Effects of continuing medical education on improving physician clinical care and patient health: A review of systematic reviews

2005 ◽  
Vol 21 (3) ◽  
pp. 380-385 ◽  
Author(s):  
Bernard S. Bloom
Keyword(s):  
Medical Education ◽  
Patient Care ◽  
Patient Outcomes ◽  
Systematic Reviews ◽  
Continuing Medical Education ◽  
Clinical Care ◽  
Care Quality ◽  
Clinical Practices ◽  
Patient Health ◽  
Meta Analyses

Objectives:The objective of physician continuing medical education (CME) is to help them keep abreast of advances in patient care, to accept new more-beneficial care, and discontinue use of existing lower-benefit diagnostic and therapeutic interventions. The goal of this review was to examine effectiveness of current CME tools and techniques in changing physician clinical practices and improving patient health outcomes.Methods:Results of published systematic reviews were examined to determine the spectrum from most- to least-effective CME techniques. We searched multiple databases, from 1 January 1984 to 30 October 2004, for English-language, peer-reviewed meta-analyses and other systematic reviews of CME programs that alter physician behavior and/or patient outcomes.Results:Twenty-six reviews met inclusion criteria, that is, were either formal meta-analyses or other systematic reviews. Interactive techniques (audit/feedback, academic detailing/outreach, and reminders) are the most effective at simultaneously changing physician care and patient outcomes. Clinical practice guidelines and opinion leaders are less effective. Didactic presentations and distributing printed information only have little or no beneficial effect in changing physician practice.Conclusions:Even though the most-effective CME techniques have been proven, use of least-effective ones predominates. Such use of ineffective CME likely reduces patient care quality and raises costs for all, the worst of both worlds.

The Mandate Project: Institutionalizing a System of Patient Care Quality Assurance

PEDIATRICS ◽  
1976 ◽  
Vol 57 (5) ◽  
pp. 775-782
Author(s):  
Daniel S. Fleisher ◽  
Clement R. Brown ◽  
Carter Zeleznik ◽  
Gerald H. Escovitz ◽  
Charles Omdal
Keyword(s):  
Medical Education ◽  
Quality Assurance ◽  
Patient Care ◽  
Psychosocial Factors ◽  
Continuing Medical Education ◽  
Care Quality ◽  
Quality Assurance Program ◽  
Patient Care Quality

In 1970, prior to present-day requirements for quality assurance programs, a project was undertaken to institute such a program voluntarily in ten hospitals. Five hospitals succeeded in fully implementing the program which was based on the "Bi-Cycle Process" and each documented improvements in desired patient care behaviors. Two hospitals partially implemented the process and demonstrated no significant changes in desired patient care behaviors. Two hospitals failed to provide the data upon which assessments could be made and one hospital never got beyond preliminary efforts at instituting the process. The project demonstrates that a voluntary quality assurance program is feasible and has important implications for PSROs and continuing medical education. It also provides evidence that attention to psychosocial factors is essential in the institutionalization of programs designed to produce desired changes in patient care behaviors.

Usage of Electronic Resources Among Ophthalmologists in India

2019 ◽  
pp. 54-80
Author(s):  
A. Ashok Kumar
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Patient Care ◽  
Continuing Medical Education ◽  
Online Resources ◽  
Clinical Practices ◽  
Electronic Resources ◽  
Academic Curriculum ◽  
Visually Challenged

The contribution of ophthalmologists is inevitable for visually challenged patient care and to eradicate unnecessary blindness in this society. Other than the academic focus of the medical students, the importance of continuing medical education (CME) for doctors in all disciplines, including ophthalmology, is a well-known factor to enhance their day-to-day clinical practices. The role of electronic and online resources in academic curriculum of medicine and CME is acceptable and inexorable among the user community worldwide. In the last several years, many research studies have focused on how people use electronic resources or on their feelings about electronic and online resources in various fields. In this study, the researcher analyzed the electronic resources usage among the ophthalmologists which indirectly supports their day-to-day clinical practices and serves the society against blindness. The results of the study show that the respondents have an average level of e-resources usage skills, particularly on awareness about many available e-resources.

