Journal of evaluation in clinical practice最新文献

{"title":"Variation in Variation Measurement: A Mapping Review of Methods to Study Clinical Variation","authors":"Amity E. Quinn,&nbsp;Jason E. Black,&nbsp;Derek Chew,&nbsp;Tyler S. Williamson,&nbsp;Dean Yergens,&nbsp;Peter Faris,&nbsp;Flora Au,&nbsp;Jane M. Fletcher,&nbsp;Simarprit Sidhu,&nbsp;Rachelle Drummond,&nbsp;Becky Skidmore,&nbsp;Braden Manns","doi":"10.1111/jep.70350","DOIUrl":"10.1111/jep.70350","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Variation in health care delivery exists at many levels (e.g., provider, practice, system) and can often be explained by various factors at each level. Understanding clinical variation presents an opportunity to improve the value of health care by identifying low-value care (overuse), gaps in high-value care (underuse), and how they can be improved. Numerous methods exist to describe or quantify clinical variation; however, these are not well identified or applied consistently.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>A mapping review was used to identify and characterize available methods to describe and quantify clinical variation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We systematically searched health care and health services-related literature for variation and related terms used in titles and abstracts. Titles and abstracts were screened for inclusion. We then identified graphical and statistical methods used, health care specialty, study setting, and health system performance area (e.g., quality, access, costs) using a keyword analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 16,969 papers screened, we excluded 10,866 that did not measure a care process or health outcome, measure variation at the person-level or higher, or analyze routinely collected data. We included 6,103 full-text studies, which were analyzed using a keyword analysis. Most studies used basic methodological approaches (e.g., regression, crude comparisons, ranges). Fewer than 1000 studies used multilevel models, a more advanced methodologic approach that quantifies the magnitude and source of variation. Multilevel models were not commonly used to study variation in health care quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While understanding clinical variation is important for all health systems, the methods used are usually able to identify but not quantify or explain variation. This review advances our knowledge of the scope and application of these methods and can be used to improve the measurement of variation to increase the value and equity of health care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12826410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complexity-Laden Health Experienced by Under-Resourced Communities- Systemic Forces and Unequal Effects","authors":"Michele Battle-Fisher","doi":"10.1111/jep.70370","DOIUrl":"10.1111/jep.70370","url":null,"abstract":"","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation Strategies to Improve Outpatient Mental Health Treatment Initiation for Primary Care Patients With Suicidal Thoughts and Behaviours: A Scoping Review","authors":"Eric S. Crosby,&nbsp;Eleanor Turi,&nbsp;Danielle Eisenman,&nbsp;Emilie Famiglio,&nbsp;Gabriela Khazanov,&nbsp;Shari Jager-Hyman,&nbsp;Courtney Benjamin Wolk","doi":"10.1111/jep.70362","DOIUrl":"10.1111/jep.70362","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Primary care is a common healthcare contact before suicide. When suicide risk is identified in primary care, patients are often referred to specialty outpatient mental health care. However, many do not initiate care. Strategies to improve the initiation of specialty outpatient mental health care among adults in primary care settings with suicidal thoughts and/or behaviours remain unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This scoping review operationalized implementation strategies used in primary care to facilitate the initiation of specialty mental health care. We used established methodology and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. MEDLINE, CINAHL, Embase, PsycInfo, and Google Scholar were searched for peer-reviewed articles in English that contained implementation strategies to improve the initiation of specialty outpatient mental health care among adults in primary care settings with suicidal thoughts and/or behaviours. We excluded abstracts, editorials, grey literature, and studies focused on intensive outpatient or partial hospitalisation programmes. At least two independent reviewers screened, completed a full-text review, and extracted study data. Implementation strategies were labelled and defined using the Expert Recommendations for Implementing Change (ERIC) strategies and operationalized using recommended reporting guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 606 citations screened, five studies were retained. An average of 8.6 unique strategies per study were identified. No study used an established taxonomy of strategies to label and define strategies nor stated all recommended reporting details. Common strategies aligned with ERIC strategies to ‘promote adaptability’, ‘develop and implement tools for quality monitoring’, ‘remind clinicians’, ‘facilitate relay of clinical data to providers’ and ‘centralise technical assistance’. Studies generally reported strategies' actions, targets, timing, and outcomes, but inconsistently reported strategy actors, dose, and justification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Greater specification of implementation strategies to improve the