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1 – 10 of over 29000Ruiling Guo, Steven D. Berkshire, Lawrence V. Fulton and Patrick M. Hermanson
The purpose of this paper is to examine whether healthcare leaders use evidence-based management (EBMgt) when facing major decisions and what types of evidence healthcare…
Abstract
Purpose
The purpose of this paper is to examine whether healthcare leaders use evidence-based management (EBMgt) when facing major decisions and what types of evidence healthcare administrators consult during their decision-making. This study also intends to identify any relationship that might exist among adoption of EBMgt in healthcare management, attitudes towards EBMgt, demographic characteristics and organizational characteristics.
Design/methodology/approach
A cross-sectional study was conducted among US healthcare leaders. Spearman’s correlation and logistic regression were performed using the Statistical Package for the Social Sciences (SPSS) 23.0.
Findings
One hundred and fifty-four healthcare leaders completed the survey. The study results indicated that 90 per cent of the participants self-reported having used an EBMgt approach for decision-making. Professional experiences (87 per cent), organizational data (84 per cent) and stakeholders’ values (63 per cent) were the top three types of evidence consulted daily and weekly for decision-making. Case study (75 per cent) and scientific research findings (75 per cent) were the top two types of evidence consulted monthly or less than once a month. An exploratory, stepwise logistic regression model correctly classified 75.3 per cent of all observations for a dichotomous “use of EBMgt” response variable using three independent variables: attitude towards EBMgt, number of employees in the organization and the job position. Spearman’s correlation indicated statistically significant relationships between healthcare leaders’ use of EBMgt and healthcare organization bed size (rs = 0.217, n = 152, p < 0.01), attitude towards EBMgt (rs = 0.517, n = 152, p < 0.01), and the number of organization employees (rs = 0.195, n = 152, p = 0.016).
Originality/value
This study generated new research findings on the practice of EBMgt in US healthcare administration decision-making.
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The evidence‐based practice (EBP) model appears to have established itself as the principal change driver and discourse for the healthcare sector. This study sets out to identify…
Abstract
Purpose
The evidence‐based practice (EBP) model appears to have established itself as the principal change driver and discourse for the healthcare sector. This study sets out to identify the emergence of the term EBP in the professional literature to establish an empirical foundation for discussion. The understanding of and relevance to healthcare practitioners in a large South West London hospital are assessed and their views related to the perspective of library and information professionals to assess implications for practice.
Design/methodology/approach
An extensive literature search was carried out and the data generated used to produce a growth curve for the literature. A survey of health care professionals using e‐mail and follow‐up interviews was undertaken at the case hospital.
Findings
Between 1998 and 2004 the number of papers appearing to discuss the theme increased four‐fold. The first recorded reference was in 1991. The EBP model had strong official and political support in the field. On the user sample there is evidence of resistance to the orthodoxy.
Practical implications
The EBP model – variously adopted by several healthcare agencies – has placed information management at the centre of the care process. In spite of this, there are few definite implications for the role of library and information professionals, since the world of information and the UK NHS itself are continually in a state of flux, and the current EBP dominance may neither strengthen nor safeguard it.
Originality/value
The bibliometric study provides a baseline. The study of healthcare professionals is a case study to add to knowledge of practice.
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Ann Dadich, Penny Abbott and Hassan Hosseinzadeh
Evidence-based practice is pivotal to effective patient care. However, its translation into practice remains limited. Given the central role of primary care in many healthcare…
Abstract
Purpose
Evidence-based practice is pivotal to effective patient care. However, its translation into practice remains limited. Given the central role of primary care in many healthcare systems, it is important to identify strategies that bolster clinician-capacity to promote evidence-based care. The purpose of this paper is to identify strategies to increase Practice Nurse capacity to promote evidence-based sexual healthcare within general practice.
Design/methodology/approach
A survey of 217 Practice Nurses in an Australian state and ten respondent-interviews regarding two resources to promote evidence-based sexual healthcare – namely, a clinical aide and online training.
Findings
The perceived impact of both resources was determined by views on relevance and design – particularly for the clinical aide. Resource-use was influenced by role and responsibilities within the workplace, accessibility, and support from patients and colleagues.
Research limitations/implications
This is the first Australian study to reveal strategies to promote evidence-based sexual healthcare among Practice Nurses. The findings provide a platform for future research on knowledge translation processes, particularly among clinicians who might be disengaged from sexual healthcare.
Practical implications
Given the benefits of evidence-based practices, it is important that managers recognize their role, and the role of their services, in promoting these. Without explicit support for evidence-based care and recognition of the Practice Nurse role in such care, knowledge translation is likely to be limited.
Originality/value
Knowledge translation among Practice Nurses can be facilitated by: resources-deemed informative, relevant, and user-friendly, as well as support from patients, colleagues, and their workplace.