Original Investigations of Anesthetic Practice 

1997 ◽  
Vol 86 (5) ◽  
pp. 1170-1196 ◽  
Author(s):  
Mehernoor F. Watcha ◽  
Paul F. White
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Gas Flow ◽  
Health Care Cost ◽  
Care Quality ◽  
New Drugs ◽  
Recent Analysis ◽  
Clinical Practices ◽  
Anesthetic Drugs ◽  
Acquisition Costs

Anesthesiologists, like all other specialists, need to examine carefully their clinical practices so that excessive costs and waste can be reduced without compromising patient care or safety. While costs of drugs used for anesthesia constitute only a small fraction of total health care cost, they are highly visible costs which are easy for administrators to scrutinize. Although cost savings in an individual case may be small, the total savings may be impressive because of the large volume of cases performed. In a recent analysis of strategies to decrease PACU costs, Dexter and Tinker found that anesthesiologists have "little control over PACU economics via the choice of anesthetic drugs". Greater savings could be achieved by timing the arrival of patients into the PACU to reduce the peak requirement of nursing personnel. Hospital and operating room management would be better served by concentrating on these simple measures to improve efficiency rather than forcing anesthesiologists to base drug usage on acquisition costs. Even in countries that have nationalized health services, salaries make up the largest part of the costs, and the expenses in delaying an operation by 30 min exceeds the costs of a 2 h propofol infusion. It is becoming increasingly apparent that attempts at better scheduling of cases, more efficient processing of patients in the PACU to optimize admission rates, and reduced wastage of anesthetic and surgical supplies lead to greater savings than reducing anesthetic-related drug costs. Nevertheless, it is still important for anesthesiologists to participate in the ongoing effort to reduce medical costs without affecting the quality of patient care. Quality care and fiscally sound decision-making are not necessarily mutually exclusive. Simple, effective cost containment measures that all anesthesiologists can practice include using low fresh gas flow rates with inhalation agents and opening sterile packages and drug ampules only if the contents will be used. The choice of an anesthetic agent for routine use depends not only on its demonstrated efficacy and side effect profile, but also on economic factors. It is important to perform careful pharmacoeconomic evaluations of these newer drugs, including assessing all associated costs and benefits for subsets of patients undergoing different types of surgical procedures. These evaluations should also include input from patients regarding their personal preferences. Excessive emphasis on the acquisition costs of drugs may lead to blanket bans on the use of new drugs because of their higher costs rather than permitting physicians to individualize therapy according to their clinical experience and the perceived needs of a given patient. Institutional and individual variations in clinical practices, their associated costs and outcomes may alter conclusions about acceptability and economic evaluation of a particular drug or technique. The information in this review can be used to provide a rational basis for incorporating cost considerations into the decision-making process regarding the drugs, devices and techniques used in anesthesiology.

scholarly journals Payment Reforms for Prehospital Care Services in a Middle Income Country: Assessing Implementation and Patient Outcomes Using a Mixed-Methods Approach

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Paibul Suriyawongpaisal ◽  
Samrit Srithamrongsawad ◽  
Pongsakorn Atiksawedparit ◽  
Khanisthar Phooseemungkun ◽  
Krongkan Bunchaiyai ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Patient Care ◽  
Patient Outcomes ◽  
Prehospital Care ◽  
Clinical Care ◽  
Mixed Methods Approach ◽  
Time Flow ◽  
Care Systems ◽  
Pay System ◽  
Made In

