Using unexpected outcomes to inform patient care and future research

2014 ◽  
Author(s):  
Eleanor R. Mackey ◽  
Abigail M. Romirowsky ◽  
Marissa Tolep ◽  
Anna Vannucci ◽  
Evan Nadler
Keyword(s):  
Patient Care ◽  
Future Research ◽  
Unexpected Outcomes

scholarly journals Nursing morale: what does the literature reveal?

2006 ◽  
Vol 30 (4) ◽  
pp. 516 ◽  
Author(s):  
Gary E Day ◽  
Victor Minichiello ◽  
Jeanne Madison
Keyword(s):  
Patient Care ◽  
Health And Safety ◽  
Nursing Workforce ◽  
Future Research ◽  
Workplace Health ◽  
Safety Issues ◽  
Quality Patient Care ◽  
Considerable Cost ◽  
Workforce Issues ◽  
Health And Safety Issues

There is increasing attention to nursing workforce issues such as recruitment, retention, turnover, workplace health and safety issues and their impact on quality patient care. A number of these problems have been linked to poor morale. While there has been a lack of consensus on the determinants of morale, it is clear that the outcomes of poor morale not only add considerable cost to the organisation but also impact negatively on patient care. This article provides a systematic overview of the literature surrounding nursing morale and the variables identified in the literature that impact upon morale, and discusses the implications for future research.

scholarly journals Obstetrical safety indicators for preventing hospital harms in low risk births: a scoping review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e036203
Author(s):  
Aislinn Conway ◽  
Jessica Reszel ◽  
Mark C Walker ◽  
Jeremy M Grimshaw ◽  
Sandra I Dunn
Keyword(s):  
Patient Care ◽  
Scoping Review ◽  
Low Risk ◽  
Cochrane Library ◽  
Future Research ◽  
Primary Concern ◽  
Sources Of Information ◽  
Patient Safety Indicators ◽  
Scoping Reviews ◽  
Meta Analyses

IntroductionOptimising the safety of obstetric patient care is a primary concern for many hospitals. Performance indicators measuring aspects of patient care processes can lead to improvements in health systems and the prevention of harm to the patient. We present our protocol for a scoping review to identify indicators for obstetric safety in low risk births. We aim to identify indicators addressing preventable hospital harms, to summarise the data and synthesise results.Methods and analysisWe will use methods described by Arksey and O’Malley and further expanded by Levacet al. We will search electronic databases such as Medline, Embase, CINAHL and the Cochrane Library, and websites from professional bodies and other organisations, using an iterative search strategy.Two reviewers will independently screen titles and abstracts of search results to determine eligibility for inclusion. If eligibility is not clear, the reviewers will screen the full text version. If reviewers’ decisions regarding eligibility differ, a third reviewer will review the record. Two reviewers will independently extract data from records that meet our inclusion criteria using a standardised data collection form. We will narratively describe quantitative data, such as the frequency with which indicators are identified, and conduct a thematic analysis of the qualitative data. We will compile a comprehensive list of patient safety indicators and organise them according to concepts that best suit the data such as the Donabedian model or the Hospital Harm Framework. We will discuss the implications for future research, clinical practice and policy-making. We will report the conduct of the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews checklist.Ethics and disseminationThe sources of information included in this scoping review will be available to the public. Therefore, ethics approval is not warranted. We will disseminate results in a peer-reviewed publication, conference/event presentation(s) and stakeholder communications.

Practice-based Research Program Promotes Dietitians' Participation in Research

2016 ◽  
Vol 77 (1) ◽  
pp. 43-46 ◽  
Author(s):  
Frances Johnson ◽  
Agnes T. Black ◽  
Jiak Chin Koh
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Research Program ◽  
Online Survey ◽  
Administrative Support ◽  
Interdisciplinary Teams ◽  
Future Research ◽  
Care Organization ◽  
Practice Based Research ◽  
Participation In Research

