Moving stroke rehabilitation research evidence into clinical practice: Consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable

Moving research evidence to practice can take years, if not decades, which denies stroke patients and families from receiving the best care. We present the results of an international consensus process prioritizing what research evidence to implement into stroke rehabilitation practice to have maximal impact. An international 10-member Knowledge Translation Working Group collaborated over a six-month period via videoconferences and a two-day face-to-face meeting. The process was informed from surveys received from 112 consumers/family members and 502 health care providers in over 28 countries, as well as from an international advisory of 20 representatives from 13 countries. From this consensus process, five of the nine identified priorities relate to service delivery (interdisciplinary care, screening and assessment, clinical practice guidelines, intensity, family support) and are generally feasible to implement or improve upon today. Readily available website resources are identified to help health care providers harness the necessary means to implement existing knowledge and solutions to improve service delivery. The remaining four priorities relate to system issues (access to services, transitions in care) and resources (equipment/technology, staffing) and are acknowledged to be more difficult to implement. We recommend that health care providers, managers, and organizations determine whether the priorities we identified are gaps in their local practice, and if so, consider implementation solutions to address them to improve the quality of lives of people living with stroke.

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Plain Language Summary: Opioid Prescribing for Analgesia After Common Otolaryngology Operations

Otolaryngology ◽

10.1177/0194599821996313 ◽

2021 ◽

Vol 164 (4) ◽

pp. 704-711

Author(s):

Samantha Anne ◽

Sandra A. Finestone ◽

Allison Paisley ◽

Taskin M. Monjur

Keyword(s):

Health Care ◽

Decision Making ◽

Clinical Practice ◽

Pain Management ◽

Health Care Providers ◽

Clinical Practice Guideline ◽

Shared Decision ◽

Care Providers ◽

Plain Language ◽

Opioid Prescribing

This plain language summary explains pain management and careful use of opioids after common otolaryngology operations. The summary applies to patients of any age who need treatment for pain within 30 days after having a common otolaryngologic operation (having to do with the ear, nose, or throat). It is based on the 2021 “Clinical Practice Guideline: Opioid Prescribing for Analgesia After Common Otolaryngology Operations.” This guideline uses available research to best advise health care providers, and it includes recommendations that are explained in this summary. Recommendations may not apply to every patient but can be used to facilitate shared decision making between patients and their health care providers.

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Consent, Refusal, and Waivers in Patient-Centered Dysphagia Care: Using Law, Ethics, and Evidence to Guide Clinical Practice

American Journal of Speech-Language Pathology ◽

10.1044/2016_ajslp-15-0041 ◽

2016 ◽

Vol 25 (4) ◽

pp. 453-469 ◽

Cited By ~ 8

Author(s):

Jennifer Horner ◽

Maria Modayil ◽

Laura Roche Chapman ◽

An Dinh

Keyword(s):

Health Care ◽

Public Policy ◽

Clinical Practice ◽

Health Care Providers ◽

Clinical Decision Making ◽

Clinical Decision ◽

Care Providers ◽

Patient Centered ◽

Legal Advice ◽

Medical Context

PurposeWhen patients refuse medical or rehabilitation procedures, waivers of liability have been used to bar future lawsuits. The purpose of this tutorial is to review the myriad issues surrounding consent, refusal, and waivers. The larger goal is to invigorate clinical practice by providing clinicians with knowledge of ethics and law. This tutorial is for educational purposes only and does not constitute legal advice.MethodThe authors use a hypothetical case of a “noncompliant” individual under the care of an interdisciplinary neurorehabilitation team to illuminate the ethical and legal features of the patient–practitioner relationship; the elements of clinical decision-making capacity; the duty of disclosure and the right of informed consent or informed refusal; and the relationship among noncompliance, defensive practices, and iatrogenic harm. We explore the legal question of whether waivers of liability in the medical context are enforceable or unenforceable as a matter of public policy.ConclusionsSpeech-language pathologists, among other health care providers, have fiduciary and other ethical and legal obligations to patients. Because waivers try to shift liability for substandard care from health care providers to patients, courts usually find waivers of liability in the medical context unenforceable as a matter of public policy.

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Concentration of health care providers: does it contribute to integration of service delivery?

Risk Management and Healthcare Policy ◽

10.2147/rmhp.s205905 ◽

2019 ◽

Vol Volume 12 ◽

pp. 153-166

Author(s):

Igor Sheiman ◽

Vladimir Shevsky

Keyword(s):

Health Care ◽

Service Delivery ◽

Health Care Providers ◽

Care Providers ◽

P Concentration

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Plain Language Summary: Sudden Hearing Loss

Otolaryngology ◽

10.1177/0194599819859884 ◽

2019 ◽

Vol 161 (2) ◽

pp. 211-217

Author(s):

Sujana S. Chandrasekhar ◽

Deena B. Hollingsworth ◽

Taskin M. Monjur ◽

Lisa Satterfield

Keyword(s):

Health Care ◽

Hearing Loss ◽

Clinical Practice ◽

Health Care Providers ◽

Clinical Practice Guideline ◽

Practice Guideline ◽

Sudden Hearing Loss ◽

Adult Patients ◽

Care Providers ◽

Plain Language

This plain language summary explains sudden hearing loss (SHL) to patients and focuses on sudden sensorineural (pronounced sen-suh-ree-noo r-uh l) hearing loss (SSNHL). The summary is for adult patients aged 18 and over and is based on the 2019 “Clinical Practice Guideline: Sudden Hearing Loss (Update).” The guideline uses research to advise doctors and other health care providers on the proper testing and treatment of patients with SSNHL. The guideline includes recommendations that are explained in this summary. Recommendations may not apply to every patient but can be used to help patients ask questions and make decisions in their own care.

