METHODS AND ANALYSIS: The scoping review will follow Arksey and O'Malley's framework and begin with a literature search using keywords in electronic databases such as PubMed/MEDLINE, Scopus and PsychINFO, covering the period from January 2013 to December 2022 and limited to English language publications. Four independent reviewers will screen titles and abstracts based on predefined inclusion criteria, followed by full-text review of selected titles. Relevant references cited in the publications will also be examined. A Preferred Reporting Items for Systematic reviews and Meta-Analyses flow diagram will be utilised to illustrate the methodology. Data from selected publications will be extracted, analysed, and categorised for further analysis.
ETHICS AND DISSEMINATION: The results of the scoping review will provide a comprehensive overview of the barriers and challenges encountered by oncology MDTs over the past decade. These findings will contribute to the existing literature and provide insights into areas that require improvement in the functioning of MDTs in oncology management. The results will be disseminated through publication in a scientific journal, which will help to share the findings with the wider healthcare community and facilitate further research and discussion in this field.
TRIAL REGISTRATION DETAILS: The protocol for this scoping review is registered with Open Science Framework, available at DOI 10.17605/OSF.IO/R3Y8U.
METHODS: A cross-sectional study was employed involving 239 ambulances from selected hospitals and clinics. Ambulance service utilization was based on the number of trips, distance and duration of travel obtained from travel logbooks. A mixed top-down and activity-based costing approach was used to estimate the monthly cost of ambulance services. This constituted personnel, maintenance, fuel, overhead, consumables, ambulance, and medical equipment costs. The utilization and costs of ambulance services were further compared between settings and geographical locations.
RESULTS: The average total cost of ambulance services was MYR 11,410.44 (US$ 2,756.14) for hospitals and MYR 9,574.39 (US$ 2,312.65) for clinics, albeit not significantly different. Personnel cost was found to be the main contributor to the total cost, at around 44% and 42% in hospitals and clinics, respectively. There was however a significant difference in the total cost in terms of the type and age of ambulances, in addition to their location. In terms of service utilization, the median number of trips and duration of ambulance usage was significantly higher in clinics (31.88 trips and 58.58 hours) compared to hospitals (16.25 trips and 39.25 hours).
CONCLUSIONS: The total cost of ambulance services was higher in hospitals compared to clinics, while its utilization showed a converse trend. The current findings evidence that despite the ambulance services being all under the MOH, their operating process and utilization reflected an inherent difference by setting.
DESIGN/METHODOLOGY/APPROACH: The framework draws on the broader receiver-focussed literature and integrates innovative findings from a series of empirical studies. These studies examined different receiver behaviour within vignettes, retrospective descriptions of real interactions and behaviour in a simulated interaction.
FINDINGS: The authors' findings indicated that speaking up is an intergroup interaction where social identities, context and speaker stance intersect, directly influencing both perceptions of and responses to the message. The authors' studies demonstrated that when spoken up to, health professionals poorly manage their emotions and ineffectively clarify the speaker's concerns. Currently, targeted training for receivers is overwhelmingly absent from speaking-up programmes. The receiver mindset framework provides an evidence-based, healthcare specific, receiver-focussed framework to inform programmes.
ORIGINALITY/VALUE: Grounded in communication accommodation theory (CAT), the resulting framework shifts speaking up training from being only speaker skill focussed, to training that recognises speaking up as a mutual negotiation between the healthcare speaker and receiver. This framework provides healthcare professionals with a novel approach to use in response to speaking up that enhances their ability to listen, understand and engage in point-of-care negotiations to ensure the physical and psychological safety of patients and staff.
METHODS: The development process was managed by a technical working group led by the Institute for Health Systems Research in the Ministry of Health. Situational analysis was conducted through a multi-pronged approach, underpinned by a review of the past and present healthcare sectoral and quality plans and guided by the WHO NQPS framework. This approach involved: (i) review of quality-related policy documents, (ii) online surveys of healthcare providers and the public, (iii) key-informant facilitated discussions and (iv) mapping of existing quality improvement initiatives (QIIs). Data gathered from these approaches informed the content of the new policy. Following thematic analysis, the findings were grouped into specific domains, which were then organized into a strengths, weaknesses, opportunities, and threats (SWOT) framework.
