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Value-based healthcare

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https://www.readbyqxmd.com/read/29141187/factors-associated-with-final-year-nursing-students-desire-to-work-in-the-primary-health-care-setting-findings-from-a-national-cross-sectional-survey
#1
Jacqueline G Bloomfield, Christina Aggar, Tamsin H T Thomas, Christopher J Gordon
BACKGROUND: Registered nurses are under-represented in the primary health care setting both internationally and in Australia, and this shortage is predicted to worsen. To address the increasingly complex healthcare needs of an ageing population, it is vital to develop and sustain a primary health care nursing workforce, yet attracting nurses is challenging. In Australia, registered nurses graduating from university typically commence their careers in hospital-based transition to professional practice programs...
October 23, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/29137959/moving-from-clinic-to-home-what-the-future-holds-for-ophthalmic-telemedicine
#2
Nancy M Holekamp
PURPOSE: To describe the expanding role of telemedicine in healthcare, the key criteria required for a successful device and program implementation, and the current and future role of home monitoring in ophthalmology. DESIGN: Expert perspective METHODS: Analysis with real-world interpretation of home monitoring technologies including current adoption barriers and expanded future demands based on demographic and market forces. RESULTS: Remote patient monitoring represents a paradigm shift in the way physicians care for patients...
November 11, 2017: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/29136150/using-value-stream-mapping-to-improve-quality-of-care-in-low-resource-facility-settings
#3
Rohit Ramaswamy, Claire Rothschild, Funmi Alabi, Eric Wachira, Faith Muigai, Nick Pearson
Quality problem or issue: Jacaranda Health (JH) is a Kenya-based organization that attempts to provide affordable, high-quality maternal and newborn healthcare through a chain of private health facilities in Nairobi. Initial assessment: JH needed to adopted quality improvement as an organization-wide strategy to optimize effectiveness and efficiency. Choice of solution: Value Stream Mapping, a Lean Management tool, was used to engage staff in prioritizing opportunities to improve clinical outcomes and patient-centered quality of care...
November 9, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29135761/ten-ceo-imperatives-for-healthcare-transformation-lessons-from-top-performing-academic-medical-centers
#4
J Seth Chatfield, Clinton O Longenecker, Laurence S Fink, Jeffery P Gold
The transition from a delivery model based on volume to a model based on value is underpinning an unprecedented rate of change in healthcare. Our research identifies academic medical centers that have successfully moved their organizations from a volume-based care delivery model to a model that is based on value, achieving top decile performance in the transition. We asked senior leaders about their key imperatives in achieving system-wide healthcare transformations.Major teaching hospitals were sampled using data envelopment analysis to identify hospitals that produced the best value-based purchasing process of care, Hospital Consumer Assessment of Healthcare Providers and Systems scores, and mortality scores with the most efficient utilization of human and financial organizational resources...
November 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/29135621/efficacy-of-implementation-of-a-chest-pain-center-at-a-community-hospital
#5
Alexandra Davis, Jason Chiu, Stanley K Lau, Yih Jen Kok, Jonathan Y H Wu
INTRODUCTION: Chest pain is the second leading cause for emergency department (ED) visits in the United States; however, <20% of the patients have acute coronary syndrome that require immediate attention. The HEART score is designed for rapid risk stratification of ED chest pain patients using the following criteria: history, electrocardiogram, age, risk factors, and troponin. It has been shown to be superior in identifying patients with low (HEART score 0-3) and high (7-10) risk of major adverse cardiac events, who can then be rapidly discharged or admitted for intervention...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29133314/decisional-needs-assessment-of-patients-with-complex-care-needs-in-primary-care-a-participatory-systematic-mixed-studies-review-protocol
#6
