Outcome measurement by graduate students in clinical practice: Trends and barriers to effective care

2013 ◽  
Author(s):  
Scott Waltman ◽  
Alyson Williams ◽  
Lisa Christiansen
Keyword(s):  
Clinical Practice ◽  
Graduate Students ◽  
Outcome Measurement ◽  
Effective Care

scholarly journals Service user and clinician perspectives on the use of outcome measures in psychological therapy

2015 ◽  
Vol 8 ◽  
Author(s):  
Graham R. Thew ◽  
Louise Fountain ◽  
Paul M. Salkovskis
Keyword(s):  
Clinical Practice ◽  
Service User ◽  
Outcome Measurement ◽  
Psychological Therapy ◽  
Service Development ◽  
Service Users ◽  
Routine Outcome Measurement ◽  
Episode Of Care ◽  
Wide Range ◽  
Clinician Perspectives

AbstractWhile the benefits of routine outcome measurement have been extolled and to some degree researched, it is surprising that service user opinions on this common therapy practice have largely not been investigated. This study aimed to assess service users’ experiences of completing measures during psychological therapy, with a view to exploring how therapists can maximize how helpful measures are in therapy. Fifteen participants completed surveys about the use of measures in their current episode of care. Ten clinicians also completed a survey about their use of, and views about, measures. Results showed that despite mixed experiences in how measures were explained and used, service users showed generally favourable attitudes towards their use in therapy, with them being perceived as most helpful when well integrated into sessions by their therapists. Clinicians reported using a wide range of measures, and generally endorsed positive beliefs about measures more strongly than negative ones. Implications for clinical practice, service development, and further research are discussed.

Patient Reported Outcome Measures in Neurologic Communication Disorders: An Update

2015 ◽  
Vol 25 (3) ◽  
pp. 114-120 ◽  
Author(s):  
Michael de Riesthal ◽  
Katherine B. Ross
Keyword(s):  
Clinical Practice ◽  
Outcomes Research ◽  
Outcome Measurement ◽  
Communication Disorders ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Patient Centered ◽  
Rehabilitation Outcomes ◽  
Patient Reported ◽  
Centered Care

In her seminal book on outcome measurement in the field of communication disorders, Carol Frattali (1998) set the path for outcomes research and clinical application in the field of speech-language pathology. In particular, she defined the many possible outcomes that can be measured to examine the influence of an intervention and the ways in which these measures can inform public policy. Of these, patient or client centered measures, which index outcome based on the patient's and family's or caregiver's perspective, have received increasing attention in recent research and clinical practice. These measures examine a variety of patient reported outcomes (PRO) associated with health. PRO measures are being used more commonly in clinical practice and as end points in medical and rehabilitation outcomes research. This perspective reflects the shift in medicine and rehabilitation toward patient-centered care. In this article, we will examine the rationale for using PRO measures, the advantages and challenges for using these tools, and current use of PRO measures in neurological communication disorders.

Improving the Care of Patients With Regard to Chemotherapy-Induced Nausea and Emesis: The Effect of Feedback to Clinicians on Adherence to Antiemetic Prescribing Guidelines

2003 ◽  
Vol 21 (7) ◽  
pp. 1373-1378 ◽  
Author(s):  
Wilson C. Mertens ◽  
Donald J. Higby ◽  
David Brown ◽  
Regina Parisi ◽  
Janice Fitzgerald ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Guideline Development ◽  
Outcome Measurement ◽  
Statistical Process ◽  
Chemotherapy Administration ◽  
Physician Participation ◽  
Delayed Nausea ◽  
Nausea And Emesis

Purpose: To evaluate the effect of performance and outcomes feedback on adherence to clinical practice guidelines regarding chemotherapy-induced nausea and emesis (CINE). Methods: Institutional CINE clinical practice guidelines were developed based on American Society of Clinical Oncology guidelines. Consecutive administrations of moderately/highly emetogenic chemotherapy were assessed for errors. Baseline statistical process control (SPC) charts were created and mean errors per administration were calculated. Prospective SPC charts were used to measure the effect of guideline development and distribution, a visiting lecturer, and ongoing feedback regarding compliance with guidelines employing SPC charts. Patients were surveyed regarding the extent and severity of CINE for 5 days postadministration. These outcomes were then shared with physicians. Results: Baseline compliance was poor (mean, 0.87 omissions per chemotherapy administration), largely because of inadequate adherence to recommendations for delayed CINE management. Most patients experienced delayed nausea, particularly on day 3 postchemotherapy. Physician prescribing performance did not undergo sustained improvement despite guideline development or distribution, a lecture by a visiting expert, or sharing of adherence data with clinicians. Once patient outcomes were shared, physicians accepted the need for compliance and instituted nurse practitioner antiemetic prescribing, with almost complete compliance and concurrent measurable reduction in day 3 nausea. SPC charts documented improvements in both outcomes. Conclusions: SPC charts effectively monitor ongoing compliance and patient symptoms and represent appropriate outcome measurement and change facilitation tools. However, physician participation in guideline development and evidence of poor compliance alone did not improve prescribing performance. Only evidence of patient CINE experience coupled with noncompliance improved results.

