Support Stakeholder Engagement Research Articles

Development, implementation and impact of an immunoglobulin stewardship programme in Saskatchewan, Canada.

Intravenous immunoglobulin (IVIG) is one of the most costly and limited-supply blood products. Judicious use of this therapy is important to ensure a continued supply is available for patients in need. The Saskatchewan IG Stewardship Program was initiated to monitor and reduce inappropriate IG use. The Program was developed and implemented through the collaborative efforts of a multidisciplinary, inter-organizational team. Funding was provided from provincial organizations to create new positions within the Program and to support stakeholder engagement throughout the process of implementation. Data were collected from local and national databases regarding the amount of IVIG used and appropriateness of orders based on published criteria. Over 20 months, the Program helped to reduce unnecessary IVIG use from pre-intervention levels by more than 20%. Interventions from nurse navigators alone reduced inappropriate IVIG use by 2.6%. During the 20-month period following Program initiation, more than 4 million CAD less was spent on IVIG compared with the previous 20 months. The Saskatchewan IG Stewardship Program has led to more appropriate IVIG use across the province, more effective preservation of this limited healthcare resource, and cost savings that more than cover the cost of administering the Program.

"It's Almost as if Stakeholder Engagement is the Annoying 'Have-to-do'…": Can Ethics Review Help Address the "3 Ts" of Tokenism, Toxicity, and Tailoring in Stakeholder Engagement?

Ethics guidance recommends that researchers engage stakeholders and that RECs review research for such engagement. The ethics review process may present a unique opportunity to support stakeholder engagement practices for HIV prevention studies. We conducted 28 interviews with experts from 12 countries to explore this issue, and analyzed the data using Thematic Analysis. We found that the value of engagement and review processes was strongly endorsed. However, we identified 3 major thematic complexities, namely: “Tokenism” where processes risk being “tick-box”; “Toxicity”, where practices may inadvertently have negative consequences; and “Tailoring”, where processes need careful variation in intensity. We make recommendations for how these “Ts” can be addressed during the review process to help contribute to thoughtful review of meaningful stakeholder engagement in research.

Knowledge translation strategies for policy and action focused on sexual, reproductive, maternal, newborn, child and adolescent health and well-being: a rapid scoping review

ObjectiveThe aim of this study was to identify knowledge translation (KT) strategies aimed at improving sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH) and well-being.DesignRapid scoping review.Search strategyA comprehensive...

Stakeholder engagement in the health policy process in a low income country: a qualitative study of stakeholder perceptions of the challenges to effective inclusion in Malawi

BackgroundInclusive engagement in healthcare policies and decision-making is essential to address the needs of patients and communities, reduce health inequities and increase the accountability of the government. In low income countries such as Malawi, with significant health challenges, stakeholder inclusion is particularly important to improve performance and service delivery. The 2017 National Health Plan II (NHP II) and accompanying Health Sector Strategic Plan II (HSSP II) aimed to improve the functioning of the healthcare system. The Ministry of Health for Malawi intended to involve all key health sector stakeholders in their development. This study explores the extent of stakeholder engagement in the health policy process through local level stakeholders’ perceptions of their involvement in the NHP II and HSSP II.MethodsA qualitative study design was used. Interviews were conducted with 19 representatives of organisations operating at the local level, such as CSOs and local government. Open questions were asked about experiences and perceptions of the development of the NHP II and HSSP II. Inductive content analysis was performed.ResultsStakeholders perceived barriers to inclusive and meaningful engagement in the health policy process. Five categories were identified: tokenistic involvement; stakeholder hierarchy; mutual distrust; preferred stakeholders; no culture of engagement.ConclusionsSerious challenges to the meaningful and equitable engagement of local level stakeholder groups in the health policy process were identified. Issues of trust, accountability and hierarchy in donor-citizen-government relations must be addressed to support stakeholder engagement. Engagement must go beyond tokenism to embed a range of stakeholders in the process with feedback mechanisms to ensure impact from their contributions. Local level stakeholders can be empowered to advocate for and participate in consultation exercises alongside greater top-down efforts to engage stakeholders via diverse and inclusive methods. These issues are not unique to Malawi or to health policy-making.

