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implementation of the World Health Organization Trauma Care Checklist program in 11 Centers Across Multiple Economic Strata: Effect on Care Process Measures

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WORLD JOURNAL OF SURGERY 2017年第4期41卷 954-962页

作者： Lashoher, Angela Schneider, Eric B. Juillard, Catherine Stevens, Kent Colantuoni, Elizabeth Berry, William R. Bloem, Christina Chadbunchachai, Witaya Dharap, Satish Dy, Sydney M. Dziekan, Gerald Gruen, Russell L. Henry, Jaymie A. Huwer, Christina Joshipura, Manjul Kelley, Edward Krug, Etienne Kumar, Vineet Kyamanywa, Patrick Mefire, Alain Chichom Musafir, Marcos Nathens, Avery B. Ngendahayo, Edouard Thai Son Nguyen Roy, Nobhojit Pronovost, Peter J. Khan, Irum Qumar Razzak, Junaid Abdul Rubiano, Andres M. Turner, James A. Varghese, Mathew Zakirova, Rimma Mock, Charles 14 Chemin Contamine F-01420 Chanay France Harvard Med Sch Brigham & Womens Hosp Ctr Surg & Publ Hlth 1620 Tremont StSuite 4-020 Boston MA 02120 USA Johns Hopkins Sch Med Johns Hopkins Surg Ctr Outcomes Res Baltimore MD 21205 USA Univ Calif San Francisco Dept Surg Ctr Global Surg Studies 1001 Potrero Ave3A San Francisco CA 94110 USA Johns Hopkins Sch Med 1800 Orleans StSuite 6107E Baltimore MD 21287 USA Johns Hopkins Univ Bloomberg Sch Publ Hlth Dept Biostat 615 N Wolfe St Baltimore MD 21205 USA Harvard Sch Publ Hlth Dept Hlth Policy & Management 401 Pk Dr Boston MA 02215 USA Suny Downstate Med Ctr Dept Emergency Med 450 Clarkson AveBox 1228 Brooklyn NY 11203 USA Khon Kaen Hosp WHO Collaborating Ctr Injury Prevent & Safety Pro Khon Kaen 40000 Thailand Lokmanya Tilak Municipal Med Coll & Gen Hosp Dept Surg Bombay 400022 Maharashtra India Johns Hopkins Bloomberg Sch Publ Hlth Rm 609624 N Broadway Baltimore MD 21205 USA World Self Medicat Ind Rue Cossonay 5Case Postale 124 CH-1023 Crissier Switzerland Nanyang Technol Univ Lee Kong Chian Sch Med Res Techno Plaza02-0750 Nanyang Dr Singapore 637553 Singapore Univ Chicago Dept Surg 5841 S Maryland Ave Chicago IL 60637 USA Unfallkrankenhaus Berlin Clin Trauma Surg & Orthoped Warener Str 7 D-12683 Berlin Germany Acad Traumatol 504 Sangita Complex Parimal Garden 380015 Ahmadabad India WHO Serv Delivery & Safety Dept 20 Ave Appia CH-1211 Geneva Switzerland WHO Dept Management NCDs Disabil Violence & Injury Pr 20 Ave Appia CH-1211 Geneva Switzerland Lokmanya Tilak Municipal Med Coll & Gen Hosp Dept Surg Coll BldgFirst Floor Bombay 400022 Maharashtra India Univ Rwanda Sch Med & Pharm Coll Med & Hlth Sci Nyarugenge CampusPOB 3286 Kigali Rwanda Univ Buea & Reg Hosp Limbe Fac Hlth Sci POB 25526 Yaounde Cameroon Univ Fed Rio de Janeiro Rua Voluntarios Patria445 SL 201 BR-22270005 Rio De Janeiro Brazil Univ Toronto Dept Surg 2075 Bayview AveRoom D5 74 Toronto ON M4N 3M5 Canada Sunn

