Analytics Team Research Articles

Health data governance for research use in Alberta.

Alberta has rich clinical and health services data held under the custodianship of Alberta Health and Alberta Health Services (AHS), which is not only used for clinical and administrative purposes but also disease surveillance and epidemiological research. Alberta is the largest province in Canada with a single payer centralised health system, AHS, and a consolidated data and analytics team supporting researchers across the province. This paper describes Alberta's data custodians, data governance mechanisms, and streamlined processes followed for research data access. AHS has created a centralised data repository from multiple sources, including practitioner claims data, hospital discharge data, and medications dispensed, available for research use through the provincial Data and Research Services (DRS) team. The DRS team is integrated within AHS to support researchers across the province with their data extraction and linkage requests. Furthermore, streamlined processes have been established, including: 1) ethics approval from a research ethics board, 2) any necessary operational approvals from AHS, and 3) a tripartite legal agreement dictating terms and conditions for data use, disclosure, and retention. This allows researchers to gain timely access to data. To meet the evolving and ever-expanding big-data needs, the University of Calgary, in partnership with AHS, has built high-performance computing (HPC) infrastructure to facilitate storage and processing of large datasets. When releasing data to researchers, the analytics team ensures that Alberta's Health Information Act's guiding principles are followed. The principal investigator also ensures data retention and disposition are according to the plan specified in ethics and per the terms set out by funding agencies. Even though there are disparities and variations in the data protection laws across the different provinces in Canada, the streamlined processes for research data access in Alberta are highly efficient.

Adherence to care and treatment review policy and impact on length of stay

PurposeThe purpose of this clinical audit was to review the adherence to the 2017 care and treatment review policy across two NHS assessment and treatment units. Care and treatment reviews should be offered to people with an intellectual disability and/or autism who are at risk of admission into a mental health hospital.Design/methodology/approachAdmission and discharge data was collected across two assessment and treatment units between January 2019 and December 2022. Adherence to the care and treatment review policy was also reviewed as was length of inpatient stay. A retrospective evaluation was conducted. Triangulation of data was collected via the trusts’ electronic patient record system and NHS analytics team. Descriptive statistics, Mann–Whitney U test and a one-way ANOVA with post hoc tests were used in the analysis.FindingsAn increase in behaviours of challenge and deterioration of mental health were the main reasons for admission. Forty-nine percent (30) of those admitted to the assessment and treatment units accessed a care and treatment review. Care and treatment reviews were more frequently provided for individuals experiencing longer inpatient stays.Originality/valueThere is limited evidence relating to outcomes and impact of care and treatment reviews. Further research is required to explore effectiveness of care and treatment reviews to understand benefits and appropriately prioritise resource.

Performance and Organizational Characteristics of Analytics Teams in Healthcare and Population Health: Methods and Preliminary Observations

ABSTRACTExisting models of the work of analytics teams and how they impact health organizations do not describe the activities, nor their relationship to the organization, in sufficient detail for optimal decision making. This poster reports on an ongoing study of the work of healthcare and population health analytics teams to rectify this gap. We are interviewing members of analytics teams in healthcare and population health organizations to gather data on the processes, deliverables, downstream and upstream stakeholders, and artifacts that the teams rely on to conduct and manage their work. The primary analysis uses a grounded theory approach, with a secondary activity theory analysis of relationships between the analytics team, identified cognitive artifacts, and intended outcomes. In this poster, we intend to present the methods, participants, and some preliminary observations. We hope that this presentation will solicit feedback that leads to improvements in the study.

