scholarly journals Improving Health Care Outcomes through Personalized Comparisons of Treatment Effectiveness Based on Electronic Health Records

2011 ◽  
Vol 39 (3) ◽  
pp. 425-436 ◽  
Author(s):  
Sharona Hoffman ◽  
Andy Podgurski
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Comparative Effectiveness ◽  
Treatment Effectiveness ◽  
Government Support ◽  
Health Care Rationing ◽  
Care Providers ◽  
Health Care Outcomes ◽  
Care Outcomes ◽  
Care Rationing

The unsustainable growth in U.S. health care costs is in large part attributable to the rising costs of pharmaceuticals and medical devices and to unnecessary medical procedures. This fact has led health reform advocates and policymakers to place considerable hope in the idea that increased government support for research on the comparative effectiveness of medical treatments will eventually help to reduce health care expenses by informing patients, health care providers, and payers about which treatments for common conditions are effective and which are not. Comparative effectiveness research (CER) has shown in some cases that expensive but commonly used treatments are significantly less effective than relatively inexpensive alternatives. Critics warn, however, that CER will homogenize patient care, limit patient choices, and lead to improper health care rationing and even to the denial of lifesaving treatments.

Best Practices to Promote Patient and Donor Engagement to Care in Living Donor Transplant

2017 ◽  
pp. 306-327
Author(s):  
Emanuela Saita ◽  
Susanna Zanini ◽  
Enrico Minetti ◽  
Chiara Acquati
Keyword(s):  
Health Care ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Best Practices ◽  
Health Care Providers ◽  
Living Donor ◽  
Care Providers ◽  
Health Care Outcomes ◽  
Care Outcomes ◽  
Donor Kidney Transplantation

Increasing evidence has demonstrated that patients' involvement promotes better health care outcomes and cost-effectiveness of services. However, limited literature is available about the experience of living donor kidney transplantation and best practices to promote patients and donors' engagement. Aim of the present chapter is to review the literature about patient engagement in the context of chronic kidney disease, and to introduce an innovative protocol developed to promote potential donors and recipients' participation and adherence to care at the Niguarda Ca' Granda Hospital in Milan (Italy). Results are critical to reflect on the identification of best practices for patients' engagement in the context of chronic kidney disease. Through a better understanding of the emotional and affective dynamics and the relational implications that may influence the elaboration of the information given by health care providers, it will be possible to develop evidence-informed interventions.

Best Practices to Promote Patient and Donor Engagement to Care in Living Donor Transplant

2017 ◽  
pp. 1-28
Author(s):  
Emanuela Saita ◽  
Susanna Zanini ◽  
Enrico Minetti ◽  
Chiara Acquati
Keyword(s):  
Health Care ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Best Practices ◽  
Health Care Providers ◽  
Living Donor ◽  
Care Providers ◽  
Health Care Outcomes ◽  
Care Outcomes ◽  
Donor Kidney Transplantation

Increasing evidence has demonstrated that patients' involvement promotes better health care outcomes and cost-effectiveness of services. However, limited literature is available about the experience of living donor kidney transplantation and best practices to promote patients and donors' engagement. Aim of the present chapter is to review the literature about patient engagement in the context of chronic kidney disease, and to introduce an innovative protocol developed to promote potential donors and recipients' participation and adherence to care at the Niguarda Ca' Granda Hospital in Milan (Italy). Results are critical to reflect on the identification of best practices for patients' engagement in the context of chronic kidney disease. Through a better understanding of the emotional and affective dynamics and the relational implications that may influence the elaboration of the information given by health care providers, it will be possible to develop evidence-informed interventions.

scholarly journals Creating Consumer-Generated Health Data: Interviews and a Pilot Trial Exploring How and Why Patients Engage (Preprint)

2018 ◽  
Author(s):  
Kara Burns ◽  
Craig A McBride ◽  
Bhaveshkumar Patel ◽  
Gerard FitzGerald ◽  
Shane Mathews ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Personal Responsibility ◽  
Pilot Trial ◽  
Health Data ◽  
Care Providers ◽  
Health Care Outcomes ◽  
Use Of Data ◽  
Consumer Perspective ◽  
Care Outcomes

