Identifying potential indicators to measure the outcome of translational cancer research: a mixed methods approach

Application of Mixed Methods in Health Services Management Research: A Systematic Review

Mixed methods research (MMR) is versatile, pragmatic, and adaptable to constraints and opportunities during a research process. Although MMR has gain popularity in health services management research, little is known about how the research approach has been used and the quality of research. We conducted a systematic review of 198 MMR articles published in selected U.S.-based and international health services management journals from 2000 through 2018 to examine the extent of MMR application and scientific rigor. Results showed limited, yet increasing, use of MMR and a high degree of correspondence between MMR designs and study purposes. However, most articles did not clearly justify using MMR designs and the reporting of method details and research integration were inadequate in a significant portion of publications. We propose a checklist to assist the preparation and review of MMR manuscripts. Additional implications and recommendations to improve transparency, rigor, and quality in MMR are discussed.

Identifying organisational capability of hospitals amid the new healthcare reform in China: a Delphi study

OBJECTIVE

Since China launched its nationwide systemic healthcare reform in 2009, policies such as the elimination of drug markups and the reform of medical insurance payments have forced some hospitals into a crisis threatening their survival. Both public and private hospitals have been building and strengthening their capacity to achieve sustainable development. However, the existing research has not provided a comprehensive evaluation tool required to support this effort. Therefore, this study develops an organisational capability evaluation index system to help public and private hospitals assess their current conditions.

DESIGN

The Delphi method was used to construct a hospital organisational capability evaluation index system in conjunction with the boundary value method and an analytic hierarchical process. Then, a questionnaire survey was administered in 55 hospitals (32 non-profit and 23 for-profit hospitals), and Cronbach's α and a factor analysis were used to verify the index system's reliability and validity.

SETTING AND PARTICIPANTS

A literature review and semistructured interviews with 23 hospital managers and scholars clarified the definition of hospital organisational capability and formed an indicator pool. Additionally, 20 hospital directors were selected from public and private hospitals to participate in two rounds of the Delphi consultation.

RESULTS

The Delphi consultation resulted in an index system including 12 primary and 40 secondary indicators demonstrated to be reliable and valid. The three indicators with the largest weights were 'regulation capability' (0.251), 'decision-making capability' (0.121) and 'executive capability' (0.105).

CONCLUSION

This study constructed an index system based on theoretical and practical considerations, and is expected to be applied to quantitatively evaluate the organisational capability of both public and private hospitals in China, and support their adaptation to external environmental changes.

A RAND-Modified Delphi on Key Indicators to Measure the Efficiency of Living Kidney Donor Candidate Evaluations

BACKGROUND AND OBJECTIVES

Many patients, providers, and potential living donors perceive the living kidney donor evaluation process to be lengthy and difficult to navigate.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS

We sought consensus on key terms and process and outcome indicators that can be used to measure how efficiently a transplant center evaluates persons interested in becoming a living kidney donor. Using a RAND-modified Delphi method, 77 participants (kidney transplant recipients or recipient candidates, living kidney donors or donor candidates, health care providers, and health care administrators) completed an online survey to define the terms and indicators. The definitions were then further refined during an in-person meeting with ten stakeholders.

RESULTS

We identified 16 process indicators (e.g., average time to evaluate a donor candidate), eight outcome indicators (e.g., annual number of preemptive living kidney donor transplants), and two measures that can be considered both process and outcome indicators (e.g., average number of times a candidate visited the transplant center for the evaluation). Transplant centers wishing to implement this set of indicators will require 22 unique data elements, all of which are either readily available or easily collected prospectively.

CONCLUSIONS

We identified a set of indicators through a consensus-based approach that may be used to monitor and improve the performance of a transplant center in how efficiently it evaluates persons interested in becoming a living kidney donor.

'Knowledge for better health' revisited - the increasing significance of health research systems: a review by departing Editors-in-Chief

How can nations organise research investments to obtain the best bundle of knowledge and the maximum level of improved health, spread as equitably as possible? This question was the central focus of a major initiative from WHO led by Prof Tikki Pang, which resulted in a range of developments, including the publication of a conceptual framework for national health research systems - Knowledge for better health - in 2003, and in the founding of the journal Health Research Policy and Systems (HARPS). As Editors-in-Chief of the journal since 2006, we mark our retirement by tracking both the progress of the journal and the development of national health research systems. HARPS has maintained its focus on a range of central themes that are key components of a national health research system in any country. These include building capacity to conduct and use health research, identifying appropriate priorities, securing funds and allocating them accountably, producing scientifically valid research outputs, promoting the use of research in polices and practice in order to improve health, and monitoring and evaluating the health research system. Some of the themes covered in HARPS are now receiving increased attention and, for example, with the assessment of research impact and development of knowledge translation platforms, the journal has covered their progress throughout that expansion of interest. In addition, there is increasing recognition of new imperatives, including the importance of promoting gender equality in health research if benefits are to be maximised. In this Editorial, we outline some of the diverse and developing perspectives considered within each theme, as well as considering how they are held together by the growing desire to build effective health research systems in all countries.From 2003 until mid-June 2017, HARPS published 590 articles on the above and related themes, with authors being located in 76 countries. We present quantitative data tracing the journal's growth and the increasing external recognition of its role. We thank the many colleagues who have kindly contributed to the journal's success, and finish on an exciting note by welcoming the new Editors-in-Chief who will take HARPS forward.