Patient and business rules extraction and formalisation using SVN and SBVR for automated healthcare

This paper describes advances in automated health service selection and composition in the Ambient Assisted Living (AAL) domain. We apply a Service Value Network (SVN) approach to automatically match medical practice recommendations to health services based on sensor readings in a home care context. Medical practice recommendations are extracted from National Health and Medical Research Council (NHMRC) guidelines. Service networks are derived from Medicare Benefits Schedule (MBS) listings. Service provider rules are further formalised using Semantics of Business Vocabulary and Business Rules (SBVR), which allows business participants to identify and define machine-readable rules. We demonstrate our work by applying an SVN composition process to patient profiles in the context of Type 2 Diabetes Management.

Feedback reporting of survey data to healthcare aides

Background

This project occurred during the course of the Translating Research in Elder Care (TREC) program of research. TREC is a multilevel and longitudinal research program being conducted in the three Canadian Prairie Provinces of Alberta, Saskatchewan, and Manitoba. The main purpose of TREC is to increase understanding about the role of organizational context in influencing knowledge use in residential long-term care settings. The purpose of this study was to evaluate healthcare aides’ (HCAs) perceptions of a one-page poster designed to feed back aggregated data (including demographic information and perceptions about influences on best practice) from the TREC survey they had recently completed.

Methods
A convenience sample of 7 of the 15 nursing homes participating in the TREC research program in Alberta were invited to participate. Specific facility-level summary data were provided to each facility in the form of a one-page poster report. Two weeks following delivery of the report, a convenience sample of HCAs was surveyed using one-to-one structured interviews.

Results
One hundred twenty-three HCAs responded to the evaluation survey. Overall, HCAs’ opinions about presentation of the feedback report and the understandability, usability, and usefulness of the content were positive. For each report, analysis of data and production and inspection of the report took up to one hour. Information sessions to introduce and explain the reports averaged 18 minutes. Two feedback reports (minimum) were supplied to each facility at a cost of CAN$2.39 per report, for printing and laminating.

Conclusions
This study highlights not only the feasibility of producing understandable, usable, and useful feedback reports of survey data but also the value and importance of providing feedback to survey respondents. More broadly, the findings suggest that modest strategies may have a positive and desirable effect in participating sites.

Realist synthesis : illustrating the method for implementation research

Background
Realist synthesis is an increasingly popular approach to the review and synthesis of evidence, which focuses on understanding the mechanisms by which an intervention works (or not). There are few published examples of realist synthesis. This paper therefore fills a gap by describing, in detail, the process used for a realist review and synthesis to answer the question 'what interventions and strategies are effective in enabling evidence-informed healthcare?' The strengths and challenges of conducting realist review are also considered.
Methods
The realist approach involves identifying underlying causal mechanisms and exploring how they work under what conditions. The stages of this review included: defining the scope of the review (concept mining and framework formulation); searching for and scrutinising the evidence; extracting and synthesising the evidence; and developing the narrative, including hypotheses.
Results
Based on key terms and concepts related to various interventions to promote evidenceinformed healthcare, we developed an outcome-focused theoretical framework. Questions were tailored for each of four theory/intervention areas within the theoretical framework and were used to guide development of a review and data extraction process. The search for literature within our first theory area, change agency, was executed and the screening procedure resulted in inclusion of 52 papers. Using the questions relevant to this theory area, data were extracted by one reviewer and validated by a second reviewer. Synthesis involved organisation of extracted data into evidence tables, theming and formulation of chains of inference, linking between the chains of inference, and hypothesis formulation. The narrative was developed around the hypotheses generated within the change agency theory area.
Conclusions
Realist synthesis lends itself to the review of complex interventions because it accounts for context as well as outcomes in the process of systematically and transparently synthesising relevant literature. While realist synthesis demands flexible thinking and the ability to deal with complexity, the rewards include the potential for more pragmatic conclusions than alternative approaches to systematic reviewing. A separate publication will report the findings of the review.

Medical tourism: a conceptual framework for an innovation in global healthcare provision

The purpose of this chapter is to establish a conceptual model that can potentially fill research gaps in the literature about medical tourism as an innovative concept in global healthcare provision by developing emerging economies as they are providing low cost alternatives in medical treatment at internationally accredited medical facilities to treat patients from developed countries. Major databases such as Ebscohost and Emerald have been used to search relevant literature. The literature on medical tourism is reviewed so as to understand the key drivers of medical tourism as well as research gaps in the existing literature. Three major drivers of medical tourism have been identified, namely cost, waiting time, and perceived quality. Further empirical research is needed to test the conceptual model in order to better understand what drives a decision to engage in medical tourism. This chapter makes three major contributions; firstly, the identification of the medical tourism literature from the service marketing and management perspectives; secondly, to propose a conceptual model representing innovation in medical tourism for global healthcare by developing emerging economies; thirdly, the identification of research gaps in the medical tourism literature through which future research can further the knowledge of why people travel to developing countries for medical treatment.

