Making sense of evidence in management decisions: the role of research-based knowledge on innovation adoption and implementation in health care. Health Serv Deliv Res 2014;2(6)

Posted on April 17, 2014. Filed under: Evidence Based Practice, Health Mgmt Policy Planning | Tags: , |

Making sense of evidence in management decisions: the role of research-based knowledge on innovation adoption and implementation in health care. Health Serv Deliv Res 2014;2(6)

Kyratsis Y, Ahmad R, Hatzaras K, Iwami M, Holmes A..

Extract from the Abstract

“Background
Although innovation can improve patient care, implementing new ideas is often challenging. Previous research found that professional attitudes, shaped in part by health policies and organisational cultures, contribute to differing perceptions of innovation ‘evidence’. However, we still know little about how evidence is empirically accessed and used by organisational decision-makers when innovations are introduced.

Aims and objectives
We aimed to investigate the use of different sources and types of evidence in innovation decisions to answer the following questions: how do managers make sense of evidence? What role does evidence play in management decision-making when adopting and implementing innovations in health care? How do wider contextual conditions and intraorganisational capacity influence research use and application by health-care managers?”

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Improving decision-making in the care and support of older people – Joseph Rowntree Foundation – 5 December 2012

Posted on January 4, 2013. Filed under: Aged Care / Geriatrics | Tags: , |

Improving decision-making in the care and support of older people – Joseph Rowntree Foundation – 5 December 2012

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Enabling Health Care Decisionmaking Through Clinical Decision Support and Knowledge Management – AHRQ – April 2012

Posted on April 26, 2012. Filed under: Evidence Based Practice, Health Informatics, Knowledge Translation | Tags: , , |

Enabling Health Care Decisionmaking Through Clinical Decision Support and Knowledge Management – AHRQ – April 2012

Evidence Report / Technology Assessment no 2-3
AHRQ = Agency for Healthcare Research and Quality [US], Prepared by: Duke Evidence-based Practice Center, Durham, North Carolina

“Structured Abstract

Objectives: To catalogue study designs used to assess the clinical effectiveness of clinical decision support systems (CDSSs) and knowledge management systems (KMSs), to identify features that impact the success of CDSSs/KMSs, to document the impact of CDSSs/KMSs on outcomes, and to identify knowledge types that can be integrated into CDSSs/KMSs.

Data Sources: MEDLINE®, CINAHL®, PsycINFO®, and Web of Science®.

Review Methods: We included studies published in English from January 1976 through December 2010. After screening titles and abstracts, full-text versions of articles were reviewed by two independent reviewers. Included articles were abstracted to evidence tables by two reviewers. Meta-analyses were performed for seven domains in which sufficient studies with common outcomes were included.

Results: We identified 15,176 articles, from which 323 articles describing 311 unique studies including 160 reports on 148 randomized control trials (RCTs) were selected for inclusion. RCTs comprised 47.5 percent of the comparative studies on CDSSs/KMSs. Both commercially and locally developed CDSSs effectively improved health care process measures related to performing preventive services (n = 25; OR 1.42, 95% confidence interval [CI] 1.27 to 1.58), ordering clinical studies (n = 20; OR 1.72, 95% CI 1.47 to 2.00), and prescribing therapies (n = 46; OR 1.57, 95% CI 1.35 to 1.82). Fourteen CDSS/KMS features were assessed for correlation with success of CDSSs/KMSs across all endpoints. Meta-analyses identified six new success features: integration with charting or order entry system, promotion of action rather than inaction, no need for additional clinician data entry, justification of decision support via research evidence, local user involvement, and provision of decision support results to patients as well as providers. Three previously identified success features were confirmed: automatic provision of decision support as part of clinician workflow, provision of decision support at time and location of decisionmaking, and provision of a recommendation, not just an assessment. Only 29 (19.6%) RCTs assessed the impact of CDSSs on clinical outcomes, 22 (14.9%) assessed costs, and 3 assessed KMSs on any outcomes. The primary source of knowledge used in CDSSs was derived from structured care protocols.

