scholarly journals COVD-14. TELEMEDICINE REVIEW IN NEURO-ONCOLOGY: COMPARATIVE EXPERIENTIAL ANALYSIS FOR BARROW NEUROLOGICAL INSTITUTE AND GEISINGER HEALTH DURING THE 2020 COVID-19 PANDEMIC

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii23-ii23
Author(s):  
Ekokobe Fonkem ◽  
Na Tosha Gatson ◽  
Ramya Tadipatri ◽  
Amir Azadi
Keyword(s):  
New Technologies ◽  
Task Force ◽  
Care Delivery ◽  
Pathways To Care ◽  
Mobility Limitations ◽  
Limited Mobility ◽  
Infectious Risk ◽  
Visit Adherence ◽  
Care Systems ◽  
Patient Care Delivery

Abstract Coronavirus disease 2019 (COVID-19) has grossly impacted how we deliver healthcare and how healthcare institutions derive value from the care provided. at increased infectious risk on immunosuppressive therapies and often have mobility limitations. Adapting to new technologies and reimbursement patterns were challenges that had to be met by the institutions while patients struggled with decisions to prioritize concerns and to identify new pathways to care. With the implementation of social distancing practices, telemedicine plays an increasing role in patient care delivery, particularly in the field of Neurology. This is of particular concern in our cancer patient population given that these patients are often at increased infectious risk on immunosuppressive therapies and often have mobility limitations. We reviewed telemedicine practices in neurology pre-/post-COVID-19 and evaluated the neuro-oncology clinical practice approaches of two large care systems, Barrow Neurological Institute and Geisinger Health. Practice metrics were collected for impact on clinic volumes, institutional recovery techniques, and task force development to address COVID-19 specific issues. Neuro-Oncology divisions reached >67% of pre-pandemic capacity (patient visits and slot utilization) within 3-weeks and returned to >90% capacity within 6-weeks of initial closures due to COVID-19. The two health systems rapidly and effectively implemented telehealth practices to recover patient volumes. While telemedicine will not replace the in-person clinical visit, telemedicine will likely continue to be an integral part of neuro-oncologic care. Telemedicine has potential for expanding access in remote areas and provides a convenient alternative to patients with limited mobility, transportation, or other socioeconomic complexities that otherwise challenge patient visit adherence.

scholarly journals Telemedicine review in neuro-oncology: comparative experiential analysis for Barrow Neurological Institute and Geisinger Health during the 2020 COVID-19 pandemic

2020 ◽  
Author(s):  
Ekokobe Fonkem ◽  
Na Tosha N Gatson ◽  
Ramya Tadipatri ◽  
Sara Cole ◽  
Amir Azadi ◽  
...  
Keyword(s):  
Health Care ◽  
New Technologies ◽  
Task Force ◽  
Care Delivery ◽  
Pathways To Care ◽  
Mobility Limitations ◽  
Limited Mobility ◽  
Infectious Risk ◽  
Care Systems ◽  
Patient Care Delivery

Abstract Coronavirus disease 2019 (COVID-19) has grossly affected how we deliver health care and how health care institutions derive value from the care provided. Adapting to new technologies and reimbursement patterns were challenges that had to be met by the institutions while patients struggled with decisions to prioritize concerns and to identify new pathways to care. With the implementation of social distancing practices, telemedicine plays an increasing role in patient care delivery, particularly in the field of neurology. This is of particular concern in our cancer patient population given that these patients are often at increased infectious risk on immunosuppressive therapies and often have mobility limitations. We reviewed telemedicine practices in neurology pre– and post–COVID-19 and evaluated the neuro-oncology clinical practice approaches of 2 large care systems, Barrow Neurological Institute and Geisinger Health. Practice metrics were collected for impact on clinic volumes, institutional recovery techniques, and task force development to address COVID-19 specific issues. Neuro-Oncology divisions reached 67% or more of prepandemic capacity (patient visits and slot utilization) within 3 weeks and returned to 90% or greater capacity within 6 weeks of initial closures due to COVID-19. The 2 health systems rapidly and effectively implemented telehealth practices to recover patient volumes. Although telemedicine will not replace the in-person clinical visit, telemedicine will likely continue to be an integral part of neuro-oncologic care. Telemedicine has potential for expanding access in remote areas and provides a convenient alternative to patients with limited mobility, transportation, or other socioeconomic complexities that otherwise challenge patient visit adherence.

