scholarly journals Establishing Practice Risk Management and Outcomes Claims for Medical Marijuana Dispensaries: Questions Legislators Should Ask

2019 ◽  
Vol 10 (1) ◽  
pp. 1
Author(s):  
Paul Langley
Keyword(s):  
Risk Management ◽  
Medical Marijuana ◽  
Evidence Base ◽  
Level Of Care ◽  
Duty Of Care ◽  
For Profit ◽  
Not For Profit ◽  
Article Type ◽  
Scant Attention ◽  
Medical Marijuana Dispensaries

In a previous commentary in INNOVATIONS in Pharmacy, the case was made that a major oversight in approving the establishment of medical marijuana programs through commercially and not-for-profit operated dispensaries is the failure to put in place standards for the monitoring and reporting of outcomes. It was pointed out that the evidence base is limited for the range of dosing options, administrative routes and conditions treated. The concern is that the ease that patients have in obtaining medical marijuana certification in many states means that a medical marijuana program is, in effect, little different from a recreational program. Dispensaries understandably focus on sales and returns to investors with scant attention given to tracking and reporting outcomes across the range of conditions and symptoms presented.  While this no doubt appeals to investors in reducing administration costs, it makes it virtually impossible to deliver the appropriate and coordinated level of care that patients should expect if a medical marijuana dispensary is to meet it responsibilities in its duty of care. This places dispensaries at malpractice risk. Given this, this commentary focuses on the questions that legislators should ask in licensing medical marijuana dispensaries to ensure they meet a defensible duty of care to their patients.   Article Type: Commentary

scholarly journals Tracking and Reporting Outcomes in Medical Marijuana: Establishing Condition Specific State Level Registries

2019 ◽  
Vol 10 (2) ◽  
pp. 4
Author(s):  
Paul C Langley
Keyword(s):  
Low Cost ◽  
Medical Marijuana ◽  
State Level ◽  
Research Quality ◽  
Duty Of Care ◽  
Article Type ◽  
On Line ◽  
Quality Framework ◽  
Medical Marijuana Dispensaries ◽  
Rule Making

In a previous commentary in INNOVATIONS in pharmacy, the question was raised as to the questions legislators should ask for the licensing of medical marijuana dispensaries. The case was made that if dispensaries accept they have a duty of care then they should be required to monitor patients over the course of their treatment with botanical cannabis, including hemp based product, to evaluate the response of patients to therapy. One option would be for individual dispensaries (or owners of multiple licenses and dispensary locations) to adopt a registry format and implement an on-line reporting system by registry staff and patients for the conditions being treated. Unfortunately, under present legislative rules for dispensaries there is no incentive for dispensaries to make the necessary investment. It is also unlikely that legislators would be prepared to mandate a registry requirement. The purpose of this commentary is to offer an alternative solution. Rather than dispensary specific registries, a state-wide low cost registry is proposed where dispensaries are required to log in and track patients with specific conditions. In the case of severe pain, a dispensary would log in patients presenting with this condition and the patient tracked over their course of treatment. A further advantage with a statewide registry is that if a patient visits a different dispensary they can still be tracked as they would be identified by their marijuana card number. The ability to track patients by condition, while still resident in a state, would not only minimize the issue of incomplete records, but would provide a comprehensive, research quality framework for evaluating claims for botanical cannabis. This could then provide feedback to legislators and establish a robust basis for rule making.   Article Type: Commentary

10. Designing an online curriculum supporting risk management and patient safety

2007 ◽  
Vol 30 (4) ◽  
pp. 33
Author(s):  
T. Gondocz ◽  
G. Wallace
Keyword(s):  
Risk Management ◽  
Medical Education ◽  
Patient Safety ◽  
Online Learning ◽  
Online Courses ◽  
Learning System ◽  
Online Curriculum ◽  
For Profit ◽  
Not For Profit ◽  
Managing Risk

The Canadian Medical Protective Association (CMPA) is a not for profit mutual defence organization with a mandate to provide medico-legal assistance to physician members and to educate health professionals on managing risk and enhancing patient safety. To expand the outreach to its 72,000 member physicians, the CMPA built an online learning curriculum of risk management and patient safety materials in 2006. These activities are mapped to the real needs of members ensuring the activities are relevant. Eight major categories were developed containing both online courses and articles. Each course and article is mapped to the RCPSC's CanMEDS roles and the CFPC's Four Principles. This poster shares the CMPA’s experience in designing an online patient safety curriculum within the context of medico-legal risk management and provides an inventory of materials linked to the CanMEDS roles. Our formula for creation of an online curriculum included basing the educational content on real needs of member physicians; using case studies to teach concepts; and, monitoring and evaluating process and outcomes. The objectives are to explain the benefits of curricular approach for course planning across the continuum in medical education; outline the utility of the CanMEDS roles in organizing the risk management and patient safety medical education curriculum; describe the progress of CMPA's online learning system; and, outline the potential for moving the curriculum of online learning materials and resources into medical schools.

