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Hammoud S, Alsabek L, Rogers L, McAuliffe E. Systematic review on the frequency and quality of reporting patient and public involvement in patient safety research. BMC Health Serv Res 2024; 24:532. [PMID: 38671476 PMCID: PMC11046929 DOI: 10.1186/s12913-024-11021-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/21/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND In recent years, patient and public involvement (PPI) in research has significantly increased; however, the reporting of PPI remains poor. The Guidance for Reporting Involvement of Patients and the Public (GRIPP2) was developed to enhance the quality and consistency of PPI reporting. The objective of this systematic review is to identify the frequency and quality of PPI reporting in patient safety (PS) research using the GRIPP2 checklist. METHODS Searches were performed in Ovid MEDLINE, EMBASE, PsycINFO, and CINAHL from 2018 to December, 2023. Studies on PPI in PS research were included. We included empirical qualitative, quantitative, mixed methods, and case studies. Only articles published in peer-reviewed journals in English were included. The quality of PPI reporting was assessed using the short form of the (GRIPP2-SF) checklist. RESULTS A total of 8561 studies were retrieved from database searches, updates, and reference checks, of which 82 met the eligibility criteria and were included in this review. Major PS topics were related to medication safety, general PS, and fall prevention. Patient representatives, advocates, patient advisory groups, patients, service users, and health consumers were the most involved. The main involvement across the studies was in commenting on or developing research materials. Only 6.1% (n = 5) of the studies reported PPI as per the GRIPP2 checklist. Regarding the quality of reporting following the GRIPP2-SF criteria, our findings show sub-optimal reporting mainly due to failures in: critically reflecting on PPI in the study; reporting the aim of PPI in the study; and reporting the extent to which PPI influenced the study overall. CONCLUSIONS Our review shows a low frequency of PPI reporting in PS research using the GRIPP2 checklist. Furthermore, it reveals a sub-optimal quality in PPI reporting following GRIPP2-SF items. Researchers, funders, publishers, and journals need to promote consistent and transparent PPI reporting following internationally developed reporting guidelines such as the GRIPP2. Evidence-based guidelines for reporting PPI should be encouraged and supported as it helps future researchers to plan and report PPI more effectively. TRIAL REGISTRATION The review protocol is registered with PROSPERO (CRD42023450715).
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Affiliation(s)
- Sahar Hammoud
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Dublin, Ireland.
| | - Laith Alsabek
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Dublin, Ireland
- Department of Oral and Maxillofacial Surgery, University Hospital Galway, Galway, Ireland
| | - Lisa Rogers
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Dublin, Ireland
| | - Eilish McAuliffe
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery and Health Systems, Health Sciences Centre, University College Dublin, Dublin, Ireland
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Bisson M, Aubrey‐Bassler K, Chouinard M, Doucet S, Ramsden VR, Dumont‐Samson O, Howse D, Lambert M, Schwarz C, Luke A, Rabbitskin N, Gaudreau A, Porter J, Rubenstein D, Taylor J, Warren M, Hudon C. Patient engagement in health implementation research: A logic model. Health Expect 2023; 26:1854-1862. [PMID: 37309078 PMCID: PMC10485341 DOI: 10.1111/hex.13782] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/31/2023] [Accepted: 05/14/2023] [Indexed: 06/14/2023] Open
Abstract
INTRODUCTION Growing evidence supports patient engagement (PE) in health implementation research to improve the quality, relevance and uptake of research. However, more guidance is needed to plan and operationalize PE before and throughout the research process. The aim of the study was to develop a logic model illustrating the causal links between context, resources, activities, outcomes and impact of PE in an implementation research programme. METHODS The Patient Engagement in Health Implementation Research Logic Model (hereafter the Logic Model) was developed using a descriptive qualitative design with a participatory approach, in the context of the PriCARE programme. This programme aims to implement and evaluate case management for individuals who frequently use healthcare services in primary care clinics across five Canadian provinces. Participant observation of team meetings was performed by all team members involved in the programme and in-depth interviews were conducted by two external research assistants with team members (n = 22). A deductive thematic analysis using components of logic models as coding categories was conducted. Data were pooled in the first version of the Logic Model, which was refined in research team meetings with patient partners. The final version was validated by all team members. RESULTS The Logic Model highlights the importance of integrating PE into the project before its commencement, with appropriate support in terms of funding and time allocation. The governance structure and leadership of both principal investigators and patient partners have significant effects on PE activities and outcomes. As an empirical and standardized illustration that facilitates a shared understanding, the Logic Model provides guidance for maximizing the impact of patient partnership in various contexts for research, patients, providers and health care. CONCLUSION The Logic Model will help academic researchers, decision makers and patient partners plan, operationalize, and assess PE in implementation research for optimal outcomes. PATIENT OR PUBLIC CONTRIBUTION Patient partners from the PriCARE research programme contributed to developing the research objectives and designing, developing and validating data collection tools, producing data, developing and validating the Logic Model and reviewing the manuscript.