Conclusions: Strong evidence shows that CDSSs/KMSs are effective in improving health care process measures across diverse settings using both commercially and locally developed systems. Evidence for the effectiveness of CDSSs on clinical outcomes and costs and KMSs on any outcomes is minimal. Nine features of CDSSs/KMSs that correlate with a successful impact of clinical decision support have been newly identified or confirmed.”

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A Risk-Characterization Framework for Decision-Making at the Food and Drug Administration – National Academies Press – 2011

Posted on May 10, 2011. Filed under: Pharmacy | Tags: , |

A Risk-Characterization Framework for Decision-Making at the Food and Drug Administration – National Academies Press – 2011

Authors: Committee on Ranking FDA Product Categories Based on Health Consequences, Phase II; National Research Council

ISBN-10: 0-309-21280-4
ISBN-13: 978-0-309-21280-9

“This report, prepared by the Committee on Ranking FDA Product Categories Based on Health Consequences, Phase II, in response to the request from FDA and DHHS, describes a risk characterization framework that can be used to evaluate and compare the public-health consequences of different decisions concerning a wide variety of products.”

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Multi-perspective Strategic Decision Making: Principles, Methods, and Tools – RAND Corporation – 2010

Posted on August 20, 2010. Filed under: Health Mgmt Policy Planning | Tags: , , |

Multi-perspective Strategic Decision Making: Principles, Methods, and Tools – RAND Corporation – 2010
 
By: Lynne Wainfan
Pages: 168
Document Number: RGSD-260

“Increasingly, governing groups must take into account diverse perspectives (values, beliefs, and expectations) from within the group, from stakeholders, analysts, and adversaries. Multi-perspective strategic decision making is the process of making long-term decisions that shape the course of an organization, while taking into account diverse perspectives. Often, these perspectives affect the group’s decision more than “objective” criteria. For complex, deeply uncertain problems, groups considering diverse perspectives can be challenged to agree on strategy. This research defines methods, principles, and tools to help groups agree on strategy despite widely diverse perspectives. It extends exploratory analysis techniques to cover new types of factors driving the choice of strategy: “perspective parameters,” including those used for aggregation and scoring variables in a multiresolution model; along with uncertain objective parameters. Six useful simplification techniques are defined to help decision makers see the essence of a complex system and the forces driving it. Finally, this research introduces a heuristic that uses driving forces’ time frame and controllability to identify the best strategy and ways to iterate options. The approach is illustrated using a defense acquisition strategy.”

Full Document (File size 2.2 MB, 9 minutes modem, < 1 minute broadband)

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Measuring Crisis Decision Making for Public Health Emergencies – RAND – August 2009

Posted on August 28, 2009. Filed under: Disaster Management, Public Hlth & Hlth Promotion | Tags: |

Measuring Crisis Decision Making for Public Health Emergencies
By: Andrew M. Parker, Christopher Nelson, Shoshana R. Shelton, David J. Dausey, Matthew W. Lewis, Amanda Pomeroy, Kristin J. Leuschner
RAND Corporation August 2009  Pages: 74   Document Number: TR-712-DHHS

“Public health emergencies often involve making difficult decisions, including when to notify the public of threats, when to close schools or suspend public events, when to dispense medication, and how to allocate scarce resources. Yet, public health practitioners often have little experience or training in crisis decision making and can be uncomfortable with the need to make decisions based on often-incomplete information and short time lines. Unfortunately, there are no established tools for identifying, measuring, and improving public health crisis decision making.

This technical report describes the development and first generation of a tool to measure key aspects of crisis decision making in public health emergencies, based on performance in exercises (e.g., tabletops, functional exercises, full-scale exercises) and real incidents (e.g., outbreaks of waterborne disease). ”

…continues on the website

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