As part of the research protocol, we established fidelity procedures that not only served to assess adherence to the behavioral study intervention but also provided ongoing supervision and improved provider proficiency during the course of the study.
Thus, we cannot evaluate provider proficiency prior to starting the study, although we know that providers were deemed competent at completion of their training.
The study also contributes to the development of a composite indicator to measure a facility's capacity to conduct newborn resuscitation, one which includes supplies and equipment as well as provider proficiency.
A month later, as more providers gained access and proficiency with the software, the picture improved, but significant discrepancies remained.
Indeed proficiency testing providers typically give feedback on expected results to participating laboratories in the form of a detailed report, but they do not provide individual assistance for performance improvement if needed.
Some providers also reported lacking proficiency in use of certain EHR features that would enable them to manage alerts more efficiently.
While the study is still on-going, we can report that common barriers identified and addressed by the patient navigators include financial difficulties, lack of health insurance, lack of social support, lack of transportation, difficulty communicating with health care providers, and limited English proficiency.
Not all studies utilize the same units of concentration when reporting results, and it is the responsibility of the proficiency testing provider to specify what units are to be used to evaluate submitted results.
Moreover, based on the identification of needs for specific emerging substances or groups of substances, NORMAN encourages Proficiency Testing (PT) providers and / or partners of the network to organise and conduct interlaboratory studies.
In our experience, however, such accompaniment is crucial in obtaining local "buy-in" and establishing true clinical proficiency among participating providers.
