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https://www.readbyqxmd.com/read/29091509/a-person-centered-registry-based-learning-health-system-for-palliative-care-a-path-to-coproducing-better-outcomes-experience-value-and-science
#1
Arif H Kamal, Kathryn B Kirkland, Diane E Meier, Tamara S Morgan, Eugene C Nelson, Steven Z Pantilat
BACKGROUND: Palliative care offers an approach to the care of people with serious illness that focuses on quality of life and aligning care with individual and family goals, and values in the context of what is medically achievable. OBJECTIVE: Measurement of the impact of palliative care is critical for determining what works for which patients in what settings, to learn, improve care, and ensure access to high value care for people with serious illness. METHODS: A learning health system that includes patients and families partnering with clinicians and care teams, is directly linked to a registry to support networks for improvement and research, and offers an ideal framework for measuring what matters to a range of stakeholders interested in improving care for this population...
November 1, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29090991/noninvasive-ventilation-across-hospitals-an-example-of-healthcare-delivery-science
#2
Jennifer P Stevens
No abstract text is available yet for this article.
November 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29045684/lean-management-to-support-choosing-wisely-in-healthcare-the-first-evidence-from-a-systematic-literature-review
#3
Maria Crema, Chiara Verbano
Purpose: Choosing Wisely (CW) is an emergent approach to identify and reduce unnecessary care, such as tests and treatments that do not add value for patients and may even cause harm. The purpose of this paper is to investigate whether and how Lean Healthcare Management (LHM) can support CW objectives, focusing on customer needs and on waste elimination. Data sources: A systematic literature review has been performed in Scopus, PubMed and Web of Science. Study selection: Peer reviewed articles published in English language have been selected...
October 17, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28981971/team-science-and-the-physician-scientist-in-the-age-of-grand-health-challenges
#4
REVIEW
Clifford J Steer, Peter R Jackson, Hortencia Hornbeak, Catherine K McKay, P Sriramarao, Michael P Murtaugh
Despite remarkable advances in medical research, clinicians face daunting challenges from new diseases, variations in patient responses to interventions, and increasing numbers of people with chronic health problems. The gap between biomedical research and unmet clinical needs can be addressed by highly talented interdisciplinary investigators focused on translational bench-to-bedside medicine. The training of talented physician-scientists comfortable with forming and participating in multidisciplinary teams that address complex health problems is a top national priority...
September 2017: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/28973515/barriers-and-enablers-of-kangaroo-mother-care-implementation-from-a-health-systems-perspective-a-systematic-review
#5
Grace Chan, Ilana Bergelson, Emily R Smith, Tobi Skotnes, Stephen Wall
Kangaroo Mother Care (KMC) is an evidence-based intervention that reduces neonatal morbidity and mortality. However, adoption among health systems has varied. Understanding the interaction between health system functions-leadership, financing, healthcare workers (HCWs), technologies, information and research, and service delivery-and KMC is essential to understanding KMC adoption. We present a systematic review of the barriers and enablers of KMC implementation from the perspective of health systems, with a focus on HCWs and health facilities...
December 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28965492/can-learning-health-systems-help-organisations-deliver-personalised-care
#6
Bright I Nwaru, Charles Friedman, John Halamka, Aziz Sheikh
There is increasing international policy and clinical interest in developing learning health systems and delivering precision medicine, which it is hoped will help reduce variation in the quality and safety of care, improve efficiency, and lead to increasing the personalisation of healthcare. Although reliant on similar policies, informatics tools, and data science and implementation research capabilities, these two major initiatives have thus far largely progressed in parallel. In this opinion piece, we argue that they should be considered as complementary, synergistic initiatives whereby the creation of learning health systems infrastructure can support and catalyse the delivery of precision medicine that maximises the benefits and minimises the risks associated with treatments for individual patients...
October 2, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28962632/advancing-the-literature-on-designing-audit-and-feedback-interventions-identifying-theory-informed-hypotheses
#7
Heather L Colquhoun, Kelly Carroll, Kevin W Eva, Jeremy M Grimshaw, Noah Ivers, Susan Michie, Anne Sales, Jamie C Brehaut
BACKGROUND: Audit and feedback (A&F) is a common strategy for helping health providers to implement evidence into practice. Despite being extensively studied, health care A&F interventions remain variably effective, with overall effect sizes that have not improved since 2003. Contributing to this stagnation is the fact that most health care A&F interventions have largely been designed without being informed by theoretical understanding from the behavioral and social sciences. To determine if the trend can be improved, the objective of this study was to develop a list of testable, theory-informed hypotheses about how to design more effective A&F interventions...