Mathieu Bujold, Pierre Pluye, France Légaré, Jeannie Haggerty, Genevieve C Gore, Reem El Sherif, Marie-Eve Poitras, Marie-Claude Beaulieu, Marie-Dominique Beaulieu, Paula L Bush, Yves Couturier, Beatrice Débarges, Justin Gagnon, Anik Giguère, Roland Grad, Vera Granikov, Serge Goulet, Catherine Hudon, Bernardo Kremer, Edeltraut Kröger, Irina Kudrina, Bertrand Lebouché, Christine Loignon, Marie-Therese Lussier, Cristiano Martello, Quynh Nguyen, Rebekah Pratt, Benoit Rihoux, Ellen Rosenberg, Isabelle Samson, Nicolas Senn, David Li Tang, Masashi Tsujimoto, Isabelle Vedel, Bruno Ventelou, Michel Wensing
INTRODUCTION: Patients with complex care needs (PCCNs) often suffer from combinations of multiple chronic conditions, mental health problems, drug interactions and social vulnerability, which can lead to healthcare services overuse, underuse or misuse. Typically, PCCNs face interactional issues and unmet decisional needs regarding possible options in a cascade of interrelated decisions involving different stakeholders (themselves, their families, their caregivers, their healthcare practitioners)...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29130869/effects-of-a-museum-based-social-prescription-intervention-on-quantitative-measures-of-psychological-wellbeing-in-older-adults
#7
Linda J Thomson, Bridget Lockyer, Paul M Camic, Helen J Chatterjee
AIMS: To assess psychological wellbeing in a novel social prescription intervention for older adults called Museums on Prescription and to explore the extent of change over time in six self-rated emotions ('absorbed', 'active', 'cheerful', 'encouraged', 'enlightened' and 'inspired'). METHODS: Participants ( n = 115) aged 65-94 years were referred to museum-based programmes comprising 10 weekly sessions, by healthcare and third sector organisations using inclusion criteria (e...
November 1, 2017: Perspectives in Public Health
https://www.readbyqxmd.com/read/29126420/healthcare-access-for-refugee-women-with-limited-literacy-layers-of-disadvantage
#8
Annette Floyd, Dikaios Sakellariou
BACKGROUND: Record numbers of people, across the world, are forced to be displaced because of conflict or other violations of their human rights, thus becoming refugees. Often, refugees not only have a higher burden of disease but also compromised access to healthcare, as they face many barriers, such as limited knowledge of the local language. However, there is very limited knowledge on the lived experiences of this population. Moreover, the strategies people might develop in their efforts to access healthcare have not been explored in depth, despite their value in establishing peer- support, community based programs...
November 10, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29122932/diagnostic-performance-of-an-acoustic-based-system-for-coronary-artery-disease-risk-stratification
#9
Simon Winther, Louise Nissen, Samuel Emil Schmidt, Jelmer Sybren Westra, Laust Dupont Rasmussen, Lars Lyhne Knudsen, Lene Helleskov Madsen, Jane Kirk Johansen, Bjarke Skogstad Larsen, Johannes Jan Struijk, Lars Frost, Niels Ramsing Holm, Evald Høj Christiansen, Hans Erik Botker, Morten Bøttcher
OBJECTIVE: Diagnosing coronary artery disease (CAD) continues to require substantial healthcare resources. Acoustic analysis of transcutaneous heart sounds of cardiac movement and intracoronary turbulence due to obstructive coronary disease could potentially change this. The aim of this study was thus to test the diagnostic accuracy of a new portable acoustic device for detection of CAD. METHODS: We included 1675 patients consecutively with low to intermediate likelihood of CAD who had been referred for cardiac CT angiography...
November 9, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29121989/determining-the-impact-of-a-new-physiotherapist-led-primary-care-model-for-back-pain-protocol-for-a-pilot-cluster-randomized-controlled-trial
#10
Jordan Miller, David Barber, Catherine Donnelly, Simon French, Michael Green, Jonathan Hill, Joy MacDermid, Jacquelyn Marsh, Kathleen Norman, Julie Richardson, Monica Taljaard, Timothy Wideman, Lynn Cooper, Colleen McPhee
BACKGROUND: Back pain is a leading contributor to disability, healthcare costs, and lost work. Family physicians are the most common first point of contact in the healthcare system for people with back pain, but physiotherapists (PTs) may be able to support the primary care team through evidence-based primary care. A cluster randomized trial is needed to determine the clinical, health system, and societal impact of a primary care model that integrates physiotherapists at the first visit for people with back pain...