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Plain Language Summary: Nosebleed (Epistaxis)

Otolaryngology ◽

10.1177/0194599819889945 ◽

2020 ◽

Vol 162 (1) ◽

pp. 26-32

Author(s):

David E. Tunkel ◽

Sarah M. Holdsworth ◽

Jacqueline D. Alikhaani ◽

Taskin M. Monjur ◽

Lisa Satterfield

Keyword(s):

Health Care ◽

Clinical Practice ◽

Health Care Providers ◽

Clinical Practice Guideline ◽

Medical Advice ◽

Care Providers ◽

Plain Language ◽

Treatment And Prevention ◽

History Of ◽

Or History

This plain language summary explains nosebleeds, also known as epistaxis (pronounced ep-ih-stak-sis), to patients. The summary applies to any individual aged 3 years and older with a nosebleed or history of nosebleed who needs medical treatment or wants medical advice. It is based on the 2020 “Clinical Practice Guideline: Nosebleed (Epistaxis).” This guideline uses research to advise doctors and other health care providers on the diagnosis, treatment, and prevention of nosebleeds. The guideline includes recommendations that are explained in this summary. Recommendations may not apply to every patient but can be used to help patients ask questions and make decisions in their own care.

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Medical Ethics in Clinical Practice in Nepal: Challenges and Way Forward

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v6i2.22500 ◽

2018 ◽

Vol 6 (2) ◽

pp. 69-72

Author(s):

Shristi Raut ◽

Anand Kumar

Keyword(s):

Health Care ◽

Clinical Practice ◽

Medical Ethics ◽

Health Care Providers ◽

Undergraduate Curriculum ◽

Medical Professionals ◽

Care Providers ◽

Treatment Providers ◽

Level Of Knowledge ◽

Hospital Ethics

Ethics for health care professional have many components. Among them, medical ethics is one of the important but neglected component which deals with issues related to confidentiality, beneficence and non-maleficence between health care providers and stake holders. Four basic principles of medical ethics are autonomy, justice, beneficence and non- maleficence which form the foundation of ethical clinical practice. The level of knowledge on medical ethics that medical students receive during the training is meagre and inadequate. In recent years, clinical practice has become more challenging. This is primarily due to increased opposition, aggression and violence against medical professionals at health care settings. As a result, the gap between clinicians and patients is increasing leading to diminishing trust and real/perceived allegations. In addition, the widening gap between doctors and patients has provided a space for middle men/broker to meddle, oppose and flare up the violence against treatment providers. Doctors and other medical professionals have been increasingly facing such challenges leading to circumspection in their practice, despondence, psychosocial trauma and depression. There is an urgent need of incorporation of medical ethics in undergraduate curriculum and independent hospital ethics committee consisting of experts from the hospital and outside to monitor and provide rational reasons to minimize such challenges.

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Pathways to psychiatric care in Ethiopia

Psychological Medicine ◽

10.1017/s0033291708003929 ◽

2008 ◽

Vol 39 (3) ◽

pp. 475-483 ◽

Cited By ~ 43

Author(s):

Y. Y. Bekele ◽

A. J. Flisher ◽

A. Alem ◽

Y. Baheretebeb

Keyword(s):

Mental Health ◽

Health Care ◽

Service Delivery ◽

Psychiatric Hospital ◽

Health Care Providers ◽

Mental Hospital ◽

Psychiatric Care ◽

Addis Ababa ◽

World Health ◽

Care Providers

BackgroundUnderstanding the pathways to psychiatric care and recognition of delay points are crucial for the development of interventions that aim to improve access to mental health-care services.MethodOver a 2-month period in 2003, a total of 1044 patients at the commencement of new episodes of care at Amanuel Specialized Mental Hospital in Addis Ababa, Ethiopia were interviewed using the encounter form that was developed by the World Health Organization (WHO) for the study of pathways to psychiatric care.ResultsThe mental hospital was contacted directly by 41% of patients. The remaining patients sought care from up to four different caregivers before arriving at the psychiatric hospital. Where the initial service was not received at the psychiatric hospital, 30.9% of patients sought care from priests/holy water/church. The median delay between onset of illness and arrival at the psychiatric hospital was 38 weeks. The longest delays before arriving at the mental hospital were associated with having no formal education, joblessness, and diagnoses of epilepsy and physical conditions.ConclusionsImplementing a robust referral system and establishing a strong working relationship with both traditional and modern health-care providers, as well as designing a service delivery model that targets particular segments of the population, such as those who are uneducated, jobless and/or suffer from epilepsy and somatic conditions, should be the most important strategies towards improving mental health service delivery and shortening of undue delay for patients receiving psychiatric care in Ethiopia.

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