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1.
BMC Health Serv Res ; 22(1):563, 2022.
Article in English | PubMed | ID: covidwho-1817219

ABSTRACT

INTRODUCTION: The first wave of the COVID-19 pandemic caused stress in healthcare organizations worldwide. Hospitals and healthcare institutions had to reorganize their services to meet the demands of the crisis. In this case study, we focus on the role of simulation as part of the pandemic preparations in a large hospital in Norway. The aim of this study is to explore hospital leaders' and simulation facilitators' expectations of, and experiences of utilizing simulation-based activities in the preparations for the COVID-19 pandemic. METHODS: This is a qualitative case study utilizing semi-structured in-depth interviews with hospital leaders and simulation facilitators in one large hospital in Norway. The data were sorted under three predefined research topics and further analyzed by inductive, thematic analysis according to Braun and Clarke within these pre-defined topics. RESULTS: Eleven members of the hospital leadership and simulation facilitators were included in the study. We identified four themes explaining why COVID-19 related simulation-based activities were initiated, and perceived consequences of the activities;1) a multifaceted method like simulation fitted a multifaceted crisis, 2) a well-established culture for simulation in the hospital was crucial for scaling up simulation-based activities during the crisis, 3) potential risks were outweighed by the advantages of utilizing simulation-based activities, and finally 4) hospital leaders and simulation facilitators retrospectively assessed the use of simulation-based activities as appropriate to prepare for a pandemic crisis. CONCLUSIONS: The hospital leadership's decision to utilize simulation-based activities in preparing for the COVID-19 crisis may be explained by many factors. First, it seems that many years of experience with systematic use of simulation-based activities within the hospital can explain the trust in simulation as a valuable tool that were easy to reach. Second, both hospital leaders and simulation facilitators saw simulation as a unique tool for the optimization of the COVID-19 response due to the wide applicability of the method. According to hospital leaders and simulation facilitators, simulation-based activities revealed critical gaps in training and competence levels, treatment protocols, patient logistics, and environmental shortcomings that were acted upon, suggesting that institutional learning took place.

2.
Mental Health and Social Inclusion ; 26(2):156-166, 2022.
Article in English | ProQuest Central | ID: covidwho-1794871

ABSTRACT

Purpose>The purpose of this paper is to explore senses of powerlessness and empowerment among Romani in Ukraine in relation to such social circles as the extended family, the Romani local community and the whole Ukrainian society. The main research interest is focused on situations and factors that make people feel powerless or empowered.Design/methodology/approach>The study was conducted using a semi-structured interview method via telephone. Romani NGO experts approved the interview content. Trained Roma-facilitators were interviewers. Every interview was transcribed for further thematic analysis.Findings>The most prominent empowerment factors for Romani people are located within their families and local communities, while the bigger society (Ukrainians themselves and Ukrainian public institutions) is a main source of powerlessness. At the same time, the rigid role of family and community expectations is seen as detrimental for both males and females.Originality/value>The paper is original in terms of its topic (senses of powerlessness and empowerment among Romani in Ukraine as social determinants of mental well-being) and research strategy (engagement of Roma-facilitators as interviewers).

3.
IFIP TC 3 Open Conference on Computers in Education, OCCE 2021 ; 642 IFIP:274-285, 2022.
Article in English | Scopus | ID: covidwho-1777665

ABSTRACT

Learning to operate in technology-driven working modes is topical in many organisations today due to the COVID-19 pandemic crisis. The pandemic has forced especially knowledge-work organisations to quickly shift to remote or hybrid working modes, where all or some of the staff are operating and collaborating via digital tools. The aim of this qualitative case study is to explore and explicate a learning story of an organisation within the public sector transitioning quickly to a technology-driven hybrid working mode during the crisis. As findings, the paper presents the identified immediate and evolving facilitators that point to the organisation’s learning to develop capabilities for operating effectively in the enforced and volatile conditions. Additionally, the potential long-term organisational development effects stemming from the situation are considered. In the findings, social aspects of work, such as open communication, collaboration, and awareness gained emphasis, while digital technology is one of the ground enablers. We apply a frame of dynamic capabilities together with workplace learning and aim to provide new insights into their development processes with a cross-organisational approach. In terms of practical implications, we suggest new understandings for the management on how organisations may learn and fare under uncertainty, volatility, and transitioning to digital collaboration. © 2022, IFIP International Federation for Information Processing.

