An evidence-based framework to measure quality of allied health care.
Ontology highlight
ABSTRACT: Background
There is no standard way of describing the complexities of allied health (AH) care, or its quality. AH is an umbrella term which excludes medicine and nursing, and variably includes disciplines which provide therapy, diagnostic, or scientific services. This paper outlines a framework for a standard approach to evaluate the quality of AH therapy services.Methods
A realist synthesis framework describing what AH does, how it does it, and what is achieved, was developed. This was populated by the findings of a systematic review of literature published since 1980 reporting concepts of quality relevant to AH. Articles were included on quality measurement concepts, theories, debates, and/or hypothetical frameworks.Results
Of 139 included articles, 21 reported on descriptions of quality potentially relevant to AH. From these, 24 measures of quality were identified, with 15 potentially relating to what AH does, 17 to how AH delivers care, 8 relating to short term functional outcomes, and 9 relating to longer term functional and health system outcomes.Conclusions
A novel evidence-based quality framework was proposed to address the complexity of AH therapies. This should assist in better evaluation of AH processes and outcomes, costs, and evidence-based engagement of AH providers in healthcare teams.
SUBMITTER: Grimmer K
PROVIDER: S-EPMC4015500 | biostudies-literature | 2014 Feb
REPOSITORIES: biostudies-literature
Publications
An evidence-based framework to measure quality of allied health care.
Grimmer Karen K Lizarondo Lucylynn L Kumar Saravana S Bell Erica E Buist Michael M Weinstein Philip P
Health research policy and systems 20140226
<h4>Background</h4>There is no standard way of describing the complexities of allied health (AH) care, or its quality. AH is an umbrella term which excludes medicine and nursing, and variably includes disciplines which provide therapy, diagnostic, or scientific services. This paper outlines a framework for a standard approach to evaluate the quality of AH therapy services.<h4>Methods</h4>A realist synthesis framework describing what AH does, how it does it, and what is achieved, was developed. T ...[more]
Similar Datasets
Project description:Evidence-based practice (EBP) has become an important competency in many allied and complementary and alternative medicine (CAM) health care practitioners' professional standards of proficiency.To compliment an EBP course for allied health care professionals and CAM practitioners, we undertook a questionnaire survey to assess learning needs. We developed a questionnaire to measure allied health care professionals and CAM practitioners' basic knowledge, skills and beliefs concerning the main principles of EBP. The questionnaires were administered to all attendees of one-day EBP workshops.During 2004-5 we surveyed 193 allied health care professionals and CAM practitioners who attended one-day EBP courses prior to commencement of teaching. Of the respondents 121 (62.7%) were allied health care professionals and 65 (33.7%) practitioners stated that they work in the CAM field Our survey found that the majority of the respondents had not previously attended a literature appraisal skills workshop (87.3%) or received formal training in research methods (69.9%), epidemiology (91.2%) or statistics (80.8%). Furthermore, 67.1% of practitioners specified that they felt that they had not had adequate training in EBM and they identified that they needed more training and education in the principles of EBM (86.7%). Differences in knowledge and beliefs concerning EBP amongst allied and CAM practitioners were found and length of time since qualification was also found to be an important factor in practitioner's beliefs. More CAM practitioners compared to allied health professionals accessed educational literature via the Internet (95.3% v 68.1%, p = 0.008). Whilst, practitioners with more than 11 years experience felt that original research papers were far more confusing (p = 0.02) than their less experienced colleagues.The results demonstrate that practitioner's learning needs do vary according to the type of profession, time since graduation and prior research experience. Our survey findings are exploratory and will benefit from further replication, however, we do believe that they warrant consideration by allied health care and CAM tutors and trainers when planning EBP teaching curricula as it is important to tailor teaching to meet the needs of specific subgroups of trainees to ensure that specific learning needs are met.
