Enabling patient-reported outcome measures in clinical trials, exemplified by cardiovascular trials.

OBJECTIVES: There has been limited success in achieving integration of patient-reported outcomes (PROs) in clinical trials. We describe how stakeholders envision a solution to this challenge. METHODS: Stakeholders from academia, industry, non-profits, insurers, clinicians, and the Food and Drug Administration convened at a Think Tank meeting funded by the Duke Clinical Research Institute to discuss the challenges of incorporating PROs into clinical trials and how to address those challenges. Using examples from cardiovascular trials, this article describes a potential path forward with a focus on applications in the United States. RESULTS: Think Tank members identified one key challenge: a common understanding of the level of evidence that is necessary to support patient-reported outcome measures (PROMs) in trials. Think Tank participants discussed the possibility of creating general evidentiary standards depending upon contextual factors, but such guidelines could not be feasibly developed because many contextual factors are at play. The attendees posited that a more informative approach to PROM evidentiary standards would be to develop validity arguments akin to courtroom briefs, which would emphasize a compelling rationale (interpretation/use argument) to support a PROM within a specific context. Participants envisioned a future in which validity arguments would be publicly available via a repository, which would be indexed by contextual factors, clinical populations, and types of claims. CONCLUSIONS: A publicly available repository would help stakeholders better understand what a community believes constitutes compelling support for a specific PROM in a trial. Our proposed strategy is expected to facilitate the incorporation of PROMs into cardiovascular clinical trials and trials in general.

A group think tank as a discourse coalition to promote minority nursing faculty retention.

BACKGROUND: The nursing profession will need one million more nurses by 2024, yet nursing schools are turning away applicants due to insufficient numbers of nursing faculty. Likewise, minority nursing faculty are needed in order to attract diverse nursing students who can then address health care disparities. PURPOSE: The purpose of this paper is to describe the use of a group think tank (GTT) as a mentoring strategy for supporting the recruitment and retention of minority nursing faculty. METHOD: Guided by Kotter's theory of change, this paper describes the application of the GTT approach with 5 African American (AA) faculty, one AA doctoral student and a cross-cultural mentor. FINDINGS: Results are presented based upon the metrics typically used to support career advancement, promotion and/or tenure. DISCUSSION: The GTT is a promising mentoring model that can be used to integrate cross-cultural and peer mentoring into academic communities to support diversity in academia.

A Disease Pathway Framework for Pain Point Identification and Elaboration of Product Requirements Across Patient Care Plan Using Innovation Think Tank Global Infrastructure.

Healthcare providers as well as medical technologists lay a strong focus on clinical conditions for patient centric care delivery. Currently, the challenges are to (1) obtain a consolidated view of various stakeholders and pain points for the entire disease lifecycle, (2) identify interdependencies between different stages of the disease, and (3) prioritize solutions based on customer needs. A structured approach is required to address clinical needs across disease care plans tailored to different geographies and ethnicities. Innovation Think Tank (ITT) teams across multiple locations formed focus groups to elaborate the pathways of 22 global diseases, selected based on ranking of associated economic burden and threat to life. Ideation sessions were held to identify pain points and find innovative solutions. Additionally, inputs were taken from co-creation sessions at universities worldwide. The optimization and design of infographics and care plan was done based on the key information gathered-facts and figures, stakeholders, pain points and solutions. Finally, validation was obtained from clinical and technology experts globally. A disease pathway framework was created to develop pathways for 22 global diseases. Over 1,500 pain points were collected and about 1,900 ideas were proposed. The approach was applied to optimize its application to 30 product and portfolio definition projects over 2 years at Siemens Healthineers, as well as co-creation programs with universities and hospitals. The disease pathway framework provides a unique foundation for extensive collaboration among multiple stakeholders, through information sharing and delivering high-quality solutions based on the identified problems and customer needs.

Corrigendum: A Disease Pathway Framework for Pain Point Identification and Elaboration of Product Requirements Across Patient Care Plan Using Innovation Think Tank Global Infrastructure.

[This corrects the article DOI: 10.3389/fpubh.2022.862384.].

Challenges facing Indigenous transplant patients living in Canada: exploring equity and utility in organ transplantation decision-making.

Indigenous peoples in Canada and in the Circumpolar North face a higher disease burden leading to end-stage organ failure and face geographic and systemic barriers to accessing health-care services, including those for end-stage organ failure and organ donation and transplantation (ODT). To address these issues, I present a think tank model used in Saskatchewan, Canada, which focused on ODT and recommended research and policy changes that address inequitable Indigenous access to ODT, most specifically in northern and remote regions. Over the past three years, think tank members, comprised of Indigenous cultural leaders, elders, and persons with lived experience in ODT, and complemented by medical and advocacy exports, have highlighted equity and utility issues as key concerns, and discussed ways in which these issues can be addressed. Recommendations include culturally-safe methods for documenting and tracking Indigenous identity, development of training to address culturally specific needs, and additional funding to support Indigenous transplant donors and recipients.

Engaging Through Awareness: Purpose-Driven Framework Development to Evaluate and Develop Future Business Strategies With Exponential Technologies Toward Healthcare Democratization.