4.
Health Education ; 122(3):350-363, 2022.
Article in English | ProQuest Central | ID: covidwho-1752255

ABSTRACT

Purpose>School principals are generally seen as key facilitators for the delivery and long-term implementation of activities on school health promotion, including health literacy. However, there is little evidence on the health literacy and health status of this occupational group. The purpose of this paper is to investigate the health literacy of school principals and its association with mental health indicators.Design/methodology/approach>A cross-sectional online survey with German school principals and members of the management board (vice principals) was conducted (n = 680, 68.3% female). Demographic (gender, age) and work characteristics (type of school, professional role) as well as health literacy served as independent variables. Mental health as a dependent variable included well-being, emotional exhaustion and psychosomatic complaints. Next to uni- and bivariate analysis, a series of binary logistic regression models was performed.Findings>Of the respondents, 29.2% showed a limited health literacy with significant differences to the disadvantage of male principals. With regard to mental health, respondents aged over 60 years and those from schools for children with special educational needs were less often affected by low well-being as well as frequent emotional exhaustion and psychosomatic complaints. Taking into account demographic and work characteristics, regression models revealed significant associations between a low level of health literacy and poor mental health across all indicators.Research limitations/implications>The cross-sectional nature of this study does not allow to draw conclusions about the causal pathways between health literacy and mental health. Although the sample has been weighted, the results cannot be generalized to the whole population of school principals. There is a need for evidence-based interventions aiming at promoting health literacy and mental health tailored to the needs of school principals.Originality/value>This is the first study to investigate health literacy and its association with health indicators among school principals.

5.
Journal of Travel & Tourism Marketing ; 39(1):18-30, 2022.
Article in English | Web of Science | ID: covidwho-1747036

ABSTRACT

Despite the prominence of visiting friends and relatives (VFR) travel to show strong resilience in the face of global crises, it has been one of the most underexplored tourism contexts in the literature. This study examined travel constraints of VFR travelers during the pandemic to enrich this tourism context. Using an inductive theory approach, thematic analysis of 167 online posts and 8,403 online comments from prospective Taiwanese VFR travelers living elsewhere unveiled a framework of VFR travel constraints that included six types of travel constraints for VFR tourists who have made travel-related decisions amid COVID-19. Specifically, fourteen travel constraints were identified and situated within a three (individual - family - community) x two (tourist generating country - tourist receiving country) framework to understand their causes and natures. Theoretically, this study served as a pioneering attempt to link the concept of travel constraints with VFR tourism and enriched our understanding of VFR travelers' related decision making. Practically, destination management organizations and tourism businesses should find the study findings insightful because they demonstrate ways of promoting VFR travel to foster tourism rejuvenation in the post-pandemic. Limitations and future research directions were discussed at the end of this study.

6.
Family Court Review ; n/a(n/a), 2022.
Article in English | Wiley | ID: covidwho-1741379

ABSTRACT

Family courts are increasingly interested in online parenting programs for divorcing and separating parents, particularly during the COVID-19 pandemic. To our knowledge, no previous study has evaluated the barriers to and facilitators of parent participation in these programs for family law cases. We interviewed 61 parents in the midst of family law cases regarding their perspectives. While many parents viewed online parent programs positively (e.g., convenient), they also reported barriers to participation (e.g., technology problems). We offer recommendations (e.g., communication about program benefits) to support courts as they decide whether to continue ordering online parent programs following the pandemic.

