scholarly journals Physician perceptions of the types of roles interpreters play in limited English proficient pediatric encounters and how they evaluate the quality of interpretation

2019 ◽  
Vol 20 ◽  
Author(s):  
Rebecca J. Schwei ◽  
Natalie Guerrero ◽  
Alissa L. Small ◽  
Elizabeth A. Jacobs
Keyword(s):  
Health Care ◽  
Limited English Proficient ◽  
Health Care Systems ◽  
Care Staff ◽  
Health Care Staff ◽  
Structured Interviews ◽  
Team Members ◽  
Medical Interpreters ◽  
Care Systems

AbstractPurposeThe purpose of this study is to understand different roles that interpreters play in a pediatric, limited English proficient (LEP) health care encounter and to describe what factors within each role inform physicians’ assessment of the overall quality of interpretation.BackgroundLanguage barriers contribute to lower quality of care in LEP pediatric patients compared to their English-speaking counterparts. Use of professional medical interpreters has been shown to improve communication and decrease medical errors in pediatric LEP patients. In addition, in many pediatric encounters, interpreters take on roles beyond that of a pure language conduit.MethodsWe conducted 11 semi-structured interviews with pediatricians and family medicine physicians in one health system. Transcripts were audio-recorded and transcribed verbatim. We analyzed our data using directed content analysis. Two study team members coded all transcripts, reviewed agreement, and resolved discrepancies.FindingsPhysicians described four different interpreter roles: language conduit, flow manager, relationship builder, and cultural insider. Within each role, physicians described components of quality that informed their assessment of the overall quality of interpretation during a pediatric encounter. We found that for many physicians, a high-quality interpreted encounter involves multiple roles beyond language transmission. It is important for health care systems to understand how health care staff conceptualize these relationships so that they can develop appropriate expectations and trainings for medical interpreters in order to improve health outcomes in pediatric LEP patients.

scholarly journals TEAM WORK IN A MEDICAL UNIT: DREAM OR A REALITY

2020 ◽  
pp. 1-2
Author(s):  
Manika Agarwal ◽  
Sharat Agarwal
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Collective Intelligence ◽  
Health Care Systems ◽  
Division Of Labour ◽  
Shared Responsibility ◽  
Team Work ◽  
Team Members ◽  
Care Systems

‘TEAM- Together Everyone Achieves More’ is a guiding principle in all departments in all organizations. On literature search, we can find plenty of materials relating to goals, principles and strategies for team work in health care settings. But are we practising it in clinical settings? And if not, is it due to lack of knowledge and skill regarding implementation of strategies for team work or is it due to attitude problems of leaders who want to force their way of thinking and their opinion in everything and then blame others or juniors for any error which is incurred? Cohesive health care teams have 5 key characteristics- Clear goals with measurable outcomes, clinical administrative systems, division of labour, training of all team members and effective communication [1]. The quality of team work is associated with higher quality of patient safety care systems and is imperative in reducing errors. This requires that staff be comfortable in recognizing and discussing challenging situations. Structural briefing and debriefing are an effective team strategy, but they like all other interventions require strong leadership to realize their benefits [2]. The hall mark of high performing organizations is that leaders defined a very clear set of behaviours that apply to everyone whether they clean the floor or are the chief of staff [3]. Smart teams are not simple team of smart members and collective intelligence requires social perceptiveness of team members or their ability to infer others mental state such as beliefs or feeling based subtle cues [4]. The study highlights that for creating smart team two critical communication processes are required from team members i.e. (a). Speak up when their expertise can be useful & (b). Influence the team’s work so that the team does its collective best for the patient [4]. The incorporation of sharing responsibilities with accountability between team members in health care systems offers great benefit. However, shared responsibility without high quality team work can result in immediate risk for patients [5]. As is a common saying ‘where everyone is responsible actually no one is responsible’, which can be a dangerous situation for health care services.

scholarly journals Experiences of Older Persons in Seeking Care at a Private Hospital in Urban India

2020 ◽  
Vol 6 ◽  
pp. 233372142091063
Author(s):  
Sachin Ganorkar ◽  
Zarina Nahar Kabir ◽  
Nasreen Rustomfram ◽  
Harshad Thakur
Keyword(s):  
Health Care ◽  
Older Persons ◽  
Private Hospital ◽  
Care Staff ◽  
Health Care Staff ◽  
Structured Interviews ◽  
Urban India ◽  
Complex Health Problems ◽  
Payment Mechanisms

Objective: The study aims to describe the experiences of older persons in seeking health care in a private hospital in urban India. Methods: Semi-structured interviews were conducted with 50 older persons admitted in or visiting a private hospital in Hyderabad city in India between the period November 2017 and April 2018. The data were analyzed using Content Analysis. Results: Dimensions related to payment mechanisms, quality of health care staff, and hospital quality were reported to be important for the older persons. Payment mechanisms were related to discounts, insurance support, and reducing out-of-pocket expenditure. Quality of care was related to optimizing hospital operational processes like discharge time, standard of treatment, and trustworthiness of the medical staff. Discussion: Payment mechanism can be made friendly for the older persons. Quality of hospital including its staff can be enhanced by developing geriatric-specific competencies which can help them to understand and treat complex health problems specific for the older population.