scholarly journals From outcome measurement to improving health outcomes following lower limb amputation - making outcome measurement work from a clinical practice perspective

2020 ◽  
Author(s):  
Chantel Ostler ◽  
Helen Scott ◽  
Imad Sedki ◽  
Sisary Kheng ◽  
Maggie Donovan-Hall ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Health Outcomes ◽  
Lower Limb ◽  
Care Delivery ◽  
Outcome Measurement ◽  
Narrative Review ◽  
Successful Outcome ◽  
Prosthetic Rehabilitation ◽  
Clinical Narrative ◽  
The Impact

Background: Outcome measurement is essential to understand the impact of clinical interventions and the performance of services. Despite national and professional encouragement outcome measurement has failed to become embedded in clinical practice and its value continues to be questioned. Objectives: To address the outcome measurement debate within lower limb prosthetic rehabilitation and provide a critical synthesis of the evidence surrounding the discussion applied within the clinical context of the UK National Health Service (NHS).Study Design: Narrative review Methods: The authors drew on over 20 years clinical experience in prosthetic rehabilitation to synthesise and critique the outcome literature across a breadth of healthcare services. A narrative review methodology was selected to give voice to the clinical narrative thread.Results: This review addresses why we should measure health outcomes, the health care delivery and organisational scenarios in which outcome measurement can be beneficial and explores where lessons can be learnt for prosthetic rehabilitation from approaches in different specialities. The current outcome measurement literature within prosthetic rehabilitation is critiqued and we discuss the issues facing this field in the future.Conclusions: The dilemma of successful outcome measurement in clinical practice is multifaceted. Understanding and embedding value at every step is key to success. Addressing the questions of `why’, `what’ and `how’ we measure outcome will move us closer to a national consensus. Routine outcome measurement implementation at the clinical level must ensure data collection is valuable to clinical practice, makes use of IT solutions and has all important organisational buy in.

scholarly journals It's not that bad: the views of consumers and carers about routine outcome measurement in mental health

2009 ◽  
Vol 33 (1) ◽  
pp. 93 ◽  
Author(s):  
Jennifer Black ◽  
Tania Lewis ◽  
Pamela McIntosh ◽  
Tom Callaly ◽  
Tim Coombs ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Outcome Measurement ◽  
Clinical Use ◽  
Self Assessment ◽  
Routine Outcome Measurement ◽  
The Past ◽  
Assessment Measure ◽  
Promotional Materials ◽  
Mandatory Use

The mandatory use of routine outcome measurement (ROM) has been introduced into all public sector mental health services in Australia over the past 6 years. Qualitative processes were used to engage consumers and carers in suggesting how the measures can be used in clinical practice. The project involved an audit by survey, followed by a range of interactive workshops designed to elicit the views of consumers, carers and clinicians, as well as to involve all parties in dialogue about ROM. In addition, there was engagement of consumers and carers in the training of clinicians in the clinical use of ROM, and in the production of promotional materials aimed at informing consumers and carers about ROM. When consumers and carers have had an opportunity to be involved in ROM they have found it a useful experience, and those who had not been involved can see the potential. Consumers and carers indicated that they believe the greatest opportunity arising from the suite of measures is the use of the consumer self-assessment measure the Behaviour and Symptom Identification Scale (BASIS-32).

scholarly journals Development of a Systematic Course On Orthodontic Temporary Anchorage Devices (TADs) for Orthodontic Residency Program

2021 ◽  
Author(s):  
Ziwei Tang ◽  
Yanzi Gao ◽  
Yiyin Chen ◽  
Lingling Pu ◽  
Lu Liu ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Graduate Students ◽  
Residency Program ◽  
Clinical Applications ◽  
West China Hospital ◽  
West China ◽  
Temporary Anchorage Devices ◽  
Different Types ◽  
Insertion Techniques ◽  
Baseline Levels

