scholarly journals Canadian College of Medical Geneticists (CCMG) points to consider: resuming genetic services in a pandemic—a summary

2020 ◽  
pp. jmedgenet-2020-107394
Author(s):  
Lauren Chad ◽  
Angelika J Dawson ◽  
Elaine Suk-Ying Goh
Keyword(s):  
Clinical Care ◽  
Quality Care ◽  
Genetic Diagnosis ◽  
Genetic Services ◽  
Ethical Principles ◽  
Patient Factors ◽  
The Public ◽  
Canadian Context ◽  
Risk Patients ◽  
Public Health Effort

The COVID-19 pandemic has disrupted the provision of genetic care in Canada. With the public health effort to flatten the curve, many clinics have moved to virtual care for select populations of patients while triaging and postponing others. As genetic services are asked to gradually resume, a roadmap is needed to ensure clinical care decisions for at-risk patients are transparent and equitable, that postponed care is resumed and that patients with or waiting for a genetic diagnosis are not disproportionately affected or abandoned.The purpose of this document is to highlight the guiding ethical principles and stakeholder considerations in resuming genetic services to help guide the competing needs going forward of both limiting exposures while maintaining high-quality care. Considerations highlighted are (1) environment of practice, (2) nature of consult, (3) patient factors, (4) provider factors, and (5) laboratory factors. The intended users are those providing genetic care in a Canadian context with the recognition that there are clinic-specific and regional variations that will influence decision-making. While specific to the Canadian context, the ethical principles used to guide these decisions would be relevant for consideration in other jurisdictions.

scholarly journals Nurses as change agents for a better future in health care: the politics of drift and dilution

2018 ◽  
Vol 13 (3-4) ◽  
pp. 475-491 ◽  
Author(s):  
Anne M. Rafferty
Keyword(s):  
Health Care ◽  
Clinical Care ◽  
Quality Care ◽  
Change Agents ◽  
Evidence Base ◽  
Short Term ◽  
Policy Makers ◽  
The Public ◽  
The United Kingdom ◽  
Strategic Direction

AbstractThis paper takes the 70th Anniversary of the National Health Service (NHS) in the United Kingdom as an opportunity to reflect upon the strategic direction of nursing policy and the extent to which nurses can realise their potential as change agents in building a better future for health care. It argues that the policy trajectory set for nursing at the outset of the NHS continues to influence its strategic direction, and that the trajectory needs to be reset with the voices of nurses being more engaged in the design, as much as the delivery of health policy. There is a growing evidence base about the benefits for patients and nurses of deploying well-educated nurses at the top of their skill set, to provide needed care for patients in adequately staffed and resourced units, as well as the value that nurses contribute to decision-making in clinical care. Yet much of this evidence is not being implemented. On the contrary, some of it is being ignored. Policy remains fragmented, driven by short-term financial constraints and underinvestment in high quality care. Nurses need to make their voices heard, and use the evidence base to change the dialogue with the public, policy makers and politicians, in order to build a better future for health care.

scholarly journals Overuse of Health Care in the Emergency Services in Chile

2021 ◽  
Vol 18 (6) ◽  
pp. 3082
Author(s):  
Ximena Alvial ◽  
Alejandra Rojas ◽  
Raúl Carrasco ◽  
Claudia Durán ◽  
Christian Fernández-Campusano
Keyword(s):  
Public Health ◽  
Emergency Services ◽  
Clinical Care ◽  
Tertiary Care ◽  
Public Health Policies ◽  
The Public ◽  
Healthcare Network ◽  
Use Of Emergency Services ◽  
Low Coverage ◽  
Different Levels

The Public Health Service in Chile consists of different levels of complexity and coverage depending on the severity and degree of specialization of the pathology to be treated. From primary to tertiary care, tertiary care is highly complex and has low coverage. This work focuses on an analysis of the public health system with emphasis on the healthcare network and tertiary care, whose objectives are designed to respond to the needs of each patient. A review of the literature and a field study of the problem of studying the perception of internal and external users is presented. This study intends to be a contribution in the detection of opportunities for the relevant actors and the processes involved through the performance of Triage. The main causes and limitations of the excessive use of emergency services in Chile are analyzed and concrete proposals are generated aiming to benefit clinical care in emergency services. Finally, improvements related to management are proposed and the main aspects are determined to improve decision-making in hospitals, which could be a contribution to public health policies.