Delivering Coordinated Cancer Care by Building Transactive Memory in a Team of Teams

2016 ◽  
Vol 12 (11) ◽  
pp. 992-999 ◽  
Author(s):  
Elizabeth Henry ◽  
Abigail Silva ◽  
Elizabeth Tarlov ◽  
Cheryl Czerlanis ◽  
Margie Bernard ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Care ◽  
Care Delivery ◽  
Health Care Systems ◽  
Oral Treatment ◽  
Transactive Memory ◽  
Health Care Use ◽  
Care Systems ◽  
Potential Strategy ◽  
Patient Care Delivery

Cancer care delivery is highly complex. Treatment involves coordination within oncology health-care teams and across other teams of referring primary and specialty providers (a team of teams). Each team interfaces with patients and caregivers to offer component parts of comprehensive care. Because patients frequently obtain specialty care from divergent health-care systems resulting in cross-system health-care use, oncology teams need mechanisms to coordinate and collaborate within and across health-care systems to optimize clinical outcomes for all cancer patients. Transactive memory is one potential strategy that can help improve comprehensive patient care delivery. Transactive memory is a process by which two or more team professionals develop a shared system for encoding, storing, and retrieving information. Each professional is responsible for retaining only part of the total information. Applying this concept to a team of teams results in system benefits wherein all teams share an understanding of specialized knowledge held by each component team. The patient’s role as the unifying member of the team of teams is central to successful treatment delivery. This clinical case presents a patient who is receiving oral treatment for advanced prostate cancer within two health systems. The case emphasizes the potential for error when multiple teams function without a point team (the team coordinating efforts of all other primary and specialty teams) and when the specialty knowledge of providers and patients is not well integrated into all phases of the care delivery process.

scholarly journals COVID-19 in Dental Settings: Novel Risk Assessment Approach

2021 ◽  
Vol 18 (11) ◽  
pp. 6093
Author(s):  
Ali Alsaegh ◽  
Elena Belova ◽  
Yuriy Vasil’ev ◽  
Nadezhda Zabroda ◽  
Lyudmila Severova ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Assessment ◽  
Dental Care ◽  
Care Delivery ◽  
Oral Diseases ◽  
Infectious Risk ◽  
Care Workers ◽  
Assessment Approach ◽  
Public Health Authorities ◽  
Novel Coronavirus

The novel coronavirus (COVID-19) outbreak is a public health emergency of international concern, and this emergency led to postponing elective dental care procedures. The postponing aimed to protect the public from an unknown risk caused by COVID-19. At the beginning of the outbreak, for public health authorities, the aerosol-generating procedures and the close proximity between dental care workers and patients in dentistry represented sufficient justification for the delay of dental visits. Dental care is a priority, and for many years, studies have proven that the lack and delay of dental care can cause severe consequences for the oral health of the general population, which can cause a high global burden of oral diseases. Safety is necessary while resuming dental activities, and risk assessment is an efficient method for understanding and preventing the COVID-19 infectious threats facing the dental industry and affecting dental care workers and patients. In this study, for safe dental care delivery, we adapted risk assessment criteria and an approach and an occupational classification system. Based on those tools, we also recommend measures that can help to minimize infectious risk in dental settings.

scholarly journals Linking the Unitary Paradigm to Policy through a Synthesis of Caring Science and Integrative Nursing

2017 ◽  
Vol 30 (3) ◽  
pp. 262-268 ◽  
Author(s):  
Mary S. Koithan ◽  
Mary Jo Kreitzer ◽  
Jean Watson
Keyword(s):  
Patient Care ◽  
Healthcare System ◽  
Care Delivery ◽  
Healthcare Policy ◽  
Patient Centered ◽  
Nursing Knowledge ◽  
Call To Action ◽  
Caring Science ◽  
Patient Care Delivery

The principles of integrative nursing and caring science align with the unitary paradigm in a way that can inform and shape nursing knowledge, patient care delivery across populations and settings, and new healthcare policy. The proposed policies may transform the healthcare system in a way that supports nursing praxis and honors the discipline’s unitary paradigm. This call to action provides a distinct and hopeful vision of a healthcare system that is accessible, equitable, safe, patient-centered, and affordable. In these challenging times, it is the unitary paradigm and nursing wisdom that offer a clear path forward.