7.
Int J Environ Res Public Health ; 19(5)2022 03 01.
Article in English | MEDLINE | ID: covidwho-1736911

ABSTRACT

While young Saudi adults are reportedly prone to experiencing a variety of mental health problems, they tend to delay seeking mental health support. Therefore, this study aimed to explore the barriers and facilitators of seeking mental health support among young adults in Saudi Arabia. A qualitative research design was implemented using semi-structured interviews with 12 young adult participants in Saudi Arabia, recruited through social media platforms, and the interviews were then analyzed using thematic analysis. Two major themes emerged: barriers that impede the process of mental health help-seeking and facilitators that assist individuals in seeking mental health support. The barriers included public stigma and lack of awareness, unprofessional mental health practitioners, lack of accessibility to services and information, unsupportive families, intrapersonal dilemmas, and misconceptions based on religious beliefs. Facilitators of help-seeking included increasing societal and family awareness, promoting the accessibility of services, enhancing sources of external support, personal motivation to change, and online therapy. The findings of this study emphasize the importance of promoting mental health literacy among the Saudi public, particularly with regard to young adults and their unique mental health needs. Exploring facilitators and barriers may also assist mental health providers in developing tailored mental health campaigns and interventions directed at young adults.


Subject(s)
Mental Disorders , Mental Health Services , Humans , Mental Disorders/therapy , Mental Health , Patient Acceptance of Health Care/psychology , Qualitative Research , Saudi Arabia , Social Stigma , Young Adult
8.
Int J Public Health ; 67: 1604221, 2022.
Article in English | MEDLINE | ID: covidwho-1731880

ABSTRACT

Objectives: Acceptance and high uptake of COVID-19 vaccines continues to be critical for controlling the COVID-19 pandemic. This narrative review aimed to summarise findings on factors influencing acceptance of COVID-19 vaccines in the period leading up to the approval and rollout. Methods: We conducted a narrative review of literature published in 2020 on factors influencing acceptance of hypothetical COVID-19 vaccines in adults in high income countries with well-established health systems. Results: Facilitators of acceptance included confidence in vaccine safety and effectiveness, high COVID-19 disease risk perception and trust in health authorities and other vaccine stakeholders, including government. Barriers included safety and effectiveness concerns, perceived scientific uncertainty, low disease risk perception, and low trust in authorities and other stakeholders. Conclusion: Evidence on facilitators and barriers to COVID-19 vaccine acceptance, at a time prior to vaccine rollout, can help health authorities address hesitancy and may inform approaches to support acceptance of novel pandemic vaccines in the future. Future research should include in-depth qualitative research to gather more nuanced evidence.


Subject(s)
COVID-19 , Vaccines , Adult , COVID-19/prevention & control , COVID-19 Vaccines/therapeutic use , Developed Countries , Humans , Pandemics , SARS-CoV-2 , Vaccination
9.
Journal of Hospitality, Leisure, Sports and Tourism Education ; 29, 2021.
Article in English | ProQuest Central | ID: covidwho-1720338

ABSTRACT

Previous studies on education travel, which is defined as a form of experiential learning for pursuing learning experiences related to the destination (Bodger, 1998), focus on the historical background and some outcomes which has resulted in fragmented knowledge. This study provides a relatively comprehensive analysis of the antecedents and outcomes of educational travel in higher education adopting various data collection approaches including in-depth interviews, focus groups, and participant observation.Using Macao as a case study, the results address (1) the roles and functions;(2) educational and socio-cultural impacts and (3) facilitators and barriers of educational travel in higher education.