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Affiliation(s)
- Mathieu Bisson
- Département de médecine de famille et de médecine d'urgenceUniversité de SherbrookeSherbrookeQuébecCanada
| | - Kris Aubrey‐Bassler
- Primary Healthcare Research Unit, Faculty of MedicineMemorial UniversitySt. John'sNewfoundland and LabradorCanada
| | | | - Shelley Doucet
- Department of Nursing and Health SciencesUniversity of New BrunswickFrederictonNew BrunswickCanada
| | - Vivian R. Ramsden
- Department of Academic Family MedicineUniversity of SaskatchewanSaskatoonSaskatchewanCanada
| | - Olivier Dumont‐Samson
- Département de médecine de famille et de médecine d'urgenceUniversité de SherbrookeSherbrookeQuébecCanada
| | - Dana Howse
- Primary Healthcare Research Unit, Faculty of MedicineMemorial UniversitySt. John'sNewfoundland and LabradorCanada
| | - Mireille Lambert
- Département de médecine de famille et de médecine d'urgenceUniversité de SherbrookeSherbrookeQuébecCanada
| | - Charlotte Schwarz
- Department of Nursing and Health SciencesUniversity of New BrunswickFrederictonNew BrunswickCanada
| | - Alison Luke
- Department of Nursing and Health SciencesUniversity of New BrunswickFrederictonNew BrunswickCanada
| | - Norma Rabbitskin
- Department of Academic Family MedicineUniversity of SaskatchewanSaskatoonSaskatchewanCanada
| | | | | | | | | | | | - Catherine Hudon
- Département de médecine de famille et de médecine d'urgenceUniversité de SherbrookeSherbrookeQuébecCanada
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Boet S, Burns JK, Brehaut J, Britton M, Grantcharov T, Grimshaw J, McConnell M, Posner G, Raiche I, Singh S, Trbovich P, Etherington C. Analyzing interprofessional teamwork in the operating room: An exploratory observational study using conventional and alternative approaches. J Interprof Care 2023; 37:715-724. [PMID: 36739535 DOI: 10.1080/13561820.2023.2171373] [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: 08/31/2021] [Revised: 10/26/2022] [Accepted: 01/07/2023] [Indexed: 02/06/2023]
Abstract
Intraoperative teamwork is vital for patient safety. Conventional tools for studying intraoperative teamwork typically rely on behaviorally anchored rating scales applied at the individual or team level, while others capture narrative information across several units of analysis. This prospective observational study characterizes teamwork using two conventional tools (Operating Theatre Team Non-Technical Skills Assessment Tool [NOTECHS]; Team Emergency Assessment Measure [TEAM]), and one alternative approach (modified-Systems Engineering Initiative for Patient Safety [SEIPS] model). We aimed to explore the advantages and disadvantages of each for providing feedback to improve teamwork practice. Fifty consecutive surgical cases at a Canadian academic hospital were recorded with the OR Black Box®, analyzed by trained raters, and summarized descriptively. Teamwork performance was consistently high within and across cases rated with NOTECHS and TEAMS. For cases analyzed with the modified-SEIPS tool, both optimal and suboptimal teamwork behaviors were identified, and team resilience was frequently observed. NOTECHS and TEAM provided summative assessments and overall pattern descriptions, while SEIPS facilitated a deeper understanding of teamwork processes. As healthcare organizations continue to prioritize teamwork improvement, SEIPS may provide valuable insights regarding teamwork behavior and the broader context influencing performance. This may ultimately enhance the development and effectiveness of multi-level teamwork interventions.
