scholarly journals Use of assessment to reinforce patient safety as a habit: Figure 1

2006 ◽  
Vol 15 (suppl 1) ◽  
pp. i30-i33 ◽  
Author(s):  
R M Galbraith ◽  
M C Holtman ◽  
S G Clyman
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Medical Profession ◽  
Assessment Tools ◽  
The Public ◽  
Malpractice Insurance ◽  
The Us ◽  
High Standards ◽  
Use Of Assessment ◽  
Training Practice

The US spends far more than any other nation on health care. Physicians undergo lengthy and comprehensive training that is carefully scrutinized, and are held to high standards in national examinations. At best the care delivered matches or exceeds that in any other country. And yet, often simple preventable medical errors occur at alarming and unacceptable rates. The public, corporate consumers of health care, large payors and malpractice insurance carriers are all becoming impatient with the pace of improvement. The medical profession recognizes that dealing with this problem is an urgent priority and is grappling to find the best approaches. This paper focuses on the constructive use of assessment to embed a pervasive and proactive culture of patient safety into practice, starting with the trainee and extending out into the practice years. This strategy is based on the adage that “assessment drives curriculum” and proposes a series of new assessment tools to be added to all phases of the training-practice continuum.

scholarly journals Bilio-pancreatic endoscopy during COVID-19 pandemic

2020 ◽  
Vol 13 ◽  
pp. 175628482093518
Author(s):  
Vincenzo Bove ◽  
Tommaso Schepis ◽  
Ivo Boškoski ◽  
Rosario Landi ◽  
Beatrice Orlandini ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Physical Distance ◽  
Health Care Facilities ◽  
Standards Of Care ◽  
Unknown Etiology ◽  
Care Providers ◽  
The Public ◽  
Frequent Exchange ◽  
High Standards

On 31 December 2019, the WHO China Country Office was informed of cases of pneumonia of unknown etiology detected in Wuhan (Hubei Province of China). In January 2020, a new coronavirus named SARS-CoV2 was isolated and, since that time, SARS-CoV2 related disease (COVID-19) rapidly spread all over the world becoming pandemic in March 2020. The COVID-19 outbreak dramatically affected the public-health and the health-care facilities organization. Bilio-pancreatic endoscopy is considered a high-risk procedure for cross-contamination and, even though it is not directly involved in COVID-19 diagnosis and management, its reorganization is crucial to guarantee high standards of care minimizing the risk of SARS-CoV2 transmission among patients and health-care providers. Bilio-pancreatic endoscopic procedures often require a short physical distance between the endoscopist and the patient for a long period of time, a frequent exchange of devices, the involvement of a large number of personnel, the use of complex endoscopes difficult to reprocess. On this basis, endoscopic units should take precautions with adjusted management of bilio-pancreatic endoscopy. The aim of this article is to discuss the approach to bilio-pancreatic endoscopy in the COVID-19 era with focus on diagnostic algorithms, indications, management of the endoscopic room, proper use of Personal Protective Equipment and correct reprocessing of instrumentation.

Integrating animal welfare into wild herbivore management: lessons from the Australian Feral Camel Management Project

2016 ◽  
Vol 38 (2) ◽  
pp. 163 ◽  
Author(s):  
Jordan O. Hampton ◽  
Bidda Jones ◽  
Andrew L. Perry ◽  
Corissa J. Miller ◽  
Quentin Hart
Keyword(s):  
Animal Welfare ◽  
Assessment Tools ◽  
Ex Situ ◽  
Control Methods ◽  
The Public ◽  
Audit System ◽  
Management Project ◽  
Management Techniques ◽  
High Standards

The Australian Feral Camel Management Project (AFCMP) was initiated in 2009 to manage the growing impacts of feral camels (Camelus dromedarius) in Australia. One of the most important considerations for the project was achieving high standards of animal welfare and demonstrating this to stakeholders and the public. The novelty of feral camels as an invasive species meant that relatively little was known about the animal welfare aspects of the available management techniques. To address this knowledge gap, quantitative animal-based assessment tools were developed to allow independent observers to perform repeatable in situ field auditing of the two main control methods used: aerial (helicopter) shooting and live capture (mustering and transport for slaughter). Although observation protocols allowed most stages of aerial shooting (in situ killing) to be assessed, not all stages of live capture operations could be assessed (namely transport and slaughter at ex situ abattoirs) due to the limitations of the jurisdiction of the Australian Feral Camel Management Project. For assessments that were performed, audit results were made available to project partners to allow procedures to be reviewed and published through peer-reviewed literature to improve transparency. Empirical evidence produced through the audit system was also used to refine humaneness ranking assessments comparing management methods. We present the lessons learnt through the animal welfare approach of the AFCMP to assist future wild herbivore management programs.

