Augmented care: An alternative model of care for people with chronic disease

2017 ◽  
Vol 20 (1-2) ◽  
pp. 5-7 ◽  
Author(s):  
Michael Gill
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Chronic Conditions ◽  
Patient Empowerment ◽  
World Health Organisation ◽  
World Health ◽  
Health Issues ◽  
Model Of Care ◽  
Current Health ◽  
Wide Range

This opinion piece challenges the concept of ‘patient’ and discusses an alternative aspect to delivering health care for those with chronic disease. Chronic conditions are defined by the World Health Organisation (WHO), as illnesses requiring ongoing management over a long period of time and may address a wide range of health issues. Success is highly dependent upon optimised patient empowerment. I argue that it is not health care that really matters but opportunities to build upon optimising wellness. This leads to the idea where I suggest that current health system rigidities inadvertently promote illness.

scholarly journals Interventions to Support Behavioral Self-Management of Chronic Diseases

2019 ◽  
Vol 40 (1) ◽  
pp. 127-146 ◽  
Author(s):  
John P. Allegrante ◽  
Martin T. Wells ◽  
Janey C. Peterson
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Health Care Expenditures ◽  
Self Management ◽  
Management Interventions ◽  
Wide Range

A majority of the US adult population has one or more chronic conditions that require medical intervention and long-term self-management. Such conditions are among the 10 leading causes of mortality; an estimated 86% of the nation's $2.7 trillion in annual health care expenditures goes toward their treatment and management. Patient self-management of chronic diseases is increasingly essential to improve health behaviors, health outcomes, and quality of life and, in some cases, has demonstrated effectiveness for reducing health care utilization and the societal cost burden of chronic conditions. This review synthesizes the current state of the science of chronic disease self-management interventions and the evidence for their effectiveness, especially when applied with a systematic application of theories or models that account for a wide range of influences on behavior. Our analysis of selected outcomes from randomized controlled trials of chronic disease self-management interventions contained in 10 Cochrane systematic reviews provides additional evidence to demonstrate that self-management can improve quality of life and reduce utilization across several conditions.

scholarly journals Risk and the Republican National Convention: Application of the Novel COVID-19 Operational Risk Assessment

2021 ◽  
pp. 1-6
Author(s):  
David Callaway ◽  
Jeff Runge ◽  
Lucia Mullen ◽  
Lisa Rentz ◽  
Kevin Staley ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Health Care ◽  
Care Delivery ◽  
The United States ◽  
Lessons Learned ◽  
World Health ◽  
Local Health ◽  
Mass Gathering ◽  
Wide Range ◽  
National Convention

Abstract The United States Centers for Disease Control and Prevention and the World Health Organization broadly categorize mass gathering events as high risk for amplification of coronavirus disease 2019 (COVID-19) spread in a community due to the nature of respiratory diseases and the transmission dynamics. However, various measures and modifications can be put in place to limit or reduce the risk of further spread of COVID-19 for the mass gathering. During this pandemic, the Johns Hopkins University Center for Health Security produced a risk assessment and mitigation tool for decision-makers to assess SARS-CoV-2 transmission risks that may arise as organizations and businesses hold mass gatherings or increase business operations: The JHU Operational Toolkit for Businesses Considering Reopening or Expanding Operations in COVID-19 (Toolkit). This article describes the deployment of a data-informed, risk-reduction strategy that protects local communities, preserves local health-care capacity, and supports democratic processes through the safe execution of the Republican National Convention in Charlotte, North Carolina. The successful use of the Toolkit and the lessons learned from this experience are applicable in a wide range of public health settings, including school reopening, expansion of public services, and even resumption of health-care delivery.

scholarly journals The Potential Contribution of Current Health Care Zeitgeists to the Success of Health and Wellness Coaches

2018 ◽  
Vol 12 (6) ◽  
pp. 456-458
Author(s):  
Jon P. Gray ◽  
Katherine R. Arlinghaus ◽  
Craig A. Johnston
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Goal Setting ◽  
Behavioral Changes ◽  
Behavior Changes ◽  
Potential Contribution ◽  
Health And Wellness ◽  
Self Monitoring ◽  
Current Health ◽  
Extended Care

Chronic disease is challenging to treat because treatment often requires lifestyle behavior changes. In recent years the use of health and wellness coaches (HWC) has emerged as a way to support patients making behavioral changes. The use of HWCs has resulted in improved management of chronic disease for many patients. The success of HWCs is often thought to be due to the extended care they provide and the behavioral modification techniques they promote such as goal setting and self-monitoring. This article describes how HWC’s conformity to the current health care zeitgeist of personalized, holistic care may be another reason for their success.