Using systems science to advance health equity in tobacco control: a causal loop diagram of smoking

ObjectivesDevelop and use a causal loop diagram (CLD) of smoking among racial/ethnic minority and lower-income groups to anticipate the intended and unintended effects of tobacco control policies.MethodsWe developed a CLD...

Baselines and monitoring: More than a means to measure the end

Monitoring is largely ignored in its capacity to provide a distinct contribution to evaluation. It is often thought of as a process of collecting data to feed into an evaluation, rather than for its own powerful transformative potential. Evaluation is considered a mechanism for producing findings that enable learning, improvement and decision-making; but what if monitoring could produce these same outcomes with, in some cases, greater alignment to quality characteristics of utility, timeliness, feasibility, propriety, accuracy, completeness and monitoring accountability? This article examines the utilisation and value of monitoring through a case study of a government funded 12-month rural health project in Victoria, Australia. The project initially commissioned a baseline to assess against post-project outcomes. However, adopting a utilisation-focused perspective to prepare for use and support stakeholder engagement enabled implementation of a multipurpose monitoring framework. The case study provides examples of monitoring in action with timely learning, decision-making and improvements resulting in incremental system and behaviour changes, rather than relying on periodic outcome recommendations at evaluation completion. This article adds to evaluation theory and practice through highlighting monitoring as a significant mechanism for enabling learning, decision-making, and improvement.

Prototyping strategies for stakeholder engagement during front-end design: Design practitioners’ approaches in the medical device industry

Prototypes are fundamental tools used throughout design processes. During early design stages, including problem definition and concept development, prototypes can support stakeholder engagement, which is considered critical for success. However, the ways in which engineering designers leverage prototypes within front-end stakeholder engagements are not well described in the literature. This research explored front-end prototyping strategies for stakeholder engagement through semi-structured interviews with medical device design practitioners. Our research findings describe seventeen strategies design practitioners used to engage stakeholders during front-end design activities. The findings add rich detail to the existing strategies broadly described in the literature, and have implications for designers across expertise levels, as they can be used to develop intentional approaches to engage stakeholders during front-end design.

Stakeholder engagement and dialogic accounting

PurposeThe purpose of this paper is to explain how sustainability reporting and stakeholder engagement processes serve as vehicles of dialogic accounting (DA), a form of critical accounting that creates opportunities for stakeholders to express their opinions, and the influence of dialogic interactions on the content of sustainability reports.Design/methodology/approachContent analysis is used to investigate reports published by 299 companies that have adopted Global Reporting Initiative guidelines. This paper studies how organizations engage stakeholders, the categories of stakeholders that are being addressed, the methods used to support stakeholder engagement, and other features of the stakeholder engagement process. Companies that disclose stakeholder perceptions, the difficulties met in engaging stakeholders, and actions aimed at creating opportunities for different groups of stakeholders to interact were subjects of discussion in a series of semi-structured interviews that focus on DA.FindingsCompanies often commit themselves to two-way dialogue with their stakeholders, but fully developed frameworks for DA are rare. However, signs of DA emerged in the analysis, thus confirming that sustainability reporting can become a platform for DA systems if stakeholder engagement is effective.Originality/valueThe findings contribute to the accounting literature by discussing if and how sustainability reporting and stakeholder engagement can serve as vehicles of DA. This is accomplished via a research design that is based on in-depth interviews and content analysis of various sustainability reports.