Expanding Support Services for Adults Born With Cleft Lip and/or Palate in the United Kingdom: An Exploratory Evaluation of the Cleft Lip and Palate Association Adult Services Programme

2021 ◽  
pp. 105566562110254
Author(s):  
Kenny Ardouin ◽  
Nicky Davis ◽  
Nicola Marie Stock
Keyword(s):  
Health Professionals ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Evidence Base ◽  
Psychosocial Needs ◽  
For Profit ◽  
Adult Services ◽  
The United Kingdom ◽  
Not For Profit ◽  
Valuable Adjunct

Background: The largest group of people living with repaired cleft lip and/or palate (CL/P) are adults. Previous research has identified unmet treatment and psychosocial needs, yet few interventions exist. This article outlines 3 interventions developed by the Cleft Lip and Palate Association as part of its 3-year community-based Adult Services Programme; an Adults Conference, a series of panel discussions (“Cleft Talk”) streamed in podcast/video format, and a Leaver’s Pack of resources for adults wishing to return to cleft care. Methods: Feedback from attendees of the Adults Conferences (2018-2019) was collected using specifically developed evaluation forms. Streaming metrics and social media interactions were extracted for Cleft Talk panel discussions (2019-2020). The Leaver’s Pack was piloted in 2020, using an online evaluation form. Specialist health professionals were invited to provide feedback or participate in a one-to-one interview regarding their perceived impact of the program. Results: All 3 interventions across the different modalities received support from participating adults, demonstrating potential to meet adults’ needs across the life span. Health professionals also offered support for the program, viewing the interventions as a valuable adjunct to formal medical CL/P services. Conclusions: This exploratory evaluation indicates that peer- and community-led interventions, in combination with ongoing access to specialist medical care, can have a range of positive impacts for adults with CL/P. There is scope for similar initiatives to be developed internationally and for individuals with other craniofacial conditions. Not-for-profit organizations are encouraged to routinely evaluate their interventions to create a stronger evidence base for their valuable work.

scholarly journals Outcomes, Registries and Medical Marijuana: Towards Establishing Dispensary Monitoring and Reporting Standards

2018 ◽  
Vol 9 (4) ◽  
pp. 7
Author(s):  
Paul Langley
Keyword(s):  
Medical Marijuana ◽  
Evidence Base ◽  
Response To Therapy ◽  
State Governments ◽  
Patient Response ◽  
Pain Location ◽  
Article Type ◽  
Health Agencies ◽  
Clinical Benefits ◽  
Patient Groups

The acceptance by a large number of state governments of medical marijuana dispensaries and the regulatory framework to support their licensing has put to one side the issue of monitoring and reporting outcomes. This is a major oversight. It is an untenable situation given the limited evidence base for the clinical benefits and risks associated with dispensed botanical marijuana. The purpose of this commentary is to propose that, as a condition of licensing, marijuana dispensaries should be required to establish a registry to support ongoing monitoring of patient response associated with botanical cannabis formulations. Patients should be monitored over the course of their treatment to assess, in the case of severe non-cancer pain as an example, pain intensity and functional status by pain location. The dispensary, in meeting required audit standards, should be in a position to report on patient response over baseline to the provider who has recommended botanical cannabis. As well, registries should be in a position to report to state licensing agencies response to therapy by target patient groups. Establishing site-specific registries should go some way to meeting the present evidence deficit for botanical marijuana, reducing barriers to its acceptance by providers, patients and health agencies.   Article Type: Commentary

scholarly journals Establishing Credibility for Medical Marijuana: The Proposed Prometheus Dispensary Registry for Botanical Cannabis

2019 ◽  
Vol 10 (1) ◽  
pp. 2
Author(s):  
Paul Langley
Keyword(s):  
Randomized Clinical Trials ◽  
Medical Marijuana ◽  
Good Clinical Practice ◽  
The United States ◽  
Evidence Base ◽  
Severe Nausea ◽  
Dosing Regimens ◽  
Medical Marijuana Dispensaries ◽  
Delivery Options ◽  
Robust Evidence

