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https://www.readbyqxmd.com/read/28840966/the-diy-digital-medical-centre
#1
James Kenneth Timmis, Kenneth Timmis
Healthcare systems worldwide are confronted with major economic, organizational and logistical challenges. Historic evolution of health care has led to significant healthcare sector fragmentation, resulting in systemic inefficiencies and suboptimal resource exploitation. To attain a sustainable healthcare model, fundamental, system-wide improvements that effectively network, and ensure fulfilment of potential synergies between sectors, and include and facilitate coherent strategic planning and organisation of healthcare infrastructure are needed...
August 25, 2017: Microbial Biotechnology
https://www.readbyqxmd.com/read/28803883/the-provision-of-emergency-contraception-in-kinshasa-s-private-sector-pharmacies-experiences-of-mystery-clients
#2
Julie H Hernandez, Muanda Fidèle Mbadu, Mélissa Garcia, Annie Glover
OBJECTIVES: Recent programmatic and research efforts on addressing gaps in health systems of low-income countries increasingly see task shifting, i.e. the provision of healthcare by non-medically trained personnel, as a possible solution to increase the availability of specific services and commodities. In Kinshasa, private-sector pharmacies are the primary and preferred provider of family planning (FP) methods, and thus constitute a potential resource for expanding access to specific contraceptives...
August 10, 2017: Contraception
https://www.readbyqxmd.com/read/28725789/improving-american-healthcare-through-clinical-lab-2-0-a-project-santa-fe-report
#3
James M Crawford, Khosrow Shotorbani, Gaurav Sharma, Michael Crossey, Tarush Kothari, Thomas S Lorey, Jeffrey W Prichard, Myra Wilkerson, Nancy Fisher
Project Santa Fe was established both to provide thought leadership and to help develop the evidence base for the valuation of clinical laboratory services in the next era of American healthcare. The participants in Project Santa Fe represent major regional health systems that can operationalize laboratory-driven innovations and test their valuation in diverse regional marketplaces in the United States. We provide recommendations from the inaugural March 2016 meeting of Project Santa Fe. Specifically, in the transition from volume-based to value-based health care, clinical laboratories are called upon to provide programmatic leadership in reducing total cost of care through optimization of time-to-diagnosis and time-to-effective therapeutics, optimization of care coordination, and programmatic support of wellness care, screening, and monitoring...
January 2017: Acad Pathol
https://www.readbyqxmd.com/read/28724399/health-needs-access-to-healthcare-and-perceptions-of-ageing-in-an-urbanizing-community-in-india-a-qualitative-study
#4
Nandita Bhan, Pavitra Madhira, Arundati Muralidharan, Bharati Kulkarni, Gvs Murthy, Sanjay Basu, Sanjay Kinra
BACKGROUND: India's elderly population is rising at an unprecedented rate, with a majority living in rural areas. Health challenges associated with ageing, changing social networks and limited public health infrastructure are issues faced by the elderly and caregivers. We examined perceptions of health needs of the elderly across local stakeholders in an urbanizing rural area. METHODS: The qualitative study was conducted among participants in the Andhra Pradesh Children and Parents Study (APCAPS) site in Rangareddy district, Telangana...
July 19, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28710222/a-developmental-evaluation-to-enhance-stakeholder-engagement-in-a-wide-scale-interactive-project-disseminating-quality-improvement-data-study-protocol-for-a-mixed-methods-study
#5
Alison Laycock, Jodie Bailie, Veronica Matthews, Frances Cunningham, Gillian Harvey, Nikki Percival, Ross Bailie
INTRODUCTION: Bringing together continuous quality improvement (CQI) data from multiple health services offers opportunities to identify common improvement priorities and to develop interventions at various system levels to achieve large-scale improvement in care. An important principle of CQI is practitioner participation in interpreting data and planning evidence-based change. This study will contribute knowledge about engaging diverse stakeholders in collaborative and theoretically informed processes to identify and address priority evidence-practice gaps in care delivery...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28671543/quality-and-innovation-redesigning-a-coordinated-and-connected-health-system
#6
Peter W Vaughan
Nova Scotia's consolidated health system was launched on April 1, 2015. This new approach to organizing health administration and services in the province arose out of necessity. When planning began, Nova Scotia was spending 41% of its annual budget on health services. In comparison to other provinces and territories, our per capita health-related spending was among the highest in the country, we had one of Canada's oldest populations and we had some of the worst health outcomes. Clearly, we could not continue to do the same things and expect different results...
