Role of the clinical learning environment in preparing new clinicians to engage in quality improvement efforts to eliminate health care disparities

Author(s):  
Baretta R Casey ◽  
Marie Chisholm-Burns ◽  
Morgan Passiment ◽  
Robin Wagner ◽  
Laura Riordan ◽  
...  

Abstract Purpose The National Collaborative for Improving the Clinical Learning Environment offers guidance to health care leaders for engaging new clinicians in efforts to eliminate health care disparities. Summary To address health care disparities that are pervasive across the United States, individuals at all levels of the health care system need to commit to ensuring equity in care. Engaging new clinicians is a key element of any systems-based approach, as new clinicians will shape the future of health care delivery. Clinical learning environments, or the hospitals, medical centers, and ambulatory care clinics where new clinicians train, have an important role in this process. Efforts may include training in cultural humility and cultural competency, education about the organization’s vulnerable populations, and continuous interprofessional experiential learning through comprehensive, systems-based QI efforts focused on eliminating health care disparities. Conclusion By preparing and supporting new clinicians to engage in systems-based QI efforts to eliminate health care disparities, clinical learning environments are instilling skills and supporting behaviors that clinicians can build throughout their careers—and helping pave the road towards equity throughout the US health care system.

2016 ◽  
Vol 22 (3) ◽  
pp. 161-165 ◽  
Author(s):  
Stephen Nelson

Disparities based on race that target communities of color are consistently reported in the management of many diseases. Barriers to health care equity include the health care system, the patient, the community, and health care providers. This article focuses on the health care system as well as health care providers and how racism and our implicit biases affect our medical decision making. Health care providers receive little or no training on issues of race and racism. As a result, awareness of racism and its impact on health care delivery is low. I will discuss a training module that helps improve awareness around these issues. Until racial issues are honestly addressed by members of the health care team, it is unlikely that we will see significant improvements in racial health care disparities for Americans.


CNS Spectrums ◽  
2007 ◽  
Vol 12 (S13) ◽  
pp. 17-25
Author(s):  
Wayne J. Katon

Depression, which is increasingly regarded as a chronic condition, is associated with significant suffering, social and functional impairment, and an estimated $44 billion in direct and indirect costs annually in the United States. Despite this severe burden on the health care system, the management of depression remains suboptimal in primary care, where many depressed patients fail to receive adequate dosage and duration of treatment. Adherence to evidence-based guidelines, essential to improving outcomes, requires key structural changes to the US health care delivery system. Several health care models aimed at improving treatment adherence in patients with chronic illnesses have been evaluated in primary care settings with promising results. Those approaches that have been found to be effective advocate multifaceted collaborative interventions that target patients, families, physicians, and the organization of the health care system to improve adherence and depression outcomes. Enhancing education and the active participation of patients and their families are now considered important elements of interventions to improve adherence to the treatment of chronic illnesses, including depression.


2016 ◽  
Vol 5 (2) ◽  
pp. 29
Author(s):  
Olga V. Filatova ◽  
David Andrew Schultz

<p>What constitutes adequate medical care and how to deliver it is a problem states across the world confront as they face similar problems of rising costs, access, changing demographics, quality of service, and technological development. This article compares health care reform in the United States and the Russian Federation between 1990 and 2015. The Russian Federation begin this period with a process of rebuilding a health care system out of the previous centralized state-run Soviet system whereas the United States sought to change a health care system largely privately run and which separated health care delivery from health care insurance. Yet, despite differences these two countries and their health care systems have, they show interesting parallels, convergences, and lessons in terms of how reform occurs. In particular, this article demonstrates how both the American and Russian reforms have tried to use market incentives and the shifting to individuals some responsibility to contain costs, the use of government and non-governmental actors to provide health care and insurance, and various levels of centralization and decentralization of select services in order to address cost, quality, and access issues.</p>


2020 ◽  
pp. OP.20.00290
Author(s):  
Ronald M. Kline ◽  
Larissa K. F. Temple ◽  
Larissa Nekhlyudov

There are currently close to 17 million survivors of cancer in the United States. This number is expected to grow as both an aging population and improved treatment increase the number of survivors. Consequently, the importance of quality survivorship care has been recognized, but implementing, measuring, and paying for this care in a highly fragmented health care system, across a broad spectrum of diseases, is difficult. Quality measurement tied to payment is one approach that has commonly been used to improve the quality of care in the US health care system, but the complexity of applying quality measurement metrics across the spectrum of cancer survivorship care had led to stalemate. In this article, we draw on prior work to develop a quality cancer survivorship framework and propose a practical path forward with a focus on the provision of colon cancer survivorship care within integrated health care delivery networks. With this narrowly defined approach, we hope that we can promote a practical solution that can be extended to other diseases and payment systems over time.


