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Browsing by Author "Azar, Jose M."
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Item Developing the Agile Implementation Playbook for Integrating Evidence-Based Health Care Services into Clinical Practice(Wolters Kluwer, 2018-10) Boustani, Malaz A.; van der Marck, Marjolein A.; Adams, Nadia; Azar, Jose M.; Holden, Richard J.; Vollmar, Horst C.; Wang, Sophia; Williams, Christopher; Alder, Catherine; Suarez, Shelley; Khan, Babar; Zarzaur, Ben; Fowler, Nicole R.; Overley, Ashley; Solid, Craig A.; Gatmaitan, Alfonso; Medicine, School of MedicineProblem: Despite the more than $32 billion the National Institutes of Health has invested annually, evidence-based health care services are not reliably implemented, sustained, or distributed in health care delivery organizations, resulting in suboptimal care and patient harm. New organizational approaches and frameworks that reflect the complex nature of health care systems are needed to achieve this goal. Approach: To guide the implementation of evidence-based health care services at their institution, the authors used a number of behavioral theories and frameworks to develop the Agile Implementation (AI) Playbook, which was finalized in 2015. The AI Playbook leverages these theories in an integrated approach to selecting an evidence-based health care service to meet a specific opportunity, rapidly implementing the service, evaluating its fidelity and impact, and sustaining and scaling up the service across health care delivery organizations. The AI Playbook includes an interconnected eight-step cycle: (1) identify opportunities; (2) identify evidence-based health care services; (3) develop evaluation and termination plans; (4) assemble a team to develop a minimally viable service; (5) perform implementation sprints; (6) monitor implementation performance; (7) monitor whole system performance; and (8) develop a minimally standardized operating procedure. Outcomes: The AI Playbook has helped to improve care and clinical outcomes for intensive care unit survivors and is being used to train clinicians and scientists in AI to be quality improvement advisors. Next Steps: The authors plan to continue disseminating the details of the AI Playbook and illustrating how health care delivery organizations can successfully leverage it.Item Evaluation of interprofessional relational coordination and patients’ perception of care in outpatient oncology teams(Taylor & Francis, 2017) Azar, Jose M.; Johnson, Cynthia S.; Frame, Amie M.; Perkins, Susan M.; Cottingham, Ann H.; Litzelman, Debra K.; Department of Medicine, School of MedicineThis pilot study was designed to measure teamwork and the relationship of teamwork to patient perceptions of care among 63 members of 12 oncology teams at a Cancer Centre in the Midwest. Lack of teamwork in cancer care can result in serious clinical errors, fragmentation of care, and poor quality of care. Many oncology team members, highly skilled in clinical care, are not trained to work effectively as members of a care team. The research team administered the Relational Coordination survey to core oncology team members—medical oncologists, nurse coordinators, and clinical secretaries—to measure seven dimensions of team skills (four relating to communication [frequency, timeliness, accuracy, and problem solving] and three relating to relationship [shared goals, shared knowledge, and mutual respect]) averaged to create a Relational Coordination Index. The results indicated that among the team member roles, nurse coordinator relational coordination indices were the strongest and most positively correlated with patient perception of care. Statistically significant correlations were intra-nurse coordinator relational coordination indices and two patient perception of care factors (information and education and patient’s preferences). All other nurse coordinator intra-role as well as inter-role correlations were also positively correlated, although not statistically significant.