RESULTS: Ten key areas of concern identified were (i) a people-centred holistic approach, (ii) governance for quality, (iii) resources, (iv) quality culture, (v) stakeholder engagement, (vi) health management information system, (vii) workforce competency, (viii) knowledge exchange, (ix) quality indicators and (x) monitoring and evaluation of quality activities. These led to the formulation of seven strategic priorities for the planning of improvements aimed at addressing the key areas of concern. The national definition of quality was affirmed. A total of 40 QIIs were mapped and grouped into three broad categories, namely (i) regulatory, (ii) domain-specific QIIs and (iii) Quality Improvement (QI) method.
CONCLUSIONS: The National Policy for Quality in Healthcare for Malaysia was developed through a comprehensive situational analysis using a multi-method approach that identified priorities across national, state, institutional and community levels. This evidence-informed approach led to meaningful contextual adaptation of the NQPS framework to shape the strategic direction to advance quality and achieve effective and safe outcomes for all Malaysians.
METHODS: Several methods were implemented. Firstly, a modified Delphi process for the contextualisation of learning outcomes was implemented with a purposefully sampled expert group of Malaysian Family Medicine Specialists. Secondly a small group review for supporting materials was undertaken. Finally, qualitative data in relation to the family medicine specialists' experiences of the processes was collected via online questionnaire and analysed via template analysis. Descriptive statistics were used.
RESULTS: Learning outcomes were reviewed over three rounds; 95.9% (1691/1763) of the learning outcomes were accepted without modification, with the remainder requiring additions, modifications, or deletions. Supporting materials were extensively altered by the expert group. Template analysis showed that Family Medicine Specialists related positively to their involvement in the process, commenting on the amount of similarity in the medical curriculum whilst recognising differences in disease profiles and cultural approaches.
CONCLUSIONS: Learning outcomes and associated material were transferable between "home" and "host" institution. Where differences were discovered this novel approach places "host" practitioners' experiences and knowledge central to the adaptation process, thereby rendering a fit for purpose curriculum. Host satisfaction with the outcome of the processes, as well as ancillary benefits were clearly identified.
Methods: This is a qualitative study with a phenomenological approach. It starts with a literature review using large databases, followed by interviews with 10 representative experts from medical schools in Indonesia.
Results: Based on the 10 studies retrieved, several components of faculty development were identified as the basis for the model. Ten experts gave input for the model. Components of the model can be grouped into: (i) content, which is materials that need to be delivered; (ii) process components, which depict aspects related to the preparation, execution and evaluation of sustainable faculty development; and (iii) components in the educational system that affect faculty development implementation.
Conclusion: A comprehensive review and development process has likely made this faculty development model suitable for medical schools in Indonesia. Breaking the model into components may help medical schools to prioritise certain aspects related to faculty development programmes.
Methods: This is a cross-sectional study using an available secondary data source - the Malaysian national dengue passive surveillance system, e-Dengue registry. A total of 61 455 serologically confirmed dengue cases from the Klang Valley, registered in year 2014, were included. We retrospectively examined the relationship between demographic factors and the choice of health-care sector by logistic regression.
Results: The median age of the cohort was 26 (interquartile range: 17 to 37) years. More private facilities (54.4%) were used for inpatient care; more public facilities (68.2%) were used for outpatient care. The Chinese and urban populations showed significantly higher use of the private health-care sector with an adjusted odds ratio of 4.8 [95% confidence interval (CI): 4.6-5.1] and 2.3 (95% CI: 2.2-2.4), respectively.
Conclusion: Both public and private health facilities bear significant responsibilities in delivering health-care services to dengue patients. The workload of both sectors should be included in future health policy planning by public agencies.