Evidence map›Paper›PMID 31848173›Full record

ArticleBMJ open2019

Mapping structure, process and outcomes in the removal of low-value care practices in Canadian intensive care units: protocol for a mixed-methods exploratory study.

Jeanna Parsons Leigh, Jennie Petersen, Chloe de Grood, Liam Whalen-Browne, Daniel Niven, Henry Thomas Stelfox

Abstract readClinical Trial Protocol
In one paragraph

Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jeanna Parsons LeighDepartment of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada Jeanna.ParsonsLeigh@uwo.ca.ORCID 0000-0002-8408-674X
Jennie PetersenDepartment of Critical Care Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
Chloe de GroodDepartment of Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
Liam Whalen-BrowneDepartment of Critical Care Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
Daniel NivenDepartment of Critical Care Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.
Henry Thomas StelfoxDepartment of Critical Care Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.

Funding

CIHR 314548
6 · The paper itself

Abstract

introductionThe challenge of implementing best evidence into clinical practice is a major problem in modern healthcare that can result in ineffective, inefficient and unsafe care. There is a growing body of literature which suggests that the removal or reduction of low-value care practices (ie, deadoption) is integral to the delivery of high-quality care and the sustainability of our healthcare system. However, currently very little is known about deadoption practices in Canada. We propose to map the current state of deadoption in Canadian intensive care units (ICUs). A key deliverable of this work will include development of an inventory of barriers, facilitators and potential implementation strategies for guiding the deadoption efforts. METHODS AND ANALYSIS: We will use Canadian adult general systems ICUs as our laboratory of investigation and employ a two-phased sequential exploratory mixed-methods approach: (1) semi-structured interviews with critical care stakeholders to develop an understanding of the structure (ie, healthcare context), process (ie, actions and events in healthcare) and outcomes (ie, effects on health status, quality, knowledge or behaviour) of deadoption (phase I) and (2) surveys with a broader sample of critical care stakeholders to further identify important barriers and facilitators, as well as potential implementation strategies (phase II). Interview data will be analysed through qualitative content analysis and survey data will be analysed through quantitative analyses to identify top barriers and facilitators, as well as top rated strategies. ETHICS AND DISSEMINATION: Ethical approval has been obtained through the University of Calgary Research Ethics Board (REB 17-2153). Participants involved will have the opportunity to provide feedback on the final written reports to support accurate representation of the data. The findings of this study will be disseminated through peer-reviewed publications and oral presentations with critical care stakeholders across Canada. Patient and family partners will receive an executive summary of the findings.

Indexed as

Quality of Health CareAdultCanadaCritical CareEvidence-Based PracticeHumansIntensive Care UnitsPractice Patterns, Physicians'Qualitative Researchadult intensive & critical careintensive & critical careprotocols & guidelinesquality in health care

Identifiers

PMID31848173
PMCPMC6937030

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.