Introduction: Quality improvement and implementation science practitioners identify relational issues as important obstacles to success. Relational interventions may be important for successful performance improvement and fostering Learning Health Systems.
Methods: This case report describes the experience and lessons learned from implementing a relational approach to organizational change, informed by Relational Coordination Theory, in a health system. Structured interviews were used to obtain qualitative participant feedback. Relational Coordination was measured serially using a validated seven-item survey.
Results: An initial, relational intervention on one unit promoted increased participant engagement, self-efficacy, and motivation that led to the spontaneous, emergent dissemination of relational change, and learning into other parts of the health system. Staff involved in the intervention reported increased systems thinking, enhanced focus on communication and relationships as key drivers for improvement and learning, and greater awareness of organizational change as something co-created by staff and executives.
Conclusions: This experience supports the hypothesis that relational interventions are important for fostering the development of Learning Health Systems.
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http://dx.doi.org/10.1002/lrh2.10270 | DOI Listing |
Lymphat Res Biol
January 2025
Ankara Bilkent City Hospital, Physical Medicine and Rehabilitation Hospital, Health Science University, Ankara, Turkiye.
The aim of this study was to comparatively determine the frequency of breast cancer-related lymphedema (BCRL) by using prospective monitoring with perometer and circumferential measurements in a group of patients who underwent breast cancer surgery. We also aimed to evaluate the relationship between volume changes and functional status and quality of life (QoL) in patients with breast cancer-related subclinical lymphedema. Patients who had unilateral breast cancer surgery for breast were assessed with circumferential and perometer, respectively, for volumes at baseline, 3rd-month, 6th-month, 9th-month, and 12th-month by the same physiotherapist.
View Article and Find Full Text PDFThis study aimed to gain knowledge of general oral health preventive measures with a specific focus on root caries preventive measures for patients ≥65 years old, performed by Norwegian dental hygienists in public and private dental health services. A secondary aim was to investigate differences and challenges in prevention practices. Materials and methods: An electronic survey was conducted among the sample in 2022.
View Article and Find Full Text PDFDiabetes Technol Ther
January 2025
Children's Mercy Kansas City, Endocrinology, Kansas City, Missouri, USA.
To use electronic health record (EHR) data to develop a scalable and transferrable model to predict 6-month risk for diabetic ketoacidosis (DKA)-related hospitalization or emergency care in youth with type 1 diabetes (T1D). To achieve a sharable predictive model, we engineered features using EHR data mapped to the T1D Exchange Quality Improvement Collaborative's (T1DX-QI) data schema used by 60+ U.S.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Department of Medicine, Duke University, Durham, North Carolina.
Importance: Health systems are increasingly required to conduct health-related social needs screening. However, how social resources negatively and positively affect recovery from acute illnesses, such as COVID-19, is incompletely understood.
Objective: To examine how social determinants of health (SDOH) influence recovery from COVID-19.
Hepatol Commun
November 2024
Department of Cell Biology, New York University School of Medicine, New York, New York, USA.
Background: Metabolic dysfunction-associated steatotic liver disease (MASLD, formerly known as NAFLD) is a major driver of cirrhosis and liver-related mortality. However, therapeutic options for MASLD, including prevention of liver steatosis, are limited. We previously described that vasoactive intestinal peptide-producing neurons (VIP-neurons) regulate the efficiency of intestinal dietary fat absorption and IL-22 production by type 3 innate lymphoid cells (ILC3) in the intestine.
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