MP34: Evaluation of real-time virtual support for rural emergency care

Introduction: In many rural and remote communities in BC, family physicians who are providing excellent primary and emergency care would like to access useful, timely, and collegial support to ensure the highest quality of health services for their patients. We undertook a real-time virtual support project in Robson Valley, located in northern BC, to evaluate the use of digital technologies such as videoconferencing for on demand consultation between family physicians at rural sites and emergency physicians at a regional site. Telehealth consults also occurred between rural sites with nurses at community emergency rooms consulting with local on-call physicians. Our aim was to use telehealth to facilitate timely access to high quality, comprehensive, coordinated team-based care. An evaluation framework, based on the Triple Aim sought to: 1) Identify telehealth use cases and assess impact on patient outcomes, patient and health professional experience, and cost of health care delivery; and 2) Assess the role of relationships among care team members in progressing from uptake to normalization of telehealth into routine usage. Methods: Using a participatory approach, all members of the pilot project were involved in shaping the pilot including the co-development of the evaluation itself. Evaluation was used iteratively throughout implementation for ongoing quality improvement via regular team meetings, sharing and reflecting on findings, and adjusting processes as required. Mixed methods were used including: interviews with family physicians, nurses, and patients at rural sites, and emergency physicians at regional site; review of records such as technology use statistics; and stakeholder focus groups. Results: From November 2016 to July 2017, 26 cases of telehealth use were captured and evaluated. Findings indicate that telehealth has positively impacted care team, patients, and health system. Benefits for care team at the rural sites included confidence in diagnoses through timely access to advice and support, while emergency physicians at the regional site gained deeper understanding of the practice settings of rural colleagues. Nevertheless, telehealth has complicated the emergency department work flow and increased physician workload. Findings demonstrated efficiencies for the health system, including reducing the need for patient transfer. Patients expressed confidence in the physicians and telehealth system; by receiving care closer to home, they experienced personal cost savings. Implementation saw a move away from scheduled telehealth visits to real use of technology for timely access. Conclusion: Evidence of the benefits of telehealth in emergency settings is needed to support stakeholder engagement to address issues of workflow and capacity. This pilot has early indications of significant local impact and will inform the expansion of emergency telehealth in all emergency settings in BC.

Integrating discrete choice models and agent-based models for ex-ante evaluation of stakeholder policy acceptability in urban freight transport

This paper discusses the potential benefits of combining discrete choice models (DCMs) and agent-based models (ABMs) to provide a stakeholder behavioural analysis and support stakeholder engagement in urban freight transport (UFT) planning. The integrated modelling framework allows to evaluate stakeholders’ policy acceptability taking into account their heterogeneous preferences and their interactive behaviour. The stakeholder behavioural analysis proposed, together with technical and economic analyses, contributes to the ex-ante policy assessment needed to support policy-makers in taking well-thought-out decisions. An application of the modelling framework is here presented with the aim to prove its feasibility and added value for UFT policy-making, since it provides a ranking of policies that are likely to be accepted by stakeholders and that satisfy their heterogeneous desires and objectives while accounting for interaction effects.

Urban Nexus Science for Future Cities: Focus on the Energy-Water-Food-X Nexus

Rapid urban expansion of the world’s cities is placing unprecedented demands on the energy, water, food, and other (X) systems (e.g., mobility) that each offer multiple life-supporting services. Coordination that considers inter-sectoral connections among these urban systems and services remains nascent in practice, yet are critical to the future well-being, resource/operational efficiency, and resilience of urban areas. This paper therefore proposes an applied “urban nexus science” framework to identify integrated and synergistic pathways toward achieving urban sustainability. The design, planning, and operation of urban W-E-F systems can benefit from integrated analyses to accelerate infrastructure, land use, and hazard mitigation planning and decision-making. New knowledge quantifying the key effects of W-E-F systems designed in isolation versus an increasingly integrated systems, especially when exposed to hazards, health risks, or extreme events, are a critical need. Interactive system modeling and participatory technologies are needed to support stakeholder engagement and two-way (and multi-directional) information flow, for exploring outcomes of alternative solutions for integrating W-E-F sectors. To support such important efforts, research is needed to fill critical gaps in data, identify tradeoffs, and develop synergistic solutions that measure sustainability co-benefits based on different levels of urban integration among W-E-F systems and services.