Trauma contributes more than ten percent of the global burden of disease. Initial assessment and resuscitation of trauma patients often requires rapid diagnosis and management of multiple concurrent complex conditions, and errors are common. We investigated whether implementing a trauma care checklist would improve care for injured patients in low-, middle-, and high-income countries. From 2010 to 2012, the impact of the World Health Organization (WHO) Trauma Care Checklist program was assessed in 11 hospitals using a stepped wedge pre- and post-intervention comparison with randomly assigned intervention start dates. Study sites represented nine countries with diverse economic and geographic contexts. Primary end points were adherence to process of care measures;secondary data on morbidity and mortality were also collected. Multilevel logistic regression models examined differences in measures pre- versus post-intervention, accounting for patient age, gender, injury severity, and center-specific variability. Data were collected on 1641 patients before and 1781 after program implementation. Patient age (mean 34 +/- 18 vs. 34 +/- 18), sex (21 vs. 22 % female), and the proportion of patients with injury severity scores (ISS) >= 25 (10 vs. 10 %) were similar before and after checklist implementation (p > 0.05). Improvement was found for 18 of 19 process measures, including greater odds of having abdominal examination (OR 3.26), chest auscultation (OR 2.68), and distal pulse examination (OR 2.33) (all p < 0.05). These changes were robust to several sensitivity analyses. implementation of the WHO Trauma Care Checklist was associated with substantial improvements in patient care process measures among a cohort of patients in diverse settings.

关键词： Process Measure Injury Severity Score program implementation Initial Resuscitation Step Wedge Design

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The Development and implementation of a School-Based Dental Sealant program for Hawaii Public Schools

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JOURNAL OF SCHOOL HEALTH 2024年第1期94卷 87-95页

作者： Mattheus, Deborah Loos, Joanne R. Vogeler, Azeema Univ Hawaii Manoa Hawaii Keiki Healthy & Ready to Learn Honolulu HI USA Univ Hawaii Manoa Nancy Atmospera Walch Sch Nursing NAWSON Honolulu HI USA UHM NAWSON Honolulu HI USA Univ Hawaii Manoa Nancy Atmospera Walch Sch Nursing NAWSON Hawaii Keiki Hlth & Ready Learn Honolulu HI USA 2528 McCarthy Mall Webster Hall 401 Honolulu HI 96822 USA

BACKGROUND: School-based dental sealant programs are noted to increase sealant uptake among children, especially those from low-income families and those living in rural and underserved areas. However, nationally school-based dental sealant programs are substantially underutilized. This paper describes a partnership approach to a school-based dental sealant program for Title 1 public schools in ***: The Hawaii Keiki: Healthy and Ready to Learn program partnered with the Hawaii Dental Service to develop and implement an interprofessional, school-based sealant program (SBSP). This article describes the development of key factors, such as partnerships, an interprofessional team, team roles, policies, and marketing tools to optimize program ***: The SBSP has completed over 3 academic years of implementation in Hawaii public schools. In its initial year (school year [SY] 2019-2020), which presented challenges due to the COVID-19 pandemic, it served 6 schools (106 students screened) on 1 island. It expanded to 14 schools on 1 island (193 students screened) in its second year (SY 2020-2021), 28 schools on 3 islands (653 students screened) in its third year (SY 2021-2022), and during the Fall of the fourth year, the program reached 50 schools on 3 islands (1821 students screened) and is projected to reach over 70 schools by the end of SY ***: Taking advantage of strategic partnerships and key interprofessional team members, a school-based dental sealant program can help to improve the oral health of children in public schools by helping to decrease barriers to care.

关键词： dental sealants school-based oral health program implementation partnerships interprofessional

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implementation of the Henry J. Kaiser Family Foundation's Community Health Promotion Grant program: A process evaluation

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MILBANK QUARTERLY 1998年第1期76卷 121-+页

作者： Wickizer, TM Wagner, E Cheadle, A Pearson, D Beery, W Maeser, J Psaty, B VonKorff, M Koepsell, T Diehr, P Perrin, EB Univ Washington Dept Hlth Serv Seattle WA 98195 USA Grp Hlth Cooperat Puget Sound Seattle WA 98121 USA

The Community Health Promotion Grants program, sponsored by the Henry J. Kaiser Family Foundation, represents a major health initiative chat established 11 community health promotion projects. Successful implementation was characterized by several critical factors: (1) intervention activities;(2) community activation;(3) success in obtaining external funding;and (4) institutionalization. Analysis of the program was based on data from several sources: program reports, key informant surveys, and a community coalition survey. Results indicate that school-based programs focusing on adolescent health problems were the most successful in reaching the populations they were targeting. The majority of the programs were able ro attract external funding, thereby adding to their initial resource base. The programs were less successful in generating health promotion activities and in achieving meaningful institutionalization in their communities.