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Nadeeshani Wanigarathna, Fred Sherratt, Andrew D.F. Price and Simon Austin
A substantial amount of research argues that built environmental interventions can improve the outcomes of patients and other users of healthcare facilities, supporting the…
Abstract
Purpose
A substantial amount of research argues that built environmental interventions can improve the outcomes of patients and other users of healthcare facilities, supporting the concept of evidence-based design (EBD). However, the sources of such evidence and its flow into healthcare design are less well understood. This paper aims to provide insights to both the sources and flow of EBD used in three healthcare projects, to reveal practicalities of use and the relationships between them in practice.
Design/methodology/approach
Three healthcare case study projects provided empirical data on the design of a number of different elements. Inductive thematic analysis was used to identify the source and flow of evidence used in this design, which was subsequently quantised to reveal the dominant patterns therein.
Findings
Healthcare design teams use evidence from various sources, the knowledge and experience of the members of the design team being the most common due to both ease of access and thus flow. Practice-based research and peer-reviewed published research flow both directly and indirectly into the design process, whilst collaborations with researchers and research institutions nurture the credibility of the latter.
Practical implications
The findings can be used to enhance activities that aim to design, conduct and disseminate future EBD research to improve their flow to healthcare designers.
Originality/value
This research contributes to understandings of EBD by exploring the flow of research from various sources in conflation and within real-life environments.
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Ali Janati, Edris Hasanpoor, Sakineh Hajebrahimi and Homayoun Sadeghi-Bazargani
Hospital manager decisions can have a significant impact on service effectiveness and hospital success, so using an evidence-based approach can improve hospital management. The…
Abstract
Purpose
Hospital manager decisions can have a significant impact on service effectiveness and hospital success, so using an evidence-based approach can improve hospital management. The purpose of this paper is to identify evidence-based management (EBMgt) components and challenges. Consequently, the authors provide an improving evidence-based decision-making framework.
Design/methodology/approach
A total of 45 semi-structured interviews were conducted in 2016. The authors also established three focus group discussions with health service managers. Data analysis followed deductive qualitative analysis guidelines.
Findings
Four basic themes emerged from the interviews, including EBMgt evidence sources (including sub-themes: scientific and research evidence, facts and information, political-social development plans, managers’ professional expertise and ethical-moral evidence); predictors (sub-themes: stakeholder values and expectations, functional behavior, knowledge, key competencies and skill, evidence sources, evidence levels, uses and benefits and government programs); EBMgt barriers (sub-themes: managers’ personal characteristics, decision-making environment, training and research system and organizational issues); and evidence-based hospital management processes (sub-themes: asking, acquiring, appraising, aggregating, applying and assessing).
Originality/value
Findings suggest that most participants have positive EBMgt attitudes. A full evidence-based hospital manager is a person who uses all evidence sources in a six-step decision-making process. EBMgt frameworks are a good tool to manage healthcare organizations. The authors found factors affecting hospital EBMgt and identified six evidence sources that healthcare managers can use in evidence-based decision-making processes.
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Alan Cowling, Karin Newman and Susie Leigh
This paper focuses on the practice of evidence‐based healthcare by doctors, nurses, midwives and the professions allied to medicine in four NHS Trusts in and around London. This…
Abstract
This paper focuses on the practice of evidence‐based healthcare by doctors, nurses, midwives and the professions allied to medicine in four NHS Trusts in and around London. This qualitative study, based on interviews and self‐efficiency ratings uncovered the extent of evidence based practice between different groups and between acute and community Trusts, the perceived obstacles to the adoption and implementation of EBHC, and throws light on the knowledge, skills and attitudes required for such practice. Five clusters of competencies were identified – personal attributes, interpersonal, self‐management, information management and technical knowledge skills – and these form the basis of a competency framework of measurable criteria to assess proficiency as well as staff training needs which it is hoped will enable NHS Trusts to devise strategies to meet the requirements and challenges of clinical governance from April 1999.
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The purpose of this paper is to explore conceptual and practical links between performance measurement and evidence‐based library and information practice (EBLIP) and to identify…
Abstract
Purpose
The purpose of this paper is to explore conceptual and practical links between performance measurement and evidence‐based library and information practice (EBLIP) and to identify lessons to be learned from evidence‐based healthcare.
Design/methodology/approach
The paper presents a selective review of key writings in EBLIP for reference to performance measurement.
Findings
The paper finds that performance measurement may variously be viewed as one small, but essential, stage of EBLIP or an overarching approach to utilisation of data of which research‐derived evidence is a single source
Research limitations/implications
Similarities and potential linkages between the two activities are currently underdeveloped and need to be explored through rigorous empirical research.
Practical implications
The stages of EBLIP are modelled in relation to a single case study of reference checking.
