Daring discourse: should acute pain medicine be a stand-alone service?

2021 ◽  
pp. rapm-2020-102288
Author(s):  
Andres Missair ◽  
Alexandru Visan ◽  
Ryan Ivie ◽  
Ralf E Gebhard ◽  
Stephen Rivoli ◽  
...  
Keyword(s):  
Operating Room ◽  
Patient Outcomes ◽  
Acute Pain ◽  
Best Practice ◽  
Healthcare Systems ◽  
Care Providers ◽  
Pain Medicine ◽  
Financial Cost ◽  
Intraoperative Care ◽  
Practice Models

Acute pain medicine (APM) has been incorporated into healthcare systems in varied manners with some practices implementing a stand-alone acute pain service (APS) staffed by consultants who are not simultaneously providing care in the operating room (OR). In contrast, other practices have developed a concurrent OR-APS model where there is no independent team beyond the intraoperative care providers. There are theoretical advantages of each approach primarily with respect to patient outcomes and financial cost, and there is little evidence to instruct best practice. In this daring discourse, we present two opposing perspectives on whether or not APM should be a stand-alone service. While evidence to guide best practice is limited, our goal is to encourage discussion of the varied APS practice models and research into their impact on outcomes and costs.

COVID-19: knowledge, awareness and perceived stress among Jordanian healthcare providers (Preprint)

2020 ◽  
Author(s):  
Emad Aborajooh ◽  
Mohammed Qussay Al-Sabbagh ◽  
Baraa Mafrachi ◽  
Muhammad Yassin ◽  
Rami Dwairi ◽  
...  
Keyword(s):  
Social Media ◽  
Psychological Stress ◽  
Health Care Providers ◽  
Best Practice ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Ordinal Logistic Regression Analysis ◽  
Source Of Information

UNSTRUCTURED We aimed to measure levels of knowledge, awareness, and stress about COVID-19 among health care providers (HCP) in Jordan. This was a cross-sectional study on 397 HCPs that utilized an internet-based questionnaire to evaluate knowledge about COVID-19, availability of personal protective equipment (PEE), future perception, and psychological distress. Ordinal logistic regression analysis was used to evaluate factors associated with knowledge and psychological stress. Overall, 24.4% and 21.2% of the participants showed excellent knowledge and poor knowledge, respectively. Social media (61.7%) was the most commonly used source of information. Being female (β= 0.521, 95% CI 0.049 to 0.992), physician (β=1.421, 95% CI 0.849 to 1.992), or using literature to gain knowledge (β= 1.161, 95% CI 0.657 to 1.664) were positive predictors of higher knowledge. While having higher stress (β= -0.854, 95% CI -1.488 to -0.221) and using social media (β= -0.434, 95% CI -0.865 to -0.003) or conventional media (β= -0.884, 95% CI -1.358 to -0.409) for information were negative predictors of knowledge levels. HCPs are advised to use the literature as a source of information about the virus, its transmission, and the best practice. PPEs should be secured for HCPs to the psychological stress associated with treating COVID-19 patients.

Closing the Loop in Computer Agent/Patient Communication

2020 ◽  
Vol 64 (1) ◽  
pp. 711-715
Keyword(s):  
Older Adults ◽  
Best Practice ◽  
Self Care ◽  
Effective Teacher ◽  
Care Providers ◽  
Conversational Agents ◽  
Patient Centered ◽  
Face To Face ◽  
Communication Techniques ◽  
Improve Instruction

While patient-centered communication supports patient self-care, providers rarely have enough time to consistently use patient- centered communication techniques. Technology has potential to support patient-centered communication, but frequently older adults prefer face-to-face communication with providers. Conversational agents (CAs) may support provider communication with older adults by emulating best practices from face-to-face communication. We investigated older adults’ response to a prototype CA communication system that served as a virtual provider and presented medication instructions using teachback, a recommended best practice that involves asking patients questions to ‘close the communication loop’. Older adults were told how to take medications by a CA who used (or did not use) teachback, and then were interviewed. Older adults were open to interacting with the CA and thought it would help support self-care. They thought the CA was a more effective teacher when using teachback and that this interactive strategy helped them remember the instructions. However, teachback did not improve instruction memory.