initiation of specialty outpatient mental health care among adults in primary care settings with suicidal thoughts and/or behaviour is needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dealing With Worsening Ethics in Biomedical Research, a Loose Cannon in the Growth of New Generations of Scientists","authors":"Guido Frosina","doi":"10.1111/jep.70366","DOIUrl":"10.1111/jep.70366","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Reputation is of fundamental importance in science. It translates into the consideration, trust, and credibility that the scientific community exudes with the public. A growing number of events that undermine the quality and integrity of scientific research undermine the trust people place in it, facilitate the spread of an anti-scientific culture, and, above all, affect the development of new generations of scientists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Major categories of research integrity issues that emerged over the past decade were analysed, including citation rate, conflict of interest, predation, quality, reproducibility, translation, and transparency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Many scientists downplay the problem of declining ethics in biomedical research, confident that errors and fraud in scientific research will be exposed and eliminated sooner or later. They forget that this self-correcting process of science almost invariably takes years, during which costly and potentially serious consequences can arise. Furthermore, the intense competition that has always driven scientific research progress prevents many from undertaking clean-up efforts that could prove detrimental under current research evaluation systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The time has come to adopt practical measures to mitigate the negative consequences of the deterioration of ethics in biomedical research. We outline possible interventions to address the main ethical issues that have emerged over the past decade.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Funders, Regulators, and Ethics Bodies Support Informative Trials? A Content Analysis of Global Guidance Documents","authors":"Sarah R. Prowse,&nbsp;Miriam Brazzelli,&nbsp;Hanne Bruhn,&nbsp;Shaun Treweek","doi":"10.1111/jep.70356","DOIUrl":"10.1111/jep.70356","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Trials are often poorly designed, address unimportant questions, or are conducted in ways that limit their usefulness. This contributes to research waste and undermines evidence-based healthcare. We examined whether guidance from funders, regulators, and ethics review bodies supports the planning and approval of informative trials, with a focus on resources available to investigators and the role of oversight organizations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a directed qualitative content analysis of guidance documents from funders, regulators, and ethics review bodies across 13 countries and three multinational organizations. Documents were analysed using a coding framework based on the five conditions for trial informativeness identified by Zarin and colleagues: <i>Importance</i>, <i>Design</i>, <i>Feasibility</i>, <i>Integrity</i>, and <i>Reporting</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The final content analysis contains 37 guiding documents, including 13 documents from funders, 14 from regulators, and 10 addressing the ethics of trials. While contextual examples varied, many of the recommended processes or actions to improve trial informativeness were consistent across global guidance from funders, regulators, and those with ethical oversight. The aspects of <i>Design</i> and <i>Integrity</i> were particularly well represented, whereas guidance on improving <i>Feasibility</i> was limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The five key aspects of trial informativeness were reasonably described in some capacity across all forms of guidance, but may benefit from further examples or elaboration. Further research is needed to explore how trial guidelines and other supporting documents might incorporate more flexible, context-sensitive approaches that reduce bureaucratic burden without compromising ethical and scientific rigour.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12826411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a Structured Music Intervention on Patient Recovery and Nursing Care in Percutaneous Coronary Intervention: A Randomised Controlled Trial","authors":"Selda Mert,&nbsp;Önder Topbaş,&nbsp;Canan Baydemir,&nbsp;Tayfun Şahin,&nbsp;Hanefi Özbek","doi":"10.1111/jep.70363","DOIUrl":"10.1111/jep.70363","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Music is recognised as a holistic therapeutic intervention that enhances evidence-based, person-centred, and humanised nursing care, thereby facilitating patient recovery. This study examined the effects of a structured music intervention on patient recovery and nursing care in individuals undergoing percutaneous coronary intervention (PCI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The study is a randomised controlled trial. The sample comprised 210 patients, including 105 in the music group (MG) and 105 in the control group (CG), all of whom were scheduled to undergo PCI at a university hospital located in northwestern Türkiye. Data were collected using a Patient Information Form, the Vital Signs Assessment Form, the Numerical Rating Scale, the State-Trait Anxiety Inventory, the Perianesthesia Comfort Scale, and the Patient Satisfaction with Nursing Care