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The exchange of health and performance information when transitioning from club to National football teams; A Delphi survey of National team practitioners”. J Sci Med Sport 2022; 25:486-491. [DOI: 10.1016/j.jsams.2022.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 02/02/2022] [Accepted: 03/20/2022] [Indexed: 11/21/2022]
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Health-care information technologies for dispersed knowledge management. JOURNAL OF KNOWLEDGE MANAGEMENT 2021. [DOI: 10.1108/jkm-10-2020-0786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Purpose
The health-care industry has multiple stakeholders, with knowledge dispersed among clinicians, experts and patients and their families. As the adoption of health-care information technologies (HITs) depends on multiple factors, this study aims to uncover the motivators for adopting them.
Design/methodology/approach
The study considers 391 respondents, representing the health-care sector, to evaluate the motivators for adopting HITs for better-dispersed knowledge management. The authors analyze the responses using exploratory factor analysis (EFA) to identify the actual structure of the factors, followed by confirmatory factor analysis (CFA).
Findings
EFA categorized the factors into four classes: quality management; information sharing; strategic governance; and available technological infrastructure. CFA revealed that the strategic governance factor is most predictive of successfully adopting HITs that model the normative pressure of Institutional theory in health-care organizations. These results indicate that, along with considerations of finances, care quality and infrastructure, effective government involvement and policy-making are important for successful HIT adoption.
Practical implications
Results reveal that stakeholders’ motivating factors for HIT adoption in a developed economy like the United Arab Emirates are based on considering HITs as a knowledge management mechanism. These factors may help other nations in HIT implementation and drive valuable innovations in the health-care sector. This research presents the implications for health-care professionals and stakeholders in relation to adopting HITs and their role in knowledge flow for efficient care.
Originality/value
HITs offer an affordable and convenient platform for collaboration among diverse teams in the health-care sector. Apart from this, it helps in facilitating an interactive platform for knowledge creation and transfer for the benefit of users and providers.
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Cecula P, Yu J, Dawoodbhoy FM, Delaney J, Tan J, Peacock I, Cox B. Applications of artificial intelligence to improve patient flow on mental health inpatient units - Narrative literature review. Heliyon 2021; 7:e06626. [PMID: 33898804 PMCID: PMC8060579 DOI: 10.1016/j.heliyon.2021.e06626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/20/2021] [Accepted: 03/24/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Despite a growing body of research into both Artificial intelligence and mental health inpatient flow issues, few studies adequately combine the two. This review summarises findings in the fields of AI in psychiatry and patient flow from the past 5 years, finds links and identifies gaps for future research. METHODS The OVID database was used to access Embase and Medline. Top journals such as JAMA, Nature and The Lancet were screened for other relevant studies. Selection bias was limited by strict inclusion and exclusion criteria. RESEARCH 3,675 papers were identified in March 2020, of which a limited number focused on AI for mental health unit patient flow. After initial screening, 323 were selected and 83 were subsequently analysed. The literature review revealed a wide range of applications with three main themes: diagnosis (33%), prognosis (39%) and treatment (28%). The main themes that emerged from AI in patient flow studies were: readmissions (41%), resource allocation (44%) and limitations (91%). The review extrapolates those solutions and suggests how they could potentially improve patient flow on mental health units, along with challenges and limitations they could face. CONCLUSION Research widely addresses potential uses of AI in mental health, with some focused on its applicability in psychiatric inpatients units, however research rarely discusses improvements in patient flow. Studies investigated various uses of AI to improve patient flow across specialities. This review highlights a gap in research and the unique research opportunity it presents.
