scholarly journals Implementation of Stroke Dysphagia Screening in the Emergency Department

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Stephanie K. Daniels ◽  
Jane A. Anderson ◽  
Nancy J. Petersen
Keyword(s):  
Emergency Department ◽  
Process Improvement ◽  
Screening Tool ◽  
Patient Contact ◽  
Health Care Outcomes ◽  
Improvement Plan ◽  
Care Outcomes ◽  
Suspected Stroke ◽  
Swallowing Screening

Early detection of dysphagia is critical in stroke as it improves health care outcomes. Administering a swallowing screening tool (SST) in the emergency department (ED) appears most logical as it is the first point of patient contact. However, feasibility of an ED nurse-administered SST, particularly one involving trial water swallow administration, is unknown. The aims of this pilot study were to (1) implement an SST with a water swallow component in the ED and track nurses’ adherence, (2) identify barriers and facilitators to administering the SST through interviews, and (3) develop and implement a process improvement plan to address barriers. Two hundred seventy-eight individuals with stroke symptoms were screened from October 2009 to June 2010. The percentage of patients screened increased from 22.6 in October 2009 to a high of 80.8 in March 2010, followed by a decrease to 61.9% in June (Cochran-Armitage testz=-5.1042, P<0.0001). The odds of being screened were 4.0 times higher after implementation compared to two months before implementation. Results suggest that it is feasible for ED nurses to administer an SST with a water swallow component. Findings should facilitate improved quality of care for patients with suspected stroke and improve multidisciplinary collaboration in swallowing screening.

Thriving in the 21st Century: Outcome Assessment, Practice Parameters, and Accountability

PEDIATRICS ◽  
1995 ◽  
Vol 96 (4) ◽  
pp. 831-835 ◽  
Author(s):  
David A. Bergman
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Health Outcomes ◽  
Practice Guidelines ◽  
Scientific Evidence ◽  
Care Practice ◽  
Health Care Outcomes ◽  
Effective Manner ◽  
Care Outcomes

The past two decades have brought about major health care changes that have been driven by an ever-increasing cost of health care, practice variability, and medical malpractice litigation. These changes pose a challenge to pediatricians to contain costs, to reduce inappropriate use of health care services, and to demonstrate improved health care outcomes. To meet this challenge, a new "clinical tool kit" is required, one that will allow the pediatrician to analyze current practices and to document effective interventions. Two of the major tools in this kit are practice guidelines and outcomes assessment instruments. Practice guidelines are optimal care specifications that provide an analytic framework for defining high-quality care and measuring health care outcomes. Ideally, these guidelines should be developed from scientific evidence. In practice, however, scientific evidence to support the majority of recommendations made in guidelines is insufficient. Consequently, these recommendations are instead developed by expert consensus. Measurement of health outcomes includes clinical outcomes, patient satisfaction, cost and use, and quality of life. Health care organizations have become very sophisticated in measuring cost and use, but considerably less work has been done in the patient-centered areas of satisfaction and quality of life. This is particularly true for children, because measures are dependent on the viewpoint chosen (parent, child, or teacher), the age of the child, and the adjustment for severity of illness. Analyzing practice patterns and improving health outcomes will not be easy tasks to accomplish. For the pediatrician to use these tools in an efficient and effective manner, a new research agenda and new skills will be required.

scholarly journals Ethics and resource allocation: can health care outcomes be QALYfied?

1994 ◽  
Vol 18 (7) ◽  
pp. 395-398
Author(s):  
Femi Oyebode
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Resource Allocation ◽  
Theoretical Foundation ◽  
Well Being ◽  
Ethical Problems ◽  
Health Care Outcomes ◽  
Care Outcomes

This paper discusses the theoretical foundation of QALY and examines the assumptions which underlie these theories. It argues that there are methodological flaws in the construction of QALY and that there are inherent risks in its possible application to psychiatry. It also draws attention to fundamental ethical problems with the concept of QALY as a tool for valuing the quality of life or well-being of persons.

Managing Overutilization, Quality of Care, and Sustainable Health Care Outcomes in Oman

2006 ◽  
Vol 25 (4) ◽  
pp. 348-355 ◽  
Author(s):  
Salim M. Abri ◽  
Daniel J. West ◽  
Robert J. Spinelli
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Outcomes ◽  
Care Outcomes ◽  
Sustainable Health

Setting priorities in and for end-of-life care: challenges in the application of economic evaluation

2012 ◽  
Vol 7 (4) ◽  
pp. 431-439 ◽  
Author(s):  
CHARLES NORMAND
Keyword(s):  
Health Care ◽  
Cost Effectiveness ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Health Care Outcomes ◽  
Care Outcomes ◽  
Short Time ◽  
Competition For Resources

