The multiple quality models paradox: how much ‘best practice’ is just enough?

2011 ◽  
Vol 23 (8) ◽  
pp. 517-531 ◽  
Author(s):  
Keith M. Heston ◽  
William Phifer
Keyword(s):  
Best Practice ◽  
Quality Models

Meeting the Best Practice for Hearing Aid Verification in Children: Challenges and Future Directions

2019 ◽  
Vol 28 (4) ◽  
pp. 877-894
Author(s):  
Nur Azyani Amri ◽  
Tian Kar Quar ◽  
Foong Yen Chong
Keyword(s):  
Clinical Practice ◽  
Hearing Aids ◽  
Best Practice ◽  
Hearing Aid ◽  
Evidence Based ◽  
Future Directions ◽  
Major Barrier ◽  
Klang Valley ◽  
Age Range ◽  
Fitting Hearing Aids

Purpose This study examined the current pediatric amplification practice with an emphasis on hearing aid verification using probe microphone measurement (PMM), among audiologists in Klang Valley, Malaysia. Frequency of practice, access to PMM system, practiced protocols, barriers, and perception toward the benefits of PMM were identified through a survey. Method A questionnaire was distributed to and filled in by the audiologists who provided pediatric amplification service in Klang Valley, Malaysia. One hundred eight ( N = 108) audiologists, composed of 90.3% women and 9.7% men (age range: 23–48 years), participated in the survey. Results PMM was not a clinical routine practiced by a majority of the audiologists, despite its recognition as the best clinical practice that should be incorporated into protocols for fitting hearing aids in children. Variations in practice existed warranting further steps to improve the current practice for children with hearing impairment. The lack of access to PMM equipment was 1 major barrier for the audiologists to practice real-ear verification. Practitioners' characteristics such as time constraints, low confidence, and knowledge levels were also identified as barriers that impede the uptake of the evidence-based practice. Conclusions The implementation of PMM in clinical practice remains a challenge to the audiology profession. A knowledge-transfer approach that takes into consideration the barriers and involves effective collaboration or engagement between the knowledge providers and potential stakeholders is required to promote the clinical application of evidence-based best practice.

A Guide to Coding and Billing for the Audiological Management of Patients Receiving Ototoxic Medical Treatments

2019 ◽  
Vol 4 (5) ◽  
pp. 936-946
Author(s):  
Dawn Konrad-Martin ◽  
Neela Swanson ◽  
Angela Garinis
Keyword(s):  
Otoacoustic Emissions ◽  
Best Practice ◽  
Private Insurance ◽  
Monitoring Program ◽  
Current Method ◽  
International Classification Of Diseases ◽  
Ethical Practice ◽  
Party Payer ◽  
High Frequency Audiometry ◽  
Icd 10

Purpose Improved medical care leading to increased survivorship among patients with cancer and infectious diseases has created a need for ototoxicity monitoring programs nationwide. The goal of this report is to promote effective and standardized coding and 3rd-party payer billing practices for the audiological management of symptomatic ototoxicity. Method The approach was to compile the relevant International Classification of Diseases, 10th Revision (ICD-10-CM) codes and Current Procedural Terminology (CPT; American Medical Association) codes and explain their use for obtaining reimbursement from Medicare, Medicaid, and private insurance. Results Each claim submitted to a payer for reimbursement of ototoxicity monitoring must include both ICD-10-CM codes to report the patient's diagnosis and CPT codes to report the services provided by the audiologist. Results address the general 3rd-party payer guidelines for ototoxicity monitoring and ICD-10-CM and CPT coding principles and provide illustrative examples. There is no “stand-alone” CPT code for high-frequency audiometry, an important test for ototoxicity monitoring. The current method of adding a –22 modifier to a standard audiometry code and then submitting a letter rationalizing why the test was done has inconsistent outcomes and is time intensive for the clinician. Similarly, some clinicians report difficulty getting reimbursed for detailed otoacoustic emissions testing in the context of ototoxicity monitoring. Conclusions Ethical practice, not reimbursement, must guide clinical practice. However, appropriate billing and coding resulting in 3rd-party reimbursement for audiology services rendered is critical for maintaining an effective ototoxicity monitoring program. Many 3rd-party payers reimburse for these services. For any CPT code, payment patterns vary widely within and across 3rd-party payers. Standardizing coding and billing practices as well as advocacy including letters from audiology national organizations may be necessary to help resolve these issues of coding and coverage in order to support best practice recommendations for ototoxicity monitoring.

Business: The Electronic Health Record: Front Line Experience

2011 ◽  
Vol 21 (1) ◽  
pp. 18-22
Author(s):  
Rosemary Griffin
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Electronic Health Record ◽  
Financial Incentives ◽  
Best Practice ◽  
Health Care Systems ◽  
The United States ◽  
Health Record ◽  
Health Trends ◽  
Electronic Health

National legislation is in place to facilitate reform of the United States health care industry. The Health Care Information Technology and Clinical Health Act (HITECH) offers financial incentives to hospitals, physicians, and individual providers to establish an electronic health record that ultimately will link with the health information technology of other health care systems and providers. The information collected will facilitate patient safety, promote best practice, and track health trends such as smoking and childhood obesity.

