Integrating quality and safety science in nursing education and practice

2011 ◽  
Vol 16 (3) ◽  
pp. 226-240 ◽  
Author(s):  
Gwen Sherwood
Keyword(s):  
Health Care ◽  
Nursing Education ◽  
Health Care Professionals ◽  
Care Delivery ◽  
The United States ◽  
Quality And Safety ◽  
Learning Collaborative ◽  
Train The Trainer ◽  
Safety Science ◽  
Health Care Delivery Systems

Worldwide, health care delivery systems are applying new quality and safety science in response to startling reports of negative patient outcomes. Many health care professionals lack the knowledge, skills and attitudes to change the systems in which they work, calling for radical redesign of nursing education to integrate new safety and quality science. This paper describes the transformation underway in nursing education in the United States to integrate quality and safety competencies through the Quality and Safety Education for Nurses (QSEN) project. A national expert panel defined the competencies and surveyed US schools of nursing to assess current implementation. To model the changes needed, a 15-school Pilot Learning Collaborative completed demonstration projects and surveyed graduating students to self-assess their achievement of the competencies. A Delphi process assessed level and placement of the competencies in the curriculum to offer educators a blueprint for spreading across curricula. Specialty organisations are cross-mapping the competencies for graduate education, educational standards have incorporated the competencies into their essentials documents, and a train the trainer faculty development model is now helping educators transform curriculum. Two key questions emerge from these findings: Are any of these projects replicable in other settings? Will these competencies translate across borders?

scholarly journals Cultural Awareness and Sensitivity of Students in a Physical Therapy Program – A Pilot Survey

2018 ◽  
Author(s):  
Olaide Oluwole-Sangoseni ◽  
Michelle Jenkins-Unterberg
Keyword(s):  
Health Care ◽  
Physical Therapy ◽  
Cultural Sensitivity ◽  
Health Care Professionals ◽  
Cultural Awareness ◽  
Health Care Disparities ◽  
Care Delivery ◽  
The United States ◽  
Cross Sectional Survey ◽  
Significant Difference

Background: Attempts to address health and health care disparities in the United States have led to a renewed focus on the training of healthcare professionals including physical therapists. Current health care policies emphasize culturally competent care as a means of promoting equity in care delivery by health care professionals. Experts agree that cultural insensitivity has a negative association with health professionals’ ability to provide quality care. Objective: To evaluate the cultural awareness and sensitivity of physical therapy (PT) students in a didactic curriculum aimed to increase cultural awareness. Methods: Using the Multicultural Sensitivity Scale (MSS), a cross-sectional survey was conducted to assess cultural sensitivity among three groups of students, (N = 139) from a doctor of physical therapy (DPT) program at a liberal arts university in Saint Louis, MO. Results: Response rate was 76.3%. Participants (n=100) were students in first (DPT1, n=36), third (DPT3, n=36), and sixth (DPT6, n=28) year of the program. Mean ranked MSS score was DPT1 = 45.53, DPT3 = 46.60 DPT6 = 61.91. Kruskal-Wallis analysis of the mean ranked scores showed a significant difference among three groups, H = 6.05 (2, N=100), p ≤ .05. Discussion: Students who have completed the cultural awareness curriculum, and undergone clinical experiences rated themselves higher on the cultural sensitivity/awareness. Results provide initial evidence that experiential learning opportunities may help PT students to more effectively integrate knowledge from classroom activities designed to facilitate cultural competence.

scholarly journals Medical Oncologists’ Experiences in Using Genomic Testing for Lung and Colorectal Cancer Care

2017 ◽  
Vol 13 (3) ◽  
pp. e185-e196 ◽  
Author(s):  
Stacy W. Gray ◽  
Benjamin Kim ◽  
Lynette Sholl ◽  
Angel Cronin ◽  
Aparna R. Parikh ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Care Delivery ◽  
Participation Rate ◽  
The United States ◽  
Genomic Testing ◽  
Genomic Test ◽  
Medical Oncologists ◽  
Health Care Delivery Systems ◽  
Test Use

