "planning and implementation management", and "behavioral-motivational factors" and inhibiting factors in the four main categories of "infrastructural, policy-making and cultural challenges", "technological and scientific infrastructural challenges", "personality-behavioral challenges", and "financial and non-financial motivations" were classified. Conclusions The participants of the research pointed out the effective role of CKS in keeping them up-to-date in the use of diagnostic, therapeutic, and even drug prescribing methods. According to their belief, knowledge sharing (KS) in the clinical setting will reduce diagnostic errors and cause the primordial prevention of diseases as well as increase the knowledge and awareness of the society members.
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Affiliation(s)
- Elaheh Mazaheri
- Student Research Committee, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mousa Alavi
- Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rahele Samouei
- Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hasan Ashrafi-rizi
- Health Information Technology Research Center, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Noar AP, Jeffery HE, Subbiah Ponniah H, Jaffer U. The aims and effectiveness of communities of practice in healthcare: A systematic review. PLoS One 2023; 18:e0292343. [PMID: 37815986 PMCID: PMC10564133 DOI: 10.1371/journal.pone.0292343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/18/2023] [Indexed: 10/12/2023] Open
Abstract
Communities of practice (CoPs) are defined as "groups of people who share a concern, a set of problems, or a passion about a topic, and who deepen their knowledge and expertise by interacting on an ongoing basis". They are an effective form of knowledge management that have been successfully used in the business sector and increasingly so in healthcare. In May 2023 the electronic databases MEDLINE and EMBASE were systematically searched for primary research studies on CoPs published between 1st January 1950 and 31st December 2022. PRISMA guidelines were followed. The following search terms were used: community/communities of practice AND (healthcare OR medicine OR patient/s). The database search picked up 2009 studies for screening. Of these, 50 papers met the inclusion criteria. The most common aim of CoPs was to directly improve a clinical outcome, with 19 studies aiming to achieve this. In terms of outcomes, qualitative outcomes were the most common measure used in 21 studies. Only 11 of the studies with a quantitative element had the appropriate statistical methodology to report significance. Of the 9 studies that showed a statistically significant effect, 5 showed improvements in hospital-based provision of services such as discharge planning or rehabilitation services. 2 of the studies showed improvements in primary-care, such as management of hepatitis C, and 2 studies showed improvements in direct clinical outcomes, such as central line infections. CoPs in healthcare are aimed at improving clinical outcomes and have been shown to be effective. There is still progress to be made and a need for further studies with more rigorous methodologies, such as RCTs, to provide further support of the causality of CoPs on outcomes.
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Affiliation(s)
- Alexander P. Noar
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
- Highgate Mental Health Centre, Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Hannah E. Jeffery
- Department of General Surgery, East and North Hertfordshire NHS Trust, Stevenage, United Kingdom
| | - Hariharan Subbiah Ponniah
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Usman Jaffer
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, United Kingdom
- Department of Vascular Surgery, Imperial College Healthcare NHS Trust, London, United Kingdom
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Implementation of Virtual Communities of Practice in Healthcare to Improve Capability and Capacity: A 10-Year Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137994. [PMID: 35805649 PMCID: PMC9265616 DOI: 10.3390/ijerph19137994] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/20/2022] [Accepted: 06/27/2022] [Indexed: 11/23/2022]
Abstract
Virtual communities of practice consist of individuals who use a common online platform to share professional expertise and experiences. In healthcare settings a virtual community of practice (VCoP) can optimise knowledge, skills, and the implementation of evidence-based practice. To ensure effective knowledge synthesis and translation into practice, it is essential to clarify the best methods for designing and implementing VCoPs within healthcare organisations. This scoping review aimed to identify the methods used to establish and facilitate online or digitally enabled communities of practice within healthcare organisations across the globe. Six online databases identified papers published from January 2010 to October 2020. Papers were independently screened by two reviewers using Covidence. Data were captured and analysed using a data extraction chart in Covidence. Twenty-four publications that detail methods for establishing a VCoP in healthcare were included. Few studies used a framework to establish a VCoP. It was difficult to identify details regarding methods of development and key elements such as roles, how they were coordinated, and types of technology used. Healthcare organisations can benefit from using a standardised framework for the establishment, implementation and evaluation of VCoPs to improve practice, staff engagement, and knowledge sharing.