November 9, 2017: Trials
https://www.readbyqxmd.com/read/29121053/adept-a-semantically-enriched-pipeline-for-extracting-adverse-drug-events-from-free-text-electronic-health-records
#11
Ehtesham Iqbal, Robbie Mallah, Daniel Rhodes, Honghan Wu, Alvin Romero, Nynn Chang, Olubanke Dzahini, Chandra Pandey, Matthew Broadbent, Robert Stewart, Richard J B Dobson, Zina M Ibrahim
Adverse drug events (ADEs) are unintended responses to medical treatment. They can greatly affect a patient's quality of life and present a substantial burden on healthcare. Although Electronic health records (EHRs) document a wealth of information relating to ADEs, they are frequently stored in the unstructured or semi-structured free-text narrative requiring Natural Language Processing (NLP) techniques to mine the relevant information. Here we present a rule-based ADE detection and classification pipeline built and tested on a large Psychiatric corpus comprising 264k patients using the de-identified EHRs of four UK-based psychiatric hospitals...
2017: PloS One
https://www.readbyqxmd.com/read/29119368/-patient-reported-outcome-measures-in-geriatric-care-first-experiences
#12
Marleen Hems, Marleen Harkes, Margriet Moret-Hartman, René J F Melis, Yvonne Schoon
BACKGROUND: There are difficulties in expressing the value of geriatric care in outcome measures such as recovery or mortality rates. Rather, the goal of geriatric care is to maintain quality of life and functionality. As such, patient reported outcome measures (PROMs) may be more effective in measuring the value healthcare creates in geriatric patients. In 2015 the Dutch Geriatrics Society asked their Committee Quality of Care Measurement to select a suitable PROM for the purpose of measuring the outcomes of geriatric hospital care...
November 8, 2017: Tijdschrift Voor Gerontologie en Geriatrie
https://www.readbyqxmd.com/read/29119339/the-prostate-cancer-screening-clinic-in-the-bahamas-a-model-for-low-and-middle-income-countries
#13
Robin Roberts, Corydon Mitchell, Ana Lourdes Tancawan, Mandi Pedican, Glenn Wayne Jones
PURPOSE: Grand Bahama (pop. 51,000) is an island within the Bahamas archipelago. A local chapter of International Us TOO Prostate Cancer Support Group (UTGB) has led an annual community-based prostate cancer screening clinic in Grand Bahama each September since 2009. Features of this initiative, characteristics of attendees, and a description of found cancers were summarized to determine the clinic's value and to guide improvements. METHOD: We analyzed the established clinic from 2012 to 2015, wherein UTGB attracted corporate funding, volunteers managed clinics, and health professionals provided healthcare services...
November 2017: Cancer Causes & Control: CCC
https://www.readbyqxmd.com/read/29118564/sex-related-differences-in-predicting-choledocholithiasis-using-current-american-society-of-gastrointestinal-endoscopy-risk-criteria
#14
Ankit Chhoda, Deepanshu Jain, Shashideep Singhal
Background: American Society of Gastrointestinal Endoscopy (ASGE) criteria is widely used to predict probability of choledocholithiasis among patients with symptomatic gallstone disease but does not take sex into consideration. Methods: The cohort study included patients who underwent either endoscopic retrograde cholangiopancreatography or intraoperative cholangiography for suspected choledocholithiasis at our medical center. Clinical, laboratory and radiological data were collected for each patient and used to stratify them based on the ASGE risk criteria for choledocholithiasis...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29118165/multicenter-evaluation-of-the-xpert-mrsa-nxg-assay-for-detection-of-methicillin-resistant-staphylococcus-aureus-in-nasal-swabs
#15
Melanie L Yarbrough, David K Warren, Karen Allen, Dennis Burkholder, Robert Daum, Curtis Donskey, Dennis Knaack, Anthony LaMarca, Larissa May, Loren G Miller, David M Parenti, Lance Peterson, Thean Yen Tan, Raymond Widen, Diana R Hernandez, Donna M Wolk, C A Burnham
Healthcare-associated methicillin-resistant Staphylococcus aureus (MRSA) infections are a burden on the healthcare system. Clinical laboratories play a key role in reducing this burden, as timely identification of MRSA colonization or infection facilitates infection control practices that are effective at limiting invasive MRSA infections. The Xpert MRSA NxG Assay recently received FDA clearance for the direct detection of MRSA from nasal swabs. This multicenter study evaluated the clinical performance characteristics of the Xpert MRSA NxG Assay with prospectively collected rayon nasal swabs (n = 1103) and flocked swab (ESwab) nasal specimens (n = 846)...