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Affiliation(s)
- Sylvain Boet
- Department of Anesthesiology & Pain Medicine, University of Ottawa, Ottawa, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Institut du Savoir Montfort, Montfort Hospital & Faculty of Education, University of Ottawa, Ottawa, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Joseph K Burns
- Department of Anesthesiology & Pain Medicine, University of Ottawa, Ottawa, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Jamie Brehaut
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Meghan Britton
- Main Operating Room, The Ottawa Hospital (General Campus), Ottawa, Canada
| | - Teodor Grantcharov
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
- Department of General Surgery, University of Toronto, Toronto, Canada
| | - Jeremy Grimshaw
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Meghan McConnell
- Department of Anesthesiology & Pain Medicine, University of Ottawa, Ottawa, Canada
- Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Glenn Posner
- Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, Canada
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada
| | - Isabelle Raiche
- Department of General Surgery, University of Ottawa, Ottawa, Canada
| | - Sukhbir Singh
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada
| | - Patricia Trbovich
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Cole Etherington
- Department of Anesthesiology & Pain Medicine, University of Ottawa, Ottawa, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
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Møller KE, Sørensen JL, Topperzer MK, Koerner C, Ottesen B, Rosendahl M, Grantcharov T, Strandbygaard J. Implementation of an Innovative Technology Called the OR Black Box: A Feasibility Study. Surg Innov 2023; 30:64-72. [PMID: 36112770 PMCID: PMC9925891 DOI: 10.1177/15533506221106258] [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] [Indexed: 11/15/2022]
Abstract
Introduction. The operating room (OR) Black Box is an innovative technology that captures and compiles extensive real-time data from the OR, allowing identification and analysis of factors that influence intraoperative procedures and performances - ultimately improving patient safety. Implementation of this kind of technology is still an emerging research area and prone to face challenges. Methods. Observational study running from May 2017 to May 2021 conducted at Copenhagen University Hospital - Rigshospitalet, Denmark, involving 152 OR staff and 306 patients. Feasibility of the OR Black Box was assessed in accordance with Bowen's framework with 8 focus areas. Results. The OR Black Box had a high level of acceptability among stakeholders with 100% participation from management, 93% from OR staff, and 98% from patients. The implementation process improved over time, and an average of 80% of the surgeries conducted were captured. The practical aspects such as numerous formal and informal meetings, ethical and legal approval, recruitment of patients were acceptable, albeit time-consuming. The OR Black Box was adopted without any changes in scheduled surgery program, but capturing hours were adjusted to match the surgery program and relocation of OR staff declining to provide consent was possible. Conclusions. Implementation of the OR Black Box was feasible yet challenging. Management, nearly all staff, and patients embraced the initiative; however, ongoing evaluation, information meetings, and commitment from stakeholders are required and crucial to sustain momentum, continue implementation and expansion. Ideas from this study can be useful in the implementation of similar initiatives.