Quality Questionnaire. Participants in the MG listened to instrumental pieces in the Rast, Acemashiran, and Hüseyni modes of Classical Turkish Music, whereas those in the CG received routine care only. In both groups, vital signs, pain, anxiety, comfort, and satisfaction with the quality of nursing care were measured before and after the procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Following PCI, patients who received music therapy experienced fewer complications, demonstrated greater physiological stability (lower respiratory and heart rates, reduced systolic and diastolic blood pressure, and increased oxygen saturation levels), had decreased pain intensity, reduced analgesic requirements, lower state anxiety levels, and higher satisfaction with nursing care. Overall, music exerted beneficial effects on the care process for both patients and nurses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings indicate that music can be safely and effectively integrated into routine nursing care as a humane and person-centred intervention. By supporting both physiological and psychological recovery, music contributes to improved patient outcomes and enhances nursing practice. These results highlight its potential applicability beyond PCI, suggesting that music therapy may be valuable across various clinical and interdisciplinary healthcare settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usability-Related Barriers and Facilitators Influencing the Adoption and Use of AI Scribes in Healthcare: A Scoping Review","authors":"Samuel Atiku,&nbsp;Olufisayo Olakotan,&nbsp;Kehinde Owolanke","doi":"10.1111/jep.70365","DOIUrl":"10.1111/jep.70365","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Clinical documentation is a major contributor to physician burnout, and artificial intelligence (AI) scribes are increasingly being adopted to help reduce the burden of documentation. These tools automatically generate clinical notes from patient–provider conversations using speech recognition and natural language processing. However, their usability and effectiveness still remain an issue.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To synthesise the existing evidence on usability-related barriers and facilitators influencing the adoption and use of AI scribes for clinical documentation in healthcare settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The scoping review employed the methodology developed by Arksey and O'Malley in 2005 and further expanded by Levac and Colquhoun in 2010. We searched PubMed, Scopus, Ovid MEDLINE, and Web of Science to identify relevant studies published in English between 2015 and 2025. All findings were reported according to PRISMA guidelines for scoping reviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 4588 identified records, 14 studies met the inclusion criteria and employed qualitative, quantitative, and mixed-methods. AI scribes were consistently associated with reduced cognitive load, faster documentation, improved work–life balance, and positive user experience. However, common barriers included frequent errors, excessive note length, limited formatting options, and poor integration with electronic health records (EHR). Editing demands varied by clinician experience, with some finding that time savings were lost when substantial corrections were needed. Overall, usability was rated more favourably in routine or protocol-driven visits, with mixed outcomes reported on long-term burnout and workflow impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>AI scribes show promise in reducing documentation burden and improving clinical workflow, but important usability challenges remain. Enhancing accuracy, streamlining integration, and allowing greater customization will be essential to support broader adoption and sustained use in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Content Validation of the Proactive Health Intentions Scale for Pre-Frailty Older Adults: A Delphi Study","authors":"Ke Tang,&nbsp;Yueping Li,&nbsp;Lingli Yang,&nbsp;Jin Yao,&nbsp;Ruixue Yin,&nbsp;Xianhong Chen,&nbsp;Yu Liu,&nbsp;Shuijuan Deng,&nbsp;Ya Jiang,&nbsp;Chunlan Zhou","doi":"10.1111/jep.70359","DOIUrl":"10.1111/jep.70359","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Pre-frail older adults are at high risk for adverse health outcomes. Enhancing their proactive health behaviours is crucial for healthy ageing. This study aimed to develop and establish the content validity of a theory-driven Proactive Health Intention Scale for this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A two-round Delphi study was conducted. Of the 36 experts invited, 16 completed the first round. Fifteen experts proceeded to complete the second round. The study was grounded in the Theory of Planned Behaviour (TPB). Content validity was assessed using the expert consensus criterion, defined as an item receiving a rating of 4 (<i>relevant</i>) or 5 (<i>very relevant</i>) from ≥ 70% of the panel.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The expert panel demonstrated strong engagement (a 44.4% response rate in Round 1 and a 93.8% retention rate in Round 2) and high authority (Cr = 0.88). After two rounds, a high consensus was achieved, with 49 out of 52 assessed items (94.2%) meeting the predefined validity criterion. The final scale encompasses five TPB dimensions: past behaviour, behavioural intention, attitude, subjective norms and perceived behavioural control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The Delphi process resulted in a 50-item Proactive Health Intention Scale with excellent content validity. This study provides a robust, theory-informed scale for measuring proactive health intentions in pre-frail older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practice Implications</h3>\u0000 \u0000 <p>The scale can be used by researchers and clinicians to assess intentions, identify barriers and facilitators, and inform the development of targeted interventions to promote proactive health behaviours in this vulnerable group.