scholarly journals THE ANALYSIS OF INDICES OF PUBLIC HEALTH OF LARGE INDUSTRIAL CENTER OF SIBERIA USING INFORMATIONAL TECHNOLOGIES AND MODERN ANALYSIS TECHNIQUES

2019 ◽  
Vol 61 (4) ◽  
pp. 172-177
Author(s):  
Natalya M. Zhilina ◽  
A. E. Vlasenko ◽  
G. I. Chechenin
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Medical Care ◽  
Population Health ◽  
Care Quality ◽  
Human Environment ◽  
Labor Conditions ◽  
Risk Zones ◽  
Effective Decision Making ◽  
Industrial Center

The study was carried out to examine population health in large industrial center exemplified by Novokuznetsk for establishing risk zones and increasing efficiency of health care functioning and medical care quality. The efficiency is determined by increasing of reliability and integration of indices of population health and its particular categories for effective decision making, amelioration of awareness of specialists and quality of medical care. The article presents the results of analysis of health of working population of a large industrial center of Siberia as exemplified by Novokuznetsk according information data bases of the Kustovoii medical informational analytical center in relationship with environmental factors and indices of health care functioning. The indicator of "problemability" is developed and its application is presented related to establishment of risk zones for population health. The results of modeling of indices of population health and algorithms of support of decision making for the most problematic indices (health of newborns and disability) are presented. The health of schoolchildren, preschoolers and pedagogic workers is analyzed according information from sub-system "Pedagogic monitoring" sub-system. The results are presented concerning the clustering of educational organizations on main health risk factors. The results of study containing summarized analytical information about human environment, zones and categories of risk are to support timely decision making by mangers of all levels, increasing of role of healthy life style, amelioration of labor conditions, ecological and social environment, preservation and promotion of population health.

scholarly journals Reducing Alert Fatigue by Sharing Low-Level Alerts With Patients and Enhancing Collaborative Decision Making Using Blockchain Technology: Scoping Review and Proposed Framework (MedAlert) (Preprint)

2020 ◽  
Author(s):  
Paul Kengfai Wan ◽  
Abylay Satybaldy ◽  
Lizhen Huang ◽  
Halvor Holtskog ◽  
Mariusz Nowostawski
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Scoping Review ◽  
Health Care Quality ◽  
Research Question ◽  
Clinical Decision ◽  
Care Quality ◽  
Alert Fatigue ◽  
Low Level ◽  
Future Work

BACKGROUND Clinical decision support (CDS) is a tool that helps clinicians in decision making by generating clinical alerts to supplement their previous knowledge and experience. However, CDS generates a high volume of irrelevant alerts, resulting in alert fatigue among clinicians. Alert fatigue is the mental state of alerts consuming too much time and mental energy, which often results in relevant alerts being overridden unjustifiably, along with clinically irrelevant ones. Consequently, clinicians become less responsive to important alerts, which opens the door to medication errors. OBJECTIVE This study aims to explore how a blockchain-based solution can reduce alert fatigue through collaborative alert sharing in the health sector, thus improving overall health care quality for both patients and clinicians. METHODS We have designed a 4-step approach to answer this research question. First, we identified five potential challenges based on the published literature through a scoping review. Second, a framework is designed to reduce alert fatigue by addressing the identified challenges with different digital components. Third, an evaluation is made by comparing MedAlert with other proposed solutions. Finally, the limitations and future work are also discussed. RESULTS Of the 341 academic papers collected, 8 were selected and analyzed. MedAlert securely distributes low-level (nonlife-threatening) clinical alerts to patients, enabling a collaborative clinical decision. Among the solutions in our framework, Hyperledger (private permissioned blockchain) and BankID (federated digital identity management) have been selected to overcome challenges such as data integrity, user identity, and privacy issues. CONCLUSIONS MedAlert can reduce alert fatigue by attracting the attention of patients and clinicians, instead of solely reducing the total number of alerts. MedAlert offers other advantages, such as ensuring a higher degree of patient privacy and faster transaction times compared with other frameworks. This framework may not be suitable for elderly patients who are not technology savvy or in-patients. Future work in validating this framework based on real health care scenarios is needed to provide the performance evaluations of MedAlert and thus gain support for the better development of this idea. CLINICALTRIAL

scholarly journals Use of EHR-Based Pediatric Quality Measures: Views of Health System Leaders and Parents