Towards a building typology and terminology for Irish hospitals

The physical form of the hospital environment shapes the care setting and influences the relationship of the hospital to the community. Due to ongoing demographic change, evolving public health needs, and advancing medical practice, typical hospitals are frequently redeveloped, retrofitted, or expanded. It is argued that multi-disciplinary and multi-stakeholder approaches are required to ensure that hospital design matches these increasingly complex needs. To facilitate such a conversation across different disciplines, experts, and community stakeholders, it is helpful to establish a hospital typology and associated terminology as part of any collaborative process. Examine the literature around hospital design, and review the layout and overall form of a range of typical Irish acute public hospitals, to outline an associated building typology, and to establish the terminology associated with the planning and design of these hospitals in Ireland. Searches in 'Academic Search Complete', 'Compendex', 'Google', 'Google Scholar', 'JSTOR', 'PADDI', 'Science Direct', 'Scopus', 'Web of Science', and Trinity College Dublin Library. The search terms included: 'hospital design history'; 'hospital typology'; 'hospital design terminology'; and 'hospital design Ireland'. Typical hospitals are composed of different layouts due to development over time; however, various discrete building typologies can still be determined within many hospitals. This paper presents a typology illustrating distinct layout, circulation, and physical form characteristics, along with a hospital planning and design terminology of key terms and definitions. This typology and terminology define the main components of Irish hospital building design to create a shared understanding around design, and support stakeholder engagement, as part of any collaborative design process.

Capturing the Stakeholders’ View in Sustainability Reporting: A Novel Approach

Sustainability reporting is the process by which companies describe how they deal with their own economic, environmental, and social impacts, thus making stakeholders able to recognize the value of sustainable practices. As stressed in the Global Reporting Initiative guidelines, which act as a de facto standard for sustainability reporting, sustainable reports should take into account the stakeholders’ view. In particular, engaging stakeholders is essential to carry out the materiality analysis, by which organizations can identify their own more relevant sustainability aspects. Yet, on the one hand, the existing guidelines do not provide specific indications on how to get stakeholders actually engaged; on the other hand, research on quantitative techniques to support stakeholder engagement in materiality analysis is scarce. Therefore, the purpose of this paper is the development of a quantitative structured approach based on multi-attribute group decision-making techniques to effectively and reliably support stakeholder engagement during materiality analysis in sustainability reporting. As it more strictly guides the reporting process, the proposed approach at the same time simplifies materiality analysis and makes it more reliable. Though any company can adopt the approach, small- and medium-sized enterprises (SMEs) are expected to particularly benefit from it, due to the quite limited implementation effort that is required. With this respect, the approach has been validated on a sample of Italian SMEs belonging to different sectors.

A systematic review of stakeholder engagement in comparative effectiveness and patient-centered outcomes research.

We conducted a review of the peer-reviewed literature since 2003 to catalogue reported methods of stakeholder engagement in comparative effectiveness research and patient-centered outcomes research. We worked with stakeholders before, during and after the review was conducted to: define the primary and key research questions; conduct the literature search; screen titles, abstracts and articles; abstract data from the articles; and analyze the data. The literature search yielded 2,062 abstracts. The review was conducted on 70 articles that reported on stakeholder engagement in individual research projects or programs. Reports of stakeholder engagement are highly variable in content and quality. We found frequent engagement with patients, modestly frequent engagement with clinicians, and infrequent engagement with stakeholders in other key decision-making groups across the healthcare system. Stakeholder engagement was more common in earlier (prioritization) than in later (implementation and dissemination) stages of research. The roles and activities of stakeholders were highly variable across research and program reports. To improve on the quality and content of reporting, we developed a 7-Item Stakeholder Engagement Reporting Questionnaire. We recommend three directions for future research: 1) descriptive research on stakeholder-engagement in research; 2) evaluative research on the impact of stakeholder engagement on the relevance, transparency and adoption of research; and 3) development and validation of tools that can be used to support stakeholder engagement in future work.