BACKGROUND Consumer-generated health data (CGHD) are any clinically relevant data collected by patients or their carers (consumers) that may improve health care outcomes. Like patient experience measures, these data reflect the consumer perspective and is part of a patient-centric agenda. The use of CGHD is believed to enhance diagnosis, patient engagement, and thus foster an improved therapeutic partnership with health care providers. OBJECTIVE The aim of this study was to further identify how these data were used by consumers and how it influences engagement via a validated framework. In addition, carer data has not been explored for the purpose of engagement. METHODS Study 1 used interviews with CGHD-experienced patients, carers, and doctors to understand attitudes about data collection and use, developing an ontological framework. Study 2 was a pilot trial with carers (parents) of children undergoing laparoscopic appendectomy. For 10 days carers generated and emailed surgical site photographs to a tertiary children’s hospital. Subsequently, carers were interviewed about the engagement framework. In total, 60 interviews were analyzed using theme and content analysis. RESULTS This study validates a framework anchored in engagement literature, which categorizes CGHD engagement outcomes into 4 domains: physiological, cognitive, emotional, and behavioral. CGHD use is complex, interconnected, and can be organized into 10 themes within these 4 domains. CONCLUSIONS CGHD can instigate an ecosystem of engagement and provide clinicians with an enhanced therapeutic relationship through an extended view into the patient’s world. In addition to clinical diagnosis and efficient use of health care resources, data offer another tool to manage consumers service experience, especially the emotions associated with the health care journey. Collection and use of data increases consumers sense of reassurance, improves communication with providers, and promotes greater personal responsibility, indicating an empowering consumer process. Finally, it can also improve confidence and satisfaction in the service.

Consent and Release

2001 ◽  
Vol 17 (3) ◽  
pp. 162-165
Author(s):  
Katherine Pohlman ◽  
Nadine Schwab
Keyword(s):  
Health Care ◽  
School Districts ◽  
Health Care Providers ◽  
Nursing Practice ◽  
School Nurses ◽  
School Nursing ◽  
Care Providers ◽  
Health Care Outcomes ◽  
Care Outcomes ◽  
General Guidance

Because school nursing practice by definition involves delivering services to minors, school nurses often find themselves with questions about consent. Because school districts, much like other health care providers, occasionally face liability for the undesired health care outcomes of their clients (i.e., students), another question that surfaces frequently deals with release from liability. Each question must be answered based on analysis of the specific facts and applicable laws. This article provides an overview of the principles that provide school nurses with general guidance on consent issues and release of liability and, by way of example, applies them in the answers to four specific questions forwarded by practicing school nurses.

The ethics of interprofessional collaboration

2013 ◽  
Vol 20 (4) ◽  
pp. 426-435 ◽  
Author(s):  
Joyce Engel ◽  
Dawn Prentice
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Moral Distress ◽  
Ethical Issues ◽  
Interprofessional Collaboration ◽  
Care Providers ◽  
Quality Health Care ◽  
Health Care Outcomes ◽  
Quality Health ◽  
Interprofessional Competencies

Interprofessional collaboration has become accepted as an important component in today’s health care and has been guided by concerns with patient safety, quality health-care outcomes, and economics. It is widely accepted that interprofessional collaboration improves patient outcomes through enhanced communication among health-care providers and increased accessibility to services. Although there is a paucity of research that provides confirmatory evidence, interprofessional competencies continue to be incorporated into the curricula of health-care students. This article examines the ethics of interprofessional collaboration and ethical issues that arise from the mainstream adoption of interprofessional competencies and the potential for moral distress in nursing.

Comparative effectiveness research: policy and politics

2012 ◽  
Vol 33 (1) ◽  
pp. E6 ◽  
Author(s):  
Edie E. Zusman
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Comparative Effectiveness Research ◽  
Comparative Effectiveness ◽  
Research Policy ◽  
Effectiveness Research ◽  
Care Providers ◽  
Future Health ◽  
The Future ◽  
Key Aspects

Comparative effectiveness research (CER) is the basis for some of the fiercest rhetoric of the current political era. While it is a relatively old and previously academic pursuit, CER may well become the foundation upon which the future of health care in the US is based. The actual impact of CER on—and uptake among—doctors, patients, hospitals, and health insurers, however, remains to be seen. Political considerations and compromises have led to the removal of key aspects of CER implementation from policy legislation to prevent alienating stakeholders critical to the success of health care reform. Health care providers, including specialists such as neurosurgeons, will need to understand both the policies and political implications of CER as its practices becomes an indelible part of the future health care landscape.

scholarly journals Development of a Questionnaire to Assess Patient Priorities in Hip Fracture Care