2019 ◽  
Vol 35 (2) ◽  
pp. 177-185
Author(s):  
David M. Hartley ◽  
Susannah Jonas ◽  
Daniel Grossoehme ◽  
Amy Kelly ◽  
Cassandra Dodds ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health System ◽  
Health Care Quality ◽  
Quality Measures ◽  
Care Quality ◽  
Quality Data ◽  
High Confidence ◽  
System Leaders ◽  
Using Data

Measures of health care quality are produced from a variety of data sources, but often, physicians do not believe these measures reflect the quality of provided care. The aim was to assess the value to health system leaders (HSLs) and parents of benchmarking on health care quality measures using data mined from the electronic health record (EHR). Using in-context interviews with HSLs and parents, the authors investigated what new decisions and actions benchmarking using data mined from the EHR may enable and how benchmarking information should be presented to be most informative. Results demonstrate that although parents may have little experience using data on health care quality for decision making, they affirmed its potential value. HSLs expressed the need for high-confidence, validated metrics. They also perceived barriers to achieving meaningful metrics but recognized that mining data directly from the EHR could overcome those barriers. Parents and HSLs need high-confidence health care quality data to support decision making.

Health Literacy: A Brief Primer for the Otolaryngologist

2016 ◽  
Vol 156 (3) ◽  
pp. 395-396 ◽  
Author(s):  
Uchechukwu C. Megwalu
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Clinical Practice ◽  
Health Literacy ◽  
Medical Care ◽  
Vital Sign ◽  
Shared Decision ◽  
Health Care Environment ◽  
Care Environment ◽  
Newest Vital Sign

Health literacy has been shown to affect outcomes in a number of medical conditions. Despite the complexity of care that is often required among otolaryngology patients, the literature on health literacy in this field is sparse. Otolaryngologists need to be aware of issues related to health literacy due to the changing health care environment. The increased complexity of medical care, the greater involvement of patients in shared decision making, and the higher administrative burden on patients have increased their health literacy requirements. Assessing health literacy in clinical practice may help identify patients who might require additional help in navigating the health care system. The Brief Health Literacy Screen and the Newest Vital Sign are 2 measures that are easy to apply in clinical practice.

Strategies for Improving Dialysis Decision Making

1991 ◽  
Vol 11 (2) ◽  
pp. 173-178 ◽  
Author(s):  
Anne Campbell
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Professionals ◽  
Medical Management ◽  
Quality Care ◽  
Thought Processes ◽  
Treatment Termination ◽  
Effective Decision ◽  
Effective Decision Making ◽  
Esrd Patients

It is important that every professional involved with guiding ESRD patients through the maze of dialysis decision making critically analyze his or her own behaviors, possible biases and thought processes influencing discussions with patients. Health care professionals need to continue to strive to improve their skills for assuring optimal assistance to their patients in making decisions about the best types of treatments for them. In this era of evermore challenging patients and technologies, the skills for informing patients and assisting them with effective decision making about issues such as medical management, dialysis, transplantation or treatment termination are vita! for assuring quality care.

scholarly journals Is there a relationship between hospital care quality assessemnt and the patient’s place of residence?

2015 ◽  
Vol 125 (2) ◽  
pp. 77-82
Author(s):  
Marek Kos ◽  
Agnieszka Dziewa ◽  
Bartłomiej Drop ◽  
Marzena Furtak-Niczyporuk ◽  
Ewa Warchoł-Sławińska
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Medical Care ◽  
Hospital Care ◽  
Care Facility ◽  
Care Quality ◽  
Satisfaction Survey ◽  
Place Of Residence ◽  
Patient Satisfaction Survey

