scholarly journals Enhancing Your Webside Manner: Optimizing Opportunities for Relationship-Centered Care in Virtual Visits

2020 ◽  
Vol 7 (6) ◽  
pp. 869-877
Author(s):  
Mary Beth Modic ◽  
Katie Neuendorf ◽  
Amy K Windover
Keyword(s):  
Health Care ◽  
Communication Strategies ◽  
Important Variable ◽  
High Quality ◽  
Improvement Project ◽  
Centered Care ◽  
Virtual Visits ◽  
Primary Means ◽  
Rapid Transmission

In the pandemic of coronavirus disease 2019, virtual visits have become the primary means of delivering efficient, high-quality, and safe health care while Americans are instructed to stay at home until the rapid transmission of the virus abates. An important variable in the quality of any patient–clinician interaction, including virtual visits, is how adroit the clinician is at forming a relationship. This article offers a review of the research that exists on forming a relationship in a virtual visit and the outcomes of a quality improvement project which resulted in the refinement of a “Communication Tip Sheet” that can be used with virtual visits. It also offers several communication strategies predicated on the R.E.D.E. to Communicate model that can be used when providing care virtually.

scholarly journals Quality of Inpatient Tuberculosis Health Care in High-Burden Resource-Limited Settings: Protocol for a Comprehensive Mixed Methods Assessment Study

10.2196/13903 ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. e13903
Author(s):  
Nune Truzyan ◽  
Zaruhi Grigoryan ◽  
Lusine Musheghyan ◽  
Byron Crape ◽  
Varduhi Petrosyan
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
International Standards ◽  
World Health ◽  
High Quality ◽  
High Burden ◽  
Resource Limited ◽  
Evaluation Instruments ◽  
Depth Interviews

Background The quality of care for tuberculosis (TB) is deficient in high-burden countries and urgently needs improvement. However, comprehensively identifying the required improvements is challenging. Providing high-quality TB care is an important step toward improving patients’ quality of life and decreasing TB morbidity and mortality. Effective tools for assessing the quality of TB services using international standards and guidelines can identify existing gaps in services and inform improvements to ensure high-quality inpatient TB services. Objective This study aimed to develop evaluation instruments for defining the quality of provision of TB services. Methods To assess quality of services in the largest TB hospital in Armenia, we developed instruments based on the Joint Commission International Accreditation Standards for Hospitals, International Standards for TB Care, TB Laboratories Bio-Safety Standards, and the World Health Organization framework for conducting TB program reviews. A mixed methods approach was utilized, triangulating quantitative (checklists) and qualitative (in-depth interviews) results. A scoring system and strengths, weaknesses, opportunities, and treats analysis was applied to detail results for each of the 122 standards assessed. A scaling approach was used to present overall performances of inpatient services for eight patient-centered functions and five organization management functions. Results Overall, 40 in-depth interviews and 91 checklists (21 observations, 16 policy papers, 20 staff qualification documents, and 34 medical records) were developed, utilized, and analyzed to explore practices of health care professionals, assess inpatient treatment experience of patients and their family members, evaluate facility environmental conditions, and define the degree of compliance to standards. Conclusions The effective comprehensive evaluation instruments and methods developed in this study for quality of inpatient TB services support the implementation of similar effective assessments in other countries. It may also become a platform to develop similar approaches for assessing ambulatory TB services in resource-limited countries. International Registered Report Identifier (IRRID) DERR1-10.2196/13903

P3415Will less developed countries be capable of giving high-quality universal coverage to cardiovascular disease survivors? Results from a national health survey, Chile ENS 2016–2017

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Margozzini ◽  
A Passi ◽  
M Kruk ◽  
G Danaei
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Health Care ◽  
Quality Of Care ◽  
National Health ◽  
Health Survey ◽  
Universal Coverage ◽  
National Health Survey ◽  
High Quality

Abstract Background Chilean Health System has fully implemented Universal Health Coverage (UHC) for acute cardiovascular events since 2005. Age-adjusted cardiovascular mortality has decreased, but there is limited information about coverage and quality of chronic health care given to cardiovascular disease (CVD) survivors at the national level. Purpose To assess the prevalence and quality of care in Chilean adult CVD survivors. Methods Chilean National Health Survey 2016–2017 (ENS 2016–2017) is a random stratified multistage sample of non-institutionalized population over 14 years (n=6240). Age, education, gender, rural/urban and geographical area weighted prevalence of CVD survivors (self-reported medical diagnosis of myocardial infarction or cerebrovascular attack) were calculated. High quality of care was defined as meeting six criteria simultaneously: under 70mg% LDL- C level, statin use, aspirin use, blood pressure under 130/80 mmHg, HgA1C<7 or 8 (>74-year-old) and non-smoking. Quality of care was explored using multivariate linear and logistic regression adjusting by age, gender, education and year of diagnosis (before or after UHC). Results Weighted national prevalence of CVD survivors in over 20-year-old population was 6.1%. The sample size for the CVD survivor analyses was n=455. 28.7% of CVS had their first event before the year 2005 (n=141). Overall 27.9% had LDL-C under 70mg%, 37.8% used statins, 41.4% used aspirin, 37.8% had controlled blood pressure, 78.3% were non-smokers and 84.3% had good glycemic control. National “high quality of care” prevalence in CVD survivors was 0.3%, 0.4% and 0.1% for men and women respectively. LDL and Blood pressure control prevalence (meet both criteria simultaneously) was 4,4%. In the adjusted multivariate model age was associated to a higher number of quality criteria achievement. Conclusion The number of CVD survivors in Chile is a huge challenge for the health care system. Universal coverage does not guarantee the quality of chronic life long care. Specific surveillance in high-risk population is needed to assess the system's effectiveness and accountability. Acknowledgement/Funding ENS 2016-2017 was funded by the chilean Ministry of Health (MINSAL)