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Affiliation(s)
- Paulina Cecula
- Imperial College London Business School, London, UK
- Imperial College School of Medicine, South Kensington Campus, London, SW7 2BU, UK
| | - Jiakun Yu
- Imperial College London Business School, London, UK
- Imperial College School of Medicine, South Kensington Campus, London, SW7 2BU, UK
| | - Fatema Mustansir Dawoodbhoy
- Imperial College London Business School, London, UK
- Imperial College School of Medicine, South Kensington Campus, London, SW7 2BU, UK
| | - Jack Delaney
- Imperial College London Business School, London, UK
- Imperial College School of Medicine, South Kensington Campus, London, SW7 2BU, UK
| | - Joseph Tan
- Imperial College London Business School, London, UK
- Brighton and Sussex Medical School, Brighton, East Sussex, BN1 9PX, UK
| | - Iain Peacock
- Imperial College London Business School, London, UK
- Brighton and Sussex Medical School, Brighton, East Sussex, BN1 9PX, UK
| | - Benita Cox
- Imperial College London Business School, London, UK
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Alrahbi DA, Khan M, Gupta S, Modgil S, Chiappetta Jabbour CJ. Challenges for developing health-care knowledge in the digital age. JOURNAL OF KNOWLEDGE MANAGEMENT 2020. [DOI: 10.1108/jkm-03-2020-0224] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Purpose
Health-care knowledge is dispersed among different departments in a health care organization, which makes it difficult at times to provide quality care services to patients. Therefore, this study aims to identify the main challenges in adopting health information technology (HIT).
Design/methodology/approach
This study surveyed 148 stakeholders in 4 key categories [patients, health-care providers, United Arab Emirates (UAE) citizens and foresight experts] to identify the challenges they face in adopting health care technologies. Responses were analyzed using exploratory (EFA) and confirmatory factor analysis (CFA).
Findings
EFA revealed four key latent factors predicting resistance to HIT adoption, namely, organizational strategy (ORGS); technical barriers; readiness for big data and the internet of things (IoT); and orientation (ORI). ORGS accounted for the greatest amount of variance. CFA indicated that readiness for big data and the IoT was only moderately correlated with HIT adoption, but the other three factors were strongly correlated. Specific items relating to cost, the effectiveness and usability of the technology and the organization were strongly correlated with HIT adoption. These results indicate that, in addition to financial considerations, effective HIT adoption requires ensuring that technologies will be easy to implement to ensure their long-term use.
Research limitations/implications
The results indicate that readiness for big data and the IoT-related infrastructure poses a challenge to HIT adoption in the UAE context. Respondents believed that the infrastructure of big data can be helpful in more efficiently storing and sharing health-care information. On the technological side, respondents felt that they may experience a steep learning curve. Regarding ORI, stakeholders expected many more such initiatives from health-care providers to make it more knowledge-specific and proactive.
Practical implications
This study has implications for knowledge management in the health -care sector for information technologies. The HIT can help firms in creating a knowledge eco-system, which is not possible in a dispersed knowledge environment. The utilization of the knowledge base that emerged from the practices and data can help the health care sector to set new standards of information flow and other clinical services such as monitoring the self-health condition. The HIT can further influence the actions of the pharmaceutical and medical device industry.
Originality/value
This paper highlights the challenges in HIT adoption and the most prominent factors. The conceptual model was empirically tested after the collection of primary data from the UAE using stakeholder theory.
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Esteves M, Esteves M, Abelha AC. A New System to Assist Elders' Self-Care and Their Informal Caregivers. ACTA ACUST UNITED AC 2020. [DOI: 10.4018/ijrqeh.2020010105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The ageing of a population increases the number of elders dependent in self-care. Thus, being dependent in a home context is a fact that deserves attention from social support entities integrated into the community, such as nursing homes, which play a central role in supporting the families involved. In this sense, this study is aimed at seniors dependent in self-care, their informal caregivers, and health professionals from Portuguese nursing homes and emerged to assist elders' self-care and their informal caregivers and to strengthen the communication strategies between the different elements of the target audience. Therefore, the design and development of an archetype of a new system is proposed, which main objectives are to accompany, teach, and share information between its users, taking into account safe medical validation and ethical issues, through emerging health ICT technologies. This archetype is a reinforcement, that is, a way to promote and complete the knowledge and skills to deal with elders' well-being and health, as well as their informal caregivers' welfare.
