scholarly journals A Localized Home-based Health Care Delivery Model for Refugees in Jordan

2018 ◽  
Vol 5 (2) ◽  
pp. 29-36
Author(s):  
Salim Suleiman ◽  
Matthew Nance ◽  
Daniel W O'Neill
Keyword(s):  
Care Delivery ◽  
Good Practice ◽  
Lessons Learned ◽  
Local Health ◽  
Team Members ◽  
Home Based ◽  
Care Delivery Model ◽  
Human Need ◽  
Program Description

Interprofessional teams delivering home-based care hold promise as an effective model for vulnerable populations, but examples of good practice are limited.  This case study presents the initial evaluation of a contextualized application of home-based medical care initiated from the faith community in Jordan toward Syrian and Iraqi refugees with constrained access to resources. Reflexive responses to human need by local churches became the basis for home-based medical outreach. Heavily dependent on volunteers, these church-based teams are selected and trained to meet specific needs, inter-professional partnerships were created through networking, and electronic medical records are deployed to facilitate communication and follow-up. The program’s standards of operation are delineated, and a program description is explained which clarifies volunteer selection, training, faith inspiration, communication, continuity, inter-professional partnerships, and addresses obstacles of care.  Based on subjective collective observations of team members, the advantages of the model in practice are reported, along with lessons learned.  These include dignity promotion, contextualization of health in the home, relationship development, inter-faith communication, inter-professional partnerships created through networking with local health professionals of other faiths, and other NGOs. Limitations of the model, and potential application in other contexts concludes the case study. 

scholarly journals Risk and the Republican National Convention: Application of the Novel COVID-19 Operational Risk Assessment

2021 ◽  
pp. 1-6
Author(s):  
David Callaway ◽  
Jeff Runge ◽  
Lucia Mullen ◽  
Lisa Rentz ◽  
Kevin Staley ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Health Care ◽  
Care Delivery ◽  
The United States ◽  
Lessons Learned ◽  
World Health ◽  
Local Health ◽  
Mass Gathering ◽  
Wide Range ◽  
National Convention

Abstract The United States Centers for Disease Control and Prevention and the World Health Organization broadly categorize mass gathering events as high risk for amplification of coronavirus disease 2019 (COVID-19) spread in a community due to the nature of respiratory diseases and the transmission dynamics. However, various measures and modifications can be put in place to limit or reduce the risk of further spread of COVID-19 for the mass gathering. During this pandemic, the Johns Hopkins University Center for Health Security produced a risk assessment and mitigation tool for decision-makers to assess SARS-CoV-2 transmission risks that may arise as organizations and businesses hold mass gatherings or increase business operations: The JHU Operational Toolkit for Businesses Considering Reopening or Expanding Operations in COVID-19 (Toolkit). This article describes the deployment of a data-informed, risk-reduction strategy that protects local communities, preserves local health-care capacity, and supports democratic processes through the safe execution of the Republican National Convention in Charlotte, North Carolina. The successful use of the Toolkit and the lessons learned from this experience are applicable in a wide range of public health settings, including school reopening, expansion of public services, and even resumption of health-care delivery.

A Blueprint for the Conduct of Large, Multi-Site Trials in Telemedicine (Preprint)

2021 ◽  
Author(s):  
Patricia Commiskey ◽  
April W Armstrong ◽  
Tumaini Rucker Coker ◽  
Earl Ray Dorsey ◽  
John Fortney ◽  
...  
Keyword(s):  
Skin Diseases ◽  
Care Delivery ◽  
Mental Healthcare ◽  
Stroke Care ◽  
Lessons Learned ◽  
Patient Centered ◽  
Implementation Challenges ◽  
Home Based ◽  
Family Based ◽  
Key Aspects

