The Role of Rehabilitation in Reducing Resource Use and Lowering Hospital Readmission Through Discharge Planning

Abstract The transitions between medical settings, the community and back again is a complex and intimidating process for patients, families and caregivers. These transitions are vulnerable points where planning is key and must begin at the initial examination with rehabilitation providers (PTs/OTs,SLPs). These providers are key members of the healthcare team to facilitate effective transition management. In this session, attendees will learn the critical factors rehabilitation providers use to evaluate patients in order to facilitate successful care transitions. An overview of the indications for rehabilitation referral will be presented, as well as evidence for effective rehabilitation strategies. The speaker will present tools from the American Physical Therapy Association Home Health Toolbox and outline a decision-making process for care transitions based on the individual, caregivers, and health care providers to achieve successful transitions that reduce resource use and hospital readmission rates. Attendees will learn strategies to facilitate inter-professional collaboration, communication, and advocacy.

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Withdrawing Versus not Offering Cardiopulmonary Resuscitation: Is There a Difference?

Canadian Respiratory Journal ◽

10.1155/2015/508602 ◽

2015 ◽

Vol 22 (1) ◽

pp. 20-22 ◽

Cited By ~ 2

Author(s):

Simon JW Oczkowski ◽

Bram Rochwerg ◽

Corey Sawchuk

Keyword(s):

Mechanical Ventilation ◽

Cardiopulmonary Resuscitation ◽

Health Care Providers ◽

Case Law ◽

Decision Makers ◽

Court Decisions ◽

Medical Team ◽

Care Providers ◽

Substitute Decision Makers ◽

The Individual

Conflict between substitute decision makers (SDMs) and health care providers in the intensive care unit is commonly related to goals of treatment at the end of life. Based on recent court decisions, even medical consensus that ongoing treatment is not clinically indicated cannot justify withdrawal of mechanical ventilation without consent from the SDM. Cardiopulmonary resuscitation (CPR), similar to mechanical ventilation, is a life-sustaining therapy that can result in disagreement between SDMs and clinicians. In contrast to mechanical ventilation, in cases for which CPR is judged by the medical team to not be clinically indicated, there is no explicit or case law in Canada that dictates that withholding/not offering of CPR requires the consent of SDMs. In such cases, physicians can ethically and legally not offer CPR, even against SDM or patient wishes. To ensure that nonclinically indicated CPR is not inappropriately performed, hospitals should consider developing ‘scope of treatment’ forms that make it clear that even if CPR is desired, the individual components of resuscitation to be offered, if any, will be dictated by the medical team’s clinical assessment.

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Patients’ Views on Self-Management of Chronic Musculoskeletal Pain

Izzivi prihodnosti ◽

10.37886/ip.2020.015 ◽

2020 ◽

Vol 5 (4) ◽

pp. 254-266

Author(s):

Barbka Huzjan ◽

Ivana Hrvatin

Keyword(s):

Health Care ◽

Chronic Pain ◽

Musculoskeletal Pain ◽

Health Care Providers ◽

Multidisciplinary Approach ◽

Research Question ◽

Chronic Musculoskeletal Pain ◽

Self Management ◽

Care Providers ◽

The Individual

Research Question (RQ): Chronic musculoskeletal pain is a complex condition and one of the most important causes of suffering of modern times. Self-management refers to the individual’s ability to manage the symptoms, treatment, physical and psychosocial consequences and life style changes inherent in living with a chronic condition. The research question is; what is the view on the selfmanagement of chronic musculoskeletal pain from the patient's perspective? Purpose: The purpose of this literature review was to review original articles that reported how selfmanagement educational programmes are viewed from the patient’s perspective. Method: We used an integrative review of the literature. The search was conducted from November 2019 to March 2020 on the PubMed, PEDro and OTseeker databases. We included original studies, written in English that examined the patients’ point of view on self-management. The included studies, needed to be conducted on adult patients of both sexes, that were suffering from chronic pain and were educated on self-management of their pain. Two authors independently searched for original studies. Results: Nine article were included in the review. Most of the studies included a multidisciplinary approach. Patients reported they more frequently used passive strategies to manage their pain. They want to be included in the management and be able to communicate with the provider of selfmanagement. There are several positive aspects of a multidisciplinary and groups approach. Organization: Health care providers can encourage an individual to proactively behave through ongoing processes of communication, partnerships and the creation of appropriate self-management plans over time. Society: We assume that the analysis will help to identify the social responsibility of the individual and society in the common concern for the health of the population and the individual within it. Originality: The research provides an up-to-date, new overview of the patients' perspective on self management on chronic pain. The review can be helpful to health care providers s they can compare their expectations with patients's. Limitations / further research: Further research would focus on high quality studies, and specific forms of multidisciplinary approach, and finding what patients use at a home setting and how to help them continue in the self management of their pain. Limitations of this review include the lack of risk of bias assessment and the fact that this is not a systematic review.