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Affiliation(s)
- Kjestine Emilie Møller
- Department of Gynecology and
Obstetrics, Copenhagen University Hospital –
Rigshospitalet, Copenhagen, Denmark,Kjestine Emilie Møller, Department of
Gynecology and Obstetrics, Juliane Marie Centre, Copenhagen University Hospital
– Rigshospitalet, Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark.
| | - Jette Led Sørensen
- Juliane Marie Centre, Children’s
Hospital Copenhagen, Copenhagen University Hospital –
Rigshospitalet and University of Copenhagen, Copenhagen, Denmark,Department of Clinical Medicine,
Faculty of Health and Medical Sciences, University of
Copenhagen, Copenhagen, Denmark
| | - Martha Krogh Topperzer
- Juliane Marie Centre, Children’s
Hospital Copenhagen, Copenhagen University Hospital –
Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - Christian Koerner
- Department of Improvement and
Digitalization, Copenhagen University Hospital –
Rigshospitalet, Copenhagen, Denmark
| | - Bent Ottesen
- Juliane Marie Centre, Children’s
Hospital Copenhagen, Copenhagen University Hospital –
Rigshospitalet and University of Copenhagen, Copenhagen, Denmark,Department of Clinical Medicine,
Faculty of Health and Medical Sciences, University of
Copenhagen, Copenhagen, Denmark
| | - Mikkel Rosendahl
- Department of Gynecology and
Obstetrics, Copenhagen University Hospital –
Rigshospitalet, Copenhagen, Denmark
| | - Teodor Grantcharov
- Department of General Surgery, University of Toronto, Toronto, ON, Canada,Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, ON, Canada
| | - Jeanett Strandbygaard
- Department of Gynecology and
Obstetrics, Copenhagen University Hospital –
Rigshospitalet, Copenhagen, Denmark,Department of Clinical Medicine,
Faculty of Health and Medical Sciences, University of
Copenhagen, Copenhagen, Denmark
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Wolfstadt JI, Cohen-Rosenblum A. 'You can't do quality between surgical cases and tea time': barriers to surgeon engagement in quality improvement. BMJ Qual Saf 2023; 32:10-12. [PMID: 36549699 DOI: 10.1136/bmjqs-2022-015083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2022] [Indexed: 12/27/2022]
Affiliation(s)
- Jesse Isaac Wolfstadt
- Surgery, Division of Orthopaedics, Sinai Health System, Toronto, Ontario, Canada .,Division of Orthopaedics, Department of Surgery, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
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Smith TG, Norasi H, Herbst KM, Kendrick ML, Curry TB, Grantcharov TP, Palter VN, Hallbeck MS, Cleary SP. Creating a Practical Transformational Change Management Model for Novel Artificial Intelligence-Enabled Technology Implementation in the Operating Room. Mayo Clin Proc Innov Qual Outcomes 2022; 6:584-596. [PMID: 36324987 PMCID: PMC9618851 DOI: 10.1016/j.mayocpiqo.2022.09.004] [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] [Indexed: 11/07/2022] Open
Abstract
Objective To identify change management (CM) strategies for implementing novel artificial intelligence and similar novel technologies in operating rooms and create a new CM model for future trials and applications inspired by the abovementioned strategies and established models. Methods Key phases of technology implementation were defined, and strategies for transformational CM were created and applied in a recent CM experience at our institution between October 15, 2020 and October 15, 2021. We appraised existing CM models and propose the newly created model. Results The key phases of the technology implementation were as follows: (1) team assembly; (2) committee approvals; (3) CM; and (4) system installation and go-live. Key strategies were (1) assemble team with necessary expertise; (2) anticipate potential institutional cultural and regulatory hurdles; (3) add agility to project planning and execution; (4) accommodate institutional culture and regulations; (5) early clinical partner buy-in and stakeholder engagement; and (6) consistent communication, all of which contributed to the new CM model creation. Conclusion Key CM strategies and a new CM model addressing the unique needs and characteristics of operating room novel technology implementation were identified and created. The new model may be customized and tested for individual institution and project’s needs and characteristics.
