Clinical Practice Experiences Using a Professional Diabetes Management Ecosystem During COVID

2021 ◽  
pp. 193229682110657
Author(s):  
Juan Francisco Merino Torres ◽  
Mike Grady ◽  
Alfonso Lopez Alba ◽  
Lía Nattero Chavez ◽  
Alicia Justel Enriquez ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Patient Care ◽  
Case Studies ◽  
Health Care Professionals ◽  
Diabetes Management ◽  
Standard Of Care ◽  
Digital Ecosystem ◽  
Clinical Case Studies

Background: Challenges of patient care in diabetes were exacerbated by COVID, undermining the ability of patients to engage in-person with health care professionals (HCPs). To combat this, there has been accelerated adoption of telemedicine to support patient and provider connectivity. Methods: We collated survey information regarding telemedicine from 21 European clinical institutions. Health care professionals joined virtual meetings focusing on the OneTouch Reveal (OTR) ecosystem and its utility for conducting telemedicine. Selected HCPs provided clinical case studies to explain how the OTR ecosystem supported patient care. Results: Remote consultations increased by nearly 50% in 21 European clinics during the pandemic (Belgium [24%], Iberia [65%], Germany [34%], Italy [54%]). In all, 52% of people with diabetes using OTR app to connect remotely with HCPs had type 1 diabetes and 48% had type 2 diabetes. Remote connection methods included telephone (60%), email (19%), video chat (10%), text only (3%), or a mix of these methods (8%). Health care professionals usually reviewed patient data during consultations (45%) rather than before consultations (25%). Fifty-five percent of HCPs indicated digital ecosystems like OTR ecosystem would become their standard of care for diabetes management. In-depth conversations with HCPs provided a deeper understanding of how a digital ecosystem integrated into clinical practice and population management. In addition, five patient case studies using OTR ecosystem were provided by a selection of our HCPs. Conclusion: Diabetes management solutions, such as OTR ecosystem, supported telemedicine during the pandemic and will continue to play a valuable role in patient care beyond the pandemic.

Moral Economy and Moral Capital in the Community of Clinical Practice

2017 ◽  
Vol 28 (4) ◽  
pp. 523-533 ◽  
Author(s):  
Chrystal Jaye ◽  
Jessica Young ◽  
Tony Egan ◽  
Martyn Williamson
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Patient Care ◽  
Health Care Professionals ◽  
Moral Economy ◽  
Clinical Work ◽  
Management Program ◽  
Long Term Conditions ◽  
Care Clinic ◽  
Moral Capital

This New Zealand study used focused ethnography to explore the activities of communities of clinical practice (CoCP) in a community-based long-term conditions management program within a large primary health care clinic. CoCP are the informal vehicles by which patient care was delivered within the program. Here, we describe the CoCP as a micro-level moral economy within which values such as trust, respect, authenticity, reciprocity, and obligation circulate as a kind of moral capital. As taxpayers, citizens who become patients are credited with moral capital because the public health system is funded by taxes. This moral capital can be paid forward, accrued, banked, redeemed, exchanged, and forfeited by patients and their health care professionals during the course of a patient’s journey. The concept of moral capital offers another route into the “black box” of clinical work by providing an alternative theoretic for explaining the relational aspects of patient care.

scholarly journals Text Messaging and Type 1 Diabetes Management: Qualitative Study Exploring Interactions Among Patients and Health Care Professionals

JMIR Diabetes ◽  
10.2196/11343 ◽  
2019 ◽  
Vol 4 (2) ◽  
pp. e11343
Author(s):  
Francesco Miele ◽  
Silvia Clementi ◽  
Renzo Gennaro ◽  
Ilaria Nicolao ◽  
Tiziana Romanelli ◽  
...  
Keyword(s):  
Health Care ◽  
Type 1 Diabetes ◽  
Qualitative Study ◽  
Health Care Professionals ◽  
Text Messaging ◽  
Diabetes Management

scholarly journals Building capacity for implementation—the KT Challenge

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Agnes T. Black ◽  
Marla Steinberg ◽  
Amanda E. Chisholm ◽  
Kristi Coldwell ◽  
Alison M. Hoens ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Qualitative Data ◽  
Practice Change ◽  
Evidence Based ◽  
Science Literature ◽  
Health Care Settings ◽  
Improvement Programs ◽  
The Impact