关键词： HEALTH AND HUMAN RESOURCES HEALTH CARE programS program EVALUATION program implementation

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implementation of a relapse prevention program among smokers undergoing arthroplasty: lessons learned

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ANZ JOURNAL OF SURGERY 2023年第4期93卷 1001-1007页

作者： Wilker, Olivia G. Stevens, Elizabeth R. Gold, Heather T. Haber, Yaa Slover, James D. Sherman, Scott E. NYU Grossman Dept Populat Hlth Sch Med New York NY USA NYU Grossman Dept Orthoped Surg Sch Med New York NY USA VA New York Harbor Healthcare Syst Dept Med New York NY USA NYU Grossman Dept Populat Hlth Sch Med 180 Madison Ave17th Floor New York NY 10026 USA

BackgroundSurgery is a potent motivator to help people quit smoking to reduce the risk of complications. Many patients who smoke receive tobacco cessation counseling prior to surgery and are able to quit, but do not receive the same resources after surgery and often resume smoking. MethodsWe present a case study describing the recruitment process, study components, and lessons learned from StayQuit, a comprehensive relapse prevention program designed to prevent relapse after arthroplasty. Lessons learned were examined post hoc to determine challenges related to program implementation, using existing study procedures and information collected. ResultsWhile a comprehensive postoperative relapse prevention program may be beneficial to patients, implementation of StayQuit is unlikely to be feasible under current circumstances. The primary challenges to successful implementation of StayQuit focused on themes of lack of engagement in the preoperative Orthopedic Surgery Quit Smoking program (OSQSP) and an environment unfavorable to in-person enrollment on the day of surgery. ConclusionsPostoperative relapse prevention programs may be beneficial for patients who quit smoking prior to elective surgery. To help guide implementation, it is important to consider surgeon behavior, the collaboration of clinical and non-clinical teams, and best practices for study enrollment in surgical settings.

关键词： arthroplasty counseling program implementation relapse prevention smoking cessation

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Making the leap from idea generation to implementation: Ten steps every geriatrics specialist should know

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JOURNAL OF THE AMERICAN GERIATRICS SOCIETY 2025年第1期73卷 12-19页

作者： Agarwal, Nimit Pagali, Sandeep R. Sharma, Kanishk D. Walke, Lisa M. Univ Arizona Coll Med Div Geriatr Med Phoenix AZ USA Mayo Clin Div Hosp Med Med Director Inpatient Geriatr Serv Rochester MN USA Donald & Barbara Zucker Sch Med Hofstra Northwell Div Geriatr Med Hempstead NY USA Univ Penn Perelman Sch Med Div Geriatr Med Philadelphia PA USA

This is an exciting time in Geriatrics, with numerous opportunities in health care for Geriatrics specialists to innovate and lead. Geriatrics specialists should know how to implement innovative care models to lead healthcare changes in their organizations and effectively facilitate change management. We highlight a 10-step framework that Geriatrics specialists can leverage to quickly move their ideas from development to implementation at a system level. This framework adapts concepts from business management to provide a step-by-step guide to move from idea generation to implementation. We provide different practical examples that a Geriatrician can correlate to in their practice, including value proposition and business canvas model. Though small components of the business canvas model may vary based on organization and program/idea-specific needs, the outlined skills will establish Geriatrics specialists as leaders of change, a resource for education, and valued consultants to a health system that is in dire need of direction to improve the quality of care, and health outcomes, for older adults.

