Enacting personalisation on a micro scale

2016 ◽  
Author(s):  
Catherine Needham ◽  
Kerry Allen ◽  
Kelly Hall
Keyword(s):  
Black Box ◽  
Care Providers ◽  
Process Of Care ◽  
Frontline Staff ◽  
Micro Scale ◽  
Trusting Relationships ◽  
High Level

An outcomes orientation can be described as taking a ‘black box’ approach which does not explain how outcomes are achieved. In this chapter the focus is on the process of care in order to explain how far services are personalised, drawing on data from the 143 people interviewed. It discusses the enactment of personalisation, highlighting the ways in which very small organisations seem to be able to adapt more flexibly to people’s desire for sustained and trusting relationships in a care context. The more personalised care provided by the smaller organisations seemed to stem from their greater continuity of frontline staff compared to large care providers, the greater autonomy of frontline staff to vary the service being offered, and the high level of familiarity of managers with individual clients and staff.

scholarly journals Community Integration After Traumatic Brain Injury and Related Factors: A Study in the Nepalese Context

2020 ◽  
Vol 6 ◽  
pp. 237796082098178
Author(s):  
Sumana Lama ◽  
Jintana Damkliang ◽  
Luppana Kitrungrote
Keyword(s):  
Social Support ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Health Care Providers ◽  
Physical Environment ◽  
Community Integration ◽  
Sampling Technique ◽  
Care Providers ◽  
Related Factors ◽  
High Level

Introduction Community integration is an essential component for rehabilitation among traumatic brain injury (TBI) survivors, which yields positive outcomes in terms of social activities, community participation, and productive work. A factor that usually facilitates community integration among TBI survivors is social support, whereas physical environment and fatigue are most often found as barriers. Objectives This study aimed to (1) describe the level of community integration, fatigue, physical environment, and social support of persons after TBI, and (2) examine the relationship between community integration and these three factors. Methods This is a descriptive correlational study. One hundred and twenty TBI survivors living in the communities of Province Number Three, Nepal were enrolled using the stratified sampling technique. The data were collected using the Community Integration Questionnaire, Modified Fatigue Impact Scale, Craig Hospital Inventory of Environmental Factors, and the Multidimensional Scale of Perceived Social Support. Descriptive statistics and Pearson’s correlation were used to analyze the data. Results Community integration, fatigue, and physical environment showed a moderate level, while social support revealed a high level. Fatigue was significantly correlated with overall community integration, whereas physical environment was found to correlate with two subscales of community integration, home integration and productive activities. Conclusion To enhance the level of community integration among TBI survivors, health care providers, in particular rehabilitation nurses and community nurses, should plan and implement strategies such as follow-up appointments or continued rehabilitation at home.

scholarly journals 407 - The Baycrest Quick-Response Caregiver Tool: The Role for a New Tool for Caregivers of Persons with Dementia

2020 ◽  
Vol 32 (S1) ◽  
pp. 123-123
Author(s):  
Ken Schwartz ◽  
Robert Madan ◽  
Anna Berall ◽  
Marsha Natadira ◽  
Anna Santiago
Keyword(s):  
Family Caregivers ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Well Being ◽  
Moderate Degree ◽  
Quick Response ◽  
Care Providers ◽  
High Level ◽  
Person With Dementia ◽  
The Impact

Background:Responsive behaviours in dementia are associated with poor outcomes for the person with dementia (PWD) and caregiver burnout. Family caregivers need a variety of tools to manage responsive behaviours. The Baycrest Quick-Response Caregiver Tool was developed to provide caregivers with a tool that can be used in real time. In this study, the feasibility, impact, and effectiveness of this new tool were studied in family caregivers and health care providers (HCP) using quantitative and qualitative measures.Methods:Family caregivers were recruited and were asked to complete a pre-survey before being sent the link to the educational tool. One month after the telephone survey, caregivers were sent an online post-survey to gather their feedback on the tool and the impact of the tool on caregiver well -being. Healthcare providers were also recruited and reviewed the tool through an online feedback survey. The feasibility, impact, and effectiveness of the tool were assessed using quantitative and qualitative measures.Results:Caregivers had a moderate degree of and reported a high level of competence - these scores were maintained throughout the study. Caregivers reported that tool positively impacted their compassion towards the person with dementia (PWD), and that their interactions with improved. 100% of HCP who completed the feedback survey would recommend the tool to other HCP and to caregivers of PWD. The caregivers and HCP provided specific suggestions for improvement.Conclusions:The Baycrest Quick-Response Caregiver Tool was found to be feasible and helpful. It provides caregivers and HCP with an additional approach for responsive behaviours.

