scholarly journals Evaluation of an Educational Strategy to Improve Medication Reconciliation in Ambulatory Care

2021 ◽  
Author(s):  
Laney K Jones ◽  
Vanessa Duboski ◽  
Katrina M. Romagnoli ◽  
Alison Flango ◽  
Jami Marks ◽  
...  
Keyword(s):  
Ambulatory Care ◽  
Educational Program ◽  
Medication Reconciliation ◽  
Adherence Rate ◽  
Structured Interviews ◽  
Evidence Based Practices ◽  
Direct Observations ◽  
Implementation Outcomes ◽  
Baseline Characteristics ◽  
Survey Interviews

Abstract Introduction. Improper medication reconciliation can result in inaccurate medication lists which can lead to adverse events including hospitalizations. Interventions targeting medication reconciliation have had varying levels of success. To improve medication reconciliation practices in our ambulatory care clinics, we developed an educational program for clinic personnel. The objective of this study is to describe the educational program, its implementation in a healthcare system, pharmacist and clinic personnel perception of the program, and its impact on clinic personnel knowledge and practice. Methods. Guided by the Conceptual Model of Implementation Research, we conducted an evaluation of a pharmacist-led educational program on evidence-based practices for medication reconciliation by examining implementation outcomes. The implementation outcomes measured include penetration, fidelity, acceptability, appropriateness, feasibility, and adoption. Data was collected through direct observations, administrative data, pre- and post-surveys, and semi-structured interviews. Results. A total of 37/46 (80%) primary care sites implemented the pharmacist delivered medication reconciliation education from April to June 2021 with representation from each of Geisinger’s regions. Ten (27%) clinic sites completed the medication reconciliation educational program as originally designed, with the remainder adapting the program. A total of 296 clinic personnel completed the pre-survey, while 178 completed the post-survey. There were no statistically significant differences in baseline characteristics between clinic personnel who completed the pre- vs. post-survey. Interviews were completed with 11 clinic personnel who attended the educational program and 4 pharmacists who delivered the educational program. All clinic personnel interviewed felt satisfied with the educational program and felt it was appropriate since it directly impacted their job. While clinic personnel felt the educational program was acceptable and appropriate, two major concerns were discussed: lack of patient knowledge about their medications and lack of time to complete the medication reconciliation. We found the adherence rate to the elements of the medication reconciliation which were covered in the education program ranged from 0% to 95% in the 55 observations conducted.Conclusion. An educational program for medication reconciliation was found to be acceptable and appropriate but was often adapted to fit site specific needs. Additional barriers affected adoption of best practices and should be addressed in future studies. Trial registration. N/A

Financial Management of Tires Retail and Restaurant Business in Greater Jakarta

2019 ◽  
Vol 2 (4) ◽  
pp. 267-275
Author(s):  
Sung Suk Kim ◽  
Jacob Donald Tan ◽  
Rita Juliana ◽  
John Tampil Purba
Keyword(s):  
Financial Management ◽  
Management Practices ◽  
Working Capital ◽  
Structured Interviews ◽  
Short Term ◽  
Direct Observations ◽  
Medium Enterprises ◽  
Cash Reserves ◽  
Retained Earnings ◽  
Computerized System

This study aims to explore the financial management practices ofsmall-and-medium-enterprises (SMEs) in the Greater Jakarta (Jabodetabek). We investigate into 3 SME cases by conducting the semi-structured interviews with the owner-managers and using direct observations to know the practices of financial management of SMEs. Through the research, we have found six propositions related to the practice of short-term financial management. They apply bootstraps to ensure availability of working capital. They set aside cash reserves from retained earnings and minimize loans from financial institutions. They have the computerized system to track receivables facilitating working capital needs. They keep theirinventory control efficient to manage working capital. They screen customers using transactional records and reputations to minimize the risk of bad debts.

scholarly journals Increasing Facemask Compliance among Healthcare Personnel during the COVID-19 Pandemic