关键词： business case Geriatrics specialist leadership skills program implementation

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A case study of one school system's adoption and implementation of an elementary science program

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JOURNAL OF RESEARCH IN SCIENCE TEACHING 2005年第1期42卷 25-52页

作者： Kelly, MP Staver, JR Kansas State Univ Ctr Sci Educ Manhattan KS 66506 USA Minot Publ Sch Minot ND USA

In this investigation we employed a case study approach with qualitative and quantitative data sources to examine and discover the characteristics of the processes used by a midwestern U.S. school system to adopt and implement a new K-6 science curriculum. Analysis of data yielded several results. Elementary teachers received what they requested, a hands-on science program with texts and kits. Teachers as a group remained in the early stages of the Concerns-Based Adoption Model profile of concerns. Many K-6 teachers remained uncomfortable with teaching science. Teachers' attitudes regarding the new program were positive, and they taught more science. Teachers struggled with science-as-inquiry, with a science program they believe contained too many concepts and too much vocabulary, and with their beliefs that students learned more and loved the new hands-on program. Traditional science teaching remained the norm. Administrative support was positive but insufficient to facilitate full implementation of the new program and more substantial change in teaching. Standardized science achievement test scores did not show an observable pattern of growth. It is concluded that a systematic, ongoing program of professional development is necessary to address teachers' concerns and help the district realize its goal of standards-based K-6 science instruction. (C) 2004 Wiley Periodicals, Inc.

关键词： Science programs Science Achievement Hands on Science Elementary School Science Adoption (Ideas) Science Instruction Case Studies program implementation Science Curriculum Elementary School Teachers Teacher Attitudes Inquiry Conventional Instruction Teaching Methods Standardized Tests Student Evaluation Achievement Tests

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The implementation of a Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) program at a Level 1 New England Trauma Center: Feasibility and Early Outcomes

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AMERICAN SURGEON 2023年第12期89卷 5474-5479页

作者： Roderick, Elizabeth Ricaurte, Daniel Croteau, Alfred Gates, Jonathan Bass, Stacy Jain, A. K. Keating, Jane Hartford Hosp Dept Trauma & Crit Care Hartford CT 06106 USA Hartford Hosp Dept Intervent Radiol Hartford CT 06106 USA Hartford Hosp Dept Vasc Surg Hartford CT 06106 USA Hartford Hosp Dept Trauma & Crit Care 80 Seymour St Hartford CT 06106 USA

Objectives We evaluated the feasibility of implementing a Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) program at our urban level 1 trauma center and evaluated early outcomes. Design A multidisciplinary committee including physicians (trauma surgery, emergency medicine, vascular surgery, and interventional radiology) and nurses created clinical practice guidelines for the placement of REBOA at our institution. All trauma surgeons and critical care board certified emergency medicine physicians were trained in placement and nurses received management training. A formal review process was implemented to identify areas for improvement. Finally, we instituted refresher training to maintain REBOA competency. Trauma patients with noncompressible torso hemorrhage from blunt or penetrating injuries who were partial or nonresponders to blood product resuscitation were included. Pregnant patients, children, or patients with significant hemothorax or suspected aortic or cardiac injury were excluded. Results Over seven months, eight catheters were successfully placed, all on the first attempt, including six in Zone 3 and two in Zone 1. All Zone 3 catheters were placed for pelvic fracture-related bleeding which were subsequently embolized. The Zone 1 catheters were placed immediately preoperatively for intraabdominal bleeding. Upon committee review, one critique was made regarding zone selection. One patient developed an arteriovenous fistula after placement which resolved without intervention. There were no other complications and all patients survived to discharge. Conclusions An REBOA program is feasible and safe following a comprehensive multidisciplinary effort. The efforts described here can be utilized by similar trauma programs for adaptation of this endovascular approach to bleeding control.

关键词： REBOA endovascular trauma hemorrhage program implementation

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implementation variation and fidelity in an inquiry science program: Analysis of GLOBE data reporting patterns

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JOURNAL OF RESEARCH IN SCIENCE TEACHING 2004年第3期41卷 294-315页

作者： Penuel, WR Means, B SRI Int Menlo Pk CA 94061 USA

This article examines variations in patterns in the enactment of a large-scale kindergarten through Grade 12 science inquiry program. Student data reports in the GLOBE program provide a useful measure of implementation because key design elements in the program are student collection and reporting of local environmental data. We examined associations among teachers' responses to survey items to patterns in GLOBE data reporting to develop hypotheses about important contextual factors related to program implementation. Implications for the study of science inquiry programs are discussed. (C) 2004 Wiley Periodicals, Inc.