2017: HealthcarePapers
https://www.readbyqxmd.com/read/28651638/comparing-regional-models-of-congenital-bleeding-disorders-preliminary-steps-in-the-italian-context
#7
Sabina Nuti, Chiara Seghieri, Francesco Niccolai, Federica Vasta, Giuliano Grazzini
BACKGROUND: Among these diseases, congenital bleeding disorders (CBD) represent a significant societal burden in terms of high morbidity costs and health outcomes. In Italy, the organization and provision of health care is a regional responsibility and regions must assure equity and quality to all their residents. This is also true for CBD care which is provided by 54 multidisciplinary Hemophilia Treatment Centers (HTCs) distributed among the regions. With the present study, we intend to stimulate a debate on the effect that the decentralization process have in the delivery of services to CBD patients across Italy...
June 26, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28638844/predictors-of-unplanned-hospitalization-in-patients-receiving-outpatient-parenteral-antimicrobial-therapy-across-a-large-integrated-healthcare-network
#8
Monica Schmidt, Bevin Hearn, Michael Gabriel, Melanie D Spencer, Lewis McCurdy
BACKGROUND: Outpatient parenteral antimicrobial therapy (OPAT) prescribing has increased along with the trend toward early discharge of hospitalized patients who have infections. There is limited literature that assesses unplanned hospitalizations during OPAT. This study aims to elucidate the predictors of unplanned hospitalization in OPAT patients after discharge from acute-care facilities within Carolinas HealthCare System (CHS). Understanding these predictors may inform future interventions to improve treatment efficacy and patient outcomes...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28633040/hematopoietic-cell-transplantation-training-challenges-and-potential-opportunities-through-networking-and-integration-of-modern-technologies-to-the-practice-setting
#9
REVIEW
Mohamed A Kharfan-Dabaja, Mahmoud Aljurf
Hematopoietic cell transplantation (HCT), particularly allogeneic HCT, is a complex and a high-risk procedure requiring expertise to manage potential treatment complications. Published data supports the value of quality management systems in improving post-transplant outcomes; however, there are no universally established, or agreed upon, criteria to assess adequacy of training of physicians, transplant or nontransplant, and supporting staff, among others. It is of paramount importance for transplant centers to identify the needed area(s) of expertise in order to seek appropriate training for their staff...
June 13, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28537207/indirect-effect-of-management-support-on-users-compliance-behaviour-towards-information-security-policies
#10
Norshima Humaidi, Vimala Balakrishnan
BACKGROUND: Health information systems are innovative products designed to improve the delivery of effective healthcare, but they are also vulnerable to breaches of information security, including unauthorised access, use, disclosure, disruption, modification or destruction, and duplication of passwords. Greater openness and multi-connectedness between heterogeneous stakeholders within health networks increase the security risk. OBJECTIVE: The focus of this research was on the indirect effects of management support (MS) on user compliance behaviour (UCB) towards information security policies (ISPs) among health professionals in selected Malaysian public hospitals...
January 1, 2017: HIM Journal
https://www.readbyqxmd.com/read/28433672/montreal-accord-on-patient-reported-outcomes-use-series-paper-1-introduction
#11
Susan J Bartlett, Sara Ahmed
BACKGROUND: Patient-centered healthcare, where we design and deliver care to address the needs and preferences of patients, represents an important paradigm shift. Patient reported outcomes (PROs) are critical to capture the patient voice, understand how illness and treatments affect people, and establish how well services and treatments address what matters most to patients. OBJECTIVE: Originally developed for use in research, PROs are now used to monitor individuals and populations, manage care, evaluate services and providers, and inform policy...
