scholarly journals Educational Experiences Within the Learning Community: ECHO Effects on Participants and Clients

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 433-434
Author(s):  
Kathleen Bishop ◽  
Yumi Shirai
Keyword(s):  
Learning Community ◽  
Qualitative Data ◽  
Community Care ◽  
Quality Care ◽  
Care Providers ◽  
Feedback Session ◽  
Project Echo ◽  
Potential Benefits

Abstract Although Project ECHO is a well-established, effective model to promote quality care in the general healthcare field, this project is the first attempt to implement the model with community care providers of individuals with IDD who are affected by dementia. In order to capture spokes’ (community providers and NTG-Affiliated Regional Trainers) experiences and explore potential benefits, we conducted a content analysis of qualitative data gathered from a spoke feedback session and follow-up surveys from the same group (n = 20). Our findings indicated that spokes appreciated (1) didactic sessions by gaining new knowledge; (2) in-depth, mutual discussion about their cases; (3) experts taking time and ensuring their good practices; and (4) the ability to apply this gained knowledge to their day-to-day practices to improve quality of life for individuals with IDD and their families. We will discuss specific examples that inform future practices.

Evaluation of medical care for Diabetic and Hypertensive patients in primary care in Mexico: Observational retrospective study (Preprint)

2020 ◽  
Author(s):  
Agustin Lara-Esqueda ◽  
Sergio A Zaizar-Fregoso ◽  
Violeta M Madrigal-Perez ◽  
Mario Ramirez-Flores ◽  
Daniel A Montes-Galindo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Medical Care ◽  
Serum Lipids ◽  
Quality Care ◽  
Premature Death ◽  
Current Standard ◽  
Anonymized Data ◽  
Quality Of Medical Care

BACKGROUND Diabetes Mellitus is a worldwide health problem and the leading cause of premature death with increasing prevalence over time. Usually, along with it, Hypertension presents and acts as another risk factor that increases mortality risk. Both diseases impact the country's health while also producing an economic burden for society, causing billions of dollars to be invested in their management. OBJECTIVE The present study evaluated the quality of medical care for patients diagnosed with diabetes mellitus (DM), hypertension (HBP), and both pathologies (DM+HBP) within a public health system in Mexico, according to the official Mexican standard for each pathology. METHODS 45,498 patients were included from 2012 to 2015. All information was taken from the electronic medical records database, exported as anonymized data for research purposes. Each patient record was compared against the standard to test the quality of medical care. RESULTS Glycemia with hypertension goals reached 29.6% in DM+HBP, 48.6% in DM, and 53.2% in HBP. The goals of serum lipids were reached by 3% in DM+HBP, 5% in DM, and 0.2% in HBP. Glycemia, hypertension, and LDL cholesterol reached 0.04%. 15% of patients had an undiagnosed disease of diabetes or hypertension. Clinical follow-up examinations reached 20% for foot examination and clinical eye examination in the whole population. Specialty referral reached 1% in angiology or cardiology in the whole population. CONCLUSIONS Goals for glycemic and hypertension reached 50% in the overall population, while serum lipids, clinical follow-up examinations, and referral to a specialist were deficient. Patients who had both diseases had more consultations, better control for hypertension and lipids, but inferior glycemic control. Overall, quality care for DM and/or HBP has not been met according to the standards. While patients with DM and HBP do not have a current standard to evaluate their own needs.

SynCardia Portable Freedom Driver: A Single-Center Experience with 11 Patients

2015 ◽  
Vol 10 (3) ◽  
pp. 188-194 ◽  
Author(s):  
Nilay R. Shah ◽  
Dawn E. Jaroszewski ◽  
Awais Ashfaq ◽  
Lucas A. Schroedl ◽  
Linda L. Staley ◽  
...  
Keyword(s):  
Hospital Readmission ◽  
Artificial Heart ◽  
Hemodynamic Instability ◽  
Total Artificial Heart ◽  
Single Center Experience ◽  
Time Period ◽  
Main Driver ◽  
Potential Benefits

