Continuous data collection and analysis have been shown essential to achieving improvement in healthcare. However, the data required for local improvement initiatives are often not readily available from hospital Electronic Health Record (EHR) systems or not routinely collected. Furthermore, improvement teams are often restricted in time and funding thus requiring inexpensive and rapid tools to support their work. Hence, the informatics challenge in healthcare local improvement initiatives consists of providing a mechanism for rapid modelling of the local domain by non-informatics experts, including performance metric definitions, and grounded in established improvement techniques. We investigate the feasibility of a model-driven software approach to address this challenge, whereby an improvement model designed by a team is used to automatically generate required electronic data collection instruments and reporting tools. To that goal, we have designed a generic Improvement Data Model (IDM) to capture the data items and quality measures relevant to the project, and constructed Web Improvement Support in Healthcare (WISH), a prototype tool that takes user-generated IDM models and creates a data schema, data collection web interfaces, and a set of live reports, based on Statistical Process Control (SPC) for use by improvement teams. The software has been successfully used in over 50 improvement projects, with more than 700 users. We present in detail the experiences of one of those initiatives, Chronic Obstructive Pulmonary Disease project in Northwest London hospitals. The specific challenges of improvement in healthcare are analysed and the benefits and limitations of the approach are discussed.
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http://dx.doi.org/10.1016/j.jbi.2014.04.014 | DOI Listing |
Community Dent Oral Epidemiol
January 2025
School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
Objectives: Supervised toothbrushing programmes (STPs), whereby children brush their teeth at nursery or school with a fluoride toothpaste under staff supervision, are a clinically and cost-effective intervention to reduce dental caries. However, uptake is varied, and the reasons unknown. The aim was to use an implementation science approach to explore the perspectives of key stakeholders on the barriers and facilitators at each level of implementation of STPs.
View Article and Find Full Text PDFSwiss Med Wkly
January 2025
Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
Aims: We aimed to explore atrial fibrillation (AF)-induced productivity losses in working-age atrial fibrillation patients and to estimate atrial fibrillation-related indirect costs.
Methods: Between 2014 and 2017, the Swiss Atrial Fibrillation prospective cohort study (Swiss-AF) enrolled 217 working-age patients with documented atrial fibrillation. Self-reported changes in professional activity and the reasons thereof were descriptively analysed over 8 years of follow-up or until patients reached the retirement age.
J Eval Clin Pract
February 2025
School of Primary and Allied Health Care, Monash University, Melbourne, Australia.
Background: Clinical practice guidelines (CPGs) are moving toward greater consideration of population-level differences, like health inequities, when creating management recommendations. CPGs have the potential to reduce or perpetuate health inequities. The intrinsic design factors of electronic interfaces that contain CPGs are known barriers to guideline use.
View Article and Find Full Text PDFSwiss Med Wkly
December 2024
Chirurgie Zentrum St. Anna, Hirslanden Hospital, Lucerne, Switzerland.
Aims: A wide range of reproductive health issues, including fertility, pregnancy outcomes and contraceptive practices can be affected by morbid obesity and weight loss subsequent to bariatric surgery. This study aimed to explore the attitudes and practices of bariatric healthcare professionals in Switzerland regarding reproductive health counselling in the context of bariatric surgery.
Methods: We conducted a national, cross-sectional, 36-question online survey among bariatric professionals in Switzerland.
Front Public Health
January 2025
Center for Experimental Economics in Education, Faculty of Education, Shaanxi Normal University, Xi'an, China.
Purpose: This study evaluates the effectiveness of rural maternal health services in improving pregnant women's health knowledge, practices, and outcomes in northwestern China, focusing on the roles of received public services and policy awareness.
Methods: Baseline surveys were conducted in rural Shaanxi Province in 2021 and 2023, involving 1,152 pregnant women from 85 townships, selected via multistage cluster random sampling. Data were collected through structured face-to-face interviews, covering health knowledge and behaviors.
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