scholarly journals Defining and Achieving Health Equity in Genomic Medicine

2019 ◽  
Vol 29 (Suppl 1) ◽  
pp. 173-178 ◽  
Author(s):  
Sonya Jooma ◽  
Michael J. Hahn ◽  
Lucia A. Hindorff ◽  
Vence L. Bonham
Keyword(s):  
Health Care ◽  
Health Equity ◽  
Health Care Providers ◽  
Genomic Medicine ◽  
Genomic Research ◽  
Infrastructure Development ◽  
Care Providers ◽  
Health Care Settings ◽  
Traditional Research ◽  
Improve Health

The potential of genomics to improve health comes with the peril that the benefits will not be equitably available to all populations. Existing health disparities can be exacer­bated if the implementation of genomic medicine does not intentionally focus on health equity. Defining what health equity means in the context of genomics and outlining how it can be achieved is impor­tant for the future of the field. Strategies to improve health equity include addressing underrepresentation of diverse popula­tions in genomic research, investigating how genomic services can be deployed in diverse health care settings and underserved communities, increasing workforce diversity, supporting infrastructure development out­side traditional research centers, and engag­ing communities and health care providers. By employing these strategies, the genomic research community can advance health equity in genomic medicine. Ethn Dis. 2019;29(Suppl 1):173-178; doi:10.18865/ed.29.S1.173.

scholarly journals Defining and Achieving Health Equity in Genomic Medicine

2019 ◽  
Vol 29 (Suppl 1) ◽  
pp. 173-178
Author(s):  
Sonya Jooma ◽  
Michael J. Hahn ◽  
Lucia A. Hindorff ◽  
Vence L. Bonham
Keyword(s):  
Health Care ◽  
Health Equity ◽  
Health Care Providers ◽  
Genomic Medicine ◽  
Genomic Research ◽  
Infrastructure Development ◽  
Care Providers ◽  
Health Care Settings ◽  
Traditional Research ◽  
Improve Health

The potential of genomics to improve health comes with the peril that the benefits will not be equitably available to all populations. Existing health disparities can be exacer­bated if the implementation of genomic medicine does not intentionally focus on health equity. Defining what health equity means in the context of genomics and outlining how it can be achieved is impor­tant for the future of the field. Strategies to improve health equity include addressing underrepresentation of diverse popula­tions in genomic research, investigating how genomic services can be deployed in diverse health care settings and underserved communities, increasing workforce diversity, supporting infrastructure development out­side traditional research centers, and engag­ing communities and health care providers. By employing these strategies, the genomic research community can advance health equity in genomic medicine. Ethn Dis. 2019;29(Suppl 1):173-178; doi:10.18865/ ed.29.S1.173.

scholarly journals The role of country-level structural stigma on sexual orientation disclosure and discrimination in health care settings among lesbian, gay, and bisexuals across Europe

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Bränström ◽  
J E Pachankis
Keyword(s):  
Health Care ◽  
Sexual Orientation ◽  
Health Care Providers ◽  
Sexual Minority ◽  
Sexual Minorities ◽  
Care Providers ◽  
Health Care Settings ◽  
Country Level ◽  
Disclosure Of Sexual Orientation ◽  
Sexual Orientation Disclosure

Abstract Background The national climate surrounding sexual minorities (i.e., those self-identifying as lesbian, gay, or bisexual [LGB]) varies greatly worldwide. Recent Cross-European studies have shown that country-level structural stigma is a strong determinant of sexual minority individuals health risk behaviors and mental health. The consequences of the significant country-level variation in structural stigma on sexual minorities’ experiences of health care discrimination and disclosure of sexual orientation to health care providers have not been previously investigated. Methods In 2012, 86 000 sexual minority individuals (aged 18 years and older) from all 28 European Union countries responded to questions concerning discrimination in health care settings and sexual orientation disclosure to health care providers (EU LGBT survey). Structural stigma was assessed using a combination of national laws and policies affecting sexual minorities and a measure of sexual minority acceptance among citizens of each country. Results Disclosure of sexual orientation to health care providers were much more common in low stigma coutries (e.g., the Netherlands, Sweden, UK) compared to high stigma coutries (e.g., Lithuania, Latvia, Slovakia). Experiences of discrimination in health care settings were more common among LGB indiviudals who were open about their sexual orientaiton and increased by degree of country-level structural stigma. Conclusions Disclosure of sexual orientation and experiences of discrimination in health care settings varies greatly among LGB individuals in Europe largely due to structural stigma surrounding sexual minorities. Main messages These findings highlight the importance of eliminating legislation, policies, and national attitudes that promote the unequal treatment of sexual minorities in currently unsupportive European countries.

