scholarly journals Mass Disasters and Burnout in Nephrology Personnel

2021 ◽  
pp. CJN.08400520
Author(s):  
Mehmet Sukru Sever ◽  
Alberto Ortiz ◽  
Umberto Maggiore ◽  
Enrique Bac-García ◽  
Raymond Vanholder
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Ad Hoc ◽  
Care Delivery ◽  
Health Problems ◽  
Care Providers ◽  
Coping With Stress ◽  
Work Related ◽  
Health Care Infrastructure ◽  
Mass Disasters

Mass disasters result in extensive health problems and make health care delivery problematic, as has been the case during the COVID-19 pandemic. Although COVID-19 was initially considered a pulmonary problem, it soon became clear that various other organs were involved. Thus, many care providers, including kidney health personnel, were overwhelmed or developed burnout. This review aims to describe the spectrum of burnout in mass disasters and suggests solutions specifically for nephrology personnel by extending previous experience to the COVID-19 pandemic. Burnout (a psychologic response to work-related stress) is already a frequent part of routine nephrology practice and, not surprisingly, is even more common during mass disasters due to increased workload and specific conditions, in addition to individual factors. Avoiding burnout is essential to prevent psychologic and somatic health problems in personnel as well as malpractice, understaffing, and inadequate health care delivery, all of which increase the health care burden of disasters. Burnout may be prevented by predisaster organizational measures, which include developing an overarching plan and optimizing health care infrastructure, and ad hoc disaster-specific measures that encompass both organizational and individual measures. Organizational measures include increasing safety, decreasing workload and fear of malpractice, optimizing medical staffing and material supplies, motivating personnel, providing mental health support, and enabling flexibility in working circumstances. Individual measures include training on coping with stress and problematic conditions, minimizing the stigma of emotional distress, and maintaining physical health. If these measures fall short, asking for external help is mandatory to avoid an inefficient disaster health care response. Minimizing burnout by applying these measures will improve health care provision, thus saving as many lives as possible.

Nurse Practitioner Challenges to the Orthodox Structure of Health Care Delivery: Regulation and Restraints on Trade

1985 ◽  
Vol 11 (2) ◽  
pp. 195-225
Author(s):  
Karla Kelly
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Allied Health ◽  
Care Delivery ◽  
The United States ◽  
Care Providers ◽  
Allied Health Care

AbstractUntil recently, physicians have been the primary health care providers in the United States. In response to the rising health care costs and public demand of the past decade, allied health care providers have challenged this orthodox structure of health care delivery. Among these allied health care providers are nurse practitioners, who have attempted to expand traditional roles of the registered nurse.This article focuses on the legal issues raised by several major obstacles to the expansion of nurse practitioner services: licensing restrictions, third party reimbursement policies, and denial of access to medical facilities and physician back-up services. The successful judicial challenges to discriminatory practices against other allied health care providers will be explored as a solution to the nurse practitioners’ dilemma.

Challenges of Providing Health Care in Complex Emergencies: A Systematic Review

2021 ◽  
pp. 1-5
Author(s):  
Hesam Seyedin ◽  
Morteza Rostamian ◽  
Fahimeh Barghi Shirazi ◽  
Haleh Adibi Larijani
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Services ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Qualitative Content Analysis ◽  
Care Delivery ◽  
Information Access ◽  
Care Providers ◽  
Complex Emergencies

Abstract Providing health care in times of complex emergencies (CEs) is one of the most vital needs of people. CEs are situations in which a large part of the population is affected by social unrest, wars, and food shortages. This systematic review study was conducted to identify the challenges of health-care delivery in CEs. We searched terms related to health-care delivery and CEs in PubMed, Web of Sciences, Science Direct, and Google scholar databases, as well as Persian databases SID and Magiran. The searching keywords included: “Health Care, Complex Crises, War, Humanitarian, Refugees, Displaced Persons, Health Services, and Challenges.” Of 409 records, we selected 6 articles based on the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist. Studies were analyzed through qualitative content analysis. The results show that CEs affect health-care delivery in 4 primary areas: the workforce, infrastructure, information access, and organization of health services. These areas can pose potential threats for health-care providers and planners at times of emergencies. Thus, they should be informed about these challenges to strengthen the health-care system.