scholarly journals A Review of a Historical Summit on Integrative Medicine

2010 ◽  
Vol 7 (4) ◽  
pp. 511-514 ◽  
Author(s):  
Dana Ullman
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Integrative Medicine ◽  
Health Care Financing ◽  
Scientific Basis ◽  
Patient Centered ◽  
The Public ◽  
Included Patient ◽  
The Us ◽  
Centered Care

The US Institute of Medical sponsors a “Summit on Integrative Medicine and the Health of the Public” on February 25–27, 2009. A prestigious body of speakers and attendees created a dynamic conference in which the content and discussions provided vital information for transforming the US health care system. Topics included: patient-centered care, the scientific basis of integrative medicine, health care financing reform and value-driven care, and mind-body relationships and health.

Medical regulation for the public interest in the United Kingdom

2018 ◽  
pp. 77-92
Author(s):  
William Roche
Keyword(s):  
Health Care ◽  
United Kingdom ◽  
Public Interest ◽  
Historical Development ◽  
Medical Profession ◽  
The Public ◽  
Medical Regulation ◽  
High Profile ◽  
The United Kingdom ◽  
The Subject

Regulation of the medical profession has a long history in the United Kingdom but a number of high profile failures of National Health Service (NHS) organisations to deliver safe health care and the unlawful killing of more than 200 patients by one rogue doctor have led to a clamour for change. Many of these tragedies have been the subject of public inquiries and have created significant public disquiet about the role and effectiveness of the medical regulator. United Kingdom governments have responded to these inquiries by means of a combination of strengthening professional regulation and the introduction of new mechanisms of appeal against the sanctions imposed on doctors by tribunals. The historical development of medical regulation is reviewed and the more recent changes to address the public interest and crises in the confidence in the regulation of health care are described.

scholarly journals Odgovornost Zdravniške zbornice Slovenije do zdravnikov, zdravstvenega sistema in družbe

2021 ◽  
pp. 21-27
Author(s):  
Zdenka Čebašek Travnik ◽  
Keyword(s):  
Health Care ◽  
Crisis Management ◽  
Professional Competence ◽  
Medical Profession ◽  
Public Authority ◽  
Safe Treatment ◽  
The Public ◽  
Social Interests ◽  
The Face ◽  
Medical Chamber

The responsibility of the Medical Chamber of Slovenia (Chamber) is reflected in the attitude towards the membership that goes through the mission, which is to represent and promote the professional, economic and social interests of doctors, care for the high professional competence and ethics of the conduct of doctors, the reputation and honor of the medical profession, ensuring the fulfillment of medical duties, promoting the rights of doctors, and the professional and safe treatment of patients. The Chamber's responsibility to the health care system lies primarily in proposals for its improvement and elimination of errors, which are recognized by the Chamber in monitoring its operations as well as through controls within the public authority. Responsibility to the company is manifested by the fact that the general public also informs and directs them to find better conditions for the functioning of the system and to help in crisis management. An example of the Chamber's work in the face of the SARS-CoV 2 pandemic causing COVID-19 is given.

scholarly journals By Her Own Authority: The Scope of Midwifery Practice under the Ontario Midwifery Act, 1991

1993 ◽  
Vol 31 (2) ◽  
pp. 349 ◽  
Author(s):  
Elizabeth Massey
Keyword(s):  
Health Care ◽  
Consumer Choice ◽  
Medical Profession ◽  
Normal Pregnancy ◽  
Professional Status ◽  
Quality Health Care ◽  
The Public ◽  
Midwifery Practice ◽  
Quality Health ◽  
Regulatory Model

Midwifery is recognized as an autonomous, self-governing profession under Ontario's Midwifery Act, 1991 and Regulated Health Professions Act, 1991. The author discusses the implications of this new legislation and addresses how the Acts define the nature and scope of midwifery practice. Although the new regulatory model grants midwives legal and professional status, their statutory scope of practice is limited to "normal" pregnancy, labour and delivery. Within the new regulatory framework, the authority to define the meaning of "normal" remains with physicians. Therefore, the capacity to control the scope and availability of midwifery services lies in the hands of the medical profession, which has historically been opposed lo the autonomous practice of midwifery. The author explores the other elements of the Midwifery Act, 1991, such as matters of assessment and diagnosis, and issues of potential liability, and whether or not these could hind midwifery practice by established medicine within the Ontario health care system. In implementing the Acts, much consultation remains to be done among members of the relevant professional bodies and the public to balance competing interests and views, while ensuring quality health care and consumer choice.