UK's Gas Heritage May Become Its Legacy

Guest editorial The United Kingdom is attempting to emulate the unconventional gas bonanza that has transformed the United States from having an energy industry that was in its “sunset” era to a nation rich in energy resources. The UK, which sits on significant shale reserves, wants to become part of this game-changing industry, viewing it as an exciting opportunity as it looks to revolutionize the energy landscape for the next generation. By its very nature, the country has a dense population with a rural and agricultural countryside and, though it boasts a huge offshore infrastructure, lacks onshore support and infrastructure. Add the obstacles of environmental concerns, a need to build awareness, and a cautious political uptake, it could take 2 more decades before investment decisions by industry could turn concern about the value of unconventionals into certainty. Unconventional gas has a particular production profile and economics; consequently, operators must be able to drill, produce, and build facilities within tight cost parameters, which can be marginal. The underpinning culture and supply chain in the North Sea is not as conducive to that development. Therefore, it is crucial that there is a fundamental shift in the approach toward equipment, infrastructure, service industry support, and onshore and community stakeholder engagement. Historically, the UK and Europe have engineered large gas deposits offshore and deployed pipeline and transport facilities to handle the delivery of large volumes of conventional high-pressure gas to market. Therefore, the existing base infrastructure presents a costly challenge for unconventional operators seeking entry into the industry. It is also true that where there has been the opportunity to turn gas into electricity by generation, both the generating and distribution network is geared to high-voltage, coal-fired power stations and nuclear electricity generation. The story now centers on the indigenous supply of natural gas. Five years ago, it looked as though the world might have only 50 to 60 years’ worth of gas. However, by some estimates, shale and other unconventional gas finds have increased that life span to 200 years or more. The successful exploration, appraisal, and development of UK onshore unconventional resources have the potential to provide a significant contribution to the hydrocarbon component of the nation’s balanced portfolio and strategy. Despite the technical, environmental, financial, and political challenges, the UK and other European countries, are taking the first tentative steps to establish the development of shale and coalbed methane. Coring activity is now under way in reservoirs to ascertain the presence of gas, geological permeability, and the natural fracture system within the rock, and that presents an encouraging commercial opportunity.

Method and Tools to Support Stakeholder Engagement in Policy Development

Good governance and open government principles require more participative, open, transparent, accountable, and collaborative. However, in public policy development, the negligence of these principles loomed particularly large until recently. In consequence, citizens have taken action by forming protest activities or responding to current politics with election turnouts leading to drastic change in political directions. Lessons from such activities are that policy makers need urgently to respond to demands of citizens to engage more pro-actively with politics in policy decisions that heavily concern particular stakeholder groups and citizens. Both groups need reliable support and up-to-date information and efficient and effective interactions on emerging societal problems and public affairs. The authors introduce an innovative approach to collaborative policy development, integrating scenario development, and formal policy modelling via an ICT toolbox. To bridge the gap between narrative texts of stakeholder-generated scenarios and formal policy models generating model-based scenarios, introducing conceptual modelling, which supports the construction of conceptual models of the policy domain and which enables tracing inputs of stakeholders to inform the formal policy models. This way, policy makers and stakeholders are better supported to understand the policy context. The OCOPOMO (Open Collaboration in Policy Modelling) approach fully supports the implementation of good governance principles.

Mapping knowledge flow during sustainability assessment

Traditionally regarded as a technical process to determine the performance of buildings against sustainability criteria, calls are now emerging for sustainability assessment to be better integrated with the subjectively-based decisions taken across a project lifecycle, to support stakeholder engagement and to promote a culture of learning about sustainability in practice. In order for sustainability assessment fully to realise this wider role, it is necessary to recognise the significance played by knowledge and its flow between stakeholders in the promotion of a common understanding of the actions required to deliver a sustainable urban environment. This paper presents the findings of a knowledge mapping exercise focused on understanding the nature of this flow during application of sustainability assessment within a university campus building project. Knowledge exists in a variety of types and forms; the key sources drawn upon by a key decision-maker were identified and classified. The mapping exercise stressed the significance of supporting the flow of not only explicit sources of knowledge, but also implicit sources such as expert and tacit knowledge. Ensuring that pathways are dynamic and facilitated through effective management to deliver continued engagement between key decision-makers, the rest of the team and wider stakeholders was highlighted as essential.