Modularising outpatient care delivery: A mixed methods case study at a Finnish University Hospital

2018 ◽  
Vol 31 (4) ◽  
pp. 195-204 ◽  
Author(s):  
Katariina Silander ◽  
Paulus Torkki ◽  
Antti Peltokorpi ◽  
Aino Lepäntalo ◽  
Maija Tarkkanen ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Care Delivery ◽  
Outpatient Care ◽  
Hospital Care ◽  
Care Delivery ◽  
University Hospital ◽  
Care Providers ◽  
Mixed Methods Case Study

Background Modularisation is a potential means to develop health care delivery by combining standardisation and customisation. However, little is known about the effects of modularisation on hospital care. The objective was to analyse how modularisation may change and support health care delivery in specialised hospital care. Methods A mixed methods case study methodology was applied using both qualitative and quantitative data, including interviews, field notes, documents, service usage data, bed count and personnel resource data. Data from a reference hospital’s unit were used to understand the context and development of care delivery in general. Results The following outcome themes were identified from the interviews: balance between demand and supply; support in shift from inpatient to outpatient care; shorter treatment times and improved management of service production. Modularisation supported the shift from inpatient towards outpatient care. Changes in resource efficiency measures were both positive and negative; the number of patients per personnel decreased, while the number of visits per personnel and the bed utilisation rate increased. Conclusions Modularisation may support health care providers in classifying patients and delivering services according to patients’ needs. However, as the findings are based on a single university hospital case study, more research is needed.

scholarly journals COVID-19 and the Mental Health of People From Refugee Backgrounds

2020 ◽  
Vol 50 (4) ◽  
pp. 415-417 ◽  
Author(s):  
Susan Rees ◽  
Jane Fisher
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Delivery ◽  
General Health ◽  
Mental Health Problems ◽  
Care Delivery ◽  
Health Problems ◽  
Vulnerable Population ◽  
High Income ◽  
Health Practitioners

Approximately 1 in 10 of the current 26 million people who are refugees reside in high-income countries. They have commonly experienced trauma related to violence, insecurity, persecution and shortage of food and medicine. Our research suggests that COVID-19 and its health and social sequalae may be triggering past traumatic reactions, exacerbating mental health problems and undermining functioning. The purpose of this article is to promptly communicate these anecdotal findings to general health practitioners to ensure informed and sensitive health care delivery to this vulnerable population.

Incentivising improvements in health care delivery

2015 ◽  
Vol 10 (3) ◽  
pp. 327-343 ◽  
Author(s):  
Adam Oliver
Keyword(s):  
Health Care ◽  
Health Economics ◽  
Performance Management ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Special Section ◽  
Care Providers ◽  
Improved Performance

AbstractThis Special Section of Health Economics, Policy and Law begins with an article on the different ways in which one might incentivise improved performance among health care providers. I asked five experts on performance management, Gwyn Bevan, Tim Doran, Peter Smith, Sandra Tanenbaum and Karsten Vrangbaek, to write brief reactions to the article and to the notion of performance management in health care in general. The commentators were given an open remit to be as critical as they wished to be, and their reactions can be found in the pages that follow. I would like to thank Albert Weale for reviewing all of the articles, and Katie Brennan for serving as the catalyst for this collection.

scholarly journals Digital Approaches to Remote Pediatric Health Care Delivery During the COVID-19 Pandemic: Existing Evidence and a Call for Further Research (Preprint)

2020 ◽  
Author(s):  
Sherif M Badawy ◽  
Ana Radovic
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Rapid Expansion ◽  
Care Providers ◽  
Financial Barriers ◽  
Pediatric Health ◽  
Pediatric Health Care ◽  
Research Areas