Objective The portable Freedom Drive (SynCardia Inc, Tucson, AZ USA) for total artificial heart (TAH-t) support was approved for an investigational device exemption study in March 2010. We review our center's experience with the portable driver. Methods A retrospective review was conducted of patients who underwent TAH-t implantation and transfer to portable driver from September 2008 to June 2012, with follow-up through December 2012. Results A total of 30 patients underwent TAH-t implantation during this time period, with 11 patients successfully transferred to the Freedom Driver. Transfer to Freedom Driver after TAH-t implant was a median of 46 days (range, 225–86 days). Ninety-one percent (10) of 11 patients transferred to Freedom Driver were bridged to transplantation. One patient died on support. Five (45.5%) of 11 patients were discharged home and 5 (45.5%) remained in-patient on the portable driver before transplantation. Four patients (80%) successfully discharged home required at least 1 hospital readmission (range, 1–5 admissions per patient). Six patients (55%) transferred to the portable driver required a return to a main driver console. Two patients were temporarily maintained on the main driver then returned to the Freedom Driver for bridge to transplantation. Conclusions Patients with TAH-t can be considered for transfer to the portable Freedom Driver while awaiting transplantation. Issues that complicated this patient population included inadequate social support, hemodynamic instability, and concurrent morbidities. The potential benefits of the portable driver are currently undergoing assessment. These may include increased mobility and improved quality of life, opportunity for discharge home, and decreased overall medical costs.

scholarly journals Exploring Health Professionals’ Experiences With a Virtual Learning and Mentoring Program (Project ECHO) on Pediatric Palliative Care in South Asia

2021 ◽  
Vol 8 ◽  
pp. 2333794X2110430
Author(s):  
Megan Doherty ◽  
Shokoufeh Modanloo ◽  
Emily Evans ◽  
Jennifer Rowe ◽  
Dennis Newhook ◽  
...  
Keyword(s):  
Palliative Care ◽  
Online Education ◽  
South Asia ◽  
Learning Community ◽  
Health Care Providers ◽  
Qualitative Description ◽  
Pediatric Palliative Care ◽  
Healthcare Outcomes ◽  
Care Providers ◽  
Project Echo

Project ECHO (Extension of Community Healthcare Outcomes) is an innovative model of online education which has been proposed to enhance access to palliative care in resource-limited settings. There is limited literature describing how health care providers in low-and middle-income countries benefit from and learn from this type of training. This qualitative description study explores the learning experiences of participants in a Project ECHO program on pediatric palliative care in South Asia through focus group discussions. Discussions were transcribed, coded, independently verified, and arranged into overarching themes. We identified learning themes including the importance of creating a supportive learning community; the opportunity to share ideas and experiences; gaining knowledge and skills, and access to additional learning materials. Designing future programs to ensure a supportive and interactive learning community with attention cultural challenges may enhance learning from future Project ECHO programs.

scholarly journals An Assessment of Cancer Pain Control in an LMIC Oncology Clinic

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 230s-230s
Author(s):  
A. Joseph ◽  
O. Salako ◽  
A. Alabi ◽  
A. Adenipekun
Keyword(s):  
Quality Of Life ◽  
Cancer Pain ◽  
Pain Assessment ◽  
Pain Control ◽  
Assessment Tool ◽  
Study Group ◽  
Care Providers ◽  
Prevalence Of Pain

Background: Cancer has become a leading cause of morbidity and mortality in adults globally. Pain is universally one of the most commonly encountered symptoms by health and supportive care providers involved in care of cancer patients. Inadequate pain control negatively impacts the patient´s quality of life, and may slow down the healing process. Health care providers often ignore pain control as a target of treatment as they focus on reducing the tumor burden. Pain management should be considered an important target and end point in the treatment of cancer patients. Aim: To assess the prevalence of pain, oncologists´ prescribing patterns; and efficacy of pain control in the Radiotherapy Department of the Lagos University Teaching Hospital. Methods: Adult cancer outpatients were assessed using a Universal Pain Assessment Tool and followed up for 2-6 weeks thereafter. Pain scores were assessed at first interview and at the follow-up appointment within 2 weeks minimum and 6 weeks maximum. Results: 347 adult clinic attendees were recruited, assessed, and followed up with interviewer-administered questionnaires over a close-out period of 6 weeks. There was an 85% (298 respondents) prevalence of pain in the study group; with over half of respondents characterizing their pain in the moderate to severe ranges. [Figure: see text] 9 out of 10 respondents stated the cancer was the primary source of their pain. Other sources of pain were medical tests; and treatment-related such as chemotherapy and radiation therapy. 86 patients (29% of study group) were not asked about pain by their attending physician, and all respondents stated their physician had not used any pain assessment tool to determine the nature or severity of their pain. [Figure: see text] Oral nonsteroidal analgesics were the most frequently prescribed form of pain control (237 patients), with radiotherapy coming in second (69 patients). The only available strong opioid analgesics at the oncology pharmacy were oral morphine and parenteral pentazocine. Oxycodone, fentanyl pethidine, and hydromorphone were unavailable. Interventional (e.g., cordotomy) and alternative (e.g., massage) forms of pain control were not prescribed in any patients. 43 respondents (15%) despite being in pain, did not receive any form of treatment or recommendation for pain control. At follow-up appointment 2-6 weeks after; 4 out of 10 respondents had not obtained pain relief from instituted measures. [Figure: see text] Conclusion: Undertreatment of cancer pain remains a major concern. The treatment process must begin with a proper and thorough evaluation of the patient's pain; a clear pain control goal and end point target; and regular reevaluation with application of guidelines when adequate control is not achieved. Inclusion of pain assessment and management guidelines in medical training would be of benefit to reduce the prevalence of inadequately controlled pain in patients living with cancer; ultimately improving their quality of life.