Originality/value
This is the first article to develop explicit links between these two areas of information practice, following in passim mentions at previous conferences.
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Kristina Rosengren, Petra Brannefors and Eric Carlstrom
This study aims to describe how person-centred care, as a concept, has been adopted into discourse in 23 European countries in relation to their healthcare systems (Beveridge…
Abstract
Purpose
This study aims to describe how person-centred care, as a concept, has been adopted into discourse in 23 European countries in relation to their healthcare systems (Beveridge, Bismarck, out of pocket).
Design/methodology/approach
A literature review inspired by the SPICE model, using both scientific studies (CINHAL, Medline, Scopus) and grey literature (Google), was conducted. A total of 1,194 documents from CINHAL (n = 139), Medline (n = 245), Scopus (n = 493) and Google (n = 317) were analysed for content and scope of person-centred care in each country. Countries were grouped based on healthcare systems.
Findings
Results from descriptive statistics (percentage, range) revealed that person-centred care was most common in the United Kingdom (n = 481, 40.3%), Sweden (n = 231, 19.3%), the Netherlands (n = 80, 6.7%), Northern Ireland (n = 79, 6.6%) and Norway (n = 61, 5.1%) compared with Poland (0.6%), Hungary (0.5%), Greece (0.4%), Latvia (0.4%) and Serbia (0%). Based on healthcare systems, seven out of ten countries with the Beveridge model used person-centred care backed by scientific literature (n = 999), as opposed to the Bismarck model, which was mostly supported by grey literature (n = 190).
Practical implications
Adoption of the concept of person-centred care into discourse requires a systematic approach at the national (politicians), regional (guidelines) and local (specific healthcare settings) levels visualised by decision-making to establish a well-integrated phenomenon in Europe.
Social implications
Evidence-based knowledge as well as national regulations regarding person-centred care are important tools to motivate the adoption of person-centred care in clinical practice. This could be expressed by decision-making at the macro (law, mission) level, which guides the meso (policies) and micro (routines) levels to adopt the scope and content of person-centred care in clinical practice. However, healthcare systems (Beveridge, Bismarck and out-of-pocket) have different structures and missions owing to ethical approaches. The quality of healthcare supported by evidence-based knowledge enables the establishment of a well-integrated phenomenon in European healthcare.
Originality/value
Our findings clarify those countries using the Beveridge healthcare model rank higher on accepting/adopting the concept of person-centered care in discourse. To adopt the concept of person-centred care in discourse requires a systematic approach at all levels in the organisation—from the national (politicians) and regional (guideline) to the local (specific healthcare settings) levels of healthcare.
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JENNIFER MACDOUGALL, J. MICHAEL BRITTAIN and ROBERT GANN
This paper provides an overview of the range and development of health informatics, with examples from the literature world wide covering the types of information involved, the…
Abstract
This paper provides an overview of the range and development of health informatics, with examples from the literature world wide covering the types of information involved, the areas of application, the impact of evidence based medicine and other professional issues, integrated information systems, and the needs of the public, patients and their carers. While medical informatics certainly comprises a major part of health informatics it is not the main focus of this paper. Medical informatics is the older term and involves the use of information technology and computing specifically for medical science research, and the diagnosis and treatment of disease involving, for example, X‐rays, imaging, resonance, and magnetic scanning techniques. Rather, the scope of this review is the literature relating to the wider concept of the management of information through the interdisciplinary application of information science and technology for the benefit of patients, scientists, managers, staff, and carers involved in the whole range of healthcare activity.
Daniel P. Lorence and Robert Jameson
The growing acceptance of evidence‐based decision support systems in healthcare organizations has resulted in recognition of data quality improvement as a key area of both…
Abstract
The growing acceptance of evidence‐based decision support systems in healthcare organizations has resulted in recognition of data quality improvement as a key area of both strategic and operational management. Information managers are faced with their emerging role in establishing quality management standards for information collection and application in the day‐to‐day delivery of health care. In the USA, rigid data‐based practice and performance standards and regulations related to information management have met with some resistance from providers. In the emerging information‐intensive healthcare environment, managers are beginning to understand the importance of formal, continuous data quality assessment in health services delivery and quality management. Variation in data quality management practice poses quality problems in such an environment, since it precludes comparative assessments across larger markets or areas, a critical component of evidence‐based quality assessments. In this study a national survey of health information managers was employed to provide a benchmark of the degree of such variation, examining how quality management practices vary across area indicators. Findings here suggest that managers continue to employ paper‐based quality assessment audits, despite nationwide mandates to adopt system‐based measures using aggregate data analysis and automated quality intervention. The level of adoption of automated quality management methods in this study varied significantly across practice characteristics and areas, suggesting the existence of data quality barriers to cross‐market comparative assessment. Implications for healthcare service delivery in an evidence‐based environment are further examined and discussed.
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