scholarly journals Design of a novel multifunction decision support/alerting system for in-patient acute care, ICU and floor (AlertWatch AC)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Douglas A. Colquhoun ◽  
Ryan P. Davis ◽  
Theodore T. Tremper ◽  
Jenny J. Mace ◽  
Jan M. Gombert ◽  
...  
Keyword(s):  
Decision Support ◽  
Operating Room ◽  
Acute Care ◽  
Care Team ◽  
Labor And Delivery ◽  
Process Of Care ◽  
Similar System ◽  
Hospital Units ◽  
High Acuity ◽  
High Level

Abstract Background Multifunction surveillance alerting systems have been found to be beneficial for the operating room and labor and delivery. This paper describes a similar system developed for in-hospital acute care environments, AlertWatch Acute Care (AWAC). Results A decision support surveillance system has been developed which extracts comprehensive electronic health record (EHR) data including live data from physiologic monitors and ventilators and incorporates them into an integrated organ icon-based patient display. Live data retrieved from the hospitals network are processed by presenting scrolling median values to reduce artifacts. A total of 48 possible alerts are generated covering a broad range of critical patient care concerns. Notification is achieved by paging or texting the appropriated member of the critical care team. Alerts range from simple out of range values to more complex programing of impending Ventilator Associated Events, SOFA, qSOFA, SIRS scores and process of care reminders for the management of glucose and sepsis. As with similar systems developed for the operating room and labor and delivery, there are green, yellow, and red configurable ranges for all parameters. A census view allows surveillance of an entire unit with flashing or text to voice alerting and enables detailed information by windowing into an individual patient view including live physiologic waveforms. The system runs via web interface on desktop as well as mobile devices, with iOS native app available, for ease of communication from any location. The goal is to improve safety and adherence to standard management protocols. Conclusions AWAC is designed to provide a high level surveillance view for multi-bed hospital units with varying acuity from standard floor patients to complex ICU care. Alerts are generated by algorithms running in the background and automatically notify the selected member of the patients care team. Its value has been demonstrated for low acuity patients, further study is required to determine its effectiveness in high acuity patients.

Workplace Fatigue Within Summer Camp: Perspectives From Camp Health Care Providers and Directors

2019 ◽  
Vol 43 (1) ◽  
pp. 71-87
Author(s):  
Alexsandra Dubin ◽  
Barry A. Garst ◽  
Tracey Gaslin ◽  
Beth E. Schultz
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Employee Performance ◽  
Summer Camps ◽  
Future Research ◽  
Care Providers ◽  
Frontline Staff ◽  
Analysis Process ◽  
Starting Point ◽  
Negative Impacts

Background: Summer camps engage millions of youth in enrichment opportunities during the summertime while employing a substantial young adult workforce to provide high-quality programs and services to camp participants. Workplace fatigue has been implicated in camp-related injury and illness events, yet few studies have targeted fatigue among camp employees. Purpose: This study aimed to better understand how fatigue impacted employee performance as well as strategies for reducing the negative impacts of fatigue within camp settings. Methodology/Approach: Focus groups were conducted with camp health care providers and directors, and their responses were analyzed using directed content analysis. The analysis process was guided by sensitizing concepts from the literature. Findings/Conclusions: Emergent themes suggested that camp-related fatigue is conceptualized as a construct of time, types, and causes; is a distinct experience leading to setting-specific outcomes; is managed using administrative and peer supports; and is sometimes perceived in positive ways. Implications: This exploratory study highlighted the unique challenges associated with working in a camp setting and the potential development of fatigue as a starting point informing future research. It suggests that future research should include a broader study population, including frontline staff, as well as possible quantitative measures.

scholarly journals Haemophilia in France: Modelisation of the Clinical Pathway for Patients

