scholarly journals Provider Preference in Exam Room Layout Design and Computing

2019 ◽  
Vol 10 (05) ◽  
pp. 972-980
Author(s):  
Jacob M. Read ◽  
Dustin T. Weiler ◽  
Tyler Satterly ◽  
Catarina Soares ◽  
Jason J. Saleem
Keyword(s):  
Health Care Organizations ◽  
Patient Centeredness ◽  
Work Habits ◽  
Patient Interaction ◽  
Room Design ◽  
Semistructured Interviews ◽  
Exam Room ◽  
Provider Perspective ◽  
The One ◽  
Screen Sharing

Abstract Background The introduction of the electronic health record (EHR) has had a significant impact on provider–patient interactions, particularly revolving around patient-centeredness. More research is needed to understand the provider perspective of this interaction. Objectives Our objective was to obtain provider feedback on a new exam room design compared with the one already in use with respect to the computing layout, which included a wall-mounted monitor for ease of (re)-positioning. An additional objective was to understand elements of exam room design and computing that were highly valued. Methods Semistructured interviews were conducted with 28 providers from several health care organizations. Interviews were audio recorded and transcribed for analysis. We used an inductive coding approach to abstract recurrent themes from the data. Results Our analysis revealed several themes organized around exam room layout, exam room computing, and provider workflow. We report frequency of occurrence of the coded data for computer accessories, computing usefulness, computer mobility, documentation habits, form factor, layout preference, patient interaction, screen sharing, and work habits. Conclusion Providers in our study preferred exam room design to promote flexibility, mobility, and body orientation directed toward the patient. Providers also expressed the need for exam room design to support varying work habits and preferences, including whether to share the computer screen or not.

Research and Design Trends for Exam Room Computing to Enhance Patient Centeredness

2021 ◽  
Vol 65 (1) ◽  
pp. 196-200
Author(s):  
Jason J. Saleem ◽  
Laura G. Militello ◽  
Onur Asan ◽  
Jacob M. Read ◽  
Enid Montague
Keyword(s):  
Patient Communication ◽  
Patient Centeredness ◽  
Patient Centered ◽  
History Of Research ◽  
Room Design ◽  
Exam Room ◽  
History Of ◽  
Recent Trends ◽  
Research And Design ◽  
Improve Patient

While there is an extensive and established history of research that demonstrates the unfortunate capacity of exam room computing and electronic health records (EHRs) to negatively impact provider-patient communication and interaction, recent trends in exam room computing are promising in that there may be an opportunity for the EHR to improve patient engagement. The logical evolution of this research is to flip the narrative to understand strategies for using exam room computing as a mediator or facilitator of provider-patient communication and interaction, rather than simply establishing ways to mitigate the documented barriers. Panelists will present and discuss their latest research and experiences that may contribute to the evolution of using exam room computing as a tool to enhance provider-patient communication and interaction. We will also discuss how a thoughtful exam room design with patient-centered exam room computing technologies and practices may positively impact specific human factors, safety, and bias outcomes.

scholarly journals Field Investigation of Ambulatory Clinic Exam Room Design with respect to Computing Devices: A Pilot Study

2018 ◽  
Vol 62 (1) ◽  
pp. 518-522
Author(s):  
Jason J. Saleem ◽  
Dustin T. Weiler ◽  
Tyler Satterly ◽  
Maury A. Nussbaum ◽  
Neale R. Chumbler ◽  
...  
Keyword(s):  
Pilot Study ◽  
Situation Awareness ◽  
Primary Care Providers ◽  
Field Investigation ◽  
Care Providers ◽  
Patient Centeredness ◽  
Design Standard ◽  
Room Design ◽  
Study Results ◽  
Exam Room

The Department of Veterans Affairs (VA) has developed a new exam room design standard that is intended to facilitate a greater degree of patient centeredness. This new design includes a wall-mounted monitor on an armature system and a moveable table workspace. To date, however, this design has not been formally evaluated in a field setting. We conducted observations and interviews with primary care providers and their patients from three locations within the Phoenix VA Health Care System, in a pilot study comparing the new exam room design standard with the older legacy exam rooms. When using the new exam room layout, providers spent a greater proportion of time focused on the patient, spent more time in screen-sharing activities with the patient, and had a higher degree of self-reported situation awareness. However, the legacy exam rooms were perceived as better facilitating workflow integration. Provider and patient debrief interviews were supportive of the new exam room design. Overall, our field study results suggest that the new exam room design does contribute to a greater degree of patient centeredness, though more thorough evaluations are required to support these preliminary results.