| S-EPMC2533291 | biostudies-literature
Project description:Objectives(1) To demonstrate average length of service (ALOS) bias in the currently used acute-care hospitalization (ACH) home health quality measure, limiting comparability across agencies, and (2) to propose alternative ACH measures.Data sources/study settingSecondary analysis of Medicare home health service data 2004-2007; convenience sample of Medicare fee-for-service hospital discharges.Study designCross-sectional analysis and patient-level simulation.Data collection/extraction methodsWe aggregated outcome and ALOS data from 2,347 larger Medicare-certified home health agencies (HHAs) in the United States between 2004 and 2007, and calculated risk-adjusted monthly ACH rates. We used multiple regression to identify agency characteristics associated with ACH. We simulated ACH during and immediately after home health care using patient and agency characteristics similar to those in the actual data, comparing the existing measure with alternative fixed-interval measures.Principal findingsOf agency characteristics studied, ALOS had by far the highest partial correlation with the current ACH measure (r(2)=0.218, p<.0001). We replicated the correlation between ACH and ALOS in the patient-level simulation. We found no correlation between ALOS and the alternative measures.ConclusionsAlternative measures do not exhibit ALOS bias and would be appropriate for comparing HHA ACH rates with one another or over time.
| S-EPMC2875756 | biostudies-literature
Project description:BackgroundWhile evidence-based practice is a familiar concept to allied health clinicians, knowledge translation (KT) is less well known and understood. The need for a framework that enables allied health clinicians to access and engage with KT was identified. The aim of this paper is to describe the development of the Translating Allied Health Knowledge (TAHK) Framework.MethodsAn iterative and collaborative process involving clinician and academic knowledge partners was utilised to develop the TAHK Framework. Multiple methods were utilised during this process, including a systematic literature review, steering committee consultation, mixed methods survey, benchmarking and measurement property analysis.ResultsThe TAHK Framework has now been finalised, and is described in detail. The framework is structured around four domains - Doing Knowledge Translation, Social Capital for Knowledge Translation, Sustaining Knowledge Translation and Inclusive Knowledge Translation - under which 14 factors known to influence allied health KT are classified. The formulation of the framework to date has laid a rigorous foundation for further developments, including clinician support and outcome measurement.ConclusionThe method of development adopted for the TAHK Framework has ensured it is both evidence and practice based, and further amendments and modifications are anticipated as new knowledge becomes available. The Framework will enable allied health clinicians to build on their existing capacities for KT, and approach this complex process in a rigorous and systematic manner. The TAHK Framework offers a unique focus on how knowledge is translated by allied health clinicians in multidisciplinary settings.
| S-EPMC6706979 | biostudies-literature
Project description:ObjectiveInconsistent performance measurement schemes hinder attempts to make international comparisons about mental health-care quality. This report describes a project undertaken by an international collaborative group that aims to develop a common framework of measures that will allow for international comparisons of mental health system performance.DesignRepresentatives from each country submitted reports of quality measurement initiatives in mental health. Indicators were reviewed, and all measurable indicators were compiled and organized. Sample Twenty-nine programs from 11 countries and two cross-national programs submitted reports.MethodsIndicators were evaluated according to measurable inclusion criteria.ResultsThese methods yielded 656 total measures that were organized into 17 domains and 80 subdomains.ConclusionsNo single program contained indicators in all domains, highlighting the need for a comprehensive, shared scheme for international measurement. By collecting and organizing measures through an inductive compilation of existing programs, the present study has generated a maximally inclusive basis for the creation of a common framework of international mental health quality indicators.
| S-EPMC3557960 | biostudies-literature
Project description:BackgroundProviding comprehensive and high-quality services is one of the most important goals of the health systems and a basic principle for Universal Health Coverage (UHC). Fulfilling this important task would be feasible through continuous evaluation and improvement of the health services quality. The aim of this study was to develop a framework for quality assessment of Primary Health Care (PHC) in Iran's health system.MethodsThis study is a literature review which continued by a qualitative research. The extracted quality dimensions and indicators for initial screening were reviewed and discussed in two panel meetings attended by the experts with regard to the current package of health system in Iran. Using Delphi method, the dimensions and Quality Indicators(QIs) were evaluated and approved by 39 national health professionals in two rounds. Finally, after 4 panel sessions at ministerial level, the selected QIs were categorized in form of the final dimensions of the quality of care.ResultsThe literature review emerged 13 Primary Health Care Quality Assessment Frameworks (PHCQAF) including 20 and 698 QIs. Delphi study resulted in developing Iranian PHCQAF comprising 7 dimensions and 40 QIs. Among these, 8 QIs of the dimension of access and equity, 5 QIs of safety dimension, 2 QIs of efficiency dimension, 13 QIs of effectiveness dimension, 2 QIs of patient-centeredness dimension, 3 QIs of governance dimension and 7 QIs of appropriateness dimension were presented.ConclusionsThe presented PHCQAF can be used as a comprehensive and practical tool for continuous improvement of the quality of PHC services at local, national and regional levels. Moreover, it can give some useful information to the health managers and policy makers on how the services are provided.