Purpose: Genomic testing improves outcomes for many at-risk individuals and patients with cancer; however, little is known about how genomic testing for non–small-cell lung cancer (NSCLC) and colorectal cancer (CRC) is used in clinical practice. Patients and Methods: In 2012 to 2013, we surveyed medical oncologists who care for patients in diverse practice and health care settings across the United States about their use of guideline- and non–guideline-endorsed genetic tests. Multivariable regression models identified factors that are associated with greater test use. Results: Of oncologists, 337 completed the survey (participation rate, 53%). Oncologists reported higher use of guideline-endorsed tests (eg, KRAS for CRC; EGFR for NSCLC) than non–guideline-endorsed tests (eg, Onco typeDX Colon; ERCC1 for NSCLC). Many oncologists reported having no patients with CRC who had mismatch repair and/or microsatellite instability (24%) or germline Lynch syndrome (32%) testing, and no patients with NSCLC who had ALK testing (11%). Of oncologists, 32% reported that five or fewer patients had KRAS and EGFR testing for CRC and NSCLC, respectively. Oncologists, rather than pathologists or surgeons, ordered the vast majority of tests. In multivariable analyses, fewer patients in nonprofit integrated health care delivery systems underwent testing than did patients in hospital or office-based single-specialty group settings (all P < .05). High patient volume and patient requests (CRC only) were also associated with higher test use (all P < .05). Conclusion: Genomic test use for CRC and NSCLC varies by test and practice characteristics. Research in specific clinical contexts is needed to determine whether the observed variation reflects appropriate or inappropriate care. One potential way to reduce unwanted variation would be to offer widespread reflexive testing by pathology for guideline-endorsed predictive somatic tests.

scholarly journals Improving Behavioral Health Equity through Cultural Competence Training of Health Care Providers

2019 ◽  
Vol 29 (Supp2) ◽  
pp. 359-364 ◽  
Author(s):  
Brian McGregor ◽  
Allyson Belton ◽  
Tracey L. Henry ◽  
Glenda Wrenn ◽  
Kisha B. Holden
Keyword(s):  
Health Care ◽  
Cultural Competence ◽  
Integrated Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Ethnic Disparities ◽  
The United States ◽  
Care Providers ◽  
Care Needs

 Racial/ethnic disparities have long persisted in the United States despite concerted health system efforts to improve access and quality of care among African Americans and Latinos. Cultural competence in the health care setting has been recognized as an important feature of high-quality health care delivery for decades and will continue to be paramount as the society in which we live becomes increasingly culturally diverse. Unfortunately, there is limited empirical evidence of patient health benefits of a culturally competent health care workforce in integrated care, its feasibility of imple­mentation, and sustainability strategies. This article reviews the status of cultural competence education in health care, the merits of continued commitment to training health care providers in integrated care settings, and policy and practice strategies to ensure emerging health care professionals and those already in the field are prepared to meet the health care needs of racially and ethnically diverse populations. Ethn Dis. 2019;29(Supp 2):359-364. doi:10.18865/ed.29.S2.359

Developing the Discipline and Practice of Comprehensive Men’s Health

2013 ◽  
Vol 7 (4) ◽  
pp. 342-349 ◽  
Author(s):  
Salvatore J. Giorgianni ◽  
Demetrius J. Porche ◽  
Scott T. Williams ◽  
Janet H. Matope ◽  
Brandon L. Leonard
Keyword(s):  
United States ◽  
Health Care ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Core Curriculum ◽  
Care Delivery ◽  
Building Blocks ◽  
The United States ◽  
Men’S Health ◽  
Men's Health

Men of all ages in the United States experience disproportionately higher rates of morbidity and premature death than females. The reasons for this are complex and include biological, sociological, and health system–related issues, but this is also in part due to the fact that men and boys tend to lead more risky lifestyles and generally avoid preventive care when compared with women and girls. These disparities not only affect males but also their loved ones and can adversely affect their participation in the workforce and in their communities. Better understanding of the drivers of men’s health disparities is needed to enable health professionals to more effectively address this problem. One of the fundamental building blocks for changing health care delivery to males is to provide a core curricular framework for education and training of health professionals related to the specific health issues of men and boys. This article will present a study assessing what men’s health courses are available in the United States and identifying the content within such courses that will prepare health care professionals to deliver programs and care to this demographic. The study identified that as of 2012, there were only 21 courses in 18 institutions that address gender-appropriate health care for boys and men. The authors conclude that developing and incorporating an expert, consensus-based men’s health core curriculum in universities and colleges, particularly in health professional programs, is an extremely important cornerstone in advancing the science and practice of true and balanced gender-based care delivery.

scholarly journals Overcoming fragmentation and waste in health care systems in Africa: Collaboration of health care professionals with pastoral caregivers