PMD9 Cost-Effectiveness of an Antibacterial Envelope for Cardiac Electronic Implantable Devices in High-Risk Patients in the Public Sector in Mexico

2021 ◽  
Vol 24 ◽  
pp. S124-S125
Author(s):  
Balderrama V Jauregui ◽  
F. Lemus ◽  
B. Flores ◽  
A. Figueroa ◽  
J. Valencia ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Public Sector ◽  
High Risk ◽  
Implantable Devices ◽  
The Public ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals Does the phthisioophthalmology section of our Ophthalmologic Society contribute in the promotion of quality care for patients with ocular tuberculosis?

2016 ◽  
Vol 9 (1) ◽  
pp. 56-63
Author(s):  
Elena I Ustinova ◽  
Olga P Ilkova
Keyword(s):  
Positive Impact ◽  
Clinical Care ◽  
Quality Care ◽  
Social Activity ◽  
Diagnosis And Treatment ◽  
Treatment Quality ◽  
Medical Society ◽  
Care Process ◽  
System Reform ◽  
Ocular Tuberculosis

The phthisioophthalmology section work over the last 15 years is analyzed. Due to the antituberculous care system reform the number of section members decreased from 27 to 17. Scientific meetings are regular, their frequency decreased up to 5-6/year. Ever and again presentations are made at plenary sessions of the St.Petersburg Scientific Medical Society of Ophthalmology (6 presentations in 15 years) and at the congresses of associations of ophthalmologists and phthisiologists. In 15 years, session members performed and published 102 studies on ocular tuberculosis, including 38 articles in scientific magazines, 5 teaching editions for doctors, 4 monographs. Based on work reports and inspection results of several institutions, it follows that the section makes positive impact on the formation in clinicians of a scientific approach to clinical care process. Some shortcomings are revealed in the application of recommended methods. We believe that for their elimination, besides social activity of the section, it is necessary to publish teaching editions at federal level on ocular tuberculosis diagnosis and treatment, as well as enhancement of diagnosis and treatment quality control by local administration.

scholarly journals Changes among US Cancer Survivors: Comparing Demographic, Diagnostic, and Health Care Findings from the 1992 and 2010 National Health Interview Surveys

ISRN Oncology ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Natasha D. Buchanan ◽  
Jessica B. King ◽  
Juan L. Rodriguez ◽  
Arica White ◽  
Katrina F. Trivers ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Support Groups ◽  
National Health ◽  
Clinical Care ◽  
Quality Care ◽  
Insurance Coverage ◽  
Cancer Control ◽  
The United States ◽  
Institute Of Medicine ◽  
Health Interview

Background. Differences in healthcare and cancer treatment for cancer survivors in the United States (US) have not been routinely examined in nationally representative samples or studied before and after important Institute of Medicine (IOM) recommendations calling for higher quality care provision and attention to comprehensive cancer care for cancer survivors. Methods. To assess differences between survivor characteristics in 1992 and 2010, we conducted descriptive analyses of 1992 and 2010 National Health Interview Survey (NHIS) data. Our study sample consisted of 1018 self-reported cancer survivors from the 1992 NHIS and 1718 self-reported cancer survivors from the 2010 NHIS who completed the Cancer Control (CCS) and Cancer Epidemiology (CES) Supplements. Results. The prevalence of reported survivors increased from 1992 to 2010 (4.2% versus 6.3%). From 1992 to 2010, there was an increase in long-term cancer survivors and a drop in multiple malignancies, and surgery remained the most widely used treatment. Significantly fewer survivors (<10 years after diagnosis) were denied insurance coverage. Survivors continue to report low participation in counseling or support groups. Conclusions. As the prevalence of cancer survivors continues to grow, monitoring differences in survivor characteristics can be useful in evaluating the effects of policy recommendations and the quality of clinical care.