Barriers to dietitians' participation in research include lack of time, self-perceived competence, confidence, administrative support, and funding. Providence Health Care, a multi-site health care organization in Vancouver, British Columbia implemented the Practice-based Research Challenge (RC), a 1-year research program, to support interdisciplinary teams of nurses and allied health professionals to conduct practice-relevant research projects. Funding, mentoring, and research education were provided to research teams. From 2011 to 2015, 37% of all dietitians in the organization were involved in the RC in 4 cohorts of the 1-year program. An online survey was conducted to understand these dietitians' interest and experience in the RC. The survey results indicated that the major reasons for participating in the program were to increase knowledge, improve patient care, and to work on a project of interest. Respondents thought they gained knowledge, enhanced professional development, and improved patient care. A majority stated they would likely conduct future research. The RC enabled and supported dietitians' participation in research; infrastructure supports for research and enabling a culture of research participation are key contributors to promoting dietitians involvement in research.

Patient experiences of care in localized prostate cancer.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 215-215 ◽  
Author(s):  
Michelle Mollica ◽  
Lisa M Lines ◽  
Timothy S. McNeel ◽  
Serban Negoita ◽  
Sarah Gaillot ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Survivors ◽  
Patient Care ◽  
Active Surveillance ◽  
Watchful Waiting ◽  
Patient Experiences ◽  
Localized Prostate Cancer ◽  
Outcome Variable ◽  
Future Research ◽  
Prostate Cancer Survivors

215 Background: Over 161,000 new prostate cancer patients diagnosed annually, with 75% diagnosed at early stages. Limited evidence exists supporting choice of treatment (including radical prostatectomy, radiation therapy, hormonal therapy, active surveillance or watchful waiting) for localized prostate cancer. Treatments have varying side effects associated with impaired functional status and health-related quality of life. Patient care experiences are important quality indicators, but research examining patient experiences by prostate cancer treatment is limited. The purpose of this study was to examine the association between treatment received (surgery, radiation, or no treatment) and CAHPS ratings of overall care over the prior six months. Methods: This study used data from SEER-CAHPS, which links Surveillance, Epidemiology, and End Results (SEER) data with Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient experience survey and Medicare claims data. Medicare Fee-for-Service beneficiaries ≥65 years with a National Comprehensive Cancer Network (NCCN) low- or intermediate-risk prostate cancer diagnosis were assigned to surgery only, radiation only, and no treatment received groups for analysis. The outcome variable was a CAHPS rating of overall care (0 = worst; 10 = best). The analysis adjusted for case mix and other cancer-specific variables. Results: The final cohort included 507 prostate cancer survivors (surgery n = 109 [21%]; radiation n = 197 [39%]; no treatment n = 201 [40%]). Respondents who received radiation rated their overall care higher than those not receiving treatment (adjusted mean 8.9 vs 8.3; p= 0.02). Ratings did not differ significantly between the surgery and no treatment groups. Conclusions: This study represents a first look at patient experiences among localized prostate cancer survivors receiving surgery, radiation, or no treatment. It is not clear whether those who did not receive treatment chose active surveillance or watchful waiting, or whether they did not have access to care, which could have affected results. Future research should explore associations between receipt of treatment and patient care experiences in an adequately powered sample to inform future interventions.

scholarly journals The Effect of Head Inclination on Intraocular Pressure in the Prone Position

2017 ◽  
Author(s):  
Vanessa Marzilli
Keyword(s):  
Systematic Review ◽  
Patient Care ◽  
Situation Awareness ◽  
High Reliability ◽  
Healthcare Providers ◽  
Information Management System ◽  
Future Research ◽  
Staff Satisfaction ◽  
Patient Handoff ◽  
The Impact

