Journal of evaluation in clinical practice
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Audit and feedback is an evidence-based implementation strategy, but studies reporting the use of theory to guide design elements are limited. ⋯ We conclude that a multistage development process including theory exploration and mapping, contributed to the design and delivery of the audit and feedback. Aligned with the MRC framework, the IMP2 ART strategy (incorporating the audit and feedback) is now being tested in a UK-wide cluster randomised controlled trial.
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Despite advancements in diabetes management, a subgroup of patients does not achieve an acceptable level of metabolic control. To achieve treatment goals for high-risk patients, a higher frequency of contact with healthcare professionals is essential. However, socioeconomic challenges often lead to nonattendance at the outpatient clinic. Therefore, home visits were introduced as a supplement/an alternative to consultations at the paediatric diabetes clinic. The aim of this study was to uncover the perception of patients, mothers and healthcare professionals regarding home visits versus consultations at the outpatient clinic in order to being able to improve the services offered. ⋯ Overall, home visits were found to contribute toward creating a more constructive relationship. However, it was still a challenge to keep the scheduled appointments, and during this short study, no improvement in metabolic control could be observed.
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Contemporary society is characterised by constant change with an ever-increasing feature of interconnection, having clear implications for healthcare professional learning and role identity. It is proposed that active participation and coproduction for learning can provide options to understand contemporary challenges and opportunities in the development of personal and professional identity. ⋯ A process of open dialogue within co-produced workshop design and delivery would appear to enhance learning and a contextual appreciation of a broader 'whole' for all participants. Future research is aimed at building on this project, to explore co-produced learning opportunities across levels and settings that provide further insight into personal and professional identity development.
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During the devastating early months of the unfolding COVID-19 pandemic in New York, healthcare systems and clinicians dynamically adapted to drastically changing everyday practice despite having little guidance from formal research evidence in the face of a novel virus. Through new, silo-breaking networks of communication, clinical teams transformed and synthesized provisional recommendations, rudimentary published research findings and numerous other sources of knowledge to address the immediate patient care needs they faced during the pandemic surge. ⋯ We draw on the concept of mindlines as developed by Gabbay and Le May as a conceptual framework for interpreting that experience from the standpoint of how early information from research and guidelines was drawn on and transformed in the course of day-to-day struggle with the crisis in New York City emergency rooms. Finally, briefly referencing the challenges to conventional models of healthcare knowledge creation and translation through research and guideline production posed by COVID-19 crisis, we offer a provisional perspective on current and future developments.