September 29, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28944730/optimization-of-medication-use-at-accountable-care-organizations
#8
Chrisanne Wilks, Erik Krisle, Kimberly Westrich, Kristina Lunner, David Muhlestein, Robert Dubois
BACKGROUND: Optimized medication use involves the effective use of medications for better outcomes, improved patient experience, and lower costs. Few studies systematically gather data on the actions accountable care organizations (ACOs) have taken to optimize medication use. OBJECTIVES: To (a) assess how ACOs optimize medication use; (b) establish an association between efforts to optimize medication use and achievement on financial and quality metrics; (c) identify organizational factors that correlate with optimized medication use; and (d) identify barriers to optimized medication use...
October 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28936475/surgical-data-science-the-new-knowledge-domain
#9
S Swaroop Vedula, Gregory D Hager
Healthcare in general, and surgery/interventional care in particular, is evolving through rapid advances in technology and increasing complexity of care with the goal of maximizing quality and value of care. While innovations in diagnostic and therapeutic technologies have driven past improvements in quality of surgical care, future transformation in care will be enabled by data. Conventional methodologies, such as registry studies, are limited in their scope for discovery and research, extent and complexity of data, breadth of analytic techniques, and translation or integration of research findings into patient care...
April 2017: Innov Surg Sci
https://www.readbyqxmd.com/read/28930711/the-angry-amish-grandfather-cultural-competence-and-empathy-a-case-commentary
#10
James L Benedict
Crosscultural encounters are common in the delivery of healthcare, and cultural differences may contribute to misunderstandings and ethical conflict. Encounters between members of the Amish ethno-religious group and modern, science-based healthcare providers hold a high potential for misunderstanding and conflict because the Amish stridently maintain a countercultural outlook and they approach such encounters with suspicion and anxiety. This commentary on the case presented by Amy E. Caruso Brown, MD,1 involving a grandfather's resistance to treating a child with leukemia commends this physician for successfully managing the case and deriving important insights from reflection upon it...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28914990/simulating-the-multi-disciplinary-care-team-approach-enhancing-student-understanding-of-anatomy-through-an-ultrasound-anchored-interprofessional-session
#11
Marianne T Luetmer, Beth A Cloud, James W Youdas, Wojciech Pawlina, Nirusha Lachman
Quality of healthcare delivery is dependent on collaboration between professional disciplines. Integrating opportunities for interprofessional learning in health science education programs prepares future clinicians to function as effective members of a multi-disciplinary care team. This study aimed to create a modified team-based learning (TBL) environment utilizing ultrasound technology during an interprofessional learning activity to enhance musculoskeletal anatomy knowledge of first year medical (MD) and physical therapy (PT) students...
September 15, 2017: Anatomical Sciences Education
https://www.readbyqxmd.com/read/28899268/linking-the-unitary-paradigm-to-policy-through-a-synthesis-of-caring-science-and-integrative-nursing
#12
Mary S Koithan, Mary Jo Kreitzer, Jean Watson
The principles of integrative nursing and caring science align with the unitary paradigm in a way that can inform and shape nursing knowledge, patient care delivery across populations and settings, and new healthcare policy. The proposed policies may transform the healthcare system in a way that supports nursing praxis and honors the discipline's unitary paradigm. This call to action provides a distinct and hopeful vision of a healthcare system that is accessible, equitable, safe, patient-centered, and affordable...
July 2017: Nursing Science Quarterly
https://www.readbyqxmd.com/read/28853200/the-2017-academic-emergency-medicine-consensus-conference-catalyzing-system-change-through-healthcare-simulation-systems-competency-and-outcomes
#13
William Bond, Joshua Hui, Rosemarie Fernandez
Over the past decade, emergency medicine took a lead role in healthcare simulation in part due to its demands for successful interprofessional and multidisciplinary collaboration, along with educational needs in a diverse array of cognitive and procedural skills. Simulation-based methodologies have the capacity to support training and research platforms that model micro-, meso- and macro- systems of healthcare. To fully capitalize on the potential of simulation-based research to improve emergency healthcare delivery will require the application of rigorous methods from engineering, social science, and basic science disciplines...
August 29, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28845351/the-national-institute-for-health-research-at-10-years-an-impact-synthesis-100-impact-case-studies
#14
Molly Morgan Jones, Adam Kamenetzky, Catriona Manville, Ioana Ghiga, Calum MacLure, Emma Harte, Anton Spisak, Anne Kirtley, Jonathan Grant
The National Institute for Health Research (NIHR) funds and supports world-leading clinical and applied health and social care research, as well as research infrastructure in the NHS. Providing £1 billion of funding each year, NIHR aims to: drive the faster translation of new treatments, technologies and diagnostics to improve outcomes for health and care services; promote the wealth of the nation, including via inward investment from the health research community; pull basic science discoveries through into tangible benefits for patients and the public; and provide research evidence to support more effective and cost-effective NHS delivery...
