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COproduction VALUE creation in healthcare service (CO-VALUE): an international multicentre protocol to describe the application of a model of value creation for use in systems of coproduced healthcare services and to evaluate the initial feasibility, utility and acceptability of associated system-level value creation assessment approaches.

ABSTRACT: INTRODUCTION:Coproduction introduces a fundamental shift in how healthcare service is conceptualised. The mechanistic idea of healthcare being a 'product' generated by the healthcare system and delivered to patients is replaced by that of a service co-created by the healthcare system and the users of healthcare services. Fjeldstad et al offer an approach for conceptualising value creation in complex service contexts that we believe is applicable to coproduction of healthcare service. We have adapted Fjeldstad's value creation model based on a detailed case study of a renal haemodialysis service in Jonkoping, Sweden, which demonstrates coproduction characteristics and key elements of Fjeldstad's model. METHODS AND ANALYSIS:We propose a five-part coproduction value creation model for healthcare service: (1) value chain, characterised by a standardised set of processes that serve a commonly occurring need; (2) value shop, which offers a customised response for unique cases; (3) a facilitated value network, which involves groups of individuals struggling with similar challenges; (4) interconnection between shop, chain and network elements and (5) leadership. We will seek to articulate and assess the value creation model through the work of a community of practice comprised of a diverse international workgroup with representation from executive, financial and clinical leaders as well as other key stakeholders from multiple health systems. We then will conduct pilot studies of a qualitative self-assessment process in participating health systems, and ultimately develop and test quantitative measures for assessing coproduction value creation. ETHICS AND DISSEMINATION:This study has been approved by the Dartmouth-Hitchcock Health Institutional Review Board (D-HH IRB) as a minimal risk research study. Findings and scholarship will be disseminated broadly through continuous engagement with health system stakeholders, national and international academic presentations and publications and an internet-based electronic platform for publicly accessible study information.

SUBMITTER: Oliver BJ

PROVIDER: S-EPMC7537448 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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COproduction VALUE creation in healthcare service (CO-VALUE): an international multicentre protocol to describe the application of a model of value creation for use in systems of coproduced healthcare services and to evaluate the initial feasibility, utility and acceptability of associated system-level value creation assessment approaches.

Oliver Brant J BJ Batalden Paul B PB DiMilia Peter Rocco PR Forcino Rachel C RC Foster Tina C TC Nelson Eugene C EC Garre Boel Anderson BA

BMJ open 20201005 10

<h4>Introduction</h4>Coproduction introduces a fundamental shift in how healthcare service is conceptualised. The mechanistic idea of healthcare being a 'product' generated by the healthcare system and delivered to patients is replaced by that of a service co-created by the healthcare system and the users of healthcare services. Fjeldstad <i>et al</i> offer an approach for conceptualising value creation in complex service contexts that we believe is applicable to coproduction of healthcare servi ...[more]

PMID: 33020095

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Project description:Background and aimsAccurate and user-friendly assessment tools quantifying alcohol consumption are a prerequisite to effective prevention and treatment programmes, including Screening and Brief Intervention. Digital tools offer new potential in this field. We developed the 'Animated Alcohol Assessment Tool' (AAA-Tool), a mobile app providing an interactive version of the World Health Organization's Alcohol Use Disorders Identification Test (AUDIT) that facilitates the description of individual alcohol consumption via culturally informed animation features. This pilot study evaluated the Russia-specific version of the Animated Alcohol Assessment Tool with regard to (1) its usability and acceptability in a primary healthcare setting, (2) the plausibility of its alcohol consumption assessment results and (3) the adequacy of its Russia-specific vessel and beverage selection.MethodsConvenience samples of 55 patients (47% female) and 15 healthcare practitioners (80% female) in 2 Russian primary healthcare facilities self-administered the Animated Alcohol Assessment Tool and rated their experience on the Mobile Application Rating Scale - User Version. Usage data was automatically collected during app usage, and additional feedback on regional content was elicited in semi-structured interviews.ResultsOn average, patients completed the Animated Alcohol Assessment Tool in 6:38 min (SD = 2.49, range = 3.00-17.16). User satisfaction was good, with all subscale Mobile Application Rating Scale - User Version scores averaging >3 out of 5 points. A majority of patients (53%) and practitioners (93%) would recommend the tool to 'many people' or 'everyone'. Assessed alcohol consumption was plausible, with a low number (14%) of logically impossible entries. Most patients reported the Animated Alcohol Assessment Tool to reflect all vessels (78%) and all beverages (71%) they typically used.ConclusionHigh acceptability ratings by patients and healthcare practitioners, acceptable completion time, plausible alcohol usage assessment results and perceived adequacy of region-specific content underline the Animated Alcohol Assessment Tool's potential to provide a novel approach to alcohol assessment in primary healthcare. After its validation, the Animated Alcohol Assessment Tool might contribute to reducing alcohol-related harm by facilitating Screening and Brief Intervention implementation in Russia and beyond.