The Future of Health Care in South Korea and the UK

2006 ◽  
Vol 5 (3) ◽  
pp. 375-385 ◽  
Author(s):  
Bob Matthews ◽  
Yoonsoon Jung
Keyword(s):  
Health Care ◽  
South Korea ◽  
Care Delivery ◽  
Health Care Systems ◽  
Public Provision ◽  
Capitalist System ◽  
Private Provision ◽  
Care Systems ◽  
Health Care Delivery Systems ◽  
The Uk

This paper discusses and compares the origin and development of the health care systems of South Korea and the UK from the end of WW2 and endeavours to compare outcomes. The paper emphasises the importance of war as a stimulus to the development of national health services in both countries and argues that there is convergence between the UK's nationalised NHS and South Korea's US-modelled capitalist system. Overall, we conclude that there is a possibility not only that the financing and nature of the Korean and UK health care delivery systems may show convergence, but it is not impossible that they will ‘change places’ with the UK system dominated by private provision and South Korea's by public provision.

scholarly journals Innovation Pathways in the NHS: An Introductory Review

2021 ◽  
Author(s):  
Anmol Arora ◽  
Andrew Wright ◽  
Mark Cheng ◽  
Zahra Khwaja ◽  
Matthew Seah
Keyword(s):  
Health Care ◽  
National Health ◽  
Health Care Professionals ◽  
New Technologies ◽  
Care Delivery ◽  
Cost Effective ◽  
Care Models ◽  
Set Up ◽  
The Uk ◽  
Introductory Review

AbstractHealthcare as an industry is recognised as one of the most innovative. Despite heavy regulation, there is substantial scope for new technologies and care models to not only boost patient outcomes but to do so at reduced cost to healthcare systems and consumers. Promoting innovation within national health systems such as the National Health Service (NHS) in the United Kingdom (UK) has been set as a key target for health care professionals and policy makers. However, while the UK has a world-class biomedical research industry, several reports in the last twenty years have highlighted the difficulties faced by the NHS in encouraging and adopting innovations, with the journey from idea to implementation of health technology often taking years and being very expensive, with a high failure rate. This has led to the establishment of several innovation pathways within and around the NHS, to encourage the invention, development and implementation of cost-effective technologies that improve health care delivery. These pathways span local, regional and national health infrastructure. They operate at different stages of the innovation pipeline, with their scope and work defined by location, technology area or industry sector, based on the specific problem identified when they were set up. In this introductory review, we outline each of the major innovation pathways operating at local, regional and national levels across the NHS, including their history, governance, operating procedures and areas of expertise. The extent to which innovation pathways address current challenges faced by innovators is discussed, as well as areas for improvement and future study.

Final Report of the FOPE II Pediatric Generalists of the Future Workgroup

PEDIATRICS ◽  
2000 ◽  
Vol 106 (Supplement_E1) ◽  
pp. 1199-1223 ◽  
Author(s):  
Laurel Leslie ◽  
Peter Rappo ◽  
Herbert Abelson ◽  
Renee R. Jenkins ◽  
Sydney R. Sewall ◽  
...  
Keyword(s):  
Young Adults ◽  
21St Century ◽  
Task Force ◽  
Care Delivery ◽  
Health Needs ◽  
Adolescents And Young Adults ◽  
Final Report ◽  
Pediatric Practice ◽  
Pediatric Education ◽  
The Future

The Future of Pediatric Education II (FOPE II) Project was a 3-year, grant-funded initiative, which continued the work begun by the 1978 Task Force on the Future of Pediatric Education. Its primary goal was to proactively provide direction for pediatric education for the 21st century. To achieve this goal, 5 topic-specific workgroups were formed: 1) the Pediatric Generalists of the Future Workgroup, 2) the Pediatric Specialists of the Future Workgroup, 3) the Pediatric Workforce Workgroup, 4) the Financing of Pediatric Education Workgroup, and 5) the Education of the Pediatrician Workgroup. The FOPE II Final Report was recently published as a supplement toPediatrics (The Future of Pediatric Education II: organizing pediatric education to meet the needs of infants, children, adolescents, and young adults in the 21st century.Pediatrics. 2000;105(suppl):161–212). It is also available on the project web site at: www.aap.org/profed/fope1.htm This report reflects the deliberations and recommendations of the Pediatric Generalists of the Future Workgroup of the Task Force on FOPE II. The report looks at 5 factors that have led to changes in child health needs and pediatric practice over the last 2 decades. The report then presents a vision for the role and scope of the pediatrician of the future and the core attributes, skills, and competencies pediatricians caring for infants, children, adolescents, and young adults will need in the 21st century. Pediatrics 2000;106(suppl):1199–1223;pediatrics, medical education, children, adolescents, health care delivery.