November 8, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29116052/quantitative-performance-evaluation-of-sup-124-sup-i-pet-mri-lesion-dosimetry-in-differentiated-thyroid-cancer
#16
Roel Wierts, Walter Jentzen, Harald H Quick, Hendrik J Wisselink, Ivo N A Pooters, Joachim E Wildberger, Ken Herrmann, Gerrit J Kemerink, Walter H Backes, Felix M Mottaghy
The aim was to investigate the quantitative performance of 124I PET/MRI for pre-therapy lesion dosimetry in differentiated thyroid cancer. Phantom measurements were performed on a PET/MRI system (Biograph mMR, Siemens Healthcare) using 124I and 18F. The PET calibration factor and the influence of radiofrequency coil attenuation were determined using a cylindrical phantom homogeneously filled with radioactivity. The calibration factor was 1.00 ± 0.02 for 18F and 0.88 ± 0.02 for 124I. Near the radiofrequency surface coil an underestimation of less than 5% in radioactivity concentration was observed...
November 8, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29111950/methods-for-coping-with-premenstrual-change-development-and-validation-of-the-german-premenstrual-change-coping-inventory-pms-cope
#17
Gudrun Kaiser, Johanna N Kues, Maria Kleinstäuber, Gerhard Andersson, Cornelia Weise
During the premenstrual phase, psychological and physiological changes can occur, which are associated with different levels of disability. When they appear with Premenstrual Dysphoric Disorder (PMDD), different coping strategies may be used by women to deal with premenstrual changes. Currently no German measure exists for assessing premenstrual symptom-related coping strategies. Therefore, we developed the Premenstrual Change Coping Inventory (PMS-Cope). First, the 33-item questionnaire was tested with an exploratory factor analytic approach (EFA) in a sample of 150 women prospectively diagnosed with PMDD or severe Premenstrual Syndrome from August 2013 until March 2016...
November 7, 2017: Women & Health
https://www.readbyqxmd.com/read/29110668/measuring-the-bias-against-low-income-country-research-an-implicit-association-test
#18
Matthew Harris, James Macinko, Geronimo Jimenez, Pricila Mullachery
BACKGROUND: With an increasing array of innovations and research emerging from low-income countries there is a growing recognition that even high-income countries could learn from these contexts. It is well known that the source of a product influences perception of that product, but little research has examined whether this applies also in evidence-based medicine and decision-making. In order to examine likely barriers to learning from low-income countries, this study uses established methods in cognitive psychology to explore whether healthcare professionals and researchers implicitly associate good research with rich countries more so than with poor countries...
November 6, 2017: Globalization and Health
https://www.readbyqxmd.com/read/29103554/clinical-guidelines-for-low-back-pain-a-critical-review-of-consensus-and-inconsistencies-across-three-major-guidelines
#19
REVIEW
Neil E O'Connell, Chad E Cook, Benedict M Wand, Stephen P Ward
Given the scale and cost of the low back pain problem, it is imperative that healthcare professionals involved in the care of people with low back pain have access to up-to-date, evidence-based information to assist them in treatment decision-making. Clinical guidelines exist to promote the consistent best practice, to reduce unwarranted variation and to reduce the use of low-value interventions in patient care. Recent decades have witnessed the publication of a number of such guidelines. In this narrative review, we consider three selected international interdisciplinary guidelines for the management of low back pain...
December 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/29103136/a-study-of-the-opinions-of-swedish-healthcare-personnel-regarding-acceptable-outcome-following-decompressive-hemicraniectomy-for-ischaemic-stroke
#20
Magnus Olivecrona, Stephen Honeybul
BACKGROUND: Decompressive hemicraniectomy (DC) is an established lifesaving treatment for malignant infarction of the middle cerebral artery (mMCAI). However, surgical decompression will not reverse the effects of the stroke and many survivors will be left severely disabled. The objective of this study was to assess what neurological outcome would be considered acceptable in these circumstances amongst Swedish healthcare workers. METHOD: Healthcare workers were invited to participate in a presentation that outlined the pathophysiology of mMCAI, the rationale behind DC and outcome data from randomised controlled trials that have investigated efficacy of the procedure...
November 4, 2017: Acta Neurochirurgica
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