BACKGROUND Recent literature supports the efficacy and efficiency of telemedicine in improving various health outcomes, despite the wide variability in results. OBJECTIVE Understanding site-specific issues in the implementation of telemedicine trials for broader replication and generalizability of results is needed. Lessons can be learned from existing trials, and a blueprint can guide researchers to conduct these challenging studies using telemedicine more efficiently and effectively. METHODS This viewpoint presents relevant challenges and solutions for conducting multi-site telemedicine trials using seven ongoing and completed studies funded by the Patient Centered Outcomes Research Institute (PCORI) portfolio of large multi-site trials to highlight the challenges in implementing telemedicine trials. RESULTS Implementation challenges related to clinical, informatics, regulatory, legal, quality and billing were identified and described. CONCLUSIONS Lessons learned from these studies were used to create a blueprint of key aspects to consider for the design and implementation of multi-site telemedicine trials. CLINICALTRIAL NCT02358135: Improving Specialty-Care Delivery in Chronic Skin Diseases (PI: AWArmstrong) NCT02396576: Using Telehealth to Deliver Developmental, Behavioral, and Mental Health Services in Primary Care Settings for Children in Underserved Areas (PI: TRCoker) NCT02038959: Connect.Parkinson (PI: RDorsey) NCT04000971: C3FIT (Coordinated, Collaborative, Comprehensive, Family-based, Integrated, Technology-enabled Care) Stroke Care Trial (PI: KGaines) NCT03694431: Noninferiority Comparative Effectiveness Trial of Home-Based Palliative Care (HomePal) Trial (PI: HNguyen, KMularski) NCT04153864: SUMMIT (Scaling Up Maternal Mental healthcare by Increasing access to Treatments) Trial (PI: DRSingla) NCT03985800: Specialty Medical Homes to Improve Outcomes for Patients with Inflammatory Bowel Disease (IBD) and Behavioral Health Conditions Trial (PI: ESzigethy)

Cardiovascular Single-Unit Stay: A Case Study in Change

2004 ◽  
Vol 13 (5) ◽  
pp. 406-409 ◽  
Author(s):  
Elizabeth I. Clark ◽  
Constance L. Roberts ◽  
Karen C. Traylor
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Single Unit ◽  
Care Delivery ◽  
Medical Center ◽  
Postoperative Course ◽  
Lengths Of Stay ◽  
Care Delivery Model

A cardiovascular single-unit-stay program began at North Memorial Medical Center, Robbinsdale, Minn, in January 2000. Before then, cardiac surgery patients had been admitted to the intensive care unit directly from the operating room and then transferred to the postcoronary care unit on postoperative day 1 or 2. The traditional care delivery model created multiple transfers and delays in care, which often led to dissatisfaction among patients, increased costs, and greater potential for errors. The cardiovascular single-unit-stay program allows patients to stay in the same room with a consistent care team throughout the patients’ postoperative course. Decreased lengths of stay, decreased morbidity and mortality, increased satisfaction among patients and their families, and improved collaboration between members of the multidisciplinary team are just a few of the positive trends since the program’s inception.

scholarly journals Lessons learnt: examining the use of case study methodology for nursing research in the context of palliative care

2019 ◽  
Vol 24 (6) ◽  
pp. 446-459
Author(s):  
Paula Brogan ◽  
Felicity Hasson ◽  
Sonja McIlfatrick
Keyword(s):  
Palliative Care ◽  
Care Delivery ◽  
Case Study Research ◽  
Lessons Learned ◽  
Research Approach ◽  
Nursing Research ◽  
Case Study Methodology ◽  
Study Research ◽  
Study Methodology

Background An empirical social research approach, facilitating in-depth exploration of complex, contemporary contextualised phenomena, case study research has been used internationally in healthcare studies across clinical settings, to explore systems and processes of care delivery. In the United Kingdom, case study methods have been championed by nurse researchers, particularly in the context of community nursing and palliative care provision, where its applicability is well established. Yet, dogged by conceptual confusion, case study remains largely underutilised as a research approach. Method Drawing on examples from nursing and palliative care studies, this paper clarifies case study research, identifies key concepts and considers lessons learned about its potential for nursing research within the unique and complex palliative and end of life context. Conclusion A case study approach offers nurse researchers the opportunity for in-depth, contextualised understanding of the systems and processes which influence their role in palliative care delivery across settings. However, philosophical and conceptual understandings are needed and further training in case study methodology is required to enable researchers to articulate and conduct case study.