scholarly journals The electronic health record as a patient engagement tool: mirroring clinicians’ screen to create a shared mental model

JAMIA Open ◽  
2018 ◽  
Vol 1 (1) ◽  
pp. 42-48 ◽  
Author(s):  
Onur Asan ◽  
Jeanne Tyszka ◽  
Bradley Crotty
Keyword(s):  
Patient Engagement ◽  
General Medicine ◽  
Clinic Visit ◽  
Care Process ◽  
Health Records ◽  
Exam Room ◽  
Quantitative Results ◽  
General Medicine Clinic ◽  
Electronic Health ◽  
Screen Sharing

Abstract Objective Electronic health records (EHRs) in physician offices can both enhance and detract from the patient experience. Best practices have emerged focusing on screen sharing. We sought to determine if adding a second monitor, mirroring the EHR for patients, would be welcome and useful for patients and clinicians. Materials and Methods This mixed-method study was conducted in a general medicine clinic from March to June 2016. Clinicians and patients met in a specially equipped exam room with a patient-facing monitor. Visits were video-recorded to assess time spent viewing the EHR and followed by interviews, which were transcribed and analyzed using established qualitative methods. Results Eight clinicians and 24 patients participated. Main themes included the second screen serving as a catalyst for patient engagement, augmenting the clinic visit in a meaningful way, improving transparency of the care process and documentation, and providing a substantially different experience for patients than a shared single screen. Concerns and suggestions for improvement were also reported. Quantitative results showed high patient engagement times with the EHR (25% of the visit length) compared to reports in previous studies. The median satisfaction score was 5 out of 5 for patients and 3.3 out of 5 for clinicians. Discussion and Conclusion Providing patient access to the EHRs with this design was linked with several benefits including improved patient engagement, education, transparency, comprehension, and trust. Future studies should explore how best to display information in such screens for patients and identify impact on care, safety, and quality.

scholarly journals Framing the Shades of Sustainability in Health Care: Pitfalls and Perspectives from Western EU Countries

2018 ◽  
Vol 10 (12) ◽  
pp. 4439 ◽  
Author(s):  
Elio Borgonovi ◽  
Paola Adinolfi ◽  
Rocco Palumbo ◽  
Gabriella Piscopo
Keyword(s):  
Health Care ◽  
Health Care Organizations ◽  
Health Care Systems ◽  
Financial Economic ◽  
Point Of View ◽  
Health Care Environment ◽  
Health Gains ◽  
Care Systems ◽  
The One ◽  
The Individual

Sustainability is momentous for the appropriate functioning of health care systems. In fact, health and sustainability are two strictly related values, which could not be separately sought. While studies discussing the contextualization of this issue with respect to the distinguishing attributes of health care systems are rapidly blooming, there is still little agreement about what is ultimately meant by sustainability in the health care arena. On the one hand, attention is primarily focused on the proper use of available financial resources; on the other hand, people engagement and empowerment are gradually arising as a crucial step to enhance the viability of the health care system. This paper tries to identify, from a conceptual point of view inspired by the European integrative movement, the different shades of sustainability in health care and proposes a recipe to strengthen the long-term viability of health care organizations. The balanced mix of financial, economic, political, and social sustainability is compelling to increase the ability of health care organizations to create meaningful value for the population served. However, the focus on a single dimension of sustainability is thought to engender several side effects, which compromise the capability of health care organizations to guarantee health gains at the individual and collective levels. From this standpoint, further conceptual and practical developments are envisioned, paving the way for a full-fledged understanding of sustainability in the health care environment.

Paradoxes of Practice Guidelines, Professional Expertise, and Patient Centeredness: The Medical Care Triangle

2018 ◽  
Vol 76 (4) ◽  
pp. 359-385 ◽  
Author(s):  
L. Michele Issel
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Practice Guidelines ◽  
Health Care Professionals ◽  
Health Care Organizations ◽  
Professional Expertise ◽  
Work Processes ◽  
Patient Centeredness ◽  
Medical Practitioners ◽  
Delivery Of Medical Care