scholarly journals INTRAVENOUS MEDICATION ADMINISTRATION ERRORS AND THIS CAN ENDANGER THE LIVES OF PATIENTS

2020 ◽  
pp. 171-175
Author(s):  
OMAR ABDULWAHID SALIH AL-ANI
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Human Error ◽  
Medication Administration ◽  
Care Providers ◽  
Medication Administration Errors ◽  
Health Quality ◽  
Standard Classification ◽  
Intravenous Medication ◽  
Improve Health

Objective: Intravenous errors are one of the most frequent and common medical errors, but no direct causes found. The theory of human error is the most common expression of errors in hospitals, and this can endanger the lives of patients. This research study aims to identify the errors in the vein and try to find solutions to avoid those errors where the study conducted on a sample of hospitals in Baghdad. Methods: The study conducted to improve health quality in some hospitals. During the study period, a group of severe cases was detected, which based on intravenous infusions. Patients’ data and information were collected through five sources, examined and documented venous errors found and placed in a standard classification according to an incorrect dose and incorrect medication. The incorrect dose includes the following: Overdose, extra dose, underdose, wrong strength, and wrong form. Results: During the period of study, a total of 99 cases, among these cases, 52 incorrect medications include (drug-drug interaction, drug-disease interaction, and not indicated medication) the incorrect dose 42 and route of administration and incorrect rate also take place in mistakes. Conclusion: Intravenous errors can cause significant harm to patients and health-care providers, so proper attention paid to them. Several reasons may cause medication errors such as lack of experience and knowledge of health-care providers, inaccurate communications that do not explain the drug, and the exact dose. The prescribing errors in the medication or dosage were collected, discussed, and clarified so that the risks arising from them observed so that health-care providers and hospital specialists would be alerted and the study would serve as an alarm for health organizations.

Genomics and Precision Medicine: Implications for Critical Care

2018 ◽  
Vol 29 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Christine Kessler
Keyword(s):  
Health Care ◽  
Precision Medicine ◽  
Health Care Providers ◽  
Care Delivery ◽  
Genomic Medicine ◽  
Hospital Setting ◽  
Disease Diagnosis ◽  
Care Providers ◽  
New Paradigm ◽  
Current State

A new paradigm for disease diagnosis and treatment is emerging that will bring about changes in health care delivery in and out of the hospital setting. Over the past several decades, genomic medicine has been one of the fastest growing fields in acute and chronic health care. This quick growth has created a lag in genomics knowledge and preparation among nurses and health care providers. Genomic medicine may lead to more precise evaluation, diagnosis, and management of selected acute care conditions. This article reviews the current state of genetic and genomics science and looks at the expanding field of genomic medicine’s integration into precision medicine. The aim of this article is to raise awareness and spark further inquiry to the remarkable field of genomics and precision medicine.

scholarly journals MEETING SOCIAL NEEDS TO IMPROVE HEALTH OUTCOMES: PARTNERSHIPS BETWEEN COMMUNITY-BASED ORGS AND HEALTH CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S499-S500
Author(s):  
Traci L Wilson ◽  
Suzanne R Kunkel ◽  
Jane Straker ◽  
Marisa Scala-Foley ◽  
Elizabeth Blair
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Social Services ◽  
Health Care Providers ◽  
Health Care Use ◽  
Social Needs ◽  
Care Providers ◽  
Community Based ◽  
Cross Sectional ◽  
Improve Health

Abstract Unmet social needs negatively affect individual and population health, and better integration of community-based supports and health systems is a promising approach to improve health outcomes and avoid unnecessary health care use. Community-based organizations (CBOs) such as Area Agencies on Aging (AAAs) and Centers for Independent Living (CILs), as providers and coordinators of social services, are well-positioned within their communities to coordinate care and provide for unmet social needs. Partnerships between CBOs and health care entities have clear potential to improve health care outcomes while also reducing expenditures. This paper will present a cross-sectional analysis of a national survey of AAAs, CILS, and other CBOs at two time points (2017: n=593; 2018: n=763) to understand the extent, type, and evolution of CBO engagement with health care providers. In addition, longitudinal analysis (n=374) shows movement at the organization level: 33% of organizations who did not have a contract at T1 but were pursuing one had achieved a contract by T2. This presentation will: describe details of the services delivered, contracting arrangements, and populations served under CBO/health care contracts, as well as challenges experienced by CBOs; examine differences by state and organizational structure; and discuss the implications of state policy on integrated care and contracting.

scholarly journals Improving Care for Elders Who Prefer Informal Spaces to Age-Separated Institutions and Health Care Settings

