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https://www.readbyqxmd.com/read/29144599/assessing-social-values-for-california-s-efforts-to-reduce-the-overuse-of-unnecessary-medical-care
#1
Susan L Perez, Desiree Backman, Marge Ginsburg
BACKGROUND: A partnership of large health-care purchasers created a workgroup to reduce the overuse of harmful and wasteful medical care in California. OBJECTIVE: Employ a civic engagement process to identify the social values important to the public in considering different strategies to reduce overuse. INTERVENTION: Use of deliberation techniques for 3 case examples that explore possible strategies: physician oversight, physician compensation, increased patient cost-sharing or taking no definitive action...
November 16, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/29138887/-developments-in-dysphagia-diagnostics-presentation-of-an-interdisciplinary-concept
#2
REVIEW
C Pflug, T Flügel, J C Nienstedt
Demographic developments and medical progress will cause the already high prevalence of swallowing disorders to increase further in the future. With the same number of specialists and economic resources, it is necessary to improve the efficiency of dysphagia diagnostics and continue to offer patients a treatment concept tailored to their needs. Manifold and often co-existing causes of dysphagia require interdisciplinary cooperation in this area. Endoscopic swallowing diagnostics play a prominent role in dysphagia diagnostics and should always contain thorough endoscopy of the upper aerodigestive tract-the domain of the ENT specialist and phoniatrician...
November 14, 2017: HNO
https://www.readbyqxmd.com/read/29133335/barriers-and-facilitators-to-learn-and-improve-through-morbidity-and-mortality-conferences-a-qualitative-study
#3
Marit S de Vos, Jaap F Hamming, Perla J Marang-van de Mheen
OBJECTIVES: To explore barriers and facilitators to successful morbidity and mortality conferences (M&M), driving learning and improvement. DESIGN: This is a qualitative study with semistructured interviews. Inductive, thematic content analysis was used to identify barriers and facilitators, which were structured across a pre-existing framework for change in healthcare. SETTING: Dutch academic surgical department with a long tradition of M&M...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29124785/time-to-address-gender-inequalities-against-female-physicians
#4
Suad Hannawi, Issa Al Salmi
Although the health care system depends heavily on female physicians, it discriminates against women and tends to concentrate female physicians' work in lower status occupations. Gender discrimination has structural, social, and cultural dimensions. Such discrimination is perceived differently by various stakeholders and the public. In addition, there is reluctance to publicly acknowledge gender discrimination, especially in the culturally conservative Middle East region. Gender discrimination leads to underrepresentation of female physicians in leadership roles and certain specialties and hence leads to less attention and understanding of the working conditions of female physicians and their roles in the health care system...
November 10, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/29121299/gender-power-and-leadership-the-effect-of-a-superior-s-gender-on-respiratory-therapists-ability-to-challenge-leadership-during-a-life-threatening-emergency
#5
N Pattni, M D Bould, M A Hayter, D McLuckie, L M K Noble, A Malavade, Z Friedman
Background: Effective communication within teams is crucial, especially in crisis situations. Hierarchy gradients between team members can contribute to communication failures and are influenced by many factors. The effect of gender on team performance has not been well studied. The objective of this study was to examine the effect of the physician's gender on respiratory therapists' ability to effectively challenge clearly incorrect clinical decisions during a life-threatening crisis...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29119470/failure-to-flow-an-exploration-of-learning-and-teaching-in-busy-multi-patient-environments-using-an-interpretive-description-method
#6
Teresa M Chan, Kenneth Van Dewark, Jonathan Sherbino, Alan Schwartz, Geoff Norman, Matthew Lineberry
INTRODUCTION: As patient volumes continue to increase, more attention must be paid to skills that foster efficiency without sacrificing patient safety. The emergency department is a fertile ground for examining leadership and management skills, especially those that concern prioritization in multi-patient environments. We sought to understand the needs of emergency physicians (EPs) and emergency medicine junior trainees with regards to teaching and learning about how best to handle busy, multi-patient environments...
November 8, 2017: Perspectives on Medical Education
https://www.readbyqxmd.com/read/29117426/get-on-board-realizing-full-partnerships-in-health-care
#7
Jake Creviston, Michael Polacek
Psychiatric-mental health nurses (PMHNs) have a strong leadership history, but challenges (e.g., subordinate roles to physicians) to presenting a professional persona have made it difficult to actualize nursing leadership and realize full partnership in health care reform. Physicians outnumber nurses approximately four to one on hospital and other boards, and data suggest this gap is widening. Time, preparation, desire to serve, lack of a unified voice, and being viewed as employees versus professionals are barriers to optimal nursing leadership...