Improving Sexual Orientation and Gender Identity Documentation at an NCI-Designated Comprehensive Cancer Center

To increase the rate of sexual orientation and gender identity (SOGI) patient data collection in healthcare software for new patients at a NCI-Designated Comprehensive Cancer Center, via targeted identification of Advanced Practice Providers (APP), development of novel SOGI collection workflows, creation of a real-time SOGI data dashboard, and tailored training utilizing existing High Reliability Organization (HRO) huddles in order to measure, analyze, and improve the quality of care, safety, and patient experiences for Sexual and Gender Minority (SGM) patients. Prior to interventions, project leadership (PL) and data analytics staff obtained SOGI baseline data, while cancer center clinical leadership, registration, and administrative staff identified APPs as the most appropriate staff to collect patient SOGI data. Intervention 1: PL met with Disease Management Groups (DMG)/HRO leads of thoracic medical oncology to identify a practice-level APP champion. PL and the APP champion scripted language for multiple scenarios when asking SOGI questions, and served as a resource for additional practice APPs. PL provided SGM-focused training during HRO huddles, which included how to ask and document SOGI, and significance of asking SOGI information. SOGI data completion rate was tracked on a HRO scorecard. This intervention was replicated across additional DMG/HROs during the study period. Intervention 2: Breast surgical oncology completed Intervention 1 and added SOGI questions to their new patient-facing intake form, allowing patients to self-identify. PL and data analytics team provided continuous feedback to DMG/HRO leads on provider-level completion rates and additional education as needed. At the end of the Interventions, there were 9 LGBTQ+ Knowledge and Awareness HRO training sessions completed resulting in over 300 unique individuals receiving advanced SOGI documentation education. For intervention 1, there were 12,322 new patients asked their SOGI information, which was a greater than 300% increase in SOGI documentation (baseline completion rate for sexual orientation and gender identity was 17% and 21%, respectively, which improved to 77% and 84%). For intervention 2, there were 3,217 new patients asked their SOGI information, which was a greater than 400% increase (baseline completion rate for sexual orientation and gender identity was 13% and 16%, respectively, which improved to 81% and 81%). Together, patient self-reporting quickly increased data completion rates from baseline, comparable to clinical sites from Intervention 1, and may decrease the burden of APPs collecting SOGI history; however, clinical review of questions is important and may further increase SOGI data completion. Leadership buy-in, site champions, and active data monitoring are essential to measurable change. Together, improved SOGI data completion will allow for improved equitable cancer care and increased assessment of SGM cancer disparities.

Learning from national implementation of the Veterans Affairs Clinical Resource Hub (CRH) program for improving access to care: protocol for a six year evaluation

BackgroundThe Veterans Affairs (VA) Clinical Resource Hub (CRH) program aims to improve patient access to care by implementing time-limited, regionally based primary or mental health staffing support to cover local staffing vacancies. VA’s Office of Primary Care (OPC) designed CRH to support more than 1000 geographically disparate VA outpatient sites, many of which are in rural areas, by providing virtual contingency clinical staffing for sites experiencing primary care and mental health staffing deficits. The subsequently funded CRH evaluation, carried out by the VA Primary Care Analytics Team (PCAT), partnered with CRH program leaders and evaluation stakeholders to develop a protocol for a six-year CRH evaluation.The objectives for developing the CRH evaluation protocol were to prospectively: 1) identify the outcomes CRH aimed to achieve, and the key program elements designed to achieve them; 2) specify evaluation designs and data collection approaches for assessing CRH progress and success; and 3) guide the activities of five geographically dispersed evaluation teams.MethodsThe protocol documents a multi-method CRH program evaluation design with qualitative and quantitative elements. The evaluation’s overall goal is to assess CRH’s return on investment to the VA and Veterans at six years through synthesis of findings on program effectiveness. The evaluation includes both observational and quasi-experimental elements reflecting impacts at the national, regional, outpatient site, and patient levels. The protocol is based on program evaluation theory, implementation science frameworks, literature on contingency staffing, and iterative review and revision by both research and clinical operations partners.DiscussionHealth systems increasingly seek to use data to guide management and decision-making for newly implemented clinical programs and policies. Approaches for planning evaluations to accomplish this goal, however, are not well-established. By publishing the protocol, we aim to increase the validity and usefulness of subsequent evaluation findings. We also aim to provide an example of a program evaluation protocol developed within a learning health systems partnership.