Aged Care Residents’ Perspectives on Quality of Care in Care Homes: A Systematic Review of Qualitative Evidence

2021 ◽  
pp. 016402752198907
Author(s):  
Andrew S. Gilbert ◽  
Stephanie M. Garratt ◽  
Leona Kosowicz ◽  
Joan Ostaszkiewicz ◽  
Briony Dow
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Quality Care ◽  
Care Home ◽  
Aged Care ◽  
Care Homes ◽  
Care Providers ◽  
Eligibility Criteria ◽  
Qualitative Evidence

There is increasing interest in harnessing aged care residents’ perspectives to drive quality improvement in aged care homes. We conducted a systematic review of qualitative evidence including literature examining residents’ descriptions of “quality of care” in aged care homes, using database searches and screening records according to eligibility criteria. Three independent reviewers conducted quality assessment of forty-six eligible articles and performed thematic synthesis of articles’ findings. We distinguish nine key themes describing factors influencing quality care: staffing levels, staff attitude, continuity, routine, environment, decision-making and choice, dignity of risk, activities, and culture and spirituality. While many themes were consistent across studies, residents’ prioritization of them varied. Aged care home residents have differing conceptions of quality care as well as heterogeneous and dynamic needs and preferences. Care providers are best able to facilitate quality care when intentional efforts are made to recognize this and tailor delivery of services the individual residents.

scholarly journals AB1298-HPR RHEUMA-VOR: A PROOF-OF-CONCEPT NETWORK STUDY FOR THE IMPROVEMENT OF RHEUMATOLOGICAL HEALTH CARE THROUGH COORDINATED COOPERATION

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1939.2-1940
Author(s):  
M. Dreher ◽  
R. E. Schmidt ◽  
T. Witte ◽  
G. Assmann ◽  
K. Hoeper ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Primary Care Providers ◽  
Multidisciplinary Teams ◽  
Inflammatory Rheumatic Diseases ◽  
Sustained Remission ◽  
Window Of Opportunity ◽  
Care Providers ◽  
Suspected Diagnosis

