scholarly journals Exploring Interpersonal Relationships in a Nurse-Managed Clinic and Their Impact on Clinical Outcomes

SAGE Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 215824401985843
Author(s):  
Charlotte T. Lee ◽  
Susanne Phillips ◽  
Susan Tiso ◽  
Camille Fitzpatrick
Keyword(s):  
Health Care ◽  
Interpersonal Relationships ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Primary Care Clinic ◽  
Patient Characteristics ◽  
Care Providers ◽  
Care Clinic ◽  
Outcomes Of Care ◽  
The Impact

This study explores the impact of interpersonal relationships on processes and outcomes of care at a nurse-managed, primary care clinic in Southern California serving a vulnerable population. Ten semistructured interviews were conducted with all health care providers in the clinic to explore patient characteristics, types of relationships experienced, and how they may have affected processes and outcomes of care. Themes in interviews were identified through thematic analysis. We found that (a) patients with limited access to health care and resources establish different types of relationships to support their needs, and (b) interpersonal relationships, including those among providers, affect quality of care.

Evaluation of a Distance Consulting Service Based on Interactive Video and Integrated Computerized Technology

1995 ◽  
Vol 1 (2) ◽  
pp. 69-78 ◽  
Author(s):  
P A Jennett ◽  
W G Hall ◽  
J E Morin ◽  
M Watanabe
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Wide Spectrum ◽  
Rural Site ◽  
Care Providers ◽  
Telemedicine System ◽  
Medical Specialties ◽  
Access To Health ◽  
The Impact

Telemedicine equipment was installed at a rural site in Drumheller and at Calgary, 85 miles (136 km) away. It allowed consultation between health-care providers at Drumheller and specialists and subspecialists at the Faculty of Medicine in Calgary. The efficacy of the system in providing more equitable access to health care for persons living in geographically remote sites was evaluated during a 12-month pilot project. Seventy-five encounters were attempted during the study. A total of 55 encounters (42 clinical and 13 non-clinical) were completed. The completed clinical encounters were distributed across a wide spectrum of medical specialties. Users of the system reported favourably on the impact of the telemedicine system on access to health services for rural patients, on diagnostic, investigative and management decisions, on patient and physician travel times, on feelings of professional isolation and educational opportunities and on overall patient health status. The study provides new knowledge and demonstrates the success of the technology in this project. As expected, other problems were raised and addressed in a preliminary manner including: the potential for health-provider education; acquisition and retention of rural physicians; ethical, legal and patient confidentiality issues; minimum acceptable technology; and network management issues.

Access to Medical Care for HIV - Infected Individuals Under the Americans with Disabilities Act: A Duty to Treat

1992 ◽  
Vol 18 (3) ◽  
pp. 233-250
Author(s):  
Jill Cohen
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Americans With Disabilities Act ◽  
Access To Health Care ◽  
Care Providers ◽  
Legislative History ◽  
Statutory Duty ◽  
Access To Medical Care ◽  
The Impact ◽  
Direct Threat

In 1990, Congress enacted the Americans with Disabilities Act (ADA). This Note examines the legislative history of the ADA and uncovers Congress's intent to impose a duty on health care providers to treat people with disabilities unless an individual poses a “direct threat” to the health or safety of others. This Note posits that, with the passage of the ADA, Congress imposed a statutory duty on health care providers to give care to people infected with HIV who qualify under the statute. This Note concludes that while the “direct threat” exception may lessen the impact of the ADA, those infected with HIV should enjoy greater access to health care than ever before.

Using Technology to Improve Access to Health Care for Culturally and Linguistically Diverse Populations

2012 ◽  
Vol 19 (3) ◽  
pp. 71-76 ◽  
Author(s):  
Pauline A. Mashima
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Underserved Populations ◽  
Linguistically Diverse ◽  
Care Providers ◽  
Department Of Health ◽  
Use Of Technology ◽  
Access To Health ◽  
Improve Access

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.

Reclaiming and Reshaping Life: Patterns of Reconstruction After the Suicide of a Loved One

2016 ◽  
Vol 27 (7) ◽  
pp. 994-1005 ◽  
Author(s):  
Dolores Angela Castelli Dransart
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Suicide Survivors ◽  
Loved One ◽  
Life Patterns ◽  
Survivors Of Suicide ◽  
And Coping ◽  
The Impact ◽  
Depth Interviews

The objective of this study is to identify patterns (components and processes) of reconstruction of suicide survivors. In-depth interviews were conducted with 50 survivors of suicide in Switzerland. Data were analyzed using ATLAS.ti and according to the Grounded Theory principles. Survivors of suicide face four major challenges: dealing with the impact of suicide, searching for meaning, clarifying responsibility, and finding a personal style of reaction and coping. The various ways in which survivors fare through the specific processes of the challenges result in various patterns of reconstruction: the vulnerability, transformation, commitment, and hard blow. The unique characteristics and dynamics of each of them are highlighted. Health care providers would benefit from an approach based on the dynamics of the various patterns of reconstruction in providing appropriate support to survivors of suicide.