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Affiliation(s)
- Marisa Esteves
- Algoritmi Research Center, University of Minho, Braga, Portugal
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A Proof of Concept of a Mobile Health Application to Support Professionals in a Portuguese Nursing Home. SENSORS 2019; 19:s19183951. [PMID: 31547445 PMCID: PMC6767027 DOI: 10.3390/s19183951] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 09/09/2019] [Accepted: 09/09/2019] [Indexed: 11/24/2022]
Abstract
Over the past few years, the rapidly aging population has been posing several challenges to healthcare systems worldwide. Consequently, in Portugal, nursing homes have been getting a higher demand, and health professionals working in these facilities are overloaded with work. Moreover, the lack of health information and communication technology (HICT) and the use of unsophisticated methods, such as paper, in nursing homes to clinically manage residents lead to more errors and are time-consuming. Thus, this article proposes a proof of concept of a mobile health (mHealth) application developed for the health professionals working in a Portuguese nursing home to support them at the point-of-care, namely to manage and have access to information and to help them schedule, perform, and digitally record their tasks. Additionally, clinical and performance business intelligence (BI) indicators to assist the decision-making process are also defined. Thereby, this solution aims to introduce technological improvements into the facility to improve healthcare delivery and, by taking advantage of the benefits provided by these improvements, lessen some of the workload experienced by health professionals, reduce time-waste and errors, and, ultimately, enhance elders’ quality of life and improve the quality of the services provided.
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Chernyshev M, Zeadally S, Baig Z. Healthcare Data Breaches: Implications for Digital Forensic Readiness. J Med Syst 2018; 43:7. [PMID: 30488291 DOI: 10.1007/s10916-018-1123-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 11/15/2018] [Indexed: 10/27/2022]
Abstract
While the healthcare industry is undergoing disruptive digital transformation, data breaches involving health information are not usually the result of integration of new technologies. Based on published industry reports, fundamental security safeguards are still considered to be lacking with many documented data breaches occurring as the result of device and equipment theft, human error, hacking, ransomware attacks and misuse. Health information is considered to be one of the most attractive targets for cybercriminals due to its inherent sensitivity, but digital investigations of incidents involving health information are often constrained by the lack of the necessary infrastructure forensic readiness. Following the analysis of healthcare data breach causes and threats, we describe the associated digital forensic readiness challenges in the context of the most significant incident causes. With specific focus on privilege misuse, we present a conceptual architecture for forensic audit logging to assist with capture of the relevant digital artefacts in support of possible future digital investigations.
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Affiliation(s)
| | | | - Zubair Baig
- Commonweath Scientific and Industrial Research Organisation (CSIRO), Data61, Melbourne, Australia
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8
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Kassa MD, Grace JM. A mixed-method study of quality, availability and timeliness of non-communicable disease (NCD) related data and its link to NCD prevention: Perceptions of health care workers in Ethiopia. Health Inf Manag 2018; 48:135-143. [PMID: 30126291 DOI: 10.1177/1833358318786313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Three-quarters of non-communicable disease (NCD) mortality occurs in low- and middle-income countries. However, in most developing countries, quality and reliable data on morbidity, mortality and risk factors for NCD to predict its burden and prevalence are less well understood and availability of these data is limited. To better inform policymakers and improve healthcare systems in developing countries, it is also important that these factors be understood within the context of the particular country in question. Objective: The aim of this study is to further inform practitioners in Ethiopia about the availability and status of NCD information within the Ethiopian healthcare system. METHOD A mixed method research design was used with data collected from 13 public referral hospitals in Ethiopia. In phase 1 quantitative data were collected from 312 health professionals (99 physicians; 213 nurses) using a cross-sectional survey. In phase 2, qualitative data were collected using: interviews (n = 13 physician hospital managers); and one focus group (n = 6 national health bureau officers). RESULTS Results highlighted the lack of NCD morbidity, mortality and risk factor data, periodic evaluation of NCD data and standardised protocols for NCD data collection in hospitals. The study also identified similar discrepancies in the availability of NCD data and standardised protocols for NCD data collection among the regions of Ethiopia. CONCLUSION This study highlighted important deficiencies in NCD data and standardised protocols for data collection in the Ethiopian healthcare system. These deficiencies were also observed among regions of Ethiopia, indicating the need to strengthen both the healthcare system and health information systems to improve evidence-based decision-making. IMPLICATIONS Identifying the status of NCD data in the Ethiopian healthcare system could assist policymakers, healthcare organisations, healthcare providers and health beneficiaries to reform and strengthen the existing healthcare system.
