scholarly journals Initial experiences of US neurologists in practice during the COVID-19 pandemic via survey

Neurology ◽  
2020 ◽  
Vol 95 (5) ◽  
pp. 215-220 ◽  
Author(s):  
Akanksha Sharma ◽  
Christina R. Maxwell ◽  
Jill Farmer ◽  
Diana Greene-Chandos ◽  
Kathrin LaFaver ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
The United States ◽  
Survey Study ◽  
Practice Model ◽  
Safety Measures ◽  
Public Health Emergencies ◽  
Care Workers ◽  
Rapid Changes ◽  
Care Systems

ObjectiveTo test the hypothesis that US neurologists were experiencing significant challenges with lack of personal protective equipment (PPE), rapid changes in practice, and varying institutional protocols, we conducted this survey study. The current coronavirus disease of 2019 (COVID-19) pandemic has caused widespread disease and death. Rapid increases in patient volumes have exposed weaknesses in health care systems and challenged our ability to provide optimal patient care and adequate safety measures to health care workers (HCWs).MethodsA 36-item survey was distributed to neurologists around the United States through various media platforms.ResultsOver a 1-week period, 567 responses were received. Of these, 56% practiced in academia. A total of 87% had access to PPE, with 45% being asked to reuse PPE due to shortages. The pandemic caused rapid changes in practice, most notably a shift toward providing care by teleneurology, although a third experienced challenges in transitioning to this model. Wide variations were noted both in testing and in the guidance provided for the exposed, sick, or vulnerable HCWs. Notably, 59% of respondents felt that their practices were doing what they could, although 56% did not feel safe taking care of patients.ConclusionsResults from our survey demonstrate significant variability in preparedness and responsiveness to the COVID-19 pandemic in neurology, affected by region, health care setting, and practice model. Practice guidelines from professional societies and other national entities are needed to improve protection for physicians and their patients, promote recommended practice changes during a pandemic, and optimize future preparedness for public health emergencies.

Continental Divide? The Attitudes of US and Canadian Oncologists on the Costs, Cost-Effectiveness, and Health Policies Associated With New Cancer Drugs

2010 ◽  
Vol 28 (27) ◽  
pp. 4149-4153 ◽  
Author(s):  
Scott R. Berry ◽  
Chaim M. Bell ◽  
Peter A. Ubel ◽  
William K. Evans ◽  
Eric Nadler ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Systems ◽  
The United States ◽  
Drug Costs ◽  
Cancer Drug ◽  
Cancer Drugs ◽  
Care Systems ◽  
Effective Treatments

Purpose Oncologists in the United States and Canada work in different health care systems, but physicians in both countries face challenges posed by the rising costs of cancer drugs. We compared their attitudes regarding the costs and cost-effectiveness of medications and related health policy. Methods Survey responses of a random sample of 1,355 United States and 238 Canadian medical oncologists (all outside of Québec) were compared. Results Response rate was 59%. More US oncologists (67% v 52%; P < .001) favor access to effective treatments regardless of cost, while more Canadians favor access to effective treatments only if they are cost-effective (75% v 58%; P < .001). Most (84% US, 80% Canadian) oncologists state that patient out-of-pocket costs influence their treatment recommendations, but less than half the respondents always or frequently discuss the costs of treatments with their patients. The majority of oncologists favor more use of cost-effectiveness data in coverage decisions (80% US, 69% Canadian; P = .004), but fewer than half the oncologists in both countries feel well equipped to use cost-effectiveness information. Majorities of oncologists favor government price controls (57% US, 68% Canadian; P = .01), but less than half favor more cost-sharing by patients (29% US, 41% Canadian; P = .004). Oncologists in both countries prefer to have physicians and nonprofit agencies determine whether drugs provide good value. Conclusion Oncologists in the United States and Canada generally have similar attitudes regarding cancer drug costs, cost-effectiveness, and associated policies, despite practicing in different health care systems. The results support providing education to help oncologists in both countries use cost-effectiveness information and discuss drug costs with their patients.