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Affiliation(s)
- Tianqi G. Smith
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | - Hamid Norasi
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
- Health Care Delivery Research, Mayo Clinic, Rochester, MN
| | - Kelly M. Herbst
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
| | | | | | - Teodor P. Grantcharov
- Department of Surgery, University of Toronto, Toronto, Canada
- International Centre for Surgical Safety, Toronto, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
| | - Vanessa N. Palter
- International Centre for Surgical Safety, Toronto, Canada
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
| | - M. Susan Hallbeck
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN
- Health Care Delivery Research, Mayo Clinic, Rochester, MN
- Department of Surgery, Mayo Clinic, Rochester, MN
- Correspondence: Address to Susan Hallbeck, PhD, Division of Health Care Delivery Research, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905
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Kasa K, Burns D, Goldenberg MG, Selim O, Whyne C, Hardisty M. Multi-Modal Deep Learning for Assessing Surgeon Technical Skill. SENSORS (BASEL, SWITZERLAND) 2022; 22:7328. [PMID: 36236424 PMCID: PMC9571767 DOI: 10.3390/s22197328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/23/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
This paper introduces a new dataset of a surgical knot-tying task, and a multi-modal deep learning model that achieves comparable performance to expert human raters on this skill assessment task. Seventy-two surgical trainees and faculty were recruited for the knot-tying task, and were recorded using video, kinematic, and image data. Three expert human raters conducted the skills assessment using the Objective Structured Assessment of Technical Skill (OSATS) Global Rating Scale (GRS). We also designed and developed three deep learning models: a ResNet-based image model, a ResNet-LSTM kinematic model, and a multi-modal model leveraging the image and time-series kinematic data. All three models demonstrate performance comparable to the expert human raters on most GRS domains. The multi-modal model demonstrates the best overall performance, as measured using the mean squared error (MSE) and intraclass correlation coefficient (ICC). This work is significant since it demonstrates that multi-modal deep learning has the potential to replicate human raters on a challenging human-performed knot-tying task. The study demonstrates an algorithm with state-of-the-art performance in surgical skill assessment. As objective assessment of technical skill continues to be a growing, but resource-heavy, element of surgical education, this study is an important step towards automated surgical skill assessment, ultimately leading to reduced burden on training faculty and institutes.
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Affiliation(s)
- Kevin Kasa
- Orthopaedic Biomechanics Lab, Holland Bone and Joint Program, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada
| | - David Burns
- Orthopaedic Biomechanics Lab, Holland Bone and Joint Program, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 1A1, Canada
- Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Mitchell G. Goldenberg
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Omar Selim
- Department of Surgery, Royal Victoria Regional Health Center, Barrie, ON L4M 6M2, Canada
| | - Cari Whyne
- Orthopaedic Biomechanics Lab, Holland Bone and Joint Program, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 1A1, Canada
- Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Michael Hardisty
- Orthopaedic Biomechanics Lab, Holland Bone and Joint Program, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada
- Division of Orthopaedic Surgery, Department of Surgery, University of Toronto, Toronto, ON M5S 1A1, Canada
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Etherington C, Lê M, Proulx L, Boet S. Bringing the patient voice into the operating room: engaging patients in surgical safety research with the Operating Room Black Box ®. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:32. [PMID: 35871038 PMCID: PMC9308267 DOI: 10.1186/s40900-022-00367-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 07/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Surgery is one of the most common patient experiences in the health care system. Yet, efforts to engage patients in surgical safety research have not matched those of other health care fields. This is a critical issue given the nature of surgery inhibits patients' abilities to advocate for themselves as they are typically under anesthetic when the procedure is performed. We partnered with patients throughout our research program, which uses the Operating Room Black Box® to enhance surgical patient safety through transparent and proactive analysis of human factors to detect and prevent avoidable errors. MAIN BODY In this article, we outline the need for, and our approach to, patient engagement in surgical safety research. Our approach included a series of planned activities and skill development opportunities designed to build capacity and bring together patients, clinicians, and researchers to inform research and practice. We also conducted evaluation surveys during the first year of our program, which have indicated a positive experience by both patient partners and the research team. CONCLUSION We believe our approach can serve as an important first step toward building a model for patient engagement in the surgical safety field and could significantly contribute to improved quality of care and outcomes for surgical patients.