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“Swinging Pendulum”: Lives of Family Members Caring for A Dying Relative

10.31235/osf.io/tqzp6 ◽

2019 ◽

Author(s):

Robert Sumaguingsing ◽

Rudolf Cymorr Kirby Palogan Martinez

Keyword(s):

Health Care Providers ◽

Family Members ◽

Spiritual Support ◽

Care Providers ◽

Interpretive Phenomenology ◽

Home Setting ◽

Face To Face ◽

Van Manen ◽

Informal Carers ◽

The Individual

Among cultures which place emphasis on the centrality of family in ones lives, the care for the dying patient is more often than not delegated on family members. Given this context, it is interesting to note that few research have been done on the experiences of these individuals who provide care to their dying relatives. This research aims to understand the lives of these informal carers as they provide care to their dying relatives. After securing clearance from an IRB, seven (5) informants, deemed as coresearchers, were recruited and agreed to participate in this study. The co-researchers where selected based on a pre-set criteria and the number were reached based on theoretical saturation. Multiple individual in-depth face-to-face interviews were done to create the individual narratives which was later reflectively analysed. Interpretive phenomenology as espoused by van Manen served as the philosophical underpinning of the study. Consequently, the proposed analytic technique of van Manen was utilized as the process of reflective analysis. After the process of reflective analysis, three (3) themes were gathered, namely: Ambivalence in anticipation, Courage in uncertainty, Meaning in suffering. These themes represent for the co-researchers their lives as they care for their dying relatives. Further, these themes reflects for the co-researchers a phenomenon of living moment-to-moment, unsure of what tomorrow will bring, patiently waiting for their relative to cross over. For them, there seems to be a constant struggle of finding a reason for being and a sense of what has happened, what is happening and what could happen to their dying relative and their family after their death. This essence can be symbolically represented by a swinging pendulum, constantly in motion trying to situate ambivalence in their anticipation, looking for courage amidst uncertainty and finding formeaning in their experience of suffering. The insights suggest that there is a need for constant dialogue among family members and health care providers as they assumed the role of primary caregivers. Further continued emotional, moral and spiritual support is implied during this transition as well as follow-ups when the families are at the home setting.

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Achievements and Challenges in Implementing Urban Family Physician Program in Iran: Viewpoint of Managers and Executives

Quarterly Journal of Management Strategies in Health System ◽

10.18502/mshsj.v4i2.1410 ◽

2019 ◽

Author(s):

Mohammad Javad Kabir ◽

Hasan Ashrafian Amiri ◽

Zahra Hassanzadeh-Rostami ◽

Reza Momtahen ◽

Rasoul Zafarmand ◽

...

Keyword(s):

Health Care ◽

Health Care Providers ◽

Family Physician ◽

Cross Sectional Study ◽

Care Providers ◽

Cross Sectional ◽

Sustainable Resources ◽

Urban Family ◽

The Individual ◽

Challenges And Strategies

Background: Urban family physician program is one of the relatively large reforms in Iran's health care system implemented in Fars and Mazandaran provinces since 2012. Nearly five years after implementation of the program, this study aimed to identify the achievements and challenges of this program from the viewpoints of managers and administrators. Methods: This cross-sectional study was conducted in winter of 2016. The research population included administrators and experts monitoring the urban family physician program and representatives of the family physicians and health care providers selected using the census method. The data collection tool was a two-part researcher-made questionnaire containing 15 questions with confirmed validity. To collect data, 29 panels of experts were held and the collected information was analyzed by SPSS 23 using independent t-tests and ANOVA. Results: Among the total of 647 participants in 2 provinces, 1540 achievement cases, 2387 challenge cases, and 1641 strategies were found. The average numbers of achievements, challenges, and strategies stated by each person were 2.38 ± 2.0, 3.70 ± 2.7, and 2.54 ± 2.0, respectively. The most frequent achievements, challenges, and strategies were increased disease detection and care (430), untimely payment to physicians (198), and providing sustainable resources for timely payments (119). The means of achievements, challenges, and strategies had significant relationship with some of the individual and social variables (p < 0.05). Conclusion: This study showed that increasing the rate of detection was the most important achievement and lack of timely payment was the biggest challenge of the program, which should be considered by policy makers.