10.
Clin Obes ; : e12512, 2022 Feb 22.
Article in English | MEDLINE | ID: covidwho-1700400

ABSTRACT

COVID-19 has been associated with worse outcomes in people living with obesity and has altered how people can engage with weight management. However, the impact of risk perceptions and changes to daily life on weight loss has not been explored. This study aimed to examine how COVID-19 and perception of risk interacted with weight loss attempts in adults participating in a behavioural weight management programme. Forty-eight participants completed a semi-structured interview exploring the impact of COVID-19 on their weight management experience. Interviews were completed via telephone and analysed using a thematic approach. Reaction to perceived risk varied, but most participants reported the knowledge of increased risk promoted anxiety and avoidance behaviours. Despite this, many reported it as a motivating factor for weight loss. Restrictions both helped (e.g., reduced temptation) and hindered their weight loss (e.g., less support). However, there was consensus that the changes to everyday life meant participants had more time to engage with and take control of their weight loss. To the authors' knowledge, this is the first study to explore the impact of COVID-19 on participation in a weight management programme started during the pandemic in the United Kingdom. Restrictions had varying impacts on participant's weight loss. How risk is perceived and reported to participants is an important factor influencing engagement with weight management. The framing of health information needs to be considered carefully to encourage engagement with weight management to mitigate risk. Additionally, the impact of restrictions and personal well-being are key considerations for weight management programmes.

11.
J Migr Health ; 5: 100086, 2022.
Article in English | MEDLINE | ID: covidwho-1693233

ABSTRACT

Background: There are widespread concerns that ethnic minorities and migrants may have inadequate access to COVID-19 vaccines. . Improving vaccine uptake among these vulnerable groups is important towards controlling the spread of COVID-19 and reducing unnecessary mortality. Here we perform a systematic review of ethnic minorities' and migrants' access to and acceptance of COVID-19 vaccines. Methods: We searched PubMed and Web of Science databases for papers published between 1 January 2020 and 7 October 2021. Studies were included if they were peer-reviewed articles; written in English, included data or estimates of ethnic minorities' or migrants' access to vaccines; and employed either qualitative or quantitative methods. Of a total of 248 studies screened, 33 met these criteria and included in the final sample. Risk of bias in the included studies was assessed using Newcastle Ottawa Scale and Critical Appraisal Skills Program tools. We conducted a Synthesis Without Meta-analysis for quantitative studies and a Framework synthesis for qualitative studies. Results: 31 of the included studies were conducted in high-income countries, including in the US (n = 17 studies), UK (n = 10), Qatar (n = 2), Israel (n = 1) and France (n = 1). One study was in an upper middle-income country -China (n = 1) and another covered multiple countries (n = 1). 26 studies reported outcomes for ethnic minorities while 9 studies reported on migrants. Most of the studies were quantitative -cross sectional studies (n = 24) and ecological (n = 4). The remaining were qualitative (n = 4) and mixed methods (n = 1). There was consistent evidence of elevated levels of COVID-19 vaccine hesitancy among Black/Afro-Caribbean groups in the US and UK, while studies of Hispanic/Latino populations in the US and Asian populations in the UK provided mixed pictures, with levels higher, lower, or the same as their White counterparts. Asians in the US had the highest COVID-19 vaccine acceptance compared to other ethnic groups. There was higher vaccine acceptance among migrant groups in Qatar and China than in the general population. However, migrants to the UK experienced barriers to vaccine access, mainly attributed to language and communication issues. Lack of confidence, mainly due to mistrust of government and health systems coupled with poor communication were the main barriers to uptake among Black ethnic minorities and migrants. Conclusions: Our study found that low confidence in COVID-19 vaccines among Black ethnic minorities driven by mistrust and safety concerns led to high vaccine hesitancy in this group. Such vaccine hesitancy rates constitute a major barrier to COVID-19 vaccine uptake among this ethnic minority. For migrants, convenience factors such as language barriers, fear of deportation and reduced physical access reduced access to COVID-19 vaccines. Building trust, reducing physical barriers and improving communication and transparency about vaccine development through healthcare workers, religious and community leaders can improve access and facilitate uptake of COVID-19 vaccines among ethnic minority and migrant communities.

