scholarly journals The Healthcare and Technology Synergy (HATS) Model for Practice and Research

2018 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Patient Care ◽  
Patient Outcomes ◽  
Bloodstream Infections ◽  
Care Patient ◽  
The Past ◽  
Healthcare Environment ◽  
Urinary Infections ◽  
Practice Approach ◽  
Care Outcomes ◽  
Seminal Article

Background: Research models that include a focus on technologies or products are critical in today,s healthcare environment. The Healthcare and Technology Synergy (HATS) model represents a synergy between three major variables, patient, product and practice, with each one affecting and being affected by the other. These variables exist within a total healthcare environment and are applicable to research in the professions of allied health, medicine and nursing. Problem: To understand and review the use of the Healthcare and Technology Synergy (HATS) model in research and practice. Approach: Models that include products can aid in evidence-based research that is translatable to patient care, patient outcomes and cost effectiveness. Outcome: In the past 5 years, five countries (Australia, Canada, China, Ireland, United States) showed interest in the model, with 143 total views of the seminal article, and 5 research studies from medicine and nursing have used the HATS model. Conclusion: Patient, product, and practice are of paramount importance in many areas of research such as bloodstream infections, urinary infections, ventilator assisted pneumonia, safety, and patient and product outcomes. Using the HATS model can strengthen research outcomes, aid in the prioritization of research agendas, establish evidencebased practice guidelines, and help in evaluating patient care outcomes.

scholarly journals Pediatric Endocrinology in the Time of COVID-19: Considerations for the Rapid Implementation of Telemedicine and Management of Pediatric Endocrine Conditions

2020 ◽  
Vol 93 (6) ◽  
pp. 343-350
Author(s):  
Molly O. Regelmann ◽  
Rushika Conroy ◽  
Evgenia Gourgari ◽  
Anshu Gupta ◽  
Ines Guttmann-Bauman ◽  
...  
Keyword(s):  
Patient Care ◽  
Care Patient ◽  
The Novel ◽  
Patient Privacy ◽  
Pediatric Endocrinology ◽  
Quality Of Patient Care ◽  
Care Outcomes ◽  
Novel Coronavirus ◽  
The Impact

<b><i>Background:</i></b> Pediatric endocrine practices had to rapidly transition to telemedicine care at the onset of the novel coronavirus disease 2019 (COVID-19) pandemic. For many, it was an abrupt introduction to providing virtual healthcare, with concerns related to quality of patient care, patient privacy, productivity, and compensation, as workflows had to change. <b><i>Summary:</i></b> The review summarizes the common adaptations for telemedicine during the pandemic with respect to the practice of pediatric endocrinology and discusses the benefits and potential barriers to telemedicine. <b><i>Key Messages:</i></b> With adjustments to practice, telemedicine has allowed providers to deliver care to their patients during the COVID-19 pandemic. The broader implementation of telemedicine in pediatric endocrinology practice has the potential for expanding patient access. Research assessing the impact of telemedicine on patient care outcomes in those with pediatric endocrinology conditions will be necessary to justify its continued use beyond the COVID-19 pandemic.

Conceptualizing Narrative Health and Medicine to Develop Cultural Competence to Improve Communication During the COVID-19 Pandemic

2021 ◽  
Vol 8 (1) ◽  
pp. 32-36
Author(s):  
Kent Willis ◽  
Colleen Marzilli
Keyword(s):  
Healthcare Professional ◽  
Cultural Competence ◽  
Severe Acute Respiratory Syndrome ◽  
Patient Care ◽  
Patient Outcomes ◽  
Healthcare Professionals ◽  
Important Concept ◽  
Healthcare Environment ◽  
Health Narrative ◽  
Improve Patient

Narrative health is a technique that healthcare professionals can use to connect with patients. The events of 2020, including the global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have identified that patient care is largely dependent upon relationships within the healthcare environment. Relationships in the healthcare environment are established through a trusting exchange between the patient and provider, and one technique to develop this relationship and trust is through narrative health. Narrative health provides the exchange of information between patient and provider in a discussion-like manner, or narrative health. This strategy promotes cultural competence amongst the healthcare professional team and improves communication between the patient and provider. Narrative health is an important concept for healthcare professionals to understand, and narrative health should be a part of any healthcare professional’s toolbox, especially in vulnerable times like the COVID pandemic. The inclusion of narrative health in practice has the potential to improve patient outcomes and empower healthcare professionals and patients.

Current Healthcare Climate: What Does it Mean for SLPs Managing Patients With Dysphagia?

2015 ◽  
Vol 24 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Nancy Swigert
Keyword(s):  
Patient Care ◽  
Patient Outcomes ◽  
Swallowing Disorders ◽  
Direct Patient Care ◽  
Healthcare Team ◽  
Speech Language Pathologists ◽  
Improve Efficiency ◽  
Healthcare Environment ◽  
Important Member ◽  
Implementing Strategies

In every setting, as a result of the changes in reimbursement, speech-language pathologists (SLPs) need to re-think how services are provided to patients with dysphagia and feeding/swallowing disorders. In addition to implementing strategies to increase efficiency (and thus productivity), SLPs must understand the changes in the healthcare environment. It is advisable that they explore ways to make their services valuable to their facility in addition to direct patient care. It is also recommended that SLPs familiarize themselves with the challenges the facility faces and consider ways they can help the facility meet those challenges. They should seek to continually improve efficiency while keeping an eye on achieving patient outcomes and providing value. In this way, the SLP can remain an important member of the healthcare team.