Curating the Evidence About COVID-19 for Frontline Public Health and Clinical Care: The Novel Coronavirus Research Compendium

2021 ◽  
pp. 003335492110587
Author(s):  
Andrew D. Redd ◽  
Lauren S. Peetluk ◽  
Brooke A. Jarrett ◽  
Colleen Hanrahan ◽  
Sheree Schwartz ◽  
...  
Keyword(s):  
Public Health ◽  
Clinical Care ◽  
The United States ◽  
The Novel ◽  
Health Crisis ◽  
The Public ◽  
Successful Model ◽  
Medical Response ◽  
Public Consumption ◽  
Novel Coronavirus

The public health crisis created by the COVID-19 pandemic has spurred a deluge of scientific research aimed at informing the public health and medical response to the pandemic. However, early in the pandemic, those working in frontline public health and clinical care had insufficient time to parse the rapidly evolving evidence and use it for decision-making. Academics in public health and medicine were well-placed to translate the evidence for use by frontline clinicians and public health practitioners. The Novel Coronavirus Research Compendium (NCRC), a group of >60 faculty and trainees across the United States, formed in March 2020 with the goal to quickly triage and review the large volume of preprints and peer-reviewed publications on SARS-CoV-2 and COVID-19 and summarize the most important, novel evidence to inform pandemic response. From April 6 through December 31, 2020, NCRC teams screened 54 192 peer-reviewed articles and preprints, of which 527 were selected for review and uploaded to the NCRC website for public consumption. Most articles were peer-reviewed publications (n = 395, 75.0%), published in 102 journals; 25.1% (n = 132) of articles reviewed were preprints. The NCRC is a successful model of how academics translate scientific knowledge for practitioners and help build capacity for this work among students. This approach could be used for health problems beyond COVID-19, but the effort is resource intensive and may not be sustainable in the long term.

scholarly journals The impact of blame culture on paramedic practice

2018 ◽  
Vol 7 (3) ◽  
pp. 214-227
Author(s):  
Andrew Kirk ◽  
Kevin Armstrong ◽  
Niina Nurkka ◽  
Annette Jinks
Keyword(s):  
Medical Profession ◽  
Clinical Care ◽  
Content Type ◽  
The Public ◽  
Inappropriate Use ◽  
Blame Culture ◽  
Working Practices ◽  
Use Of Social Media ◽  
The Impact ◽  
Insight Into

Purpose The purpose of this paper is to explore English and Finnish paramedic perceptions of the healthcare blame culture, its relationship to complaints, the use of defensive practice and if this impacts on paramedic practice and clinical care. Design/methodology/approach Participants were recruited from English and Finnish ambulance services that have similar organisational and professional scopes of practice. The aim was to gain insight into the similarities and differences between the countries regarding the existence of a blame culture in paramedic practice. Semi-structured focus groups and interviews involving 20 English and Finnish paramedics were undertaken. Qualitative perceptions concerning the reality of a blame culture in paramedic practice and its impact on professional roles were sought. Findings Three major themes that were identified in the thematic analysis included: blame culture and its influences; the impact of complaints against paramedics; and the use of defensive practice within their roles. These data themes were similar for both groups of participants. The majority of participants thought the healthcare blame culture to be widespread and believed that this was likely to directly influence paramedics’ working practices. Originality/value Whilst the impact of blame culture and complaints on the medical profession has previously been examined, this study makes an important contribution by exploring the factors that impact on paramedics’ lives and their practice, within two European countries. The inappropriate use of social media by some members of the public in both countries was a disturbing issue for many participants and was identified as an area for further research.