A Longitudinal Study of Cognitive and Instrumental Activities of Daily Living Disablement Among the Oldest Mexican Americans

2021 ◽  
pp. 089826432110375
Author(s):  
Jiwon Kim ◽  
Jacqueline L. Angel ◽  
Sunshine M. Rote
Keyword(s):  
Activities Of Daily Living ◽  
Cognitive Decline ◽  
Mexican Americans ◽  
Daily Living ◽  
Oldest Old ◽  
Epidemiologic Study ◽  
Mobility Limitations ◽  
Limited Mobility ◽  
Community Activities ◽  
Instrumental Activities

Objectives Mexican Americans live longer on average than other ethnic groups, but often with protracted cognitive and physical disability. Little is known, however, about the role of cognitive decline for transitions in instrumental activities of daily living (IADL) disability and tertiary outcomes of the IADL disablement for the oldest old (after 80 years old). Methods We employ the Hispanic Established Populations for the Epidemiologic Study of the Elderly (2010–2011, 2012–2013, and 2016, N = 1,078) to investigate the longitudinal patterns of IADL decline using latent transition analysis. Results Three IADL groups were identified: independent (developing mobility limitations), emerging dependence (limited mobility and community activities), and dependent (limited mobility and household and community activities). Declines in cognitive function were a consistent predictor of greater IADL disablement, and loneliness was a particularly salient distal outcome for emerging dependence. Discussion These results highlight the social consequences of cognitive decline and dependency as well as underscore important areas of intervention at each stage of the disablement process.

scholarly journals Essential medicines for emergency care in Africa

2018 ◽  
Vol 35 (7) ◽  
pp. 412-419 ◽  
Author(s):  
Morgan C Broccoli ◽  
Jennifer L Pigoga ◽  
Mulinda Nyirenda ◽  
Lee Wallis ◽  
Emilie J Calvello Hynes
Keyword(s):  
Emergency Care ◽  
Online Survey ◽  
Care Delivery ◽  
Careful Consideration ◽  
Essential Medicines ◽  
Health Priorities ◽  
Consensus Process ◽  
Expert Review ◽  
District Hospitals ◽  
Care Systems

ObjectivesEssential medicines lists (EMLs) are efficient means to ensure access to safe and effective medications. The WHO has led this initiative, generating a biannual EML since 1977. Nearly all countries have implemented national EMLs based on the WHO EML. Although EMLs have given careful consideration to many public health priorities, they have yet to comprehensively address the importance of medicines for treating acute illness and injury.MethodsWe undertook a multistep consensus process to establish an EML for emergency care in Africa. After a review of existing literature and international EMLs, we generated a candidate list for emergency care. This list was reviewed by expert clinicians who ranked the medicines for overall inclusion and strength of recommendation. These medications and recommendations were then evaluated by an expert group. Medications that reached consensus in both the online survey and expert review were included in a draft emergency care EML, which underwent a final inperson consensus process.ResultsThe final emergency care EML included 213 medicines, 25 of which are not in the 2017 WHO EML, but were deemed essential for clinical practice by regional emergency providers. The final EML has associated recommendations of desirable or essential and is subdivided by facility level. Thirty-nine medicines were recommended for basic facilities, an additional 96 for intermediate facilities (eg, district hospitals) and an additional 78 for advanced facilities (eg, tertiary centres).ConclusionThe 25 novel medications not currently on the WHO EML should be considered by planners when making rational formularies for developing emergency care systems. It is our hope that these resource-stratified lists will allow for easier implementation and will be a useful tool for practical expansion of emergency care delivery in Africa.

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