Abstract Introduction. Measuring the patient satisfaction with the hospital stay, as well as the knowledge of their requirements are very important in the management of health institutions. A good example of the recognition of patients’ expectations is studying the level of satisfaction with specially prepared questionnaires. Aim. The aim of the study was to investigate the relationship between the patients’ place of residence and their satisfaction with the medical care they received when treated in local hospitals Material and methods. Patient satisfaction survey was carried out in the Independent Public Health Care Centre in Kraśnik in two subsequent years: at the turn of 2011/2012 and in February 2013. The survey consisted of patients hospitalized in the surgical wards of the hospital. A testing tool for this survey was a self-designed questionnaire entitles “Patient satisfaction survey” specifically developed by nursing managers and approved by the management of the hospital. Results. Patients of the District Hospital in Kraśnik gave their complex assessment of satisfaction with the benefits provided by the health care facility, taking into account not only the quality of strictly medical services, but the entire infrastructure of the hospital, including ancillary services. The obtained results gave a positive assessment of the analyzed branches. No statistically significant differences between the assessments of rural and urban inhabitants were found. The results allow knowledge of the strengths and weaknesses of medical care in the wards. Conclusions. Residents of rural areas, who are slightly better than those who live in cities, assess the work of local hospital surgical wards. You can clearly see it by assessing the quality of nurses’ and doctors’ work and the assessment of nutrition and the appearance of patient rooms. Systematic research, measurement and evaluation of patient satisfaction with hospital care can be the basis for the improvement and ensure an appropriate level of quality

Result-Based Compensation in Health Care: A Good, but Limited, Idea

2001 ◽  
Vol 29 (2) ◽  
pp. 174-181 ◽  
Author(s):  
E. Haavi Morreim
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Medical Ethics ◽  
American Medical ◽  
Medical Care ◽  
Care Setting ◽  
Health Care Setting ◽  
Considerable Success

David Hyman and Charles Silver are quite right. Opinion 6.01 in the American Medical Association's (AMA) Code of Medical Ethics is difficult to defend. Ties between compensation and outcomes need not mislead patients into thinking that results are guaranteed; they are widely used in other fields with considerable success, even if they have some disadvantages; they can potentially bring patients more actively into decision-making about whether and from whom to purchase which medical care; and, if carefully tuned, they can promote quality by aligning providers’ welfare more closely with patients’.The purpose of this commentary is thus not to disagree with the fundamental thesis that result-based compensation arrangements (RBCAs) can be appropriate and useful in the health-care setting. Rather, the objective is to “cut the next swath,” so to speak. While Hyman and Silver are right that RBCAs have potential to do good, they may be overly optimistic about benefits, while underestimating the potential limitations and hazards.

scholarly journals Reducing Alert Fatigue by Sharing Low-Level Alerts With Patients and Enhancing Collaborative Decision Making Using Blockchain Technology: Scoping Review and Proposed Framework (MedAlert)

10.2196/22013 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e22013
Author(s):  
Paul Kengfai Wan ◽  
Abylay Satybaldy ◽  
Lizhen Huang ◽  
Halvor Holtskog ◽  
Mariusz Nowostawski
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Scoping Review ◽  
Health Care Quality ◽  
Research Question ◽  
Clinical Decision ◽  
Care Quality ◽  
Alert Fatigue ◽  
Low Level ◽  
Future Work

