Formal Evaluation Of Outcomes Research Articles

Establishment of a Cancer Acute Care Clinic Within an Infusion Center

Context: With the release of an outcome-based quality measure from the Centers for Medicare and Medicaid Services that aimed to reduce emergency department (ED) and hospital admissions for patients receiving outpatient chemotherapy, new models of care needed to be implemented. Clinical Setting: This case study describes development and implementation of a cancer acute care clinic (CACC) within an extremely busy infusion center located in a National Cancer Institute-designated Comprehensive Cancer Center. Modifications that were necessary in the context of COVID-19 pandemic are described. Process: The development of the CACC involved a transdisciplinary team who determined CACC’s purpose; established patient admission criteria; created a nursing leadership and staffing plan; developed initial operating procedures; and made necessary adjustments to provide care during the COVID-19 pandemic. Clinical pathways were developed to guide care. Informal patient and staff surveys were done to evaluate satisfaction with CACC’s services. Outcomes: Of the initial 142 visits, 75.4% of patients were discharged home, and 12.6% and 12.0% were admitted to the ED or hospital, respectively. Both patients and staff reported high levels of satisfaction with CACC services. Conclusion: While COVID-19 disrupted plans for an evaluation of reductions in ED visits, because of high levels of staff and patient satisfaction, plans are underway to expand CACC services and conduct more formal outcome evaluations. Implications for Practice: Description of the processes involved in the development and implementation of the CACC may serve as a model for other organization on how to provide acute care to oncology patients.

Reflective Practice: Co-Creating Reflective Activities for Pharmacy Students.

Reflective practice is important in pharmacy education to support skill development for decision-making, critical thinking, problem-solving, and in continuing professional development and beyond. Despite the importance of reflective practice in higher education and professional practice, reflection assignments are not universally embraced by students. This project was initiated due to recent interest in the co-creation of pharmacy curriculum by students and faculty. The purpose of this project was to develop reflection assignments for pharmacy students. The principles of the analysis, design, development, implementation, evaluation (ADDIE) instructional design framework guided the development of reflection assignment templates for three focus areas: personal development, professional development, and professional identity formation. Templates included background and definitions for these specific focus areas as well as objectives, instructions, guiding questions, assessment methods, and submission requirements. A previously tested assessment rubric was adopted for reflection assignments. Development involved target audience and expert reviews and a trial implementation was held in a year 3 patient care skills course. The co-creation process enriched the experiences of students and faculty involved in it. Future co-creation projects including groups of students, formal evaluation of outcomes, and impact on the program will further support integration of reflective practice in the pharmacy curriculum.

Implementing virtual experiences and remote assessments during the COVID-19 pandemic: A college experience

With nine weeks remaining in the term, COVID-19 necessitated emergency remote learning and remote online exams. This required a series of software trainings for administrators, faculty and students at Howard University College of Pharmacy, USA. The experiential department also had to look beyond normal clerkship placements. The described telemedicine and virtual experiences were used to supplement face-to-face experiences. Assessments for both learning innovations were successful, based on faculty and student feedback. Student reflections describe how COVID-19 helped advance the use of telehealth and indicate their learning of clinical decision-making skills, effective communication, and the digital health industry. A formal evaluation of outcomes from the implemented pandemic innovations is being planned. The use of online proctoring with artificial intelligence during the emergency remote learning was successful. With software training, this type of service can be adopted to ensure the integrity of assessments. The cost of the service and the reporting time should be considered in academic planning.

Visualizing the knowledge structure of medication-adherence research: A bibliometric analysis (1997-2016).

This study involves a bibliometric analysis of the medication-adherence research and covers publications from 1997 to 2016. A database of 19 621 publications and 335 208 references from the Web of Science was investigated using the CiteSpace software. Some interesting findings were obtained. First, the most significant developments and progress in the medication-adherence research have occurred in North America and Europe. Second, Osterberg L. and the Journal of the American Medical Association (JAMA) are the most cited author and journal, respectively, with the strongest academic influence. Third, the existing studies on medication adherence primarily focus on pharmacology/pharmacy, psychiatry, public environmental occupational health, and general internal medicine. Fourth, research hotspots showed a diversifying trend and increasingly covered chronic diseases. Moreover, the topic of integrating formal outcome evaluations into adherence interventions is one long-term research hotspot. In addition, the research frontiers mainly focus on medication adherence for HIV/AIDS patients, especially active antiretroviral therapy. Finally, the evolution of the medication-adherence research has occurred in approximately three stages: The first stage involved the introduction of the term "compliance" into medicine, then the primary focus shifted to patient adherence to HIV/AIDS medication, and the final stage has involved a diversifying trend with more diseases and methods for measuring adherence being researched in the current stage. Furthermore, because of an aging population and a disease spectrum change in the current phase, the focus of medication-adherence research has gradually shifted from infectious diseases to chronic diseases.

