scholarly journals Patient-Centered Models of Care: Closing the Gaps in Physician Readiness

2015 ◽  
Vol 30 (7) ◽  
pp. 870-872 ◽  
Author(s):  
Anna Chang ◽  
Christine Ritchie
Keyword(s):  
Models Of Care ◽  
Patient Centered ◽  
Closing The Gaps

Focus on Patient in Virtual Reality-Assisted Rehabilitation

2018 ◽  
pp. 1422-1450 ◽  
Author(s):  
Stefano Mottura ◽  
Luca Fontana ◽  
Sara Arlati ◽  
Claudia Redaelli ◽  
Andrea Zangiacomi ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Emotional State ◽  
Models Of Care ◽  
Point Of View ◽  
Self Awareness ◽  
Patient Centered ◽  
Natural Interaction ◽  
Rehabilitation Outcomes ◽  
Rehabilitation Programs

Since several years scientists are carrying on research about innovative systems, based on robotics, mechatronics devices and IT tools – especially the graphical ones – to support patients in rehabilitation programs for rescuing from various brain damages due to adverse events as stroke. Training sessions with a combination of robot and virtual reality (VR) lead to better rehabilitation outcomes than using only a robot and evidence from the field proved the importance of the use of VR interfaces in rehabilitation. The main aim of such a kind of environments is to monitor, motivate and drive the patient during the rehabilitation sessions. These systems mainly provide motor guidance and multimedia communication channels also measuring patients' performance and other observable variables. The approach implemented is usually based on gaming, where the patient has the key role to perform certain tasks or movements for controlling the game in the correct way and exercise the injured part. According to daily experience from physiotherapists, different aspects related to the physical and self-perceived patients' state revealed to have a fundamental role in influencing the rehabilitation session. Indeed, the treatment result depends not only on motor skills but also on patient's personal behavior and feelings that are not directly investigable, observable and measurable from outside. In other words this kind of elements can only be assessed by subjective measurements (as questions, interviews, narratives) revealing the point of view of the patient. Moreover, the emotional state has implications at different levels: on one hand, it is important to evaluate if the single rehabilitation session affects the emotional state of the patient, on the other, if the performance was influenced by this state. Some answers of a questionnaire administrated to post-stroke patients in a previous study underlined also the need for the patient to focus his/her attention on the trained body portion and the relevance of a visual feedback on movements to increase self-awareness on the action performed, avoiding any possible distraction derived from other kind of tasks and related visual/auditory stimuli. Patient-centered models of care are actually becoming increasingly common among rehabilitation clinical settings. They help to focus the therapy on improving the treatment of those deficiencies that most influence the quality of life of the patient. Another important aspect is represented by the relationship with the caregiver that in virtually assisted rehabilitation would not be direct anymore and will need to be mediated without completely loosing natural interaction. According to this patient centered vision, and in order to reduce possible side effects related to semi-automatic rehabilitation systems, it has been studied and developed a system which has not the aim of merely entertain the patient but to focalize the rehabilitation on him/her as a proactive character aware of what is happening and of the quality of the work performed.

scholarly journals Prevalence of Low-Value Care and Its Associations with Patient-Centered Outcomes in Dementia

2021 ◽  
pp. 1-13
Author(s):  
Moritz Platen ◽  
Steffen Flea ◽  
Anika Rädke ◽  
Diana Wucherer ◽  
Jochen René Thyrian ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Models Of Care ◽  
Adverse Outcomes ◽  
Future Research ◽  
Patient Centered ◽  
Treatment Pathways ◽  
Patient Reported ◽  
Evidence Based Treatments ◽  
Related Quality

Background: Low-value care (LvC) is defined as care unlikely to provide a benefit to the patient regarding the patient’s preferences, potential harms, costs, or available alternatives. Avoiding LvC and promoting recommended evidence-based treatments, referred to as high-value care (HvC), could improve patient-reported outcomes for people living with dementia (PwD). Objective: This study aims to determine the prevalence of LvC and HvC in dementia and the associations of LvC and HvC with patients’ quality of life and hospitalization. Methods: The analysis was based on data of the DelpHi trial and included 516 PwD. Dementia-specific guidelines, the “Choosing Wisely” campaign and the PRISCUS list were used to indicate LvC and HvC treatments, resulting in 347 LvC and HvC related recommendations. Of these, 77 recommendations (51 for LvC, 26 for HvC) were measured within the DelpHi-trial and finally used for this analysis. The association of LvC and HvC treatments with PwD health-related quality of life (HRQoL) and hospitalization was assessed using multiple regression models. Results: LvC was highly prevalent in PwD (31%). PwD receiving LvC had a significantly lower quality of life (b = –0.07; 95%CI –0.14––0.01) and were significantly more likely to be hospitalized (OR = 2.06; 95%CI 1.26–3.39). Different HvC treatments were associated with both positive and negative changes in HRQoL. Conclusion: LvC could cause adverse outcomes and should be identified as early as possible and tried to be replaced. Future research should examine innovative models of care or treatment pathways supporting the identification and replacement of LvC in dementia.

Personalized Health Care

2015 ◽  
Author(s):  
Jared Sparks
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Ethical Issues ◽  
Models Of Care ◽  
Care Providers ◽  
Patient Centered ◽  
Broad Term ◽  
Personalized Health ◽  
Personalized Health Care ◽  
Effective Health Care

Personalized health care (PHC) is a broad term that describes how we leverage our growing understanding of the human body and developing technology to provide more effective health care. PHC requires that health care providers consider prevention and treatment in the context of available advanced technologies, best practices, and known variables that define us as individuals. These variables or characteristics may run the gamut from genetic, to biologic, to environmental, to even personality, personal values, and choice. By considering how these characteristics interact with specific illnesses and available interventions, outcomes can be improved. The purpose of this article is to: describe PHC’s current conceptualization including relationship with personalized medicine and patient-centered models of care, discuss its development and application by specific stakeholders, and review pertinent economic, legislative, and ethical issues.