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Stacy Torres ◽  
Xuemei Cao
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Providers ◽  
Public Transportation ◽  
Urban Areas ◽  
Health Care Services ◽  
Well Being ◽  
Care Providers ◽  
Third Places ◽  
Health Care Settings

Abstract Background and Objectives Despite advantages of urban areas (such as walkability, public transportation, nearby shopping, and health care services), challenges remain for elders aging in place to access care. The changing demographics of older adults, with higher rates of divorce, singlehood, and childlessness, often living alone and far from family, necessitate new strategies to support health and well-being. Research Design and Methods Drawing on 5 years of ethnographic fieldwork and 25 interviews with elders in New York City, this study presents empirical insights into older adults’ use of “third places” close to home, in conjunction with more formal settings. Results This article identifies external and internalized ageism and complicated age-based identity as important reasons why older adults preferred “third places” to age-separated spaces such as senior centers and formal settings such as health care settings. We find that neighborhood “third places” offer important physical venues for older adults to process negative or hurried interactions in other formal and age-separated places. Discussion and Implications This article makes policy suggestions for increasing access and usage of essential services, including developing attractive and appealing intergenerational spaces in which older community members can obtain services and dispatching caseworkers to public spaces where elders congregate. Furthermore, this article recommends improving exchanges between health care providers and older adults so that they feel recognized, respected, and cared for, which can improve health care outcomes.

Legal and Ethical Imperatives for Using Certified Sign Language Interpreters in Health Care Settings: How to “Do No Harm” When “It’s (All) Greek” (Sign Language) to You

2016 ◽  
Vol 17 (3) ◽  
pp. 114-128 ◽  
Author(s):  
Angela M. Nonaka
Keyword(s):  
Health Care ◽  
Sign Language ◽  
Health Care Providers ◽  
Limited English Proficiency ◽  
Ethical Issues ◽  
The United States ◽  
Care Providers ◽  
Sign Language Interpreters ◽  
Health Care Settings ◽  
Sign Language Interpreting

Communication obstacles in health care settings adversely impact patient–practitioner interactions by impeding service efficiency, reducing mutual trust and satisfaction, or even endangering health outcomes. When interlocutors are separated by language, interpreters are required. The efficacy of interpreting, however, is constrained not just by interpreters’ competence but also by health care providers’ facility working with interpreters. Deaf individuals whose preferred form of communication is a signed language often encounter communicative barriers in health care settings. In those environments, signing Deaf people are entitled to equal communicative access via sign language interpreting services according to the Americans with Disabilities Act and Executive Order 13166, the Limited English Proficiency Initiative. Yet, litigation in states across the United States suggests that individual and institutional providers remain uncertain about their legal obligations to provide equal communicative access. This article discusses the legal and ethical imperatives for using professionally certified (vs. ad hoc) sign language interpreters in health care settings. First outlining the legal terrain governing provision of sign language interpreting services, the article then describes different types of “sign language” (e.g., American Sign Language vs. manually coded English) and different forms of “sign language interpreting” (e.g., interpretation vs. transliteration vs. translation; simultaneous vs. consecutive interpreting; individual vs. team interpreting). This is followed by reviews of the formal credentialing process and of specialized forms of sign language interpreting—that is, certified deaf interpreting, trilingual interpreting, and court interpreting. After discussing practical steps for contracting professional sign language interpreters and addressing ethical issues of confidentiality, this article concludes by offering suggestions for working more effectively with Deaf clients via professional sign language interpreters.

Incident Reporting by Health-Care Workers in Noninstitutional Care Settings

2016 ◽  
Vol 18 (4) ◽  
pp. 445-456 ◽  
Author(s):  
Colleen L. Campbell
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Workers ◽  
Public Affairs ◽  
Incident Reporting ◽  
Care Providers ◽  
Comprehensive Review ◽  
Health Care Settings ◽  
Patient Violence ◽  
Care Workers

Patient-perpetrated violence and aggression toward health-care workers, specifically in noninstitutional health-care settings, cause concerns for both health-care providers and the clients whom they serve. Consequentially, this presents a public affairs problem for the entire health-care system, which the current research has failed to adequately address. While the literature overwhelmingly supports the assertion that accurate incident reporting is critical to fully understanding patient violence and aggression toward health-care providers, there is limited research examining provider decision making related to reporting incidents of patient violence and aggression targeted toward the provider. There is an even greater paucity of research specifically examining this issue in noninstitutional health-care settings. It is therefore the objective of this review to examine this phenomenon across disciplines and service settings in order to offer a comprehensive review of incident reporting and to examine rationales for providers reporting or failing to report instances of patient violence and aggression toward health-care providers.

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