The data-driven leader: developing a big data analytics leadership competency framework

PurposeThis study focuses on leadership in organizations where big data analytics (BDA) is an essential component of corporate strategy. While leadership researchers have conducted promising studies in the field of digital transformation, the impact of BDA on leadership is still unexplored.Design/methodology/approachThis study is based on semi-structured interviews with 33 organizational leaders and subject-matter experts from various industries. Using a grounded theory approach, a framework is provided for the emergent field of BDA in leadership research.FindingsThe authors present a conceptual model comprising foundational competencies and higher order roles that are data analytical skills, data self-efficacy, problem spotter, influencer, knowledge facilitator, visionary and team leader.Research limitations/implicationsThis study focuses on BDA competency research emerging as an intersection between leadership research and information systems research. The authors encourage a longitudinal study to validate the findings.Practical implicationsThe authors provide a competency framework for organizational leaders. It serves as a guideline for leaders to best support the BDA initiatives of the organization. The competency framework can support recruiting, selection and leader promotion.Originality/valueThis study provides a novel BDA leadership competency framework with a unique combination of competencies and higher order roles.

Young women's dialectical responses to fitspiration and thinspiration: A qualitative study

With the popularity of image-based social media platforms like Instagram, researchers have begun to study relationships between social media and body image. Much of this research has used quantitative research methods, which cannot capture the rich, inner experiences of individuals. Given the dearth of qualitative research on what young women internally experience when viewing “Thinspiration” or “Fitspiration,” this study used the consensual qualitative research (CQR) method, with the aim of capturing in their own words what young women feel and think in response to viewing fitspiration and thinspiration. Twelve young women viewed Fitspiration and Thinspiration profiles and were interviewed about these and similar everyday experiences. The CQR analytic team identified 10 general, 18 typical, and 11 variant domains (i.e., topic areas). An example general domain was “body image,” under which the category “body dissatisfaction,” fell; by viewing Thinspiration or Fitspiration, these young women were reminded how they are dissatisfied with how they see their own body or were prompted to believe others are reminded of this when viewing such content. An example typical domain was “diet/disordered eating”; several participants associated Thinspiration or Fitspiration with diet or disordered eating. From five of the 10 general domains emerged what we call an emergent dialectical theory of social media and body image. When viewing Thinspiration or Fitspiration, young women often seemed to feel or think two seemingly opposite things simultaneously within the topic areas of attainability, emotional reactions, social comparison, body image, and health.

Practice integration profile revised: Improving item readability and completion.

The Practice Integration Profile (PIP) is a reliable, valid, and broadly used measure of the integration of behavioral health (BH) into primary care. The PIP assesses operational and procedural elements that are grounded in the AHRQ Lexicon for Behavioral Health and Primary Care Integration. Prior analyses of PIP data and feedback from users suggested the measure was in need of revisions. This article describes the process used to improve readability, clarity, and pragmatic utility of the instrument. Two rounds of structured cognitive interviews were conducted with clinicians in primary care settings. After each round, interview transcripts were coded by an analytic team using an iterative and consensus-driven process. Themes were identified based on codes. Themes and recommendations for revisions were reviewed and modified by committee. Based on feedback and a prior factor analysis of the PIP, revisions were undertaken to: (a) eliminate redundant or overlapping items; (b) clarify the meaning of items; (c) standardize the response categories, and (d) place items in the most appropriate domains. The resulting measure has 28 items in five domains. PIP 2.0 will need further examination to confirm its continuing use as a foundational tool for evaluating integrated care. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Development of a multiphase patient-reported outcomes dashboard to support population health and drive quality improvement in ambulatory oncology.