Expanded Roles for Pharmacy Technicians in the Medication Reconciliation Process: A Qualitative Review.

Background: Collection of a complete and accurate medication history is an essential component of the medication reconciliation process. The role of pharmacy technicians in supporting medication reconciliation has been the subject of recent interest. Purpose: The purpose of this article is to review the existing literature on pharmacy technician involvement in the medication reconciliation process and to summarize outcomes on the quality and accuracy of pharmacy technician-collected medication histories. Method: A literature review was conducted using MEDLINE and Academic Search Premier (1948 - April 2015). Results: Sixteen papers were identified, with 12 containing a formal evaluation of outcomes. Three were purely descriptive, and 9 compared the pharmacy technician's performance to pharmacists, nurses, physicians, and/or interdisciplinary teams. Studies used a variety of endpoints, but they demonstrated similar or improved outcomes by engaging pharmacy technicians. Evidence demonstrates that trained pharmacy technicians are able to gather medication histories with similar completeness and accuracy to other health care professionals. Conclusion: The use of pharmacy technicians may be a viable strategy for developing and expanding medication reconciliation processes with appropriate supervision. Future efforts should focus on evaluating the impact of expanded roles for pharmacy technicians in the health care system; assessing the need for standardization of pharmacy technician education, training, and certification; and obtaining clarification from state pharmacy boards regarding these expanded roles.

Academic-service partnerships in nursing: an integrative review.

This integrative review summarizes currently available evidence on academic-service partnerships in the profession of nursing. More than 300 articles, published primarily in refereed journals, were accessed. Articles (110) were included in this review as they presented detailed and substantive information about any aspect of a nursing academic-service partnership. The majority were anecdotal in nature. Topics clustered around the following categories: pre-requisites for successful partnerships, benefits of partnerships, types of partnerships, and workforce development with its themes of academic-practice progression and educational re-design. Many examples of partnerships between academic and service settings were thoroughly described and best practices suggested, most often, however, without formal evaluation of outcomes. Nursing leaders in both settings have a long tradition of partnering with very little replicable evidence to support their efforts. It is critical that future initiatives evaluate the effectiveness of these partnerships, not only to ensure quality of patient outcomes but also to maximize efforts at building capacity for tomorrow's workforce.

Understandings of efficacy: cross-national perspectives on ‘what works’ in supporting parents and families

The research literature on parenting support typically focuses on English-speaking countries, such as England, the United States and Australia. This article draws on a review, commissioned by the English government, which examined policies and services to support parenting in five European countries: Denmark, France, Germany, Italy and the Netherlands, and considered the evidence for effectiveness. In exploring differences between the five countries, and with England, this article raises questions about the way in which understandings of ‘what works’ can inform the ways in which support for parents and families is designed and delivered. An emphasis on formal outcome evaluations, as in England, favours the use of standardised parenting programmes, which are more amenable to evaluation of effectiveness using quasi-experimental research designs. In some other European countries, support for parents and families is embedded in universal service provision, rather than a discrete, time-limited ‘intervention’, and hence evaluation is more likely to involve assessment of individual progress (is this working for this family?) rather than assessment of the overall efficiency of a standardised programme.

Corporate hospitality: executive indulgence or vital corporate communications weapon?

Heads of marketing in 189 UK companies known to engage in corporate hospitality (CH) completed questionnaires regarding their attitudes and approaches towards the practice. A cluster analysis of the replies revealed four distinct groups of enterprise: CH “warriors”, “pragmatists”, “reactors”, and “strategic hopefuls”. Corporate hospitality warriors displayed strategic CH orientations and carefully measured the outcomes. Pragmatists also evaluated the impacts of CH, but adopted essentially ad hoc approaches. Strategic hopefuls used CH strategically, yet without bothering to assess its consequences. Reactors undertook CH only because their competitors did so. Additionally the research examined the extents to which the sample businesses applied conventional marketing management methods to the CH function, and the respondents’ perceptions of the benefits and problems of CH. A regression analysis identified some major sources of satisfaction with CH activities. These included the employment of formal market research to match CH events with clients, the location of responsibility for CH in a marketing or public relations department, the adoption of strategic approaches to CH, and the formal evaluation of outcomes.

Client Perceptions of Inpatient Treatment: a qualitative account with implications for service delivery

Forty-two clients attending two specialist inpatient programmes for drug and alcohol dependence in South London participated in a semi-structured, researcher-administered interview about their treatment experiences. The quality of the therapeutic relationships with staff and other clients were amongst the most positive aspect of treatment described. Clients were generally enthusiastic about the content of the treatment programme and support services. Treatment dissatisfaction mostly centred on aspects of the programme regulations and physical environment. Concerns included: the physical comfort at the programme,shared personal space and a rule restricting visitors. Qualitative studies of this kind can be a valuable adjunct to formal outcome evaluations, and can offer an illuminating account of clients experiences in treatment. The results can guide continuous quality improvement and programme development efforts.