The coexistence of institutionalized evidence-based practice guidelines, professional expertise of medical practitioners, and the patient centeredness approach form a triangle. Each component of this Medical Care Triangle has characteristics that create paradoxes for health care professionals and their patients. The value of a paradox lies in uncovering and utilizing the contradiction to better understand the underlying organizational phenomenon. Method: Following Poole and van de Ven’s (1989) suggested approaches to resolving paradoxes, each paradox of the Medical Care Triangle is defined and analyzed. Results: A total of 10 paradoxes related to practice guidelines, professional expertise, and patient centeredness are revealed. The resolution of each paradox yields insights specific to structuring health care organizations in ways that support the delivery of medical care. Implications: The results renew an emphasis on the centrality of practitioners’ work processes to health care organizations; this has potential benefits for organizations, clinicians/employees, and patients.

scholarly journals Choice of root canal irrigants by Serbian dental practitioners

2016 ◽  
Vol 73 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Goran Tosic ◽  
Milan Miladinovic ◽  
Milorad Kovacevic ◽  
Miodrag Stojanovic
Keyword(s):  
Root Canal ◽  
Web Page ◽  
Significance Level ◽  
Work Habits ◽  
Root Canal Irrigants ◽  
Dental Practitioners ◽  
Comprehensive Survey ◽  
Anesthetic Solution ◽  
The One ◽  
Observation Period

Background/Aim. Root canal treatment is considered to be the one of the most important procedures in endodontic treatment. To irrigate the root canal it is most common to use sodium hypochlorite (NaOCl), chlorhexodine, ethylenediami-netetraacetic acid (EDTA), local anesthetic solution, while the most used in Serbia is hydrogen peroxide (H2O2). The aim of this survey was to reveal the preferred root canal irrigants used by general dental practitioners in Serbia and to determine the influence of the continuing education program, delivered over the 3-year observation period, on work habits of dental practitioners. This was the first comprehensive survey of this nature carried out in Serbia. Methods. The survey was conducted in two instances, a 4-month observation period each, from November 1, 2009 to March 1, 2010 and from November 1, 2012 to March 1, 2013. Internet Web Page Survey was posted on the official web site of the Serbian Association of Private Dentists. In the first survey, 569 completed questionnaires were subjected to analysis. In the next attempt (3 years later), the survey was launched again and 615 completed questionnaires were analyzed using the same criteria. The statistical analysis was carried out with simple descriptive statistics applying the ?2 test, at a significance level of p < 0.05. Results. The first survey included 569 dental practitioners, while 3 years later the number of them was 615. Analyzing the questionnaires revealed the number of 10 to 30 interventins on the root canal montly. The most commonly used irrigant solution was H2O2 in 2009, while in 2012 it was yet H2O2, but also NaOCl, chlorhexodine, and a little less EDTA. Conclusion. This study shows significant changes in the irrigation protocol applied in Serbian dental community. After 3 years of observation, NaOCl became widely accepted as the irrigant of choice, whereas H2O2 lost its popularity.

scholarly journals How Health Care Organizations Approach Social Media Measurement: Qualitative Study

10.2196/18518 ◽  
2020 ◽  
Vol 4 (8) ◽  
pp. e18518 ◽  
Author(s):  
Chukwuma Ukoha
Keyword(s):  
Health Care ◽  
Social Media ◽  
Continuous Improvement ◽  
Health Care Organizations ◽  
Study Data ◽  
Consensus Approach ◽  
Health Care Settings ◽  
Australian Health ◽  
Conversion Rates ◽  
Semistructured Interviews

Background Many health care organizations use social media to support a variety of activities. To ensure continuous improvement in social media performance, health care organizations must measure their social media. Objective The purpose of this study is to explore how health care organizations approach social media measurement and to elucidate the tools they employ. Methods In this exploratory qualitative research, Australian health care organizations that use social media, varying in size and locality, were invited to participate in the study. Data were collected through semistructured interviews, and the transcripts were analyzed using thematic analysis. Results The study identified health care organizations’ approaches to social media measurement. While some measured their social media frequently, others used infrequent measurements, and a few did not measure theirs at all. Those that measured their social media used one or a combination of the following yardsticks: personal benchmarking, peer benchmarking, and metric benchmarking. The metrics tracked included one or more of the following: reach, engagement, and conversion rates. The tools employed to measure social media were either inbuilt or add-on analytics tools. Although many participants showed great interest in measuring their social media, they still had some unanswered questions. Conclusions The lack of a consensus approach to measurement suggests that, unlike other industries, social media measurement in health care settings is at a nascent stage. There is a need to improve knowledge, sophistication, and integration of social media strategy through the application of theoretical and analytical knowledge to help resolve the current challenge of effective social media measurement. This study calls for social media training in health care organizations. Such training must focus on how to use relevant tools and how to measure their use effectively.