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Evidence of prophylaxis treatment in adult haemophiliacs

Hämostaseologie ◽

10.1055/s-0037-1619747 ◽

2011 ◽

Vol 31 (S 01) ◽

pp. S34-S37

Author(s):

J. Holzschuh ◽

K.-H. Beck

Keyword(s):

Health Care Providers ◽

Task Force ◽

Scientific Evidence ◽

Individual Case ◽

Opinion Leaders ◽

Care Providers ◽

Federal Joint Committee ◽

Randomized Controlled ◽

Set Up ◽

The Individual

SummaryIn contrast to children with haemophilia the scientific evidence of prophylaxis treatment in adults is not yet proven. Existing studies are of observational character and mostly retrospectively designed. Therefore, opinion leaders in this field postulate prospectively designed, randomized, controlled and multicentric studies to set up urgently needed guidelines. Evidence according to the Canadian task force ranking is assessed as level III with a re- commendation grade C by the authors.The recognition of benefits of health care providers in accordance with the German Federal Joint Committee generally demands a Grade- Ia to Ib evidence. As long as the actual evidence of prophylaxis in adult haemophiliacs does not meet the postulated criteria of the German Federal Joint Committee, prophylactic replacement therapy of the individual case has to be well documented and reasonably explained.

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A FRAMEWORK FOR CARE TRANSITIONS FOR OLDER ADULTS WITH COMPLEX HEALTH CONDITIONS

Innovation in Aging ◽

10.1093/geroni/igz038.2534 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S687-S687

Author(s):

Paul Stolee ◽

Jacobi B Elliott ◽

Kerry Byrne ◽

Joanie Sims-Gould ◽

Catherine Tong ◽

...

Keyword(s):

Older Adults ◽

Health Care ◽

Health Care Providers ◽

Service Use ◽

Care Transitions ◽

Ethnographic Study ◽

System Level ◽

Health Conditions ◽

Care Providers ◽

Framework Analysis

Abstract For older adults with complex health conditions, transitions between care settings are common and a major risk to quality of care and patient safety. Care transition interventions have shown positive impacts on continuity of care and health service use, however, most require additional human resources (e.g., transition coach), focus on one transition or “handoff”, and provide support for individual patients without addressing underlying challenges of health system integration. We sought to develop a framework for system-level enhancements to care transitions for older adults. We report a secondary framework analysis of an ethnographic investigation (the “InfoRehab” project) of care transitions for older persons who had experienced a hip fracture. The ethnographic study involved interviews, observations, and document reviews for 23 patients, 19 family caregivers, and 92 health care providers. Data were collected at each transition point (1-4/patient) along the care continuum, at three Canadian sites (large urban, mid-size urban, rural). Our framework analysis followed the approach described by Gale et al. (2013), using as cases 12 peer-reviewed papers which had reported InfoRehab results. Two researchers coded findings from each paper, then developed an analytical framework of eight themes by consensus; these include: patient involvement and choice, family caregiver involvement, patient complexity, health care provider coordination, information sharing, documentation, system constraints, and relationships. NVivo 11 was used to index findings into these themes and to generate a matrix. We are working with system stakeholders, including patients and caregivers, to apply this framework in the development of improved systems for care transitions.

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Consequences of Repression of Emotion: Physical Health, Mental Health and General Well Being

International Journal of Psychotherapy Practice and Research ◽

10.14302/issn.2574-612x.ijpr-18-2564 ◽

2019 ◽

Vol 1 (3) ◽

pp. 16-21

Author(s):

Jainish Patel ◽

Prittesh Patel

Keyword(s):

Mental Health ◽

Physical Health ◽

Health Care Providers ◽

Emotional Expression ◽

Well Being ◽

Psychological Processes ◽

Care Providers ◽

Holistic View ◽

The Individual ◽

General Wellbeing

The widely held belief that emotional and psychological processes affect our physical health, mental health and general well-being are central to a holistic view of the individual, and as such, it is a useful foundational concept in integrative medicine. The purpose of this paper is to review substantial amounts of the latest research and recent findings on this issue to enable us to throw some light on how inhibitory factors to emotional expression and experience can endanger our health, both physically and psychologically including our general wellbeing. In addition, the connection between repression of emotion and certain mental disorders like depression and scientifically proven healthy ways to manage issues bordering on emotion was outlined. The information contained in this paper is just as important to health care providers and also to the patients they deal with

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Developing HIV Assisted Partner Notification Services Tailored to Mexican Key Populations: A Qualitative Approach

10.21203/rs.3.rs-108692/v1 ◽

2020 ◽

Author(s):

Heleen Vermandere ◽

Santiago Aguilera-Mijares ◽

Liliane Martínez-Vargas ◽

M. Arantxa Colchero ◽

Sergio Bautista-Arredondo

Keyword(s):