Health care staff of Russia. Staff imbalance and its elimination in health care

2019 ◽  
Vol 2019 (4) ◽  
pp. 49-59 ◽  
Author(s):  
Татьяна Семенова ◽  
Tat'yana Semenova
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Systems ◽  
Professional Staff ◽  
Care Staff ◽  
Health Care Staff ◽  
Staffing Levels ◽  
Regional Health Care ◽  
Care Systems ◽  
Care System

The article dedicated to the realization of the federal project «Provision of medical organizations of the health care system with qualified staff» that aimed at increase of staffing levels in health care system. The article presents the schemes of staff provision for regional health care systems and recommended methods of requirement estimation of professional staff, as well as the ways of elimination of staff imbalances and deficits in the regions of the Russian Federation.

From “Don't Ask, Just Trust” to “Trust Those Who are Accountable”

2014 ◽  
Vol 3 (2) ◽  
pp. 60-73
Author(s):  
Vahé A. Kazandjian
Keyword(s):  
Health Care ◽  
Performance Improvement ◽  
Health Care Systems ◽  
Project Design ◽  
The Past ◽  
Measurement Tools ◽  
Care Systems ◽  
Key Dimensions ◽  
Local Traditions

The past three decades have primarily focused on improving performance across health care providing organizations and even individual professionals. While their interest in performance improvement is global, the strategies across health care systems remain variable and the resulting methods of accountability to select audiences continue to be influenced by tradition and expectation. The purpose of this article is to review the key dimensions of the operationalization of performance measurement and the translation of its findings to statements about quality of care. While significant literature exists on the conceptual debates about the nature of quality, the deciding factor in demonstrating that better quality may have been achieved resides in the acceptability of the measurement tools to translate performance measures into profiles of quality. Fundamentally, the use of the tools is seen as only one component of a successful strategy – the education of various audiences as to what the measures mean not only is a necessary requisite for sound project design but also will determine how the accountability model is shaped in each environment based on the generic measurement tools results, local traditions of care and caring, and expectations about outcomes.

The making and sustaining of leaders in health care

2019 ◽  
Vol 33 (2) ◽  
pp. 241-262 ◽  
Author(s):  
Terry J. Boyle ◽  
Kieran Mervyn
Keyword(s):  
Health Care ◽  
Community Health ◽  
Health Care Services ◽  
Health Care Systems ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
Triple Aim ◽  
Content Type ◽  
Care Services ◽  
Care Systems

Purpose Many nations are focussing on health care’s Triple Aim (quality, overall community health and reduced cost) with only moderate success. Traditional leadership learning programmes have been based on a taught curriculum, but the purpose of this paper is to demonstrate more modern approaches through procedures and tools. Design/methodology/approach This study evolved from grounded and activity theory foundations (using semi-structured interviews with ten senior healthcare executives and qualitative analysis) which describe obstructions to progress. The study began with the premise that quality and affordable health care are dependent upon collaborative innovation. The growth of new leaders goes from skills to procedures and tools, and from training to development. Findings This paper makes “frugal innovation” recommendations which while not costly in a financial sense, do have practical and social implications relating to the Triple Aim. The research also revealed largely externally driven health care systems under duress suffering from leadership shortages. Research limitations/implications The study centred primarily on one Canadian community health care services’ organisation. Since healthcare provision is place-based (contextual), the findings may not be universally applicable, maybe not even to an adjacent community. Practical implications The paper dismisses outdated views of the synonymity of leadership and management, while encouraging clinicians to assume leadership roles. Originality/value This paper demonstrates how health care leadership can be developed and sustained.

Implementing Distress Screening in a Community and Veteran’s Administration Oncology Clinic

2018 ◽  
Author(s):  
Paul Montgomery ◽  
Nicole Thurston ◽  
Michelle Betts ◽  
C. Scott Smith
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Department Of Veterans Affairs ◽  
Distress Screening ◽  
Community Clinic ◽  
Patients With Cancer ◽  
Community Oncology ◽  
Care Systems

The complexities of cancer treatment present a myriad of life-altering impacts for patients. These impacts can be addressed only if health care systems have been designed to detect and address all of these challenges. One significant, but often hidden, challenge is distress. This reaction to the myriad obstacles that cancer presents can impact the quality of life, and influence outcomes, of patients with cancer. Health systems have been slow to address these problems, and a prime example is the implementation of a distress screening and management system. This case study summarizes distress screening in a community oncology clinic compared to a Department of Veterans Affairs (VA) oncology clinic. The community clinic responded to accreditation and grant-driven initiatives, whereas the VA responded to mental health and integrated primary care initiatives. This case study explores the history and the ongoing challenges of distress screening in these community-based health care systems.

