scholarly journals The Implementation Chasm Hindering Genome-informed Health Care

2020 ◽  
Vol 48 (1) ◽  
pp. 119-125
Author(s):  
Kevin B. Johnson ◽  
Ellen Wright Clayton ◽  
Justin Starren ◽  
Josh Peterson
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Disease Management ◽  
High Quality ◽  
Healthcare Settings ◽  
Care Processes ◽  
Last Mile ◽  
New Knowledge ◽  
Health And Disease ◽  
The Impact

The promises of precision medicine are often heralded in the medical and lay literature, but routine integration of genomics in clinical practice is still limited. While the “last mile” infrastructure to bring genomics to the bedside has been demonstrated in some healthcare settings, a number of challenges remain — both in the receptivity of today's health system and in its technical and educational readiness to respond to this evolution in care. To improve the impact of genomics on health and disease management, we will need to integrate both new knowledge and new care processes into existing workflows. This change will be onerous and time-consuming, but hopefully valuable to the provision of high quality, economically feasible care worldwide.

IMPACT OF JOINT COMMISSION INTERNATIONALACCREDITATION (JCIA) ON HEALTH CARE PROCESSES AND THE CHALLENGES FACED BY PHYSICIANS AND NURSES.

2021 ◽  
pp. 34-35
Author(s):  
Binu Thomas ◽  
Ankur Joshi
Keyword(s):  
Health Care ◽  
Employee Engagement ◽  
Interdisciplinary Collaboration ◽  
Joint Commission ◽  
Health Centers ◽  
Cross Sectional ◽  
Care Processes ◽  
Before And After ◽  
Collaboration And Communication ◽  
The Impact

Purpose: To evaluate the impact of joint commission international accreditation on health care processes as well as to assess the challenges faced by the physicians and nurses . Method: Conducted a cross sectional study in 11 health centers belong to Dubai health authority. Prepared a checklist and questionnaire to assess the changes in the processes brought by accreditation as well as the challenges faced by employees respectively. Studied perceived challenges by recruiting physician (n=106) and nurses (n=194) using convenience sampling technique. Done content validity of the tools with clinical quality experts. Conducted pilot study for the questionnaire and checked the reliability using Cronbach alpha (0.924). After obtaining ethical clearance and consent from subjects, the researcher visited health centers and administered questionnaire to the participants. To evaluate the process improvements, the researcher audited documents for the availability of processes before and after accreditation using the validated checklist, which consisted of 25 processes reecting various domains of quality, employee engagement, interdisciplinary collaboration and communication. Results: Observed tremendous improvements in the availability of processes. The proportion of processes before and after the accreditation was statistically signicantly different (p <.001) for quality of health care. However for employee engagement (p=.250) and interdisciplinary collaboration and communication (p=1.000) no statistical signicance were noted even though there were signicant improvements. Majority (57.5%) of doctors and nurses perceived that the accreditation processes were challenging. Discussion: Observed processes improvements ensuring quality, employee engagement, interdisciplinary collaboration and communication after accreditation.However,majority ofthe employees perceived that, the accreditationwas challenging in terms ofworkload, communication and documentation.

scholarly journals The Impact of Population-Based Disease Management Services on Health Care Utilisation and Costs: Results of the CAPICHe Trial

2018 ◽  
Vol 34 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Paul A. Scuffham ◽  
Joshua M. Byrnes ◽  
Christine Pollicino ◽  
David Cross ◽  
Stan Goldstein ◽  
...  
Keyword(s):  
Health Care ◽  
Disease Management ◽  
Population Based ◽  
Health Care Utilisation ◽  
Care Utilisation ◽  
The Impact ◽  
Management Services

Better Knowledge for Better Health Services

2011 ◽  
pp. 233-255
Author(s):  
Stefano De Luca ◽  
Enrico Memo
Keyword(s):  
Data Mining ◽  
Health Care ◽  
Clinical Practice ◽  
Disease Management ◽  
Hidden Markov Models ◽  
Practice Guidelines ◽  
Markov Models ◽  
Hidden Markov ◽  
The Right ◽  
The Given

The expenses in Health Care are an important portion of the overall expenses of every country, so it is very important to determine if the given cares are the right ones. This work is about a methodology, Health Discoverer, and a consequent software, aimed to disease management and to the measure of appropriateness of cares, and in particular is about the data mining techniques used to verify Clinical Practice Guidelines (CPGs) compliance and the discovery of new, better guidelines. The work is based on Quality Records, episode parsing using Ontologies and Hidden Markov Models.

scholarly journals Operating Room Guide for Confirmed or Suspected COVID-19 Pregnant Patients Requiring Cesarean Delivery