Industry 4.0 and digital transformation will likely come with an era of changes for most manufacturers and tech industries, and even healthcare delivery will likely be affected. A few trends are already foreseeable such as an increased number of patients, advanced technologies, different health-related business models, increased costs, revised ethics, and regulatory procedures. Moreover, cybersecurity, digital invoices, price transparency, improving patient experience, management of big data, and the need for a revised education are challenges in response to digital transformation. Indeed, forward-looking innovation about exponential technologies and their effect on healthcare is now gaining momentum. Thus, we developed a framework, followed by an online survey, to investigate key areas, analyze and visualize future-oriented developments concerning technologies and innovative business models while attempting to translate visions into a strategy toward healthcare democratization. When forecasting the future of health in a short and long-term perspective, results showed that digital healthcare, data management, electronics, and sensors were the most common predictions, followed by artificial intelligence in clinical diagnostic and in which hospitals and homes would be the places of primary care. Shifting from a reactive to a proactive digital ecosystem, the focus on prevention, quality, and faster care accessibility are the novel value propositions toward democratization and digitalization of patient-centered services. Longevity will translate into increased neurodegenerative, chronic diseases, and mental illnesses, becoming severe issues for a future healthcare setup. Besides, data privacy, big data management, and novel regulatory procedures were considered as potential problems resulting from digital transformation. However, a revised education is needed to address these issues while preparing future health professionals. The "P4 of health", a novel business model that is outcome-based oriented, awareness and acceptance of technologies to support public health, a different mindset that is proactive and future-oriented, and an interdisciplinary setting to merge clinical and technological advances would be key to a novel healthcare ecosystem. Lastly, based on the developed framework, we aim to conduct regular surveys to capture up-to-date technological trends, sustainable health-related business models, and interdependencies. The engagement of stakeholders through awareness and participation is the key to recognizing and improving healthcare needs and services.

Strategies for Research, Practice, and Policy for Autism in Later Life: A Report from a Think Tank on Aging and Autism.

Over the past decade, there has been a growing interest in adults on the autistic spectrum, and more recently, the challenges related to aging in this population. A two-day Think Tank meeting, focused on aging in autism, was convened amongst international leaders in the field of autism research and practice. This meeting included a series of presentations addressing the current status of aging research, followed by discussions regarding priorities going forward. Attendees shared their thoughts and concerns regarding community services, government policies, societal perspectives and physical and mental health. The goal of these discussions was to consider systematic approaches aimed at providing meaningful supports that can ensure a quality of life for seniors on the autism spectrum.

A think tank in action: Building new knowledge about professional identity in nursing.

A notable body of research regarding professional identity development and formation in nursing currently exists. Unfortunately, no one definition has guided a plan to build new knowledge within the profession. The think tank methodology used with professional identity in nursing has successfully brought together international leaders in education, regulation, and practice to begin to think, plan, study, and disseminate the findings of the professional identity in nursing initiative. This article briefly explains the state of the science regarding professional identity and discusses in depth a think tank methodology. This approach produced important outcomes about professional identity in nursing, showing how a well-constructed think tank offers clarity and an understanding about the next steps needed to build new knowledge and language within a discipline.

A Novel Think Tank Program to Promote Innovation and Strategic Planning in Ophthalmic Surgery.

BACKGROUND: Continuous quality improvement is a pillar of all surgical groups. Innovation is a critical aspect to continuously improve, but traditional staff retreats have several disadvantages which limit their utility in identifying needs and developing innovative solutions. To address these challenges, we designed the novel Think Tank Program to spur innovation and strategic planning for an academic ophthalmology department including the Kellogg Eye Center 6 operating rooms. METHODS: The Think Tank program is a structured seven-phase program for faculty in small teams to identify, innovate, and implement meaningful change. Participants brainstormed problems and possible solutions to those problems, formed teams, acquired data, and implemented meaningful change in clinical care, research, education, and administration. RESULTS: The program generated 19 novel proposals and significant faculty engagement and discussion in improving the department. A case example of improving the operating room (OR) utilization resulted in improved OR utilization from 63.8% to 74.6% over a 3 month period before and after implementation. It also resulted in a reduction of cancelled or rescheduled surgeries within 2 weeks or surgery from 29.8% to 15.2%. This resulted in an estimated positive financial margin of over $141,000 to the institution in addition to improvement in patient, surgeon, and staff satisfaction with the quality of care. CONCLUSIONS: Engaged faculty, critical data analysis, and value proposition analysis with data-driven metrics and accountability can result in a significant increase in OR utilization and reduction in surgical cancellations. Think Tank serves as a model transformative program to assist practices and institutions to best fulfill their mission while actively engaging and retaining their members.

Advancing health policy education in nursing: American Association of Colleges of Nursing Faculty Policy Think Tank.

Based upon an awareness of the need to increase its policy footprint, the American Association of Colleges of Nursing's (AACN) Board of Directors convened a think tank of nurse experts in the field of policy curriculum to advise the Board. The goal of the think tank was to review the current landscape, analyze trends, and create a set of recommendations for AACN's Board to consider. The Faculty Policy Think Tank (FPTT) met between 2016 and 2017 to review and reflect on methods to increase expertise of nursing faculty and students in health policy and make recommendations to the AACN Board to advance the agenda of the organization, member schools, and the profession. This article describes the methods and processes the Think Tank employed to develop a set of recommendations for the AACN Board of Directors.