Quantification of Standards for Length-of-Stay Based upon Optimal Patient Care and Standard Medical Practice

1981 ◽  
Vol 89 (1) ◽  
pp. 27-33 ◽  
Author(s):  
F. Owen Black ◽  
Jonas Johnson ◽  
Eugene N. Myers ◽  
Olga Perkun
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Medical Practice ◽  
Care Delivery ◽  
Radical Neck Dissection ◽  
Preoperative Assessment ◽  
Cost Effective ◽  
Point Of View ◽  
Increased Risk ◽  
Postoperative Length

Length-of-stay criteria are being developed by the Allegheny Professional Standards Review Organization (APSRO) in western Pennsylvania. In order to statistically document the standard of practice at the Eye and Ear Hospital of Pittsburgh, a retrospective review of patients who underwent laryngectomy with or without radical neck dissection was performed. Results demonstrated that routinely allowing only one day preoperative assessment deviates significantly from optimal medical practice and may place some patients at increased risk, especially for postoperative complications. From a cost-effective health care delivery point of view, abbreviated preoperative preparation contributes negatively to postoperative length-of-stay which was the most costly component of hospital health care for this group of patients. The development of appropriate standards of medical practice criteria using preexisting HEW mechanisms and scientifically designed prospective studies should be encouraged.

scholarly journals Innovation Pathways in the NHS: An Introductory Review

2021 ◽  
Author(s):  
Anmol Arora ◽  
Andrew Wright ◽  
Mark Cheng ◽  
Zahra Khwaja ◽  
Matthew Seah
Keyword(s):  
Health Care ◽  
National Health ◽  
Health Care Professionals ◽  
New Technologies ◽  
Care Delivery ◽  
Cost Effective ◽  
Care Models ◽  
Set Up ◽  
The Uk ◽  
Introductory Review

AbstractHealthcare as an industry is recognised as one of the most innovative. Despite heavy regulation, there is substantial scope for new technologies and care models to not only boost patient outcomes but to do so at reduced cost to healthcare systems and consumers. Promoting innovation within national health systems such as the National Health Service (NHS) in the United Kingdom (UK) has been set as a key target for health care professionals and policy makers. However, while the UK has a world-class biomedical research industry, several reports in the last twenty years have highlighted the difficulties faced by the NHS in encouraging and adopting innovations, with the journey from idea to implementation of health technology often taking years and being very expensive, with a high failure rate. This has led to the establishment of several innovation pathways within and around the NHS, to encourage the invention, development and implementation of cost-effective technologies that improve health care delivery. These pathways span local, regional and national health infrastructure. They operate at different stages of the innovation pipeline, with their scope and work defined by location, technology area or industry sector, based on the specific problem identified when they were set up. In this introductory review, we outline each of the major innovation pathways operating at local, regional and national levels across the NHS, including their history, governance, operating procedures and areas of expertise. The extent to which innovation pathways address current challenges faced by innovators is discussed, as well as areas for improvement and future study.

scholarly journals Unique Challenges for Otolaryngology Patients During the COVID-19 Pandemic

2020 ◽  
pp. 019459982095483
Author(s):  
Melissa Ghulam-Smith ◽  
Yeyoon Choi ◽  
Heather Edwards ◽  
Jessica R. Levi
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Intimate Contact ◽  
Respiratory Mucosa ◽  
Increased Risk ◽  
Centered Care ◽  
Upper Respiratory

The coronavirus disease 2019 (COVID-19) pandemic has drastically altered health care delivery and utilization. The field of otolaryngology in particular has faced distinct challenges and an increased risk of transmission as day-to-day procedures involve intimate contact with a highly infectious upper respiratory mucosa. While the difficulties for physicians have been thoroughly discussed, the unique challenges of patients have yet to be considered. In this article, we present challenges for patients of otolaryngology that warrant thoughtful consideration and propose solutions to address these challenges to maintain patient-centered care both during and in the aftermath of the COVID-19 pandemic.

scholarly journals DENTAL HYGIENISTS AS ESSENTIAL MEMBERS OF THE HEALTH CARE TEAM

2018 ◽  
Vol 1 (2) ◽  
pp. 73
Author(s):  
Jacqueline Juhl
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Care Delivery ◽  
Cost Effective ◽  
Economic Loss ◽  
The United States ◽  
Health Care Team ◽  
Care Team ◽  
Oral Disease ◽  
Dental Hygienists

Despite the advances in dental sciences, innovative oral health programs, and efforts dedicated by oral health professionals,globally, unmet oral disease, and the economic loss it causes, is growing. In the present, oral health care delivery systemsurgently need improvement. The introduction of dental hygienists as essential members of the health care team can contributeto improved and cost-effective health care outcomes. This paper provides definitions of dental hygienists from both, aninternational and the United States (U.S.) and describes their education, functions, and contributions to the health care team.

