Kathleen L. Bagot

Perceived deterrents to being a plasmapheresis donor in a voluntary, nonremunerated environment

BACKGROUND: As demand for plasma‐derived products increases internationally, maintaining a committed plasmapheresis panel membership is critical for blood collection agencies. This study addresses the current lack of knowledge regarding deterrents to the recruitment and retention of plasmapheresis donors in a voluntary nonremunerated environment.

Asking for something different from our donors: factors influencing persuasion success

Demand for plasma‐derived products, and consequently plasmapheresis donors, continues to increase. This study aims to identify the factors that facilitate the persuasion success of conversations with whole blood (WB) donors to convert to plasmapheresis donation within a voluntary nonremunerated context.

Victorian Stroke Telemedicine Project: implementation of a new model of translational stroke care for Australia

Stroke telemedicine is widely used to treat patients with acute stroke in Europe and North America but is seldom used in Australia. The Victorian Stroke Telemedicine (VST) programme aims to enhance acute stroke care in regional Australia.

Telemedicine expedites access to optimal acute stroke care

www.thelancet.com Vol 388 August 20, 2016 757 survey of transgender individuals found that 19% had been denied access to health care because of their gender identity and 28% reported verbal harassment in a medical setting. While we await the overturning of HB2, the vicious cycle that links institutionalised discrimination and transgender harm needs to be broken. Establishment of mandatory transgender training in medical schools and clarification of hospital discrimination policies are two key steps. These steps will become more important in 2017 when the Aff ordable Care Act prohibits health insurers from discrimination against transgender individuals. Health professionals in North Carolina and around the world have a responsibility to serve the needs of all, including transgender people. North Carolina’s bigotry bill serves as a powerful reminder of the need to ensure the rights that underlie health.

Is telemedicine helping or hindering the delivery of stroke thrombolysis in rural areas? A qualitative analysis.

Fast diagnosis and delivery of treatment to patients experiencing acute stroke can reduce subsequent disability. While telemedicine can improve rural community access to specialists and facilitate timely diagnosis and treatment decisions, it is not widely used for stroke in Australia.

Telemedicine in the acute health setting: A disruptive innovation for specialists (an example from stroke):

Introduction Telemedicine is a disruptive innovation within health care settings as consultations take place via audio-visual technology rather than traditional face-to-face. Specialist perceptions and experiences of providing audio-visual consultations in emergency situations, however, are not well understood. The aim of this exploratory study was to describe the experience of medical specialists providing acute stroke decision-making support via telemedicine. Methods Data from the Victorian Stroke Telemedicine (VST) programme were used. The experiences of specialists providing an acute clinical telemedicine service to rural emergency departments were explored, drawing on disruptive innovation theory. Document analysis of programme consultation records, meeting minutes and in-depth individual interviews with three neurologists were analysed using triangulation. Results Since February 2014, 269 stroke telemedicine consultations with 12 neurologists have occurred. Retention on the roster has varied between 1 and >4 years. Overall, neurologists reported benefits of participation, as they were addressing health equity gaps for rural patients. Negative effects were the unpredictability of consultations impacting on their personal life, the mixed level of experience of colleagues initiating the consult and not knowing patient outcomes since follow-up communication was not routine. Conclusions Insights into workforce experience and satisfaction were identified to inform strategies to support specialists to adapt to the disruptive innovation of telemedicine.

Using an Extended Theory of Planned Behavior to Predict a Change in the Type of Blood Product Donated

BackgroundDemand for essential plasma-derived products is increasing.PurposeThis prospective study aims to identify predictors of voluntary non-remunerated whole blood (WB) donors becoming plasmapheresis donors.MethodsSurveys were sent to WB donors who had recently (recent n = 1,957) and not recently donated (distant n = 1,012). Theory of Planned Behavior (TPB) constructs (attitude, subjective norm, self-efficacy) were extended with moral norm, anticipatory regret, and donor identity. Intentions and objective plasmapheresis donation for 527 recent and 166 distant participants were assessed.ResultsMulti-group analysis revealed that the model was a good fit. Moral norm and self-efficacy were positively associated while role identity (suppressed by moral norm) was negatively associated with plasmapheresis intentions.ConclusionsThe extended TPB was useful in identifying factors that facilitate conversion from WB to plasmapheresis donation. A superordinate donor identity may be synonymous with WB donation and, for donors with a strong moral norm for plasmapheresis, may inhibit conversion.

Recruiting and retaining plasmapheresis donors: A critical belief analysis

This paper identifies critical beliefs underpinning intentions to commence and continue plasmapheresis donation. Whole blood (n = 624) and first-time plasmapheresis (n = 460) donors completed a cross-sectional survey assessing the belief-base of the theory of planned behaviour and rated their plasmapheresis donation intentions. While the idea of red blood cells being returned was a key deterrent for all donors, critical beliefs underlying commencement and continuation in the plasmapheresis donor panel differed and varied as a function of blood donation history. Findings will assist the development of targeted persuasion messages to optimise recruitment and retention of plasmapheresis donors in a non-remunerated context.

Plasmapheresis: recruitment, retention and flexible donors

With worldwide demand for plasma‐derived products increasing, a critical question is how to effectively recruit and retain voluntary non‐remunerated (VNR) plasmapheresis donors? This review summarizes an emerging empirical literature and translates this into practical strategies for Blood Collection Agency (BCAs). We extend this to consider how ‘flexible’ donors – donors who move between panels as required to donate the right product at the right time – may be best cultivated by BCAs.

Exploring the benefits of a stroke telemedicine programme: An organisational and societal perspective.

We undertook a qualitative analysis to identify the broader benefits of a state-wide acute stroke telemedicine service beyond the patient-clinician consultation. Since 2010, the Victorian Stroke Telemedicine (VST) programme has provided a clinical service for regional hospitals in Victoria, Australia. The benefits of the Victorian Stroke Telemedicine programme were identified through document analysis of governance activities, including communications logs and reports from hospital co-ordinators of the programme. Discussions with the Victorian Stroke Telemedicine management were undertaken and field notes were also reviewed. Several benefits of telemedicine were identified within and across participating hospitals, as well as for the state government and community. For hospitals, standardisation of clinical processes was reported, including improved stroke care co-ordination. Capacity building occurred through professional development and educational workshops. Enhanced networking, and resource sharing across hospitals was achieved between hospitals and organisations. Governments leveraged the Victorian Stroke Telemedicine programme infrastructure to provide immediate access to new treatments for acute stroke care in regional areas. Standardised data collection allowed routine quality of care monitoring. Community awareness of stroke symptoms occurred with media reports on the novel technology and improved patient outcomes. The value of telemedicine services extends beyond those involved in the clinical consultation to healthcare funders and the community.