April 19, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28375497/a-direct-experience-in-a-new-accountable-care-organization-results-challenges-and-the-role-of-the-neurosurgeon
#12
Dong H Kim, Christopher Lloyd, Douglas K Fernandez, Amanda Spielman, David Bradshaw
The passage of the Affordable Care Act saw the creation of Accountable Care Organizations (ACOs), a new approach to healthcare delivery moving from fee-for-service toward population health. This paper presents a case study of the Memorial Hermann ACO (MHACO), launched in response to the Medicare Shared Savings Program, with goals to align physician and hospital incentives, practice evidence-based medicine, develop care coordination, and increase efficiency. Building blocks included an affiliated primary care network, a clinical integration program (involving shared electronic medical record platforms and quality data reporting), and significant investments in information technology...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28375496/a-review-and-survey-of-neurosurgeon-hospital-relationships-evolution-and-options
#13
Dong H Kim, Bernard Duco, Daniel Wolterman, Charles Stokes, Rod Brace, Robert A Solomon, Nicholas Barbaro, Richard Westmark, David MacDougall, James Bean, Joanna O'Leary, Nicole Moayeri, Ralph G Dacey, Mitchel S Berger, Robert Harbaugh
As healthcare delivery shifts from fee-for-service, episodic care to pay for performance and population health, both hospitals and physicians are looking for new forms of integration. A number of regulations and restrictions govern physician relationships with hospitals. In this paper, we review the legal basis for such relationships and the options available. We also survey neurosurgeons and hospital executives to gain their perspective on the current situation and likely future. Two series of structured interviews were conducted with 10 neurosurgeons who work in a range of situations in diverse markets, and with Memorial Hermann Healthcare System senior executive leadership...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28319006/high-rates-of-severe-hypoglycemia-among-african-american-patients-with-diabetes-the-surveillance-prevention-and-management-of-diabetes-mellitus-supreme-dm-network
#14
Andrew J Karter, Kasia J Lipska, Patrick J O'Connor, Jennifer Y Liu, Howard H Moffet, Emily B Schroeder, Jean M Lawrence, Gregory A Nichols, Katherine M Newton, Ram D Pathak, Jay Desai, Beth Waitzfelder, Melissa G Butler, Abraham Thomas, John F Steiner
AIMS: Seven-year surveillance study (2005-2011) to evaluate race/ethnic differences in the trends in rates of severe hypoglycemia (SH) in a population of insured, at-risk adults with diabetes. METHODS: SH events were identified via any primary or principal diagnosis from emergency department or inpatient encounters among African American, Asian, Latino and White adult diabetes patients treated with insulin or secretagogues (Sulfonylureas or Meglitinides), receiving care from integrated healthcare delivery systems across the United States...
May 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28290933/leveraging-the-partnership-for-patients-initiative-to-improve-patient-safety-and-quality-within-the-military-health-system
#15
Heidi B King, Kimberly Kesling, Carmen Birk, Theodore Walker, Heather Taylor, Michael Datena, Brittany Burgess, Lyndsay Bower
INTRODUCTION: Partnership for Patients (PfP) was a national initiative sponsored by the Department of Health and Human Services, Centers for Medicare and Medicaid Services, to reduce preventable hospital acquired conditions (HACs) by 40% and readmissions (within 30 days) by 20%, by the end of 2013 (as compared to the baseline of CY2010). Along with partners across the nation, the Assistant Secretary of Defense for Health Affairs, Dr. Jonathan Woodson, pledged to support PfP in June 2011...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28173827/integrated-solutions-for-sustainable-fall-prevention-in-primary-care-the-isolve-project-a-type-2-hybrid-effectiveness-implementation-design
#16
Lindy Clemson, Lynette Mackenzie, Chris Roberts, Roslyn Poulos, Amy Tan, Meryl Lovarini, Cathie Sherrington, Judy M Simpson, Karen Willis, Mary Lam, Anne Tiedemann, Dimity Pond, David Peiris, Sarah Hilmer, Sabrina Winona Pit, Kirsten Howard, Lorraine Lovitt, Fiona White
BACKGROUND: Despite strong evidence giving guidance for effective fall prevention interventions in community-residing older people, there is currently no clear model for engaging general medical practitioners in fall prevention and routine use of allied health professionals in fall prevention has been slow, limiting widespread dissemination. This protocol paper outlines an implementation-effectiveness study of the Integrated Solutions for Sustainable Fall Prevention (iSOLVE) intervention which has developed integrated processes and pathways to identify older people at risk of falls and engage a whole of primary care approach to fall prevention...