eHealth in cardiac rehabilitation

2020 ◽  
pp. 171-176
Author(s):  
Ines Frederix ◽  
Paul Dendale
Keyword(s):  
Cardiac Rehabilitation ◽  
Progress Monitoring ◽  
Care Delivery ◽  
Cost Effective ◽  
Daily Practice ◽  
Point Of View ◽  
Successful Implementation ◽  
Sustained Delivery ◽  
Definition Of

TeleCR is an innovative and (cost-)effective preventive care delivery strategy that can overcome the challenges associated with traditional centre-based cardiac rehabilitation (CR). This chapter describes how it can be implemented in daily practice. From an organizational point of view, it implies a shift in traditional and operational workflows and reorganization of the (non-)human resources for care delivery. The establishment of a well-coordinated tele-team, the definition of clear goals, profound progress monitoring and follow-up, and the creation of an environment that promotes sustained delivery of teleCR are paramount. Tackling the current legal and technological challenges is another prerequisite for successful implementation.

Tele-ICU Partners Enhance Evidence-Based Practice

2012 ◽  
Vol 23 (3) ◽  
pp. 312-322 ◽  
Author(s):  
Carol Olff ◽  
Cynthia Clark-Wadkins
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Best Practice ◽  
Evidence Based Practice ◽  
Care Delivery ◽  
Health Care Team ◽  
Evidence Based ◽  
New Members ◽  
Management Protocol ◽  
Information Research

Evidence-based practice (EBP) has become more than just a trendy buzzword in health care; EBP validates care delivery methods and grants satisfaction to nurses in knowing the care they provide is based on valid, current information. Research-based enhancements are paramount to the advancement of nursing practice and prompt the implementation of creative methods to improve care. The advent of the tele–intensive care unit (ICU) introduces new members of the health care team to assist with implementation of EBP initiatives. This new partnership results in improved length of stay, mortality rates, and ventilator times for critical care patients. Current literature suggests that a clinician-driven, standardized ventilator management protocol is of significant benefit. Tele-ICU clinicians provide an interactive element to coordinate interdisciplinary team efforts. Enhanced communication, data evaluation, and timely intervention expedite the weaning process and reduce ventilator length of stay. Consistent collaboration between tele-ICU and bedside clinicians successfully improves patient outcomes through standardized adherence to best-practice initiatives.

scholarly journals Impact of Pressure Injury Prevention Protocol in Home Care Services on the Prevalence of Pressure Injuries in the Dubai Community

2020 ◽  
Vol 3 (3) ◽  
pp. 99-104
Author(s):  
Sajitha Prasad ◽  
Nazneen Hussain ◽  
Sangeeta Sharma ◽  
Somy Chandy ◽  
Jessy Kurien
Keyword(s):  
Health Care ◽  
Home Care ◽  
Care Delivery ◽  
Assessment Tools ◽  
Care Plan ◽  
Significant Drop ◽  
Braden Scale ◽  
Increased Risk ◽  
Prevention Protocol ◽  
The Impact

<b><i>Background:</i></b> Pressure injuries (PIs) in the community have emerged as a health care burden in the past few years, leading to high rates of morbidity and mortality among the elderly population. There is evidence that simple risk assessment tools and protocols have reduced the prevalence of PIs considerably by shifting the focus to timely prevention and adequate management. The prevalence of PIs is high in home care setting and utilizes a major share of the organizational resources for its treatment and prevention. <b><i>Aim:</i></b> This study aims to assess the impact of the newly developed PI prevention protocol for home care patients in Dubai. The objectives are to evaluate effective implementation of the proposed protocol and its impact on the prevalence of PIs in the community to identify the gaps for improvement in the future. <b><i>Methods:</i></b> This retrospective observational was conducted in 13 primary health care centers in Dubai, UAE. Data were collected from 249 patients’ records at an average age of 75.5 ± 14.5 years old with compromised mobility (bedbound/chairbound) from January to July 2019. The PI prevalence was assessed before and after 6 months of implementing the PI prevention protocol and comparison was done using a standardized skin assessment scale (Braden Scale). Internationally validated tools from the Agency for Healthcare Research and Quality and National Institute for Health and Care Excellence were used to ensure the reliable use of the Braden Scale and PI protocol compliance. The prevalence was calculated from the existing key performance indicators in the home care office and considering the significant improvement at <i>p</i> value of &#x3c;0.05. <b><i>Results:</i></b> The findings in the first quarter revealed a significant drop in both prevalence (9.0%) and incidence rate (6.0%) to approximately 2.0%. Overall PIs prevalence declined significantly after implementing the protocol (<i>p</i> &#x3c; 0.0001) among both genders. Also, a significant improvement was detected in the use of Braden Scale and multidisciplinary care plan (<i>p</i> &#x3c; 0.0001). <b><i>Conclusion:</i></b> This study indicates that standardization of care delivery reduces the increased risk and incidence of PIs with a potentially positive outcome on PI prevalence.