scholarly journals Order, experience, and critique: The phenomenological method in political and legal theory

2021 ◽  
Author(s):  
Sophie Loidolt
Keyword(s):  
Best Practice ◽  
Legal Theory ◽  
Legal Issues ◽  
Main Task ◽  
Phenomenological Method ◽  
The Public ◽  
Practice Models ◽  
Critical Phenomenology ◽  
Flexible Framework ◽  
The Public Sphere

AbstractThe paper investigates phenomenology’s possibilities to describe, reflect and critically analyse political and legal orders. It presents a “toolbox” of methodological reflections, tools and topics, by relating to the classics of the tradition and to the emerging movement of “critical phenomenology,” as well as by touching upon current issues such as experiences of rightlessness, experiences in the digital lifeworld, and experiences of the public sphere. It is argued that phenomenology provides us with a dynamic methodological framework that emphasizes correlational, co-constitutional, and interrelational structures, and thus pays attention to modes of givenness, the making and unmaking of “world,” and, thereby, the inter/subjective, affective, and bodily constitution of meaning. In the case of political and legal orders, questions of power, exclusion, and normativity are central issues. By looking at “best practice” models such as Hannah Arendt’s analyses, the paper points out an analytical tool and flexible framework of “spaces of meaning” that phenomenologists can use and modify as they go along. In the current debates on political and legal issues, the author sees the main task of phenomenology to reclaim experience as world-building and world-opening, also in a normative sense, and to demonstrate how structures and orders are lived while they condition and form spaces of meaning. If we want to understand, criticize, act, or change something, this subjective and intersubjective perspective will remain indispensable.

scholarly journals Addressing the medicines access challenge through balance, evidence, collaboration and transparency: key take-away lessons of the 4th PPRI Conference

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Sabine Vogler ◽  
Nina Zimmermann ◽  
Zaheer-Ud-Din Babar ◽  
Reinhard Busse ◽  
Jaime Espin ◽  
...  
Keyword(s):  
Best Practice ◽  
Access To Medicines ◽  
Health Technologies ◽  
Relevant Evidence ◽  
Practice Models ◽  
The Future ◽  
Pricing And Reimbursement ◽  
Multi Stakeholder

AbstractThe 4th PPRI Conference, held in Vienna in October 2019, addressed issues related to equitable and affordable access to medicines. A multi-stakeholder audience from around the globe discussed solutions and best practice models for current challenges such as high-priced medicines, limitations of current pricing and reimbursement policies and tight budgets for health technologies. A multi-faceted approach (so-called balance, evidence, collaboration and transparency/BECT strategy) was also discussed. This includes an improved balance of different interests and policy areas, generation of relevant evidence, collaboration between countries and stakeholders, and transparency, and was considered as the most promising pathway for the future.

Cultural Considerations in the Management of Chronic Pain

CAND Journal ◽  
2021 ◽  
Vol 28 (4) ◽  
pp. 11-13
Author(s):  
Shakila Mohmand ◽  
Sumar Chams
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Cultural Competency ◽  
Patient Outcomes ◽  
Health Care Providers ◽  
Cultural Beliefs ◽  
Coping Mechanisms ◽  
Care Providers ◽  
Pain Experience ◽  
Cultural Considerations

Cultural competency within health care helps eliminate racial and ethnic health disparities. When assessing and treating patients with chronic pain, practitioners should feel confident in using information regarding a patient’s individual cultural beliefs due to their significant impact on the pain experience. Culture impacts perception, outlook, and communication of pain, as well as coping mechanisms. These are aspects of subjective history that influence important decisions regarding the management of chronic pain. Becoming more aware of what to look for and which questions to ask can allow naturopathic doctors and other health-care providers to continue improving therapeutic relationships and patient outcomes.

