scholarly journals Arthroplasty implants and materials: Cost awareness and value perception

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255061
Author(s):  
Mursal Gardezi ◽  
Taylor D. Ottesen ◽  
Vineet Tyagi ◽  
Josiah J. Z. Sherman ◽  
Jonathan N. Grauer ◽  
...  
Keyword(s):  
Registered Nurses ◽  
Physician Assistants ◽  
The United States ◽  
Relative Cost ◽  
Clinical Value ◽  
Team Members ◽  
Value Perception ◽  
Knowledge Deficit ◽  
Willingness To Use ◽  
Cost Differences

Arthroplasty procedures are commonly performed and contribute to healthcare expenditures seen in the United States. Surgical team members may make selections among implants and materials without always knowing their relative cost. The current study reports on a survey aimed to investigate the perceptions of an academic group about the relative cost and value of commonly used operating room implants and materials related to joint arthroplasty cases using 10 matched pairs of items. Of the 124 persons eligible to take the survey, 102 responded (response rate of 82.3%) including attendings, fellows, residents, physician assistants (PAs), advanced practice registered nurses (APRNs) and registered nurses (RNs). On average for the ten pairs of items, the more expensive items were correctly selected by 90.2+/-13.9% (mean+/- standard deviation) of respondents with a range from 54.9% to 100%. Of note, the cost differences were significantly overestimated for 8/10 item pairs. The majority of respondents perceived the more expensive item as the item with the higher clinical value for 9/10 item pairs. Most arthroplasty attendings (91.3%) indicated willingness to use the less expensive item of two similar items. Nonetheless, 17.9% of fellows, residents, PAs, APRNs and RNs indicated that they would not feel comfortable suggesting using the less expensive item. Although attending arthroplasty surgeons stated a desire to consider costs, a knowledge deficit with regards to identifying the extent of cost differences was identified, and a significant portion of the surgical support team reported being hesitant to suggest less expensive options.

scholarly journals Patient-Centered Medical Home With Colocation: Observations and Insights From an Academic Family Medicine Clinic

2020 ◽  
Vol 11 ◽  
pp. 215013272090256
Author(s):  
George G. A. Pujalte ◽  
Sally Ann Pantin ◽  
Thomas A. Waller ◽  
Livia Y. Maruoka Nishi ◽  
Floyd B. Willis ◽  
...  
Keyword(s):  
Family Medicine ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
The United States ◽  
Care Team ◽  
Patient Centered ◽  
Team Members ◽  
Auditory Distance ◽  
Practice Style ◽  
Almost All

There is a movement in the United States to transform family medicine practices from single physician–based patient care to team-based care. These teams are usually composed of multiple disciplines, including social workers, pharmacists, registered nurses, physician assistants, nurse practitioners, and physicians. The teams support patients and their families, provide holistic care to patients of all ages, and allow their members to work to the highest level of their training in an integrated fashion. Grouping care team members together within visual and auditory distance of each other is likely to enhance communication and teamwork, resulting in more efficient care for patients. This grouping is termed colocation. The authors describe how the use of colocation can lead to clearer, faster communication between care team members. This practice style has the potential to be expanded into various clinical settings in any given health system and to almost all clinical specialties and practices.

Prescription in Locker Box (PILBOX): Remodeling of the Medication Collection Process (Preprint)

2020 ◽  
Author(s):  
Lim Jit Fan Christina ◽  
Goh Boon Kwang ◽  
Chee Wing Ling Vivian ◽  
Tang Woh Peng ◽  
Goh Qiuling Bandy
Keyword(s):  
Cross Sectional Study ◽  
Ease Of Use ◽  
Prescription Medications ◽  
Pharmacy Staff ◽  
Cross Sectional ◽  
Team Members ◽  
Face To Face ◽  
Ranking Score ◽  
Study Team ◽  
Willingness To Use