2020 ◽  
Vol 11 ◽  
pp. 215145932094600
Author(s):  
Naomi Turner ◽  
Jennifer M. Dinh ◽  
Jennah Durham ◽  
Lisa K. Schroder ◽  
Jeanette Y. Ziegenfuss ◽  
...  
Keyword(s):  
Health Care ◽  
Hip Fracture ◽  
Patient Reported Outcome Measures ◽  
Relative Importance ◽  
Care Providers ◽  
Health Care Outcomes ◽  
Patient Reported ◽  
Care Outcomes ◽  
Framework Development ◽  
Physical Outcomes

Background: Patient reported outcome measures (PROMs) are becoming well recognized as an important component of health care outcomes and determinants of value in patient-centered care. Yet, there is emerging recognition that guidance is lacking in the utilization of PROMs in hip fracture patients. The aim of this study was to collect input from hip fracture patients and their health care advocates as proxies to identify outcomes that are important and to gain insight into which ones are of greatest importance. Methods: A cross-section of patients aged 65 and older treated for hip fractures at a single level 1 trauma center within the previous 3 to 9 months was identified. Semistructured telephone interviews of patients and/or health care proxies were performed in 2 phases: (1) concept identification and conceptual framework development and (2) item generation and assessment of relative importance of health care outcomes. Each phase was completed by separate patient cohorts. Results: Sixty-four interviews were completed. Eighteen interviews with 13 patients and 5 proxies were completed for framework development. Forty-six interviews with 33 patients and 13 proxies were completed for the assessment of relative importance. Care team and communication were reported as important in hip fracture patients. Physical outcomes were ranked as most important by only 9% of respondents. “Having confidence that I/my loved one received the best care possible” was perceived as very important by 98% of respondents and “Having access to the surgeon” was perceived as very important by 76% of the respondents. Conclusions: In our study, communication between patients and care providers as well as collaboration among patients’ care providers ranked as the most important postoperative preferences in our cohort. Notably, physical outcomes were ranked as most important by only 9% of respondents.

scholarly journals Birth Plans: Encouraging Patient Engagement

2016 ◽  
Vol 25 (4) ◽  
pp. 215-222
Author(s):  
Renece Waller-Wise
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Health Care Providers ◽  
Patient Engagement ◽  
Family Members ◽  
Active Role ◽  
Health Care Team ◽  
Care Providers ◽  
Birth Plan ◽  
Care Outcomes

ABSTRACTPatient engagement is defined as a set of actions by patients, family members, and health-care providers that promotes patients and family members as active participants of the health-care team. As focus turns toward patient engagement where patients have an active role in their health care, childbirth educators and nurses are in a position to support patient choices. The focus is to assist the engaged woman to stay engaged and to encourage those not engaged to become engaged. The results can be improved patient care outcomes and improved patient satisfaction. One way to promote patient engagement can be the birth plan. This process can be facilitated through education of choices and assisting with writing choices into a formal birth plan.

Malpractice & Negligence: Cal. Supreme Court Clarifies Negligence Provisions under State’s Elder Abuse Act

1999 ◽  
Vol 27 (2) ◽  
pp. 203-203
Author(s):  
Kendra Carlson
Keyword(s):  
Health Care ◽  
Supreme Court ◽  
Health Care Providers ◽  
Elder Abuse ◽  
Skilled Nursing Facility ◽  
Pressure Sores ◽  
Care Providers ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
The Supreme Court

The Supreme Court of California held, in Delaney v. Baker, 82 Cal. Rptr. 2d 610 (1999), that the heightened remedies available under the Elder Abuse Act (Act), Cal. Welf. & Inst. Code, §§ 15657,15657.2 (West 1998), apply to health care providers who engage in reckless neglect of an elder adult. The court interpreted two sections of the Act: (1) section 15657, which provides for enhanced remedies for reckless neglect; and (2) section 15657.2, which limits recovery for actions based on “professional negligence.” The court held that reckless neglect is distinct from professional negligence and therefore the restrictions on remedies against health care providers for professional negligence are inapplicable.Kay Delaney sued Meadowood, a skilled nursing facility (SNF), after a resident, her mother, died. Evidence at trial indicated that Rose Wallien, the decedent, was left lying in her own urine and feces for extended periods of time and had stage I11 and IV pressure sores on her ankles, feet, and buttocks at the time of her death.

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