e18864 Background: The Patient Reported Data (PRD) Program at Dana-Farber Cancer Institute (DFCI) has implemented a portfolio of electronic questionnaires including patient-reported outcome measures (PROMs) and risk screeners in routine practice. Over 141,906 questionnaires have been completed by over 60,158 patients across solid tumor, liquid tumor, and supportive care (see table). We are now prepared to share this data internally in an accessible and actionable format via the development of an Outcomes Dashboard. Methods: PRD and the DFCI Clinical Operations & Business Analytics team created a roadmap for iterative dashboards to be developed with Tableau 2022.1, a business analytics platform. The development team included a business analyst, data scientist, and content experts. The goal of our roadmap was to balance rapid delivery of data with the resources needed to develop more complex dashboards incorporating PRD with other data. The Outcomes Dashboard roadmap consists of four phases. Phase 1 focuses on creating a core dashboard and displaying aggregate PROMs-derived scores and risk scores with filters and stratification by patient demographics and clinical encounter data. Phase 2 adds clinical outcomes data including hospitalizations and treatment adherence. Phase 3 adds non-scored questionnaire data such as social determinants of health. Phase 4 incorporates oncology treatment data including treatment route, goals, class, and other characteristics. Results: Data was generated using Microsoft SQL Server Management Studio and loaded into Tableau to create visualizations with data refreshed daily. Dashboard Phase 1 is complete and will be released in spring 2023. Dashboard users will include executive leaders, operations, clinicians, and others. The dashboard will be used to identify differences and disparities in care delivery and outcomes by disease type, treatment, and other characteristics; highlight opportunities for interventions to improve quality and care delivery; identify areas for future research; and help fulfill emerging regulatory requirements. Conclusions: By making aggregate PRD and associated outcomes available in an accessible format, we aim to drive quality improvement and enable population health management. Future efforts will include educating users, assessing uptake of the dashboard, and partnering with stakeholders to develop clinical interventions to improve outcomes. [Table: see text]

Comparison of Public Health IT Reporting Capabilities Between a Large Network Hospital and Small Independent Hospital During Disaster Response

Introduction:Management of outbreaks rely on hospitals’ health information technology (IT) to electronically share data to public health systems. Studies show that half of non-federal hospitals reported a lack of capacity to exchange information with public health agencies, placing a variable burden on institutions to meet the government mandated reporting requirements. This study aims to contrast the impact of COVID-19 reporting requirements across two New York City institutions with disparate health IT capabilities.Method:A retrospective, qualitative study contrasting the impact of reporting requirements on a small independent hospital (SIH) with 198 staffed beds and a large, networked hospital (LNH) with eleven campuses during the COVID-19 pandemic. Researchers conducted 51 interviews with hospital leadership, clinical directors, and infection control personnel. Interviews were transcribed and coded using qualitative analysis software.Results:The LNH had a 50-person analytic team that handled reporting tasks, a centralized data warehouse that was automatically updated, electronically generated reports with universal access, and limited burden of clinical staff. The SIH had no dedicated analytic team. Seventeen departments were utilized to handle reporting tasks with no centralized place to share electronic data, limited capacity to create automatically updated reports, a daily manual information gathering processes, and significant need of clinical staff to collect data. Both SIH and LNH faced challenges associated with the distribution of responsibilities and resources with pressure to report in a timely fashion. However, the burden on the SIH was so onerous that it significantly impeded routine hospital work and patient care.Conclusion:The disparity in health IT capabilities highlights significant institutional inequities and variability in response during a pandemic. The findings have implications for how government and other regulatory bodies may adjust policies to equitably meet public health needs and not unfairly burden small hospitals.

