Association of Virtual Nursing and Task Completeness: An Observational Study.

Introduction: Higher nurse turnover rates are associated with lower care quality and worse patient and nurse outcomes. Healthcare systems nationwide are implementing virtual nursing (VN), an innovative nursing care model, to reduce nurse turnover. However, there is a lack of evidence regarding the association between VNs and Electronic Health Record (EHR) documentation completeness and care services provided.

Use of telebehavioral health services by critical access hospitals in the United States: A qualitative study of the impacts of medicare flexibilities and future opportunities.

Objective: This study examined the delivery of telehealth for behavioral health services among Critical Access Hospitals (CAH). More specifically, we describe how CAHs representatives reported using telebehavioral health (TBH) to meet the behavioral health needs of patients, identify ways in which Medicare billing flexibility did or did not affect TBH use and behavioral health staffing among CAHs, and explore opportunities and challenges CAHs face for using TBH in the future.

Methods: We conducted semi-structured interviews of CAH administrators and providers to examine the circumstances under which TBH was used.

Assessing the antenatal care-seeking determinants associated with the penetration of the WHO eight-visit antenatal care policy across states in Nigeria.

Background: Following the adoption and implementation of the 2016 WHO eight-visit antenatal care (8vANC) policy in Nigeria, a national cross-sectional survey conducted in 2021 indicated significant state-level differences in the utilization rates of 8vANC.

Methods: We used a post-implementation sample, n = 9,416, obtained from the Nigeria Multiple Indicator Cluster Survey 2021 data to perform secondary analyses using the theory, model, and framework (TMF) implementation research approach. The outcome was defined as the penetration of the WHO 8vANC policy and measured as the proportion of women who used a minimum of 8vANC out of the total number of women who had live births within two years before the survey in 2021.

Using an implementation research approach to assess the birth outcomes associated with the 2016 World Health Organization antenatal care policy across states in Nigeria: multilevel analysis of national survey data.

Background: In 2017, the Nigerian Federal Ministry of Health adopted and implemented the 2016 World Health Organization (WHO) antenatal care (ANC) policy, including the eight-visit ANC (8vANC) recommendation, to improve ANC uptake and reduce perinatal deaths. This study aimed to examine the impact of the 2016 WHO ANC policy implementation on selected birth outcomes in Nigeria.

Methods: This research applied an implementation research approach to assess cesarean births, low birth weight (LBW), and perinatal death outcomes associated with the 2016 WHO ANC policy implementation across states in Nigeria.

Telehealth payment parity and outpatient service utilization: evidence from privately insured workers.

Telehealth was catalyzed by the COVID-19 pandemic and has become a new norm in healthcare. In response to the pandemic, some states passed telehealth payment parity legislation, mandating equal payment rates for telehealth and in-person services. We evaluated the relationship between telehealth payment parity and health service utilization, focusing on insured workers in commercial insurance plans.

Whose Role Is It Anyway? Beneficiary Engagement During the Transition to Medicaid Managed Care in North Carolina.

Empowering beneficiaries to choose a health plan that meets their health needs during the transition to Medicaid managed care is critical to promote informed decision-making. This study uses North Carolina's transition under the 1115 waiver to examine the role of the state, health plans, and providers in informing beneficiaries about the transition. We reviewed policy documents and interviewed 43 individuals representing provider practices and 10 representing the State Department of Health and Human Services and health plans between December 2020 and September 2021.

Psychometric assessment of scales used to evaluate sexual assault prevention programming in the United States Air Force.

Background: Preventing sexual assault in the United States (U.S.) military is essential to safeguard the overall well-being of military personnel and support the military to function in alignment with its intended mission and objectives.

North Carolina Academic Health Centers and Social Determinants of Health.

Background: Academic health centers (AHCs) have traditionally focused on 3 core missions: patient care, research, and education. The current changing health care environment requires AHCs to broaden their focus to improve the health of their communities. This study reports the opportunities and challenges for the 5 North Carolina AHCs addressing social determinants of health (SDOH).

Community-Level Internet Connectivity and Utilization of Maternal Telehealth.

The COVID-19 pandemic brought about a drastic increase in the utilization of telehealth services in place of or as a complement to in-person health services. Telehealth is a tool to help reduce disparities in the receipt of maternal health care. However, a stable internet connection is required for patients to connect to providers via telehealth; lack of internet connectivity is a barrier to maternal telehealth access.

Design Approaches for Developing Quality Checklists in Healthcare Organizations: A Scoping Review.

Quality checklists have demonstrated benefits in healthcare and other high-reliability organizations, but there remains a gap in the understanding of design approaches and levels of stakeholder engagement in the development of these quality checklists. This scoping review aims to synthesize the current knowledge base regarding the use of various design approaches for developing quality checklists in healthcare. Secondary objectives are to explore theoretical frameworks, design principles, stakeholder involvement and engagement, and characteristics of the design methods used for developing quality checklists.

The evolution of health system planning and implementation of maternal telehealth services during the COVID-19 Pandemic.

Background: Differential access to healthcare is associated with disparities in maternal outcomes. Telehealth is one approach for improving access to maternal services. However, little is known regarding how health systems leverage telehealth to close the access gap.

Disparities in Maternal Health Visits Between Rural and Urban Communities in the United States, 2016-2018.

Objective: The objective was to estimate the rural-urban differences in the receipt of prepregnancy, prenatal, and postpartum services.