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity, and practice change. Methods The evaluation used a mixed-methods retrospective pre-post design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, 6 months into implementation, and at the end of the 2-year funded projects) to measure KT capacity (knowledge, skills, and confidence) and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analyzed using non-parametric statistics. Results Participants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. Conclusions The KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.

scholarly journals Examining the role of MEDLINE as a patient care information resource: an analysis of data from the Value of Libraries study

2017 ◽  
Vol 105 (4) ◽  
Author(s):  
Kathel Dunn ◽  
Joanne Gard Marshall ◽  
Amber L. Wells ◽  
Joyce E. B. Backus
Keyword(s):  
Health Care ◽  
Adverse Events ◽  
Patient Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Information Resources ◽  
Information Resource ◽  
Care Providers ◽  
Other Information

Objective: This study analyzed data from a study on the value of libraries to understand the specific role that the MEDLINE database plays in relation to other information resources that are available to health care providers and its role in positively impacting patient care.Methods: A previous study on the use of health information resources for patient care obtained 16,122 responses from health care providers in 56 hospitals about how providers make decisions affecting patient care and the role of information resources in that process. Respondents indicated resources used in answering a specific clinical question from a list of 19 possible resources, including MEDLINE. Study data were examined using descriptive statistics and regression analysis to determine the number of information resources used and how they were used in combination with one another.Results: Health care professionals used 3.5 resources, on average, to aid in patient care. The 2 most frequently used resources were journals (print and online) and the MEDLINE database. Using a higher number of information resources was significantly associated with a higher probability of making changes to patient care and avoiding adverse events. MEDLINE was the most likely to be among consulted resources compared to any other information resource other than journals.Conclusions: MEDLINE is a critical clinical care tool that health care professionals use to avoid adverse events, make changes to patient care, and answer clinical questions.

scholarly journals Impact of Diabetes Continuing Education on Knowledge and Practice of Diabetes Care among Health Care Professionals in Yemen

2021 ◽  
pp. 221-230
Author(s):  
Salmeen D. Babelgaith ◽  
Mansour Almetwazi ◽  
Syed Wajid ◽  
Saeed Alfadly ◽  
Ahmed M Shaman ◽  
...  
Keyword(s):  
Health Care ◽  
Continuing Education ◽  
Diabetes Care ◽  
Health Care Professionals ◽  
Diabetes Management ◽  
Knowledge Score ◽  
General Knowledge ◽  
Significant Difference ◽  
Knowledge And Practice ◽  
The Impact

Background: This study aimed to evaluate the Impact of diabetes continuing education on knowledge and practice of diabetes care among health care professionals in Yemen. Methods: A quasi-experimental study was carried out among health care professionals. The original questionnaire consisted of 22 multiple choice questions. A total of 73 HCPs received continuing education (CE) intervention.  Knowledge attitude and practice (KAP) was assessed using a validated questionnaire.  Results: The result showed that majority of the HCPs has a good general knowledge on diabetes and its managements prior to the CE program. Evaluation of the general knowledge score of the HCPs found some improvement in the knowledge score, however the improvement was not significant (p=0.31). The result of this study found that HCPs has good knowledge on monitoring the sign, symptoms and laboratory parameters. Conclusion: Evaluation of the knowledge score on Goal of Diabetes Management of HCPs found significant (p=0.024) improvement in the knowledge score. The results indicated that the lab values were rated as the most important in the goal for the treatment of diabetes patients.  The study also found no significant difference in practice score after CE program among HCPs.

scholarly journals Perceptions of Interprofessional and Collaborative Practice in Collegiate Athletic Trainers

2018 ◽  
Vol 53 (7) ◽  
pp. 703-708 ◽  
Author(s):  
Dorice Hankemeier ◽  
Sarah A. Manspeaker
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Current Practice ◽  
Practice Patterns ◽  
Core Competencies ◽  
Athletic Trainers ◽  
Medical Model ◽  
Collaborative Practice ◽  
Cross Sectional

