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https://www.readbyqxmd.com/read/28529215/innovative-program-delivery-and-determinants-of-frequent-visitation-to-a-mobile-medical-clinic-in-an-urban-setting
#1
Britton A Gibson, Jamie P Morano, Mary R Walton, Ruthanne Marcus, Alexei Zelenev, R Douglas Bruce, Frederick L Altice
The Community Health Care Van (CHCV) is a mobile medical clinic (MMC) that has served vulnerable populations in New Haven, Connecticut since 1993. This study explores utilization patterns to understand if certain populations frequently rely upon non-traditional health care within a representative MMC. Patient characteristics, services used, and visitation frequency were described and compared for 8,415 unique clients making 29,728 visits. Negative binomial regression was used to model the impact of specific indicators on visitation...
2017: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/28527551/successful-implementation-of-new-technology-using-an-interdepartmental-collaborative-approach
#2
Sue Tetef
The implementation of new technology is vital to the success of health care organizations. New technology provides health care organizations an opportunity to obtain new patients, increase revenue, and stay competitive. In 2014, a union hospital in Southern California successfully implemented a bronchial thermoplasty program. To implement this new technology, the administration created a strategy, identified financial risks and benefits, created an implementation model, established a plan based on Lewin's change model and Roger's diffusion of innovations theory, and recognized adult learning needs through an interdepartmental, open communication, and collaborative approach...
June 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28526666/a-smart-toy-to-enhance-the-decision-making-process-at-children-s-psychomotor-delay-screenings-a-pilot-study
#3
María Angeles Gutiérrez García, María Luisa Martín Ruiz, Diego Rivera, Laura Vadillo, Miguel Angel Valero Duboy
BACKGROUND: EDUCERE ("Ubiquitous Detection Ecosystem to Care and Early Stimulation for Children with Developmental Disorders") is an ecosystem for ubiquitous detection, care, and early stimulation of children with developmental disorders. The objectives of this Spanish government-funded research and development project are to investigate, develop, and evaluate innovative solutions to detect changes in psychomotor development through the natural interaction of children with toys and everyday objects, and perform stimulation and early attention activities in real environments such as home and school...
May 19, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28526041/implementation-of-enhanced-recovery-after-surgery-a-strategy-to-transform-surgical-care-across-a-health-system
#4
Leah M Gramlich, Caroline E Sheppard, Tracy Wasylak, Loreen E Gilmour, Olle Ljungqvist, Carlota Basualdo-Hammond, Gregg Nelson
BACKGROUND: Enhanced Recovery After Surgery (ERAS) programs have been shown to have a positive impact on outcome. The ERAS care system includes an evidence-based guideline, an implementation program, and an interactive audit system to support practice change. The purpose of this study is to describe the use of the Theoretic Domains Framework (TDF) in changing surgical care and application of the Quality Enhancement Research Initiative (QUERI) model to analyze end-to-end implementation of ERAS in colorectal surgery across multiple sites within a single health system...
May 19, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28522893/hearcare-hearing-and-communication-assistance-for-resident-engagement
#5
REVIEW
Catherine V Palmer, Reem Mulla, Elizabeth Dervin, Kathleen Costigan Coyan
Impaired hearing is related to poor health outcomes, including compromised cognitive function, in aging individuals. Hearing loss is the third most common chronic health condition after arthritis and heart disease in older adults and the fourth most detrimental condition related to quality of life in older adults. Only 18% of aging adults who have impactful hearing loss actually use custom-fit amplification. Therefore, the majority of aging individuals entering senior living facilities will have untreated hearing loss...
May 2017: Seminars in Hearing
https://www.readbyqxmd.com/read/28522162/implementing-shared-decision-making-for-diabetes-care-across-country-settings-what-really-matters-to-people
#6
Michela Tinelli, Panagiotis Petrou, George Samoutis, Vivie Traynor, George Olympios, Alistair McGuire
CONTEXT: Growing evidence of improved clinical outcomes and patient/professional satisfaction supports shared-decision-making (SDM) services as an effective primary care interventions for diabetes. However, only a few countries have actually adopted them (e.g. England). In other European countries (e.g. Cyprus) there is awareness that patients play a crucial role in decision-making, and SDM services could be considered as innovative strategies to promote the actual implementation of patient rights legislation and strengthen primary care...
May 10, 2017: Health Policy
https://www.readbyqxmd.com/read/28521785/expect-with-me-development-and-evaluation-design-for-an-innovative-model-of-group-prenatal-care-to-improve-perinatal-outcomes
#7
Shayna D Cunningham, Jessica B Lewis, Jordan L Thomas, Stephanie A Grilo, Jeannette R Ickovics
BACKGROUND: Despite biomedical advances and intervention efforts, rates of preterm birth and other adverse outcomes in the United States have remained relatively intransigent. Evidence suggests that group prenatal care can reduce these risks, with implications for maternal and child health as well as substantial cost savings. However, widespread dissemination presents challenges, in part because training and health systems have not been designed to deliver care in a group setting. This manuscript describes the design and evaluation of Expect With Me, an innovative model of group prenatal care with a strong integrated information technology (IT) platform designed to be scalable nationally...