scholarly journals Quality and Clinical Care Development in Spine Surgery—Connecting the Dots: An Expanded Clinical Narrative

2020 ◽  
Vol 10 (1_suppl) ◽  
pp. 10S-16S
Author(s):  
Sarah Hopkins ◽  
Polly Brune ◽  
Jens R. Chapman ◽  
Marc Horton ◽  
Rod Oskouian ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Care ◽  
Quality Care ◽  
Clinical Quality ◽  
Knowledge Process ◽  
Clinical Narrative ◽  
Spine Care ◽  
Evidenced Based ◽  
Connecting The Dots ◽  
Care Development

Our health care system is an evidenced-based quality-centric environment. Pursuit of quality is a process that encompasses knowledge development and care advancements through collaboration and expertise. Depicted here is the foundational knowledge, process, and contributions that hallmark successful clinical quality programs. Beginning with methodology, followed by process and form, we create the foundational knowledge and exemplars demonstrating framework and continuum of process in pursuit and attainment of successful clinical quality and care development for patients. Although our protocol has been devised for complex spine care, this could be implemented across all health care specialties to provide individualized and high-quality care for all current and future patients, all while creating a culture of accountability for physicians.

scholarly journals COVID-19 mental health care toolkit: an international collaborative effort by Early Career Psychiatrists section

2020 ◽  
Vol 33 (5) ◽  
pp. e100270
Author(s):  
Frances Adiukwu ◽  
Laura Orsolini ◽  
Drita Gashi Bytyçi ◽  
Samer El Hayek ◽  
Jairo M Gonzalez-Diaz ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Clinical Care ◽  
Outpatient Setting ◽  
Early Career ◽  
Collaborative Effort ◽  
Risk Patients ◽  
International Research Team ◽  
Health Field

The collaborative effort of an international research team from the Early Career Psychiatrists section of the World Psychiatry Association has brought about an easy-to-use, quick and stepwise mental health care toolkit for the identification and appropriate referral of those in need of mental health care during the pandemic. This simple guide can be applied in the general outpatient setting and is catered for all healthcare professionals, regardless of their expertise within the mental health field with minimal training. It is our hope that by incorporating this toolkit into our daily clinical care during the pandemic for high-risk patients and patients with non-specific complaints, we will be able to bridge the mental health gap present in our society.

Service Quality, Satisfaction and Trust: a Study of Public Hospitals in Bandung, Indonesia

2018 ◽  
Vol 7 (3.30) ◽  
pp. 393
Author(s):  
Marcellia Susan ◽  
. .
Keyword(s):  
Service Quality ◽  
Structural Equation ◽  
Service Providers ◽  
Clinical Care ◽  
Healthcare Services ◽  
Public Hospitals ◽  
Care Process ◽  
Primary Data ◽  
Equation Modeling ◽  
The Public

Research on service quality has been performed by researchers on various research objects. In many previous studies, service quality provided by service providers became the factor that affects customer satisfaction and other various research variables. The study was conducted at public hospitals that offer healthcare services with a focus on service quality. The purpose of this study was to analyze the service quality provided by public hospitals, and to test their effect on the satisfaction and trust of patients or attendants. The objects of this research are the public hospitals in Bandung with the patients or attendants as the unit of analysis. Primary data were obtained through the dissemination of questionnaires on patients or attendants to obtain data on their evaluation of service quality of public hospitals, and their satisfaction and trust towards public hospitals. Obtained data was processed using structural equation modeling to confirm causality of related research variable. The results depict the service quality provided by public hospitals in Bandung covering infrastructure, personnel quality, clinical care process, administrative procedures, safety indicators, and social responsibility. Moreover, the results of hypothesis testing show that service quality has an influence on patient satisfaction, and ultimately affects their trust in the hospital.  

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