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Peissig P, Schwei KM, Kadolph C, Finamore J, Cancel E, McCarty CA, Okorie A, Thomas KL, Allen Pacheco J, Pathak J, Ellis SB, Denny JC, Rasmussen LV, Tromp G, Williams MS, Vrabec TR, Brilliant MH. Prototype Development: Context-Driven Dynamic XML Ophthalmologic Data Capture Application. JMIR Med Inform 2017; 5:e27. [PMID: 28903894 PMCID: PMC5617903 DOI: 10.2196/medinform.7465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 05/31/2017] [Accepted: 06/29/2017] [Indexed: 11/13/2022] Open
Abstract
Background The capture and integration of structured ophthalmologic data into electronic health records (EHRs) has historically been a challenge. However, the importance of this activity for patient care and research is critical. Objective The purpose of this study was to develop a prototype of a context-driven dynamic extensible markup language (XML) ophthalmologic data capture application for research and clinical care that could be easily integrated into an EHR system. Methods Stakeholders in the medical, research, and informatics fields were interviewed and surveyed to determine data and system requirements for ophthalmologic data capture. On the basis of these requirements, an ophthalmology data capture application was developed to collect and store discrete data elements with important graphical information. Results The context-driven data entry application supports several features, including ink-over drawing capability for documenting eye abnormalities, context-based Web controls that guide data entry based on preestablished dependencies, and an adaptable database or XML schema that stores Web form specifications and allows for immediate changes in form layout or content. The application utilizes Web services to enable data integration with a variety of EHRs for retrieval and storage of patient data. Conclusions This paper describes the development process used to create a context-driven dynamic XML data capture application for optometry and ophthalmology. The list of ophthalmologic data elements identified as important for care and research can be used as a baseline list for future ophthalmologic data collection activities.
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Affiliation(s)
- Peggy Peissig
- Marshfield Clinic Research Institute, Biomedical Informatics Research Center, Marshfield, WI, United States
| | - Kelsey M Schwei
- Marshfield Clinic Research Institute, Center for Oral and Systemic Health, Marshfield, WI, United States
| | - Christopher Kadolph
- Marshfield Clinic Research Institute, Biomedical Informatics Research Center, Marshfield, WI, United States
| | - Joseph Finamore
- Marshfield Clinic Research Institute, Biomedical Informatics Research Center, Marshfield, WI, United States
| | - Efrain Cancel
- Marshfield Clinic, Department of Ophthalmology, Marshfield, WI, United States
| | - Catherine A McCarty
- Essentia Institute of Rural Health, Center for Research and Education, Duluth, MN, United States
| | - Asha Okorie
- Marshfield Clinic, Department of Ophthalmology, Marshfield, WI, United States
| | - Kate L Thomas
- Marshfield Clinic Research Institute, Biomedical Informatics Research Center, Marshfield, WI, United States
| | | | - Jyotishman Pathak
- Weill Cornell Medical College, Healthcare Policy and Research, Cornell University, New York, NY, United States
| | - Stephen B Ellis
- Personalized Medicine Institute, Mount Sinai, New York, NY, United States
| | - Joshua C Denny
- School of Medicine, Biomedical Informatics, Vanderbilt University, Nashville, TN, United States
| | - Luke V Rasmussen
- Division of Health and Biomedical Informatics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Gerard Tromp
- Autism and Developmental Medicine Institute (ADMI), Geisinger, Danville, PA, United States
| | - Marc S Williams
- Genomic Medical Institute, Geisinger, Danville, PA, United States
| | - Tamara R Vrabec
- Department of Ophthalmology, Geisinger, Danville, PA, United States
| | - Murray H Brilliant
- Marshfield Clinic Research Foundation, Human Genetics, Marshfield, WI, United States
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Adaba GB, Kebebew Y. Improving a health information system for real-time data entries: An action research project using socio-technical systems theory. Inform Health Soc Care 2017; 43:159-171. [PMID: 28350236 DOI: 10.1080/17538157.2017.1290638] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND/PURPOSE This paper presents the findings of an action research (AR) project to improve a health information system (HIS) at the Operating Theater Department (OTD) of a National Health Service (NHS) hospital in South East England, the UK. METHODS Informed by socio-technical systems (STS) theory, AR was used to design an intervention to enhance an existing patient administration system (PAS) to enable data entries in real time while contributing to the literature. The study analyzed qualitative data collected through interviews, participant observations, and document reviews. RESULTS The study found that the design of the PAS was unsuitable to the work of the three units of the OTD. Based on the diagnoses and STS theory, the project developed and implemented a successful intervention to enhance the legacy system for data entries in real time. CONCLUSIONS The study demonstrates the value of AR from a socio-technical perspective for improving existing systems in healthcare settings. The steps adopted in this study could be applied to improve similar systems. A follow-up study will be essential to assess the sustainability of the improved system.