scholarly journals Providing a primary care service for psychiatric in-patients

2004 ◽  
Vol 28 (5) ◽  
pp. 167-170 ◽  
Author(s):  
Enone Welthagen ◽  
Sarah Talbot ◽  
Oliver Harrison ◽  
Michael Phelan
Keyword(s):  
Primary Care ◽  
Chronic Conditions ◽  
Psychiatric Care ◽  
Care Service ◽  
Primary Care Service ◽  
Clinical Implications ◽  
Model Of Care ◽  
Wide Range ◽  
Set Up ◽  
Acute Psychiatric Care

Aims and MethodA prospective descriptive study was set up to evaluate the feasibility, acceptability and activity of an innovative weekly primary care service for patients admitted for acute psychiatric care.ResultsDuring 10 months, 36 clinics were held and 123 appointments were attended. Presenting complaints included a wide range of acute and chronic conditions, affecting all body systems. As well as treating specific complaints, the doctor providing this service undertook considerable health promotion work and gave advice about patient management to junior psychiatrists.Clinical ImplicationsIt appears that there is considerable need for primary care expertise within an acute psychiatric unit, and that a weekly clinic is a feasible model of care.

scholarly journals The influence of primary health care organizational models on patients’ experience of care in different chronic disease situations

2011 ◽  
Vol 31 (3) ◽  
pp. 109-120 ◽  
Author(s):  
R Pineault ◽  
S Provost ◽  
M Hamel ◽  
A Couture ◽  
JF Levesque
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Primary Health Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Chronically Ill ◽  
Organizational Models ◽  
Experience Of Care ◽  
Primary Health

Objectives To examine the extent to which experience of care varies across chronic diseases, and to analyze the relationship of primary health care (PHC) organizational models with the experience of care reported by patients in different chronic disease situations. Methods We linked a population survey and a PHC organizational survey conducted in two regions of Quebec. We identified five groups of chronic diseases and contrasted these with a no–chronic-disease group. Results Accessibility of care is low for all chronic conditions and shows little variation across diseases. The contact and the coordination-integrated models are the most accessible, whereas the single-provider model is the least. Process and outcome indices of care experience are much higher than accessibility for all conditions and vary across diseases, with the highest being for cardiovascular-risk-factors and the lowest for respiratory diseases (for people aged 44 and under). However, as we move from risk factors to more severe chronic conditions, the coordination-integrated and community models are more likely to generate better process of care, highlighting the greater potential of these two models to meet the needs of more severely chronically ill individuals within the Canadian health care system.

scholarly journals Training school teachers in Malawi about substance misuse and trauma: the need for a sustainable strategy

2021 ◽  
Vol 16 (6) ◽  
pp. 480-488
Author(s):  
Nicola Evans ◽  
Rhiannon Lane ◽  
Gemma Stacey-Emile ◽  
Anthony Sefasi
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Substance Misuse ◽  
World Health Organisation ◽  
World Health ◽  
Content Type ◽  
Sustainable Improvement ◽  
Post Measure ◽  
Health Need

Purpose The World Health Organisation found depression to be the fourth leading cause of disability in Malawi (Bowie, 2006) with the prevalence of mental health need in children and young people in Malawi estimated between 10 and 30% (Kutcher et al., 2019). One option to address this was to provide schoolteachers with skills and knowledge related to mental health so they can better support children. There is generally a lack of evidence of the utility or feasibility of school-based mental health literacy programmes in low to medium income countries (LMIC). This paper aims to report on a project to train schoolteachers in Malawi on aspects of mental health. Design/methodology/approach The aim of this project was to determine the acceptability and feasibility of delivering a training initiative in Malawi to teachers to better enable them to recognise and cope with school children who had been exposed to trauma and substance misuse. Findings Feedback was generated through the use of a specifically designed pre and post measure, focus groups, interviews and observations of the teaching delivery. Practical implications Teachers found the training built on their existing knowledge and they requested further opportunities for training and consultation about how to manage difficult presentations. It was evident that teachers did not know how to access mental health care or support for children whose needs could not be met by schoolteachers alone. Originality/value For a sustainable improvement for children’s mental health care in this context, further training becomes valuable when located as part of a network of joined up health and educational services.

scholarly journals Detection of Multi-drug Resistant Mycobacterium tuberculosis among Suspected Patients in Northeastern Nigeria

2019 ◽  
pp. 1-11
Author(s):  
B. A. Haruna ◽  
F. Tahir ◽  
A. F. Umar ◽  
Mohammad M. Ibrahim ◽  
H. J. Balla ◽  
...  
Keyword(s):  
Health Care ◽  
Mycobacterium Tuberculosis ◽  
World Health Organisation ◽  
World Health ◽  
Conventional Pcr ◽  
Resistant Tuberculosis ◽  
National Tuberculosis ◽  
Study Population ◽  
The Government ◽  
Health Care Centers

