scholarly journals Implementing enhanced patient care to promote patient engagement in HIV care in a rural setting in Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Juddy Wachira ◽  
Becky Genberg ◽  
Diana Chemutai ◽  
Ann Mwangi ◽  
Omar Galarraga ◽  
...  
Keyword(s):  
Patient Care ◽  
Patient Engagement ◽  
Quantitative Data ◽  
Clinical Care ◽  
Descriptive Analysis ◽  
Care Program ◽  
System Level ◽  
Rural Setting ◽  
Hiv Care ◽  
Provider Training

Abstract Background Patient engagement is effective in promoting adherence to HIV care. In an effort to promote patient-centered care, we implemented an enhanced patient care (EPC) intervention that addresses a combination of system-level barriers including provider training, continuity of clinician-patient relationship, enhanced treatment dialogue and better clinic scheduling. We describe the initial implementation of the EPC intervention in a rural HIV clinic in Kenya, and the factors that facilitated its implementation. Methods The intervention occurred in one of the rural Academic Model Providing Healthcare (AMPATHplus) health facilities in Busia County in the western region of Kenya. Both qualitative and quantitative data were collected through training and meeting proceedings/minutes, a patient tracking tool, treatment dialogue and a peer confirmation tool. Qualitative data were coded and emerging themes on the implementation and adaptation of the intervention were developed. Descriptive analysis including percentages and means were performed on the quantitative data. Results Our analysis identified four key factors that facilitated the implementation of this intervention. (1) The smooth integration of the intervention as part of care that was facilitated by provider training, biweekly meetings between the research and clinical team and having an intervention that promotes the health facility agenda. (2) Commitment of stakeholders including providers and patients to the intervention. (3) The adaptability of the intervention to the existing context while still maintaining fidelity to the intervention. (4) Embedding the intervention in a facility with adequate infrastructure to support its implementation. Conclusions This analysis demonstrates the value of using mixed methods approaches to study the implementation of an intervention. Our findings emphasize how critical local support, local infrastructure, and effective communication are to adapting a new intervention in a clinical care program.

scholarly journals Metrics of Patient, Public, Consumer, and Community Engagement in Healthcare Systems: How Should We Define Engagement, What Are We Measuring, and Does It Matter for Patient Care? Comment on "Metrics and Evaluation Tools for Patient Engagement in Healthcare Organization- and System-Level Decision-Making: A Systematic Review"

2018 ◽  
Vol 8 (1) ◽  
pp. 49-50
Author(s):  
Zackary Berger
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Patient Care ◽  
Clinical Outcomes ◽  
Patient Engagement ◽  
Clinical Care ◽  
Healthcare Systems ◽  
System Level ◽  
Patient Representatives ◽  
Conceptual Foundations

In a rigorous systematic review, Dukhanin and colleagues categorize metrics and evaluative tools of the engagement of patient, public, consumer, and community in decision-making in healthcare institutions and systems. The review itself is ably done and the categorizations lead to a useful understanding of the necessary elements of engagement, and a suite of measures relevant to implementing engagement in systems. Nevertheless, the question remains whether the engagement of patient representatives in institutional or systemic deliberations will lead to improved clinical outcomes or increased engagement of individual patients themselves in care. Attention to the conceptual foundations of patient engagement would help make this systematic review relevant to the clinical care of patients.

scholarly journals EVALUATING INTERPROFESSIONAL EDUCATION PRINCIPLE IN A LONGITUDINAL COMMUNITY-BASED PROGRAM FOR 3 SCHOOLS OF HEALTH PROFESSIONS: MEDICINE, NURSING, AND NUTRITION

2018 ◽  
Vol 7 (1) ◽  
pp. 59
Author(s):  
Doni Widyandana
Keyword(s):  
Undergraduate Students ◽  
Interprofessional Education ◽  
Quantitative Data ◽  
Descriptive Analysis ◽  
Community Setting ◽  
Care Program ◽  
Health Professions ◽  
Attitude Scale ◽  
Patient Centeredness ◽  
Community Based