Analysis Using Identical Patient Types Across Providers and the Implications for the Health Care Supply Chain

2011 ◽  
Vol 3 (1) ◽  
pp. 24-38 ◽  
Author(s):  
Breanne Cameron ◽  
Fay Cobb Payton
Keyword(s):  
Health Care ◽  
Supply Chain ◽  
Length Of Stay ◽  
Care Delivery ◽  
Clinical Pathways ◽  
Statistical Significance ◽  
Urban Hospital ◽  
Health Care Supply ◽  
Health Care Supply Chain ◽  
Total Charges

Along the health care supply chain, cost and quality measures are vital in the decision-making process for treatment and care delivery. This study applies statistical significance to a hypothesis about cost effectiveness of patients’ total charges by health insurance providers for different heart conditions. A retrospective, observational analysis of data is collected from an urban hospital in the Southeastern United States. Using the Agency for Healthcare Research and Quality (AHRQ) database, diagnoses are selected for further analysis based on their prevalence in the general population. The numbers of procedures as well as the patient’s length of stay in the hospital are significantly higher among the Medicare population. However, results indicate that although Medicaid and Medicare have significantly higher ordinary average total charges than the private counterparts, the difference is negligible when comparing means adjusted to remove covariate influence. One implication is that if private insurers were to insure the same types of high risk patients as Medicare and Medicaid the average total charges of a visit would be comparable between providers. These results also suggest that to enhance cost saving measures in government funded insurance programs, the clinical pathways need to be adapted to reduce length of stay and number of procedures per visit.

Sharing Common Principles: Blending the Primary Health Care and Harm Reduction Paradigms to Meet Common Health Goals in HIV/AIDS Prevention

2006 ◽  
Vol 12 (3) ◽  
pp. 34 ◽  
Author(s):  
Christopher A Pankonin
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Hiv Prevention ◽  
Disease Prevention ◽  
Harm Reduction ◽  
Care Delivery ◽  
Prevention Strategy ◽  
Primary Health ◽  
Increased Risk ◽  
Hiv Aids

HIV/AIDS continues to spread globally and deeply affecting resource-poor settings, with over 90% of cases occurring in developing countries. In these areas, primary health care remains the preferred model of health care delivery; advocating core principles including community involvement, equity, and an emphasis on disease prevention while providing basic medical treatment. The harm reduction paradigm shares key principles with primary health care, and as this paper will argue, a combined comprehensive HIV prevention strategy would provide a holistic and particularly effective approach to HIV prevention. The most important improvement achieved through a combined HIV prevention strategy is by providing the community with an increased number of social services including housing and employment services, financial counselling, mental health counselling, and referrals to additional medical services. In also addressing the social determinants of health, a combined primary health care and harm reduction approach act to provide a holistic disease prevention strategy that also seeks to address the conditions that lead to increased risk-taking behaviours. Additional evidence indicating a successful comprehensive prevention strategy remains closely tied to measures of effectiveness, including improvements in HIV prevalence and incidence rates, needle and syringe coverage, and treatment services for HIV/AIDS patients.

Rapid Process Optimization

2016 ◽  
Vol 32 (2) ◽  
pp. 172-177 ◽  
Author(s):  
Jennifer L. Wiler ◽  
Kelly Bookman ◽  
Derek B. Birznieks ◽  
Robert Leeret ◽  
April Koehler ◽  
...  
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Process Optimization ◽  
Process Improvement ◽  
Care Delivery ◽  
Health Care Systems ◽  
Process Redesign ◽  
Rapid Process ◽  
Left Without Being Seen ◽  
Care Systems

Health care systems have utilized various process redesign methodologies to improve care delivery. This article describes the creation of a novel process improvement methodology, Rapid Process Optimization (RPO). This system was used to redesign emergency care delivery within a large academic health care system, which resulted in a decrease: (1) door-to-physician time (Department A: 54 minutes pre vs 12 minutes 1 year post; Department B: 20 minutes pre vs 8 minutes 3 months post), (2) overall length of stay (Department A: 228 vs 184; Department B: 202 vs 192), (3) discharge length of stay (Department A: 216 vs 140; Department B: 179 vs 169), and (4) left without being seen rates (Department A: 5.5% vs 0.0%; Department B: 4.1% vs 0.5%) despite a 47% increased census at Department A (34 391 vs 50 691) and a 4% increase at Department B (8404 vs 8753). The novel RPO process improvement methodology can inform and guide successful care redesign.

Sign in / Sign up

Export Citation Format

Share Document