Primary care provider perceptions of an asthma home visiting program

Introduction Pediatric asthma home visiting programs have improved clinical outcomes, but little is known about how providers perceive these programs. The purpose of this study was to understand how primary care providers and their colleagues in a medical home perceive an asthma home visiting program that is available at no cost to their patients. Methods After several years of running an asthma home visiting program using community health workers (CHW) in 10 pediatric primary care offices in the South Coast of Massachusetts, we surveyed the providers of patients who had enrolled in the program. An anonymous online survey was developed by the program leaders, the program analytics team, and the CHWs for quality improvement purposes. Survey domains included the perceived utility of various aspects of the program, impact on patients, and interaction with CHWs, as well as demographic information about the providers. Results Of the 24 providers asked to complete the survey from eight primary care practices, 21 completed the survey (88%). Respondents perceived that the most beneficial aspects were environmental assessment (95%), asthma education (91%), and addressing environmental issues (86%). In addition to numerous positive free-text responses, suggestions for improvement were in the areas of referral completion, post-visit communication, and patient identification in the medical record. All respondents would continue to refer to the program. Conclusions Primary care providers and medical home staff perceived an asthma home visiting program to have high utility, particularly the environmental assessment, asthma education, and mitigation of environmental issues. Additional opportunities for improvement were identified.

Exploring Leadership Competencies and Mentoring Needs of Physical and Occupational Therapy Leaders in the United States

Abstract Study Design The current study used a phenomenological qualitative design to investigate leadership competencies and mentoring needs of physical and occupational therapy leaders. Objectives The purpose of the study was to evaluate leadership competencies of physical and occupational therapy leaders based on years of leadership experience and determine their mentoring needs for developing leadership competencies. Background Personnel shortages are a major issue in health care, and health care organizations should focus on professional development of health care leaders for better staff retention. Methods and Measures Nonprobability convenience sampling was used to recruit physical and occupational therapists currently working as therapy leaders in the United States. A self-developed, two-part structured interview guide was created and contained three demographic questions regarding leadership and four open-ended questions. Before the interview, participants reviewed the National Center for Healthcare Leadership Health Leadership Competency Model 3.0, which discusses seven domains of leadership competency, and the interview guide. Interviews took ∼30 to 45 minutes and were conducted using Zoom. NVivo software was used to code interviews for themes, and identified themes were grouped into five categories of years of leadership experience. Results Twenty-five physical and occupational therapists participated in the study. Participants in all five experience categories identified collaboration and communication as leadership competencies they possessed. Other identified competencies were analytical thinking, team leadership, accountability, and professional and social responsibility. Human resource management, financial skills, and relationship and network development were identified as mentoring needs for developing leadership competencies by participants in all categories. Information technology management and self-confidence were also identified. Conclusions By determining the current leadership competencies and mentoring needs, the results of the current study may be useful for establishing leaders who can address personnel shortages in health care.