Background: Interprofessional education (IPE) is a method offered to support the collaboration of two health professions or more in order to create an ideal teamwork. This study aims to evaluate students’ interprofessional attitudes during the implementation of IPE in a community-based program among 3 health professions students.Method: Second and third year undergraduate students from three health profession schools in Faculty of Medicine, Universitas Gadjah Mada, medicine (n = 50), nursery (n = 50), and nutrition (n = 50), were recruited in 2015. Students were sent to a community setting in a small group of 10 consisting of those three schools’ students. They were assigned to a certain family and followed them longitudinally in a curriculum called the Community and Family Health Care program. Quantitative data were collected with a survey using Interprofessional Attitude Scale instrument containing 5 subscales (27 items): teamwork, roles and responsibilities; patient-centeredness; interprofessional biases; diversity and ethics; and community-centeredness. The items used 5-level Likert scale. Descriptive analysis was performed for the quantitative data and comparison among those three groups used Kruskal-Wallis test.Results: Most of the students strongly agreed they learned a lot about interprofessional attitudes during this program (mean scores of each subscale: 3.85, 4.19, 3.18, 3.83, and 3.99, respectively). There were significant differences among mean scores of each subscale (p< 0.05). Medical and nursery students had higher mean scores compared to nutrition students, except in the subscale of community-centeredness (p = 0.197).Conclusion: IPE can be implemented successfully in a longitudinal community-based education curriculum and benefits undergraduate students in studying interprofessional attitudes. The program should be evaluated and improved to assure all students to get equal benefits.

scholarly journals Evaluation of the effect of the capitation compensation mechanism among pulmonary tuberculosis patients with a full period of treatment

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Xing-Yu Hu ◽  
Guang-Ying Gao
Keyword(s):  
Pulmonary Tuberculosis ◽  
Patient Compliance ◽  
Quantitative Data ◽  
Financial Burden ◽  
Descriptive Analysis ◽  
Compensation Mechanism ◽  
Medication Costs ◽  
Implementation Time ◽  
Full Period ◽  
The Impact

Abstract Background PTB is an infectious disease, which not only seriously affects people’s health, but also causes a heavier disease economic burden on patients. At present, reform of the medical insurance payment can be an effective method to control medical expenses. Therefore, our study is to explore the compensation mechanism for pulmonary tuberculosis (PTB) patients with a full period of treatment, to alleviate the financial burden of PTB patients and provide a reference and basis for the reform of PTB payment methods in other regions and countries. Methods The quantitative data of PTB patients was collected from the first half of 2015 to the first half of 2018 in Dehui Tuberculosis Hospital in Jilin Province, and medical records of PTB patients registered in the first half of 2018 (n = 100) from the hospital was randomly selected. Descriptive analysis of these quantitative data summarized the number, cost, medication and compliance. Semi-structured in depth interviews with policymakers and physicians were conducted to understand the impact of interventions and its causes. Results After implementation of the compensation mechanism, the number of PTB patient visits in 2018 was increased by 14.2%, average medical costs for outpatients and inpatients were significantly reduced by 31.8% and 47.0%, respectively, and the auxiliary medication costs was reduced by 36.5%. Moreover, the hospital carried out standardized management of tuberculosis, and the patient compliance was very high, reaching almost 90%. Conclusions The capitation compensation mechanism with a full period of treatment was a suitable payment method for PTB, and it is worthy of promotion and experimentation. In addition, the model improved patient compliance and reduced the possibility of drug-resistant PTB. However, due to the short implementation time of the model in the pilot areas, the effect remains to be further observed and demonstrated.