Health Care ◽

Health Care Providers ◽

Partner Notification ◽

Essential Elements ◽

Care Providers ◽

Structured Interviews ◽

Hiv Diagnosis ◽

Hiv Awareness ◽

Sex With Men ◽

The Individual

Abstract Background. Assisted partner notification services (APNS) may increase HIV testing, early diagnosis, and treatment, but they are not formally implemented in Mexico, where the HIV epidemic is concentrated in men who have sex with men (MSM) and transwomen (TW).Methods. We conducted semi-structured interviews to explore partner notification with MSM, TW and health care providers to identify the essential elements to include in the design and implementation of APNS directed to MSM and TW in Mexico City. Afterwards, brainstorm sessions were carried out to produce strategies for implementing APNS.Results. Most participants reported experiences with informal partner notification, but not with APNS. Only one health care provider indicated assisting notification systematically. The main barriers for notifying mentioned by both MSM and TW included fear of (violent) reactions, discrimination and lacking contact information of casual partners. Participants thought it was easier notifying a formal partner, conditional of being well informed about HIV. Given current stigma and lack of awareness, it was suggested that APNS should be preceded by HIV awareness efforts, and be provided by counsellors or peers to mitigate potential rejection or violent reactions. Conclusions. While APNS are not formally implemented in Mexico, all participants supported the service, indicating that APNS can enhance early HIV diagnosis in Mexico. Strategies to implement such services need to be flexible addressing the individual needs of participants, guaranteeing the safety of more vulnerable participants.

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Developing HIV Assisted Partner Notification Services Tailored to Mexican Key Populations: A Qualitative Approach

10.21203/rs.3.rs-68392/v1 ◽

2020 ◽

Author(s):

Heleen Vermandere ◽

Santiago Aguilera-Mijares ◽

Liliane Martínez-Vargas ◽

M. Arantxa Colchero ◽

Sergio Bautista-Arredondo

Keyword(s):

Health Care ◽

Health Care Providers ◽

Partner Notification ◽

Essential Elements ◽

Care Providers ◽

Structured Interviews ◽

Hiv Diagnosis ◽

Hiv Awareness ◽

Sex With Men ◽

The Individual

Abstract Background. Assisted partner notification services (APNS) may increase HIV testing, early diagnosis, and treatment, but they are not formally implemented in Mexico, where the HIV epidemic is concentrated in men who have sex with men (MSM) and transwomen (TW). We conducted semi-structured interviews to explore partner notification with MSM, TW and health care providers to identify the essential elements to include in the design and implementation of APNS directed to MSM and TW in Mexico City. Afterwards, brainstorm sessions were carried out to produce strategies for implementing APNS. Results. Most participants reported experiences with informal partner notification, but not with APNS. Only one health care provider indicated assisting notification systematically. The main barriers for notifying mentioned by both MSM and TW included fear of (violent) reactions, discrimination and lacking contact information of casual partners. Participants thought it was easier notifying a formal partner, conditional of being well informed about HIV. Given current stigma and lack of awareness, it was suggested that APNS should be preceded by HIV awareness efforts, and be provided by counsellors or peers to mitigate potential rejection or violent reactions. Conclusions. While APNS are not formally implemented in Mexico, all participants supported the service, indicating that APNS can enhance early HIV diagnosis in Mexico. Strategies to implement such services need to be flexible addressing the individual needs of participants, guaranteeing the safety of more vulnerable participants.

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Implementation of public health practices in tribal populations of India: challenges and remedies

Healthcare in Low-resource Settings ◽

10.4081/hls.2013.e3 ◽

2013 ◽

Vol 1 (1) ◽

pp. 3 ◽

Cited By ~ 5

Author(s):

Saurabh Rambiharilal Shrivastava ◽

Prateek Saurabh Shrivastava ◽

Jegadeesh Ramasamy

Keyword(s):

Health Care Providers ◽

Family Health ◽

Healthcare Services ◽

Indigenous Populations ◽

Physical Factors ◽

Care Providers ◽

Innovative Strategies ◽

Administrative Reforms ◽

Tribal Populations ◽

The Individual

Large inequities in health exist between indigenous and non-indigenous populations worldwide. This health divide has also been demonstrated in India, where indigenous groups are officially classified as scheduled tribes (STs). India has one of the largest tribal populations in the world. Tribal communities in general and primitive tribal groups in particular are highly disease prone and their misery is compounded by poverty, illiteracy, ignorance of causes of diseases, hostile environment, poor sanitation, lack of safe drinking water, blind beliefs, etc. As per the estimates of National Family Health Survey-3 (NFHS-3), the likelihood of having received care from a doctor is lowest for ST mothers (only 32.8% compared to India of 50.2%). While many strategies have been attempted over the years to discuss some of the economic, social, and physical factors preventing tribal population to get access to healthcare services, the ultimate outcome has remained far less than the expectations. Considering that these ST groups are culturally and economically heterogeneous, the methods to tackle their health problems should not only be integrated and multi-fold, but also specific to the individual groups as feasibly as possible. Measures like strengthening of the existing human resources, bringing health services within the reach of remote populations, promotion of health awareness, facilitation of community participation using innovative strategies, bringing about a change in the behavior of health care providers, implementation of measures for the empowerment of ethnic groups by carrying out administrative reforms and finally by ensuring the sustainability of all above recommended measures.

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