Perioperative considerations in the management of cold agglutinin disease in laparoscopic surgery

2021 ◽  
Vol 14 (5) ◽  
pp. e241294
Author(s):  
Yisi D Ji ◽  
Paul M Cavallaro ◽  
Britlyn D Orgill
Keyword(s):  
Case Report ◽  
Laparoscopic Surgery ◽  
Acute Cholecystitis ◽  
Operating Room ◽  
Patient Outcomes ◽  
Cold Agglutinin ◽  
Surgical Team ◽  
Cold Agglutinin Disease ◽  
Disease Exacerbation ◽  
Multidisciplinary Collaboration

An 80-year-old man with idiopathic cold agglutinin disease presented with acute cholecystitis. We describe operating room and anaesthetic considerations for patients with cold agglutinin disease and measures that can be taken to prevent disease exacerbation in this case report. Multidisciplinary collaboration and planning between the operative room staff, anaesthesia team and surgical team are needed to ensure safe surgery and optimal patient outcomes.

Implementing Best Practice Models of Return to Work

2020 ◽  
pp. 589-613
Author(s):  
Vicki L. Kristman ◽  
Cécile R. L. Boot ◽  
Kathy Sanderson ◽  
Kathryn E. Sinden ◽  
Kelly Williams-Whitt
Keyword(s):  
Return To Work ◽  
Best Practice ◽  
Practice Models

scholarly journals Lean management in health care: effects on patient outcomes, professional practice, and healthcare systems

2020 ◽  
Author(s):  
Thomas Rotter ◽  
Christopher Plishka ◽  
Adegboyega Lawal ◽  
Michelle Fiander ◽  
Elizabeth L Harrison ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Outcomes ◽  
Professional Practice ◽  
Healthcare Systems ◽  
Lean Management

scholarly journals Promoting rational antibiotics prescribing for non-complicated infections: Understanding social influence in primary care networks in Germany

2019 ◽  
Author(s):  
Regina Poss-Doering ◽  
Martina Kamradt ◽  
Katharina Glassen ◽  
Edith Andres ◽  
Petra Kaufmann-Kolle ◽  
...  
Keyword(s):  
Social Support ◽  
Primary Care ◽  
Social Influence ◽  
Health Professionals ◽  
Best Practice ◽  
Care Providers ◽  
Self Reflection ◽  
Physician Health ◽  
Depth Analysis ◽  
Improvement Programs

Abstract Primary care networks in Germany are formalized regional collaborations of physicians and other healthcare providers. Common goals are optimized healthcare processes and services for patients, enhanced communication, agency for professional concerns and strengthened economic power. In the ARena study (Sustainable reduction of antibiotic-induced antimicrobial resistance), 14 primary care networks in two federal German states aimed to promote appropriate antibiotics use for acute non-complicated infections by fostering awareness and understanding. Factors related to the role of primary care networks were to be identified. Methods For this study, audio-recorded telephone interviews were conducted with physicians, non-physician health professionals and stakeholder representatives. Pseudonymized verbatim transcripts were coded using thematic analysis. In-depth analysis was based on the inductive categories ‘social support’, ‘social learning’, ‘social normative pressures’ and ‘social contagion’ to reflect social influence processes. To foster understanding of the networks’ potential impact on antibiotics prescribing, data generated through surveys with physicians and non-physician health professionals were analyzed descriptively. Results : Social influence processes proved to be relevant regarding knowledge transfer, manifestation of best-practice care and self-reflection. Peer communication was seen as great asset, main reason for membership and affirmative for own perspectives. All interviewed physicians (n=27) considered their network to be a strong support factor for daily routines, introduction of new routines, and continuity of care. They utilized network-offered training programs focusing on best practice guideline-oriented use of antibiotics and considered their networks supportive in dealing with patient expectations. A shared attitude combined with ARena intervention components facilitated reflected management of antibiotics prescribing. Non-physician health professionals (n=11) also valued network peer exchange. They assumed their employers joined networks to offer improved and continuous care. Stakeholders (n=7) expected networks and their members to be drivers for care optimization. Conclusion: Primary care networks play a crucial role in providing a platform for professional peer exchange, social support and reassurance. With regards to their impact on antibiotics prescribing for acute non-complicated infections, networks seem to facilitate and amplify quality improvement programs by providing a platform for refreshing awareness, knowledge and self-reflection among care providers. They are well suited to promote a rational use of antibiotics. .

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