MP16-05 A NOVEL EMR-BASED CARE PATHWAY FOR NEPHROLITHIASIS: DEVELOPMENT AND 1 YEAR UTILIZATION

You have accessJournal of UrologyCME1 Apr 2023MP16-05 A NOVEL EMR-BASED CARE PATHWAY FOR NEPHROLITHIASIS: DEVELOPMENT AND 1 YEAR UTILIZATION Soum Lokeshwar, Daniel Heacock, Ankur Choksi, Devin Shaheen, Dylan Heckscher, Syed Rahman, Dinesh Singh, and Piruz Motamedinia Soum LokeshwarSoum Lokeshwar More articles by this author , Daniel HeacockDaniel Heacock More articles by this author , Ankur ChoksiAnkur Choksi More articles by this author , Devin ShaheenDevin Shaheen More articles by this author , Dylan HeckscherDylan Heckscher More articles by this author , Syed RahmanSyed Rahman More articles by this author , Dinesh SinghDinesh Singh More articles by this author , and Piruz MotamediniaPiruz Motamedinia More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003236.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Patients with acute renal colic due to stones frequently visit the ED. With limited ED resources due to the COVID-19 pandemic, we developed a best practice management pathway within our electronic medical records (EMR) to provide consistent, expeditious and appropriate care for patients with nephrolithiasis. The objective of this study is to describe the development and 1 year outcomes of our EMR Care Pathway for nephrolithiasis. METHODS: Our hospital system is composed of many centers. To standardize best practice care, we convened a clinical consensus group, with key stakeholders in emergency medicine, urology, interventional and diagnostic radiology to develop a pathway for the initial work up and management of acute renal colic. AUA guidelines, current literature, and expert consensus across specialties were used to develop the pathway to guide work up and management. Risk assessment tools, and criteria for specific imaging modalities, lab work, and pain protocols were outlined. Criteria for routine discharge with follow-up, including pre-populated links for referrals, indications for urology consult, hospital admission and urgent decompression (stent versus nephrostomy tube) were provided. Data was gathered through the EMR analytics team and descriptive statistics were performed. RESULTS: The Care Pathway was utilized 944 times from August 3, 2021 – September 17, 2022 at 11 different hospitals or care centers (Table 1). Usage increased overtime (r2=0.77). The majority of usage was in the ED (892, 94.4%). A total of 194 providers utilized the Pathway with the majority being residents (64, 33.0%). The pathway included care of 505 unique patients, with 106 primary diagnosis key words triggering pathway use. 139 Urology referrals were placed through the pathway with 124 new 28 day prescriptions of tamsulosin. CONCLUSIONS: An EMR-integrated care pathway has been readily utilized in our system and may augment triage and best practice management of patients presenting with stone disease. Further studies are needed to understand the full impact on outcomes. Source of Funding: NA © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e203 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Soum Lokeshwar More articles by this author Daniel Heacock More articles by this author Ankur Choksi More articles by this author Devin Shaheen More articles by this author Dylan Heckscher More articles by this author Syed Rahman More articles by this author Dinesh Singh More articles by this author Piruz Motamedinia More articles by this author Expand All Advertisement PDF downloadLoading ...

Value-oriented proactive management in high-tech project teams

The main principles of high-tech project management and the specifics of the teams involved in the implementation of such projects are considered. Challenges arising in high-tech project teams are identified. Possible approaches for minimizing management risks in the implementation of high-tech projects are analyzed, in particular, the paradigm of proactive value-oriented project management and the approach of a logical framework model are considered. Proactive management involves the use of models for predicting results and management decisions. Management decisions are classified based on the methods used to make them. Individual, consultative, group decisions are defined, as well as strategic, tactical and operational decisions based on the nature of the goal. The sequence of actions and errors regarding decision-making at the stage of diagnosing the situation when managing problems that arise during project management are formulated. The decision is considered as a product of management work, and its adoption as a process that leads to the appearance of this product. The effectiveness of proactive project management tools in identifying and working out options for solving unique problems that require a creative approach and creative search has been demonstrated. The special importance of building constant interaction of the project manager with various members of the project team is emphasized, which conditions the inclusion of the team in the project management process and includes solving project problems and tasks, planning, discussing interdependencies between tasks, monitoring, analysis of key indicators of project performance, risk management, etc. others A detailed analysis of the implementation of the technology adoption model as a research framework model, which is fully reflected by the P2M knowledge system, is provided. The constituent components of such a model are defined: perceived value (usefulness); ease of use of the innovation; intent and motivation of use; perceived risk. The approach of the logical framework model, which is a key approach used by many international organizations and donors when implementing projects, is considered. This approach is proposed as a tool that promotes the motivation of the process of analytical thinking in the project team, helps to structure and optimize information in the project, take into account problematic issues and related risks, identify weaknesses of the selected project implementation scenario, involve key specialists in the regular process of discussion and updating logical matrix of the project. An example of the practical use of a logical framework model by creating and analyzing a matrix of a logical framework model in a specific high-tech project on nuclear and radiation safety implemented with the financial support of the European Union is given.

The perioperative utility of 3D printed models in complex surgical care: feedback from 106 cases.