Influence of high performance work systems on employee subjective well-being and job burnout: empirical evidence from the Chinese healthcare sector

Over the last two decades, high performance work systems (HPWSs) research has been dominated by examining the effects of these systems on firm performance. Research on the impact of HPWSs on employees has been marginalised. This study examines the impact of HPWSs on two psychological outcomes for employees, namely, subjective well-being (SWB) and workplace burnout, by utilising data collected from 1488 physicians and nurses in 25 Chinese hospitals. It also examines the moderating effects of employees' organisational based self-esteem (OBSE), as an individual intervention and physician–nurse relationships, as an organisational intervention, on the relationship between HPWSs and employee outcomes. HPWS is found to increase employees' SWB and decrease burnout. Such well-being-enhancing and burnout-relieving effects are stronger when employees have high OBSE. The positive effect of HPWS on SWB is also stronger when there is a collaborative relationship among employees in an organisation. The major contribution of this study is to unpack the ‘black box’ of how HPWS influences employee well-being in the Chinese healthcare sector context.

Tweet reach : a research protocol for using Twitter to increase information exchange in people with communication disabilities

Objective: To (a) outline the background to research evaluating Twitter use by people with severe physical and communication disabilities participating actively in online communication forums for increasing information exchange and (b) illustrate a range of potential methods that might be applied in furthering research on the use of social media by people with developmental and acquired communication disabilities. Methods: The literature on communication disabilities, augmentative and alternative communication, and social media research informed the rationale for and design of three studies investigating the use of Twitter by people with communication disabilities. Results: To date, there is little information in the literature about how people with a range of communication disabilities might use Twitter to increase their access to information and help them to feel knowledgeable and in control of their own lives. In this paper, three studies are proposed to investigate the use of Twitter by people with communication disabilities.

Nurses' experiences of ethical preparedness for public health emergencies and healthcare disasters: a systematic review of qualitative evidence

Little is known about nurses' direct experiences of ethical preparedness for dealing with catastrophic public health emergencies and healthcare disasters or the ethical quandaries that may arise during such events. A systematic literature review was undertaken to explore and synthesize qualitative research literature reporting nurses' direct experiences of being prepared for and managing the ethical challenges posed by catastrophic public health emergencies and healthcare disasters. Twenty-six research studies were retrieved for detailed examination and assessed by two independent reviewers for methodological validity prior to inclusion in the review. Of these, 12 studies published between 1973 and 2011 were deemed to meet the inclusion criteria and were critically appraised. The review confirmed there is a significant gap in the literature on nurses' experiences of ethical preparedness for managing public health emergencies and healthcare disasters, and the ethical quandaries they encounter during such events. This finding highlights the need for ethical considerations in emergency planning, preparedness, and response by nurses to be given more focused attention in the interests of better informing the ethical basis of emergency disaster management.

Strategic facilities management for Australian public healthcare operation

This research developed a conceptual framework on strategic Facilities Management for public healthcare organisation in Australia. Findings from this study prove that healthcare users have the same view on building performance and facilities business operation but not on Facilities Management service delivery. The model framework can assist public healthcare organisations to better manage facilities management in healthcare organisation.

Clinical research and leadership training program as a knowledge translation initiative across an Australian health care service

 Health professionals need to be integrated more effectively in clinical research initiatives to ensure that research addresses key clinical needs and provides practical, implementable solutions at the coal face of care. Here we describe the informative phase of a broader program to enable and support health professionals at Monash Health who do not have a research background, to engage in and lead research to improve healthcare outcomes. The findings will be used to develop a dedicated clinical research and leadership training program. The training program will support Monash Health staff to up-skill or enhance skills to conduct rigorous research; engage and lead multidisciplinary, collaborative teams; and to use research to guide practice, as well as identify and address gaps in clinical research.  

Happily ever after: communicating results to participants in research

Discusses how results of a research study on lifelong disabilities can be relayed to participants once it is accomplished. Importance of the need of participants to hear and understand the results of studies in which they have been involved; Selection of the best way to disseminate results.