scholarly journals Nurses as change agents for a better future in health care: the politics of drift and dilution

2018 ◽  
Vol 13 (3-4) ◽  
pp. 475-491 ◽  
Author(s):  
Anne M. Rafferty
Keyword(s):  
Health Care ◽  
Clinical Care ◽  
Quality Care ◽  
Change Agents ◽  
Evidence Base ◽  
Short Term ◽  
Policy Makers ◽  
The Public ◽  
The United Kingdom ◽  
Strategic Direction

AbstractThis paper takes the 70th Anniversary of the National Health Service (NHS) in the United Kingdom as an opportunity to reflect upon the strategic direction of nursing policy and the extent to which nurses can realise their potential as change agents in building a better future for health care. It argues that the policy trajectory set for nursing at the outset of the NHS continues to influence its strategic direction, and that the trajectory needs to be reset with the voices of nurses being more engaged in the design, as much as the delivery of health policy. There is a growing evidence base about the benefits for patients and nurses of deploying well-educated nurses at the top of their skill set, to provide needed care for patients in adequately staffed and resourced units, as well as the value that nurses contribute to decision-making in clinical care. Yet much of this evidence is not being implemented. On the contrary, some of it is being ignored. Policy remains fragmented, driven by short-term financial constraints and underinvestment in high quality care. Nurses need to make their voices heard, and use the evidence base to change the dialogue with the public, policy makers and politicians, in order to build a better future for health care.

Papers please: Predictive factors for national and international COVID-19 immunity and vaccination passport uptake as determined by representative surveys (Preprint)

2021 ◽  
Author(s):  
Paul Michael Garrett ◽  
Joshua Paul White ◽  
Simon Dennis ◽  
Stephan Lewandowsky ◽  
Cheng-Ta Yang ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Policy Decision ◽  
National Accounts ◽  
Policy Makers ◽  
The Public ◽  
The United Kingdom ◽  
Social Risks ◽  
Effective Policy ◽  
Generalized Linear Mixed Effects ◽  
The Uk

BACKGROUND In response to the COVID-19 pandemic, countries are introducing digital passports that allow citizens to return to normal activities if they were previously infected with (immunity passport) or vaccinated against (vaccination passport) SARS-CoV-2. To be effective, policy decision makers must know whether immunity and vaccination passports will be widely accepted by the public, and under what conditions? This study focuses attention on immunity passports, as these may prove useful in countries both with and without an existing COVID-19 vaccination program, however, our general findings also extend to vaccination passports. OBJECTIVE We aimed to assess attitudes towards the introduction of immunity passports in six countries, and determine what social, personal, and contextual factors predicted their support. METHODS We collected online representative samples across six countries – Australia, Japan, Taiwan, Germany, Spain, and the United Kingdom – from April to May of the 2020 COVID-19 pandemic, and assessed attitudes and support for the introduction of immunity passports. RESULTS Immunity passport support was moderate-to-low, ranging from 51% in the UK and Germany, 47% in Australia and Spain, 46% in Taiwan, and 22% in Japan. Bayesian generalized linear mixed effects modelling controlling assessed predictive factors for immunity passport support across countries. International results showed neoliberal world views, personal concern and perceived virus severity, the fairness of immunity passports, and willingness to become infected to gain an immunity passport, were all predictive factors of immunity passport support. By contrast, gender (woman), immunity passport concern, and risk of harm to society predicted a decrease in support for immunity passports. Minor differences in predictive factors were found between countries and results were modelled separately to provide national accounts of these data. CONCLUSIONS Our research suggests that support for immunity passports is predicted by the personal benefits and social risks they confer. These findings generalized across six countries and may also prove informative for the introduction of vaccination passports, helping policy makers to introduce effective COVID-19 passport policies in these six countries and around the world.

scholarly journals Quality and Clinical Care Development in Spine Surgery—Connecting the Dots: An Expanded Clinical Narrative