The Use of and Attitude Towards Telehealth in Rural Communities

2007 ◽  
Vol 13 (3) ◽  
pp. 29 ◽  
Author(s):  
Emily Mauldon
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Routine Practice ◽  
Care Providers ◽  
Urban Hospital ◽  
Primary Health ◽  
The Impact ◽  
Rural Patients

This paper reports on the attitudes of a sample of health care providers towards the use of telehealth to support rural patients and integrate rural primary health and urban hospital care. Telehealth and other information technologies hold the promise of improving the quality of care for people in rural and remote areas and for supporting rural primary health care providers. While seemingly beneficial for rural patients, study participants believed that telehealth remains underused and poorly integrated into their practice. In general, participants thought that telehealth is potentially beneficial but places constraints on their activities, and few actually used it. Published literature usually reports either on the success of telehealth pilot projects or initiatives that are well resourced and do not reflect the constraints of routine practice, or has an international focus limiting its relevance to the Australian context. Because of the paucity of systematic and generalisable research into the effects of the routine use of telehealth to support rural patients, it is unclear why health care professionals choose to provide such services or the costs and benefits they incur in doing so. Research and policy initiatives continue to be needed to identify the impact of telehealth within the context of Australian primary health care and to develop strategies to support its use.

Intimate Partner Violence Screening and Referral Practices in an Outpatient Care Setting

2017 ◽  
Vol 35 (23-24) ◽  
pp. 5877-5888 ◽  
Author(s):  
Cari Jo Clark ◽  
Lynette M. Renner ◽  
Mary E. Logeais
Keyword(s):  
Intimate Partner Violence ◽  
Health Care Providers ◽  
Partner Violence ◽  
Primary Care Clinic ◽  
Well Being ◽  
Intimate Partner ◽  
Care Providers ◽  
Care Clinic ◽  
Barriers And Opportunities ◽  
Academic Primary Care

Health care providers who screen for intimate partner violence (IPV) and counsel patients can reduce victimization and positively impact women’s health and well-being; yet only 2% to 50% of medical professionals report routinely screening female patients. The purpose of this study was to identify current practices, policies, barriers, and opportunities for a coordinated and routinized response to IPV in an outpatient academic primary care clinic. Data were collected through interviews and the Physician Readiness to Manage Intimate Partner Violence questionnaire. Data on IPV screening practices over a 5-month period were also available through the electronic health record. Study participants expressed that there was no uniform method of documenting screening results and great variability in the patient populations and circumstances that prompted screening. Over two thirds of the survey respondents reported either a lack of IPV protocol or a lack of knowledge about one if it existed. Providers and staff who participated believed it was within their scope of work to screen for IPV and recognized IPV as a serious health threat; however, they cited an absence of patient education resources, a lack of staff training and awareness, and no established IPV referral network as barriers to screening for IPV. The results of the pilot are in line with existing research highlighting a general lack of screening, variability in process, and the absence of systems-level policies and protocols and linkages to community resources. Pilot findings have been used to initiate a project which encompasses routinized screening, documentation, and care coordination between providers and community organizations to improve patient well-being.

The legal framework applicable to insecurity and violence affecting the delivery of health care in armed conflicts and other emergencies

2013 ◽  
Vol 95 (889) ◽  
pp. 83-127 ◽  
Author(s):  
Alexander Breitegger
Keyword(s):  
Health Care ◽  
Medical Ethics ◽  
Health Care Providers ◽  
Delivery Of Health Care ◽  
Access To Health Care ◽  
Legal Framework ◽  
Armed Conflicts ◽  
Health Care Personnel ◽  
International Human Rights Law ◽  
Care Providers

AbstractEnsuring respect for, and protection of, the wounded and sick and delivery of health care to them were at the origin of the Red Cross and Red Crescent Movement, as well as the development of international humanitarian law (IHL). In today's armed conflicts and other emergencies, the problem is not the lack of existing international rules but the implementation of relevant IHL and international human rights law (IHRL) which form a complementary framework governing this issue. Against the backdrop of the different manifestations of violence observed by the ICRC in the field and expert consultations held in the framework of the Health Care in Danger Project, this article identifies commonalities between the two legal regimes, including with respect to obligations to provide and facilitate impartial health care; prohibitions of attacks against wounded and sick and health-care providers; prohibitions to arbitrarily obstruct access to health care; prohibitions to harass health-care personnel, in violation of medical ethics; or positive obligations to ensure essential medical supplies and health-care infrastructure and protect health-care providers against violent interferences by others. The article concludes by indicating certain areas where implementation of existing IHL and IHRL is needed, including in domestic normative frameworks, military doctrine and practice, as well as training of health-care personnel on these international legal frameworks and medical ethics.

Health Care Providers in War and Armed Conflict: Operational and Educational Challenges in International Humanitarian Law and the Geneva Conventions, Part I. Historical Perspective

2018 ◽  
Vol 13 (02) ◽  
pp. 109-115 ◽  
Author(s):  
Frederick M. Burkle ◽  
Adam L. Kushner ◽  
Christos Giannou ◽  
Mary A. Paterson ◽  
Sherry M. Wren ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Armed Conflict ◽  
Historical Perspective ◽  
Geneva Convention ◽  
World Health ◽  
International Humanitarian Law ◽  
Humanitarian Law ◽  
Care Providers ◽  
The Impact

AbstractSince 1945, the reason for humanitarian crises and the way in which the world responds to them has dramatically changed every 10 to 15 years or less. Planning, response, and recovery for these tragic events have often been ad hoc, inconsistent, and insufficient, largely because of the complexity of global humanitarian demands and their corresponding response system capabilities. This historical perspective chronicles the transformation of war and armed conflicts from the Cold War to today, emphasizing the impact these events have had on humanitarian professionals and their struggle to adapt to increasing humanitarian, operational, and political challenges. An unprecedented independent United Nations–World Health Organization decision in the Battle for Mosul in Iraq to deploy to combat zones emergency medical teams unprepared in the skills of decades-tested war and armed conflict preparation and response afforded to health care providers and dictated by International Humanitarian Law and Geneva Convention protections has abruptly challenged future decision-making and deployments. (Disaster Med Public Health Preparedness. 2019;13:109–115)

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