February 7, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28086925/partnerships-in-mental-healthcare-service-delivery-in-low-resource-settings-developing-an-innovative-network-in-rural-nepal
#17
Bibhav Acharya, Duncan Maru, Ryan Schwarz, David Citrin, Jasmine Tenpa, Soniya Hirachan, Madhur Basnet, Poshan Thapa, Sikhar Swar, Scott Halliday, Brandon Kohrt, Nagendra P Luitel, Erick Hung, Bikash Gauchan, Rajeev Pokharel, Maria Ekstrand
BACKGROUND: Mental illnesses are the largest contributors to the global burden of non-communicable diseases. However, there is extremely limited access to high quality, culturally-sensitive, and contextually-appropriate mental healthcare services. This situation persists despite the availability of interventions with proven efficacy to improve patient outcomes. A partnerships network is necessary for successful program adaptation and implementation. PARTNERSHIPS NETWORK: We describe our partnerships network as a case example that addresses challenges in delivering mental healthcare and which can serve as a model for similar settings...
January 13, 2017: Globalization and Health
https://www.readbyqxmd.com/read/27924187/evaluating-outcomes-in-patients-with-overactive-bladder-within-an-integrated-healthcare-delivery-system-using-a-treatment-patterns-analyzer
#18
Daniel B Ng, Melissa McCart, Christopher Klein, Chelsey Campbell, Robert Schoenhaus, Todd Berner
BACKGROUND: Overactive bladder (OAB) is a relatively common disease that has been linked to a variety of comorbidities, reductions in quality of life, and increased healthcare costs. Antimuscarinic agents are the standard of care among pharmacologic treatments for OAB, but these drugs are linked to high levels of anticholinergic burden, especially in the elderly. OBJECTIVE: To demonstrate how efficient data analysis can be used to identify gaps in care as a result of improvement strategies for OAB within an integrated healthcare delivery system setting...
September 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/27770772/frequency-of-satisfaction-and-dissatisfaction-with-practice-among-rural-based-group-employed-physicians-and-non-physician-practitioners
#19
Anthony C Waddimba, Melissa Scribani, Nicole Krupa, John J May, Paul Jenkins
BACKGROUND: Widespread dissatisfaction among United States (U.S.) clinicians could endanger ongoing reforms. Practitioners in rural/underserved areas withstand stressors that are unique to or accentuated in those settings. Medical professionals employed by integrating delivery systems are often distressed by the cacophony of organizational change(s) that such consolidation portends. We investigated the factors associated with dis/satisfaction with rural practice among doctors/non-physician practitioners employed by an integrated healthcare delivery network serving 9 counties of upstate New York, during a time of organizational transition...
October 22, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27668560/the-central-role-of-physician-leadership-for-driving-change-in-value-based-care-environments
#20
Adam Lustig, Michael Ogden, Robert W Brenner, Jerry Penso, Kimberly D Westrich, Robert W Dubois
BACKGROUND: In 2013, it was reported that about 1 of every 3 U.S. adults has hypertension. Of these 70 million individuals, approximately 50% have their blood pressure under control. Achieving hypertension control, especially in at-risk populations, requires a multipronged approach that includes lifestyle modifications and pharmacological treatment. As provider groups, hospital systems, and integrated delivery networks optimize their care processes to promote population health activities in support of the accountable care organization (ACO) model of care, managing hypertension and other chronic diseases will be essential to their success...
October 2016: Journal of Managed Care & Specialty Pharmacy
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