2021 ◽  
pp. 1-22
Author(s):  
Rupak Datta ◽  
Keith Glenn ◽  
Anthony Pellegrino ◽  
Jessica Tuan ◽  
Brian Linde ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Baseline Period ◽  
Healthcare Personnel ◽  
Structured Interviews ◽  
Time Series Regression ◽  
Multimodal Intervention ◽  
Direct Observations ◽  
Chi Squared ◽  
Ancillary Staff

Abstract Objective: Prior studies of universal masking have not measured facemask compliance. We performed a quality improvement study to monitor and improve facemask compliance among healthcare personnel (HCP) during the coronavirus disease 2019 (COVID-19) pandemic. Design: Mixed-methods study Setting: Tertiary care center in West Haven, Connecticut Patients: HCP including physicians, nurses, and ancillary staff Methods: Facemask compliance was measured through direct observations during a 4-week baseline period after universal masking was mandated. Frontline and management HCP completed semi-structured interviews from which a multimodal intervention was developed. Direct observations were repeated during a 14-week period following implementation of the multimodal intervention. Differences between units were evaluated with chi-squared testing using the Bonferroni correction. Facemask compliance between baseline and intervention periods was compared using time series regression. Results: Among 1,561 observations during the baseline period, median weekly facemask compliance was 82.2% (range, 80.8%-84.4%). Semi-structured interviews were performed with 16 HCP. Qualitative analysis informed the development of a multimodal intervention consisting of audit and passive feedback, active discussion, and increased communication from leadership. Among 2,651 observations during the intervention period, median weekly facemask compliance was 92.6% (range, 84.6%-97.9%). There was no difference in weekly facemask compliance between COVID-19 and non-COVID-19 units. The multimodal intervention was associated with an increase in facemask compliance (β=0.023, p=0.002) Conclusions: Facemask compliance remained suboptimal among HCP despite a facility-wide mandate for universal masking. A multimodal intervention consisting of audit and passive feedback, active discussion, and increased communication from leadership was effective in increasing facemask compliance among HCP.

scholarly journals Team functioning and implementation of innovations in healthcare and human service settings: a systematic review protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Elizabeth A. McGuier ◽  
David J. Kolko ◽  
Mary Lou Klem ◽  
Jamie Feldman ◽  
Grace Kinkler ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mixed Methods ◽  
Human Service ◽  
Meta Analysis ◽  
Bibliographic Databases ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Implementation Outcomes ◽  
Services Implementation ◽  
Team Functioning

Abstract Background Healthcare and human services increasingly rely on teams of individuals to deliver services. Implementation of evidence-based practices and other innovations in these settings requires teams to work together to change processes and behaviors. Accordingly, team functioning may be a key determinant of implementation outcomes. This systematic review will identify and summarize empirical research examining associations between team functioning and implementation outcomes in healthcare and human service settings. Methods We will conduct a comprehensive search of bibliographic databases (e.g., MEDLINE, PsycINFO, CINAHL, ERIC) for articles published from January 2000 or later. We will include peer-reviewed empirical articles and conference abstracts using quantitative, qualitative, or mixed methods. We will include experimental or observational studies that report on the implementation of an innovation in a healthcare or human service setting and examine associations between team functioning and implementation outcomes. Implementation outcomes of interest are acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability. Two reviewers will independently screen all titles/abstracts, review full-text articles, and extract data from included articles. We will use the Mixed Methods Appraisal Tool to assess methodological quality/bias and conduct a narrative synthesis without meta-analysis. Discussion Understanding how team functioning influences implementation outcomes will contribute to our understanding of team-level barriers and facilitators of change. The results of this systematic review will inform efforts to implement evidence-based practices in team-based service settings. Systematic review registration PROSPERO CRD42020220168