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Affiliation(s)
- Cole Etherington
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Canada
| | | | - Laurie Proulx
- The Ottawa Hospital, Ottawa, Canada
- Canadian Arthritis Patient Alliance, Ottawa, Canada
| | - Sylvain Boet
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Canada.
- Department of Innovation in Medical Education, University of Ottawa, Ottawa, Canada.
- Francophone Affairs, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
- Institute du Savoir Monfort, Ottawa, ON, Canada.
- Faculty of Education, University of Ottawa, Ottawa, ON, Canada.
- Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, University of Ottawa, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
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Vanderhout S, Nicholls S, Monfaredi Z, Hampel C, Ashdown L, Bilodeau M, Rich S, Shea B, Fergusson D. Facilitating and supporting the engagement of patients, families and caregivers in research: the "Ottawa model" for patient engagement in research. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:25. [PMID: 35672808 PMCID: PMC9172149 DOI: 10.1186/s40900-022-00350-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 04/20/2022] [Indexed: 05/26/2023]
Abstract
BACKGROUND Patient engagement is increasingly being recognized as a critical component of health research; however, institutional models for building infrastructure and capacity for patient engagement in research are limited. There is an opportunity to create reproducible and scalable models of patient engagement in research and share best and promising practices. MAIN BODY In this article, we describe the development and features of the framework for the Ottawa Patient Engagement in Research Model at The Ottawa Hospital (TOH) and the Ottawa Hospital Research Institute (OHRI). Key components of the model include: a Patient and Family Engagement Program at TOH, which recruits, educates, and supports patients, families and caregivers to engage in clinical care, governance, and research; the Ottawa Methods Centre within the OHRI, which leads methodological research and provides support to investigators for patient engagement and patient-oriented research at TOH; and the Office of Patient Engagement in Research Activities, also within the OHRI, which facilitates collaborations between patients, researchers, clinicians and other stakeholders. Early success of this model can be attributed to aligned institutional priorities between TOH, OHRI and patients, the establishment of a patient engagement policy, ongoing education and support provided to patient partners and researchers, and innovative recruitment, tracking and evaluation procedures. Ongoing challenges and next steps include promoting diversity among patient partners, implementing an equitable compensation policy, engaging patients across a variety of roles and research areas, and developing resources to expand and sustain this program. CONCLUSION This model represents a unique effort of patients, clinicians, researchers, and policymakers across disciplines and institutions to produce a harmonized strategy and infrastructure for meaningful collaboration with patients and families in health research, and capacity building in patient-oriented research.
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Affiliation(s)
- Shelley Vanderhout
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, ON, K1H 8L6, Canada
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, ON, K1G 5Z3, Canada
| | - Stuart Nicholls
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, ON, K1H 8L6, Canada
| | - Zarah Monfaredi
- Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11300, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Claudia Hampel
- Patient Relations, The Ottawa Hospital, 1053 Carling Avenue, Box 133, Ottawa, ON, K1Y 4E9, Canada
| | - Lynn Ashdown
- Patient Partner Expert, Faculty of Medicine, University of Ottawa, 451 Smyth Rd #2044, Ottawa, ON, K1H 8M5, Canada
| | - Maxime Bilodeau
- Patient Partner, The Ottawa Hospital, 1053 Carling Ave, Box 133, Ottawa, ON, K1Y 4E9, Canada
| | - Susan Rich
- Patient Partner Expert, The Ottawa Hospital, 1053 Carling Ave, Box 133, Ottawa, ON, K1Y 4E9, Canada
| | - Beverley Shea
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, ON, K1H 8L6, Canada
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, ON, K1G 5Z3, Canada
| | - Dean Fergusson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Box 201B, Ottawa, ON, K1H 8L6, Canada.