Context:  The ability to engage in interprofessional and collaborative practice (IPCP) has been identified as one of the Institute of Medicine's core competencies required of all health care professionals. Objective:  To determine the perceptions of athletic trainers (ATs) in the collegiate setting regarding IPCP and current practice patterns. Design:  Cross-sectional study. Patients or Other Participants:  Of 6313 ATs in the collegiate setting, 739 (340 men, 397 women, 2 preferred not to answer; clinical experience = 10.97 ± 9.62 years) responded (11.7%). Main Outcome Measure(s):  The Online Clinician Perspectives of Interprofessional Collaborative Practice survey section 1 assessed ATs' perceptions of working with other professionals (construct 1), ATs engaged in collaborative practice (construct 2), influences of collaborative practice (construct 3), and influences on roles, responsibilities, and autonomy in collaborative practice (construct 4). Section 2 assessed current practice patterns of ATs providing patient care and included the effect of communication on collaborative practice (construct 5) and patient involvement in collaborative practice (construct 6). Between-groups differences were assessed using a Kruskal-Wallis H test and Mann-Whitney U tests (P < .05). Results:  Athletic trainers in the collegiate setting agreed with IPCP constructs 1 through 4 (construct 1 = 3.56 ± 0.30, construct 2 = 3.36 ± 0.467, construct 3 = 3.48 ± 0.39, construct 4 = 3.20 ± 0.35) and indicated that the concepts of constructs 5 and 6 (1.99 ± 0.46, 1.80 ± 0.50, respectively) were sometimes true in their setting. Athletic trainers functioning in a medical model reported lower scores for construct 5 (1.88 ± 0.44) than did those in an athletic model (2.03 ± 0.45, U = 19 522.0, P = .001). A total of 42.09% of the ATs' patient care was performed in collaborative practice. Conclusions:  Athletic trainers in the collegiate setting agreed that IPCP concepts were beneficial to patient care but were not consistently practicing in this manner. Consideration of a medical model structure, wherein more regular interaction with other health care professionals occurs, may be beneficial to increase the frequency of IPCP.

scholarly journals Closed-loop management of inpatient hyperglycaemia

2019 ◽  
Vol 80 (11) ◽  
pp. 665-669
Author(s):  
CK Boughton ◽  
R Hovorka
Keyword(s):  
Health Care ◽  
Insulin Therapy ◽  
Health Care Professionals ◽  
Glucose Control ◽  
Closed Loop ◽  
Diabetes Management ◽  
Inpatient Setting ◽  
Glucose Levels ◽  
Closed Loop Systems ◽  
Inpatient Diabetes

The prevalence of diabetes in the inpatient setting is increasing, and suboptimal glucose control in hospital is associated with increased morbidity and mortality. Attaining the recommended glucose levels is challenging with standard insulin therapy. Hypoglycaemia and hyperglycaemia are common and diabetes management in hospital can be a considerable workload burden for health-care professionals. Fully automated insulin delivery (closed-loop) has been shown to be safe, and achieves superior glucose control than standard insulin therapy in the hospital, including in those patients receiving haemodialysis and enteral or parenteral nutrition where glucose control can be particularly challenging. Evidence that the improved glucose control achieved using closed-loop systems can translate into improved clinical outcomes for patients is key to support widespread adoption of this technology. The closed-loop approach has the potential to provide a paradigm shift in the management of inpatient diabetes, particularly in the most challenging inpatient populations, and may reduce staff work burden and the health-care costs associated with inpatient diabetes.

scholarly journals Development and Process Evaluation of a 5-Week Exercise Program to Prevent Falls in People after Stroke: The FALLS Program

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
H. J. R. van Duijnhoven ◽  
D. De Kam ◽  
W. Hellebrand ◽  
E. Smulders ◽  
A. C. H. Geurts ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Clinical Practice ◽  
Process Evaluation ◽  
Fall Prevention ◽  
Health Care Professionals ◽  
Exercise Program ◽  
Community Dwelling ◽  
Falls Prevention ◽  
Common Complication

Falls are a common complication after stroke, with balance and gait deficits being the most important risk factors. Taking into account the specific needs and capacities of people with stroke, we developed the FALLS program (FALL prevention after Stroke), based on the “Nijmegen falls prevention program” (a proven-effective 5-week exercise program designed for community-dwelling elderly people). The program was tested in twelve community-dwelling persons with stroke, and a process evaluation was conducted with patients, trainers, health care professionals, and managers. The FALLS program was considered suitable and feasible by people with stroke in the study and relevant health care professionals, and recommendations for implementation in clinical practice have been suggested.

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