BACKGROUND Traditionally, patients wishing to obtain their prescription medications have had to present themselves physically at pharmacy counters and collect their medications via face-to-face interactions with pharmacy staff. Prescription in Locker Box (PILBOX) is a new innovation which allows patients and their caregivers to collect their medication asynchronously, 24/7 at their convenience, from medication lockers instead of from pharmacy staff and at any time convenient to them instead of being restricted to pharmacy operating hours. OBJECTIVE This study aimed to determine the willingness by patients/caregivers to use this new innovation and factors that affect their willingness. METHODS This prospective cross-sectional study was conducted over 2 months at 2 public primary healthcare centres in Singapore. Patients or caregivers who were at least 21 yo and turned up at the pharmacies to collect medications were administered a self-developed 3-part questionnaire face-to-face by trained study team members, if they gave their consent to participate in the study. RESULTS A total of 222 participants completed the study. About 40% of them participants were willing to use the PILBOX to collect their medications. Amongst the participants who were keen to use the PILBOX service, slightly more than half (i.e. 52.8%) of them were willing to pay for the PILBOX service. The participants felt that the ease of use (3.46±1.21 i.e. mean of ranking score ± standard deviation) of the PILBOX was the most important factor that would affect their willingness to use the medication pick up service. This was followed by “waiting time” (3.37±1.33), cost of using the medication pick up service (2.96±1.44) and 24/7 accessibility (2.62±1.35). This study also found that age (p=0.006), language literacy (p=0.000), education level (p=0.000), working status (p=0.011) and personal monthly income (p=0.009) were factors that affected the willingness of the patients or caregivers to use the PILBOX. CONCLUSIONS Patients and caregivers are keen to use PILBOX to collect their medications for its convenience and the opportunity to save time, if it is easy to use and not costly.

scholarly journals The COVID Army: Experiences from the Deployment of Non-Hospitalist Physician Volunteers during the 2020 COVID Pandemic

2021 ◽  
pp. 1-15
Author(s):  
Kevin Hauck ◽  
Katherine Hochman ◽  
Mark Pochapin ◽  
Sondra Zabar ◽  
Jeffrey A Wilhite ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Medical Center ◽  
The United States ◽  
Lessons Learned ◽  
Front Line ◽  
Clinical Leadership ◽  
Team Members ◽  
Medical Centers ◽  
Hospitalist Physician

Abstract Objective New York City was the epicenter of the outbreak of the 2020 COVID-19 pandemic in the United States. As a large, quaternary care medical center, NYU Langone Medical Center was one of many New York medical centers that experienced an unprecedented influx of patients during this time. Clinical leadership effectively identified, oriented, and rapidly deployed a “COVID Army”, consisting of non-hospitalist physicians, to meet the needs of this patient influx. We share feedback from our providers on our processes and offer specific recommendations for systems experiencing a similar influx in the current and future pandemics. Methods In order to assess the experiences and perceived readiness of these physicians (n=183), we distributed a 32-item survey between March and June of 2020. Thematic analyses and response rates were examined in order to develop results. Results Responses highlighted varying experiences and attitudes of our front-line physicians during an emerging pandemic. Thematic analyses revealed a series of lessons learned, including the need to: (1) provide orientations, (2) clarify roles/ workflow, (3) balance team workload, (4) keep teams updated on evolving policies, (5) make team members feel valued, and (6) ensure they have necessary tools available. Conclusions Lessons from our deployment and assessment are scalable at other institutions.

scholarly journals “We Are Doing These Things So That People Will Not Laugh at Us”: Caregivers’ Attitudes About Dementia and Caregiving in Nigeria

2021 ◽  
pp. 104973232110041
Author(s):  
Candidus C. Nwakasi ◽  
Kate de Medeiros ◽  
Foluke S. Bosun-Arije
Keyword(s):  
The United States ◽  
Structured Interviews ◽  
Dementia Caregivers ◽  
Term Care ◽  
Awareness Campaigns ◽  
Knowledge Deficit ◽  
People With Dementia ◽  
Qualitative Descriptive ◽  
The Impact

Some Nigerians, in their effort to make sense of dementia symptoms, use descriptions that may stigmatize people with dementia and their families. This qualitative descriptive study focused on the everyday understanding of dementia and the impact of stigma on the caregiving experiences of informal female Nigerian dementia caregivers. Semi-structured interviews were conducted with a purposive sample of 12 adult informal female caregivers in Nigeria and analyzed for themes. Afterward, results were presented to focus groups of 21 adult Nigerians residing in the United States for more contextual insight on the findings. The three major themes were misconceptions about dementia symptoms, caregiving protects against stigmatization, and stigma affects caregiving support. Overall, we argue that knowledge deficit, poor awareness, and traditional spiritual beliefs combine to drive dementia-related stigmatization in Nigeria. Strategies such as culturally appropriate dementia awareness campaigns and formal long-term care policies are urgently needed to help strengthen informal dementia caregiving in Nigeria.