2020 ◽  
Vol 10 (1_suppl) ◽  
pp. 10S-16S
Author(s):  
Sarah Hopkins ◽  
Polly Brune ◽  
Jens R. Chapman ◽  
Marc Horton ◽  
Rod Oskouian ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Care ◽  
Quality Care ◽  
Clinical Quality ◽  
Knowledge Process ◽  
Clinical Narrative ◽  
Spine Care ◽  
Evidenced Based ◽  
Connecting The Dots ◽  
Care Development

Our health care system is an evidenced-based quality-centric environment. Pursuit of quality is a process that encompasses knowledge development and care advancements through collaboration and expertise. Depicted here is the foundational knowledge, process, and contributions that hallmark successful clinical quality programs. Beginning with methodology, followed by process and form, we create the foundational knowledge and exemplars demonstrating framework and continuum of process in pursuit and attainment of successful clinical quality and care development for patients. Although our protocol has been devised for complex spine care, this could be implemented across all health care specialties to provide individualized and high-quality care for all current and future patients, all while creating a culture of accountability for physicians.

scholarly journals Overpriced? Are Hospital Prices Associated with the Quality of Care?

Healthcare ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 135
Author(s):  
Brad Beauvais ◽  
Glen Gilson ◽  
Steve Schwab ◽  
Brittany Jaccaud ◽  
Taylor Pearce ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Clinical Care ◽  
Healthcare Services ◽  
Cost Ratio ◽  
Performance Score ◽  
Significant Positive Association ◽  
The Public ◽  
Total Performance

In most consumer markets, higher prices generally imply increased quality. For example, in the automobile, restaurant, hospitality, and airline industries, higher pricing generally conveys a signal of complexity and superiority of a service or product. However, in the healthcare industry, there is room to challenge the price-quality connection as both health prices and health quality can be difficult to interpret. In the best of circumstances, health care costs, prices, and quality can often be difficult to isolate and measure. Recent efforts by the Trump Administration and the Center for Medicare and Medicaid Services (CMS) have required the pricing of hospital services to be more transparent. Specifically, hospital chargemaster (retail) prices must now be available to the public. However, many continue to question if the pricing of health care services reflects the quality of service delivery. This research focuses on investigating the prices hospitals charge for their services in relation to the costs incurred and the association with the quality of care provided. By analyzing data from a nationwide sample of U.S. hospitals, this study considers the relationship between hospital pricing (as measured by the charge-to-cost ratio) and hospital quality performance as measured by the Value Based Purchasing Total Performance Score (TPS) and its associated sub-domains. Results of the study indicate that hospital prices, as measured by our primary independent variable of interest, the charge-to-cost ratio, are significantly and negatively associated with Total Performance Score, Patient Experience, and the Efficiency and Cost Reduction domains. A marginal statistically significant positive association is shown in the Clinical Care domain. The findings indicate that unlike most other industries, in medicine, higher pricing compared to cost does not necessarily associate with higher quality and, in fact, might indicate the opposite. The results of this study suggest that purchasers of healthcare, at all levels, have justification in challenging the pricing of healthcare services considering the quality scores available in the public domain.

Who Is Listening? When Scholars Think They Are Talking to Congress

2014 ◽  
Vol 657 (1) ◽  
pp. 265-273
Author(s):  
Kenneth Prewitt
Keyword(s):  
Public Sphere ◽  
Science Policy ◽  
The Political ◽  
Political Climate ◽  
Short Term ◽  
Social Scientists ◽  
Public Funds ◽  
Policy Makers ◽  
The Public ◽  
The Public Sphere

The editors asked for my view on whether, in the current political climate, the recommendations in this volume of The ANNALS are likely to be heeded. The question that precedes this one is whether the volume’s contributors understand why policy-makers make use of science at all. “No” is the obvious answer, though I see this not as a failure particular to their effort but rather as a broader failure of social science. Getting the science right is a necessary but not sufficient step in getting it used. Social scientists have not investigated the use of science in policy in a serious way. They must if science is to have influence in the public sphere. I also comment on the political climate, unhelpfully described by many worried observers as antiscience. It is more informative to say that there is a Congress-led effort to push science policy and federal expenditures toward short-term and narrow national goals. This is harmful to science and consequently to the nation, and scientists should explain why. But they must also respect that science policy and setting priorities for spending public funds are congressional responsibilities.

scholarly journals Analyzing U.S. nurse turnover: Are nurses leaving their jobs or the profession itself?