2022 ◽  
Vol 19 (2) ◽  
pp. 646
Author(s):  
Karen Beny ◽  
Benjamin du Sartz de Vigneulles ◽  
Florence Carrouel ◽  
Denis Bourgeois ◽  
Valérie Gay ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Health Professionals ◽  
Care Pathway ◽  
Exploratory Research ◽  
Care Providers ◽  
Process Of Care ◽  
Treatment Delivery ◽  
Community Environment ◽  
Specialized Service ◽  
A Current

Process-of-care studies participate in improving the efficiency of the care pathway for patient with haemophilia (CPPH) and rationalize the multidisciplinary management of patients. Our objective is to establish a current overview of the different actors involved in the management of patients with haemophilia and to provide an accurate description of the patient trajectory. This is a qualitative exploratory research based on interviews of the principal health professionals of four haemophilia services, between November 2019 and February 2020, in France. Mapping of the CPPH processes within the different institutions and/or services, as well as the rupture zones, were identified. Treatment delivery and biological analyses were carried out exclusively in healthcare institutions. The main liberal health professionals solicited were nurses, physiotherapists and general practitioner. Obstacles and barriers within the specialized service, with other hospital services and external hospital or private services, community health care providers et community environment and individual one was complex and multiples. Our research identified potential concerns that need to be addressed to improve future studies to identify influential elements. Similarly, other qualitative studies will have to be conducted on the perceptions and literacy of patients with haemophilia to develop a global interactive mapping of their trajectories.

Competence

2017 ◽  
Author(s):  
Lisa Freitag
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Care Needs ◽  
Medical Problems ◽  
Special Health Care ◽  
Level Of Knowledge ◽  
High Level ◽  
Work Done

Parents caring for children with special health care needs or long-term disabilities are called to a new level of competence as medical caregivers, often as soon as the child is discharged from the hospital. There is no accepted measure for success with this task, though failure can be met with repeated hospitalization or removal of the child from the home. This chapter evaluates, through parent narratives, how parents obtain and view their competence. Some parents perform in-depth research into their child’s medical problems and achieve a surprisingly high level of knowledge. This is often discounted by both the parents and health care providers. The moral work done in this area is significant. Parents must change their priorities and re-align their expectations for their child’s success. They must adapt to a slower developmental pace, and create for the child a safe haven where the child’s disability becomes the accepted norm.

Caring power of mothers who have a child with cancer and its predictors

2019 ◽  
Author(s):  
Fatemeh Khademi ◽  
Maryam Rassouli ◽  
Leila Khanali Mojen ◽  
Mehdi Heidarzadeh ◽  
Azam Shirinabadi Farahani ◽  
...  
Keyword(s):  
Care Provider ◽  
Family Income ◽  
Role Play ◽  
Family Care ◽  
Average Score ◽  
Patient Questionnaire ◽  
Care Providers ◽  
Effective Role ◽  
High Level ◽  
Caring Power

Background: Attention to the family care provider needs and their caring power is essential. Since mothers are considered as the child’s main care provider, this study aimed to determine the caring power and its predictors among mothers of children with cancer. Materials and Methods: In this descriptive-correlational study, 196 mothers who had a child with cancer were selected through purposive sampling. The data were collected using two questionnaires, namely demographics questionnaire and the care power of the care providers of cancer patient questionnaire. The data were analyzed using SPSS 19 and running descriptive statistics and regression analysis. Results: The highest average score belonged to dimensions of “effective role play” (44.62 ± 5.28) and “trust” (14 ± 1.67), and the lowest ones respectively belonged to dimensions of “fatigue and resignation” (22.38 ± 6.33), “awareness” (8.46 ± 2.70), and “uncertainty” (12.38 ± 3.50). In addition, variables of educational level (p <0.001), adequacy of family income (p <0.001), and duration of illness (p0.29) were found as predictors of caring power. Conclusion: The results of this study showed that the caring power of mothers with a child with cancer is favorable. High trust and effective role-play reduced fatigue and resignation of mothers, and low awareness about the provision of care caused uncertainty affecting negatively the care power. In addition, the adequacy of family income, the high level of mother's education, and the reduction in the duration of the disease had a direct impact on care power.

scholarly journals Modelling COVID - 19 Transmission in a Hemodialysis Centre Using Simulation Generated Contacts Matrices