Project description:OBJECTIVES:The DACAPO study as a multicentre nationwide observational healthcare research study investigates the influence of quality of care on the quality of life in patients with acute respiratory distress syndrome. The aim of this study was to investigate the acceptability to the participating research personnels by assessing attitudes, experiences and workload associated with the conduct of the DACAPO study. DESIGN, SETTING AND PARTICIPANTS:A prospective anonymous online survey was sent via email account to 169 participants in 65 study centres. The questionnaire included six different domains: (1) training for performing the study; (2) obtaining informed consent; (3) data collection; (4) data entry using the online documentation system; (5) opinion towards the study and (6) personal data. Descriptive data analysis was carried out. RESULTS:A total of 78 participants took part (46%) in the survey, 75 questionnaires (44%) could be evaluated. 51% were senior medical specialists. 95% considered the time frame of the training as appropriate and the presentation was rated by 93% as good or very good. Time effort for obtaining consent, data collection and entry was considered by 41% as a burden. Support from the coordinating study centre was rated as good or very good by more than 90% of respondents. While the DACAPO study was seen as scientifically relevant by 81%, only 45% considered the study results valuable for improving patient care significantly. CONCLUSION:Collecting feedback on the acceptability of a large multicentre healthcare research study provided important insights. Recruitment and data acquisition was mainly performed by physicians and often regarded as additional time burden in clinical practice. Reducing the amount of data collection and simplifying data entry could facilitate the conduct of healthcare research studies and could improve motivation of researchers in intensive care medicine. TRIAL REGISTRATION NUMBER:NCT02637011; Pre-results.

Project description:Port wine, the ultimate expression of the Demarcated Douro Region's (DDR's) history, cultural heritage experience, and art, was born on the slopes of the Douro river valley. One of the categories of port wine that is much appreciated by consumers is tawny port wine. This category of wine is aged in oak barrels and is characterized by oxidative aromas. Thus, the objective of the present work was to develop a tawny port wine-like fragrance, the first according to the literature. First, a group of 50 consumers in an informal environment and using two samples of tawny port wine (13 and over 40 years of aging in wood, respectively) was asked about the pleasantness of the aromas and the possible use of a tawny port wine-like fragrance. More than 80% of the group stated that they would use the fragrance as an air freshener (scent marketing in restaurants) or even in personal-use products. Then, a sensory panel of 12 participants (3 men and 9 women) was trained, and using tawny port wines of various brands and ages, the panel selected six descriptors to aromatically describe this type of wine. For the descriptors, seven aromatic chemical compounds were appointed and fragrances were developed with contributions from the panel. After several sessions with the sensory panel, three fragrances were selected, created with only three of the aromatic compounds initially used: benzaldehyde, sotolon, and vanillin. Afterward, the levels of consumer acceptability (150 individuals) for the three developed fragrances were studied and the optimization of their sensory characteristics was evaluated using a "just about right" (JAR) scale. It was found that male individuals assigned higher ratings and preferred fragrance 5.1, which was a statistically significant result (p < 0.001). Regarding age, Tukey's test showed significant differences in responses to fragrance 5.3 between young adults and middle-aged adults (p = 0.018). Young adults gave higher scores for this fragrance. Additionally, consumers considered that the intensity of the tawny port wine aroma was ideal in the three fragrances, however, the fragrance color was not very intense. The use of the three compounds (benzaldehyde, sotolon, and vanillin) seems to be enough to obtain a tawny port wine-like fragrance.

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