Browsing by Author "Rabi, Sarah"
Now showing 1 - 5 of 5
Results Per Page
Sort Options
- ItemEmbargoAn Examination of Patients’ Experiences with Navigation Services in Alberta’s Healthcare System(2024-06-20) Rabi, Sarah; Tang, Karen; Santana, Maria; McBrien, Kerry; Dimitropoulos, GinaBackground: The concept of patient navigation (PN) was first envisioned to assist marginalized cancer patients access appropriate and timely healthcare resources. While this understanding of PN may still hold for a subgroup of programs today, the expansion of PN over the past 30 years has resulted in a diverse set of interventions with distinct care settings, patient eligibility criteria, navigator training, and program objectives. Noting this, our study sought to better understand how PN has evolved by gathering information on patients’ perspectives and interactions with PN programs across Alberta. Our objectives were to (i) explore patients’ current experiences with PN programs, and (ii) identify the features of PN felt to be of particular value to patients. Methods: To address these objectives, we conducted an interpretive descriptive study to collate the experiences of adult patients with longitudinal exposure to Albertan PN programs (involvement for greater than or equal to one month). Participant recruitment occurred via key informant sampling with navigators across Alberta. One-on-one semi-structured interviews were conducted to explore patient experiences with PN and their understanding of it as a broader concept. Inductive thematic analysis and interpretive exercises were subsequently performed to construct a coherent message from the data. Continued collaboration with two patient partners was maintained throughout the study to ensure responsiveness to patient priorities. Results: This study involved 23 participants with experience using nurse navigators, transition navigators, and lay community health navigators. Irrespective of navigation type, the participants’ stories were tethered by their navigators’ promotion of seamless and personalized care, as well as their ability to seemingly humanize the healthcare system. This was accomplished through a set of participant-identified navigator characteristics, including approachability, accessibility, and comprehensive systems knowledge. While the identified functions and characteristics of navigators were consistent across participants, how these components were operationalized varied based on the program’s setting and the particular needs of each patient. Conclusion: As a patient-centred intervention, understanding patients’ experiences and valuations of PN is critical to distilling the essence of the intervention. This research directly addresses ongoing knowledge gaps surrounding contemporary understandings of PN, particularly from patients’ perspectives.
- ItemOpen AccessFactors affecting implementation of patient-reported outcome and experience measures in a pediatric health system(2023-03-09) McCabe, Erin; Rabi, Sarah; Bele, Sumedh; Zwicker, Jennifer D.; Santana, Maria J.Abstract Background The use of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) in pediatric clinical practice can enhance clinical care and bring children and families’ perspectives into evaluations of healthcare services. Implementing these measures is complex and requires a thorough assessment of the context of implementation The purpose of this study is to describe the barriers and facilitators to PROMs and PREMs implementation and to recommend strategies for implementing these measures in a pediatric health system. Methods We used a qualitative descriptive approach to analyse data from interviews to understand the experiences of PROMs and PREMs users across different pediatric settings in a single Canadian healthcare system. Results There were 23 participants representing a variety of roles within the healthcare system and pediatric populations. We found five main factors that affected implementation of PROMs and PREMs in pediatric settings: 1) Characteristics of PROMs and PREMs; 2) Individual’s beliefs; 3) Administering PROMs and PREMs; 4) Designing clinical workflows; and 5) Incentives for using PROMs and PREMs. Thirteen recommendations for integrating PROMs and PREMs in pediatric health settings are provided. Conclusions Implementing and sustaining the use of PROMs and PREMs in pediatric health settings presents several challenges. The information presented will be useful for individuals who are planning or evaluating the implementation of PROMs and PREMs in pediatric settings.
- ItemOpen AccessPatient-reported experiences and outcomes of virtual care during COVID-19: a systematic review(2023-12-01) Bajgain, Bishnu; Rabi, Sarah; Ahmed, Sadia; Kiryanova, Veronika; Fairie, Paul; Santana, Maria J.Abstract Introduction The onset of COVID-19 has caused an international upheaval of traditional in-person approaches to care delivery. Rapid system-level transitions to virtual care provision restrict the ability of healthcare professionals to evaluate care quality from the patient's perspective. This poses challenges to ensuring that patient-centered care is upheld within virtual environments. To address this, the study’s objective was to review how virtual care has impacted patient experiences and outcomes during COVID-19, through the use of patient-reported experience and outcome measures (PREMs and PROMs), respectively. Methods A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines to evaluate patient responsiveness to virtual care during COVID-19. Using an exhaustive search strategy, relevant peer-reviewed articles published between January 2020 and 2022 were pulled from MEDLINE, CINAHL, EMBASE, and PsychInfo databases. Study quality was independently assessed by two reviewers using the Mixed Methods Appraisal Tool. A patient partner was consulted throughout the study to provide feedback and co-conduct the review. Results After removing duplicates, 6048 articles underwent title and abstract review, from which 644 studies were included in the full-text review stage. Following this, 102 articles were included in the study. Studies were published in 20 different countries, were predominantly cross-sectional, and reported on the delivery of virtual care in specialized adult outpatient settings. This review identified 29 validated PREMs and 43 PROMs. Several advantages to virtual care were identified, with patients citing greater convenience, (such as saving travel time and cost, less waiting experienced to see care providers) and increased protection from viral spread. Some studies also reported challenges patients and caregivers faced with virtual care, including feeling rushed during the virtual care appointment, lack of physical contact or examination presenting barriers, difficulty with communicating symptoms, and technology issues. Conclusion This review provides supportive evidence of virtual care experiences during the COVID-19 pandemic from patient and caregiver perspectives. This research provides a comprehensive overview of what patient-reported measures can be used to record virtual care quality amid and following the pandemic. Further research into healthcare professionals’ perspectives would offer a supportive lens toward a strong person-centered healthcare system.