Telestroke and Teleneurology

2021 ◽  
pp. 95-108
Author(s):  
Hartmut Gross ◽  
Jeffrey A. Switzer
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Professionals ◽  
Stroke Patients ◽  
High Quality ◽  
Optimal Care ◽  
Widespread Application ◽  
Rural Sites ◽  
Physician Liability

Evaluation and treatment of acute stroke is the oldest and most widespread application of telemedicine. Telestroke systems allow provision of the same high quality of care provided at specialized stroke centers to patients at emergency departments without stroke coverage. The early treatment achieved with telestroke leads to better functional outcomes in stroke patients, thereby lowering overall cost of patient care. Telestroke networks facilitate optimal care, decrease hospital and physician liability, educate health care professionals, and keep many patients closer to home. Admissions to, rather than transfers from, rural sites retain hospitalization revenues locally and help keep small, financially struggling hospitals viable.

Patient-Centered Medicine: Who, What, and How?

2016 ◽  
Author(s):  
Mark D. Sullivan
Keyword(s):  
Health Care ◽  
Chronic Illness ◽  
Clinical Problem ◽  
Chronic Illness Care ◽  
Patient Centered ◽  
Patient Agency ◽  
Centered Care ◽  
Primary Means ◽  
Patient Centered Medicine ◽  
Clear Idea

We don’t have a clear idea where health comes from. Our efforts to reform health care to make it more patient-centered and more responsive to the challenges of chronic illness have been too superficial. Three lessons for chronic illness care are derived: 1) we cannot assume that death and disease are the most important targets for health care, 2) we must draw on the patient’s perspective to define the nature of the clinical problem and the criteria of success for our clinical interventions, and 3) we must always aim toward increasing the patient’s capacity for self-care. The patient-centered care of chronic disease requires that we recognize the patient as the primary perceiver and producer of health. We must move not only from the passive patient to the informed and activated patient, but to the autonomous patient. Patient agency is both the primary means and primary end of health care.

From Patient to Agent

2016 ◽  
Author(s):  
Mark Sullivan MD, PhD
Keyword(s):  
Health Care ◽  
Chronic Illness ◽  
Patient Autonomy ◽  
Clinical Problem ◽  
Patient Centered ◽  
Objective Health ◽  
Centered Care ◽  
Primary Means ◽  
Definition Of Health ◽  
Definition Of

In the 21st century, the primary challenge for health care is chronic illness. To meet this challenge, we need to think anew about the role of the patient in health and health care. There have been widespread calls for patient-centered care, but this model of care does not question deeply enough the goals of health care, the nature of the clinical problem, and the definition of health itself. We must instead pursue patient-centered health, which is a health perceived and produced by patients. We should not only respect, but promote patient autonomy as an essential component of this health. Objective health measures cannot capture the burden of chronic illness, so we need to draw on the patient's perspective to help define the clinical problem. We require a new definition of health as the capacity for meaningful action. It is recognized that patients play a central role in chronic illness care, but the concept of health behavior retards innovation. We seek not just an activated patient, but an autonomous patient who sets and pursues her own vital goals. To fully enlist patients, we must bridge the gap between impersonal disease processes and personal processes. This requires understanding how the roots of patient autonomy lie in the biological autonomy that allows organisms to carve their biological niche. It is time for us to recognize the patient as the primary customer for health care and the primary producer of health. Patient agency is both the primary means and primary end of health care.

scholarly journals ATTITUDE AND EVALUATION BY THE MOSCOW CITY YOUTH OF THE SYSTEM OF MEDICAL INSTITUTIONS (ON THE EXAMPLE OF CLINICS)

2020 ◽  
pp. 206-210
Author(s):  
T. V. Smirnova ◽  
R. G. Smirnov ◽  
E. I. Tcoi ◽  
V. V. Maslyakov
Keyword(s):  
Health Care ◽  
Gender Differences ◽  
Young People ◽  
High Quality ◽  
Medical Institutions ◽  
Moscow City ◽  
Questionnaire Method ◽  
Study Questionnaire ◽  
Timely Treatment

