A ‘Wholistic Needs’ Tool: The Process of Co-designing a Proactive Screener to Identify and Support Health and Social Needs
Notice bibliographique
Résumé
Based in Ontario, Canada, this ongoing co-design initiative aims to develop a Wholistic Needs Pre-Screener for proactive identification and management of health and social needs for the 525,000 people in the Middlesex London Ontario Health Team’s attributed population. The significance of this tool was underscored in prior co-design efforts, where patients, caregivers, and providers identified several key themes for improvement in healthcare within the Ontario context. These themes included the need for improved access to services, early diagnosis, and more self-management. These opportunities formed the purpose of developing the Wholistic Needs Pre-Screener. A literature review entailing 24 different screeners, assessments and tools was completed to ensure the development of the pre-screener was novel in the local and national context. Through additional co-design, the stakeholders co-developed the definition of health for the purpose of the screener, the function of the screener and the vision of how it could work. The co-designed definition of health spans across eight aspects of patient wellness: physical, spiritual, mental, emotional, environmental, social, cultural, and economic wellness. These domains have been developed by the National Collaborating Centers for Public Health (NCCPH) & National Collaborating Center for Determinants of Health (NCCDH). The co-designed functions of the screener include the ability to screen the wholistic health of patients using 10 questions or fewer to enable reaching the full population and increased awareness and access to services through the navigation pathways that will be triggered by the screener questions. The navigation pathways are being developed through leveraging various stakeholder groups including the Navigators Collaborative and the London Middlesex Primary Care Alliance, to improve both the patient and provider navigation experience. This Ontario-based tool will be a steppingstone for integration through a proactive and wholistic approach. The tool’s potential to screen the health and social care of an attributed population aligns with the goals of global health initiatives and the nine pillars of integrated care identified by the International Foundation for Integrated Care. Upon further development of the Wholistic Needs Pre-Screener initiative, the opportunities for innovative knowledge exchange that can occur between countries, populations, and communities are expansive. Ensuring the screener can be used locally, nationally and internationally has been integral in its development. As such, the project team has been and will continue to document the process of the localization of the associated navigation pathways, so that this screener can be replicated and adapted to fit the needs of national and international populations.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,078 | 0,084 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,007 | 0,002 |
| Études des sciences et des technologies | 0,004 | 0,004 |
| Communication savante | 0,006 | 0,004 |
| Science ouverte | 0,003 | 0,007 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,010 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».