Aim: We determine the prevalence of TB and MDRTB within the study population. Methodology: The sampling consists of 192 (54.4%) males and 161 (45.6%) females.  Ziehel Neelsen staining method was used for the detection of Acid Fast Bacilli (AFB) in the sputum samples collected. Rifampicin resistant (MDRTB) isolates were detected by GeneXpert and the conventional PCR technique. Results: In this study, 6 (9.5%) out of the 63 positive samples were rifampicin resistant Mycobacterium tuberculosis in which 4(6.3%) were found among females and 2 (3.2%) were found among males. Infection with Mycobacterium tuberculosis was not dependent on gender statistically in this study P>0.05. Secondary institution among the health care centers had highest cases of tuberculosis18 (33.3%) while tertiary institute had higher rifampicin resistant tuberculosis 5(2.5%). Statistically there was significant relationship between occurrence of tuberculosis and health care centers p<0.05. Conclusion: There is need to establish more reference laboratories within the country in order to address the rising cases of tuberculosis. There is also need for urgent attention of the government and other developmental partners to address the rising cases of MTB and MDRTB which is outside the expected ratio of 3:1 (male : female) stipulated by the World Health Organisation (WHO) and to conduct a national tuberculosis drug resistance survey so as to determine the actual burden of MDRTB in Nigeria.

scholarly journals Patients with more comorbidities have better detection of chronic conditions, but poorer management and control: findings from six middle-income countries

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Grace Sum ◽  
Gerald Choon-Huat Koh ◽  
Stewart W. Mercer ◽  
Lim Yee Wei ◽  
Azeem Majeed ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
World Health Organisation ◽  
World Health ◽  
Uncontrolled Hypertension ◽  
Adult Health ◽  
Cross Sectional ◽  
Middle Income ◽  
Middle Income Countries ◽  
Increased Risk ◽  
And Control

Abstract Background The burden of non-communicable diseases (NCDs) is rising rapidly in middle-income countries (MICs), where NCDs are often undiagnosed, untreated and uncontrolled. How comorbidity impacts diagnosis, treatment, and control of NCDs is an emerging area of research inquiry and have important clinical implications as highlighted in the recent National Institute for Health and Care Excellence guidelines for treating patients suffering from multiple NCDs. This is the first study to examine the association between increasing numbers of comorbidities with being undiagnosed, untreated, and uncontrolled for NCDs, in 6 large MICs. Methods Cross-sectional analysis of the World Health Organisation Study of Global Ageing and Adult Health (WHO SAGE) Wave 1 (2007–10), which consisted of adults aged ≥18 years from 6 populous MICs, including China, Ghana, India, Mexico, Russia and South Africa (overall n = 41, 557). Results A higher number of comorbidities was associated with better odds of diagnosis for hypertension, angina, and arthritis, and higher odds of having treatment for hypertension and angina. However, more comorbidities were associated with increased odds of uncontrolled hypertension, angina, arthritis, and asthma. Comorbidity with concordant conditions was associated with improved diagnosis and treatment of hypertension and angina. Conclusion Patients with more comorbidities have better diagnosis of chronic conditions, but this does not translate into better management and control of these conditions. Patients with multiple NCDs are high users of health services and are at an increased risk of adverse health outcomes. Hence, improving their access to care is a priority for healthcare systems.

scholarly journals Teaching clinical handover with ISBAR

2020 ◽  
Vol 20 (S2) ◽  
Author(s):  
Annette Burgess ◽  
Christie van Diggele ◽  
Chris Roberts ◽  
Craig Mellis
Keyword(s):  
Health Professional ◽  
Community Setting ◽  
World Health Organisation ◽  
World Health ◽  
Clinical Environment ◽  
Clinical Handover ◽  
Professional Students ◽  
Wide Range ◽  
Health Professional Students ◽  
Patient Care Errors

AbstractClinical handover is one of the most critical steps in a patient’s journey and is a core skill that needs to be taught to health professional students and junior clinicians. Performed well, clinical handover should ensure that lapses in continuity of patient care, errors and harm are reduced in the hospital or community setting. Handover, however, is often poorly performed, with critical detail being omitted and irrelevant detail included. Evidence suggests that the use of a structured, standardised framework for handover, such as ISBAR, improves patient outcomes. The ISBAR (Introduction, Situation, Background, Assessment, Recommendation) framework, endorsed by the World Health Organisation, provides a standardised approach to communication which can be used in any situation. In the complex clinical environment of healthcare today, ISBAR is suited to a wide range of clinical contexts, and works best when all parties are trained in using the same framework. It is essential that healthcare leaders and professionals from across the health disciplines work together to ensure good clinical handover practices are developed and maintained. Organisations, including universities and hospitals, need to invest in the education and training of health professional students and health professionals to ensure good quality handover practice. Using ISBAR as a framework, the purpose of this paper is to highlight key elements of effective clinical handover, and to explore teaching techniques that aim to ensure the framework is embedded in practice effectively.

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