A Theoretically Informed Approach to Support the Implementation of Pre-Operative Anemia and Iron Deficiency Screening, Evaluation, and Management Pathways: Protocol for a Type Two Hybrid-Effectiveness Study

Delaforce, Alana; Duff, Jed; Munday, Judy; Farmer, Shannon; Miller, Kristen; Glover, Lynne; Corney, Christopher; Hurst, Cameron; Ansell, Gareth; Gutta, Naadir; Tuffaha, Haitham; Hardy, Janet

doi:10.2147/jmdh.s313309

Cited by 2 publications

(11 citation statements)

References 38 publications

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“…The study used a type two hybrid‐effectiveness implementation design 23 . Type two hybrid‐effectiveness designs evaluate both the effect of an intervention and the implementation strategies which support its delivery 31 .…”

Section: Methodsmentioning

confidence: 99%

“…Theoretically informed implementation strategies supporting the change package delivery are outlined in Table 1. 23 Implementation strategy selection was informed by previously collected data that used semi-structured interviews of relevant stakeholders (including health professionals (n = 13) and patients (n = 2)). 22 The interviews aimed to understand the barriers to implementation of the PAIDSEM-P.…”

Section: Implementation Strategiesmentioning

confidence: 99%

“…However, testing of these tools remains limited in the context of patient blood management and, more specifically, PAIDSEM‐P 21,23 . This study aimed to test if a theoretically informed change package that leveraged implementation science theory could improve the uptake of PAIDSEM‐P 23 . It measures the impact of the change package on provider, facility, patient, and outcomes, as well as implementation outcomes of acceptability, appropriateness, and feasibility.…”

Section: Introductionmentioning

confidence: 99%

“…Barriers to PAIDSEM‐P can be addressed using theoretically informed change packages. Change packages should comprise tailored knowledge tools and interventions supported by appropriate implementation strategies 23 . Knowledge tools include highly synthesized research such as clinical decision aids or pathways (e.g., the National Blood Authority Patient Blood Management Guidelines) 24 .…”

Section: Introductionmentioning

confidence: 99%

“…Implementation plans should include bespoke change packages that are conceptualized and delivered with the support of implementation theories, models, and frameworks 28 . In this study the Consolidated Framework for Implementation Research (CFIR) was used to identify barriers, which were then classified according to actor (stakeholder) categories and mapped to the Expert Recommendations for Implementing Change (ERIC) framework, explained in detail elsewhere 23,27,29,30 . However, testing of these tools remains limited in the context of patient blood management and, more specifically, PAIDSEM‐P 21,23 .…”

Section: Introductionmentioning

confidence: 99%

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Results from a type two hybrid‐effectiveness study to implement a preoperative anemia and iron deficiency screening, evaluation, and management pathway

et al. 2023

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Background Implementation of pathways to screen surgical patients for preoperative anemia and iron deficiency remains limited. This study sought to measure the impact of a theoretically informed, bespoke change package on improving the uptake of a Preoperative Anemia and Iron Deficiency Screening, Evaluation, and Management Pathway. Study Design and Methods Pre‐post interventional study using a type two hybrid‐effectiveness design evaluated implementation. Four hundred (400) patient medical record reviews provided the dataset (200 pre‐ and 200‐post implementation). The primary outcome measure was compliance with the pathway. Secondary outcome measures (clinical outcomes) were anemia on day of surgery, exposure to a red blood cell (RBC) transfusion, and hospital length of stay. Validated surveys facilitated data collection of implementation measures. Propensity score‐adjusted analyses determined the effect of the intervention on clinical outcomes, and a cost analysis determined the economic impact. Results For the primary outcome, compliance improved significantly post‐implementation (Odds Ratio 10.6 [95% CI 4.4–25.5] p < .000). In secondary outcomes, adjusted analyses point estimates showed clinical outcomes were slightly improved for anemia on day of surgery (Odds Ratio 0.792 [95% CI 0.5–1.3] p = .32), RBC transfusion (Odds Ratio 0.86 [95% CI 0.41–1.78] p = .69) and hospital length of stay (Hazard Ratio 0.96 [95% CI 0.77–1.18] p = .67), although these were not statistically significant. Cost savings of $13,340 per patient were realized. Implementation outcomes were favorable for acceptability, appropriateness, and feasibility. Conclusion The change package significantly improved compliance. The absence of a statistically significant change in clinical outcomes may be because the study was powered to detect an improvement in compliance only. Further prospective studies with larger samples are needed. Cost savings of $13,340 per patient were achieved and the change package was viewed favorably.

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Section: Methodsmentioning

confidence: 99%

Section: Implementation Strategiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Results from a type two hybrid‐effectiveness study to implement a preoperative anemia and iron deficiency screening, evaluation, and management pathway

et al. 2023

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Regulatory Compliance and Managerial Control in the Hemotherapy and Blood Bank Program of EsSalud Huancayo

Montes Hijar,

Cuyubamba Pérez,

Manrique Meza

et al. 2024

Salud, Ciencia y Tecnología

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Introducción: la seguridad transfusional es crítica para prevenir efectos adversos potencialmente graves. Se analizó una posible relación entre conocimiento de leyes sanitarias y control gerencial en el Programa de Hemoterapia y Banco de Sangre de un hospital de EsSalud en Perú. Objetivo: determinar si un mayor conocimiento de regulaciones vigentes se asocia con mejores prácticas de control gerencial y disminución de riesgos transfusionales. Métodos: estudio observacional, transversal, la población estuvo conformada por el personal médico, de enfermería, administrativo y usuarios del servicio de hemoterapia y banco de sangre de EsSalud en Huancayo. Se utilizó una muestra probabilística aleatoria estratificada de 319 personas, a las cuales se les aplicaron encuestas validadas para medir variables de interés. Análisis con estadística descriptiva. Resultados: se evidenció asociación significativa entre mayor conocimiento de leyes de salud con mejor control gerencial, disminución de riesgos potenciales y mayor satisfacción de usuarios (p<0,05). Conclusiones: es fundamental capacitar al personal sanitario en legislación y normativas vigentes para optimizar la seguridad y calidad transfusional.

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A Theoretically Informed Approach to Support the Implementation of Pre-Operative Anemia and Iron Deficiency Screening, Evaluation, and Management Pathways: Protocol for a Type Two Hybrid-Effectiveness Study

Cited by 2 publications

References 38 publications

Results from a type two hybrid‐effectiveness study to implement a preoperative anemia and iron deficiency screening, evaluation, and management pathway

Results from a type two hybrid‐effectiveness study to implement a preoperative anemia and iron deficiency screening, evaluation, and management pathway

Regulatory Compliance and Managerial Control in the Hemotherapy and Blood Bank Program of EsSalud Huancayo

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