scholarly journals Re-Engineering Healthcare

2007 ◽  
Vol 129 (11) ◽  
pp. 22-27 ◽  
Author(s):  
Ahmed Noor
Keyword(s):  
United States ◽  
Healthcare System ◽  
Healthcare Workers ◽  
Medical Technology ◽  
Rapid Change ◽  
Medical Knowledge ◽  
The United States ◽  
Rapid Changes ◽  
Pervasive Access ◽  
Delivery Of Health Services

This article reviews a system that is in need of repair in the United States, and engineers are uniquely equipped to help fix it. Although the expenditure per capita on healthcare in the United States is higher than in any other country, the current US healthcare system cannot be sustained, and major improvements are needed. Lives unnecessarily lost each year in the United States due to medical errors are estimated to be as high as 98,000 and injuries over a million. The healthcare system is currently facing many problems and challenges, including rapid changes in medical technology and practice, severe shortages in skilled healthcare workers, and an aging population with increased incidence of disease and disability. The cyber infrastructure will facilitate technology-based, distributed delivery of health services, as well as training and lifelong learning for healthcare workers. It can evolve into an electronic care continuum with pervasive access to global, accurate, and timely medical knowledge for individuals about their health needs in an era of rapid change and expanding knowledge.

Choosing Wisely in the COVID-19 Era: Preventing Harm to Healthcare Workers

10.12788/3457 ◽  
2020 ◽  
Vol 15 (6) ◽  
pp. 360-362 ◽  
Author(s):  
Hyung J Cho ◽  
Leonard S Feldman ◽  
Sara Keller ◽  
Ari Hoffman ◽  
Amit K Pahwa ◽  
...  
Keyword(s):  
United States ◽  
Healthcare System ◽  
Healthcare Workers ◽  
Limited Resource ◽  
The United States ◽  
Choosing Wisely ◽  
Limited Time ◽  
Changing Environment ◽  
The Public ◽  
System 1

With more than 3 million people diagnosed and more than 200,000 deaths worldwide at the time this article was written, coronavirus disease of 2019 (COVID-19) poses an unprecedented challenge to the public and to our healthcare system.1 The United States has surpassed every other country in the total number of COVID-19 cases. Hospitals in hotspots are operating beyond capacity, while others prepare for a predicted surge of patients suffering from COVID-19. Now more than ever, clinicians need to prioritize limited time and resources wisely in this rapidly changing environment. Our most precious limited resource, healthcare workers (HCWs), bravely care for patients while trying to avoid acquiring the infection. With each test and treatment, clinicians must carefully consider harms and benefits, including exposing themselves and other HCWs to SARS-CoV-2, the virus causing this disease.

scholarly journals Impact of the COVID-19 Vaccine on Asymptomatic Infection Among Patients Undergoing Pre-Procedural COVID-19 Molecular Screening

2021 ◽  
Author(s):  
Aaron J Tande ◽  
Benjamin D Pollock ◽  
Nilay D Shah ◽  
Gianrico Farrugia ◽  
Abinash Virk ◽  
...  
Keyword(s):  
United States ◽  
Relative Risk ◽  
Healthcare System ◽  
The United States ◽  
Asymptomatic Infection ◽  
Screening Tests ◽  
Molecular Screening ◽  
Molecular Tests ◽  
Asymptomatic Individuals ◽  
The Impact

Abstract Background Several vaccines are now clinically available under emergency use authorization in the United States and have demonstrated efficacy against symptomatic COVID-19. The impact of vaccines on asymptomatic SARS-CoV-2 infection is largely unknown. Methods We conducted a retrospective cohort study of consecutive, asymptomatic adult patients (n = 39,156) within a large United States healthcare system who underwent 48,333 pre-procedural SARS-CoV-2 molecular screening tests between December 17, 2020 and February 8, 2021. The primary exposure of interest was vaccination with at least one dose of an mRNA COVID-19 vaccine. The primary outcome was relative risk of a positive SARS-CoV-2 molecular test among those asymptomatic persons who had received at least one dose of vaccine, as compared to persons who had not received vaccine during the same time period. Relative risk was adjusted for age, sex, race/ethnicity, patient residence relative to the hospital (local vs. non-local), healthcare system regions, and repeated screenings among patients using mixed effects log-binomial regression. Results Positive molecular tests in asymptomatic individuals were reported in 42 (1.4%) of 3,006 tests performed on vaccinated patients and 1,436 (3.2%) of 45,327 tests performed on unvaccinated patients (RR=0.44 95% CI: 0.33-0.60; p<.0001). Compared to unvaccinated patients, the risk of asymptomatic SARS-CoV-2 infection was lower among those >10 days after 1 st dose (RR=0.21; 95% CI: 0.12-0.37; p<.0001) and >0 days after 2 nd dose (RR=0.20; 95% CI: 0.09-0.44; p<.0001) in the adjusted analysis. Conclusions COVID-19 vaccination with an mRNA-based vaccine showed a significant association with a reduced risk of asymptomatic SARS-CoV-2 infection as measured during pre-procedural molecular screening. The results of this study demonstrate the impact of the vaccines on reduction in asymptomatic infections supplementing the randomized trial results on symptomatic patients.

scholarly journals Managing Cancer Care During the COVID-19 Pandemic: Agility and Collaboration Toward a Common Goal

2020 ◽  
Vol 18 (4) ◽  
pp. 366-369 ◽  
Author(s):  
Masumi Ueda ◽  
Renato Martins ◽  
Paul C. Hendrie ◽  
Terry McDonnell ◽  
Jennie R. Crews ◽  
...  
Keyword(s):  
United States ◽  
Cancer Treatment ◽  
Cancer Care ◽  
Rapid Change ◽  
The United States ◽  
Shared Vision ◽  
Health Crisis ◽  
Global Pandemic ◽  
The Face ◽  
Snohomish County