Integrating Concurrent Palliative Care into Cancer Care Delivery Settings

2018 ◽  
Author(s):  
Meagan Whisenant ◽  
Kathi Mooney
Keyword(s):  
Palliative Care ◽  
Advanced Cancer ◽  
Care Delivery ◽  
Scale Up ◽  
Fee For Service ◽  
National Guidelines ◽  
Reimbursement Mechanisms ◽  
Early Integration ◽  
Home Based

This case study reviews the evidence for adoption of concurrent palliative care (CPC) during treatment for advanced cancer. Increasing research evidence and expert panel consensus has resulted in national guidelines and professional society endorsement of early integration of palliative care into oncology care. However, there is variable uptake of these guidelines and penetration of CPC into practice. Barriers to implementation include the need to increase awareness of existing evidence and guidelines, stigma, adequacy of a workforce for scale-up, lack of models for integration and delivery, and restrictive reimbursement mechanisms. Changing health care models that emphasize value-based care over fee-for-service can accelerate adoption. Use of technology can also overcome barriers related to scalability and resource use. The case study concludes with the recommendation that implementation science methodologies be used to guide successful integration of CPC in outpatient and home-based settings for patients with advanced cancer and their family caregivers.

Organizational innovation and integrated care: lessons from Buurtzorg

2014 ◽  
Vol 22 (4) ◽  
pp. 174-184 ◽  
Author(s):  
Sharda Nandram ◽  
Nicole Koster
Keyword(s):  
Integrated Care ◽  
Management Practice ◽  
Good Practice ◽  
Integrated Approach ◽  
Lessons Learned ◽  
Secondary Process ◽  
Community Based ◽  
Content Type ◽  
First Case

Purpose – The purpose of this paper is to describe the case of Buurtzorg Nederland as a good practice example of integrated care, focussing in particular on the organizational aspects of its innovation. As the field of integrated care is still in many ways in its infancy, it is hoped that lessons learned could help other agencies and other systems seeking to reform community-based care. Design/methodology/approach – Drawing on a grounded approach, this case study is based on individual interviews with 38 respondents comprising staff, founder, co-founders, coaches, nurses, clients and a trainer and analysis of internal company reports. Findings – Based on the case study the authors suggest an integrated approach as the main explanation of the good practice at Buurtzorg rather than a focus on one single concept such as management structure, information and communication technology, community-based care or a patient focus. Next to the multi-level approach it furthermore shows a multi-dimensional approach as explanation for its success. In this perspective the primary process is the leading process but fully supported by the secondary process containing support facilities from a head office of the organization. Practical implications – Buurtzorg Nederland has been awarded with several prizes for its good management practice in integrated care and attention internationally is growing. Originality/value – This paper provides the first case study write-up of the Buurtzorg model for an international audience, based on extensive research to be published in an international book.

scholarly journals Scaling virtual health at the epicentre of coronavirus disease 2019: A case study from NYU Langone Health

2020 ◽  
pp. 1357633X2094139
Author(s):  
Jason Sherwin ◽  
Katharine Lawrence ◽  
Veronica Gragnano ◽  
Paul A Testa
Keyword(s):  
Health Care ◽  
At Risk ◽  
Health Systems ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Lessons Learned ◽  
Virtual Care ◽  
Health Enterprise

The coronavirus disease 2019 (COVID-19) pandemic has accelerated the drive of health-care delivery towards virtual-care platforms. While the potential of virtual care is significant, there are challenges to the implementation and scalability of virtual care as a platform, and health-care organisations are at risk of building and deploying non-strategic, costly or unsustainable virtual-health systems. In this article, we share the NYU Langone Health enterprise approach to building and scaling an integrated virtual-health platform prior to and during the COVID-19 pandemic, and offer lessons learned and recommendations for health systems that need to undertake or are currently undertaking the transition to virtual-care delivery.

Lean Six Sigma and Assurance of Learning (AoL) in higher education: a case study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Iman Adeinat ◽  
Naseem Al Rahahleh ◽  
Tameem Al Bassam
Keyword(s):  
Higher Education ◽  
Curriculum Design ◽  
Six Sigma ◽  
Lean Six Sigma ◽  
Lessons Learned ◽  
Content Type ◽  
Team Members ◽  
Institutional Goals ◽  
Assurance Of Learning