November 8, 2017: Journal of Psychosocial Nursing and Mental Health Services
https://www.readbyqxmd.com/read/29116889/family-physicians-perspectives-on-interprofessional-teamwork-findings-from-a-qualitative-study
#8
Olga Szafran, Jacqueline M I Torti, Sandra L Kennett, Neil R Bell
The aim of this study was to describe family physicians' perspectives of their role in the primary care team and factors that facilitate and hinder teamwork. A qualitative study was conducted employing individual interviews with 19 academic/community-based family physicians who were part of interprofessional primary care teams in Edmonton, Alberta, Canada. Professional responsibilities and roles of physicians within the team and the facilitators and barriers to teamwork were investigated. Interviews were audiotaped, transcribed and analysed for emerging themes...
November 8, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29112663/training-physicians-in-advocacy-why-it-matters
#9
Sarp Aksel, Megan L Evans, Thomas M Gellhaus
At a time in our country's history when state and federal legislative regulations on medical practice and access to services are at an all-time high, effective physician advocacy in women's health is crucial to the evolution of our profession and the provision of quality and equitable patient care. Inclusion of specific advocacy training programs in residency and beyond should be considered a priority. Ensuring a unified set of goals for advocacy training is important to training the next generation of competent and skilled physician advocates for leadership in academia and professional organizations...
November 3, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29071767/communicating-value-in-simulation-cost-benefit-analysis-and-return-on-investment
#10
Carl V Asche, Minchul Kim, Alisha Brown, Antoinette Golden, Torrey A Laack, Javier Rosario, Christopher Strother, Vicken Y Totten, Yasuharu Okuda
Value-based health care requires a balancing of medical outcomes with economic value. Administrators need to understand both the clinical and economic effects of potentially expensive simulation programs to rationalize the costs. Given the often-disparate priorities of clinical educators relative to health care administrators, justifying the value of simulation requires the use of economic analyses few physicians have been trained to conduct. Clinical educators need to be able to present thorough economic analyses demonstrating returns on investment and cost effectiveness to effectively communicate with administrators...
October 26, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29069376/contextual-levers-for-team-based-primary-care-lessons-from-reform-interventions-in-five-jurisdictions-in-three-countries
#11
Grant M Russell, William L Miller, Jane M Gunn, Jean-Frederic Levesque, Mark F Harris, William E Hogg, Cathie M Scott, Jenny R Advocat, Lisa Halma, Sabrina M Chase, Benjamin F Crabtree
Background: Most Western nations have sought primary care (PC) reform due to the rising costs of health care and the need to manage long-term health conditions. A common reform-the introduction of inter-professional teams into traditional PC settings-has been difficult to implement despite financial investment and enthusiasm. Objective: To synthesize findings across five jurisdictions in three countries to identify common contextual factors influencing the successful implementation of teamwork within PC practices...
October 23, 2017: Family Practice
https://www.readbyqxmd.com/read/29068816/concerns-and-responses-for-integrating-health-systems-science-into-medical-education
#12
Jed D Gonzalo, Kelly J Caverzagie, Richard E Hawkins, Luan Lawson, Daniel R Wolpaw, Anna Chang
With the aim of improving the health of individuals and populations, medical schools are transforming curricula to ensure physician competence encompasses health systems science (HSS), which includes population health, health policy, high-value care, interprofessional teamwork, leadership, quality improvement, and patient safety. Large-scale, meaningful integration remains limited, however, and a major challenge in HSS curricular transformation efforts relates to the receptivity and engagement of students, educators, clinicians, scientists, and health system leaders...
October 24, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29066908/establishing-community-based-integrated-care-for-elderly-patients-through-interprofessional-teamwork-a-qualitative-analysis
#13
Tomohiro Asakawa, Hidenobu Kawabata, Kengo Kisa, Takayoshi Terashita, Manabu Murakami, Junji Otaki
BACKGROUND: Working in multidisciplinary teams is indispensable for ensuring high-quality care for elderly people in Japan's rapidly aging society. However, health professionals often experience difficulty collaborating in practice because of their different educational backgrounds, ideas, and the roles of each profession. In this qualitative descriptive study, we reveal how to build interdisciplinary collaboration in multidisciplinary teams. METHODS: Semi-structured interviews were conducted with a total of 26 medical professionals, including physicians, nurses, public health nurses, medical social workers, and clerical personnel...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/29064937/a-history-of-us-army-pas
#14
Robyn L Chalupa, W Sanders Marble
The US military has a long tradition of using physician assistants (PAs). The Army began using PAs in 1971 in an effort to supplement the physicians and surgeons in the medical corps. As their numbers grew, PAs gradually replaced general medical officers assigned to battalions. Later, specialty positions developed in aviation medicine, orthopedics, and emergency medicine. The need for a PA serving as an adviser in the major commands slowly developed at all levels of leadership. In 2015, the Army removed limitations on female PAs assigned to combat units...