2014 ◽  
Vol 70 (2) ◽  
Author(s):  
Emem Agbiji ◽  
Christina Landman
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Hospital Care ◽  
Care Delivery ◽  
Health Care Systems ◽  
Medical Model ◽  
World Health ◽  
African Countries ◽  
Care Systems ◽  
Health Care Delivery Systems

This article explores the possibility and limits of collaboration between medical professionals and pastoral caregivers with a view to overcoming fragmentation and waste in the African hospital care sector. It argues that the quality of health and health care in many African countries is poor. Therefore, a purposeful reform of health care delivery systems in Africa is necessary. Building on the World Health Organization’s statement that the medical model that focuses on medicine and surgery and ignores the factors of belief and faith in healing is no longer satisfactory, it further argues that the medical model (including the bio-psychosocial model) is not sufficient for holistic hospital care; it therefore needs to accommodate complementary approaches (such as pastoral care) and include these as collaborative treatments. The connection of collaboration with quality, value, relationships and the ending of life implies that collaboration is an ethical process of reflection – which could have a legal implication.

scholarly journals Collaborative Public Health Surveillance Strategies to Address Local Health Needs

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Norma Padron
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Delivery ◽  
Public Health Surveillance ◽  
Care Delivery ◽  
The United States ◽  
Delivery Systems ◽  
Health Surveillance ◽  
Local Health ◽  
Health Care Delivery Systems

IntroductionThis presentation will review the current strategies being used by health care delivery systems across the US to incorporate via linkage, publicly available data assets. The discussion will focus on lessons learned with a specific emphasis of collaborations between health systems to address the opioid crisis. Objectives and ApproachTo review ongoing strategies to incorporate local, publicly available data assets to clinical data assets that health systems have for purposes of collaborations with public health surveillance. The emphasis of the discussion presented will be in the data strategies that local health departments and health care delivery systems have used to address the opioid crisis in the US. This presentation will propose strategies to be explored and bring forth concerns about data fairness, accountability and transparency when collaborations for public health surveillance are in place. ResultsThe presentation will discuss the experiences learned in specific regions in the United States. The main results will center around assessing the effectiveness of current strategies to share and analyze data across health care delivery systems and local agencies and government partners. The lessons learned of what works and what hasn't will be discussed in light of the ongoing epidemic of opioid use and drug overdose deaths in the United States. Finally the presentation will present strategies that could be explored for collaborative public health surveillance that address issues and concers of fairness, accountability and transparency. Conclusion/ImplicationsThe implications of this report and presentation is that ongoing data linkage and sharing strategies have been -for the most part- insufficient to enable delivery systems and local public health departments and government address rising epidemiological concerns. The proposed strategies complement what is being done and advance data-driven public health

scholarly journals 346 - Canadian Guidelines on Opioid and Benzodiazepine Use Disorders in Older Adults

2020 ◽  
Vol 32 (S1) ◽  
pp. 107-107
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Substance Use ◽  
Health Care Professionals ◽  
Population Aging ◽  
Care Delivery ◽  
World Population ◽  
Benzodiazepine Use ◽  
Health Care Delivery Systems ◽  
Part Presentation

The United Nations 20171 report on World Population Aging predicts that the number of persons over age 60 years will reach nearly 2.1 billion by the year 2050, representing 22% of the overall population. Despite this predicted demographic surge there is a vast lack of awareness of substance use disorders (SUDs) in older adults, a phenomenon that has been called “an invisible epidemic” by the Royal College of Psychiatrists2. Older adults, principally baby boomers, face the highest risk for SUDs3, but often go underrecognized, undertreated and underrepresented in clinical trials.Vaccarino et al in 20184 has put out a Call to Action to better serve the unmet needs of this population. There is an urgent need for raising awareness and improving education regarding SUDs, especially among older adults. There is also a great need for better training of health care professionals to improve their skills, knowledge, and attitudes towards treating SUDs in older adults. Policy and decision makers regarding health care delivery systems need to be better informed to make wiser decisions in order to improve access and availability of age-specific SUD treatments in older adults. To this end, The Canadian Coalition for Seniors’ Mental Health (CCSMH)5, with a grant from the Substance Use and Addictions Program (SUAP) of Health Canada, has recently created and published an introductory paper6 and a set of four guidelines on the prevention, assessment, and treatment of alcohol7, benzodiazepine8, cannabis9, and opioid10 use disorders among older adults.This is Part 1 of a two-part presentation of CCSMH’s SUD guidelines highlighting the opioid and benzodiazepine use disorders in older adults; Part 2, second presentation, will highlight guidelines related to alcohol and cannabis use disorder in older adults.

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