12.
S Afr J Commun Disord ; 69(1): e1-e12, 2022 Jan 31.
Article in English | MEDLINE | ID: covidwho-1662742

ABSTRACT

BACKGROUND: There is slow progress in early hearing detection and intervention (EHDI) services within South Africa. Audiologists are EHDI gatekeepers and can provide valuable insights into the barriers and facilitators that can progressively move EHDI towards best practice in South Africa. OBJECTIVES: The study aimed to determine the barriers and facilitators to EHDI in KwaZulu-Natal as reported by audiologists/speech therapists and audiologists (A/STAs). METHOD: A descriptive qualitative approach was used. Telephonic interviews were conducted with 12 A/STAs working in public and private healthcare facilities, using the strengths, weaknesses, opportunities, threats (SWOT) conceptual framework. Data was analysed using thematic analysis in conjunction with NVivo software. RESULTS: One of the main barriers perceived by A/STAs, affecting EHDI was the lack of resources in healthcare facilities. The participants indicated that although there was a guideline in place to guide practice, it may be more suited to an urban area versus a rural area. Poor knowledge and awareness of EHDI was also identified as a barrier. Information provided from A/STAs at grassroots level, in the various provinces, may benefit in developing a more contextually relevant and practical guideline. Facilitators included; development of task teams specifically for EHDI programmes, creation of improved communication networks for collaboration and communication, training of healthcare professionals and improving data management systems. CONCLUSION: Strategies such as an increase in resources, further education and training, development of contextually relevant, culturally, and linguistically diverse practices and protocols need to be in place to improve EHDI implementation. Further research, clinical implications and limitations are provided emanating from the study.


Subject(s)
Hearing Tests , Hearing , Audiologists , Early Diagnosis , Humans , Qualitative Research , South Africa
13.
J Telemed Telecare ; : 1357633X211070725, 2022 Jan 24.
Article in English | MEDLINE | ID: covidwho-1648418

ABSTRACT

BACKGROUND: With the rapid increase in telehealth use during the COVID-19 pandemic, concerns have been raised about the potential for exacerbating existing healthcare disparities in marginalized populations. While eliminating barriers such as transportation and time constraints, telehealth may introduce barriers related to technology access. With little known about the patient experience accessing telehealth during the COVID-19 pandemic, this study seeks to understand the barriers and facilitators to telehealth use as well as interventions that may address them. METHODS: We conducted qualitative interviews with parents of pediatric patients of a primary care clinic in a diverse community during the study period of March-May 2021. The interviews explored barriers and facilitators to telehealth during the COVID-19 pandemic. Interviews were balanced across language (Spanish and English) as well as across visit type (in-person vs. telehealth). Recruitment, collection of demographic information, and interviews were conducted by telephone. The conversations were recorded and transcribed. Once thematic saturation was achieved, the data were analyzed using a modified grounded theory approach. RESULTS: Of the 33 participants, 17 (52%) spoke English and 16 (48%) spoke Spanish. A total of 17 (52%) had experienced a telehealth encounter as their first visit during the study period while 16 (48%) had an in-person visit. Five themes were identified: (1) a recognition of differences in technological knowledge and access, (2) situational preferences for telehealth versus in-person visits, (3) avoidance of COVID-19 exposure, (4) convenience, and (5) change over time. English-speaking patients expressed greater ease with and a preference for telehealth, while Spanish-speaking participants expressed more technological difficulty with telehealth and a preference for in-person visits. Suggested interventions included informational tutorials such as videos before the visit, technical support, and providing families with technological devices. CONCLUSION: In this study, we examined patient and family perspectives on pediatric telehealth during the COVID-19 pandemic. Implementation of the suggested interventions to address barriers to telehealth use is essential to prevent further exacerbation of health disparities already experienced by marginalized populations.