2015 ◽  
Vol 4 (4) ◽  
pp. 48 ◽  
Author(s):  
Olena Mazurenko ◽  
Gouri Gupte ◽  
Guogen Shan
Keyword(s):  
Health Care ◽  
Registered Nurses ◽  
Quality Care ◽  
The United States ◽  
National Sample ◽  
Sample Survey ◽  
P Value ◽  
Health Care Managers ◽  
Policy Makers ◽  
Care Managers

Objective: To examine and compare factors associated with making the decision to vacate a job (organizational turnover) versus leaving the profession (professional turnover) among registered nurses (RN) in the United States (U.S.).Methods: Nationally representative data from the 2008 National Sample Survey of Registered Nurses was used. The sample consisted of 8,796 RNs who held an active RN license as of March 10, 2008, but changed a place of work or left the profession entirely. The analysis has been performed using SAS, version 9.3.Results: The results of binary logistic regression revealed that RNs who reported work-related disability (OR = 14.51; p-value: < .001), illness (OR = 3.32; p-value: < .001), experienced high physical demands (OR = 1.57; p-value: < .001) or burnout (OR = 1.39; p-value: < .001), were unsatisfied with their schedule (OR = 2.16; p-value: < .001), or staffing arrangements (OR = 1.41; p-value: < .001) were more likely to leave the profession. Whereas RNs who reported high levels of stress (OR = 0.59; p-value: < .001) were unsatisfied with the organization’s leadership (OR = 0.22; p-value: < .001), unsatisfied with their opportunity to advance their career (OR = 0.56; p-value: < .001), or were not adequately compensated (OR = 0.63; p-value: < .001), were more likely to leave the organization.Conclusions: Policy makers and health care managers should be aware of the different factors that are associated with RNs’ decision to leave the profession or an organization. Health care managers involved in the development of nurse retention strategies should address organizational leadership and consider development of comprehensive career development programs. Policy makers should consider allocating additional resources to ensure that RN workforce is of adequate size, is qualified, and is able to provide high quality care in the U.S..

scholarly journals Wi-Fi radiation levels at BCIT

2014 ◽  
Author(s):  
Ketan Minhas ◽  
BCIT School of Health Sciences, Environmental Health ◽  
Bobby Sidhu
Keyword(s):  
Reliability And Validity ◽  
Public Domain ◽  
The Body ◽  
Probability Level ◽  
Policy Makers ◽  
The Public ◽  
Average Value ◽  
The United Kingdom ◽  
Data Points ◽  
New Research

  Objective: To determine if there are any difference in the amount of EMF Wi-Fi radiation being emitted between three locations at the BCIT campus in Burnaby, BC. Background: Wi-Fi radiation is widely being used in today’s society for the quick access it gives us to connect to the internet. Some cities in the United Kingdom have installed many Wi-Fi devices throughout the public domain so people can be connected all the time. Furthermore, most schools are being outfitted with routers to provide internet access for their students. But, as this paper will show, new research is forcing a shift in the thinking of some policy makers in choosing to install these connections in the public domain. Method: To measure the amount of non-ionizing EMF radiation being absorbed by the body, an Extech RF meter was used. This instrument provides instantaneous and average readings for a particular area one measures. During the experiment, the RF meter was held stationary at one location for approximately 10-15 seconds in order to stabilize the reading. The average value was taken as the instantaneous reading was fluctuating. This process was done in 3 buildings at BCIT and in order to increase the reliability and validity, 30 data points were collected from each building. Results: The Tests of Assumption showed that the data was not normally distributed as there was more than one “Reject” at the 0.05 probability level. For analysis, the Krukal-Wallis One-Way ANOVA was utilized and results showed that due to a high probability level of 0.57, the H0 could not be rejected and as a result there are no differences in radiation levels being emitted into the buildings tested. Conclusion: The amount of Wi-Fi radiation in the three buildings tested at BCIT were not significantly different from one another.  