AbstractHealth technology assessment processes aim to provide evidence on the effectiveness and cost-effectiveness of different elements of health care to assist setting priorities. There is a risk that services that are difficult to evaluate, and for which there is limited evidence on cost-effectiveness, may lose out in the competition for resources to those with better evidence. It is argued here that end-of-life care provides particular challenges for evaluation. Outcomes are difficult to measure, can take place over short time scales, and services can be difficult to characterise as they are tailored to the specific needs of individuals. Tools commonly used to measure health care outcomes do not appear to discriminate well in the end-of-life care context. It is argued that the assumption that units of time of different quality of life can simply be added to assess the overall experience at the end of life may not apply, and that alternative perspectives, such as the Peak and End Rule, might offer useful perspectives.

scholarly journals The Process, Structure and Contribution of Work-Based Learning (WBL) to Nursing or Health

2021 ◽  
pp. 14-35
Author(s):  
Elizabeth Namukombe Ekong
Keyword(s):  
Health Care ◽  
Action Plan ◽  
Workplace Education ◽  
Health Care Outcomes ◽  
Life Long Learning ◽  
Care Outcomes ◽  
Key Steps ◽  
Process Structure ◽  
Nurses And Midwives

Background: Nurses and midwives’ contribution to the health workforce is commended globally. Continuous professional guidelines for nurses and midwives are in place to enhance life-long learning. However, literature on Work-Based Learning in healthcare settings is limited. It is important to document evidence on how nurses learn at their places of work to strengthen life-long learning. Aim: To identify existing evidence on the process, structure and contribution of WBL to nursing or health care outcomes. Design: we used scoping review approach. Data sources: EBSCOhost, Wiley Online University, and Science Direct. Google was used as a general search engine. Review Methods: Screening was by reading abstracts and full texts. Contextualization and thematic analysis were employed. The John Hopkins Nursing Evidence-Based Practice appraisal tools were used to determine the level and quality of evidence. Results: A total of 14 articles were reviewed. Identifying the problem, assessing the environment, having a learning action plan and documentation are key steps for WBL. A positive workplace culture, collaboration between the learner, organization, regulation and education institutions in addition to learning resources make a strong structure for WBL. Individual and institutional growth and visibility that contribute to improved quality of care are outcomes of WBL. Conclusion: The literature reviewed suggests that nurses ought to engage in a step wise process for effective WBL. Efficient collaboration between the learner, workplace, education and regulatory institutions are needed to support WBL. WBL plays an important role in improving nursing and health care outcomes.

Value-based health-care principles in health-care organizations

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Fiorella Pia Salvatore ◽  
Simone Fanelli ◽  
Chiara Carolina Donelli ◽  
Michele Milone
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Organizations ◽  
Organizational Changes ◽  
Content Type ◽  
Health Care Outcomes ◽  
Analytical Technique ◽  
A Value ◽  
Care Outcomes

Purpose This study aims to analyze the value-based health-care model in defining a strategy to guide the evolution of health-care organizations toward a value-oriented model. To improve the quality of care by ensuring economic sustainability, it is necessary to redefine the concept of competition in healthcare and align it with the concept of maximizing value for patients. Design/methodology/approach Performance measurement is a crucial aspect of the analysis of health-care organizations. Porter developed an effective analytical technique and presented the measurement of health-care outcomes based on health conditions, the efficiency of health-care organizations and the type of service provided. Findings Clinical outcomes and data on the costs of care of each patient are essential to evaluate improvement in treatment value over time. Engaging in the evaluation of what happens to patients in their course of care enables the expansion of the measurement of outcomes because it measures all the health services related to it. Originality/value Building a health-care system based on the value and continuous improvement of care and services provided is a goal shared by many countries and international organizations. Today, the analysis of outcomes is important for making informed decisions, directing and planning clinical and organizational changes by improving the quality of care and services.

scholarly journals Telehealth - an emerging health technology as a future model in Vietnam during Covid-19 pandemic: practical experience from Phutho General Hospital (Preprint)

2021 ◽  
Author(s):  
Ngoc Huy Nguyen
Keyword(s):  
Rural Areas ◽  
Health Technology ◽  
Healthcare Services ◽  
Practical Experience ◽  
Modern Technology ◽  
Digital Transformation ◽  
Health Care Outcomes ◽  
Care Outcomes ◽  
Positive Input

UNSTRUCTURED Telehealth has been emerging as a model of modern technology for healthcare services in Vietnam during the Covid-19 pandemic. Actively preventing the outbreak of Covid-19 and national digital transformation program, Vietnamese Ministry of Health has launched the project 2628/QD-BYT that approved a scheme for remote medical examination and treatment for 2020-2025. The project is aiming to connect 1000 hospitals to strengthen the quality of medical services from central hospitals to rural areas via provincial hospitals. The Phutho Genral Hospital (PGH) is one of leading provincial hospitals that participating and appling early the telehealth systems in Vietnam. By telehealth systems, PGH can offer a valuable support to the doctor’s activity by streamlining and facilitating their work. Telehealth was demonstrated to be feasible, acceptable, and effective in PGH of Vietnam, and allowed for significant improvements in health care outcomes. As the achieved results, the Covid-19 pandemic represents a positive input for the acceleration and enhancement of Telehealth in Vietnam. The success of telehealth here may be a useful reference for other parts of the world.

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