- ItemOpen AccessPatient-reported outcome measures in pediatric asthma care: using theoretical domains framework to explore healthcare providers’ perceptions(2022-08-19) Bele, Sumedh; Rabi, Sarah; Zhang, Muning; Oddone Paolucci, Elizabeth; Johnson, David W.; Quan, Hude; Santana, Maria J.Abstract Background Patient-reported outcome measures (PROMs) play an important role in promoting and supporting patient and family-centered care. Implementing interventions like PROMs in routine clinical care require key stakeholders to change their behavior. The aim of this study was to utilize the Theoretical Domains Framework (TDF) to identify barriers and enablers to the implementation of PROMs in pediatric outpatient asthma clinics from healthcare providers’ perspective. Methods This TDF-guided qualitative descriptive study is part of a larger multi-phase project to develop the KidsPRO program, an electronic platform to administer, collect, and use PROMs in pediatrics. Semi-structured qualitative interviews were conducted with 17 participants, which included pediatricians, nurses, allied health professionals and administrative staff from outpatient asthma clinics. All the interviews were transcribed, deductively coded, inductively grouped in themes, and categorized into barriers and enablers. Results We identified 33 themes within 14 TDF domains, which were further categorized and tabulated into 16 barriers and 17 enablers to implementing PROMs in asthma clinics. Barriers to behavioral change were attributed to personal, clinical, non-clinical, and other system-level factors; they ranged from limited awareness of PROMs to language barriers and patient’s complex family background. Enablers ranged from a personal commitment to providing patient and family-centered care to administering PROMs electronically. Conclusion This implementation of science-based systematic inquiry captured the complexity of PROMs implementation in pediatric outpatient clinical care for asthma. Considering the consistency in barriers and enablers to implementing PROMs across patient populations and care settings, many findings of this study will be directly applicable to other pediatric healthcare settings.
- ItemOpen AccessUptake of pediatric patient-reported outcome and experience measures and challenges associated with their implementation in Alberta: a mixed-methods study(2023-07-18) Bele, Sumedh; Rabi, Sarah; Zhang, Muning; Ahmed, Sadia; Paolucci, Elizabeth O.; Johnson, David W.; Quan, Hude; Santana, Maria J.Abstract Background Implementing Patient-reported Outcome Measures (PROMs) and Patient-reported Experience Measures (PREMs) is an effective way to deliver patient- and family-centered care (PFCC). Although Alberta Health Services (AHS) is Canada's largest and fully integrated health system, PROMs and PREMs are yet to be routinely integrated into the pediatric healthcare system. This study addresses this gap by investigating the current uptake, barriers, and enablers for integrating PROMs and PREMs in Alberta's pediatric healthcare system. Methods Pediatric clinicians and academic researchers with experience using PROMs and PREMs were invited to complete a quantitative survey. Additionally, key stakeholders were qualitatively interviewed to understand current challenges in implementing pediatric PROMs and PREMs within AHS. Quantitative data gathered from 22 participants were descriptively analyzed, and qualitative data from 14 participants were thematically analyzed. Results Participants identified 33 PROMs and 6 PREMs showing diversity in the types of pediatric PROMs and PREMs currently being used in Alberta and their mode of administration. The qualitatively identified challenges were associated with patients, family caregivers, and clinicians. The absence of system-level support, such as integration within electronic medical records, is considered a significant system-level challenge. Conclusions The significant variation in the types of PROMs and PREMs used, the rationale for their use, and their mode of administration demonstrate the diverse and sporadic use of these measures in Alberta. These findings highlight the need for province-wide uniform implementation of pediatric PROMs and PREMs in Alberta. Our results could benefit healthcare organizations in developing evidence-based PROM and PREM implementation strategies in pediatrics.