14.
Information ; 13(1):30, 2022.
Article in English | ProQuest Central | ID: covidwho-1637320

ABSTRACT

The banking sector has been considered as one of the primary adopters of Information and Communications Technologies. Especially during the last years, they have invested a lot into the digital transformation of their business process. Concerning their retail customers, banks realized very early the great potential abilities to provide value added self-services functions via mobile devices, mainly smartphones to them;thus, they have invested a lot into m-banking apps’ functionality. Furthermore, the COVID-19 pandemic has brought out different ways for financial transactions and even more mobile users have taken advantage of m-banking app services. Thus, the purpose of this empirical paper is to investigate the determinants that impact individuals on adopting or not m-banking apps. Specifically, it examines two groups of individuals, users (adopters) and non-users (non-adopters) of m-banking apps, and aims to reveal if there are differences and similarities between the factors that impact them on adopting or not this type of m-banking services. To our knowledge, this is the second scientific attempt where these two groups of individuals have been compared on this topic. The paper proposes a comprehensive conceptual model by extending Venkatech’s et al. (2003) Unified Theory of Acceptance and Use of Technology (UTAUT) with ICT facilitators (i.e., reward and security) and ICT inhibitors (i.e., risk and anxiety), as well as the recommendation factor. However, this study intends to fill the research gap by investigating and proving for the first time the impact of social influence, reward and anxiety factors on behavioral intention, the relationship between risk and anxiety and the impact of behavioral intention on recommendation via the application of Confirmatory Factor Analysis and Structural Equation Modeling (SEM) statistical techniques. The results reveal a number of differences regarding the factors that impact or not these two groups towards m-banking app adoption;thus, it provides new insights regarding m-banking app adoption in a slightly examined scientific field. Thus, the study intends to assist the banking sector in better understanding their customers with the aim to formulate and apply customized m-business strategies and increase not only the adoption of m-banking apps but also the level of their further use.

15.
International Journal of Emotional Education ; 13(2):23-39, 2021.
Article in English | ProQuest Central | ID: covidwho-1628300

ABSTRACT

This article reports the findings of a pre-pandemic national survey of English primary schools (n=621) examining how Social and Emotional Learning (SEL) is prioritised and practiced in school. Perceived benefits and prioritisation of SEL, barriers and facilitators in supporting implementation, and the nature and extent to which whole school approaches, classroom interventions and/or individual teaching practices are present, are discussed. Responses showed consistency in respect to some established findings in the field, namely concerns of time in respect to implementation, however some novel findings emerged, including satisfaction with programmes and training approaches, and a higher prevalence of SEL practice than previously reported. Findings are discussed in relation to an increasing nuance in understanding SEL provision within schools. The study contributes to limited research regarding typical practices, especially outside of funded trials, and in doing so provides useful and relevant information for educational professionals responsible for the implementation of SEL post-pandemic.

16.
African Perspectives of Research in Teaching and Learning ; 5:147-157, 2021.
Article in English | ProQuest Central | ID: covidwho-1628206

ABSTRACT

As curriculum designers and facilitators of doctoral education pedagogy at one South African higher education institution, we critically reflect on the transitioning of a traditional face-toface supervisor-led PhD community of practice (communal research supervision) to a fully online 'model', a reimagining brought on by the vicissitudes of the COVID-19 pandemic. This reflection responds to the erroneous tendency to critique online pedagogies in preference for inperson contact deliveries. The article suggests that establishing unique communities of practice are required for sustaining the new modes of delivery to counteract nostalgia for past operations. A forthcoming online engagement is likely to be characteristic of all higher education institutions irrespective of their former dominant methods of pedagogy. We invoke key social practice constructs, namely 'domain', 'community' and 'practice' (Wenger, 1999;Wenger, McDermott & Snyder, 2002) as theoretical heuristics in our contemplation of sustaining community vibrance and continuity. We consider the tensions that present as they relate to, firstly, developing a continually (re)negotiated joint enterprise, secondly, enabling mutual engagement, and thirdly, facilitating a shared repertoire of the community's resources in an evolving, technologically mediated mode of operation. We argue that the key enterprise of this community, namely affordances of participation (research supervision and research learning) by both core and peripheral members of the community are likely to continue to accrue in the online space, despite challenges presented by video-conferencing technologies. We contend that given the strength of its leadership, the community as a social space of academic interaction/engagement can mutate into productive new assemblages. Shared communal resources are important for anchoring the community in COVID-19 era and beyond.