Medication reconciliation in ambulatory care: A work in progress

2016 ◽  
Vol 73 (22) ◽  
pp. 1813-1814 ◽  
Author(s):  
Jeffrey L. Schnipper ◽  
Stephanie Labonville
Keyword(s):  
Ambulatory Care ◽  
Medication Reconciliation ◽  
Work In Progress

Patient and Clinician Perspectives of New and Return Ambulatory Teleneurology Visits

2021 ◽  
pp. 10.1212/CPJ.0000000000001065
Author(s):  
Samantha M.R. Kling ◽  
Jessica J. Falco-Walter ◽  
Erika A. Saliba-Gustafsson ◽  
Donn W. Garvert ◽  
Cati G. Brown-Johnson ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Ambulatory Care ◽  
Physical Exam ◽  
Structured Interviews ◽  
Perceived Utility ◽  
Perceived Quality Of Care ◽  
Neurology Clinic ◽  
Clinician Perspectives ◽  
Level Scheduling

ObjectiveTo evaluate the adoption and perceived utility of video visits for new and return patient encounters in ambulatory neurology subspecialties.MethodsVideo visits were launched in an academic, multi-subspecialty, ambulatory neurology clinic in March 2020. Adoption of video visits for new and return patient visits was assessed using clinician-level scheduling data from March 22 to May 16, 2020. Perceived utility of video visits was explored via a clinician survey and semi-structured interviews with clinicians and patients/caregivers. Findings were compared across 5 subspecialties and 2 visit types (new vs return).ResultsVideo visits were adopted rapidly; all clinicians (n = 65) integrated video visits into their workflow within the first 6 weeks and 92% of visits were conducted via video although this varied by subspeciality. Utility of video visits was higher for return than new patient visits, as indicated by surveyed (n = 48) and interviewed clinicians (n = 30), aligning with adoption patterns. Compared to in-person visits, clinicians believed it was easier to achieve a similar physical exam, patient-clinician rapport, and perceived quality of care over video for return rather than new patient visits. Of the 25 patients/caregivers interviewed, most were satisfied with the care provided via video, regardless of visit type, with the main limitation being the physical exam.ConclusionsTeleneurology was robustly adopted for both new and return ambulatory neurology patients during the COVID-19 pandemic. Return patient visits were preferred over new patient visits, but both were feasible. These results provide a foundation for developing targeted guidelines for sustaining teleneurology in ambulatory care.

scholarly journals Knowledge gain and usage of knowledge learned during internet-based CBT treatment for adolescent depression - a qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Matilda Berg ◽  
Anna Malmquist ◽  
Alexander Rozental ◽  
Naira Topooco ◽  
Gerhard Andersson
Keyword(s):  
Adolescent Depression ◽  
Controlled Trial ◽  
Treatment Strategies ◽  
Adherence Rate ◽  
Knowledge Gain ◽  
Structured Interviews ◽  
Behavioural Treatment ◽  
Cognitive Behavioural ◽  
Present Life

Abstract Background The role of explicit learning of treatment content in internet-based cognitive-behavioural treatment (ICBT) is an emerging field of research. The objective of this study was to explore clients experiences of their ICBT treatment for depression with a focus on knowledge gain and usage of knowledge learned during treatment. Methods A strategic sample of ten adolescents, aged between 15 and 19 years, who had received ICBT for major depression within a clinical controlled trial were recruited for the study. Semi-structured interviews were conducted 6 months following trial completion. Data were transcribed and analysed using thematic analysis. The participants had a general adherence rate of 6–8 opened modules out of 8 possible. Results Two main themes were identified; “Active agents of CBT” and “Passive agents of CBT”, with each theme consisting of three and two sub-themes. Active agents of CBT reflect a tendency to specifically remember and actively apply specific CBT principles in present life situations. Passive agents of CBT reflect a tendency to remember CBT treatment principles vaguely and express a passive or reactive usage of learned therapy content. Conclusion The findings suggest that young clients can remember and apply CBT principles 6 months after their treatment. However, while experiencing benefits of treatment, clients recall and application of treatment strategies vary. The study emphasizes the importance of exploring client recall of CBT components and how valuable it is to explicitly remember contents of a treatment in order to improve and maintain improvement. Further studies on the role of knowledge and memory of ICBT for adolescent populations are warranted.