It’s Time to Talk to Prehospital Providers: Feedback Disparities among Ground-Based Emergency Medical Services Providers and its Impact on Job Satisfaction

2021 ◽  
pp. 1-9
Author(s):  
Sarayna S. McGuire ◽  
Anuradha Luke ◽  
Aaron B. Klassen ◽  
Lucas A. Myers ◽  
Aidan F. Mullan ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Patient Care ◽  
Emergency Medical Services ◽  
Performance Feedback ◽  
Life Support ◽  
Clinical Care ◽  
Medical Services ◽  
The Past ◽  
Emergency Medical ◽  
Overall Job Satisfaction

Abstract Objective: Performance feedback on clinical care and patient outcomes is a cornerstone of medical education, yet it remains lacking in the prehospital environment. Research seeking to establish the quantity of feedback provided to Emergency Medical Services (EMS) has been limited and studies focused on complimentary feedback or how feedback relates to EMS job satisfaction are lacking. The objectives of this study were to measure the frequency and nature of feedback received by EMS agencies and to identify the importance of receiving feedback as it relates to EMS job satisfaction. Methods: This was an anonymous, survey-based study of twenty-nine Basic Life Support (BLS) and fifteen Advanced Life Support (ALS) agencies located in Southeastern Minnesota (USA). Descriptive statistics and Fisher exact tests were used. The study was deemed exempt by the Mayo Clinic Institutional Review Board. Results: Ninety-four responses were included from nineteen different EMS agencies, including sixty-one (64.9%) paramedics and thirty-three (35.1%) emergency medical technicians (EMTs). One-half of all respondents reported that they had not received any type of feedback in the past 30 days, while another 43.6% of respondents indicated that they had only received feedback one to three times in the same time period. Twenty (60.6%) EMTs reported receiving no feedback in the past 30 days, compared with twenty-seven (44.3%) paramedics (P = .123). Of respondents receiving feedback, 65.9% reported never or rarely receiving positive reinforcing feedback and 60.6% reported never or rarely receiving constructive criticism or feedback regarding something that did not go well with patient care or transport. The majority of respondents were dissatisfied with the quantity (86.1%) and quality (73.4%) of feedback received. An overwhelming majority (93.6%) indicated that feedback on patient care or outcomes was important in influencing their overall job satisfaction. This high importance was maintained across all demographic groups. Conclusion: Within the cohort of survey respondents, a paucity of feedback received by EMS personnel is a source of dissatisfaction for EMS providers. Feedback on patient care strongly relates to overall job satisfaction. These findings suggest system-wide opportunities for structured feedback processes, focusing upon both quality and quantity of delivered feedback, to improve both patient care and staff satisfaction.

scholarly journals Indispensability of Clinical Bioinformatics for Effective Implementation of Genomic Medicine in Pathology Laboratories

ACI Open ◽  
2020 ◽  
Vol 04 (02) ◽  
pp. e167-e172
Author(s):  
Srikar Chamala ◽  
Siddardha Majety ◽  
Shesh Nath Mishra ◽  
Kimberly J. Newsom ◽  
Shaileshbhai Revabhai Gothi ◽  
...  
Keyword(s):  
Patient Care ◽  
Clinical Laboratory ◽  
Clinical Care ◽  
Genomic Medicine ◽  
Clinical Pathology ◽  
Genetic Mutation ◽  
Genomic Research ◽  
Pathology Laboratory ◽  
Clinical Bioinformatics ◽  
Effective Implementation

AbstractPatient care is rapidly evolving toward the inclusion of precision genomic medicine when genomic tests are used by clinicians to determine disease predisposition, prognosis, diagnosis, and improve therapeutic decision-making. However, unlike other clinical pathology laboratory tests, the development, deployment, and delivery of genomic tests and results are an intricate process. Genomic technologies are diverse, fast changing, and generate massive data. Implementation of these technologies in a Clinical Laboratory Improvement Amendments-certified and College of American Pathologists-accredited pathology laboratory often require custom clinical grade computational data analysis and management workflows. Additionally, accurate classification and reporting of clinically actionable genetic mutation requires well-curated disease/application-specific knowledgebases and expertise. Moreover, lack of “out of the box” technical features in electronic health record systems necessitates custom solutions for communicating genetic information to clinicians and patients. Genomic data generated as part of clinical care easily adds great value for translational research. In this article, we discuss current and future innovative clinical bioinformatics solutions and workflows developed at our institution for effective implementation of precision genomic medicine across molecular pathology, patient care, and translational genomic research.