17.
Journal of Workplace Learning ; 34(1):58-73, 2022.
Article in English | ProQuest Central | ID: covidwho-1608505

ABSTRACT

PurposeThe purpose of this paper is to explore managers’ learning-oriented leadership, and what conditions managers face when working with the promotion of employees’ learning.Design/methodology/approachData was collected through semi-structured interviews with managers in three manufacturing firms. Verbatim expressions of the interview participants were analysed using stepwise analytical procedures.FindingsThe managers used many kinds of activities to promote learning. Most common were activities related to learning opportunities that arose during daily work. The identified activities ranged from being planned to occurring more spontaneously. Depending on the situation or the learning activity, the managers used different behaviours to promote learning. They supported, educated and confronted employees, and they acted as role models. Factors constraining the implementation of learning-oriented leadership included limited resources, and a lack of commitment from top management, employees or the managers themselves.Research limitations/implicationsFuture research should study learning-oriented leadership from the employees’ perspective.Practical implicationsManagers’ notions about learning and development constitute an important condition for learning-oriented leadership. Therefore, managers need to be trained in how to promote their employees’ learning at work.Originality/valueThis study adds to the limited knowledge of how managers carry out a learning-oriented leadership in their daily work. The findings contribute knowledge regarding managerial practices of promoting employees’ workplace learning by identifying different activities and behaviours that managers could incorporate into their leadership.

18.
BMC Med Inform Decis Mak ; 21(1): 362, 2021 12 26.
Article in English | MEDLINE | ID: covidwho-1577221

ABSTRACT

BACKGROUND: Electronic medical records systems (EMRs) adoption in healthcare to facilitate work processes have become common in many countries. Although EMRs are associated with quality patient care, patient safety, and cost reduction, their adoption rates are comparatively low. Understanding factors associated with the use of the implemented EMRs are critical for advancing successful implementations and scale-up sustainable initiatives. The aim of this study was to explore end users' perceptions and experiences on factors facilitating and hindering EMRs use in healthcare facilities in Kenya, a low- and middle-income country. METHODS: Two focus group discussions were conducted with EMRs users (n = 20) each representing a healthcare facility determined by the performance of the EMRs implementation. Content analysis was performed on the transcribed data and relevant themes derived. RESULTS: Six thematic categories for both facilitators and barriers emerged, and these related to (1) system functionalities; (2) training; (3) technical support; (4) human factors; (5) infrastructure, and (6) EMRs operation mode. The identified facilitators included: easiness of use and learning of the system complemented by EMRs upgrades, efficiency of EMRs in patient data management, responsive information technology (IT) and collegial support, and user training. The identified barriers included: frequent power blackouts, inadequate computers, retrospective data entry EMRs operation mode, lack of continuous training on system upgrades, and delayed IT support. CONCLUSIONS: Users generally believed that the EMRs improved the work process, with multiple factors identified as facilitators and barriers to their use. Most users perceived system functionalities and training as motivators to EMRs use, while infrastructural issues posed as the greatest barrier. No specific EMRs use facilitators and/or barriers could be attributed to facility performance levels. Continuous evaluations are necessary to assess improvements of the identified factors as well as determine emerging issues.