scholarly journals Parents and Teachers’ Involvement in Designing Educational Programmes within the Albanian Curricula of Pre-university Education: Their Perceptions in this Context

2020 ◽  
Vol 4 (1) ◽  
pp. 115-134
Author(s):  
Manjola Lumani Zaçellari ◽  
◽  
Heliona Miço ◽  
Keyword(s):  
Education System ◽  
Primary Schools ◽  
Educational Program ◽  
Educational Institution ◽  
University Education ◽  
Structured Interviews ◽  
School Life ◽  
Parents And Children ◽  
Children’S Wellbeing ◽  
The Law

The purpose of this study is to analyse the legislative measures and their implementation regarding the participation of children, parents and teachers in creating an educational program in pre-university education system, as a need for better involvement in school of all the actors, as well as the need for the children’s wellbeing. In addition, the study aims to bring parents’ and teachers’ views on the obstacles they face when they try to collaborate and participate in school life and in designing an educational program. Qualitative methods are used to achieve the aim of this study. The data were collected through document analysis (legislation, strategies, and regulations) for analysing how the law addresses participation of children, parents and teachers’ in school and through semi-structured interviews with parents and teachers from two primary schools so that they can state their perceptions on participation in school life. Each of them was posed 12 different interview questions. After evaluating the responses, some important issues were identified. The participation of children, parents and teachers in Albanian education system has changed in recent years, even promoted as a key that leads to success. However, because of the monist system, where such participation was neither legally recognised nor culturally accepted, this trinomial collaboration has not been easily introduced and integrated in the Albanian educational system. However, parents do not feel very involved in school life, or appreciated when they try to get involved, even though it is legally admitted the need for the collaboration between family and school. They neither take part in the approval of the curricula of the educational institution, nor in the selection of school textbooks as provided by the law. Research has shown that schools as bureaucratic and conservative institutions need to have clear written policies to encourage the participation of the parents and children when drafting an education program. However, when teachers were asked about parents’ participation in school, they said that in many cases parents neglect the collaboration with the school and appear usually when there are problems or troubles, while the participation of children in creating an educational program is still lagging behind.

scholarly journals An Empirical Investigation of Supervisory Management Styles and Associated Factors for Postgraduate Level Research Supervision

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Tooba Saleem ◽  
Rizwan Akram Rana
Keyword(s):  
Mixed Methods Research ◽  
Management Style ◽  
Research Approach ◽  
Second Phase ◽  
Management Styles ◽  
Structured Interviews ◽  
Chi Square ◽  
Research Supervision ◽  
Postgraduate Level ◽  
Baseline Characteristics

Based on the dynamic model of supervisory management styles this research focused on the empirical verification of the preferred supervisory management styles and their associated baseline characteristics of supervisors and supervisees. The study used a mixed-methods research approach and conducted in two phases. In the first phase, semi-structured interviews were conducted from 30 supervisors from different disciplines to get an overview of the context specific supervision problems faced by supervisors and their approaches to solve them during the different research stages. These interviews helped to develop items of supervisory management styles questionnaire (SMSQ). This questionnaire was based on 12 different situations. In the second phase, supervisors and supervisees from the 13 different universities of Punjab were selected purposively to respond the supervisory management styles questionnaire. The chi-square tests were performed to analyze the preferred supervisory management styles and their association with personal, academic and institutional characteristics of supervisors and supervisees. The results showed significant influence of the supervisees’ background profile characteristics and supervisors’ administrative position on the adoption of a particular supervisory management style at postgraduate level. The study identified the baseline characteristics associated with different supervision styles that may help to resolve possible supervisory alignment conflicts

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