scholarly journals Η επίδραση του θεσμικού, πολιτικού και διοικητικού περιβάλλοντος στη μεταρρύθμιση του τομέα της υγείας στην Ελλάδα, 1950-2005

2013 ◽  
Author(s):  
Ηλίας Γορανίτης
Keyword(s):  
Health Care ◽  
Health Care Reform ◽  
Health Care Systems ◽  
Implementation Process ◽  
The United States ◽  
International Experience ◽  
Health Care Reforms ◽  
Care Systems ◽  
Veto Points ◽  
Theories Of Change

The Greek NHS, thirty years after its establishment, faces important performance deficiencies. With an ongoing economic crisis placing a further burden, a call for national health care reform is urgent. This doctoral thesis drawing upon (a) political theories of change, (b) institutional, political and administrative developments in Greece as well as (c) international experience, aims to provide a framework, in terms of planning and implementation process, for health care reform in Greece. The existing order of things, in every public policy system, impedes change and forces policies along specific paths, the deviation from which to a new policy paradigm is extremely difficult. The Greek NHS has never deviated from this path indicating the existence of strong interest groups, institutions with high set-up cost and limited political willingness or ability for strategic approach to overcome the ‘veto points’ of the reform in the system. In this thesis the way forward in reforming fragmented and path-dependent health care systems like the Greek NHS has been identified. By addressing big questions such as: How the Greek NHS reached this low performing level? What are the ingredients of a well performing health care system? What factors impede or promote successful reforms? How health care reforms in systems with multiple ‘veto points’ should be implemented? Political science and international experience from Spain, Portugal, Italy, the Netherlands and the United States provide important insights to our study.

scholarly journals Application of Health-Care Networking in COVID-19: A Brief Report

2020 ◽  
pp. 1-5
Author(s):  
Punidha Kaliaperumal ◽  
Tamorish Kole ◽  
Neha Chugh
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Systems ◽  
Public Health Care ◽  
Current Crisis ◽  
Delivery Of Care ◽  
Public Health Emergencies ◽  
Northern India ◽  
Care Systems ◽  
Private And Public

ABSTRACT Health-care systems all over the world are stretched out and being reconfigured to deal with the coronavirus disease 2019 (COVID-19) pandemic. Some countries have flattened the curve, some are still fighting to survive it, and others are embracing the second wave. Globally, there is an urgent need to increase the resilience, capacity, and capability of health-care systems to deal with the current crisis and improve upon the future responses. The epidemiological burden of COVID-19 has led to rapid exhaustion of local response resources and massive disruption to the delivery of care in many countries. Health-care networking and liaison are essential component in disaster management and public health emergencies. It aims to provide logistical support between hospitals; financial support through local or regional governmental and nongovernmental agencies for response; manpower and mechanism for coordination and to implement policies, procedures, and technologies in the event of such crisis. This brief report describes how 4 independent private hospitals in northern India had adopted the principles of health-care networking, pooled their resources, and scaled up 1 of the partner hospitals as Dedicated COVID-19 Hospital (DCH) to treat moderate to severe category of COVID-19 patients. It brings out the importance of a unique coalition between private and public health-care system.

Commitment to Change Among Health Care Workers in Pakistan

2020 ◽  
Vol 22 (3) ◽  
pp. 330-347
Author(s):  
Haroon Bakari ◽  
Ahmed Imran Hunjra ◽  
Stephen Jaros
Keyword(s):  
Health Care ◽  
Factor Analysis ◽  
Organizational Change ◽  
Health Care Workers ◽  
Health Care Systems ◽  
Change Initiative ◽  
Commitment To Change ◽  
Research Attention ◽  
Care Workers ◽  
Care Systems

