Connecting Clinical Capacity and Intervention Sustainability in Resource-Variable Pediatric Oncology Centers in Latin America.

Autor: McKay V; Brown School, Washington University, MSC 1196-251-46, 1 Brookings Drive, St. Louis, MO 63130, USA., Chen Y; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA., Prewitt K; Brown School, Washington University, MSC 1196-251-46, 1 Brookings Drive, St. Louis, MO 63130, USA., Malone S; Brown School, Washington University, MSC 1196-251-46, 1 Brookings Drive, St. Louis, MO 63130, USA.; Division of Population Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA., Puerto-Torres M; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA., Acuña-Aguirre C; Hospital Calvo Mackenna, Santiago, Chile., Alfonso-Carreras Y; Hospital Saint Damien, Port Au Prince, Haiti., Alvarez-Arellano SY; Benemérito Hospital General con Especialidades 'Juan María de Salvatierra', La Paz, Mexico., Andrade-Sarmiento LA; Centro Medico Nacional Siglo XXI, Mexico, Mexico., Arce-Cabrera D; Hospital Pediatrico de Sinaloa, Culiacán, Mexico., Argüello-Vargas D; Hospital Nacional de Niños, San Jose, Costa Rica., Barragán-García MDC; SOLCA Cuenca, Cuenca, Ecuador., Batista-Del-Cid R; Hospital Jose Domingo De Obaldia, Barú, Chiriqui, Panama., Blasco-Arriaga EE; SOLCA Guayaquil, Guayaquil, Ecuador., Cach-Castaneda MDC; Hospital General Agustin O'Horan, Mérida, Mexico., Ceballo-Batista GI; Hospital del Niño 'Jose Renan Esquivel', Panama, Panama., Chávez-Rios M; Hospital para el Niño Poblano, Puebla, Mexico., Costa ME; Hospital del Nino de la Santísima Trinidad, Cordoba, Argentina., Cuencio-Rodriguez ME; Hospital Universitario Austral, Buenos Aires, Argentina., Diaz-Coronado R; Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru., Fing-Soto EA; Hospital General Celaya, Celaya, Mexico., García-Sarmiento TDJ; Hospital de Especialidades Pediatricas, Tuxtla, Mexico., Gómez-García WC; Hospital Infantil Dr. Robert Reid Cabral, Santo Domingo, Dominican Republic., Hernández-González CJ; Hospital Infantil Teleton de Oncologia (HITO), Querétaro, Mexico., Jimenez-Antolinez YV; Hospital Universitario Dr. José E. González, Monterrey, Mexico., Juarez-Tobias MS; Hospital Central Dr. Ignacio Morones Prieto, San Luis Potosí, Mexico., León-López EM; Hospital Guillermo Almenara Irigoyen, Lima, Peru., Lopez-Facundo NA; ISSEMYM Materno Infantil, Toluca, Mexico., Martínez Soria RA; Hospital General de Tijuana, Tijuana, Mexico., Miralda-Méndez ST; Hospital Escuela Universitario, Tegucigalpa, Honduras., Montalvo E; SOLCA Quito, Quito, Ecuador., Pérez-Alvarado CM; Centro Estatal de Cancerologia, Xalapa, Mexico., Perez-Fermin CK; Hospital Infantil Regional Universitario Dr. Arturo Grullon, Santiago, Dominican Republic., Quijano-Lievano ML; Centro Médico Imbanaco, Cali, Colombia., Salas-Mendoza B; Hospital del Niño Manuel Ascencio Villarroel, Cochabamba, Bolivia., Sanchez-Fuentes EE; Hospital Nacional de Ninos Benjamin Bloom, San Salvador, El Salvador., Serrano-Landivar MX; Hospital Caja Petrolera de Salud Santa Cruz, Santa Cruz, Bolivia., Soto-Chavez V; Hospital Civil de Guadalajara, Guadalajara, Mexico., Tejocote-Romero I; Hospital para el Nino (IMIEM), Toluca, Mexico., Valle S; Unidad Nacional de Oncologia Pediatrica (UNOP), Guatemala, Guatemala., Vasquez-Roman EA; Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru., Costa JT; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA., Cardenas-Aguirre A; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA., Devidas M; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA., Luke DA; Brown School, Washington University, MSC 1196-251-46, 1 Brookings Drive, St. Louis, MO 63130, USA., Agulnik A; Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA.
Jazyk: angličtina
Zdroj: Global implementation research and applications [Glob Implement Res Appl] 2024 Mar; Vol. 4 (1), pp. 102-115. Date of Electronic Publication: 2023 Nov 14.
DOI: 10.1007/s43477-023-00106-2
Abstrakt: Clinical capacity for sustainability, or the clinical resources needed to sustain an evidence-based practice, represent proximal determinants that contribute to intervention sustainment. We examine the relationship between clinical capacity for sustainability and sustainment of PEWS, an evidence-based intervention to improve outcomes for pediatric oncology patients in resource-variable hospitals. We conducted a cross-sectional survey among Latin American pediatric oncology centers participating in Proyecto Escala de Valoración de Alerta Temprana (EVAT), an improvement collaborative to implement Pediatric Early Warning Systems (PEWS). Hospitals were eligible if they had completed PEWS implementation. Clinicians were eligible to participate if they were involved in PEWS implementation or used PEWS in clinical work. The Spanish language survey consisted of 56 close and open-ended questions about the respondent, hospital, participants' assessment of clinical capacity to sustain PEWS using the clinical sustainability assessment tool (CSAT), and perceptions about PEWS and its use as an intervention. Results were analyzed using a multi-level modeling approach to examine the relationship between individual, hospital, intervention, and clinical capacity determinants to PEWS sustainment. A total of 797 responses from 37 centers in 13 countries were included in the analysis. Eighty-seven percent of participants reported PEWS sustainment. After controlling for individual, hospital, and intervention factors, clinical capacity was significantly associated with PEWS sustainment (OR 3.27, p < .01). Marginal effects from the final model indicate that an increasing capacity score has a positive influence (11% for every additional CSAT point) of predicting PEWS sustainment. PEWS is a sustainable intervention and clinical capacity to sustain PEWS contributes meaningfully to PEWS sustainment.
Competing Interests: Conflict of interest We have no known conflict of interest to disclose.
Databáze: MEDLINE
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