scholarly journals Creating Change in Health Care: Developing a Shared Understanding and Roadmap for Action

2015 ◽  
Vol 76 (3) ◽  
pp. 161-164 ◽  
Author(s):  
M. E. Maurer ◽  
P. Dardess ◽  
D. L. Frosch ◽  
K. L. Carman
Keyword(s):  
Health Care ◽  
Shared Understanding

scholarly journals Decision-making in complex health care situations: Shared understanding, experimenting, reflecting and learning

2021 ◽  
pp. 205343452110087
Author(s):  
Antoinette T Reerink ◽  
Jet Bussemaker ◽  
C Bastiaan Leerink ◽  
Jan AM Kremer
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Support Network ◽  
Health Conditions ◽  
Shared Understanding ◽  
Complex Problems ◽  
Strong Focus

People who have complex problems affecting multiple areas of their lives need a different approach than people who have singular health conditions. They benefit more from an effectively cooperating support network that explores appropriate ways of providing assistance, rather than a strong focus on outcome-based care.

scholarly journals New directions in health care and disability: the need for a shared understanding of human functioning

2012 ◽  
Vol 36 (5) ◽  
pp. 458-461 ◽  
Author(s):  
Ros Madden ◽  
Manuela Ferreira ◽  
Stewart Einfeld ◽  
Eric Emerson ◽  
Robert Manga ◽  
...  
Keyword(s):  
Health Care ◽  
Shared Understanding ◽  
Human Functioning ◽  
New Directions

Achieving shared understanding in chronic care interactions: the role of caregivers

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Sarah Bigi
Keyword(s):  
Health Care ◽  
Elderly Patients ◽  
Health Care Professionals ◽  
Chronic Care ◽  
Second Step ◽  
Original Research ◽  
Clinical Settings ◽  
Shared Understanding ◽  
Content Type

Purpose Within the context of a research program on the most relevant discourse types in chronic care medical encounters, this contribution reports on a qualitative study on the role caregivers play within the process of shared understanding occurring between health-care professionals and elderly patients. The purpose of the paper is to highlight one dimension of such complexity, by bringing to light the challenges connected to the achievement of shared understanding between health-care professionals and elderly patients when caregivers are involved in the conversation. Design/methodology/approach The paper reports on a two-step analysis of a corpus of transcripts of interactions in diabetes and hypertension settings. In the first step, caregivers’ contributions to deliberative sequences have been analyzed. In the second step, the analysis was extended to caregivers’ contributions to the whole encounter. Findings The results show that professionals’ ability to engage caregivers in deliberations during the encounter and, more generally, to assign a role to caregivers as legitimate participants in the consultation may favor the smooth development of the interaction and an effective process of shared understanding among all participants. Originality/value The paper further develops original research about the functions of the argumentative component in dialogues occurring in clinical settings.

scholarly journals Case Report: Type 2 Diabetes Mellitus

2018 ◽  
Vol 1 (2) ◽  
pp. 45
Author(s):  
Shofi Hesfianto
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Health Care ◽  
Chronic Disease ◽  
Health Care Providers ◽  
The Other ◽  
Shared Understanding ◽  
Care Providers ◽  
Patient’S Expectation

.......A patient who was first diagnosed with a chronic disease often does not fully understand the meaning or significanceof the chronic disease with which his/ her body suffers, against the risk of future complications if the disease is not well-controlled. On the other hand, in this reported case, the patient’s expectation was that her chronic disease, the T2DM, can be cured. Therefore, a shared understanding between health care providers and patient is likely the key to commencing the course of managing any chronic disease in a patient effectively.......

scholarly journals Defining when specialised mental health care is needed: a focus group study

BJGP Open ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. bjgpopen20X101004
Author(s):  
Marit Nymoen ◽  
Eva Biringer ◽  
Jostein Helgeland ◽  
Harald Bjarne Hellesen ◽  
Liv Alsaker Sande ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Focus Group ◽  
Mental Health Care ◽  
Research Process ◽  
Shared Understanding ◽  
Focus Group Study ◽  
Timely Access ◽  
Patient Representatives ◽  
Definition Of

BackgroundShared understanding between GPs and hospital specialists concerning when patients need specialised mental health care is important to ensure patients receive appropriate care. The large amount of rejected referrals often indicates a lack of such shared understanding.AimTo explore how patient representatives, GPs, and mental health specialists understand ‘need for specialised mental health care’, meaning that primary care is no longer sufficient.Design & settingThis qualitative study was conducted in western Norway. The study has a service user-involved research design in which GPs and patient representatives participated in all stages of the research process.MethodSix semi-structured focus group interviews were conducted. The groups were homogenous as they included only the perspectives of either GPs, mental health specialists, or patient representatives. Data were analysed using thematic analysis.ResultsThe need for specialised mental health care was assessed using two continuums: (a) the patient’s level of functioning and symptoms; and (b) characteristics of the healthcare system and the patient’s informal support networks. Assessment along these continuums were often overruled by the evaluation of expected usefulness of specialised mental health care. In addition, all participants reported they often adapted their definition of need to fit other stakeholders’ interpretations of need.ConclusionEvaluation of need for specialised mental health care is complex and depends on several factors. This may explain some of the current challenges that exist with regard to equity and timely access to appropriate healthcare interventions.