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Affiliation(s)
- Godfried Bakiyem Adaba
- a Birkbeck, University of London , Department of Computer Science and Information Systems , London , United Kingdom
| | - Yohannes Kebebew
- a Birkbeck, University of London , Department of Computer Science and Information Systems , London , United Kingdom
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11
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Cresswell KM, Bates DW, Sheikh A. Ten key considerations for the successful optimization of large-scale health information technology. J Am Med Inform Assoc 2016; 24:182-187. [PMID: 27107441 DOI: 10.1093/jamia/ocw037] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 02/08/2016] [Accepted: 02/17/2016] [Indexed: 11/14/2022] Open
Abstract
Implementation and adoption of complex health information technology (HIT) is gaining momentum internationally. This is underpinned by the drive to improve the safety, quality, and efficiency of care. Although most of the benefits associated with HIT will only be realized through optimization of these systems, relatively few health care organizations currently have the expertise or experience needed to undertake this. It is extremely important to have systems working before embarking on HIT optimization, which, much like implementation, is an ongoing, difficult, and often expensive process. We discuss some key organization-level activities that are important in optimizing large-scale HIT systems. These include considerations relating to leadership, strategy, vision, and continuous cycles of improvement. Although these alone are not sufficient to fully optimize complex HIT, they provide a starting point for conceptualizing this important area.
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Affiliation(s)
- Kathrin M Cresswell
- Chief Scientist Office Postdoctoral Fellow, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, UK
| | - David W Bates
- Professor of Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, and Department of Health Policy and Management, Harvard School of Public Health, Boston MA, USA
| | - Aziz Sheikh
- Professor of Primary Care Research and Development and Co-Director, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, UK
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Farre A, Cummins C. Understanding and evaluating the effects of implementing an electronic paediatric prescribing system on care provision and hospital work in paediatric hospital ward settings: a qualitatively driven mixed-method study protocol. BMJ Open 2016; 6:e010444. [PMID: 26842275 PMCID: PMC4746465 DOI: 10.1136/bmjopen-2015-010444] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 12/23/2015] [Accepted: 01/15/2016] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Electronic prescribing systems can improve the quality and safety of healthcare services, but their implementation is not straightforward and may create unexpected change. However, the added complexity of paediatric prescribing (eg, dose calculations, dilutions, manipulations) may pose additional challenges. This study will aim to (1) understand the complex organisational reality of a paediatric hospital in which a new electronic paediatric prescribing (ePP) system will be introduced; (2) describe ePP-related change, over time, in paediatric hospital ward settings; (3) explore staff perspectives in relation to currently established practices and processes; and (4) assess the impact of ePP on care provision and hospital work from the perspective of paediatricians, paediatric nurses and managers. METHODS AND ANALYSIS A qualitatively driven mixed-method approach will be adopted, including 3 inter-related substudies. The core component of the study will be qualitative (substudy 1): we will use ethnographic research methods, including non-participant observation in wards and informal conversational interviews with members of staff. In addition, the design will include 2 embedded supplementary components: a qualitative 1 (substudy 2) based on in-depth interviews and/or focus groups with paediatricians, paediatric nurses, paediatric pharmacists/pharmacy technicians and managers; and a quantitative 1 (substudy 3) in which a staff survey will be developed and administered before and after the ePP implementation. Analytic themes will be identified from ethnographic field notes and interview data. Survey data will be analysed using descriptive statistics and baseline and follow-up data compared to establish impact evaluation measures. ETHICS AND DISSEMINATION A favourable ethical opinion has been obtained from a National Health Service (NHS) Research Ethics Committee (15/SS/0157). NHS research governance approval has been obtained at the relevant hospital site. The results of the study will be disseminated through conferences and peer-reviewed journals, as well as fed back to those involved in clinical practice and policy development at the study site.