Icon and taboo: single-payer politics in Canada and the US

2019 ◽  
Vol 35 (1) ◽  
pp. 5-24 ◽  
Author(s):  
Carolyn Hughes Tuohy
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Profession ◽  
Private Insurance ◽  
The United States ◽  
Hospital Services ◽  
Popular Support ◽  
Single Payer ◽  
The Us ◽  
Political Economies

AbstractIn 1965 and 1966, the United States and Canada adopted single-payer models of government insurance for physician and hospital services – universal in Canada, but restricted to certain population groups in the US. At the time, the American and Canadian political economies of health care and landscapes of public opinion were remarkably similar, and the different policy designs must be understood as products of the distinctive macro-level politics of the day. Subsequently, however, the different scopes of single-payer coverage would drive the two systems in different directions. In Canada, the single-payer system became entrenched in popular support and in the nexus of interest it created between the medical profession and the state. In the US, Medicare became similarly entrenched in popular support, but did so as part of the larger multi-payer private insurance system. In the process universal single-payer coverage became politically iconic in Canada and taboo in the US.

scholarly journals Experience(s) of the medical profession: A qualitative study using narrative facilitators

2021 ◽  
Author(s):  
Celine Bourquin ◽  
Sandy Orsini ◽  
Friedrich Stiefel
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Care System ◽  
Medical Profession ◽  
Institutional Context ◽  
The Public ◽  
Practice Of Medicine ◽  
Narrative Process ◽  
Inner World ◽  
Key Aspects

Physicians narratives are means to approach and comprehend their experiences. They reveal the practice of medicine, and inform about the physicians embedment in their work and the healthcare context. This study aimed to examine physicians experience by means of interviews based on narrative facilitators, which goal is to encourage storytelling and to support the narrative process. Core stories were elaborated on the key aspects that emerged from the analysis. Thirty-three physicians participated in the study. The findings showed a focus on the transformations of a profession, the need for physicians to adapt in terms of role and status, and their withstanding of conflicting projections from the public and patients. The institutional context was described as darkness in which physicians are moving. When reacting to the quotes from their peers, participants showed a variety of un-patterned stances with regard to different aspects of medicine and the medical profession. Findings also indicated that as narrators, physicians may have particular difficulties accessing their inner world. Disenchanted physicians are not beneficial, neither for the patient nor for the health care system, and their feeling of being worn out may do harm and is certainly negatively affecting themselves and their families.

Publicness, Goal Ambiguity and Patient Safety

2020 ◽  
pp. 259-286
Author(s):  
Stuart Anderson
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Health Care Organizations ◽  
The Public ◽  
Goal Ambiguity

This article explores possible links between organizational publicness, goal ambiguity and patient safety. Despite organizational and management initiatives designed to improve matters, patient safety in hospitals remains a major challenge. Much research has focused on leadership and culture, which have been shown to be crucial factors in assuring patient safety. However, improvements have been slow in coming. There may be merit therefore in examining other factors that play a part in assuring safety, especially those that address the ambiguities inherent in health care organizations. Two such factors that have received increasing attention from organization theorists are publicness and goal ambiguity. Publicness addresses the complexity now inherent in defining the public or private nature of health care organizations; goal ambiguity addresses the diversity of goals that organizations, especially public ones, are expected to fulfil. Both hinder improvements in patient safety; greater effort needs to be made to minimise the ambiguities involved.

State Medical Boards and the Problem of Unnecessary Care and Treatment

2013 ◽  
Vol 99 (2) ◽  
pp. 25-32
Author(s):  
Carl F. Ameringer
Keyword(s):  
Adverse Effect ◽  
Health Care ◽  
Patient Safety ◽  
Professional Ethics ◽  
Medical Profession ◽  
Medical Tests ◽  
Complex Detection ◽  
Specialty Society ◽  
Care And Treatment ◽  
State Medical Boards

ABSTRACTThe overutilization of medical tests and procedures has been identified as an important reason for the high costs of health care in America. Because the problem of overutilization is so multifaceted and complex, detection has been uneven and deterrence has been erratic. Recognizing the increasing severity of the problem and the adverse effect that overutilization may have on patient safety and care, the medical profession in recent years has increased its efforts to curtail excess treatment. Several national specialty societies, for example, have identified certain tests and procedures that may be unnecessary or overused, and they have disseminated their findings to physicians and patients. The question that this article seeks to address is what role state medical boards should have in reducing unnecessary care and treatment. This article argues that state medical boards, congruent with their mission of public protection, should enhance their oversight, detection, and regulation in this area. Professional ethics and specialty society guidelines could provide the basis for disciplining persistent and egregious offenders.

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