关键词： Science programs program implementation Elementary Secondary Education Hands on Science Data Collection Science Education Teacher Surveys Educational Environment Physical Environment Science Activities

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Perspectives of HIV Clinic Staff on the implementation of a Client Financial Incentives program Targeting Viral Suppression

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JANAC-JOURNAL OF THE ASSOCIATION OF NURSES IN AIDS CARE 2017年第5期28卷 770-783页

作者： Anderson, Susannah Jenner, Eric Lass, Katherine Burgess, Samuel Policy & Res Grp New Orleans LA 70118 USA Policy & Res Grp Res New Orleans LA USA Louisiana Dept Hlth Off Publ Hlth STD HIV Program New Orleans LA USA

We present perspectives of health care providers and clinic staff on the implementation of a financial incentive program for clients living with HIV in three Louisiana clinics. Interviews were conducted in May-June 2015 with 27 clinic staff to assess their perspectives on implementation of the Health Models financial incentive program, which was initiated in September 2013. Many providers and staff welcomed the program, but some were concerned about sustainability and the ethics of a program that paid patients to receive care. Most said they eventually found the program to be helpful for patients and clinic operations in general, by facilitating partnerships between providers and patients, improving appointment keeping, providing opportunities for patient education, engaging patients in care, and helping patients form new prevention habits. The findings can improve understanding of staff and leadership perceptions of incentive programs and can inform planning and implementation of these programs in the future. Copyright (C) 2017 Association of Nurses in AIDS Care

关键词： health care providers HIV treatment incentive program program implementation viral suppression

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Feasibility of using patient navigation to improve identification of hereditary cancer syndromes in newly diagnosed patients with colorectal cancer

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GENETICS IN MEDICINE 2025年第5期27卷 101372页

作者： Sears, Emma Dahlquist, Jacky Stayman, Sarah Ko, Cynthia Konnick, Eric Q. Cole, Allison Zhang, Ying Kohn, Marlana Henderson, Vida Knerr, Sarah Univ Washington Inst Publ Hlth Genet Sch Publ Hlth Seattle WA USA Univ Washington Sch Publ Hlth Dept Hlth Syst & Populat Hlth Seattle WA USA Univ Washington Sch Med Dept Med Seattle WA USA Univ Washington Sch Med Dept Lab Med & Pathol Seattle WA USA Univ Washington Dept Family Med Sch Med Seattle WA USA Fred Hutch Canc Ctr Publ Hlth Sci Div Seattle WA USA

Purpose: Germline genetic testing to identify hereditary cancer syndromes in patients newly diagnosed with colorectal cancer (CRC) carries substantial benefits. We examined the feasibility of using patient navigation, an evidence-based approach to reduce structural barriers to recommended care, to improve test completion by increasing pretest counseling attendance. Methods: We conducted key informant interviews with representatives from organizations providing cancer care to CRC patients. Interviews included questions derived from the Consolidated Framework for implementation Research, which delineates barriers and facilitators to implementing evidence-based practices. We used an inductive-deductive coding approach to identify themes related to program feasibility. Results: We interviewed 19 participants across 13 organizations. Key feasibility barriers included funding to implement and sustain a navigation program, staffing and supervising the navigator role, health information technology needs, gaining administrators' buy-in, and evolving genetic service delivery models. Participants suggested multiple strategies to address implementation barriers, but most would prefer other approaches to improve genetic test completion over implementing a genomics-focused patient navigation program. Conclusion: Stakeholders across a range of health care organizations saw limited value in improving the identification of hereditary CRC syndromes by implementing a program designed to increase pretest genetic counseling attendance. The need to scale up genetic testing has shifted interest toward delivery models better integrated in established care pathways, requiring fewer resources and providing broader reach. (c) 2025 American College of Medical Genetics and Genomics. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

关键词： Cancer prevention Feasibility Lynch syndrome Patient navigation program implementation

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