scholarly journals Considerations for the Management of Women with Breast Cancer during the COVID-19 Pandemic

2020 ◽  
Vol 5 (03) ◽  
pp. 260-263
Author(s):  
Monica Irukulla ◽  
Palwai Vinitha Reddy
Keyword(s):  
Breast Cancer ◽  
Resource Allocation ◽  
Patient Care ◽  
Cancer Patients ◽  
Cancer Care ◽  
Clinical Care ◽  
Current Availability ◽  
The Individual

AbstractOutcomes in cancer patients are strongly influenced by timeliness and quality of multidisciplinary interventions. The COVID-19 pandemic has led to severe disruption in cancer care in many countries. This has necessitated several changes in clinical care and workflow, including resource allocation, team segregation and deferment of many elective procedures. Several international oncological societies have proposed guidelines for the care of patients afflicted with breast cancer during the pandemic with a view to optimize resource allocation and maximize risk versus benefit for the individual and society. Clinicians may utilize these recommendations to adapt patient care, based on the current availability of resources and severity of the COVID-19 pandemic in each region. This article discusses the guidelines for care of patients afflicted with breast cancer during the pandemic.

Psychology Staffing at Cancer Centers: Data From National Comprehensive Cancer Network Member Institutions

2020 ◽  
Vol 16 (11) ◽  
pp. e1343-e1354
Author(s):  
Laura Melton ◽  
Diana Krause ◽  
Jessica Sugalski
Keyword(s):  
National Comprehensive Cancer Network ◽  
Patient Care ◽  
Clinical Care ◽  
The United States ◽  
Direct Patient Care ◽  
Cancer Center ◽  
Network Member ◽  
Full Time ◽  
Cancer Centers ◽  
Cancer Network

PURPOSE: The field of psycho-oncology is relatively undeveloped, with little information existing regarding the use of psychologists at cancer centers. Comprising 30 leading cancer centers across the United States, the National Comprehensive Cancer Network (NCCN) set out to understand the trends in its Member Institutions. METHODS: The NCCN Best Practices Committee surveyed NCCN Member Institutions regarding their use of psychologists. The survey was administered electronically in the spring/summer of 2017. RESULTS: The survey was completed by 18 cancer centers. Across institutions, 94% have psychologists appointed to provide direct care to their cancer center patients. The number of licensed psychologist full-time equivalents (FTEs) on staff who provide direct patient care ranged from < 1.0 FTE (17%) to 17.0-17.9 FTEs (6%). Regarding psychologist appointments, 41% have both faculty and staff appointments, 41% have all faculty appointments, and 18% have all staff appointments. Forty-three percent of institutions indicated that some licensed psychologists at their centers (ranging from 1%-65%) do not provide any direct clinical care, and 57% indicated that all licensed psychologist on staff devote some amount of time to direct clinical care. The percent of clinical care time that is spent on direct clinical care ranged from 15%-90%. CONCLUSION: There is great variability in psychology staffing, academic appointments, and the amount of direct patient care provided by on-staff psychologists at cancer centers.

scholarly journals Payment Reforms for Prehospital Care Services in a Middle Income Country: Assessing Implementation and Patient Outcomes Using a Mixed-Methods Approach

2018 ◽  
Vol 2018 ◽  
pp. 1-10
Author(s):  
Paibul Suriyawongpaisal ◽  
Samrit Srithamrongsawad ◽  
Pongsakorn Atiksawedparit ◽  
Khanisthar Phooseemungkun ◽  
Krongkan Bunchaiyai ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Patient Care ◽  
Patient Outcomes ◽  
Prehospital Care ◽  
Clinical Care ◽  
Mixed Methods Approach ◽  
Time Flow ◽  
Care Systems ◽  
Pay System ◽  
Made In