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Room 101, Ottawa, ON, K1G 5Z3, Canada.
- Faculty of Medicine, University of Ottawa, Roger Guindon Hall, 451 Smyth Rd #2044, Ottawa, ON, K1H 8M5, Canada.
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Managing a Team in the Operating Room: The Science of Teamwork and Non-Technical Skills for Surgeons. Curr Probl Surg 2022; 59:101172. [DOI: 10.1016/j.cpsurg.2022.101172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 05/04/2022] [Indexed: 11/19/2022]
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Bakhshaie J, Doorley J, Reichman M, Mace R, Laverty D, Matuszewski PE, Elwy AR, Fatehi A, Bowers LC, Ly T, Vranceanu AM. Optimizing the implementation of a multisite feasibility trial of a mind-body program in acute orthopedic trauma. Transl Behav Med 2022; 12:642-653. [PMID: 35195266 PMCID: PMC9154268 DOI: 10.1093/tbm/ibac004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The Toolkit for Optimal Recovery (TOR) is a mind-body program for patients with acute orthopedic injuries who are at risk for persistent pain/disability. In preparation for a multisite feasibility trial of TOR at three orthopedic trauma centers, we aim to qualitatively identify barriers and facilitators to study implementation and strategies to mitigate the implementation barriers and leverage facilitators.We conducted 18 live video focus groups among providers and three one-on-one interviews with department chiefs at Level 1 trauma centers in three geographically diverse sites (N = 79 participants). Using a content analysis approach, we detected the site-specific barriers and facilitators of implementation of TOR clinical trial. We organized the data according to 26 constructs of the Consolidated Framework for Implementation Research (CFIR), mapped to three Proctor implementation outcomes relevant to the desired study outcomes (acceptability, appropriateness, and feasibility). Across the three sites, we mapped six of the CFIR constructs to acceptability, eight to appropriateness, and three to feasibility. Prominent perceived barriers across all three sites were related to providers' lack of knowledge/comfort addressing psychosocial factors, and organizational cultures of prioritizing workflow efficiency over patients' psychosocial needs (acceptability), poor fit between TOR clinical trial and the fast-paced clinic structure as well as basic needs of some patients (appropriateness), and limited resources (feasibility). Suggestions to maximize the implementation of the TOR trial included provision of knowledge/tools to improve providers' confidence, streamlining study recruitment procedures, creating a learning collaborative, tailoring the study protocol based on local needs assessments, exercising flexibility in conducting research, dedicating research staff, and identifying/promoting champions and using novel incentive structures with regular check-ins, while keeping study procedures as nonobtrusive and language as de-stigmatizing as possible. These data could serve as a blueprint for implementation of clinical research and innovations in orthopedic and other medical settings.
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Affiliation(s)
- Jafar Bakhshaie
- Harvard Medical School, Boston, MA 02115, USA
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02115, USA
| | - James Doorley
- Harvard Medical School, Boston, MA 02115, USA
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02115, USA
| | - Mira Reichman
- Harvard Medical School, Boston, MA 02115, USA
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02115, USA
| | - Ryan Mace
- Harvard Medical School, Boston, MA 02115, USA
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02115, USA
| | - David Laverty
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX 78712, USA
| | - Paul E Matuszewski
- Department of Orthopaedic Surgery & Sports Medicine, College of Medicine, University of Kentucky, Lexington, KY 40506, USA
| | - A Rani Elwy
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI 02912, USA
- Center for Healthcare Organization and Implementation Research, VA Bedford Healthcare System, Bedford, MA 01730, USA
| | - Amirreza Fatehi
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX 78712, USA
| | - Lucy C Bowers
- Department of Orthopaedic Surgery & Sports Medicine, College of Medicine, University of Kentucky, Lexington, KY 40506, USA
| | - Thuan Ly
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA 02115, USA
| | - Ana-Maria Vranceanu
- Harvard Medical School, Boston, MA 02115, USA
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02115, USA
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