Introduction. Financing health systems constitutes a key element of well-functioning healthcare system. Prior to 2015, two new financial arrangements (direct-pay and E-claim systems) were introduced on a voluntary basis which aimed to pool more financial resources and improve cash flow of prehospital care systems. The aims of this study were to (1) assess the effects of direct-pay system in terms of (a) timeliness of reimbursement to EMS agencies, (b) changes in clinical care processes, and (c) the outcomes of patient care as compared to previous system; (2) identify the reasons for or against EMS agencies to participate in direct-pay system mechanisms; (3) identify the emerging issues with potential to significantly further the advancement of EMS systems. Using a mixed-methods approach, retrospective datasets of 3,769,399 individual records of call responses from 2015 to 2017 were analyzed which compared EMS units with the direct-pay system against those without in terms of time flow of claim data and patient outcomes. For qualitative data, in-depth interviews were conducted. Results. EMS units participating in both systems had the highest percentages of financial claim being made in time as compared to those not participating in any (p=0.012). However, there were not any practically meaningful differences between EMS units participating and not participating in either of the payment systems in terms of patient care such as appropriateness of response time, airway management, and outcome of treatment. Analysis of data from focus-group and individual interviews ended up with a causal loop diagram demonstrating potential explanatory mechanisms for those findings. Conclusion. It is evident that progress has been made in terms of mobilising more financial inputs and improving financial information flow. However, there is no evidence of any changes in patient outcomes and quality of care. Furthermore, whether the progress is meaningful in filling the gaps of financial demands of the prehospital care systems is still questionable. Room for future improvement of prehospital care systems was discussed with implications for other countries.

scholarly journals Improving Type 2 Diabetes Patient Health Outcomes with Individualized Continuing Medical Education for Primary Care

2016 ◽  
Vol 7 (3) ◽  
pp. 473-481 ◽  
Author(s):  
Brian Lee ◽  
Dace Trence ◽  
Silvio Inzucchi ◽  
Jay Lin ◽  
Steven Haimowitz ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Medical Education ◽  
Health Outcomes ◽  
Continuing Medical Education ◽  
Diabetes Patient ◽  
Patient Health

scholarly journals The Relevance of Telemedicine in Continuing Medical Education

2020 ◽  
Vol 42 (5_suppl) ◽  
pp. 97S-102S
Author(s):  
Samir Kumar Praharaj ◽  
Shahul Ameen
Keyword(s):  
Medical Education ◽  
Continuing Medical Education ◽  
Clinical Care ◽  
Traditional Methods ◽  
Medical Practitioners ◽  
Knowledge And Skills ◽  
Online Format ◽  
Technological Limitations

Continuing medical education (CME) is essential for medical practitioners to update their knowledge and skills periodically to provide clinical care in keeping with the evidence available. Traditional methods of CME such as workshops, conferences, and seminars are helpful to bridge the gaps in practice. With advancing technologies, online format is used to deliver CME with appropriate modifications. Although there are distinct advantages of online CME in regards to wider reach and flexibility, there are certain drawbacks beyond just technological limitations. Interactivity using ingenious ideas may be required to motivate and engage learners during online CME.

CME and the Pharmaceutical Industry: Towards a More Ethical Relationship

2002 ◽  
Vol 10 (2) ◽  
pp. 108-110
Author(s):  
Julian Freidin ◽  
Nigel Prior ◽  
Grant Sara
Keyword(s):  
Medical Education ◽  
Pharmaceutical Industry ◽  
Patient Care ◽  
Continuing Medical Education ◽  
General Council ◽  
Complex Nature ◽  
The Public ◽  
The Relationship

Objectives: To feedback the strategies put to, and accepted by, General Council as a result of the survey of College Fellows views on the ethics of the relationship between the Pharmaceutical Industry and Continuing Medical Education (CME). Conclusions: The proposals accepted by General Council recognise that education of registrars and psychiatrists about the complex nature of their relationships with Industry, increasing their awareness of how this may impact on patient care and encouraging greater individual and collective openness are important steps to take in increasing the confidence of the public that we genuinely are their advocates in all matters to do with the Pharmaceutical Industry.

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