The first confirmed case of coronavirus disease 2019 (COVID-19) in the United States was reported on January 20, 2020, in Snohomish County, Washington. At the epicenter of COVID-19 in the United States, the Seattle Cancer Care Alliance, Fred Hutchinson Cancer Research Center, and University of Washington are at the forefront of delivering care to patients with cancer during this public health crisis. This Special Feature highlights the unique circumstances and challenges of cancer treatment amidst this global pandemic, and the importance of organizational structure, preparation, agility, and a shared vision for continuing to provide cancer treatment to patients in the face of uncertainty and rapid change.

scholarly journals Impact of a Dashboard to Improve Antimicrobial Stewardship in the Largest Not-For-Profit Healthcare System in the United States

2015 ◽  
Vol 2 (suppl_1) ◽  
Author(s):  
Roy Guharoy ◽  
Mohamad G. Fakih ◽  
Jeffrey Seggerman ◽  
Karen Smethers ◽  
Ann Hendrich
Keyword(s):  
United States ◽  
Healthcare System ◽  
Antimicrobial Stewardship ◽  
The United States ◽  
For Profit ◽  
Not For Profit

scholarly journals Evaluation of United States chiropractic professional subgroups: a survey of randomly sampled chiropractors

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jordan A. Gliedt ◽  
Stephen M. Perle ◽  
Aaron A. Puhl ◽  
Sarah Daehler ◽  
Michael J. Schneider ◽  
...  
Keyword(s):  
United States ◽  
Clinical Practice ◽  
Healthcare System ◽  
Large Scale ◽  
Multinomial Logistic Regression ◽  
The United States ◽  
Chiropractic Profession ◽  
Practice Characteristic ◽  
And Behaviors

Abstract Background Professional subgroups are common and may play a role in aiding professional maturity or impeding professional legitimization. The chiropractic profession in the United States has a long history of diverse intra-professional subgroups with varying ideologies and practice styles. To our knowledge, large-scale quantification of chiropractic professional subgroups in the United States has not been conducted. The purpose of this study was to quantify and describe the clinical practice beliefs and behaviors associated with United States chiropractic subgroups. Methods A 10% random sample of United States licensed chiropractors (n = 8975) was selected from all 50 state regulatory board lists and invited to participate in a survey. The survey consisted of a 7-item questionnaire; 6 items were associated with chiropractic ideological and practice characteristics and 1 item was related to the self-identified role of chiropractic in the healthcare system which was utilized as the dependent variable to identify chiropractic subgroups. Multinomial logistic regression with predictive margins was used to analyze which responses to the 6 ideology and practice characteristic items were predictive of chiropractic subgroups. Results A total of 3538 responses were collected (39.4% response rate). Respondents self-identified into three distinct subgroups based on the perceived role of the chiropractic profession in the greater healthcare system: 56.8% were spine/neuromusculoskeletal focused; 22.0% were primary care focused; and 21.2% were vertebral subluxation focused. Patterns of responses to the 6 ideologies and practice characteristic items were substantially different across the three professional subgroups. Conclusions Respondents self-identified into one of three distinct intra-professional subgroups. These subgroups can be differentiated along themes related to clinical practice beliefs and behaviors.

scholarly journals La construcción social del sueño americano en la frontera entre México y Estados Unidos. Formación y proyectos migratorios de los estudiantes de enfermería

Revista Trace ◽  
2018 ◽  
pp. 62
Author(s):  
Patrick Pérez
Keyword(s):  
United States ◽  
Working Conditions ◽  
Healthcare Workers ◽  
Home Country ◽  
The United States ◽  
Topical Issue ◽  
The Real ◽  
Conditions De Travail ◽  
Personnel De Santé ◽  
The Individual

En México, el “sueño americano” no deja de ser reciente, las expectativas del personal de cuidado de la salud en materia de movilidad dependen de la iniciativa individual. Los factores que determinan tanto la migración, como la admisión de los candidatos, son numerosos y difíciles de objetivar, debido a que se encuentran sedimentados por la historia y las complejas relaciones con Estados Unidos, que simbolizan la promesa de un “horizonte de movilidad abierto”, con referencia al cual se desprecian profundamente las condiciones de trabajo en el país de origen. Sin embargo, las condiciones reales de trabajo en Estados Unidos no son tan idílicas como los estudiantes gustan creerlo.Abstract: In Mexico, the “American dream” is still a topical issue. The expectations of the healthcare workers in terms of mobility depends on the individual initiative. The factors which determine migration, as well as the admission of candidates are numerous and uneasy to specify, given that they are frozen by history and complex relations with the United States, which symbolizes the promise of an “open mobility horizon”, in reference to the disregard of working conditions in their home country. However, the real working conditions in the United-States are not as idyllic as the students want to believe.Résumé : Au Mexique, le « rêve américain » n’en finit pas d’être d’actualité. Les perspectives du personnel de santé en matière de mobilité dépendent de l’initiative individuelle. Les facteurs déterminants de la migration, ainsi que de l’admission des candidats sont nombreux et difficiles à spécifier, puisqu’ils sont figés par l’histoire et les relations complexes avec les États-Unis, lesquels symbolisent la promesse d’un « horizon de mobilité ouvert », et font référence au mépris des conditions de travail dans le pays d’origine. Cependant, les conditions réelles de travail aux États-Unis ne sont pas aussi idylliques que les étudiants veulent le croire.

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