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Affiliation(s)
- Albert Farre
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Research and Development, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - Carole Cummins
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Deeny SR, Steventon A. Making sense of the shadows: priorities for creating a learning healthcare system based on routinely collected data. BMJ Qual Saf 2015; 24:505-15. [PMID: 26065466 PMCID: PMC4515981 DOI: 10.1136/bmjqs-2015-004278] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 04/13/2015] [Indexed: 11/08/2022]
Abstract
Socrates described a group of people chained up inside a cave, who mistook shadows of objects on a wall for reality. This allegory comes to mind when considering 'routinely collected data'-the massive data sets, generated as part of the routine operation of the modern healthcare service. There is keen interest in routine data and the seemingly comprehensive view of healthcare they offer, and we outline a number of examples in which they were used successfully, including the Birmingham OwnHealth study, in which routine data were used with matched control groups to assess the effect of telephone health coaching on hospital utilisation.Routine data differ from data collected primarily for the purposes of research, and this means that analysts cannot assume that they provide the full or accurate clinical picture, let alone a full description of the health of the population. We show that major methodological challenges in using routine data arise from the difficulty of understanding the gap between patient and their 'data shadow'. Strategies to overcome this challenge include more extensive data linkage, developing analytical methods and collecting more data on a routine basis, including from the patient while away from the clinic. In addition, creating a learning health system will require greater alignment between the analysis and the decisions that will be taken; between analysts and people interested in quality improvement; and between the analysis undertaken and public attitudes regarding appropriate use of data.
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Pezaro S, Lilley L. Digital voice recorders - A conceptual intervention to facilitate contemporaneous record keeping in midwifery practice. Women Birth 2015; 28:e171-6. [PMID: 25997729 DOI: 10.1016/j.wombi.2015.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 04/29/2015] [Accepted: 04/30/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND The first responder, faced with any obstetric incident, frequently finds themselves within a dichotomy of multi-tasking activities. One challenge for the midwife, is to keep accurate and contemporaneous medical records, whilst simultaneously providing immediate clinical care. AIM This paper aims to propose an innovative conceptualisation and a practical solution for maternity services, which strive to uphold best practice in creating contemporaneous and accurate medical records. The feasibility of introducing the use of voice recorders within maternity services will be explored, and offered as a mechanism to facilitate record keeping and simultaneous clinical care. METHODS A synthesised narrative review of the literature is conducted. This review academically tests the conceptual hypothesis that the implementation of voice recorders within maternity services may augment the midwife's ability to generate contemporaneous medical records. A background literature review will also explore the key drivers for this particular innovation, and the challenges facing healthcare leaders in service improvement. FINDINGS This paper builds upon previous suggestions that digital voice recorders may be an effective solution to enhance overall obstetric outcomes, and focuses upon conceptual processes for implementation. CONCLUSIONS This paper offers the principal conclusion that the integration of voice recorders into midwifery practice for the purpose of supporting contemporaneous record keeping may be feasible within the current healthcare climate.
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Affiliation(s)
- Sally Pezaro
- Coventry University, Centre for Technology Enabled Health Research, UK.
| | - Linda Lilley
- School of Health, University of Northampton, Park Campus, Boughton Green Road, Northampton NN2 7AL, UK
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