Challenges and promising solutions to engaging patients in healthcare implementation in the United States: an environmental scan

Woodward, Eva N.; Castillo, Andrea Isabel Melgar; True, Gala; Willging, Cathleen; Kirchner, JoAnn E.

doi:10.1186/s12913-023-10315-y

Cited by 3 publications

(1 citation statement)

References 52 publications

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“…The literature collection was also used by ENW to conduct an environmental scan in the U.S. to identify examples of patient engagement in healthcare service delivery implementation activities (such as facilitation) ( 44 ). The research team's goal was to amass a body of examples of this work, synthesize challenges, and identify promising solutions to patient engagement in implementation activities, such as facilitation.…”

Section: Discussionmentioning

confidence: 99%

Building a sharable literature collection to advance the science and practice of implementation facilitation

Ritchie,

Smith,

Kim

et al. 2024

Front. Health Serv.

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BackgroundImplementation science seeks to produce generalizable knowledge on strategies that promote the adoption and sustained use of evidence-based innovations. Literature reviews on specific implementation strategies can help us understand how they are conceptualized and applied, synthesize findings, and identify knowledge gaps. Although rigorous literature reviews can advance scientific knowledge and facilitate theory development, they are time-consuming and costly to produce. Improving the efficiency of literature review processes and reducing redundancy of effort is especially important for this rapidly developing field. We sought to amass relevant literature on one increasingly used evidence-based strategy, implementation facilitation (IF), as a publicly available resource.MethodsWe conducted a rigorous systematic search of PubMed, CINAHL, and Web of Science citation databases for peer-reviewed, English-language articles with “facilitation” and a combination of other terms published from January 1996 to December 2021. We searched bibliographies of articles published from 1996 to 2015 and identified articles during the full text review that reported on the same study. Two authors screened 3,168 abstracts. After establishing inter-rater reliability, they individually conducted full-text review of 786 relevant articles. A multidisciplinary team of investigators provided recommendations for preparing and disseminating the literature collection.FindingsThe literature collection is comprised of 510 articles. It includes 277 empirical studies of IF and 77 other articles, including conceptual/theoretical articles, literature reviews, debate papers and descriptions of large-scale clinical initiatives. Over half of the articles were published between 2017 and 2021. The collection is publicly available as an Excel file and as an xml file that can be imported into reference management software.ConclusionWe created a publicly accessible collection of literature about the application of IF to implement evidence-based innovations in healthcare. The comprehensiveness of this collection has the potential to maximize efficiency and minimize redundancy in scientific inquiry about this strategy. Scientists and practitioners can use the collection to more rapidly identify developments in the application of IF and to investigate a wide range of compelling questions on its use within and across different healthcare disciplines/settings, countries, and payer systems. We offer several examples of how this collection has already been used.

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Section: Discussionmentioning

confidence: 99%

Building a sharable literature collection to advance the science and practice of implementation facilitation

Ritchie,

Smith,

Kim

et al. 2024

Front. Health Serv.

Self Cite

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A Randomized Pilot Study On The Effects Of A Socially Assistive Robot Intervention On Surgery Patients' Engagement, Perceived Quality of Care, And Quality Of Life

Mlakar,

Smrke,

Šafran

et al. 2024

Preprint

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Aims and Objective: The study aimed to evaluate the feasibility and preliminary effects of a SAR intervention on patient engagement, perceived quality of care, and health-related quality of life in surgical wards. Background: The healthcare sector faces significant challenges, including workforce shortages and increasing demands. Socially Assistive Robots (SARs) have emerged as a potential solution to enhance patient outcomes, such as engagement, perceived quality of care, and health-related quality of life. However, their implementation in hospital wards remains largely unexplored. Methods: We conducted a randomized trial in the thoracic surgery and abdominal and general surgery wards in the University Medical Center Maribor. Patients (N = 229) were allocated to either the SAR intervention group (standard care + SAR) or the control group receiving only standard care. The SAR intervention involved daily interactions for patient education and support. Outcomes included patient engagement , perceived quality of care, and health-related quality of life. We additionally explored the moderators that may alter the effects of the intervention. Results: The overall retention rate was 78.2% (90.1% in control and 66.9% in intervention), and the overall retention of patients from baseline to post-intervention was 86.9% (90.1% in control and 83.2% in intervention) demonstrating feasibility rather than attrition. While overall changes in patient engagement were not statistically significant, the intervention group showed a slight increase compared to a decrease in the control group. Perceived quality of care decreased significantly in both groups. The SAR intervention had a significant positive effect on pain/discomfort management. The department and acceptance of robots moderated the intervention's impact on patient engagement. Conclusions: The study demonstrates the feasibility of implementing SAR interventions in surgical wards. While the observed overall effects on patient engagement and perceived care quality were limited, the positive impact on pain management and the moderating effects of contextual factors highlight the potential of SAR in specific domains. Furthermore, we did not detect any negative effects of the intervention. Future research should consider longer intervention periods, larger sample sizes, and more department-specific applications to fully realize the benefits of SAR in surgical care settings.

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A clinical decision support tool for metabolic dysfunction-associated steatohepatitis in real-world clinical settings: a mixed-method implementation research study protocol

Fishman,

Alexander,

Kim

et al. 2024

J. Comp. Eff. Res.

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Aim: A clinical decision support (CDS) tool for metabolic dysfunction-associated steatohepatitis (MASH) was developed to align health systems with clinical guidelines detailed in the MASH Clinical Care Pathway and improve patients' proactive self-management of their disease. The tool includes a provider-facing web-based application and a mobile application (app) for patients. This protocol outlines a pilot study that will systematically evaluate the implementation of the tool in real-world clinical practice settings. Materials & methods: This implementation research study will use a simultaneous mixed-methods design and is guided by the Consolidated Framework for Implementation Research. The CDS tool for MASH will be piloted for ≥3 months at multiple US-based sites with eligible gastroenterologists and hepatologists (n = 5–10 per site) and their patients (n = 50–100 per site) with MASH or suspected MASH. Each pilot site may choose one or all focus areas within the tool (i.e., risk stratification, screening and referral, or patient care management), based on on-site capabilities. Prior to and at the end of the pilot period, providers and patients will complete quantitative surveys and partake in semi-structured interviews. Outcomes will include understanding the feasibility of implementing the tool in real-world clinical settings, its effectiveness in increasing patient screenings and risk stratification for MASH, its ability to improve provider and patient knowledge of MASH, barriers to adoption of the tool and the tool's capacity to enhance patient engagement and satisfaction with their care. Conclusion: Findings will inform the scalable implementation of the tool to ensure patients at risk for MASH are identified early, referred to specialty care when necessary and managed appropriately. Successful integration of the patient app can contribute to better health outcomes for patients by facilitating their active participation in the management of their condition.

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Challenges and promising solutions to engaging patients in healthcare implementation in the United States: an environmental scan

Cited by 3 publications

References 52 publications

Building a sharable literature collection to advance the science and practice of implementation facilitation

Building a sharable literature collection to advance the science and practice of implementation facilitation

A Randomized Pilot Study On The Effects Of A Socially Assistive Robot Intervention On Surgery Patients' Engagement, Perceived Quality of Care, And Quality Of Life

A clinical decision support tool for metabolic dysfunction-associated steatohepatitis in real-world clinical settings: a mixed-method implementation research study protocol

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