Clinical Oncology Practice 2015: Preparing for the Future

2015 ◽  
pp. e622-e627 ◽  
Author(s):  
Michael P. Kosty ◽  
Anupama Kurup Acheson ◽  
Eric D. Tetzlaff
Keyword(s):  
Clinical Oncology ◽  
Nurse Practitioners ◽  
Cancer Care ◽  
Medical Knowledge ◽  
Physician Assistants ◽  
The United States ◽  
Practice Model ◽  
American Society ◽  
Oncology Practice

The clinical practice of oncology has become increasingly complex. An explosion of medical knowledge, increased demands on provider time, and involved patients have changed the way many oncologists practice. What was an acceptable practice model in the past may now be relatively inefficient. This review covers three areas that address these changes. The American Society of Clinical Oncology (ASCO) National Oncology Census defines who the U.S. oncology community is, and their perceptions of how practice patterns may be changing. The National Cancer Institute (NCI)-ASCO Teams in Cancer Care Project explores how best to employ team science to improve the efficiency and quality of cancer care in the United States. Finally, how physician assistants (PAs) and nurse practitioners (NPs) might be best integrated into team-based care in oncology and the barriers to integration are reviewed.

scholarly journals A Bibliometric Analysis of Dropbox on Scopus Publication

Webology ◽  
2021 ◽  
Vol 18 (SI02) ◽  
pp. 54-78
Author(s):  
Nor Nashrah Azmi ◽  
Azham Hussain
Keyword(s):  
Growth Rate ◽  
The United States ◽  
Subject Area ◽  
Future Research ◽  
Microsoft Excel ◽  
Team Members ◽  
Digital Storage ◽  
Result Show ◽  
Popular Subject ◽  
Online Storage

Having a considered that online storage and sharing has becoming an essential to organised, stay focused and get in sync contents for all team members to enlighten way to work. Dropbox is the world‟s first smart work space which bring content of all team members together whilst letting users use the tool they want. Dropbox was initiated in 2008. Based on the usefulness and benefits of Dropbox, there are many kinds of research has been conducted on this topic. Therefore, this paper aims to analyse the scientific literature and report various types of published documents related to the Dropbox based on the data obtained from the Scopus Database by using Perish software to combine the obtained data, VOS Viewer Software to visualize the obtained data and Microsoft Excel to analysis the obtained data analysis. As of 27thApril 2020, there are 506 documents were retrieved and analysed based on the „key words‟ search result thru database. By using standard bibliometric indicators, this paper reports the documents types, source types, publication years, language of publications, subject area, most active source title, keywords, distribution of publications by countries, authorship, text analysis, most active institutions and citation analysis. As the result show that 1) 81% of the articles were published in conferences proceedings and journals articles. 2) 91% of the articles were published in English. 3) There is an increased growth rate of literature on Dropbox since 1985. However, the growth rate is slightly lower from 2016 until 2018. 4) Computer Science is the most popular subject category with respect to the frequency of citations, Halevi, Harnik, Pinkas and Shulman-Peleg (2011)‟s article appears as the most cited paper with an average of 30.44 citations per year. 5) Keywords of the Digital Storage, Cloud Storages and Cloud Computing were the top three keywords used in the database which represented the main areas of about Dropbox. 6) An analysis by country, The United States (US) is first country published most articles about Dropbox with 138 (27.27%).Meanwhile, 6) a total of 446 (88.14%) articles were published as multi-authored with a mean index of 3.55 authors per paper. Therefore, this research reviews of Dropbox published articles and delivers details of growth of Drop box for these35 years. This may help in potential directions or reference for future research.

