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Healthcare teams

Flávia de Oliveira Motta Maia, Diná de Almeida Lopes Monteiro da Cruz, Gilceria Tochika Shimoda, Karina Sichieri, Luciana Inaba Senier Iida
OBJECTIVES: The main objective of this project was to reduce the incidence and harm from falls that occur among patients admitted in the acute Internal Medicine Unit and Intensive Care Unit in a public teaching hospital in São Paulo, Brazil. INTRODUCTION: Falls are a challenge for health professionals and healthcare services as they may result in high-impact outcomes for patients, such as functional decline, increase in length of hospital stay, increase in the cost of healthcare services, and death...
August 2018: JBI Database of Systematic Reviews and Implementation Reports
Alexandra F Dalton, Corey Lyon, Bennett Parnes, Douglas Fernald, Carmen L Lewis
PURPOSE: The purpose of this project was to: (1) develop a strategy for primary care quality measurement using an environmental scan and interviews to identify best practices and candidate measures; (2) present recommendations to facilitate successful measurement. METHODS: Following stakeholder interviews and review of existing measures, we created a three-tiered recommendation system for selecting and implementing measures. We also developed a framework for reviewing and prioritizing measures and prepared a detailed project report...
August 14, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
Debbie W Chen, Angela M Gerolamo, Elissa Harmon, Anna Bistline, Shoshana Sicks, Lauren Collins
BACKGROUND: Research on caregivers, defined as designated family members or support persons, in the medical intensive care unit (MICU) has primarily focused on their emotional needs and experiences, thus leaving a gap in knowledge related to their perceptions of team dynamics. OBJECTIVE: To examine caregivers' perceptions of team interactions and competencies for interprofessional collaborative practice (IPCP) and overall satisfaction with the MICU team. METHODS: The Support Person Jefferson Teamwork Observation Guide (JTOG)™ was administered to a convenience sample of caregivers in the MICU at a large urban academic medical center between May 2016 and December 2016...
August 15, 2018: Journal of General Internal Medicine
Roopa Hariprasad, Gayatri Palat, Ravi Mehrotra, Nandini Vallath
With unprecedented surge in the incidence and prevalence of cancer in India, it has become imperative to strengthen the workforce for all the domains of cancer care. A large proportion of the activity required for prevention as well as for palliation, lie outside of tertiary institutions, in the community. Palliative care (PC) as a field is expanding exponentially across the country and the service providers often engage and work actively within the local community in their region. This article describes the scope for reducing the cancer burden in the community, through capacity building of community based PC healthcare functionaries in the domains of Prevention, and Early detection of common cancers along with Palliative care - the PEP domains...
July 2018: Indian Journal of Palliative Care
Julian Thompson, Marius Rehn, Stephen J M Sollid
BACKGROUND: Helicopter EMS (HEMS) teams may perform a variety of clinical, managerial and transport functions during major incident management. Despite national and international variations in HEMS systems, the rapid delivery of HEMS personnel with advanced skills in major incident management and clinical scene leadership has been crucial to the delivery of an effective medical response at previous incidents. This document outlines the Best Practice Advice of the European HEMS and Air Ambulance Committee (EHAC) Medical Working Group on how HEMS and Pre Hospital Critical Care teams may maximise the positive impact of their resources in the event of Major Incidents...
August 15, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Anja Siegle, Matthias Villalobos, Jasmin Bossert, Katja Krug, Laura Hagelskamp, Johannes Krisam, Violet Handtke, Nicole Deis, Jana Jünger, Michel Wensing, Michael Thomas
BACKGROUND: The care needs of patients with a limited prognosis (<12 months median) are complex and dynamic. Patients and caregivers must cope with many challenges, including physical symptoms and disabilities, uncertainty. and compromised self-efficacy. Healthcare is often characterized by disruptions in the transition between healthcare providers. The Milestones Communication Approach (MCA) is a structured, proactive, interprofessional concept that involves physicians and nurses and is aimed at providing coherent care across the disease trajectory...
August 14, 2018: Trials
Kiyotaka Uchiyama, Naoki Washida, Nobuyuki Yube, Takahiro Kasai, Keisuke Shinozuka, Kohkichi Morimoto, Akihito Hishikawa, Hiroyuki Inoue, Hidenori Urai, Aika Hagiwara, Kentaro Fujii, Shu Wakino, Souzana Deenitchina, Hiroshi Itoh
AIMS: Remote monitoring (RM) can improve management of chronic diseases. We evaluated the impact of RM in automated peritoneal dialysis (APD) in a simulation study. MATERIALS AND METHODS: We simulated 12 patient scenarios with common clinical problems and estimated the likely healthcare resource consumption with and without the availability of RM (RM+ and RM- groups, respectively). Scenarios were evaluated 4 times by randomly allocated nephrologist-nurse teams or nephrologist-alone assessors...