November 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/29056177/use-of-unit-based-interventions-to-improve-the-quality-of-care-for-hospitalized-medical-patients-a-national-survey
#15
Kevin J O'Leary, Julie K Johnson, Milisa Manojlovich, Gopi J Astik, Mark V Williams
BACKGROUND: Recent publications have drawn attention to interventions to redesign aspects of care delivery for hospitalized medical patients, including localization of physicians to specific units, nurse-physician co-leadership, interdisciplinary rounds (IDR), and access to quality performance data. Use of these interventions across hospitals has not been previously described. METHODS: A cross-sectional survey of internal medicine (IM) residency program directors and hospital medicine group (HMG) leaders in the United States was conducted to characterize use of unit-based interventions on inpatient medical services...
November 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29055662/organization-in-response-to-massive-afflux-of-war-victims-in-civilian-practice%C3%A2-%C3%A2-experimental-feedback-from-the-november-2015-paris-terrorist-attacks
#16
M Borel, R Rousseau, F Le Saché, D Pariente, S Castro, M Delay, P Hausfater, M Raux, F Menegaux
The arrival of a large number of war-weapon casualties at a civilian trauma center requires anticipation. A plan defining the management principles and the respective roles of the involved physicians and nurses and their interaction with each other is essential. Uni-directional patient flow associated with adequate numbers of staff physicians and nurses under the leadership of a medical director is essential to prevent the overwhelming of the trauma center. Routine and regular interaction between the pre-hospital medical flow control system and the medical director, on one hand, and between surgical teams and the medical director, on the other, are necessary to know when to apply "damage control" surgical techniques...
October 18, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29045988/postgraduate-experiences-with-an-advanced-reproductive-health-and-abortion-training-and-leadership-program
#17
Alison Block, Christine Dehlendorf, M Antonia Biggs, Sarah McNeil, Suzan Goodman
BACKGROUND AND OBJECTIVES: Family physicians are critical to reproductive health service provision including miscarriage management and abortion care, but many graduates report barriers in integrating these services into practice. We designed and implemented CREATE (Continuing Reproductive Education for Advanced Training Efficacy), an elective advanced training and leadership program for senior residents aimed to help new graduates integrate miscarriage and abortion care into practice...
October 2017: Family Medicine
https://www.readbyqxmd.com/read/29042191/roadmap-to-achieve-25-hypertension-control-in-africa-by-2025
#18
Anastase Dzudie, Brian Rayner, Dike Ojji, Aletta E Schutte, Marc Twagirumukiza, Albertino Damasceno, Seringe Abdou Ba, Abdoul Kane, Euloge Kramoh, Jean Baptiste Anzouan Kacou, Basden Onwubere, Ruth Cornick, Karen Sliwa, Benedict Anisiuba, Ana Olga Mocumbi, Elijah Ogola, Mohamed Awad, George Nel, Harun Otieno, Ali Ibrahim Toure, Samuel Kingue, Andre Pascal Kengne, Pablo Perel, Alma Adler, Neil Poulter, Bongani Mayosi
BACKGROUND: The Pan-African Society of Cardiology (PASCAR) has identified hypertension as the highest area of priority action to reduce heart disease and stroke on the continent. OBJECTIVES: The aim of this PASCAR roadmap on hypertension was to develop practical guidance on how to implement strategies that translate existing knowledge into effective action and improve detection, treatment and control of hypertension and cardiovascular health in sub-Saharan Africa (SSA) by the year 2025...
October 14, 2017: Global Heart
https://www.readbyqxmd.com/read/29041971/finnish-physicians-stress-related-to-information-systems-keeps-increasing-a-longitudinal-three-wave-survey-study
#19
Tarja Heponiemi, Hannele Hyppönen, Tuulikki Vehko, Sari Kujala, Anna-Mari Aalto, Jukka Vänskä, Marko Elovainio
BACKGROUND: Poorly functioning, time-consuming, and inadequate information systems are among the most important work-related psychosocial factors causing stress in physicians. The present study examined the trend in the perceived stress that was related to information systems (SRIS) among Finnish physicians during a nine-year follow-up. In addition, we examined the associations of gender, age, employment sector, specialization status, leadership position, on-call burden, and time pressure with SRIS change and levels...
October 17, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29028468/lessons-for-physicians-from-flint-s-water-crisis
#20
Laura A Carravallah, Lawrence A Reynolds, Susan J Woolford
Physicians form a vital front in recognizing unusual clinical presentations that could herald a health threat. In the Flint water crisis, physicians can be credited with playing critical roles in both uncovering the crisis and providing leadership when government failed to respond effectively. Yet most physicians in Flint were not formally trained in advocacy or leadership and might have recognized the health implications of the crisis more quickly had they received formal environmental health training. Furthermore, connections to other professional disciplines-and to the community-are vital for effective responses to environmental health threats...
October 1, 2017: AMA Journal of Ethics
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