Features and nature of the perception of medical institutions by the Moscow city youth have been considered. According to the results of a quantitative study (questionnaire method, N = 622) of the attitude of Moscow youth to service in medical institutions, it was concluded that, in general, young people are not sufficiently trustful of medical institutions. Among the main reasons for such a cautious attitude, respondents call insufficient equipment of clinics with high-quality equipment and organization issues. Relief gender differences have been defined: in general, according to the sample, young girls not only visit polyclinics more often than young boys, but are also more demanding to the quality of medical services provided and service. Informing the population about the positive changes in the health care system, new possibilities of medicine can serve as an incentive to change the attitude of young people to prevention and timely treatment.

scholarly journals Effective Team Working in Health Care

2016 ◽  
Author(s):  
Michael A. West ◽  
Lynn Markiewicz
Keyword(s):  
Professional Development ◽  
Health Care ◽  
Patient Satisfaction ◽  
Well Being ◽  
High Quality ◽  
Quality Health Care ◽  
Team Working ◽  
Quality Health ◽  
High Quality Health Care

In this chapter we show that team working is vital for high quality health care but that team working is often poor. We draw on research to show that effective team working is associated with fewer errors that harm staff and patients; fewer staff injuries; better staff well-being; higher levels of patient satisfaction; better quality of care; and lower patient mortality. “Pseudo team working” leads to the opposite outcomes. We describe how effective team based working can be developed and identify the importance of team objectives and leadership. The chapter describes the specific challenges for team working in health care, including the complexity of the context and the historical legacy of separate professional development and status hierarchies. We explore how these challenges can be overcome, arguing that ensuring effective team working in health care is critical to ensuring the delivery of high quality, continually improving and compassionate health care.

Anaesthetics

2016 ◽  
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Professional Practice ◽  
Health Care Organizations ◽  
Quality Care ◽  
Technical Skills ◽  
High Quality ◽  
Ventilatory Assistance ◽  
Applied Physiology

Current anaesthetic practice is provided using a combination of many different available techniques and drugs, with the primary aim of ensuring patient safety and high-quality care are provided for patients. Anaesthesia today is extremely safe, with mortality less than one death in 250 000 directly related to anaesthetic intervention alone. This is due to a continued focus on the principles of patient safety and quality of care, underpinned by continued innovation in pharmacology, applied physiology, physics, and engineering. These have yielded improved techniques and technologies to enhance airway management, provide ventilatory assistance and haemodynamic support, and monitor physiological parameters. Modern professional practice is continually seeking to improve by emphasizing the importance of individual non-technical skills in educational curricula and the workplace. In addition, anaesthetists are heavily involved in the integration of human factors science into health-care organizations.

scholarly journals Assessment of Construct Validity of a Tool to Measure the Quality of Brief Advice for Dietary Sodium Reduction by Health Care Providers (P16-056-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Katherine Jefferson ◽  
Amber Armstrong-Izzard ◽  
JoAnne Arcand
Keyword(s):  
Health Care ◽  
Construct Validity ◽  
Health Care Providers ◽  
Dietary Sodium ◽  
Care Providers ◽  
Sodium Reduction ◽  
High Quality ◽  
Brief Advice ◽  
Advice Group

Abstract Objectives To test the construct validity of the Sodium Advice Score (SAS). The SAS is a tool developed to measure the quality of brief advice provided by health care providers (HCP) about dietary sodium reduction. The validation of this tool will support its implementation in a behavioural intervention trial. Methods Thirty English speaking patients with a diagnosis of hypertension and no memory impairments were recruited from a primary care clinic in Ontario, Canada. Patients were randomized to a high quality dietary sodium advice group or to a low quality dietary sodium advice group. Each intervention was delivered by a registered dietitian and took no longer than 5–7 minutes for high quality advice and 1–2 minutes for low quality advice. After the dietary sodium advice was provided the patient completed the SAS tool (< 5 minutes). Frequency, type and duration of advice was assessed by the SAS tool, which had a maximum score of 16. Therefore, the high quality advice had an expected SAS score of 16. The low quality advice had an expected SAS score of 5. Results Patients included were 71.3 ± 7.9 years old and 53% were male. Overall, 43% and 47% of patients had received previous counseling from a dietitian and family doctor, respectively. Mean daily sodium intakes of 2593 ± 1403 mg/day and 3040 ± 2283 mg/day were similar between high and low quality advice groups. The mean SAS score was 6.9 ± 3.6 (range: 2 to 14) in the low quality advice group and 14.5 ± 1.5 (range: 10 to 16) in the high quality advice group. The high quality advice scores observed were statistically similar to the expected scores (P = 0.001), however the low advice scores were not. Overall, the low quality advice score was significantly lower than the high quality advice score (P < 0.000). Conclusions The SAS tool showed evidence of construct validity as it can differentiate between high and low quality sodium reduction advice provided by HCPs. It can be used as a valid tool for measuring quality of brief sodium reduction advice by HCPs in future research. Funding Sources Heart and Stroke Foundation of Canada.

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