Introduction. Financing health systems constitutes a key element of well-functioning healthcare system. Prior to 2015, two new financial arrangements (direct-pay and E-claim systems) were introduced on a voluntary basis which aimed to pool more financial resources and improve cash flow of prehospital care systems. The aims of this study were to (1) assess the effects of direct-pay system in terms of (a) timeliness of reimbursement to EMS agencies, (b) changes in clinical care processes, and (c) the outcomes of patient care as compared to previous system; (2) identify the reasons for or against EMS agencies to participate in direct-pay system mechanisms; (3) identify the emerging issues with potential to significantly further the advancement of EMS systems. Using a mixed-methods approach, retrospective datasets of 3,769,399 individual records of call responses from 2015 to 2017 were analyzed which compared EMS units with the direct-pay system against those without in terms of time flow of claim data and patient outcomes. For qualitative data, in-depth interviews were conducted. Results. EMS units participating in both systems had the highest percentages of financial claim being made in time as compared to those not participating in any (p=0.012). However, there were not any practically meaningful differences between EMS units participating and not participating in either of the payment systems in terms of patient care such as appropriateness of response time, airway management, and outcome of treatment. Analysis of data from focus-group and individual interviews ended up with a causal loop diagram demonstrating potential explanatory mechanisms for those findings. Conclusion. It is evident that progress has been made in terms of mobilising more financial inputs and improving financial information flow. However, there is no evidence of any changes in patient outcomes and quality of care. Furthermore, whether the progress is meaningful in filling the gaps of financial demands of the prehospital care systems is still questionable. Room for future improvement of prehospital care systems was discussed with implications for other countries.

Ostomy Patient Care Program

1972 ◽  
Vol 6 (11) ◽  
pp. 374-379
Author(s):  
Margaret C. Gebhardt ◽  
Stephen M. Caiola ◽  
Fred M. Eckel
Keyword(s):  
Patient Care ◽  
Hospital Pharmacy ◽  
Local Community ◽  
Hospital Pharmacist ◽  
Care Program ◽  
Memorial Hospital ◽  
Continuing Care ◽  
Community Or ◽  
Patient Profile ◽  
Care Information

The ostomate is often a forgotten patient with regards to proper psychological and emotional preparation for his surgery and proper continuing care of his ostomy. The pharmacist can play an important role in aiding the ostomy patient, especially in providing him adequate appliances and ostomy-care information. The development and implementation of the ostomy program of the N. C. Memorial Hospital Pharmacy is presented in detail. A brief explanation of why ostomy surgery is necessary, of the various types of ostomies and of the various appliances utilized is also presented. The following services of the program are described: Use of a patient profile card in order to have on record the patient's specific appliance and replacement parts; Fitting the new ostomate with the proper appliance and instructing him on its proper use; Interviewing patient on return clinic visits to determine if the patient is having ostomy-related problems or needs any replacement parts for his appliance; Providing patient's appliance needs through the mail or through communication with the patient's local community or hospital pharmacist, and Conducting a presurgical consultation with the future ostomate to briefly explain appliances and how their use will affect his life, plus answer questions which may be making him apprehensive.

Letter to the Editor

PEDIATRICS ◽  
1969 ◽  
Vol 43 (3) ◽  
pp. 472-472
Author(s):  
Clement A. Smith
Keyword(s):  
Patient Care ◽  
Social Service ◽  
Mental Hygiene ◽  
Care Program ◽  
Daily Mail ◽  
Personal Assistance ◽  
Letter To The Editor

Letter to the Editor are often the most interesting thing in the daily mail. When they concern a teaching and patient-care program in a hospital so long and affectionately known to the recipient, he may perhaps be allowed to offer an answer. We would first thank Dr. Brazleton for writing. Then we would remark that the Editor finds much of the spirit—if not all the letter (in Biblical sense)—reminiscent of earlier and simpler times. Outstanding memories of houseofficership in the thirties are the participation of Miss Amy Greene as Head of Social Service on many of Dr. Blackfan's regular rounds, the regular attendance of the Nursing Supervisor, and the frequent, highly personal, assistance of Dr. Crothers (a pediatrician in search of mental hygiene) often with Miss Elizabeth Lord, his associate in psychology.

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