Background:Rheumatoid arthritis (RA), psoriasis arthritis (PsA) and spondyloarthritis (SpA) are the most common chronic inflammatory rheumatic diseases. For all three diseases, the so-called “window of opportunity” [1,2,4] has been identified as the decisive factor affecting the outcome.Objectives:The aim of the prospective study is to improve the early diagnosis of RA, PsA and SpA and thus positively impact the quality of care for patients with the support of coordinating centers.Methods:Primary care providers are given access to screening questionnaires to document potential early cases of RA, PsA, and SpA, based on characteristic symptoms. These are evaluated by multidisciplinary teams at the regional coordinating centers. If they fulfill the criteria for referral, patients get an appointment at a cooperating rheumatology specialist within weeks. If a rheumatic disease is diagnosed, physicians and patients receive questionnaires about sociodemographic, physilogical and psychological parameters.In order to increase the quality of referrals, a 15-minute rheumatological consultation at the ACURA Rheumatology Center was implemented for all patients from Rhineland-Palatinate whose suspected diagnosis was confirmed by the coordination centre. In course of this, the Rheuma-VOR Screening-App will also be developed and optimized. The cooperating partners and additional information are already published [5].Results:Preliminary data (31 Dec 2019) are presented. In Rhineland-Palatinate, Saarland and Lower Saxony, 4942 suspected diagnoses of 1526 different referring physicians have now been reported. A total of 2578 patients were referred by the three coordination centres to one of the 49 participating rheumatological specialists. 1004 patients were diagnosed with one of the three diseases. About 306 patients have already taken the follow-up appointment after one year.In course of a screening consultation 736 patients have been screened to date. The patients have to wait in average about 42 days from the suspected diagnosis to the rejected or confirmed rheumatological diagnosis.Conclusion:Although the average waiting time for all three diseases is currently almost twice as long as the 23.9 days in the Rhineland-Palatinate predecessor project ADAPTHERA which just focuses on RA, the current results are very positive compared to the national average [3]. The aim is to further increase the screening quality and screening numbers, especially in the 1-year follow-up.Current data will be presented at the conference.References:[1]Boehncke WH, Menter A (2013) Burden of disease: psoriasis and psoriatic arthritis. Am J Clin Dermatol 14:377-388[2]Claudepierre P (2014) Spondyloarthritis: a window of opportunity? Joint Bone Spine 81:197-199[3]Lauter A, Triantafyllias K, Leiß R et al. (2019) ADAPTHERA—Statewide cross-sectoral care network for patients with early rheumatoid arthritis shows sustained remission in standard care. ZRheumatol. 78 (7): 660–669[4]O’dell JR (2002) Treating rheumatoid arthritis early: a window of opportunity? Arthritis Rheum 46:283-285[5]Schwarting A (2018) From ADAPTHERA to Rheuma-VOR: Concept of Coordinated Cooperation to Improve the Quality of Rheumatology Care Akt Rheumatol 43 (05): 406-409Acknowledgments:The authors thank all partners and participants of Rheuma-VORDisclosure of Interests:Matthias Dreher: None declared, Reinhold E. Schmidt: None declared, Torsten Witte: None declared, Gunter Assmann: None declared, Kirsten Hoeper Consultant of: AbbVie, Celgene,, Speakers bureau: Abbvie, Chugai, Novartis, Lilly, Celgene, Sandoz Hexal, Konstantinos Triantafyllias: None declared, Jan Zeidler: None declared, Harald Binder: None declared, Andreas Schwarting: None declared

scholarly journals Quality of sex life and perceived sexual pleasure of PrEP users in the Netherlands

2020 ◽  
Author(s):  
Mart van Dijk ◽  
John de Wit ◽  
Thomas Guadamuz ◽  
Joel Eduardo Martinez ◽  
Kai Jonas
Keyword(s):  
Health Care Providers ◽  
Sexual Pleasure ◽  
Care Providers ◽  
Positive Effects ◽  
Quality Of Sex Life ◽  
Psychosocial Benefits ◽  
Promotion Campaigns ◽  
Preventive Effects

Next to its benefits for HIV prevention, PrEP may have psychosocial benefits relating to improved quality of sex life. The aim of the current study was to investigate the onset of changes in quality of sex life and sexual pleasure of PrEP users in the first months of commencing PrEP use. Moreover, we investigated what factors were related to the quality of sex life of PrEP users. We recruited 145 participants via the Dutch PrEP-advocacy website PrEPnu.nl, and they received follow-up questionnaires after three and six months. We found that PrEP users reported an increase in the quality of their sex life, which was related to reduced fear of HIV since they started using PrEP, but not to decreased condom use. PrEP users were more interested in experimenting with sex practices, but they did not always feel more desirable as a sex partner because of PrEP use. Health care providers and health promotion campaigns could emphasize the positive effects of PrEP on the quality of sex life, in addition to the HIV-preventive effects of PrEP, to decrease PrEP stigma and increase PrEP uptake.

scholarly journals Judgment of the Quality of Restorative Care as Predictors of Restoration Retreatment: Findings from the National Dental PBRN