scholarly journals Registered Nurses' Knowledge of Pneumonia Prevention Implementing Incentive Spirometry in Adult Hospitalized Postoperative Patients: A Quality Improvements

2019 ◽  
Author(s):  
Melissa Gaffney
Keyword(s):  
At Risk ◽  
Registered Nurses ◽  
The United States ◽  
Development Project ◽  
Small Sample ◽  
Postoperative Pneumonia ◽  
Model Framework ◽  
Improvement Program ◽  
Incentive Spirometry ◽  
Nurses Knowledge

In 2011, the Centers for Disease Control and Prevention (2018) estimated there were 157,500 cases of hospital-acquired pneumonia (HAP). Of those, ventilator associated pneumonia (VAP) had declined with increased efforts aimed at prevention, while nonventilator pneumonia (NV-HAP) did not have such prevention interventions and escalated, with approximately 2300 cases and 5600 respectively reported in one state (Baker&Quinn, 2018). The 2012 Healthcare Cost and Utilization Project National Inpatient Sample reported only 4 million people were at risk for VAP, while approximately 35 million more people were at risk for NV-HAP in the United States. The purpose of this project was to evaluate surgical unit registered nurses’ knowledge related to incentive spirometer (IS) in the prevention of NV-HAP postoperatively. The design of this quality improvement, program development project included a pretest, an evidence-based educational intervention specific to IS and a posttest administered to a small sample of RNs, guided by the Logic Model Framework. The results indicated that RNs’ perspectives on patients’ use of IS can be influenced following an educational session related to IS; however, the results showed a decrease in agreement reflecting the new knowledge of the nurses of the present evidence as it relates to incentive spirometry. These results also supported previous research findings and contribute to a body of knowledge validating nurses’ need for endorsed guidelines on appropriate usage of IS to prevent postoperative pneumonia. The Advanced Practice Nurse has a unique role that can directly impact the prevention of postoperative pneumonia.

Identifying Strategies for Robust Survivorship Program Implementation: A Qualitative Analysis of Cancer Programs

2021 ◽  
Author(s):  
Soohyun Hwang ◽  
Burcu Bozkurt ◽  
Tamara Huson ◽  
Sarah Asad ◽  
Lauren Richardson ◽  
...  
Keyword(s):  
Program Implementation ◽  
Health Care Professionals ◽  
Implementation Strategies ◽  
The United States ◽  
Survivorship Care ◽  
Team Members ◽  
Care Plans ◽  
Care Processes ◽  
Key Stakeholders ◽  
Template Analysis

PURPOSE The Commission on Cancer seeks to promote robust survivorship programs among accredited cancer programs. In practice, cancer programs' survivorship programs range from cursory (eg, developing care plans without robust services) to robust (eg, facilitating follow-up care). To inform cancer programs' future efforts, in this study, we identified the implementation strategies that cancer programs used to achieve robust survivorship programs, distinguishing them from cursory programs. METHODS We sampled 39 cancer programs across the United States with approaches to survivorship program implementation ranging from cursory to robust on the basis of LIVESTRONG survivorship care consensus elements. Within sampled cancer programs, we conducted in-depth semistructured interviews with a total of 42 health care professionals. We used template analysis to distinguish implementation strategies used in cancer programs with robust survivorship programs from strategies that yielded cursory survivorship programs. RESULTS Cancer programs with robust survivorship programs established clear systems survivorship care and formal committees to improve the survivorship care processes. They sought buy-in from multiple stakeholders to leverage cancer program resources and defined clear roles with shared accountability among multidisciplinary groups. By contrast, cancer programs with cursory survivorship programs reported less consistency in survivorship care processes and lacked buy-in from key stakeholders. They had limited resources, faced persistent structural concerns, and had insufficient clarity in roles among team members. CONCLUSION Accrediting bodies may consider incorporating the implementation strategies that robust survivorship programs have used as guidance for supporting cancer programs in operationalizing survivorship care and evaluating the use of these strategies during the accreditation and review process.

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