A previous commentary in INNOVATIONS in Pharmacy argued that, given the lack of evidence for outcomes in medical marijuana, outside of a handful of randomized clinical trials and even fewer observational studies, good clinical practice points to the need for monitoring patients who received cannabis through certified medical marijuana dispensaries. The commentary noted the lack of standards for monitoring cannabis patients and the lack of feedback from the dispensary to providers. Botanical cannabis administration was occurring in, effectively, an evidence vacuum. More to the point, dispensary owners and investors seem uninterested in establishing a robust evidence base for cannabis outcomes.  Given the range of conditions and symptoms presented by patients, to include the prevalence of multiple symptoms together with the range of potential cannabis formulations, dosing regimens and delivery options, a failure to monitor patients over the course of their exposure to cannabis in not acceptable. The purpose of this commentary is to report on a proposed on-line registry structure proposed by Prometheus Research for medical marijuana dispensaries in the US. The registry tracks and reports on patients over the course of treatment with botanical cannabis with the focus on severe or chronic non-cancer pain, severe nausea, persistent muscle spasms and seizures, together with prevalent comorbidities – fatigue, anxiety, depression and sleep. This is the first time a registry has been developed for dispensaries in the United States as a model for a robust evidence base to support botanical cannabis as a therapy option.   Article Type: Commentary

scholarly journals Enhancing Intervention for Residual Rhotic Errors Via App-Delivered Biofeedback: A Case Study

2017 ◽  
Vol 60 (6S) ◽  
pp. 1810-1817 ◽  
Author(s):  
Tara McAllister Byun ◽  
Heather Campbell ◽  
Helen Carey ◽  
Wendy Liang ◽  
Tae Hong Park ◽  
...  
Keyword(s):  
Effective Treatment ◽  
Evidence Base ◽  
Proof Of Concept ◽  
Research Partnerships ◽  
Treatment Progress ◽  
Acoustic Measures ◽  
For Profit ◽  
Not For Profit ◽  
Biofeedback Treatment

Purpose Recent research suggests that visual-acoustic biofeedback can be an effective treatment for residual speech errors, but adoption remains limited due to barriers including high cost and lack of familiarity with the technology. This case study reports results from the first participant to complete a course of visual-acoustic biofeedback using a not-for-profit iOS app, Speech Therapist's App for /r/ Treatment. Method App-based biofeedback treatment for rhotic misarticulation was provided in weekly 30-min sessions for 20 weeks. Within-treatment progress was documented using clinician perceptual ratings and acoustic measures. Generalization gains were assessed using acoustic measures of word probes elicited during baseline, treatment, and maintenance sessions. Results Both clinician ratings and acoustic measures indicated that the participant significantly improved her rhotic production accuracy in trials elicited during treatment sessions. However, these gains did not transfer to generalization probes. Conclusions This study provides a proof-of-concept demonstration that app-based biofeedback is a viable alternative to costlier dedicated systems. Generalization of gains to contexts without biofeedback remains a challenge that requires further study. App-delivered biofeedback could enable clinician–research partnerships that would strengthen the evidence base while providing enhanced treatment for children with residual rhotic errors. Supplemental Material https://doi.org/10.23641/asha.5116318

scholarly journals Supported accommodation for people with severe mental illness: an update

2012 ◽  
Vol 18 (5) ◽  
pp. 381-391 ◽  
Author(s):  
Rob Macpherson ◽  
Geoff Shepherd ◽  
Praveen Thyarappa
Keyword(s):  
Mental Health Problems ◽  
Evidence Base ◽  
Essential Elements ◽  
Policy And Practice ◽  
For Profit ◽  
Supported Accommodation ◽  
Recovery Movement ◽  
Not For Profit ◽  
Recent Trends

SummaryAppropriate housing and support are essential elements in the care of many people with mental health problems, and housing has a major impact on the quality of their lives. In the post-deinstitutionalised services of most high-income countries, a complex range of supported accommodation is available, mostly in the private (for-profit and not-for-profit) sector. We describe the different forms of accommodation and consider recent trends in policy and practice and the evidence base in this area. We also discuss quality issues and the potential impact of the recovery movement.

scholarly journals The effect of fraud on risk management in not-for-profit organizations

2014 ◽  
Vol 12 (1) ◽  
pp. 641-655 ◽  
Author(s):  
Tyge-F. Kummer ◽  
Kishore Singh ◽  
Peter Best
Keyword(s):  
Risk Management ◽  
New Zealand ◽  
Learning Process ◽  
Internal Controls ◽  
Organizational Characteristics ◽  
Prevention Measures ◽  
Prevention Strategies ◽  
Fraud Prevention ◽  
For Profit ◽  
Not For Profit

Not-for-Profit (NFP) organizations have specific organizational characteristics as their objectives are ethically motivated and trust is indispensable. Additionally, NFP organizations are often small sized and do not have the expertise to prevent fraud. As a result, an effective risk management is of substantial importance. We use survey data from NFP organizations in Australia and New Zealand (N = 652) to identify factors that influence fraud prevention strategies. Our findings indicate that organizations that have not experienced fraud rely partially on ineffective prevention measures. The occurrence of fraud seems to trigger a learning process that leads to a more sophisticated understanding of internal controls and a more suitable risk management. Our results are applicable to support fraud prevention strategies and are highly relevant for practitioners

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