Patient safety relies on effective and efficient communication among healthcare providers. Tools, such as standardized checklists, ensure information sharing in a consistent, predictable format. In the perioperative setting, where handoffs occur at several points and among various disciplines, high reliability is essential. This systematic review focused on the impact of standardized communication practices on perioperative staff satisfaction as it relates to sustainability of the new practice. The electronic databases PubMed and Google Scholar were used. Six articles met inclusion for the systematic review and of these six, four were determined to be of high quality through the application of The CASE Worksheet. The handoff tools implemented in these four studies were the electronic anesthesia information management system (AIMS), I-PASS mnemonic that described the illness, patient summary, action list, situation awareness and synthesis by receiver, Peri-op Handoff Protocol and a variation of the ‘Surgical Safety Checklist’ originally developed by WHO. Results of this systematic review suggest that these standardized communication methods are effective in improving perioperative staff satisfaction. Further research may prove helpful to determine if one handoff tool design is superior to the others. While future research could be performed to provide a larger sample size, the limited data gathered from this systematic review shows promising results. Implementing a standardized approach to perioperative communication and patient handoff has been shown in these studies to be beneficial in terms of staff satisfaction. Furthermore, it would be valuable to examine the indirect impact these communication tools have on patient care. Healthcare providers have the responsibility and opportunity to improve patient care through the adoption of standardized communication processes.

scholarly journals Availability of Standard Operating Guidelines for Primary Healthcare Facilities in Sub-saharan Africa: A Scoping Review Protocol

2020 ◽  
Author(s):  
Nelly Sharpley ◽  
Desmond Kuupiel ◽  
Jacqueline Marina van Wyk
Keyword(s):  
Patient Care ◽  
Scoping Review ◽  
Primary Healthcare ◽  
Service Provision ◽  
Sub Saharan Africa ◽  
Quality Monitoring ◽  
Future Research ◽  
Standard Operating ◽  
Operational Management ◽  
Sub Saharan

Abstract Background: Primary healthcare (PHC) clinics play an essential role in the delivery of community-based health services, particularly in resource-limited settings. However, there is little systematic documentation on the availability of standard operating guidelines governing their operation or evaluating the services provided by PHC facilities. This study, therefore, will aim to systematically map literature and describe the evidence on the availability of standard operating guidelines or procedures for PHC facilities in sub-Saharan Africa (SSA).Methods: This scoping review study will be conducted inline with the Arksey and O'Malley's framework. PubMed, EBSCOhost (Academic search complete, CINAHL with full text, and Health Sources), Scopus, and Google Scholar will be searched from 2010 to 2020 for relevant evidence sources using a search strategy comprising of keywords, Boolean terms, and medical subject headings. This study will include evidence sources/studies written/published in English that focused standard on standard operating guidelines for staffing and operational management, patient care and service provision, and quality monitoring procedures to assess the functioning of PHC facilities in SSA. The screening of the evidence sources/studies at all the stages and the data extraction will be conducted independently by two reviewers. Thematic analysis will be carried out to identify the themes and sub-themes and the findings relating to this study's research question summarised and reported for each theme narratively. Discussion: This scoping review anticipates to highlight standard operating guidelines available for staffing and operational management, patient care and service provision, and quality monitoring procedures to assess the functioning of PHC facilities to inform the development of relevant standard operating guidelines to improve healthcare services at the primary level. This study also anticipates revealing literature gaps for future research to ensure the attainment of universal health coverage by 2030.

scholarly journals Pharmacists' Roles and Factors Affecting Patient Care in Korea

2015 ◽  
Vol 6 (1) ◽  
Author(s):  
Monica J. Hwang ◽  
Henry N. Young
Keyword(s):  
Patient Care ◽  
Pharmacy Practice ◽  
Community Pharmacists ◽  
Sampling Technique ◽  
Future Research ◽  
Original Research ◽  
Primary Role ◽  
Snowball Sampling ◽  
Factors Affecting ◽  
The Impact

Objectives: This study was conducted to explore Korean community pharmacists' perceptions of their roles in providing care to patients after the implementation of the Separation of Prescribing and Dispensing Act (SPD Act) and to investigate pharmacists' perceptions about factors that impact their patient care. Methods: Eight community pharmacists participated in semi-structured, face-to-face, in-depth interviews in Korea. A snowball sampling technique was used to obtain participants. Interviews were audio-recorded and transcribed. Interviews were analyzed using a summative content analysis procedure. Key findings: Participants' perceptions of their roles centered on dispensing prescriptions, educating and counseling patients, and helping patients with OTC products. Participants perceived time constraints due to prescription volume and patient expectations as factors influencing their provision of patient care. Conclusion: This study suggests that the SPD Act was successful in changing pharmacists' roles in the Korean health care system. None of the participants perceived their role to include prescribing, while all of the participants indicated that their primary role was to dispense medications. Future research should examine the pervasiveness of the themes identified in this study across Korean community pharmacy practice in order to generalize the impact of the SPD Act.   Type: Original Research

scholarly journals Future research trends in understanding the mechanisms underlying allergic diseases for improved patient care