May 18, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28521383/-quality-management-for-surgeons-the-knowledge-of-basic-contexts-and-innovative-strategies-promotes-the-competitiveness-of-clinical-department
#8
Wolfgang Hellmann
Efficient quality management aiming to achieve high quality in patient care is crucial to the success of a surgery department. This requires the knowledge of relevant terms und contexts of quality management. Implementation remains difficult in the light of demographic change and skills shortage. If a hospital has an efficient internal quality management in place, this should be used as a supplementary instrument. Otherwise it is the (sole) task of a specialist department to ensure quality for patients, employees, and cooperative partners...
May 18, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28516800/undertriage-of-pediatric-major-trauma-patients-in-the-united-states
#9
Jin Peng, Krista Wheeler, Jonathan I Groner, Kathryn J Haley, Henry Xiang
Although trauma undertriage has been widely discussed in the literature, undertriage in the pediatric trauma population remains understudied. Using the 2009-2013 Nationwide Emergency Department Sample, we assessed the national undertriage rate in pediatric major trauma patients (age ≤16 years and injury severity score [ISS] >15), and identified factors associated with pediatric trauma undertriage. Nationally, 21.7% of pediatric major trauma patients were undertriaged. Children living in rural areas were more likely to be undertriaged ( P = ...
May 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28516345/performance-and-cost-evaluation-of-health-information-systems-using-micro-costing-and-discrete-event-simulation
#10
Olfa Rejeb, Claire Pilet, Sabri Hamana, Xiaolan Xie, Thierry Durand, Saber Aloui, Anne Doly, Pierre Biron, Lionel Perrier, Vincent Augusto
Innovation and health-care funding reforms have contributed to the deployment of Information and Communication Technology (ICT) to improve patient care. Many health-care organizations considered the application of ICT as a crucial key to enhance health-care management. The purpose of this paper is to provide a methodology to assess the organizational impact of high-level Health Information System (HIS) on patient pathway. We propose an integrated performance evaluation of HIS approach through the combination of formal modeling using the Architecture of Integrated Information Systems (ARIS) models, a micro-costing approach for cost evaluation, and a Discrete-Event Simulation (DES) approach...
May 17, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28514641/mapping-workforce-configuration-and-operational-models-in-australian-emergency-departments-a-national-survey
#11
Glenn Gardner, Anne Gardner, Sandy Middleton, Julie Considine, Gerard Fitzgerald, Luke Christofis, Anna Doubrovsky, Margaret Adams, Jane O'Connell
Objective Hospital emergency departments (ED) in Australia and internationally have been experiencing increased demand, resulting in reduced hospital quality, impaired access and adverse health outcomes. Effective evaluation of new ED service models and their effect on outcomes is reliant on baseline measures of the staffing configuration and organisational characteristics of the EDs being studied. The aim of the present study was to comprehensively measure these variables in Australian EDs.Methods Australian hospital EDs with 24-h medical and nursing cover were identified and invited to participate in the study...
May 18, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28509657/the-palliative-care-challenge-analysis-of-barriers-and-opportunities-to-integrate-palliative-care-in-europe-in-the-view-of-national-associations
#12
Carlos Centeno, Eduardo Garralda, José Miguel Carrasco, Marlieke den Herder-van der Eerden, Melissa Aldridge, David Stevenson, Diane E Meier, Jeroen Hasselaar
BACKGROUND: Palliative care (PC) development is diverse and lacks an effective integration into European healthcare systems. This article investigates levels of integrated PC in European countries. METHODS: A qualitative survey was undertaken for the 2013 EAPC Atlas of PC in Europe with boards of national associations, eliciting opinions on opportunities for, and barriers to, PC development. ANALYSIS: Barriers and opportunities directly related to PC integration were identified and analyzed thematically according (1) to the dimensions of the World Health Organization (WHO) public health model and (2) by the degree of service provision in each country...
May 16, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28503040/recommendations-to-support-nurses-and-improve-the-delivery-of-oncology-and-palliative-care-in-india
#13
Virginia T LeBaron, Gayatri Palat, Sudha Sinha, Sanjeeva Kumari Chinta, Beaulah John Battula Jamima, Usha Lakshmi Pilla, Nireekshana Podduturi, Yadamma Shapuram, Padma Vennela, Vineela Rapelli, Zahra Lalani, Susan L Beck
CONTEXT: Nurses in India often practice in resource-constrained settings and care for cancer patients with high symptom burden yet receive little oncology or palliative care training. AIM: The aim of this study is to explore challenges encountered by nurses in India and offer recommendations to improve the delivery of oncology and palliative care. METHODS: Qualitative ethnography. SETTING: The study was conducted at a government cancer hospital in urban South India...