3D models are an emerging tool for surgical planning, providing an augmented method for the visualisation of a patient's anatomy. As their use increases, more data about the utility of these models is critical to inform budget allocation. This study provides the most comprehensive analysis to date for the use of 3D models in perioperative management. 3D models for complex surgical cases in NHS hospitals were delivered alongside a surgeon feedback survey. The survey on the model's utility had been designed alongside the university data analytical team and focused on five areas: surgical planning and diagnosis, economic impact, impact on intraoperative and preoperative time, effect on communication and direct impact on the patient. There were 106 models used by 63 surgeons for complex surgical cases between May 2020 and March 2021, across multiple surgical specialties. The models were reported to have benefits in all perioperative areas, with 92.5% of responses agreeing that the 3D model was a better method for diagnosis and planning than traditional 2D techniques. Benefits were reported on preoperative planning (92.4%), economic savings due to equipment selection (54.4%), reduction in surgical time (41.5%) and surgeon-to-surgeon communication (92.6%). 3D models were shown to have a wide range of benefits in a surgical setting. The reduction in surgical time could have the potential to help alleviate surgical backlogs. With more widespread use and optimisation of costs the use of 3D models could become the standard for unusual and complex surgical cases.

An Analytical Specialty Team Enabling Merck′s Pipeline with Pioneering Measurement Science

AbstractThis invited Team Profile was created by the above group. They recently published an article on the introduction of a hybrid separation technique, referred to as Dual‐Gradient Unified Chromatography (DGUC), enabling simultaneous multicomponent analysis of both small and large molecules across a wide polarity range in single experimental runs. DGUC lays the foundation for the next generation of hybrid chromatographic techniques with the deployment of universal elution profiles obtained via multi‐eluent blending beyond traditional separation modes. “Dual‐Gradient Unified Chromatography: A New Paradigm for Versatility in Simultaneous Multicomponent Analysis”, G. L. Losacco, R. Bennett, I. A. Haidar Ahmad, R. C. Barrientos, J. O. DaSilva, Y. Dong, A. W. Schuppe, Z. Wang, S. Aiken, I. Mangion, V. K. Aggarwal, E. L. Regalado, Angew. Chem. Int. Ed. 2022, e202208854; Angew. Chem. 2022, e202208854.

An Analytical Specialty Team Enabling Merck's Pipeline with Pioneering Measurement Science.

This invited Team Profile was created by the above group. They recently published an article on the introduction of a hybrid separation technique, referred to as Dual-Gradient Unified Chromatography (DGUC), enabling simultaneous multicomponent analysis of both small and large molecules across a wide polarity range in single experimental runs. DGUC lays the foundation for the next generation of hybrid chromatographic techniques with the deployment of universal elution profiles obtained via multi-eluent blending beyond traditional separation modes. "Dual-Gradient Unified Chromatography: A New Paradigm for Versatility in Simultaneous Multicomponent Analysis", G. L. Losacco, R. Bennett, I. A. Haidar Ahmad, R. C. Barrientos, J. O. DaSilva, Y. Dong, A. W. Schuppe, Z. Wang, S. Aiken, I. Mangion, V. K. Aggarwal, E. L. Regalado, Angew. Chem. Int. Ed. 2022, e202208854; Angew. Chem. 2022, e202208854.

Sexual and Reproductive Health Advocacy Successes, Failures, and Needs in the United States: Perspectives From Key Stakeholders.

Physician advocates for sexual and reproductive health (SRH) care have been active in the United States for decades. Despite such activism, access to SRH services has been fraught with persistent restrictions, particularly for abortion care. We sought the perspectives of key stakeholders on what makes for an effective SRH physician advocate and thoughts about the successes, failures, and needs of the abortion advocacy movement. We interviewed 15 SRH key informants (KIs) in sectors with expertise in organizational policy and advocacy (n = 6); clinical leadership and education (n = 3), media (n = 3), and reproductive justice (n = 3). The analytic team coded repeating ideas and conducted a thematic analysis, organizing findings within KI perspectives on the role of physician advocates in the field of abortion and contraception; successes, failures, and needs in abortion and contraception advocacy; and recommendations on the composition and components of an ideal clinician advocacy training program. KIs relayed that skill building related to communication, developing relationships with changemakers, and understanding political systems was critical for effective advocacy. They felt clinician advocacy training programs should include providers other than physicians and be designed for trainees to build relationships with one another over time. KI perspectives can be valuable in informing advocacy training programs and for contributing strategic approaches to increasing equitable and widespread access to SRH services.