January 2017: Rand Health Quarterly
https://www.readbyqxmd.com/read/28841874/science-of-health-care-delivery-milestones-for-undergraduate-medical-education
#15
Rachel D Havyer, Suzanne M Norby, Andrea N Leep Hunderfund, Stephanie R Starr, Tara R Lang, Alexandra P Wolanskyj, Darcy A Reed
BACKGROUND: The changing healthcare landscape requires physicians to develop new knowledge and skills such as high-value care, systems improvement, population health, and team-based care, which together may be referred to as the Science of Health Care Delivery (SHCD). To engender public trust and confidence, educators must be able to meaningfully assess physicians' abilities in SHCD. We aimed to develop a novel set of SHCD milestones based on published Accreditation Council for Graduate Medical Education (ACGME) milestones that can be used by medical schools to assess medical students' competence in SHCD...
August 25, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28837006/the-delivery-of-palliative-and-end-of-life-care-in-ontario
#16
Amy T Hsu, Peter Tanuseputro
Healthcare use in the year prior to death represents a large portion of healthcare spending by older adults. While Canada is considered to have advanced integration of palliative care services within our healthcare system, much of this care is still delivered in hospitals and with varying levels of access according to cause of death trajectory and geography. Results presented in a series of studies from the Institute for Clinical Evaluative Sciences (ICES) unveil gaps in current palliative care delivery and offer directions for future research and policy development...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28828869/utilisation-of-the-partogram-among-nurses-and-midwives-in-selected-health-facilities-in-the-eastern-province-of-rwanda
#17
Oliva Bazirete, Nomafrench Mbombo, Oluyinka Adejumo
BACKGROUND: Maternal mortality continues to be a global burden, with more than 200 million women becoming pregnant each year and a large number dying as a result of complications of pregnancy or childbirth. The World Health Organisation has recommended use of the partogram to monitor labour and delivery in order to improve healthcare and reduce maternal and foetal mortality rates. OBJECTIVE: This study described factors affecting utilisation of the partogram among nurses and midwives in selected health facilities of Rwanda...
August 3, 2017: Curationis
https://www.readbyqxmd.com/read/28825978/the-effect-of-an-interprofessional-simulation-based-education-program-on-perceptions-and-stereotypes-of-nursing-and-medical-students-a-quasi-experimental-study
#18
Kelly S Lockeman, Nital P Appelbaum, Alan W Dow, Shelly Orr, Tanya A Huff, Christopher J Hogan, Brenda A Queen
BACKGROUND: Interprofessional education is intended to train practitioners to collaboratively address challenges in healthcare delivery, and interprofessional simulation-based education (IPSE) provides realistic, contextual learning experiences in which roles, responsibilities, and professional identity can be learned, developed, and assessed. Reducing negative stereotypes within interprofessional relationships is a prime target for IPSE. OBJECTIVES: We sought to understand whether perceptions of interprofessional education and provider stereotypes change among nursing and medical students after participating in IPSE...
August 10, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28774786/family-caregiving-a-vision-for-the-future
#19
Richard Schulz, Sara J Czaja
The authors of this review both served on the National Academy of Science, Engineering, and Medicine Committee that produced the report, "Caring for an Aging America". In this commentary we summarize key findings and recommendations most relevant to clinicians and researchers in geriatric psychiatry and related disciplines. The report notes the growing prevalence of family caregiving in the United States, especially those caring for high-need patients with multiple chronic conditions, disability, and/or cognitive impairment...
July 4, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28764687/sustainability-and-scalability-of-a-volunteer-based-primary-care-intervention-health-tapestry-a-mixed-methods-analysis
#20
Monika Kastner, Radha Sayal, Doug Oliver, Sharon E Straus, Lisa Dolovich
BACKGROUND: Chronic diseases are a significant public health concern, particularly in older adults. To address the delivery of health care services to optimally meet the needs of older adults with multiple chronic diseases, Health TAPESTRY (Teams Advancing Patient Experience: Strengthening Quality) uses a novel approach that involves patient home visits by trained volunteers to collect and transmit relevant health information using e-health technology to inform appropriate care from an inter-professional healthcare team...
August 1, 2017: BMC Health Services Research
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