Connecting Clinical Capacity and Intervention Sustainability in Resource-Variable Pediatric Oncology Centers in Latin America
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Published:2023-11-14
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ISSN:2662-9275
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Container-title:Global Implementation Research and Applications
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language:en
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Short-container-title:Glob Implement Res Appl
Author:
McKay VirginiaORCID, Chen Yichen, Prewitt Kim, Malone Sara, Puerto-Torres Maria, Acuña-Aguirre Carlos, Alfonso-Carreras Yvania, Alvarez-Arellano Shilel Y., Andrade-Sarmiento Leticia A., Arce-Cabrera Daniela, Argüello-Vargas Deiby, Barragán-García Mariuxy D. C., Batista-Del-Cid Rosario, Blasco-Arriaga Erika E., Cach-Castaneda Maria D. C., Ceballo-Batista Gloria I., Chávez-Rios Mayra, Costa Maria E., Cuencio-Rodriguez Maria E., Diaz-Coronado Rosdali, Fing-Soto Ever A., García-Sarmiento Teresa D. J., Gómez-García Wendy C., Hernández-González Cinthia J., Jimenez-Antolinez Yajaira V., Juarez-Tobias Maria S., León-López Esmeralda M., Lopez-Facundo Norma A., Martínez Soria Ruth A., Miralda-Méndez Scheybi T., Montalvo Erika, Pérez-Alvarado Carlos M., Perez-Fermin Clara K., Quijano-Lievano Monica L., Salas-Mendoza Beatriz, Sanchez-Fuentes Edwin E., Serrano-Landivar Marcia X., Soto-Chavez Veronica, Tejocote-Romero Isidoro, Valle Sergio, Vasquez-Roman Elizabeth A., Costa Juliana Texeira, Cardenas-Aguirre Adolfo, Devidas Meenakshi, Luke Douglas A., Agulnik Asya
Abstract
AbstractClinical 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.
Funder
National Cancer Institute St. Jude Children's Research Hospital
Publisher
Springer Science and Business Media LLC
Subject
General Earth and Planetary Sciences,General Environmental Science
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