scholarly journals Papers please: Predictive factors for the uptake of national and international COVID-19 immunity and vaccination passports

2021 ◽  
Author(s):  
Paul Michael Garrett ◽  
Joshua Paul White ◽  
Simon Dennis ◽  
Stephan Lewandowsky ◽  
Cheng-Ta ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Policy Decision ◽  
Decision Makers ◽  
Policy Makers ◽  
The Public ◽  
The United Kingdom ◽  
Effective Policy ◽  
Generalized Linear Mixed Effects ◽  
The Uk ◽  
Representative Samples

In response to the COVID-19 pandemic, countries are introducing digital passports that allow citizens to return to normal activities if they were previously infected with (immunity passport) or vaccinated against (vaccination passport) SARS-CoV-2. To be effective, policy decision makers must know whether immunity and vaccination passports will be widely accepted by the public, and under what conditions? We collected representative samples across six countries – Australia, Japan, Taiwan, Germany, Spain, and the United Kingdom – during the 2020 COVID-19 pandemic to assess attitudes towards the introduction of immunity passports. Immunity passport support was moderate-to-low, ranging from 51% in the UK and Germany, down to 22% in Japan. Bayesian generalized linear mixed effects modelling controlling for each country showed neoliberal world views, personal concern and perceived virus severity, the fairness of immunity passports, and willingness to become infected to gain an immunity passport, were all predictive factors of immunity passport support. By contrast, gender (woman), immunity passport concern, and risk of harm to society predicted a decrease in support for immunity passports. Minor differences in predictive factors were found between countries. These findings will help policy makers introduce effective immunity passport policies in these six countries and around the world.

scholarly journals The Shared Principles of Primary Care: A Multistakeholder Initiative to Find a Common Voice

2019 ◽  
Vol 51 (2) ◽  
pp. 179-184
Author(s):  
Ted Epperly ◽  
Christine Bechtel ◽  
Rosemarie Sweeney ◽  
Ann Greiner ◽  
Kevin Grumbach ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Consensus Building ◽  
Patient Centered Medical Home ◽  
Multiple Stakeholders ◽  
Patient Centered ◽  
Policy Makers ◽  
The Public ◽  
Seven Principles ◽  
Family Centered

As America’s health care system continues to transform, the foundational importance of primary care becomes more clear. The Joint Principles of the Patient Centered Medical Home are now more than a decade old. As delivery reform continues, the importance of seven essential shared principles have emerged from a dynamic, collaborative, and iterative process of consensus building across multiple stakeholders. These seven principles will help the public, policy makers, payers, physicians, and other clinical providers speak with a unified voice about these core principles that define the enduring essence and value of primary care. The seven shared principles of primary care consist of: (1) person and family centered, (2) continuous, (3) comprehensive and equitable, (4) team based and collaborative, (5) coordinated and integrated, (6) accessible, and (7) high value. When used together, these shared principles provide a solid platform on which to build all further health care reform.

Patient Navigation and Cancer Care Delivery

2018 ◽  
Author(s):  
Harold P. Freeman ◽  
Melissa A. Simon
Keyword(s):  
Health Care ◽  
Cancer Care ◽  
Patient Navigation ◽  
Care Delivery ◽  
Clinical Care ◽  
Quality Care ◽  
Successful Implementation ◽  
Care Continuum ◽  
Patient Navigators ◽  
Health Care Delivery Systems

Although the US health care system offers the very best care to many, the poor and uninsured typically face challenges in accessing timely health care, even when faced with a life-threatening disease such as cancer. Spurred by unmet patient needs and the growing complexity of health care delivery systems, patient navigation seeks to diminish social, economic, cultural, and medical system barriers to timely quality care. This case study discusses the emergence of patient navigation as a strategy for improving cancer outcomes, especially among vulnerable populations. It explores challenges and opportunities related to advancing successful implementation of patient navigation across the cancer care continuum. It seeks to harness and apply the power and energy of patient navigators with the goal of guiding individuals across the health care continuum—from the communities where they live all the way through screening, diagnosis, and treatment at clinical care sites.

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