PEDIATRICS ◽  
1983 ◽  
Vol 71 (2) ◽  
pp. 301-301
Author(s):  
PHILIP R. WYATT

To the Editor.— The report of the New England Regional Screening Program1 on neonatal hypothyroidism is a stunning illustration of the vulnerability of screening programs. It is unfortunate that this experience will probably be used as an argument to minimize the input of screening programs in the health care system in the United States. The report illustrates that, in addition to the 2% of the screened population that eluded the program, 14 infants with hypothyroidism escaped the full benefits of early detection and treatment.


Pharmacy ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 78 ◽  
Author(s):  
Jon Schommer ◽  
Lawrence Brown ◽  
Ryan Bortz ◽  
Alina Cernasev ◽  
Basma Gomaa ◽  
...  

Pharmacist workforce researchers are predicting a potential surplus of pharmacists in the United States that might result in pharmacists being available for engagement in new roles. The objective for this study was to describe consumer opinions regarding medication use, the health care system, and pharmacists to help identify new roles for pharmacists from the consumer perspective. Data were obtained from the 2015 and 2016 National Consumer Surveys on the Medication Experience and Pharmacist Roles. Out of the representative sample of 36,673 respondents living in the United States, 80% (29,426) submitted written comments at the end of the survey. Of these, 2178 were specifically about medicines, pharmacists or health and were relevant and usable for this study. Thematic analysis, content analysis, and computer-based text mining were used for identifying themes and coding comments. The findings showed that 66% of the comments about medication use and 82% about the health care system were negative. Regarding pharmacists, 73% of the comments were positive with many commenting about the value of the pharmacist for overcoming fears and for filling current gaps in their healthcare. We propose that these comments might be signals that pharmacists could help improve coordination and continuity for peoples’ healthcare and could help guide the development of new service offerings.


Author(s):  
Adinda Kharisma Apriliani ◽  
Eti Poncorini Pamungkasari ◽  
Amandha Boy Timor Randita

Background: Needs of health workers, especially general practitioners, relatively high in Indonesia. Career choices among medical students are various, such as general practitioner, specialist, medical researcher, etc. Many factors affect medical students’ career choices, one of them is learning environments. This study aims to prove the correlation between clerkship students’ perceptions of clinical learning environments and their career choices.Methods: This research was an analytical observational research with cross sectional approach. The subjects were clerkship students who underwent clinical rotation. The samples were 178 clerkship students from all departments. They were chosen by probability proportional to size sampling. Every respondent was given career choices questionnaire and PHEEM questionnaire which has analyzed for its validity and reliability with α≥0,6 (α=0,826) and r≥0,30 (r=0,442). The result of this study was analyzed by Chi-square test and followed by Contingency Coefficient with 95% confidence level (α = 0,05). Result: The result showed that students’ perception of clinical learning environment “good but still need improvement” category was nearly the same as “plenty of problems” category. The result on the students’ career choices, most students choose clinical career. There was significant correlation between perception of clinical learning environment and career choices on clerkship students of medical faculty, Sebelas Maret University with p <0,05 (p= 0,018), x2 count (x2=5,625) > x2 table (x2=3,841) and also very weak correlation (C= 0,189).Conclusion: There was very weak correlation between perception of clinical learning environments and career choice on clerkship students. 


2020 ◽  
Vol 6 (1) ◽  
pp. 41
Author(s):  
Ram Lakhan ◽  
Sean Y. Gillette ◽  
Sean Lee ◽  
Manoj Sharma

Background and purpose: Access to healthcare services is an essential component for ensuring the quality of life. Globally, there is inequity and disparities regarding access to health care. To meet the global healthcare needs, different models of healthcare have been adopted around the world. However, all healthcare models have some strengths and weaknesses. The purpose of this study was to examine the satisfaction among a group of undergraduate students from different countries with their health care models namely, insurance-based model in the United States and “out-of-pocket” model prevalent in low-income countries.Methods and materials: The study utilized a cross-sectional research design. Undergraduate students, representing different nationalities from a private Southeastern College, were administered a researcher-designed 14-item self-reported electronic questionnaire. Independent t-test and χ2 statistics were used to examine the differences between two health care systems and the qualitative responses were analyzed thematically.Results: Satisfaction towards health care system between the United States and low-income countries was found significantly different (p < .05). However, students in both settings experienced an inability toward affording quality healthcare due to economic factors and disparities.Conclusions: There is dissatisfaction with health care both in the United States and low-income developing countries among a sample of undergraduate students representing these countries. Efforts to ensure low-cost affordable health care should be a global goal.


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