P094Sexual and reproductive health advocacy successes, failures, and needs in the US: Perspectives from key stakeholders

<h3>Objectives</h3> Despite active advocacy for access to sexual and reproductive health (SRH) services in the US, persistent restrictions have created barriers to care. We sought the perspectives of key stakeholders on what makes for an effective SRH physician advocate and thoughts about the successes, failures, and needs of the abortion advocacy movement. <h3>Methods</h3> We interviewed 15 SRH key informants (KIs) in sectors with expertise in organizational policy and advocacy (n=6); clinical leadership and education (n=3); media (n=3); and reproductive justice (n=3) as part of a mixed-methods evaluation of a physician advocacy training program. The analytic team coded repeating ideas and conducted a thematic analysis, organizing findings within KI perspectives on the role of physician advocates; successes, failures, and needs in SRH advocacy; and recommendations on the composition and components of an ideal advocacy training program. <h3>Results</h3> KIs felt successes included mandated access to contraception under the Affordable Care Act and the application of reproductive justice and storytelling to abortion advocacy. Failures included misplaced political focus and increased abortion bans. Participants highlighted the importance of building community across disciplines and diminishing silos. Skill-building related to communication, developing relationships with changemakers, and understanding political systems was thought to be critical for effective advocacy. They felt clinician advocacy training programs should include providers other than physicians and be designed for trainees to build relationships with one another over time. <h3>Conclusions</h3> KI perspectives can be valuable in informing advocacy training programs and for contributing strategic approaches to increasing equitable and widespread access to SRH services.

Using a longitudinal multi-method approach to document, assess, and understand adaptations in the Veterans Health Administration Advanced Care Coordination program.

Understanding adaptations supports iterative refinement of the implementation process and informs scale out of programs. Systematic documentation of adaptations across the life course of programs is not routinely done, and efficient capture of adaptations in real world studies is not well understood. We used a multi-method longitudinal approach to systematically document adaptations during pre-implementation, implementation, and sustainment for the Veteran Health Administration (VA) Advanced Care Coordination program. This approach included documenting adaptations through a real-time tracking instrument, process maps, Implementation and Evaluation (I&E) team meeting minutes, and adaptation interviews. Data collection was guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) enhanced framework for reporting adaptations and modifications to evidence-based interventions (FRAME) model. Adaptations were evaluated across 9 categories, and analytic team consensus and member-checking were used to validate the results. A total of 144 individual adaptations were identified across two implementation sites and the four data sources; analytic team consensus and member-checking processes resulted in 50 unique adaptations. Most adaptations took place during the early implementation and mid-implementation phases and were: 1) planned; 2) made to address changes in program delivery; 3) made to extend a component; 4) related to the core component of the intervention concerning notification of the community emergency department visit; 5) initiated by the entire or most of the I&E team; 6) made on the basis of: pragmatic/practical considerations; 7) made with an intent to improve implementation domain (to make the intervention delivered more consistently; to better fit the local practice, patient flow or Electronic Health Record (EHR) and/or for practical reasons); 8) a result of internal influences; 9) perceived to impact the RE-AIM implementation dimension (consistent delivery of quality care or costs). I&E team meeting minutes and process maps captured the highest numbers of unique adaptations (n = 19 and n = 13, respectively). Our longitudinal, multi-method approach provided a feasible way to collect adaptations data through engagement of multiple I&E team members, allowing and a broader understanding of adaptations that took place. Recommendations for future research include pragmatic assessment of the impact of adaptations and meaningful data collection without overburdening the implementing teams and front-line staff.