UNSTRUCTURED The global spread of the coronavirus disease (COVID-19) outbreak poses a public health threat and has affected people worldwide in various unprecedented ways, both personally and professionally. There is no question that the current global COVID-19 crisis, now more than ever, is underscoring the importance of leveraging digital approaches to optimize pediatric health care delivery in the era of this pandemic. In this perspective piece, we highlight some of the available digital approaches that have been and can continue to be used to streamline remote pediatric patient care in the era of the COVID-19 pandemic, including but not limited to telemedicine. <i>JMIR Pediatrics and Parenting</i> is currently publishing a COVID-19 special theme issue in which investigators can share their interim and final research data related to digital approaches to remote pediatric health care delivery in different settings. The COVID-19 pandemic has rapidly transformed health care systems worldwide, with significant variations and innovations in adaptation. There has been rapid expansion of the leveraging and optimization of digital approaches to health care delivery, particularly integrated telemedicine and virtual health. Digital approaches have played and will play major roles as invaluable and reliable resources to overcome restrictions and challenges imposed during the COVID-19 pandemic and to increase access to effective, accessible, and consumer-friendly care for more patients and families. However, a number of challenges remain to be addressed, and further research is needed. Optimizing digital approaches to health care delivery and integrating them into the public health response will be an ongoing process during the current COVID-19 outbreak and during other possible future pandemics. Regulatory changes are essential to support the safe and wide adoption of these approaches. Involving all relevant stakeholders in addressing current and future challenges as well as logistical, technological, and financial barriers will be key for success. Future studies should consider evaluating the following research areas related to telemedicine and other digital approaches: cost-effectiveness and return on investment; impact on quality of care; balance in use and number of visits needed for the management of both acute illness and chronic health conditions; system readiness for further adoption in other settings, such as inpatient services, subspecialist consultations, and rural areas; ongoing user-centered evaluations, with feedback from patients, families, and health care providers; strategies to optimize health equity and address disparities in access to care related to race and ethnicity, socioeconomic status, immigration status, and rural communities; privacy and security concerns for protected health information with Health Insurance Portability and Accountability Act (HIPAA)–secured programs; confidentiality issues for some specific populations, especially adolescents and those in need of mental health services; early detection of exposure to violence and child neglect; and integration of training into undergraduate and graduate medical education and subspecialty fellowships. Addressing these research areas is essential to understanding the benefits, sustainability, safety, and optimization strategies of telemedicine and other digital approaches as key parts of modern health care delivery. These efforts will inform long-term adoption of these approaches with expanded dissemination and implementation efforts.

Hearing Health Care Delivery Outside the Booth

2021 ◽  
pp. 1-14
Author(s):  
Kathy Gates ◽  
Quintin A. Hecht ◽  
Marjorie A. M. Grantham ◽  
Andrew J. Fallon ◽  
Malisha Martukovich
Keyword(s):  
Health Care ◽  
Hearing Loss ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Health Care Services ◽  
Care Delivery ◽  
Review Article ◽  
Care Providers ◽  
Technical Specifications ◽  
Hearing Health

Purpose The purpose of this review article is to discuss how boothless audiometry may help address changes in hearing health care services and provide progressive tools to expand beyond traditional audiology clinic visits. The primary drivers for these changes include the COVID-19 pandemic, our aging population, comorbid effects of unidentified hearing loss, and the critical need for effective communication between patients and providers. This review article highlights key features and technical specifications of boothless audiometry, provides an overview of Food and Drug Administration (FDA)–approved boothless audiometry products, and describes how to leverage these products to increase access to hearing health services across the continuum of health care. Method Boothless audiometry literature was reviewed using PubMed and audiometry technology websites. FDA-approved boothless audiometry products were reviewed, and audiological features were categorized. Civilian and Department of Defense subject matter experts were consulted. Conclusions Boothless audiometry technology introduces opportunities for early audiometric assessment outside of the audiology clinic, in settings where traditional testing has been less possible, or even impossible, such as military environments, clinic waiting areas, schools, and nursing homes. This technology allows health care providers to identify individuals with significant hearing loss early and seek comprehensive services to prevent and treat hearing loss. By expanding the current hearing health care delivery model via boothless audiometry technology, the following benefits may be achieved, which can result in better outcomes overall: increased access to care, early identification and treatment of hearing loss, and reduced impact from the comorbid effects of hearing impairment.

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