Impact of Transitioning from In-Person to Virtual Heart Transplantation Selection Committee Meetings: An Observational Study (Preprint)

2021 ◽  
Author(s):  
Rongzi Shan ◽  
Neha V. Chandra ◽  
Jeffrey J. Hsu ◽  
Stephanie Fraschilla ◽  
Melissa Moore ◽  
...  
Keyword(s):  
Patient Care ◽  
Patient Outcomes ◽  
Patient Selection ◽  
Heart Transplant ◽  
Medical Records ◽  
Transition Period ◽  
Care Patient ◽  
Selection Committee ◽  
Perceived Impact ◽  
Impact Patient Care

BACKGROUND Heart transplant selection committee meetings have transitioned from in-person to remote video meetings during the COVID-19 pandemic, but how this impacts committee members and patient outcomes is unknown. OBJECTIVE To determine perceived impact of remote video transplant selection meetings on usability and patient care and to measure patient selection outcomes during the transition period from in-person to virtual meetings. METHODS A 35-item anonymous survey was developed and distributed electronically to the heart transplant selection committee. We reviewed medical records to compare outcomes of patients presented at in-person meetings (January-March 2020) to those presented at video meetings (March-June 2020). RESULTS Among 83 committee members queried, 50 were regular attendees (48% physicians, 52% non-physicians), and 46 responses were received (50% physicians, 50% non-physicians) and included in the analysis. Overall, respondents were satisfied with the video conference format, felt that video meetings did not impact patient care and were an acceptable alternative to in-person meetings. However, 54% preferred in-person meetings, with 71% of non-physicians preferring in-person meetings compared to only 35% of physicians (P=.02). Of the 46 new patient evaluations presented, there was a statistically nonsignificant trend towards fewer patients initially declined at video meetings compared with in-person meetings (25% vs. 45%, P=.32). CONCLUSIONS The transition from in-person to video heart transplant selection committee meetings was well-received and did not appear to affect committee members’ perceived ability to deliver patient care. Patient selection outcomes were similar between meeting modalities.

scholarly journals Paramedic interactions with the packaging of medications and medical supplies: Poor package design has the potential to impact patient outcomes

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255099
Author(s):  
Jiyon Lee ◽  
Rebecca E. Cash ◽  
Remle P. Crowe ◽  
Hyokyoung G. Hong ◽  
Ashish R. Panchal ◽  
...  
Keyword(s):  
Patient Care ◽  
Coping Strategies ◽  
Patient Outcomes ◽  
National Registry ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Package Design ◽  
The Past ◽  
Medical Supplies ◽  
Emergency Medical

Background Settings where Emergency Medical Services (EMS) are provided to stabilize patients and transport them to locations better equipped to provide comprehensive care, “prehospital settings,” are not frequently considered when designing packaged products. Packaging design is an understudied area, potentially impacting both healthcare provider behavior and patient outcomes. Our objectives were to: 1) describe difficulties associated with packaging in prehospital settings 2) investigate the coping strategies used by paramedics when difficulties occurred, and 3) assess the potential impacts these difficulties had on patient care. Methods An online, cross-sectional survey was distributed via email using the National EMS Certification database maintained by the National Registry of Emergency Medical Technicians (NREMT) to a random sample of nationally-certified paramedics. Eligible respondents were aged 18 and older, employed as paramedics and had administered care in a prehospital setting within the previous 12 months. Survey items explored difficulties experienced and coping strategies used when difficulty was encountered identifying or opening medications and/or medical supplies. Descriptive statistics and logistic regression were calculated to analyse responses for trends. Results Of the 12,000 emails sent, 1,912 participants responded (response rate = 16%). After removing respondents who had not administered care within the past 12 months and partial surveys, data from 1,702 respondents were analysed. Nearly 20% of all respondents reported that they had experienced difficulties identifying (21.1%) or opening (20.5%) medications and identifying (17.0%) or opening (23.4%) medical supplies within the past year. Between 1.2% (identifying a medication) and 3.0% (opening supplies) of those included in the analysis indicated that reported difficulties had negatively impacted patient care. Common coping strategies reported to deal with difficulty opening included partner assistance, tool use (scissors, pens, and knives), and the use of teeth, all potential pathways for the transmission of microbes, conceivably further impacting outcomes. Conclusion More thoughtfully designed packaging for prehospital settings has the potential to benefit both EMS providers and the patients that they care for.