Methods: The authors conducted a cross-sectional data analysis using data from the Pregnancy Risk Assessment and Monitoring System from 2016 to 2018 to analyze rural-urban differences in the receipt of medical visits and care content delivery during the prepregnancy year, as well as the prenatal and postpartum periods among birthing people in the US, using survey-weighted multivariable logistic regression models.

Results: Rural-dwelling birthing people were significantly less likely to attend a medical visit in the prepregnancy year or postpartum period, even when controlled for sociodemographic and clinical characteristics.

Who are vaccine champions and what implementation strategies do they use to improve adolescent HPV vaccination? Findings from a national survey of primary care professionals.

Background: Implementation science researchers often cite clinical champions as critical to overcoming organizational resistance and other barriers to the implementation of evidence-based health services, yet relatively little is known about who champions are or how they effect change. To inform future efforts to identify and engage champions to support HPV vaccination, we sought to describe the key characteristics and strategies of vaccine champions working in adolescent primary care.

Methods: In 2022, we conducted a national survey with a web-based panel of 2527 primary care professionals (PCPs) with a role in adolescent HPV vaccination (57% response rate).

Virtual quality improvement collaborative with primary care practices during COVID-19: a case study within a clinically integrated network.

Introduction: Quality improvement collaboratives (QICs) are a common approach to facilitate practice change and improve care delivery. Attention to QIC implementation processes and outcomes can inform best practices for designing and delivering collaborative content. In partnership with a clinically integrated network, we evaluated implementation outcomes for a virtual QIC with independent primary care practices delivered during COVID-19.

North Carolina Medicaid System Perspectives on Substance Use Disorder Treatment Policy Changes During the COVID-19 Pandemic.

Objective: This study aimed to describe perspectives from stakeholders involved in the Medicaid system in North Carolina regarding substance use disorder (SUD) treatment policy changes during the coronavirus disease 2019 pandemic.

Methods: We conducted semistructured interviews in early 2022 with state agency representatives, Medicaid managed care organizations, and Medicaid providers (n = 22) as well as 3 focus groups of Medicaid beneficiaries with SUD (n = 14). Interviews and focus groups focused on 4 topics: policies, meeting needs during COVID, demand for SUD services, and staffing.

Using intervention mapping to develop an implementation strategy to improve timely uptake of streamlined birth-dose vaccines in the Democratic Republic of the Congo.

Despite the policy recommendation and effectiveness of administering the hepatitis B birth-dose vaccine (HepB-BD) to newborns to prevent mother-to-child hepatitis B transmission, timely uptake remains an issue. Countries adopting the HepB-BD to their national immunization schedule report programmatic challenges to administering the vaccine within the recommended 24-hour window after delivery. Further, while the World Health Organization recommends streamlining three birth-dose vaccines (HepB-BD, BCG, and OPV0), scarce Sub-Saharan(SSA)-based literature reports on a streamlined and timely approach to birth-dose vaccines.

Ready, set, go! The role of organizational readiness to predict adoption of a family caregiver training program using the Rogers' diffusion of innovation theory.

Background: Caregivers FIRST is an evidence-based program addressing gaps in caregivers' skills. In 2020, the Veterans Health Administration Caregiver Support Program (CSP) nationally endorsed Caregivers FIRST, offering credit in leadership performance plans to encourage all VA medical centers (VAMCs) to implement locally. This study examines the association of organizational readiness with VAMC adoption of Caregivers FIRST.

Telehealth Use by Pregnancy Stage Among Commercially Insured Patients in the United States, 2016-2019.

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Analysis of shared cognitive tasks in the application of non-invasive ventilation to patients with COPD exacerbation.

Interprofessional teamwork plays a key role in the uptake of evidence-based interventions, such as noninvasive ventilation (NIV) for patients with exacerbated Chronic Obstructive Pulmonary Disease (COPD). We aimed to identify the shared cognitive tasks in interprofessional teams using NIV for patients with COPD exacerbation. We used a cognitive task analysis approach (CTA) to engage nurses, rapid response team members, respiratory therapists, and physicians involved in the use of NIV to treat patients with COPD exacerbation.

The Key Driver Implementation Scale (KDIS) for practice facilitators: Psychometric testing in the "Southeastern collaboration to improve blood pressure control" trial.

Background: Practice facilitators (PFs) provide tailored support to primary care practices to improve the quality of care delivery. Often used by PFs, the "Key Driver Implementation Scale" (KDIS) measures the degree to which a practice implements quality improvement activities from the Chronic Care Model, but the scale's psychometric properties have not been investigated. We examined construct validity, reliability, floor and ceiling effects, and a longitudinal trend test of the KDIS items in the Southeastern Collaboration to Improve Blood Pressure Control trial.

Changes in Patient Characteristics and Practice Outcomes of a Tele-Urgent Care Clinic Pre- and Post-COVID-19 Telehealth Policy Expansions.

Introduction: The coronavirus 2019 pandemic (COVID-19) has resulted in major changes in lifestyle practices and healthcare delivery. The goal of this study was to examine changes in practice and service outcomes in a telehealth program before and after the federal and private telehealth policy expansion during the COVID-19 pandemic. These findings are particularly useful to understand what may be needed to overcome telehealth challenges in future disasters.

A mixed methods study of provider factors in buprenorphine treatment retention.

Background: Low retention is a persistent challenge in the delivery of buprenorphine treatment for opioid use disorder (OUD). The goal of this study was to identify provider factors that could drive differences in treatment retention while accounting for the contribution of patient characteristics to retention.

Methods: We developed a novel a mixed-methods approach to explore provider factors that could drive retention while accounting for patient characteristics.