2016 ◽  
Vol 2 (2) ◽  
pp. 151-157 ◽  
Author(s):  
J.L. Riley ◽  
G.H. Gilbert ◽  
G.W. Ford ◽  
J.L. Fellows ◽  
B. Rindal ◽  
...  
Keyword(s):  
Quality Care ◽  
Permanent Tooth ◽  
Additional Treatment ◽  
Dental Patients ◽  
Patient Satisfaction Survey ◽  
Subjective Assessments ◽  
The Cost ◽  
Dental Work

The primary aim of this study was to test the hypothesis that a patient’s subjective assessments of the dentist’s technical competence, quality of care, and anticipated restoration longevity during a restorative visit are predictive of restoration outcome. This prospective cohort study involved 3,326 patients who received treatment for a defective restoration in a permanent tooth, participated in a baseline patient satisfaction survey, and returned for follow-up. Of the 4,400 restorations that were examined by 150 dentists, 266 (6%) received additional treatment after baseline. Reporting satisfaction with the technical skill of the dentist or quality of the dental work at baseline was not associated with retreatment after baseline. However, patients’ views at baseline that the fee was reasonable (odds ratio [OR], 1.6) was associated with retreatment after baseline, whereas satisfaction at baseline with how long the filling would last (OR, 0.6) was associated with less retreatment. These findings suggest that retreatment occurs more often for patients who at baseline are satisfied with the cost or who at baseline have less confidence in the restoration. The authors found no associations between restoration retreatment and the patients’ baseline evaluations of the technical skills of their dentists or perceptions of quality care. Knowledge Transfer Statement: Dental patients’ ratings of their dentist’s skills were not related to a restoration needing retreatment. Patients focus on other aspects of the dental visit when making this judgment.

scholarly journals Effect of Intradialytic Exercise on Hyperphosphatemia and Malnutrition

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2464 ◽  
Author(s):  
Nada Salhab ◽  
Mona Alrukhaimi ◽  
Jeroen Kooman ◽  
Enrico Fiaccadori ◽  
Harith Aljubori ◽  
...  
Keyword(s):  
United Arab Emirates ◽  
Moderate Intensity ◽  
Post Intervention ◽  
Post Evaluation ◽  
Study Results ◽  
Quasi Experimental ◽  
Potential Benefits ◽  
Intradialytic Exercise

Intradialytic exercise (IDE) is not routinely prescribed in hemodialysis (HD) units despite its potential benefits on patients’ outcomes. This study was the first in the United Arab Emirates to examine the effect of aerobic IDE on hyperphosphatemia, malnutrition, and other health outcomes among HD patients. Participants were chosen from the largest HD unit in Sharjah Emirate for a quasi-experimental intervention with pre and post evaluation. The study lasted for 12 months. Study parameters were collected at baseline, post intervention, and follow-up. The intervention included a moderate-intensity aerobic IDE of 45 min per HD session; intensity was assessed using the Borg Scale. Patients were educated on the importance of exercise. Study outcomes were serum phosphorus (P), malnutrition inflammation score (MIS), quality of life (QOL), and pertinent blood tests. Forty-one eligible consenting HD patients were included in the study. Results at follow-up showed a non-significant reduction in P (p = 0.06) in patients who were hyperphosphatemic at baseline, but not in the sample as whole. MIS did not deteriorate throughout the study (p = 0.97). IDE resulted in a non-significant increase in the QOL visual analogue scale (p = 0.34). To conclude, aerobic IDE for 45 min is safe and could be beneficial, especially for hyperphosphatemic patients.

scholarly journals Historical perspective on antipsychotic long-acting injections

2009 ◽  
Vol 195 (S52) ◽  
pp. s7-s12 ◽  
Author(s):  
D. A. W. Johnson
Keyword(s):  
Historical Context ◽  
Research Literature ◽  
Past Century ◽  
Potential Benefits ◽  
Potential Success ◽  
Long Acting ◽  
Made In

BackgroundClinical experience has shown considerable potential benefits from long-term continuous medication for chronic or relapsing forms of schizophrenia. These benefits have not always been realised.AimsTo review the research literature in order to understand the problems of long-term medication and use of antipsychotic oral medication and long-acting injections (LAIs), and to place these in an historical context.MethodReview of literature.ResultsResearch showed that the potential success of LAI therapy depends on the quality of the follow-up service.ConclusionsFollowing the advent of second-generation oral antipsychotics confidence in the use of LAIs has eroded and that mistakes made in LAI use during the past century may be repeated.

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