Journal of evaluation in clinical practice
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Sturmberg and Martin's application of systems and complexity theory to understanding Universal Health Care (UHC) and Primary Health Care (PHC) is evaluated in the light of the influence of political economy on health systems. Furthermore, the role that neoliberal approaches to governance have had in creating increased inequities is seen as a key challenge for UHC. COVID-19 has emphasized long standing discrepancies in health and these disadvantages require government will and cooperation together with adequate social services to redress these discrepancies in UHC.
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The benefits of clinical practice guideline (CPG) adoption for the management of patients with back pain are well documented. However, the gap between knowledge creation and implementation remains wide with few studies documenting the iterative process of comprehensive implementation in clinical settings. The objective of this study was to improve adherent physical therapy care according to CPG's for low back pain and describe the knowledge to action (K2A) process used in a rural healthcare organization. ⋯ This study extends the literature of guideline implementation by describing the unique cycles required for promoting provider behaviour change within a rural healthcare system. Adherence and confidence results suggest increased provider CPG use which was supported by the process evaluation. This study demonstrates the importance of multiple site comparisons, long-term reporting and standardized frameworks for assessment of real-world CPG implementation.
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Perform sound decisions making while operating is crucial to the success of surgical procedures. The bewildering to choose the preferred mode of decision-making during a surgical procedure is regularly observed. This study was aimed to assess the mode of decision-making approach in surgical procedures among women who have undergone obstetrics and gynaecologic surgeries, Jimma, Ethiopia 2020. ⋯ In the study, the shared decision-making was inadequate and not in line with recent recommendation guidelines. The paternalism mode of decision-making was still practice. Build patient-health care providers' relationship is vital for promoting and advance the patients' autonomy on the decision-making approach. The healthcare providers should be motive for collaborative decision-making with the patient.
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To identify outcome measures used to evaluate performance of healthcare professional role substitution against usual medical doctor or specialist medical doctor care to facilitate our understanding of the adequacy of these measures in assessing quality of healthcare delivery. ⋯ There are a growing number of studies measuring the performance of non-medical healthcare professional substitution roles. Few have been subject to robust evaluations, and there is limited evidence on the scientific rigour and adequacy of outcomes measured. A systematic and coordinated approach is required to support healthcare settings in assessing the value of non-medical role substitution healthcare delivery models.