scholarly journals Adaptive capacities for safe clinical practice for patients hospitalised during a suicidal crisis: A qualitative study

2019 ◽  
Author(s):  
Siv Hilde Berg ◽  
Kristine Rørtveit ◽  
Fredrik. A. Walby ◽  
Karina Aase
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Clinical Practice ◽  
Clinical Care ◽  
Sense Making ◽  
Shared Understanding ◽  
Therapeutic Milieu ◽  
Trade Offs ◽  
Collegial Trust ◽  
Suicidal Crisis

Abstract Background. Safe clinical practice for patients during a suicidal crisis is situated within a complex, non-linear and uncertain context. It involves a complex set of practices in which adaptation is perceived as a source of safety. This study aims to develop a deeper understanding of safe clinical practice and the capacity to adapt to challenges and changes in clinical care for patients hospitalised in mental health wards during a suicidal crisis. Methods. This study applied a qualitative design based on focus group and individual interviews. Twenty-five health care professionals (HCPs) participated in the focus groups, and 18 HCPs were individually interviewed. The study was conducted at open and locked wards in a university hospital in Norway that provides specialised mental health services for adults.Findings. Adaptive capacities for clinical practice were described in relation to three themes. 1) HCPs described using expertise to make sense of suicidal behaviour to support complex decision-making. Their strategies relied on setting the checklist aside to prioritise trust and making judgements beyond spoken words. They improved their understanding by seeking others’ perspectives through a collaborative sense-making process involving the health care team and the patient. 2) HCPs reported individualising the therapeutic milieu to address the diversity of patients with suicidal behaviour. Safe clinical practice was provided by creating individual clinical pathways, making trade-offs between under- and over-protection and adjusting observations 3) It was necessary for HCPs manage uncertainty to provide safe clinical practice. They did so as a team by developing mutual collegial trust, support and shared understanding. Conclusion. HCPs’ adaptive capacities are vital to the complex set of practices involved in safe clinical practice for patients hospitalised during a suicidal crisis. By using expertise, individualising the therapeutic milieu, and managing uncertainty, HCPs individually and collectively develop their capacity to adapt to challenges and changes in clinical care. Safe clinical practice cannot easily be ensured by following standards; it depends on HCP adaptations. Ward systems ensuring collegial trust and support are needed, as are arenas supporting shared understanding and collaborative sense-making. Keywords: Adaptation, sense-making, situational awareness, shared understanding, trade-offs, mental health, suicide, uncertainty

Reaching a shared understanding of shared decision making in health care: NICE's experience of scoping the shared decision making guideline

2019 ◽  
Vol 25 (6) ◽  
pp. 1027-1029 ◽  
Author(s):  
Clare Wohlgemuth ◽  
Katrina Penman ◽  
Monica Desai ◽  
Kay Nolan ◽  
Nichole Taske ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Shared Understanding ◽  
Shared Decision

Malpractice & Negligence: Cal. Supreme Court Clarifies Negligence Provisions under State’s Elder Abuse Act

1999 ◽  
Vol 27 (2) ◽  
pp. 203-203
Author(s):  
Kendra Carlson
Keyword(s):  
Health Care ◽  
Supreme Court ◽  
Health Care Providers ◽  
Elder Abuse ◽  
Skilled Nursing Facility ◽  
Pressure Sores ◽  
Care Providers ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
The Supreme Court

The Supreme Court of California held, in Delaney v. Baker, 82 Cal. Rptr. 2d 610 (1999), that the heightened remedies available under the Elder Abuse Act (Act), Cal. Welf. & Inst. Code, §§ 15657,15657.2 (West 1998), apply to health care providers who engage in reckless neglect of an elder adult. The court interpreted two sections of the Act: (1) section 15657, which provides for enhanced remedies for reckless neglect; and (2) section 15657.2, which limits recovery for actions based on “professional negligence.” The court held that reckless neglect is distinct from professional negligence and therefore the restrictions on remedies against health care providers for professional negligence are inapplicable.Kay Delaney sued Meadowood, a skilled nursing facility (SNF), after a resident, her mother, died. Evidence at trial indicated that Rose Wallien, the decedent, was left lying in her own urine and feces for extended periods of time and had stage I11 and IV pressure sores on her ankles, feet, and buttocks at the time of her death.

A Tribute to the Late William J. Curran

1996 ◽  
Vol 24 (3) ◽  
pp. 274-275
Author(s):  
O. Lawrence ◽  
J.D. Gostin
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
United Nations ◽  
Mental Health Care ◽  
Harvard University ◽  
Legal Medicine ◽  
General Assembly ◽  
International Institute ◽  
University Professor

In the summer of 1979, a group of experts on law, medicine, and ethics assembled in Siracusa, Sicily, under the auspices of the International Commission of Jurists and the International Institute of Higher Studies in Criminal Science, to draft guidelines on the rights of persons with mental illness. Sitting across the table from me was a quiet, proud man of distinctive intelligence, William J. Curran, Frances Glessner Lee Professor of Legal Medicine at Harvard University. Professor Curran was one of the principal drafters of those guidelines. Many years later in 1991, after several subsequent re-drafts by United Nations (U.N.) Rapporteur Erica-Irene Daes, the text was adopted by the U.N. General Assembly as the Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care. This was the kind of remarkable achievement in the field of law and medicine that Professor Curran repeated throughout his distinguished career.

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