August 14, 2018: Clinical Nephrology
Robin Urquhart, Jyoti Kotecha, Cynthia Kendell, Mary Martin, Han Han, Beverley Lawson, Cheryl Tschupruk, Emily Gard Marshall, Carol Bennett, Fred Burge
BACKGROUND: Strategies have been developed for use in primary care to identify patients at risk of declining health and dying, yet little is known about the perceptions of doing so or the broader implications and impacts. AIM: To explore the acceptability and implications of using a primary care-based electronic medical record algorithm to help providers identify patients in their practice at risk of declining health and dying. DESIGN AND SETTING: Qualitative descriptive study in Ontario and Nova Scotia, Canada...
August 13, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Rachel McKittrick, Rosemary McKenzie
The Australian Government Health Care Homes (HCH) model recently implemented in general practice targets people with chronic complex conditions. Identifying how general practitioners (GPs) and practice nurses (PNs) can work within this model is important given existing health workforce challenges. A narrative review and synthesis has been undertaken to develop a preliminary understanding of this, incorporating literature describing health workforce challenges, GP and PN functions, and team-based care; supplemented by interviews with key informants from within the primary healthcare system...
August 14, 2018: Australian Journal of Primary Health
Emmanuel Ugwa, Emmanuel Otolorin, Mark Kabue, Gbenga Ishola, Cherrie Evans, Adetiloye Oniyire, Gladys Olisaekee, Boniface Onwe, Amnesty E LeFevre, Julia Bluestone, Bright Orji, Gayane Yenokyan, Ugo Okoli
BACKGROUND: There is limited information from low and middle-income countries on learning outcomes, provider satisfaction and cost-effectiveness on the day of birth care among maternal and newborn health workers trained using onsite simulation-based low-dose high frequency (LDHF) plus mentoring approach compared to the commonly employed offsite traditional group-based training (TRAD). The LDHF approach uses in-service learning updates to deliver information based on local needs during short, structured, onsite, interactive learning activities that involve the entire team and are spaced over time to optimize learning...
August 13, 2018: BMC Health Services Research
Sheila Feitosa Ramos, Genival Araujo Dos Santos Júnior, André Mascarenhas Pereira, Aline Santana Dosea, Kérilin Stancine Santos Rocha, Déborah Mônica Machado Pimentel, Divaldo Pereira de Lyra-Jr
BACKGROUND: Clinical Pharmacy Services (CPS) are a reality in many health systems around the world. However, there are few studies that discuss the facilitators and the strategies to implement CPS in healthcare systems. In this way, the objective of this study was to identify the facilitators and strategies involved in the CPS implementation process in some public health units in a metropolis in the Northeast Brazil. METHODS: A qualitative study was carried out with health-system pharmacists and managers who experienced the implementation of CPS...
August 13, 2018: BMC Health Services Research
B Ahmad, D Landes, S Moffatt
This paper presents a case study on the use of mixed methods in research into practice to inform policy. The study was undertaken as part of a review of oral healthcare for older people in residential and nursing care homes in County Durham, North East England. The findings highlighted challenges in the provision of good quality oral healthcare to older people in residential and nursing care homes and informed the county's oral health strategy (Durham County Council DCC, 2016). Key recommendations include the need to develop and implement a minimum set of best practice oral health standards within care home contracts and train care home staff in oral healthcare...
August 9, 2018: Community Dental Health
Charlotte M Lewis, Thelma Gamboa-Maldonado, Juan Carlos Belliard, Anna Nelson, Susanne Montgomery
Traditional community health workers (CHWs) are expanding their role into clinical settings (cCHW) to support patients with care coordination and advocacy services. We investigated the potential to integrate cCHWs, via evaluation of patients' and CHWs' key demographics, needs, and abilities. This mixed-methods study, including adult patients and CHWs, was conducted in the Inland Valley of Southern California, between 2016 and 2017. Survey data, key informant interviews, and focus group discussions were evaluated to compare patient/CHW core demographics, and contrast patient-identified healthcare needs against CHW-identified cCHW service capabilities...
August 12, 2018: Journal of Community Health
Timothy J Bauler, Shanna Cole, Tyler Gibb, Richard Van Enk, Larry Lutwick, Bonny L Dickinson
In medical and healthcare-related education, case-based learning (CBL) is a teaching strategy that uses clinical cases to engage students in active learning using course concepts to solve important problems. Here we describe the design and implementation of a CBL module to teach first year medical students about the human immunodeficiency virus (HIV), acute retroviral syndrome, clinical progression to acquired immunodeficiency syndrome, HIV diagnostics, assays used to assess stage of disease and response to antiretroviral treatment, and highly active antiretroviral therapy...