2021 ◽  
Author(s):  
Mohammadali Tofighi ◽  
Ali Asgary ◽  
Asad A. Merchant ◽  
Mohammad Ali Shafiee ◽  
Mahdi M. Najafabadi ◽  
...  
Keyword(s):  
Discrete Event ◽  
Intermittent Hemodialysis ◽  
Physical Interaction ◽  
Generation Process ◽  
Care Providers ◽  
Time Step ◽  
Dialysis Unit ◽  
Agent Based ◽  
Micro Scale ◽  
Contact Matrix

AbstractThe COVID-19 pandemic has been particularly threatening to the patients with end-stage kidney disease (ESKD) on intermittent hemodialysis and their care providers. Hemodialysis patients who receive life-sustaining medical therapy in healthcare settings, face unique challenges as they need to be at a dialysis unit three or more times a week, where they are confined to specific settings and tended to by dialysis nurses and staff with physical interaction and in close proximity. Despite the importance and critical situation of the dialysis units, modelling studies of the SARS-CoV-2 spread in these settings are very limited. In this paper, we have used a combination of discrete event and agent-based simulation models, to study the operations of a typical large dialysis unit and generate contact matrices to examine outbreak scenarios. We present the details of the contact matrix generation process and demonstrate how the simulation calculates a micro-scale contact matrix comprising the number and duration of contacts at a micro-scale time step. We have used the contacts matrix in an agent-based model to predict disease transmission under different scenarios. The results show that micro-simulation can be used to estimate contact matrices, which can be used effectively for disease modelling in dialysis and similar settings.

The Whole Story

2018 ◽  
Author(s):  
Michael Strevens
Keyword(s):  
Convergent Evolution ◽  
Explanatory Models ◽  
Black Box ◽  
Psychological Processes ◽  
Causal Explanations ◽  
Low Level ◽  
Biological Features ◽  
Neural Processes ◽  
Underlying Mechanisms ◽  
High Level

Causal explanations in the high-level sciences typically black-box the low-level details of the causal mechanisms that they invoke to account for their explananda: economists’ black-box psychological processes, psychologists’ black-box neural processes, and so on. Are these black-boxing explanatory models complete explanations of the phenomena in question, or are they just sketches of or templates for the whole explanatory story? This chapter poses a focused version of the question in the context of convergent evolution, the existence of which appears to show that underlying mechanisms are completely irrelevant to the explanation of high-level biological features, including perhaps thought and language—in which case a black-boxing model would be a complete explanation of such features rather than a mere sketch. Arguments for and against such a model’s explanatory completeness are considered; the chapter comes down tentatively against.

scholarly journals Geographical variations in access to expert centers for multiple sclerosis in France

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
E Leray ◽  
F Mamadou ◽  
A Guilleux ◽  
J Roux ◽  
O Grimaud
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Social Deprivation ◽  
Care Providers ◽  
Geographic Variations ◽  
Geographical Variations ◽  
Set Up ◽  
High Level

Abstract Background Multiple sclerosis (MS) is a chronic neurological disease affecting about 100,000 persons in France. Disease management is mainly supervised by the neurologist, supported by the general practitioner (GP). The complexity of the disease, due to the variety of symptoms as well as the recent changes in the therapeutic arsenal, requires both a high level of expertise and coordination between the different health care providers. To face this challenge, integrated and coordinated network of services “MS expert centers” have been progressively set up from 2000 onwards. Our objectives are to describe referrals to MS expert centers over the 2010-2015 period, to look for geographic variations and if any, to identify potential determinants of access. Methods The analysis is performed on the French health insurance database which covers 97% of the French population. Geographic variations of access are explored, as well as association with the following parameters: demographics (age, sex), socio-economic characteristics (social deprivation index at residence, degree of urbanization), and density of health care services (GPs, neurologists, hospital beds). Results Overall, 112,415 people with MS (70% women, mean age 46 years) were included. Initial results show that over the study period, 98% of patient had at least one visit to GP, 87% to neurologist, and 36% in a CRC SEP. Conclusions The present study will assess to what extent MS patients have been able to take full advantage of an innovative organization of specialized care which was recently deployed in France. This model of care has been generalized by the French Ministry of Health in 2016 and 23 ‘competence and resource centers’ for MS (CRC SEP) are now covering the whole national territory. Further research will be performed to identify whether and how this has modified access to specialized coordinated MS care.

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