PurposeThis study aims to present a case study using a Lean Six Sigma (LSS) process to manage the Assurance of Learning (AoL) process in higher education. The case study highlights the value that LSS can bring to the higher education context in respect to making the AoL process more efficient and more effective. The article also illustrates lessons learned in relation to adopting LSS in higher education institutes (HEIs).Design/methodology/approachThe case study presented is part of a larger undertaking implemented by the Faculty of Economics and Administration (FEA) at King Abdulaziz University in Saudi Arabia to improve its curricula for all its programs as the graduate and undergraduate level in line with the 2013 Association to Advance Collegiate Schools of Business standards. The FEA project team implemented the AoL process using an LSS methodology – define–measure–analyze–improve–control (DMAIC).FindingsThe experience of the FEA as described in the case study suggests that the DMAIC framework can be very useful in managing the AoL process. Three aspects of LSS used in the AoL context are identified as critical in ensuring that the process achieves its stated institutional goals. Firstly, it is necessary to clearly identify which team members have which areas of responsibility in relation to, for example, sponsoring, implementing, managing and monitoring the project. Secondly, the common language provided by LSS is essential to fostering collaboration among members of a cross-disciplinary team. Lastly, quantifiable priorities should be identified.Research limitations/implicationsThe experience of the FEA as described in the case study suggests that the DMAIC framework can be very effective in advancing and managing the AoL process. For example, writing the project charter, mapping the process using the suppliers, inputs, process, outputs, customers model and using various LSS tools and techniques to measure and control the assessment were critical to improving the AoL process.Practical implicationsThis paper provides a guide to the range of practices cited in the literature on implementing LSS in relation to AoL as a comprehensive means of assessing, evaluating and improving curriculum design and delivery. The importance of this process to accreditation is explored and recommendations are offered focused on realizing both short- and long-term benefits through the initial assessments and subsequent iterations.Originality/valueThe defining contribution of this paper to the literature is its consideration of LSS implementation in the HEI context through the development and management of the AoL process.

scholarly journals Implementing Integrative Nursing in a Pediatric Setting

Children ◽  
2018 ◽  
Vol 5 (8) ◽  
pp. 103
Author(s):  
Megan Voss ◽  
Mary Kreitzer
Keyword(s):  
Health Center ◽  
Care Delivery ◽  
Academic Health Center ◽  
Lessons Learned ◽  
Academic Health ◽  
Advanced Nursing Practice ◽  
Deep Dive ◽  
Integrative Health ◽  
Care Delivery Model ◽  
Health And Healing

Pediatric blood and marrow transplantation (BMT) is one of the most challenging allopathic treatments a patient and family can be faced with. A large Midwest academic health center, and leader in pediatric BMT, made the decision in 2013 to incorporate integrative nursing as the care delivery model. Nurses trained in advanced nursing practice and specialized in integrative health and healing performed a deep-dive needs assessment, national benchmarking, a comprehensive review of the literature, and ultimately designed a comprehensive integrative program for pediatric patients and their families undergoing BMT. Four years after implementation, this paper discusses lessons learned, strengths, challenges and next phases of the program, including a research agenda. The authors conclude that it is feasible, acceptable and sustainable to implement a nurse-led integrative program within an academic health center-based pediatric BMT program.

scholarly journals Providing real-time resources in support of LGBTQ+ and HIV+ populations as information experts on the ECHO hub team: a case report

2021 ◽  
Vol 109 (4) ◽  
Author(s):  
Laura Menard ◽  
Chelsea Misquith
Keyword(s):  
Health Care ◽  
Real Time ◽  
Health Care Providers ◽  
Value Added ◽  
Local Health ◽  
Care Providers ◽  
Team Members ◽  
Project Echo ◽  
Information Professionals

Background: Project ECHO (Extension for Community Healthcare Outcomes) is a telehealth initiative that aims to reduce disparities in delivery of health care by leveraging technology and local expertise to provide guidance on specialized subjects to health care providers across the world. In 2018, a new ECHO hub convened in Indianapolis with a focus on health care for individuals in the lesbian, gay, bisexual, trans, and queer (LGBTQ+) populations. This ECHO iteration was one of the first of its kind and would soon be followed by a new human immunodeficiency virus (HIV) ECHO as well.Case Presentation: In a novel approach, information professionals participated in the early planning stages of the formation of these ECHO teams, which enabled the provision of real-time medical evidence and resources at the point-of-need once the teams were launched. This case study demonstrates proof of concept for including health sciences librarians and/or information professionals in the ECHO as hub team members. In this case study, the authors describe and quantify the value added to the HIV and LGBTQ+ ECHO sessions by the medical librarians, as well as provide a template for how other telehealth initiatives can collaborate with their local health information professionals.Conclusions: Librarian involvement in Project ECHO over the past three years has been enthusiastically received. The librarians have contributed hundreds of resources to ECHO participants, helped build and curate resource repositories, and expanded the embedded librarian program to an additional two ECHO iterations. ECHO hub team members report high rates of satisfaction with the performance of embedded librarians and appreciate the provision of point-of-need evidence to ECHO participants.

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