2018: Journal of Microbiology & Biology Education: JMBE
Donna M Zulman, Colin W O'Brien, Cindie Slightam, Jessica Y Breland, David Krauth, Andrea L Nevedal
BACKGROUND: Intensive outpatient programs address the complex medical, social, and behavioral needs of individuals who account for disproportionate healthcare costs. Despite their promise, the impact of these programs is often diminished due to patient engagement challenges (i.e., low rates of patient participation and partnership in care). OBJECTIVE: The objective of this study was to identify intensive outpatient program features and strategies that increase high-need patient engagement in these programs...
August 10, 2018: Journal of General Internal Medicine
Teodora Sorana Truta, Cristian Marius Boeriu, Sanda-Maria Copotoiu, Marius Petrisor, Emilia Turucz, Dan Vatau, Marc Lazarovici
Errors are frequent in healthcare, but Emergency Departments are among the highest risk areas due to frequent changes in team composition, complexity and variety of cases, and difficulties encountered in managing multiple patients simultaneously.Crisis resource management (CRM) training has been associated with decreased error rates in the aviation industry as well as in certain areas of acute medical care, such as anesthesia and emergency medicine. In this study, we assessed whether a single day CRM training, combining didactic and simulation sessions, improves nontechnical skills (NTS) of interprofessional emergency medical teams...
August 2018: Medicine (Baltimore)
Amar Shah, Auzewell Chitewe, Emma Binley, Forid Alom, James Innes
Early intervention following initial referral into healthcare services can have a significant impact on the prognosis and outcomes of patients. Long waiting times and non-attendance can have an immediate and enduring negative impact on patients and healthcare service providers. The traditional management options in reducing waiting times have largely revolved around setting performance targets, providing financial incentives or additional resourcing. This large-scale quality improvement project aimed to reduce waiting times from referral to first appointment and non-attendance for a wide range of services providing primary and secondary care mental health and community health services at East London NHS Foundation Trust (ELFT)...
2018: BMJ Open Quality
Nirvani Goolsarran, Carine E Hamo, Susan Lane, Stacey Frawley, Wei-Hsin Lu
BACKGROUND: Although the American Council of Graduate Medical Education (ACGME) mandates formal education in patient safety, there is a lack of standardized educational practice on how to conduct patient safety training. Traditionally, patient safety is taught utilizing instructional strategies that promote passive learning such as self-directed online learning modules or didactic lectures that result in suboptimal learning and satisfaction. METHODS: During the summer of 2015, 76 trainees consisting of internal medicine interns and senior-level nursing students participated in an interactive patient safety workshop that used a flipped classroom approach integrating team based learning (TBL) and interprofessional simulated application exercises...
August 8, 2018: BMC Medical Education
Terusha Chetty, H Manisha N Yapa, Carina Herbst, Pascal Geldsetzer, Kevindra K Naidu, Jan-Walter De Neve, Kobus Herbst, Philippa Matthews, Deenan Pillay, Sally Wyke, Till Bärnighausen
BACKGROUND: Gaps in maternal and child health services can slow progress towards achieving the Sustainable Development Goals. The Management and Optimization of Nutrition, Antenatal, Reproductive, Child Health & HIV Care (MONARCH) study will evaluate a Continuous Quality Improvement (CQI) intervention targeted at improving antenatal and postnatal health service outcomes in rural South Africa where HIV prevalence among pregnant women is extremely high. Specifically, it will establish the effectiveness of CQI on viral load (VL) testing in pregnant women who are HIV-positive and repeat HIV testing in pregnant women who are HIV-negative...
August 8, 2018: BMC Health Services Research
Christy Noble, Laurie Grealish, Andrew Teodorczuk, Brenton Shanahan, Balaji Hiremagular, Jodie Morris, Sarah Yardley
BACKGROUND: There is a pressing need to improve end-of-life care in acute settings. This requires meeting the learning needs of all acute care healthcare professionals to develop broader clinical expertise and bring about positive change. The UK experience with the Liverpool Care of the Dying Pathway (LCP), also demonstrates a greater focus on implementation processes and daily working practices is necessary. METHODS: This qualitative study, informed by Normalisation Process Theory (NPT), investigates how a tool for end-of-life care was embedded in a large Australian teaching hospital...
August 8, 2018: BMC Palliative Care
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