Abstract Background: Orthodontic temporary anchorage devices (TADs) offer absolute anchorage for clinical orthodontics. No systematic course on TADs has been described so far. The objectives of this study were to develop a systematic course on orthodontic TADs and to determine its teaching outcome.Methods: Five modules (fundamentals, anatomic sites, clinical applications, complications and insertion techniques, FACCI) were designed in this FACCI course on TADs. A total of 61 orthodontic graduate students from Department of Orthodontics, West China Hospital of Stomatology, Sichuan University were enrolled in this study. Baseline levels on the use of TADs were surveyed through a before-course questionnaire and the teaching outcomes were assessed through an after-course questionnaire.Results: After the course, significantly more students were willing to insert TADs by themselves (p<0.001). Students were significantly more familiar with the clinical applications of TADs for different types of tooth movements (p<0.001) and the insertion techniques of TADs at different anatomic sites (p<0.001). Before the course, most of the students had no knowledge on addressing TADs-associated complication and they were significantly more familiar with the techniques and skills of addressing TADs-associated complication after the course (p<0.001).Conclusions: The FACCI course on orthodontic TADs was effective and promoted the clinical applications of TADs in clinical practice among orthodontic graduate students.

Measuring outcomes and monitoring progress in the era of evidence-based clinical practice

2019 ◽  
Vol 20 (3) ◽  
pp. 276-288
Author(s):  
Robyn L. Tate
Keyword(s):  
Clinical Practice ◽  
Outcome Measurement ◽  
Presidential Address ◽  
Assessment Instruments ◽  
Scientific Quality ◽  
Evidence Based ◽  
Behavioural Assessment ◽  
The Status ◽  
Measuring Outcomes

AbstractHealth outcome measurement is a growth industry. Thousands of behavioural assessment instruments, developed for neurological populations alone, are available for diagnosis, prediction and evaluation of interventions. The task of selecting the best instrument for the purpose at hand is thus a daunting one for the clinician and researcher. Fortunately, there are guides that make the task easier. This presidential address covers three interrelated themes that inform assessment in neurorehabilitation: First, it reviews current concepts and the status of behavioural assessment in neurorehabilitation. It then examines evidence-based clinical practice as applied to assessment of function, along with methods to benchmark the scientific quality of assessment instruments. Finally, the article considers the need to move beyond outcome measurement in the neurorehabilitation setting.

scholarly journals Narrative Medicine to integrate patients’, caregivers’ and clinicians’ migraine experiences: the DRONE multicentre project

2021 ◽  
Author(s):  
Maria Clara Tonini ◽  
Alessandra Fiorencis ◽  
Rosario Iannacchero ◽  
Mauro Zampolini ◽  
Antonietta Cappuccio ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Social Impact ◽  
Care Pathway ◽  
Narrative Medicine ◽  
Illness Experience ◽  
Caregiving Burden ◽  
Written Narratives ◽  
Pathway Evolution ◽  
Effective Care ◽  
Headache Centres

Abstract Background Although migraine is widespread and disabling, stigmatisation and poor awareness of the condition still represent barriers to effective care; furthermore, research on migraine individual and social impact must be enhanced to unveil neglected issues, such as caregiving burden. The project investigated the migraine illness experience through Narrative Medicine (NM) to understand daily life, needs and personal resources of migraneurs, their caregivers and clinicians, and to provide insights for clinical practice. Methods The project involved 13 Italian headache centres and targeted migraneurs, their caregivers and migraine specialists at these centres. Written narratives, composed by a sociodemographic survey and illness plot or parallel chart, were collected through the project’s webpage. Illness plots and parallel charts employed open words to encourage participants’ expression. Narratives were analysed through Nvivo software, interpretive coding and NM classifications. Results One hundred and seven narratives were collected from patients and 26 from caregivers, as well as 45 parallel charts from clinicians. The analysis revealed migraine perception in social, domestic and work life within the care pathway evolution and a bond between chaos narratives and day loss due to migraine; furthermore, narratives suggested the extent of the caregiving burden and a risk of underestimation of migraine burden in patients’ and caregivers’ life. Conclusion The project represents the first investigation on migraine illness experience through NM simultaneously considering migraneurs’, caregivers’ and clinicians’ perspectives. Comparing narratives and parallel charts allowed to obtain suggestions for clinical practice, while NM emerged as able to foster the pursuing of migraine knowledge and awareness.

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