scholarly journals Ambulatory Clinic Exam Room Design with respect to Computing Devices: A Laboratory Simulation Study

2018 ◽  
Vol 6 (3-4) ◽  
pp. 165-177 ◽  
Author(s):  
Dustin T. Weiler ◽  
Tyler Satterly ◽  
Shakaib U. Rehman ◽  
Maury A. Nussbaum ◽  
Neale R. Chumbler ◽  
...  
Keyword(s):  
Simulation Study ◽  
Laboratory Simulation ◽  
Ambulatory Clinic ◽  
Room Design ◽  
Exam Room

scholarly journals User Experiences and Preferences Regarding an App for the Treatment of Urinary Incontinence in Adult Women: Qualitative Study

10.2196/17114 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e17114 ◽  
Author(s):  
Nienke J Wessels ◽  
Lisa Hulshof ◽  
Anne M M Loohuis ◽  
Lisette van Gemert-Pijnen ◽  
Petra Jellema ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Qualitative Study ◽  
Mobile App ◽  
Adult Women ◽  
Adherence To Treatment ◽  
User Experiences ◽  
Face To Face ◽  
Semistructured Interviews ◽  
Data Saturation ◽  
The One

Background Although several apps are available to support the treatment of urinary incontinence (UI), little has been reported about the experiences and preferences of their users. Objective The objective of this study was to explore the experiences and preferences of women using a mobile app for the treatment of UI and to identify potential improvements to the app. We developed this app for three types of UI: stress UI, urgency UI, and mixed UI. Methods The participants in this qualitative study were women with self-reported stress UI, urgency UI, or mixed UI who used an app-based treatment to manage their condition for at least six weeks. Following the intervention, semistructured interviews were conducted to explore the participants’ experiences and preferences regarding the app. All interviews were audio-recorded, transcribed verbatim, and analyzed separately by two researchers. Results Data saturation was reached after interviewing 9 women (aged 32-68 years) with stress UI (n=1, 11%), urgency UI (n=3, 33%), or mixed UI (n=5, 56%). Accessibility, awareness, usability, and adherence emerged as the main themes. On the one hand, participants appreciated that the app increased their accessibility to care, preserved their privacy, increased their awareness of therapeutic options, was easy to use and useful, and supported treatment adherence. On the other hand, some participants reported that they wanted more contact with a care provider, and others reported that using the app increased their awareness of symptoms. Conclusions This qualitative study indicates that women appreciate app-based treatment for UI because it can lower barriers to treatment and increase both awareness and adherence to treatment. However, the app does not offer the ability of face-to-face contact and can lead to a greater focus on symptoms.

scholarly journals THE ROLE OF KINDERGARTEN IN THE FUNCTION OF PREPARING CHILDREN FOR STARTING SCHOOL

2021 ◽  
Vol 4 (1) ◽  
pp. 68-76
Author(s):  
Mejrima Tajar Škaljo
Keyword(s):  
Special Function ◽  
Kindergarten Children ◽  
Theoretical Research ◽  
Special Significance ◽  
Educational Preparation ◽  
Work Habits ◽  
The Family ◽  
Introductory Part ◽  
The One

The partnership between kindergarten and family has a special function and importance in the upbringing and education of the child. The content of the topic refers to the introductory part, which explains what we will be researching. The partnership between family and kindergarten has a special significance and role in the function of preparing children for school. Numerous definitions of family are mentioned in the literature, but given the diversity of structure, relationships, functions, ways of formation, there are many combinations and it could be said that each family is unique or a separate definition should be made for each family. The child is the center of attention in the partnership. The results show that parents are involved in kindergarten activities, and that they are available for cooperation. This is the first prerequisite for establishing, above all, quality communication, and thus cooperation. All parents are interested in the progress of their child and want to cooperate with the kindergarten in this area. This research is of a theoretical-empirical character. We used specifically descriptive statistics, which have special significance. The educational preparation of a child refers to what we call the formation of work habits of learning, on the one hand, and the acquisition of prior knowledge, on the other. Kindergarten children do not read or write, make figurines, play, draw, learn numbers up to ten. Educators need to continuously learn and establish a partnership with the family and the child, in order for the child to feel accepted, satisfied, happy and successful. It is certainly evident, through our theoretical research, that we can conclude that educators need to be specially educated to work with the population of preschool children with a special “dose” of sensibility. Key words: child, kindergarten, family.

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