scholarly journals As Normas de Orientação Clínica em Portugal e os Valores dos Doentes

2015 ◽  
Vol 28 (6) ◽  
pp. 754 ◽  
Author(s):  
Paulo Santos ◽  
Isabel Nazaré ◽  
Carlos Martins ◽  
Luísa Sá ◽  
Luciana Couto ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Clinical Guidelines ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Value Systems ◽  
Patient Centered ◽  
Centered Care ◽  
The Individual ◽  
Satisfaction Rates

<strong>Introduction:</strong> Clinical guidelines are support tools, aiming to improve quality of the clinical practice. Patient centered care allows best satisfaction rates, with greater health self-management, and potential gains in quality with fewer costs.<br /><strong>Objective:</strong> To evaluate the integration of patients’ values in Portuguese guidelines.<br /><strong>Material and Methods:</strong> We reviewed the 18 guidelines about cardiovascular diseases published in Portugal from 2011 to 2013, searching for the integration of patients’ ideas, fears, expectations and preferences.<br /><strong>Results:</strong> Eight guidelines were related to diagnosis approach and 10 with treatment. We found references to patients’ values in 5 (28%) guidelines, all about treatment aspects. The incorporation of patients’ expectations was the most present feature. Reference to financial costs was present in 78% of the guidelines.<br /><strong>Discussion:</strong> Clinical guidelines are health technology instruments available to practitioners in order to improve the quality of care provided to patients, who are the real users of these tools. As in other countries, there is a tendency to disregard the users’ value systems in the conception of the guidelines, giving the privilege to a population logic, not always applicable to the individual, and to financial arithmetic with low support in cost-effectiveness assessments. In the Portuguese case, the way guidelines were proposed conditioned also some suspicion both in the professionals and in the users.<br /><strong>Conclusion: </strong>Portuguese guidelines have low incorporation of references to patients’ values. This is more evident when questions about diagnosis are addressed, placing patients in a secondary role in the clinical decision-making process with potential losses in quality of care and eventual increase in costs.

scholarly journals Ready for prime time: role for geriatric assessment to improve quality of care in hematology practice

Hematology ◽  
2019 ◽  
Vol 2019 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Heidi D. Klepin
Keyword(s):  
Older Adults ◽  
Quality Of Care ◽  
Geriatric Assessment ◽  
Hematologic Malignancies ◽  
Patient Centered ◽  
Functional Reserve ◽  
Centered Care ◽  
Assessment Measures

Abstract Older adults represent the growing majority of patients diagnosed with hematologic disorders, yet they remain underrepresented on clinical trials. Older patients of the same chronologic age differ from one another with varying comorbidity and functional reserve. The concepts of frailty and resilience are important to patient-centered care and are patient and setting specific. The use of geriatric assessment to inform tailored decision making and management can personalize care for older adults with hematologic malignancies. This article will highlight available evidence to support the role of geriatric assessment measures to enhance quality of care for older adults diagnosed with hematologic malignancies.

The Business Values of Patient Knowledge Management (PKM) in the Healthcare Industry

2013 ◽  
Vol 8 (2) ◽  
pp. 70-79 ◽  
Author(s):  
Mohammad Soltani Delgosha ◽  
Ali Amoei Ojaki ◽  
Hamidreza Farhadi
Keyword(s):  
Decision Making ◽  
Knowledge Management ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Specific Information ◽  
Patient Knowledge ◽  
Patient Centered ◽  
Patient Decision Making ◽  
Business Values ◽  
Centered Care

Today, healthcare has become a progressive industry with novel techniques, approaches and findings in this field quickly being evaluated and improved. One of these approaches is patient-centered care (PCC), which is defined essentially as an approach that respects and responds to individual patient’s preferences, needs and values. As such, PCC concept focuses not only on the disease, but also on leveraging specific information of a patient. PCC approach is therefore going to enlarge the role of patients and families in the process of clinical decision making. Still, the authors are observing the lack of innovation in this particular domain. In this paper, the authors develop the concept of patient knowledge management (PKM) based on customer knowledge management and PCC approaches. PKM creates many values such as decreasing opportunity costs and treatment costs, aiding patient decision making to be efficient and effective, as well as creating new knowledge and developing new treatment methods.