Background Clinical decision support (CDS) is a tool that helps clinicians in decision making by generating clinical alerts to supplement their previous knowledge and experience. However, CDS generates a high volume of irrelevant alerts, resulting in alert fatigue among clinicians. Alert fatigue is the mental state of alerts consuming too much time and mental energy, which often results in relevant alerts being overridden unjustifiably, along with clinically irrelevant ones. Consequently, clinicians become less responsive to important alerts, which opens the door to medication errors. Objective This study aims to explore how a blockchain-based solution can reduce alert fatigue through collaborative alert sharing in the health sector, thus improving overall health care quality for both patients and clinicians. Methods We have designed a 4-step approach to answer this research question. First, we identified five potential challenges based on the published literature through a scoping review. Second, a framework is designed to reduce alert fatigue by addressing the identified challenges with different digital components. Third, an evaluation is made by comparing MedAlert with other proposed solutions. Finally, the limitations and future work are also discussed. Results Of the 341 academic papers collected, 8 were selected and analyzed. MedAlert securely distributes low-level (nonlife-threatening) clinical alerts to patients, enabling a collaborative clinical decision. Among the solutions in our framework, Hyperledger (private permissioned blockchain) and BankID (federated digital identity management) have been selected to overcome challenges such as data integrity, user identity, and privacy issues. Conclusions MedAlert can reduce alert fatigue by attracting the attention of patients and clinicians, instead of solely reducing the total number of alerts. MedAlert offers other advantages, such as ensuring a higher degree of patient privacy and faster transaction times compared with other frameworks. This framework may not be suitable for elderly patients who are not technology savvy or in-patients. Future work in validating this framework based on real health care scenarios is needed to provide the performance evaluations of MedAlert and thus gain support for the better development of this idea.

Key Elements of the Critical Care Work Environment Associated With Burnout and Compassion Satisfaction

2021 ◽  
Vol 30 (2) ◽  
pp. 113-120
Author(s):  
Lesly A. Kelly ◽  
Karen L. Johnson ◽  
R. Curtis Bay ◽  
Michael Todd
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Critical Care ◽  
Work Environment ◽  
Compassion Satisfaction ◽  
Well Being ◽  
Nurse Turnover ◽  
Effective Decision ◽  
Effective Decision Making ◽  
The Impact

Background As the role of a health care system’s influence on nurse burnout becomes better understood, an under-standing of the impact of a nurses’ work environment on burnout and well-being is also imperative. Objective To identify the key elements of a healthy work environment associated with burnout, secondary trauma, and compassion satisfaction, as well as the effect of burnout and the work environment on nurse turnover. Methods A total of 779 nurses in 24 critical care units at 13 hospitals completed a survey measuring burnout and quality of the work environment. Actual unit-level data for nurse turnover during a 5-month period were queried and compared with the survey results. Results Among nurses in the sample, 61% experience moderate burnout. In models controlling for key nurse characteristics including age, level of education, and professional recognition, 3 key elements of the work environment emerged as significant predictors of burnout: staffing, meaningful recognition, and effective decision-making. The latter 2 elements also predicted more compassion satisfaction among critical care nurses. In line with previous research, these findings affirm that younger age is associated with more burnout and less compassion satisfaction. Conclusions Efforts are recommended on these 3 elements of the work environment (staffing, meaningful recognition, effective decision-making) as part of a holistic, systems-based approach to addressing burnout and well-being. Such efforts, in addition to supporting personal resilience-building activities, should be undertaken especially with younger members of the workforce in order to begin to address the crisis of burnout in health care.

Modern problems of medical care quality (review of literature)

10.12737/8114 ◽  
2015 ◽  
Vol 9 (1) ◽  
pp. 0-0 ◽  
Author(s):  
Орлова ◽  
A. Orlova
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Medical Profession ◽  
Social Activity ◽  
Subjective Assessment ◽  
Care Quality ◽  
Medical Institutions ◽  
The World ◽  
The Moment

High quality of medical care is the primary goal of a health system. At the moment it cann’t be considered high. The results of sociological surveys presented that quite a large proportion of patients isn’t satisfied with the care provided by medical assistance. The causes of this are: absence of funding for health care (and related problems of material and technical base, staffing, staff interest and other), as well as the absence of commonly agreed (and unified with the world) approaches to the definition criteria (indicators), means of verification and a unified system of quality assurance. The moral and ideological factors (destructive changes in the medical profession, the divergence of moral and professional principles, a dominance of the economic aspects of rela-tions, reduced social activity and responsibility) are important. In addition, managers of medical institutions are the following problems of theoretical and methodological nature: the need for a clear distinction between the concepts of "quality of care", "quality of medical services", "quality organization" (including accessibility, ethi-cal aspects, sanitary conditions, which significantly affect the level of subjective assessment). In the context of globalization and international cooperation, it is very important to bring domestic approaches to understanding, assessing, managing the quality of health care in the world.

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