Reliability of the Conversational Interaction Coding Form When Applied to Natural Conversation of Individuals With Aphasia

2010 ◽  
Vol 20 (4) ◽  
pp. 125-135 ◽  
Author(s):  
Ashley Pozzolo Coote ◽  
Jane Pimentel
Keyword(s):  
Best Practice ◽  
Interobserver Reliability ◽  
Training Session ◽  
Clinical Tool ◽  
Group Setting ◽  
Conversational Interaction ◽  
Video Recordings ◽  
Aphasia Therapy ◽  
Natural Conversation ◽  
Point To Point

Purpose: Development of valid and reliable outcome tools to document social approaches to aphasia therapy and to determine best practice is imperative. The aim of this study is to determine whether the Conversational Interaction Coding Form (CICF; Pimentel & Algeo, 2009) can be applied reliably to the natural conversation of individuals with aphasia in a group setting. Method: Eleven graduate students participated in this study. During a 90-minute training session, participants reviewed and practiced coding with the CICF. Then participants independently completed the CICF using video recordings of individuals with non-fluent and fluent aphasia participating in an aphasia group. Interobserver reliability was computed using matrices representative of the point-to-point agreement or disagreement between each participant's coding and the authors' coding for each measure. Interobserver reliability was defined as 80% or better agreement for each measure. Results: On the whole, the CICF was not applied reliably to the natural conversation of individuals with aphasia in a group setting. Conclusion: In an extensive review of the turns that had high disagreement across participants, the poor reliability was attributed to inadequate rules and definitions and inexperienced coders. Further research is needed to improve the reliability of this potentially useful clinical tool.

Gastroesophageal Reflux Disease: A Gastroenterologist's Perspective

2011 ◽  
Vol 21 (3) ◽  
pp. 89-99
Author(s):  
Michael F. Vaezi
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Best Practice ◽  
Clinical Care ◽  
Diagnostic Testing ◽  
Diagnostic Tools ◽  
Swallowing Function ◽  
Atypical Symptoms

Gastroesophageal reflux disease (GERD) is a commonly diagnosed condition often associated with the typical symptoms of heartburn and regurgitation, although it may present with atypical symptoms such as chest pain, hoarseness, chronic cough, and asthma. In most cases, the patient's reduced quality of life drives clinical care and diagnostic testing. Because of its widespread impact on voice and swallowing function as well as its social implications, it is important that speech-language pathologists (SLPs) understand the nature of GERD and its consequences. The purpose of this article is to summarize the nature of GERD and GERD-related complications such as GERD-related peptic stricture, Barrett's esophagus and adenocarcinoma, and laryngeal manifestations of GERD from a gastroenterologist's perspective. It is critical that SLPs who work with a multidisciplinary team understand terminology, diagnostic tools, and treatment to ensure best practice.

Praxisentwicklung in Richtung Best Practice – Best Care

Pflege ◽  
2006 ◽  
Vol 19 (5) ◽  
pp. 273-274
Author(s):  
Irena Anna Frei
Keyword(s):  
Best Practice

Whistleblowing: Ein schwieriges Konzept aus Sicht der Pflegenden

Pflege ◽  
2010 ◽  
Vol 23 (5) ◽  
pp. 321-329 ◽  
Author(s):  
Monika Habermann ◽  
Henning Cramer ◽  
Friedhelm Pielage ◽  
Maya Stagge
Keyword(s):  
Best Practice ◽  
Patient Advocacy

Zur Fehlervermeidung und erfolgreichen Einführung von Fehlermanagementsystemen im Gesundheitswesen und in der Pflege sind Erkenntnisse notwendig, die sich auf Teilaspekte der Fehlerwahrnehmung durch Pflegende, etwa den Umgang mit und das Melden von Fehlern, beziehen. «Whistleblowing» stellt eine Form der Berichterstattung über Fehler und Missstände dar, bei der unmittelbare Arbeitszusammenhänge verlassen werden und Personen, Institutionen oder Medien – vor allem auch außerhalb der betroffenen Organisation – Ansprechpartner werden. In halbstrukturierten Interviews mit 18 Pflegenden aus stationären Pflegeeinrichtungen wurde u. a. die Frage gestellt, ob gegebenenfalls eine derartige Berichterstattung vorstellbar wäre bzw. schon praktiziert wurde. Das Spektrum der Einschätzungen bewegte sich zwischen einer mehrheitlich deutlichen Missbilligung eines solchen Verhaltens und einer aufgrund persönlicher Risiken meist nur zögernd eingebrachten Zustimmung. Zentrale Themen waren Loyalitäten gegenüber der Organisation, dem Arbeitsteam und den Kolleginnen, Verpflichtungen gegenüber den Patientinnen/Bewohnerinnen und die Abwägung persönlicher Risiken. Die Ergebnisse der vorgestellten Studie decken sich mit Ergebnissen anderer Studien zum Thema, wie in der Diskussion dargestellt wird. Es gilt, die Übernahme profes­sioneller Verantwortung zu stärken sowie organisationale Wege für Fehlermeldungen zu finden und beispielsweise im Sinne von Best-Practice-Beispielen zur Diskussion zu stellen. Whistleblowing sollte verstanden werden als eine Handlung, in der sich «Patient Advocacy» ausdrückt.

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