2020 ◽  
Vol 37 (08) ◽  
pp. 825-828 ◽  
Author(s):  
Veronica M. Gonzalez-Brown ◽  
Joseph Reno ◽  
Heather Lortz ◽  
Kasey Fiorini ◽  
Maged M. Costantine
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Cesarean Delivery ◽  
Multidisciplinary Team ◽  
Team Approach ◽  
Health Care Settings ◽  
Multidisciplinary Team Approach ◽  
Local Resources ◽  
Care Processes ◽  
Key Points

We sought to provide a clinical practice protocol for our labor and delivery (L&D) unit, to care for confirmed or suspected COVID-19 patients requiring cesarean delivery. A multidisciplinary team approach guidance was designed to simplify and streamline the flow and care of patient with confirmed or suspected COVID-19 requiring cesarean delivery. A protocol was designed to improve staff readiness, minimize risks, and streamline care processes. This is a suggested protocol which may not be applicable to all health care settings but can be adapted to local resources and limitations of individual L&D units. Guidance and information are changing rapidly; therefore, we recommend continuing to update the protocol as needed. Key Points

scholarly journals A Critical Approach to Clinical Practice Guidelines

2000 ◽  
Vol 14 (6) ◽  
pp. 505-509 ◽  
Author(s):  
John K Marshall
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Patient Outcomes ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Care Delivery ◽  
Critical Approach ◽  
High Quality ◽  
Number Of Publications ◽  
Improve Patient

The rate of publication of clinical practice guidelines for the management of common medical illnesses continues to accelerate. The appropriate dissemination and uptake of high quality practice guidelines can synthesize evidence, improve patient outcomes and enhance the efficiency of health care delivery. However, the methodological rigour and relevance of the growing number of publications labelled ’clinical practice guidelines’ vary widely. Health care payers, providers and advocates must learn to appraise and interpret guideline recommendations critically. A simple and practical nine-question approach to evaluating the quality, relevance and effectiveness of clinical practice guidelines is presented.

scholarly journals Integrating a Dimensional, Hierarchical Taxonomy of Psychopathology into Clinical Practice_

2018 ◽  
Author(s):  
Camilo Ruggero
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Health Care Providers ◽  
Reliability And Validity ◽  
Daily Practice ◽  
Care Providers ◽  
Diagnostic Systems ◽  
Healthcare Settings ◽  
Co Morbidity ◽  
Common Barriers

Diagnosis is a cornerstone of clinical practice for mental health care providers, yet traditional diagnostic systems have well-known shortcomings, including inadequate reliability in daily practice, high co-morbidity, and marked within-diagnosis heterogeneity. The Hierarchical Taxonomy of Psychopathology (HiTOP) is a data-driven, hierarchically based alternative to traditional classifications that conceptualizes psychopathology as a set of dimensions organized into increasingly broad, transdiagnostic spectra. Prior work has shown that using a dimension-based approach improves reliability and validity, but translating a model like HiTOP into a workable system that is useful for health care providers remains a major challenge. To this end, the present work outlines the HiTOP model and describes the core principles to guide its integration into clinical practice. We review potential advantages and limitations for clinical utility, including case conceptualization and treatment planning. We illustrate what a HiTOP approach might look like in practice relative to traditional nosology. Finally, we discuss common barriers to using HiTOP in real-world healthcare settings and how they can be addressed.

Interventions to Decrease Use in Prehospital and Emergency Care Settings Among Super-Utilizers in the United States: A Systematic Review

2019 ◽  
Vol 77 (2) ◽  
pp. 99-111 ◽  
Author(s):  
Samantha Iovan ◽  
Paula M. Lantz ◽  
Katie Allan ◽  
Mahshid Abir
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Acute Care ◽  
Emergency Care ◽  
Grey Literature ◽  
The United States ◽  
Care Utilization ◽  
Regression To The Mean ◽  
High Quality ◽  
The Impact

Interest in high users of acute care continues to grow as health care organizations look to deliver cost-effective and high-quality care to patients. Since “super-utilizers” of acute care are responsible for disproportionately high health care spending, many programs and interventions have been implemented to reduce medical care use and costs in this population. This article presents a systematic review of the peer-reviewed and grey literature on evaluations of interventions to decrease prehospital and emergency care use among U.S. super-utilizers. Forty-six distinct evaluations were included in the review. The most commonly evaluated intervention was case management. Although a number of interventions reported reductions in prehospital and emergency care utilization and costs, methodological and study design weaknesses—especially regression to the mean—were widespread and call into question reported positive findings. More high-quality research is needed to accurately assess the impact of interventions to reduce prehospital and emergency care use in the super-utilizer population.

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