scholarly journals E08-C Developing National Palliative and End-of-Life Indicators to Monitor System Performance

2016 ◽  
Vol 52 (6) ◽  
pp. e44
Author(s):  
Ruth Barker ◽  
Margaret Fitch ◽  
Deborah Dudgeon ◽  
Esther Green ◽  
Raquel Shaw-Moxam
Keyword(s):  
End Of Life ◽  
System Performance ◽  
Monitor System

scholarly journals Measuring indicators of health system performance for palliative and end-of-life care using health administrative data: a scoping review

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1438
Author(s):  
Suman Budhwani ◽  
Ashlinder Gill ◽  
Mary Scott ◽  
Walter P. Wodchis ◽  
JinHee Kim ◽  
...  
Keyword(s):  
Performance Measurement ◽  
End Of Life ◽  
Administrative Data ◽  
Scoping Review ◽  
System Performance ◽  
End Of Life Care ◽  
Population Level ◽  
Health System Performance ◽  
Life Care ◽  
Health Administrative Data

Background: A plethora of performance measurement indicators for palliative and end-of-life care currently exist in the literature. This often leads to confusion, inconsistency and redundancy in efforts by health systems to understand what should be measured and how.  The objective of this study was to conduct a scoping review to provide an inventory of performance measurement indicators that can be measured using population-level health administrative data, and to summarize key concepts for measurement proposed in the literature.  Methods: A scoping review using MEDLINE and EMBASE, as well as grey literature was conducted.  Articles were included if they described performance or quality indicators of palliative and end-of-life care at the population-level using routinely-collected administrative data.  Details on the indicator such as name, description, numerator, and denominator were charted. Results: A total of 339 indicators were extracted.  These indicators were classified into nine health care sectors and one cross-sector category.  Extracted indicators emphasized key measurement themes such as health utilization and cost and excessive, unnecessary, and aggressive care particularly close to the end-of-life.  Many indicators were often measured using the same constructs, but with different specifications, such as varying time periods used to ascribe for end-of-life care, and varying patient populations.  Conclusions: Future work is needed to achieve consensus ‘best’ definitions of these indicators as well as a universal performance measurement framework, similar to other ongoing efforts in population health.  Efforts to monitor palliative and end-of-life care can use this inventory of indicators to select appropriate indicators to measure health system performance.

scholarly journals Testing Whole Building LCA: Research and Practice

2015 ◽  
Author(s):  
Kathrina Simonen ◽  
Keyword(s):  
Life Cycle Assessment ◽  
Life Cycle ◽  
Greenhouse Gas ◽  
End Of Life ◽  
System Performance ◽  
Research And Practice ◽  
Operation And Maintenance ◽  
Environmental Life Cycle Assessment ◽  
Construction Operation ◽  
System Selection

Research and Practice Environmental Life Cycle Assessment (LCA) can be used to evaluate the environmental impacts of a building resulting from manufacturing, construction, operation and maintenance and the end of life demolition and disposal/re-use. Tracking impacts such as greenhouse gas emissions and smog formation, LCA can enable comparison of building proposals testing options of material use, system selection and system performance.

scholarly journals Building Blocks for Integrating Image Analysis Algorithms into a Clinical Workflow

2020 ◽  
Author(s):  
Krishna Juluru ◽  
Hao-Hsin Shih ◽  
Pierre Elnajjar ◽  
Amin El-Rowmeim ◽  
Josef Fox ◽  
...  
Keyword(s):  
Image Analysis ◽  
System Performance ◽  
Performance Monitoring ◽  
Building Blocks ◽  
Error Rates ◽  
Monitor System ◽  
Clinical Workflow ◽  
Time Period ◽  
Image Analysis Algorithm ◽  
Timely Delivery

PurposeStarting from a broad-based needs assessment and utilizing an image analysis algorithm (IAA) developed at our institution, the purpose of this study was to define generalizable building blocks necessary for the integration of any IAA into a clinical practice.MethodsAn IAA was developed in our institution to process lymphoscintigraphy exams. A team of radiologists defined a set of building blocks for integration of this IAA into clinical workflow. The building blocks served the following roles: (1) Timely delivery of images to the IAA, (2) quality control, (3) IAA results processing, (4) results presentation & delivery, (5) IAA error correction, (6) system performance monitoring, and (7) active learning. Utilizing these modules, the lymphoscintigraphy IAA was integrated into the clinical workflow at our institution. System performance was tested over a 1 month period, including assessment of number of exams processed and delivered, and error rates and corrections.ResultsFrom June 26-July 27, 2019, the building blocks were used to integrate IAA results from 132 lymphoscintigraphy exams into the clinical workflow, representing 100% of the exams performed during the time period. The system enabled radiologists to correct 21 of the IAA results. All results and corrections were successfully stored in a database. A dashboard allowed the development team to monitor system performance in real-time.ConclusionsWe describe seven building blocks that optimize the integration of IAAs into clinical workflow. The implementation of these building blocks in this study can be used to inform development of more robust, standards-based solutions.

Much Ado About Fried Chicken: Abetting Aspiration or Respecting Autonomy?

2019 ◽  
Vol 28 (3) ◽  
pp. 1356-1362
Author(s):  
Laurence Tan Lean Chin ◽  
Yu Jun Lim ◽  
Wan Ling Choo
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Multidisciplinary Team ◽  
Biopsychosocial Model ◽  
Family Members ◽  
Clinical Decisions ◽  
Goals Of Care ◽  
Complex Needs ◽  
Aspiration Risk ◽  
Patient Centric

Purpose Palliative care is a philosophy of care that encompasses holistic, patient-centric care involving patients and their family members and loved ones. Palliative care patients often have complex needs. A common challenge in managing patients near their end of life is the complexity of navigating clinical decisions and finding achievable and realistic goals of care that are in line with the values and wishes of patients. This often results in differing opinions and conflicts within the multidisciplinary team. Conclusion This article describes a tool derived from the biopsychosocial model and the 4-quadrant ethical model. The authors describe the use of this tool in managing a patient who wishes to have fried chicken despite aspiration risk and how this tool was used to encourage discussions and reduce conflict and distress within the multidisciplinary team.

End-of-Life Issues for People Who Use AAC

2005 ◽  
Vol 14 (3) ◽  
pp. 15-19 ◽  
Author(s):  
Melanie Fried-Oken ◽  
Lisa Bardach
Keyword(s):  
End Of Life ◽  
Life Issues ◽  
End Of Life Issues

Dysphagia in Hospice Care: The Roles of Social Work and Speech-Language Pathologists

2014 ◽  
Vol 23 (4) ◽  
pp. 173-186 ◽  
Author(s):  
Deborah Hinson ◽  
Aaron J. Goldsmith ◽  
Joseph Murray
Keyword(s):  
Social Work ◽  
End Of Life ◽  
Case Studies ◽  
End Of Life Care ◽  
Hospice Care ◽  
Patient Communication ◽  
Life Care ◽  
Speech Language Pathologists ◽  
Four Levels

This article addresses the unique roles of social work and speech-language pathologists (SLPs) in end-of-life and hospice care settings. The four levels of hospice care are explained. Suggested social work and SLP interventions for end-of-life nutrition and approaches to patient communication are offered. Case studies are used to illustrate the specialized roles that social work and SLP have in end-of-life care settings.

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