Models of Care

2017 ◽  
Author(s):  
Tyson Sawchuk ◽  
Joan K. Austin ◽  
Debbie Terry
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Hospital Setting ◽  
Models Of Care ◽  
Stepped Care ◽  
Patient Centered ◽  
Care Approach ◽  
Centered Care ◽  
Care Models

This chapter addresses common barriers to care delivery in psychogenic nonepileptic seizures (PNES) and limitations of current approaches. Theoretical and practical considerations in delivering PNES care are discussed. These include a stepped-care approach, which offers a strategy for efficiently managing health care resources and has promise in treatment of PNES. Patient-centered care, a general approach to providing health care services in a manner that takes into consideration the patients’ expressed needs, desires, and preferences, is also considered. Examples of care models are presented, including a pediatric model for PNES recently developed and being tested in a Canadian hospital setting. Future directions for the development of care models in PNES are discussed and a list of recommendations is provided.

The Patient-Centered Medical Home

2017 ◽  
Author(s):  
Colleen Conry ◽  
Shandra Brown Levy ◽  
Bonnie T. Jortberg
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Medical Home ◽  
Behavioral Health Care ◽  
Models Of Care ◽  
Insurance Companies ◽  
Patient Centered Medical Home ◽  
Coordinated Care ◽  
Patient Centered ◽  
Delivery Of Care

The Patient-Centered Medical Home (PCMH) involves an organizing set of principles for the delivery of primary care that has become widely accepted by primary care medical associations, policymakers, businesses, and insurance companies. The PCMH places the patient at the center of the delivery of care. One physician directs the patient’s care. The PCMH emphasizes a whole-person orientation and coordinated care, including integration of physical health with behavioral health. Care is coordinated across the health care system. Use of a PCMH enhances access to medical care and ensures quality and safety. This chapter reviews the history of the PCMH and discusses joint principles of the PCMH; models of care, space, and payment; and the newer concept of the “medical neighborhood.”

Comparison of Athletic Trainer Stress and Job Satisfaction with Different Models of Care Delivery

2018 ◽  
Vol 23 (4) ◽  
pp. 150-155 ◽  
Author(s):  
Carrie S. Baker ◽  
Gary B. Wilkerson
Keyword(s):  
Job Satisfaction ◽  
Athletic Training ◽  
Care Delivery ◽  
Models Of Care ◽  
Athletic Trainer ◽  
Patient Centered ◽  
Life Balance ◽  
Work Related ◽  
Related Stress ◽  
Training Services

A patient-centered model (PCM) for athletic training services may function as a better model to decrease athletic trainer (AT) stress and result in a more desirable work-life balance compared to the traditional model (TM). The purpose of this study was to assess differences in AT stress and job satisfaction between healthcare models for delivery of AT services. A one-time electronic stress survey was administered to ATs working in both settings. ATs who work in the TM are more likely to report greater work-related stress, and less likely to report job satisfaction than ATs who work in the PCM setting.

E-Mental Health and models of care: The evidence base and feasibility of picking one vs. another?

2016 ◽  
Vol 33 (S1) ◽  
pp. S26-S26
Author(s):  
D. Hilty
Keyword(s):  
Social Media ◽  
New Technologies ◽  
Healthcare Delivery ◽  
Online Communication ◽  
Mental Healthcare ◽  
Evidence Base ◽  
Models Of Care ◽  
Patient Centered ◽  
Use Of Technology ◽  
Pathological Internet Use

The patient-centered care features quality, affordable, and timely care in a variety of settings – technology is a key part of that – particularly among younger generations and child and adolescent patients. The consumer movement related to new technologies is nearly passing clinicians by, as new ways of communicating with others (text, email, Twitter, Facebook) revolutionizes how we experience life and access healthcare. This paper explores a continuum with healthy, innovative behavior on one end (e.g., social media) and pathological Internet use on the other end–and the range of self-help and e-mental healthcare options being used. Specifically, it focuses on how social media adds to, yet may complicate healthcare delivery, such that clinicians may need to adjust our approach to maintain therapeutic relationships, interpersonal/clinical boundaries, and privacy/confidentiality. We suggest planning ahead to discuss expectations about online communication between doctors and patients as part of the informed consent process, offer other do's and don’ts for patients and clinicians, and review applicable guidelines. More research is needed on consumer and patient use of technology related to healthcare, as is an approach to basic and advanced measurement of outcomes.Disclosure of interestThe author has not supplied his declaration of competing interest.

Team-Based Health Care

2020 ◽  
Author(s):  
Michael A. Patchner ◽  
Lisa S. Patchner
Keyword(s):  
Health Care ◽  
Social Workers ◽  
Care Delivery ◽  
Models Of Care ◽  
Patient Centered ◽  
Public And Private ◽  
Health Care Settings ◽  
Macro Practice ◽  
Multiple Health ◽  
Complicated Nature

The complicated nature of illness and health care delivery along with the complexity of insurance and health policy demand team-based health care. As a consequence, social workers have become engaged in team-based health care with numerous other professionals within multiple settings. Through the engagement of client-centered practice social workers experience systems that weigh the provision of direct services against macro quantitative accountability. This has resulted in newly defined roles and expectations for social workers who are well trained for both micro and macro practice. In multiple health care settings, social workers are partners in team-based models of care where patient-centered practice is a component within larger public and private delivery systems.

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