April 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28502809/challenges-of-informed-consent-for-pragmatic-trials
#14
Shona Kalkman, Ghislaine Jmw van Thiel, Mira Gp Zuidgeest, Iris Goetz, Boris M Pfeiffer, Diederick E Grobbee, Johannes Jm van Delden
The Innovative Medicines Initiative's (IMI) GetReal consortium aims to develop strategies to incorporate real world evidence earlier into the drug life cycle to better inform health care decision-makers on the comparative risks and benefits of new drugs. Pragmatic trials are currently explored as a means to generate such evidence in routine care settings. The traditional informed consent model for randomized clinical trials has been argued to pose substantial hurdles to the practicability of pragmatic trials: it would lead to recruitment difficulties, reduced generalizability of the results and selection bias...
May 11, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28496378/ethnopsychiatry-fosters-creativity-and-the-adoption-of-critical-and-reflexive-thinking-in-higher-education-students-insights-from-a-qualitative-analysis-of-a-preliminary-pilot-experience-at-the-faculty-of-medicine-and-surgery-university-of-genoa-italy
#15
Anna Siri, Giovanni Del Puente, Mariano Martini, Nicola Luigi Bragazzi
Creativity is an ability that plays a major role in the modern economy and society. It should represent an important component of the medical syllabus. However, it is often overlooked by the formal courses at universities. The current study aimed at evaluating whether the interactive educational models, recently adopted by the Faculty of Medicine and Surgery, at the University of Genoa, Italy, would favor the adoption of critical thinking, attitudes to changes, cultural diversity acceptance, and the adoption of relational soft skills versus traditional and frontal didactic teaching...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28495348/development-of-a-tripolar-model-of-technology-acceptance-hospital-based-physicians-perspective-on-ehr
#16
Mher Beglaryan, Varduhi Petrosyan, Edward Bunker
BACKGROUND AND PURPOSE: In health care, information technologies (IT) hold a promise to harness an ever-increasing flow of health related information and bring significant benefits including improved quality of care, efficiency, and cost containment. One of the main tools for collecting and utilizing health data is the Electronic Health Record (EHR). EHRs implementation can face numerous barriers to acceptance including attitudes and perceptions of potential users, required effort attributed to their implementation and usage, and resistance to change...
June 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28493268/development-of-services-for-substance-use-problems-need-for-a-system-based-approach
#17
REVIEW
Thomas F Babor
This review describes systems-level innovations that may enhance accessibility, economy and integration of treatment services for substance-related disorders. After introducing a conceptual model to describe the resources, qualities and effectiveness of drug treatment services, evidence is reviewed in three areas (primary care, criminal justice, and mental health) that illustrate how systems-level concepts can be used to organize services to maximize their population impact. Special attention is given to systems issues in relation to the development of services in countries of the Eastern Mediterranean Region...
May 1, 2017: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
https://www.readbyqxmd.com/read/28492400/epinephrine-auto-injector-versus-drawn-up-epinephrine-for-anaphylaxis-management-a-scoping-review
#18
Nnenna O Chime, Victoria G Riese, Daniel J Scherzer, Julianne S Perretta, LeAnn McNamara, Michael A Rosen, Elizabeth A Hunt
OBJECTIVE: Anaphylaxis is a life-threatening event. Most clinical symptoms of anaphylaxis can be reversed by prompt intramuscular administration of epinephrine using an auto-injector or epinephrine drawn up in a syringe and delays and errors may be fatal. The aim of this scoping review is to identify and compare errors associated with use of epinephrine drawn up in a syringe versus epinephrine auto-injectors in order to assist hospitals as they choose which approach minimizes risk of adverse events for their patients...
May 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28491340/the-financial-impact-of-advanced-kidney-disease-on-canada-pension-plan-and-private-disability-insurance-costs
#19
Braden Manns, Susan Q McKenzie, Flora Au, Pamela M Gignac, Lawrence Ian Geller
BACKGROUND: Many working-age individuals with advanced chronic kidney disease (CKD) are unable to work, or are only able to work at a reduced capacity and/or with a reduction in time at work, and receive disability payments, either from the Canadian government or from private insurers, but the magnitude of those payments is unknown. OBJECTIVE: The objective of this study was to estimate Canada Pension Plan Disability Benefit and private disability insurance benefits paid to Canadians with advanced kidney failure, and how feasible improvements in prevention, identification, and early treatment of CKD and increased use of kidney transplantation might mitigate those costs...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28489225/models-of-care-for-adolescents-and-young-adults-with-type-1-diabetes-in-transition-shared-medical-appointments-and-telemedicine
#20
Jennifer K Raymond
Transitioning through adolescence and young adulthood is challenging, and even more so for patients living with a chronic disease such as type 1 diabetes. Patients in this age group encounter multiple obstacles to effectively managing their diabetes, experience suboptimal glycemic control, face higher rates of acute complications, and are often lost to medical follow-up. Comprehensive strategies and innovative clinical models are needed to engage this population in diabetes medical care, address barriers to ideal management, and improve outcomes...
May 1, 2017: Pediatric Annals
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