| S-EPMC6617563 | biostudies-literature
Project description:BackgroundGrowing concerns over ethical issues in mentoring in medicine and surgery have hindered efforts to reinitiate mentoring for Palliative Care (PC) physicians following the easing of COVID-19 restrictions. Ranging from the misappropriation of mentee's work to bullying, ethical issues in mentoring are attributed to poor understanding and structuring of mentoring programs, underlining the need for a consistent approach to mentoring practices.MethodsGiven diverse practices across different settings and the employ of various methodologies, a novel approach to narrative reviews (NR)s is proposed to summarize, interpret, and critique prevailing data on novice mentoring. To overcome prevailing concerns surrounding the reproducibility and transparency of narrative reviews, the Systematic Evidenced Based Approach (SEBA) adopts a structured approach to searching and summarizing the included articles and employed concurrent content and thematic analysis that was overseen by a team of experts.ResultsA total of 18 915 abstracts were reviewed, 62 full text articles evaluated and 41 articles included. Ten themes/categories were ascertained identified including Nature; Stakeholders; Relationship; Approach; Environment; Benefits; Barriers; Assessments; Theories and Definitions.ConclusionBy compiling and scrutinizing prevailing practice it is possible to appreciate the notion of the mentoring ecosystem which sees each mentee, mentor, and host organization brings with them their own microenvironment that contains their respective goals, abilities, and contextual considerations. Built around competency based mentoring stages, it is possible to advance a flexible yet consistent novice mentoring framework.
| S-EPMC7517982 | biostudies-literature
Project description:BACKGROUND:It is widely acknowledged that health policy and practice do not always reflect current research evidence. Whether knowledge transfer from research to practice is more successful when specific implementation approaches are used remains unclear. A model to assist engagement of allied health managers and clinicians with research implementation could involve disseminating evidence-based policy recommendations, along with the use of knowledge brokers. We developed such a model to aid decision-making for the provision of weekend allied health services. This protocol outlines the design and methods for a multi-centre cluster randomised controlled trial to evaluate the success of research implementation strategies to promote evidence-informed weekend allied health resource allocation decisions, especially in hospital managers. METHODS:This multi-centre study will be a three-group parallel cluster randomised controlled trial. Allied health managers from Australian and New Zealand hospitals will be randomised to receive either (1) an evidence-based policy recommendation document to guide weekend allied health resource allocation decisions, (2) the same policy recommendation document with support from a knowledge broker to help implement weekend allied health policy recommendations, or (3) a usual practice control group. The primary outcome will be alignment of weekend allied health service provision with policy recommendations. This will be measured by the number of allied health service events (occasions of service) occurring on weekends as a proportion of total allied health service events for the relevant hospital wards at baseline and 12-month follow-up. DISCUSSION:Evidence-based policy recommendation documents communicate key research findings in an accessible format. This comparatively low-cost research implementation strategy could be combined with using a knowledge broker to work collaboratively with decision-makers to promote knowledge transfer. The results will assist managers to make decisions on resource allocation, based on evidence. More generally, the findings will inform the development of an allied health model for translating research into practice. TRIAL REGISTRATION:This trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) ( ACTRN12618000029291 ). Universal Trial Number (UTN): U1111-1205-2621.
| S-EPMC5916715 | biostudies-literature
Project description:Background: The development of evidence-based clinical practice guidelines (EB-CPGs) has increasing global growth; however, the certainty of impact on patients and health systems, as well as the magnitude of the impact, is not apparent. The objective of this systematic review was to assess the effectiveness of the application of EB-CPGs for the improvement of the quality of health care in three dimensions: structure, process and results in the patient for the management of cardiovascular disease. Methods: We followed the methods described by the Cochrane Handbook and present a descriptive analysis because of the high heterogeneity found across the included studies. We searched the Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE databases, as well as the grey literature, between 1990 and June 2016. No language restrictions were applied. Only randomised clinical trials (RCTs) were selected. Three authors independently carried out the data extraction, using a modified version of the Cochrane Effective Practice and Organization of Care form. Results: Of the total of 84 interventions included in the nine RCTs evaluated, three (4%) were related to health care structure, 54 (64%) to the health care delivery process and 27 (32%) to patient outcomes. Regarding the impact of using the EB-CPGs, in 55 interventions (65%), there were no significant differences between control and experimental groups. In four interventions (5%), the result favoured the control group, and the result favoured the intervention group on 25 of the interventions (30%). Conclusions: This systematic review showed that EB-CPGs could be useful to improve the process and structure of health care and, to a lesser extent, to improve the patients' outcomes. After analysing many studies, we could have one more hypothesis for further research, which could shed more light upon those undiscovered variables that might interfere with the use of the EB-CPGs. Registration: PROSPERO CRD42013003589.