Commitment to organizational change as an important focus of commitment has received greater attention in the literature of action commitments. Research indicates that this construct represents employee attitude towards change initiative and may be a greater predictor of support for change. This is of particular import in health care systems, globally, and in developing nations, in particular, which are constantly seeking to change and adapt to new medical and administrative advances. However, commitment to change (C2C) has received very little research attention from Asian health care systems. Therefore, this study answers the call for validation, by validating a culture-specific translated version of the C2C scale in a sample drawn from the privatization context of public sector hospitals in Pakistan. The goals are to: (a) examine some psychometric properties of the major Western-derived measures of C2C in Pakistan to see if they are valid and reliable there; and (b) draw implications from our results for the management of change efforts in Pakistani health care systems. Thus, exploratory factor analysis and confirmatory factor analysis (CFA) were conducted using SPSS and analysis of moment structures (AMOS) to provide evidence of reliability, construct validity and predictive validity of C2C among Pakistani health care workers. Results found evidence of the measure’s cross-cultural validity and revealed a positive correlation between C2C and three dimensions of behavioural support for change. This study is a significant contribution to the literature, being the first to provide comprehensive evidence of validity of the C2C scale in Pakistan, a developing country. An important implication for leaders of organizational change in Pakistan is that they may use this construct to unearth employee level of understanding and attitude towards change initiative to envisage mechanisms to foster employee support for change. Researchers may also use this construct in Pakistan’s context to assess employee C2C.

Utilization of Health Care Coalitions and Resiliency Forums in the United States and United Kingdom: Different Approaches to Strengthen Emergency Preparedness

2015 ◽  
Vol 10 (1) ◽  
pp. 161-164 ◽  
Author(s):  
John Walsh ◽  
Allan Graeme Swan
Keyword(s):  
United States ◽  
Health Care ◽  
United Kingdom ◽  
Emergency Management ◽  
Emergency Preparedness ◽  
Health Care Systems ◽  
Management Strategies ◽  
The United States ◽  
The United Kingdom ◽  
Care Systems

ABSTRACTThe process for developing national emergency management strategies for both the United States and the United Kingdom has led to the formulation of differing approaches to meet similar desired outcomes. Historically, the pathways for each are the result of the enactment of legislation in response to a significant event or a series of events. The resulting laws attempt to revise practices and policies leading to more effective and efficient management in preparing, responding, and mitigating all types of natural, manmade, and technological hazards. Following the turn of the 21st century, each country has experienced significant advancements in emergency management including the formation and utilization of 2 distinct models: health care coalitions in the United States and resiliency forums in the United Kingdom. Both models have evolved from circumstances and governance unique to each country. Further in-depth study of both approaches will identify strengths, weaknesses, and existing gaps to meet continued and future challenges of our respective disaster health care systems. (Disaster Med Public Health Preparedness. 2016;10:161–164)

Teaching health-care trainees empathy and homelessness IQ through service learning, reflective practice, and altruistic attribution

2017 ◽  
Vol 52 (3) ◽  
pp. 245-254 ◽  
Author(s):  
Leanne Chrisman-Khawam ◽  
Neelab Abdullah ◽  
Arjun Dhoopar
Keyword(s):  
Health Care ◽  
Service Learning ◽  
Reflective Practice ◽  
Medical Training ◽  
Health Care Systems ◽  
The United States ◽  
Narrative Methods ◽  
Care Systems ◽  
Effective Use ◽  
Medical Programs

This article describes a novel inter-professional curriculum designed to address the needs of homeless patients in a Midwestern region of the United States which has high rates of poverty. The curriculum is intended for healthcare trainees coming from undergraduate pre-medical programs, nursing, pharmacy, social work, clinical psychology, medical school and post-graduate medical training in family medicine, medicine-pediatrics, and psychiatry. The clinical component is specifically designed to reach destitute patients and the curriculum is structured to reverse commonly held myths about homelessness among the trainees, thereby improving their Homelessness Information Quotient, the ability to more fully understand homelessness. Participants across all disciplines and specialties have shown greater empathy and helper behavior as determined by qualitative measures. Learners have also developed a greater understanding of health-care systems allowing them to more consistently address social determinants of health identified by the authors as their Disparity Information Quotient. This article outlines the process of initiating a homeless service program, a curriculum for addressing common myths about homelessness and the effective use of narrative methods, relational connections, and reflective practice to enable trainees to process their experience and decrease burnout by focusing on the value of altruism and finding meaning in their work.

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