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Zhang B, Tang F, Sun B, Niu Y, Tang Z, Sun X. High-performance work systems, multiple commitments, and knowledge exchange and combination among Chinese public hospital nurses. Nurs Open 2021; 9:1445-1455. [PMID: 33988910 PMCID: PMC8859067 DOI: 10.1002/nop2.921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/09/2021] [Accepted: 03/15/2021] [Indexed: 11/30/2022] Open
Abstract
Aim This research explores and examines the differentiated mediation roles of multi‐foci commitment in the relationship between HPWS and knowledge exchange and combination among Chinese hospital nurses. Design This study employs a quantitative research approach and survey design. Methods Individual‐level time‐lagged data were collected from 845 nurses in public hospitals in China using online questionnaires. Aside from personal information, the items in the questionnaires were adopted from mature scales in previous research. Results The results of multiple regression analysis demonstrate that nurses’ professional and affective commitments partially mediate the relationship between HPWS and KEC. Nurses’ continuance commitment does not play a mediation role in HPWS‐KEC relationship, although HPWS positively influences nurse continuance commitment, which then weakly and positively impacts KEC.
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Affiliation(s)
- Bo Zhang
- School of Economics and Management, Beijing University of Chemical Technology, Beijing, China
| | - Fangcheng Tang
- School of Economics and Management, Beijing University of Chemical Technology, Beijing, China
| | - Bo Sun
- PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Yi Niu
- HRM Department, Luoxin Pharmaceutical Group (Shanghai)Co., Ltd, Beijing, China
| | - Zhisong Tang
- School of Economics and Management, Beijing University of Chemical Technology, Beijing, China
| | - Xiangdong Sun
- School of Economics and Management, Beijing University of Chemical Technology, Beijing, China
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Rolls KD, Hansen MM, Jackson D, Elliott D. Intensive care nurses on social media: An exploration of knowledge exchange on an intensive care virtual community of practice. J Clin Nurs 2020; 29:1381-1397. [PMID: 31856353 PMCID: PMC7328784 DOI: 10.1111/jocn.15143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 07/31/2019] [Accepted: 10/18/2019] [Indexed: 11/28/2022]
Abstract
Aims and objectives To explore the nature of knowledge exchange on a multi‐disciplinary Australasian intensive care virtual community of practice, “ICUConnect.” Background Current organisational structures and cultures constrain the social networks of healthcare professionals, limiting access to contemporary best practice knowledge. While virtual communities can facilitate knowledge and clinical expertise exchange in professional networks, their effectiveness has not been established. Design A sequential mixed‐methods design with a quantitative core and qualitative supplementary component was used to explore the content of discussions from an intensive care virtual community. SRQR has been used to report this study. Methods Email archives of an intensive care listserv (2003–2013) were mined using a two‐stage sampling technique to identify discussion threads (with >2 posts) concerning ventilator or airway practices (cluster) and two sets of 20 threads (stratified across years). Summative content analysis was used to examine both manifest and latent content. Results Forty threads containing 326 emails posted by 133 individuals from 80 organisations were analysed. Nurses contributed 68% (55% were in clinical leadership roles) and physicians 27%. Three subject areas were identified: clinical practices (71%); equipment (23%); and clinical governance (6%). “Knowledge‐requested” and “knowledge‐supplied” posts were categorised as follows: experiential and explicit (33% and 16%, respectively); experiential (27% and 35%); or explicit (40% and 17%). Knowledge supplied was also categorised as “know‐how” (20%); “know‐why” (5%) or “no knowledge” exchanged (6%). The central construct of virtual community work was identified with six elements that facilitated participation and knowledge exchange including: (a) the discussion thread; (b) sharing of artefacts; (c) community; (d) cordiality; (e) maven work; and (f) promotion of the VC. Members asked questions to benchmark their practice, while those who answered were focused on ensuring that best practices were delivered. Conclusions ICUConnect reflected characteristics of a virtual community of practice, enabling key benefits for members and the broader Australasian intensive care community, especially access to best practice knowledge from clinical experts. Relevance to clinical practice This study demonstrated that a practice‐based VC can function effectively as a VCoP to establish an effective professional network where members have access to up‐to‐date best practice knowledge. Healthcare organisations could leverage VCs to support the professional development of HCPs and ensure that local clinical practices are based on contemporaneous knowledge. Participation by nurses in these communities facilitates individual professional development and access to important clinical knowledge and expertise, and ultimately reinforcing the unique position of nursing in delivering effective, consistent high‐quality patient care.
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Affiliation(s)
- Kaye Denise Rolls
- Centre for Applied Nursing Research, University of Wollongong, Liverpool, NSW, Australia.,AVATAR, Griffith University Menzies Health, Nathan, Australia.,Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | | | - Debra Jackson
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Doug Elliott
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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