| S-EPMC6790909 | biostudies-literature
Project description:BACKGROUND:Allied Health Professionals (AHPs) form a significant part of the healthcare workforce and have great potential to improve services through research and research-informed practice. However, there is a lack of tradition in research embedded in practice in these professional groups. Barriers include clinical caseload pressures, a lack of sustainable training and consequent lack of confidence in practitioners. Practice managers are ill-equipped to monitor and guide staff research development. The modern healthcare system is a multi-disciplinary environment focused on the needs of the patient. A common framework across all AHP disciplines, offering equality in research knowledge and skills and shared language, might be helpful in planning and developing clinical career pathways. Our aim is to develop a consolidated research framework to help AHPs to plan and guide research activity throughout their career. METHODS:The study was conducted in three phases. Phase one identified existing AHP research frameworks (AHPRF) through expert consultations and literature searches. Phase two involved framework analysis of the AHPRFs to develop a single consolidated framework. Phase three included a workshop with experts to validate and adapt the framework for practice. RESULTS:Nineteen AHPRFs were identified. A consolidated framework was shaped by analysis of the AHPRFs resulting in a consolidated framework of eight sections, each containing a series of statements. Each section relates to an analytic theme within the framework analysis, and the statements were based on sub-categories of themes. The final framework was further shaped by the phase three workshop into a set of 'stem' statements that can be adapted to reflect different levels of expertise and the inclusion of a set of guiding principles developed through expert consultation. CONCLUSION:The consolidated framework was entitled 'Shaping Better Practice Through Research: A Practitioner Framework' by stakeholders, thus emphasising its ambition to embed research activity into practice. It instigates a new perspective within AHP research by offering practitioners and managers a tool that can be applied across public, private, and voluntary settings for AHPs in all disciplines. Its ambition is to develop capacity in the AHPs that can undertake research to improve services and the health of service users.
| S-EPMC7488424 | biostudies-literature
Project description:BACKGROUND:In this paper we assess the quality of six deliberative stakeholder consultations regarding the implementation of a precision diagnostic for life-threatening pediatric brain tumors. Decision makers who base policy recommendations on the outputs of consultative exercises can presuppose that all deliberants are well informed of the policy issue, that participation in the deliberative process was fair, and that overcoming implementation barriers will necessarily result in practice change. Additional evidence is therefore needed to substantiate the informational quality of the deliberation, measure the equality of participation and study the effects on stakeholder reasoning to appropriately guide uptake of proposed recommendation(s). METHODS:Using the DeVries framework for assessing the deliberative quality, we analyzed data from 44 post-consultation evaluation surveys completed by pediatric oncology and palliative care teams at two tertiary pediatric healthcare centers in Canada. We also conducted turn-taking and word-contribution analyses from the text transcriptions of each deliberation to assess equality of participation using descriptive statistics. RESULTS:Deliberants agreed the quality of the deliberative process was fair (median ratings ranging from 9-10 out of 10) and the opportunities to receive expert information and discuss with others about the implementation of a new LDT were helpful (9.5 out of 10). While the session improved understanding of the implementation barriers and opportunities, it had marginal effects on deliberants' reasoning about whether LDTs would change their own clinical practice (3-10 out of 10). Participation was proportionate in at least four of the six deliberations, where no deliberant took more than 20% of total turns and contributed equal to, or less than 20% of total words. CONCLUSION:The quality assessment we performed demonstrates high informational value and perceived fairness of two deliberative stakeholder consultations involving pediatric palliative care and oncology teams in Canada. Quality assessments can reveal how the process of deliberation unfolds, whether deliberative outputs are the result of equitable participation among deliberants and what, if any, stakeholder voices may be missing. Such assessments should be routinely reported as a condition of methodological rigor and trustworthiness of deliberative stakeholder engagement research.
| S-EPMC8672505 | biostudies-literature