Clinical Decision-Making for a Person Centered Medicine: the necessity of casuistic reasoning

2014 ◽  
Vol 2 (1) ◽  
pp. 71
Author(s):  
Mark Tonelli
Keyword(s):  
Decision Making ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Patient Choice ◽  
Clinical Expertise ◽  
Patient Centered ◽  
Patient Centered Medicine ◽  
The Individual ◽  
Based Medicine

In their call to develop a consistent, coherent and comprehensive notion of person-centered medicine, Miles and Mezzich have elucidated several specific challenges that need to be urgently addressed. One of these foundational tasks is the development of a more complete understanding of person-centered clinical decision-making. Miles and Mezzich note that while the emphasis on clinical research in evidence-based medicine has served to de-emphasize the importance of the individual patient, the alternative of patient-centered medicine has the potential to de-emphasize the judgment of the clinician by making unfettered patient choice paramount. A practice of medicine that reduces professional healers to an informational role only, one where they lay out potential interventions devoid of context and allow patients to choose from amongst them, undervalues clinical expertise and will clearly not lead to better outcomes. Person-centered medicine (PCM), then, must be able to develop and defend a model of clinical judgment and practice that strikes the correct balance between the science of medicine and the personal experience of the individual in search of care.

scholarly journals Management of Cancer-Associated Thrombosis: An Evolving Area

Cancers ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2999
Author(s):  
Corinne Frere ◽  
Jean M. Connors ◽  
Dominique Farge
Keyword(s):  
Cancer Patient ◽  
Clinical Decision Making ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Clinical Decision ◽  
Patient Centered ◽  
Patient Values ◽  
The Individual ◽  
The Right ◽  
Cancer Associated Thrombosis

The management of cancer-associated thrombosis (CAT) is an evolving area. With the use of direct oral anticoagulants as a new option in the management of CAT, clinicians now face several choices for the individual cancer patient with venous thromboembolism. A personalized approach, matching the right drug to the right patient, based on drug properties, efficacy and safety, side effect profile of each drug, and patient values and preference, will probably supplant the one size fits all approach of use of only low-molecular-weight heparin in the near future. We herein present eight translational, clinical research, and review articles on recent advances in the management of CAT published in the Special Issue “Treatment for Cancer-Associated Thrombosis” of Cancers. For now, a multidisciplinary patient-centered approach involving a close cooperation between oncologists and other specialists is warranted to guide clinical decision making and optimize the treatment of VTE in cancer patient.

Effect of Patient-Centered Care on Patient Satisfaction and Quality of Care

2008 ◽  
Vol 23 (4) ◽  
pp. 316-321 ◽  
Author(s):  
Debra M. Wolf ◽  
Lisa Lehman ◽  
Robert Quinlin ◽  
Thomas Zullo ◽  
Leslie Hoffman
Keyword(s):  
Patient Satisfaction ◽  
Quality Of Care ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Centered Care

scholarly journals Patient-Centered Outcomes Research and Patient-Centered Care for Older Adults

2017 ◽  
Vol 3 ◽  
pp. 233372141770075 ◽  
Author(s):  
Ravishankar Jayadevappa
Keyword(s):  
Older Adults ◽  
Outcomes Research ◽  
Well Being ◽  
Clinical Decision ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Health Decision ◽  
Centered Care ◽  
Value Based Care

Patient-centered care that reflects consumer-driven health care decision of an individual as opposed to collective or social choice–based health decision has many implications for clinical decision and resource allocation. With possession of required information and faced with appropriate assessment of preferences, older adults make better choices for their own health. However, one must acknowledge that patient-centered approach for older adults should effectively integrate tenets of value-based care to improve overall quality of care and societal well-being. In this perspective, I present the importance and challenges of patient-centered care and patient-centered outcomes research among older adults.

scholarly journals The Influence of Personalised Sarcoma Care (PERSARC) Prediction Modelling on Clinical Decision Making in a Multidisciplinary Setting

Sarcoma ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
H. S. Femke Hagenmaier ◽  
Annelies G. K. van Beeck ◽  
Rick L. Haas ◽  
Veroniek M. van Praag ◽  
Leti van Bodegom-Vos ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Treatment Decision ◽  
Clinical Decision ◽  
Patient Centered ◽  
Treatment Protocols ◽  
Treatment Decision Making ◽  
Heterogenous Group ◽  
Centered Care ◽  
Made In

Background. With soft-tissue sarcoma of the extremity (ESTS) representing a heterogenous group of tumors, management decisions are often made in multidisciplinary team (MDT) meetings. To optimize outcome, nomograms are more commonly used to guide individualized treatment decision making. Purpose. To evaluate the influence of Personalised Sarcoma Care (PERSARC) on treatment decisions for patients with high-grade ESTS and the ability of the MDT to accurately predict overall survival (OS) and local recurrence (LR) rates. Methods. Two consecutive meetings were organised. During the first meeting, 36 cases were presented to the MDT. OS and LR rates without the use of PERSARC were estimated by consensus and preferred treatment was recorded for each case. During the second meeting, OS/LR rates calculated with PERSARC were presented to the MDT. Differences between estimated OS/LR rates and PERSARC OS/LR rates were calculated. Variations in preferred treatment protocols were noted. Results. The MDT underestimated OS when compared to PERSARC in 48.4% of cases. LR rates were overestimated in 41.9% of cases. With the use of PERSARC, the proposed treatment changed for 24 cases. Conclusion. PERSARC aids the MDT to optimize individualized predicted OS and LR rates, hereby guiding patient-centered care and shared decision making.

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