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining Relational Coordination Among Nurses and Nursing Assistants in VA Community Living Centers","authors":"Princess Nash,&nbsp;Emma Quach,&nbsp;Valerie Clark,&nbsp;Shibei Zhao,&nbsp;A. Lynn Snow,&nbsp;Christine W. Hartmann","doi":"10.1111/jep.70360","DOIUrl":"10.1111/jep.70360","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The Veterans Health Administration (VA) is the largest healthcare entity in the United States dedicated to serving Veterans. The VA has focused on improving resident-centered care through increased communication and strengthened relationships among staff who work in Community Living Centers (CLCs). This study employed the Relational Coordination (RC) survey to assess communication and relationships among nurses and nursing assistants in CLCs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study is a secondary analysis of relational coordination data as reported by nurses and nursing assistants from 8 VA CLCs. As part of a parent study of person-centered care implementation, these CLCs were selected from the national population of 134 CLCs for high resident-level quality indicators and artifacts of culture change. The Relational Coordination Survey was administered to assess dimensions of communication (timeliness, frequency, accuracy, and problem-solving <i>vs.</i> blaming) and relationship (shared goals, shared knowledge, and mutual respect). A total of 153 nurses and 133 nursing assistants responded (25% response rate). Within-group and between-group mean ratings for each dimension were computed and classified via the survey benchmarks as ‘weak,’ ‘medium,’ or ‘strong.’</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nursing assistant ratings met benchmarks for ‘strong’ when assessing the frequency of communication with both fellow nursing assistants and with nurses. Nurse ratings also met benchmarks for ‘strong’ when assessing communication frequency with fellow nurses, though ‘moderate’ when assessing communication frequency with nursing assistants. For domains of timely, accurate, and problem-solving communication, ratings by nurses and nursing assistants were ‘weak.’ Shared goals and mutual respect fell into the weak category for within-role and across-role relationships for nurses and nursing assistants. Nursing assistant ratings for shared knowledge with nurses fell into the moderate rating category.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>High frequency of communication may co-exist with low quality of communication and relationships.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' Waiting Times in Operating Rooms and Relevant Reasons","authors":"Çağla Islatti Mutlu,&nbsp;Manar Aslan","doi":"10.1111/jep.70361","DOIUrl":"10.1111/jep.70361","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Effective management of the operating room serves as a connector between patients and healthcare teams and institutions. This study monitored the surgical process of patients between the periods when they left their clinic to undergo a surgical operation and when they came back to their clinic after the surgery, to identify the waiting times spent in the waiting areas and to determine the reasons that cause patients to wait.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a longitudinal follow-up study. Surgical operations related to the clinics of general surgery, otorhinolaryngology, orthopaedics and traumatology conducted in a university hospital and within the business hours were followed up for 30 business days. Data were collected from 416 patients who underwent elective surgical operations between May and October 2019. Descriptive statistics and covariance analysis were used to analyse the data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The patients waited in nine areas during the surgical operation. The operating room occupancy rate was 62.01 ± 21.47%. The mean preoperative waiting time was 41.36 ± 28.86 min, the mean postoperative waiting time was 27.30 ± 16.07 min and the mean total waiting time was 65.84 ± 34.17 min. The most common reasons for waiting were the delay in completing the previous surgery (33.8%), preparation of the team (23.8%), preparation of the tables and equipment (16.1%), the reasons related to the personnel (13%) and cleaning of the operating room (9.2%). They had to wait in the T3 (31.68 ± 24.04 min), T4 (10.37 ± 16.68 min) and T8 (25.00 ± 15.79 min) areas for the longest period. Delay in completing the previous surgery (51.5%), which accounted for the largest portion of waiting time in area T3, preparation of the tables and equipment (44.8%) in area T4 and personnel-related factors (23.8%) in area T8 were the primary reasons for prolonged patient waiting times.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study found that patients experienced long waiting times due to various factors, which can be reduced through organizational improvements. Planning of the operating room and effective communication among team members are key factors in these arrangements.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}