{"id":"W2887277209","doi":"10.7759/cureus.3086","title":"Exploring Policy Change in the Emergency Department: A Qualitative Approach to Understanding Local Policy Creation and the Barriers to Implementing Change","year":2018,"lang":"en","type":"article","venue":"Cureus","topic":"Health Policy Implementation Science","field":"Health Professions","cited_by":21,"is_retracted":false,"has_abstract":true,"ca_institutions":"Trillium Health Centre; McMaster University","funders":"","keywords":"Medicine; Knowledge translation; Context (archaeology); Public relations; Bureaucracy; Health care; Qualitative research; Process (computing); Health policy; Knowledge management; Nursing; Political science; Public health; Sociology; Computer science; Politics","routes":{"ca_aff":true,"ca_fund":false,"ca_venue":false,"about_ca":true,"invisible_to_affiliation_only":false},"retraction":null,"screen":null,"direct_labels":[],"prediction":{"model_version":"codex-gemma-dda1882f352a","candidate_categories":["sts"],"consensus_categories":[],"category_scores_codex":[0.007368809,0.0001912038,0.0002352349,0.000431227,0.002249874,0.00003484063,0.0003937963,0.00005519502,0.0001359385],"category_scores_gemma":[0.00283823,0.0001258992,0.00003419397,0.002115246,0.0001994569,0.0005830487,0.0003117831,0.0002494017,0.00007069621],"about_ca_system_candidate":false,"about_ca_system_consensus":false,"about_ca_system_score_codex":0.0009717565,"about_ca_system_score_gemma":0.0004385963,"about_ca_topic_candidate":true,"about_ca_topic_consensus":false,"about_ca_topic_score_codex":0.03161418,"about_ca_topic_score_gemma":0.01500203,"domain_scores_codex":[0.994746,0.002418014,0.0007382,0.0003961315,0.0004773971,0.001224295],"domain_scores_gemma":[0.9978479,0.0009634289,0.0002273783,0.0003733133,0.0001040737,0.0004839313],"domain_codex":null,"domain_gemma":null,"domain_candidate":null,"domain_consensus":null,"study_design_codex":"qualitative","study_design_gemma":"qualitative","study_design_scores_codex":[0.00004044885,0.000007501924,0.002134421,0.00004031237,0.00000692789,1.895809e-7,0.7985326,3.230216e-7,0.000005020063,0.1968308,0.0009229933,0.001478487],"study_design_scores_gemma":[0.00147485,0.0001800959,0.02222265,0.00009932067,0.00001361305,0.000001657485,0.9277588,0.0002912202,0.000009744423,0.006133296,0.04158378,0.0002310253],"study_design_candidate":"qualitative","study_design_consensus":"qualitative","genre_codex":"empirical","genre_gemma":"empirical","genre_scores_codex":[0.5578259,0.0001235914,0.03710189,0.3590304,0.0008578236,0.01503807,0.0002480402,0.0001345055,0.02963979],"genre_scores_gemma":[0.9470203,0.0001152658,0.0004035918,0.04312267,0.00209566,0.007164424,0.000008230249,0.00002228762,0.00004756647],"genre_candidate":"empirical","genre_consensus":"empirical","teacher_disagreement_score":0.3891944,"threshold_uncertainty_score":0.9990491,"prediction_status":"machine_predicted_unvalidated"},"machine_scores":{"provisional":true,"baseline":true,"maturity_gate_passed":false,"score_opus":0.8690245979312028,"score_gpt":0.6774756827452728,"score_spread":0.19154891518593,"validation_status":"score_only:v0-immature-baseline","note":"Baseline scores from an immature model (maturity gate not passed). Scores rank; they never assert a category."}}