Using Cannabis Therapeutically in the UK: A Qualitative Analysis

2003 ◽  
Vol 33 (2) ◽  
pp. 325-356 ◽  
Author(s):  
Ross Coomber ◽  
Michael Oliver ◽  
Craig Morris
Keyword(s):  
Health Care ◽  
Criminal Justice ◽  
Justice System ◽  
Therapeutic Agent ◽  
Health Care Systems ◽  
Beneficial Effects ◽  
Access Cost ◽  
Care Systems ◽  
The Uk

Thirty-three therapeutic cannabis users in England were interviewed about their experiences using an illegal drug for therapeutic purposes. Interviews were semi-structured, and responses highly qualitative. Particular issues included how and why cannabis was used therapeutically; what problems its illegality posed in terms of access, cost, reliability of supply, and quality of the product; the perceived beneficial effects of its use; and unwanted effects (problems in relation to family, friends, partners, the criminal justice system, and the health care system). The study did not seek to prove or disprove the efficacy of cannabis used as a therapeutic agent merely to report the experiences of those who use it in that way. It was found that users perceived cannabis to be highly effective in treating their symptoms, to complement existing medication, and to produce fewer unwanted effects. Smoking was the preferred method of administration, permitting greater control over dose and administration. Problems related to prescribed medication motivated many to use cannabis therapeutically. Few problems were experienced with friends, family, partners, and the criminal justice or health care systems, although other concerns about cannabis's illegality were reported. Although most were relatively unconcerned about the risk involved and were determined to continue use, many resented that they felt they were being forced to break the law. Problems relating to access to the drug (in an illegal context) and managing its administration were reported. A brief discussion of the continued prohibition of cannabis for this group is undertaken, and a harm reduction approach is suggested.

scholarly journals Events, Public Discourses and Responsive Government: Quality Assurance in Health Care in England, Sweden and Japan

2010 ◽  
Vol 30 (3) ◽  
pp. 263-289 ◽  
Author(s):  
NAONORI KODATE
Keyword(s):  
Health Care ◽  
Quality Assurance ◽  
Political Institutions ◽  
Health Care Systems ◽  
Public Access ◽  
Dynamic Interactions ◽  
Policy Domain ◽  
Policy Debates ◽  
Care Systems

AbstractOne would expect the common agenda of improving the quality of care in hospital sectors across nations to bring about a convergence of their quality assurance systems. However, one finds great variations in the ways in which such schemes are constructed and communicated to the general public in different countries. This paper examines three universal health care systems (England, Sweden and Japan) and explores the degree to which political institutions and public opinions affect the processes of quality assurance system building within them. It argues that the inputs from governments in response to public concerns are the key to understanding the changes in this seemingly profession-dominated policy domain; therefore policy changes are significantly affected by dynamic interactions between events, public discourses and governance structures within these countries. The findings also demonstrate that public access to information has begun to have a large impact on policy debates in all three countries.

scholarly journals Multidisciplinary Reference Centers: The Care of Neuroendocrine Tumors

2010 ◽  
Vol 6 (6) ◽  
pp. e11-e16 ◽  
Author(s):  
Simron Singh ◽  
Calvin Law
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Neuroendocrine Tumor ◽  
Neuroendocrine Tumors ◽  
Health Care Systems ◽  
Reference Center ◽  
Care Systems ◽  
Provider Experience ◽  
Positive Effect

As providers at a neuroendocrine tumor multidisciplinary reference center, the authors believe these centers have a positive effect on patient and provider experience, and the creation of specialty centers with a focus on improving outcomes and quality of care should be a goal of health care systems.

scholarly journals International Students’ Experience With Health Care in Japan

SAGE Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 215824402110092
Author(s):  
Masumi Soneta ◽  
Akiko Kondo ◽  
Renaguli Abuliezi ◽  
Aya Kimura
Keyword(s):  
Health Care ◽  
International Students ◽  
Medical System ◽  
Care Staff ◽  
Health Care Staff ◽  
Culturally Competent ◽  
Structured Interviews ◽  
International Graduate ◽  
Medical Fees ◽  
Medical University

The number of foreign residents and visitors in Japan is increasing, which necessitates culturally competent care in hospitals. This study aimed to describe the experience of international students who visited hospitals in Japan. In total, nine international graduate students in a medical university participated in semi-structured interviews in English. The interview contents were transcribed and analyzed using content analysis. While participants were satisfied with an efficient medical system and kind staff, they also had difficulty communicating with staff and receiving health care due to language and cultural differences. Participants desired Japanese health care staff speak English, as well as have English documents. The differences from their own countries were mainly medical fees, insurance, the medical system itself, and use of English to communicate with foreign patients. It is necessary to improve staff’s English skills, provide English documents, use multilanguage interpreter services, and explain Japanese hospitals’ medical system.

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