Allergy ◽  
2019 ◽  
Vol 74 (12) ◽  
pp. 2293-2311 ◽  
Author(s):  
Heimo Breiteneder ◽  
Zuzana Diamant ◽  
Thomas Eiwegger ◽  
Wytske J. Fokkens ◽  
Claudia Traidl‐Hoffmann ◽  
...  
Keyword(s):  
Patient Care ◽  
Allergic Diseases ◽  
Research Trends ◽  
Future Research

scholarly journals MANAGING MANAGED CARE: PERSPECTIVES FROM KEY STAKEHOLDERS IN SKILLED NURSING FACILITIES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S498-S499
Author(s):  
Andrea E Daddato ◽  
Cynthia Drake ◽  
Edward A Miller ◽  
Pamela Nadash ◽  
Denise Tyler ◽  
...  
Keyword(s):  
Managed Care ◽  
Patient Care ◽  
Decision Makers ◽  
Skilled Nursing Facilities ◽  
Future Research ◽  
Fee For Service ◽  
Nursing Facilities ◽  
Skilled Nursing ◽  
Key Stakeholders ◽  
The Relationship

Abstract In recent years, Medicare Advantage (MA) plan enrollment has increased, a trend that is expected to continue. Many skilled nursing facilities (SNFs) rely on MA managed care insurer referrals to maintain their census in a market with high competition for post-acute care patients. This study used semi-structured interviews to describe the relationship between MA plans and SNFs from the perspective of key decision-makers in SNFs. Twenty-three interviews were conducted with key stakeholders from 11 Denver Metropolitan area SNFs. A combined purposive-snowball sampling approach was used to identify and recruit select staff from the participating facilities. Interviews focused on the relationship between MA plans and SNFs, including mechanisms of control, power dynamics, and preferences for MA versus Fee-for-Service (FFS) Medicare patients. Key findings included: 1) challenges SNF staff had navigating MA plans’ case management processes, a key mechanism used by MA plans to influence the behavior of SNF decision-makers; 2) MA plans exercising power over beneficiaries’ length of stay, potentially leading to early discharge and heightened risk for rehospitalization; 3) SNF preference for admitting Medicare FFS over MA patients due to higher rates of Medicare FFS reimbursement and greater control over patient care. SNFs are increasingly reliant on MA plans for patient referrals and revenue. The themes suggest that this growing reliance may place SNFs at odds with MA plans on how best to manage overall patient care. It is therefore important that future research investigate how MA plans’ influence over care affects patient outcomes in SNFs and other post-acute settings.

A Perspective on Incentive Design: Challenges and Opportunities

2019 ◽  
Vol 2 (1) ◽  
pp. 305-338
Author(s):  
Lillian J. Ratliff ◽  
Roy Dong ◽  
Shreyas Sekar ◽  
Tanner Fiez
Keyword(s):  
Resource Constraints ◽  
State Of The Art ◽  
Future Research ◽  
Tight Coupling ◽  
Incentive Design ◽  
New Class ◽  
Current State ◽  
Challenges And Opportunities ◽  
The Face ◽  
Unexpected Outcomes

The increasingly tight coupling between humans and system operations in domains ranging from intelligent infrastructure to e-commerce has led to a challenging new class of problems founded on a well-established area of research: incentive design. There is a clear need for a new tool kit for designing mechanisms that help coordinate self-interested parties while avoiding unexpected outcomes in the face of information asymmetries, exogenous uncertainties from dynamic environments, and resource constraints. This article provides a perspective on the current state of the art in incentive design from three core communities—economics, control theory, and machine learning—and highlights interesting avenues for future research at the interface of these domains.

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