Subject(s)
Delivery of Health Care , Electronic Health Records , Focus Groups , Humans , Kenya , Perception , Retrospective Studies
19.
J Cyst Fibros ; 20 Suppl 3: 23-28, 2021 12.
Article in English | MEDLINE | ID: covidwho-1587339

ABSTRACT

BACKGROUND: The COVID-19 pandemic forced cystic fibrosis (CF) care programs to rapidly shift from in-person care delivery to telehealth. Our objective was to provide a qualitative exploration of facilitators and barriers to: 1) implementing high-quality telehealth and 2) navigating reimbursement for telehealth services. METHODS: We used data from the 2020 State of Care CF Program Survey (n=286 U.S. care programs) administered in August-September to identify two cohorts of programs, with variation in telehealth quality (n=12 programs) and reimbursement (n=8 programs). We conducted focus groups and semi-structured interviews with CF program directors and coordinators in December 2020, approximately 9 months from onset of the pandemic. We used the Consolidated Framework for Implementation Research to identify facilitators and barriers of implementation, and inductive thematic analysis to identify facilitators and barriers of reimbursement. RESULTS: Factors differentiating programs with greater and lower perceived telehealth quality included telehealth characteristics (perceived advantage over in-person care, cost, platform quality); external influences (needs and resources of those served by the CF program), characteristics of the CF program (compatibility with workflows, relative priority, available resources); characteristics of team members (individual stage of change), and processes for implementation (engaging patients and teams). Reimbursement barriers included documentation to optimize billing; reimbursement of multi-disciplinary team members, remote monitoring, and telephone-only telehealth; and lower volume of patients. CONCLUSIONS: A number of factors are associated with successful implementation and reimbursement of telehealth. Future efforts should provide guidance and incentives that support telehealth delivery and infrastructure, share best practices across CF programs, and remove barriers.


Subject(s)
COVID-19 , Communication Barriers , Cystic Fibrosis , Disease Transmission, Infectious/prevention & control , Health Services Accessibility , Patient Participation , Telemedicine , Adult , Attitude of Health Personnel , COVID-19/epidemiology , COVID-19/prevention & control , Child , Cystic Fibrosis/epidemiology , Cystic Fibrosis/psychology , Cystic Fibrosis/therapy , Health Services Accessibility/organization & administration , Health Services Accessibility/trends , Humans , Needs Assessment , Patient Participation/methods , Patient Participation/psychology , Qualitative Research , Quality Improvement , Reimbursement Mechanisms , SARS-CoV-2 , Telemedicine/economics , Telemedicine/methods , Telemedicine/standards , United States/epidemiology
20.
J Health Organ Manag ; ahead-of-print(ahead-of-print)2021 Dec 16.
Article in English | MEDLINE | ID: covidwho-1583853

ABSTRACT

PURPOSE: This study aimed to identify the barriers and facilitators related to the implementation of radical innovations in secondary healthcare. DESIGN/METHODOLOGY/APPROACH: A systematic review was conducted and presented in accordance with a PRISMA flowchart. The databases PubMed and Web of Science were searched for original publications in English between the 1st of January 2010 and 6th of November 2020. The level of radicalness was determined based on five characteristics of radical innovations. The level of evidence was classified according to the level of evidence scale of the University of Oxford. The Consolidated Framework for Implementation Research was used as a framework to classify the barriers and facilitators. FINDINGS: Based on the inclusion and exclusion criteria, nine publications were included, concerning six technological, two organizational and one treatment innovation. The main barriers for radical innovation implementation in secondary healthcare were lack of human, material and financial resources, and lack of integration and organizational readiness. The main facilitators included a supportive culture, sufficient training, education and knowledge, and recognition of the expected added value. ORIGINALITY/VALUE: To our knowledge, this is the first systematic review examining the barriers and facilitators of radical innovation implementation in secondary healthcare. To ease radical innovation implementation, alternative performance systems may be helpful, including the following prerequisites: (1) Money, (2) Added value, (3) Timely knowledge and integration, (4) Culture, and (5) Human resources (MATCH). This study highlights the need for more high-level evidence studies in this area.


Subject(s)
Delivery of Health Care , Humans
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