Background
Objectives
-
▪ To identify the key elements described in the literature, focusing on barriers and facilitators at the macro, meso and micro levels of management and clinical practice in healthcare systems.
-
▪ To structure the key aspects identified within a framework relevant to the feasibility of risk stratification implementation.
Methods
Scoping review
Identifying the research question
-
MEDLINE (Pubmed)
-
EMBASE.com
-
The Cochrane Library (Wiley platform)
-
CINAHL
-
PsycINFO
-
CRD
-
Google scholar
-
TripDatabase
-
Lilacs
Identifying relevant studies
Selecting key studies
Charting the data: table of evidence
Collating, summarizing and reporting results
Interviews with key experts
Results
Results of the scoping review
Type of study | Information support |
---|---|
Data sources | Key players (teamwork, leadership) |
Data access | Timing |
Methodological support | Outcomes |
ICT visualisation | Change management |
Training/mutual learning | Payment per outcomes |
Quality Assessment- Evaluation - follow up | Patient enrolment/recruitment |
Risk prediction outcomes | Patient follow-up |
Deployment strategy | Impactable patients |
Target population | Incentives |
Refinement/validation of the RS tool | Workload |
Knowledge of patients portfolio | Clinicians involvement |
Planning | RS functionalities |
Communication | Ethical issues/Conflict of interests/equity |
RS update | Patient activation/engagement |
Patient selection and identification | Budget distribution |
Cost/Financing | Intervention |
Dimensions | Categories | Topic | Papers |
---|---|---|---|
Cost | Cost | Cost/Financing | |
Timing | Timing | [38] | |
Ethics | Ethical issues | Ethical issues/Conflict of interests/equity | |
Funding and resource allocation | Funding and resource allocation | Budget distribution | |
Resource redistribution | |||
Revisions of the reimbursement model | Payment per outcomes | ||
Key aspects of care intervention | Case finding | Impactable patients | |
Patient activation/engagement | |||
Patient enrollment/recruitment | |||
Patient selection and identification | |||
Case finding/data accuracy | Target population | ||
Case finding/funding and resource allocation | RS functionalities | ||
Pathway definition and implementation | Intervention | ||
Patient follow-up | |||
Others | Others | Knowledge of patients portfolio | |
Planning, deployment and change management | Clinicians engagement | Change management | |
Clinicians involvement | |||
Incentives | |||
Methodological support | |||
Workload | |||
Communication | Communication | ||
ICT visualization | ICT visualization | ||
Information support | |||
Multidisciplinary team for RS deployment | Key players (teamwork, leadership) | ||
Quality assessment and improvement process | Quality Assessment- Evaluation - follow up | ||
Operational plan | Deployment strategy | ||
Planning | |||
Training and mutual learning | Training/mutual learning | ||
RS information | Data accuracy | Refinement/validation of the RS tool | |
Data availability | Data access | ||
Data source | Data sources | ||
Outcomes | Health related outcomes | ||
Risk tool outputs | Risk prediction scores | ||
Updating frequency | RS update |
Results of the semi-structured interviews to key experts: refinement of the assessment framework
Final feasibility framework
Dimensions | Categories | Papers |
---|---|---|
Planning, deployment and change management | Communication | |
Training and mutual learning | ||
Multidisciplinarity of the team leading RS deployment | ||
Clinicians’ engagement | ||
Operational plan | ||
ICT - Information display and functionalities | ||
Care intervention | Case finding/Selection of the target population | |
Pathway definition and implementation | ||
Quality assessment and improvement process |