Laryngeal Manifestations of Autoimmune Diseases

2020 ◽  
Vol 5 (2) ◽  
pp. 439-456
Author(s):  
Jenny L. Pierce
Keyword(s):  
Autoimmune Disease ◽  
Autoimmune Diseases ◽  
Patient Outcomes ◽  
Correct Diagnosis ◽  
Upper Airway ◽  
Clinical Implications ◽  
Laryngeal Function ◽  
The Past ◽  
Referral Practices ◽  
Timely Referral

Purpose This review article provides an overview of autoimmune diseases and their effects on voice and laryngeal function. Method A literature review was conducted in PubMed. Combinations of the following keywords were used: “autoimmune disease and upper airway,” “larynx,” “cough,” “voice,” “dysphonia,” and “dyspnea.” Precedence was given to articles published in the past 10 years due to recent advances in this area and to review articles. Ultimately, 115 articles were included for review. Results Approximately 81 autoimmune diseases exist, with 18 of those highlighted in the literature as having laryngeal involvement. The general and laryngeal manifestations of these 18 are discussed in detail, in addition to the clinical implications for a laryngeal expert. Conclusions Voice, breathing, and cough symptoms may be an indication of underlying autoimmune disease. However, these symptoms are often similar to those in the general population. Appropriate differential diagnosis and timely referral practices maximize patient outcomes. Guidelines are provided to facilitate correct diagnosis when an autoimmune disease is suspected.

Context in Action and How to Study It

2019 ◽  
Keyword(s):  
Social Science Research ◽  
Science Research ◽  
Research Process ◽  
Care Patient ◽  
Organizational Life ◽  
Integration Of Care ◽  
Research Experiences ◽  
Organization And Management ◽  
Care Outcomes ◽  
Definition Of

The concept of context is a cornerstone of a large part of social science research, particularly in organization and management studies, yet it has received little theoretical and methodological attention in lieu of its relevance. This book offers a definition of context as a theoretical construct, a discussion of the methodological implications of this, and a framework for how to reflect upon and operationalize the role of context in the different stages of a research process, from formulating research questions to analyzing and writing about results. The chapters presented here integrate lessons derived from various research experiences across the complex and dynamic field of health care. Contributors share their experiences with theorizing about and empirically studying significant organizational phenomena such as implementation of policy, organizational change, integration of care, patient involvement, human-technology interactions in practice, and the interplay between work environment and care outcomes in eldercare. These contributions exemplify how a nuanced approach to context might unfold in different fields, through different designs, methods, and analytical lenses. Relevant to researchers and practitioners, within both healthcare, organization and management studies, and the social sciences more broadly, this book leaves the reader with a practical framework from which to carry out contextual research and analysis and a gain deeper understanding of the significance of context in organizational life.

Occupational Exposures in the Homecare Environment: Piloting an Observation Tool

2021 ◽  
pp. 108482232098691
Author(s):  
Elizabeth Bien ◽  
Kermit Davis ◽  
Susan Reutman ◽  
Gordon Gillespie
Keyword(s):  
Home Care ◽  
Patient Care ◽  
Occupational Safety ◽  
Occupational Exposures ◽  
Care Patient ◽  
Home Healthcare ◽  
Occupational Hazards ◽  
Cross Sectional ◽  
Direct Observations ◽  
Occupational Setting

The population of home healthcare workers (HHCWs) is rapidly expanding. Worker tasks and the unique home care environments place the worker at increased risks of occupational exposures, injury, and illness. Previous studies focusing on occupational exposures of HHCWs are limited to self-reports and would benefit from direct observations. The purpose of this study is to describe the occupational hazards observed in the unique work environment of home healthcare. HHCWs and home care patient participants were recruited from one home care agency in the Midwest to be observed during a routine home visit. This cross-sectional study used a trained occupational health nurse for direct observation of the occupational setting. Standardized observations and data collection were completed using the Home Healthcare Worker Observation Tool. The observer followed a registered nurse and occupational therapist into 9 patient homes observing visits ranging from 22 to 58 minutes. Hazards observed outside of and within the home include uneven pavements (n = 6, 67%), stairs without railings (n = 2, 22%), throw rugs (n = 7, 78%), unrestrained animals (n = 2, 22%), dust (n = 5, 56%), and mold (n = 2, 22%). Hand hygiene was observed prior to patient care 2 times (22%) and after patient care during 5 visits (56%). Observations have identified hazards that have the potential to impact workers’ and patients’ health. The direct observations of HHCWs provided opportunities for occupational safety professionals to understand the occupational exposures and challenges HHCWs encounter in the home care environment and begin to identify ways to mitigate occupational hazards.

scholarly journals Temporal Changes in Central-Line–Associated Bloodstream Infection Time Between Events, 2017–2018 Versus 2015–2016

2020 ◽  
Vol 41 (S1) ◽  
pp. s403-s404
Author(s):  
Jonathan Edwards ◽  
Katherine Allen-Bridson ◽  
Daniel Pollock
Keyword(s):  
Length Of Stay ◽  
Patient Care ◽  
Average Length ◽  
Bloodstream Infections ◽  
Central Line ◽  
Significant Shift ◽  
Care Hospital ◽  
Average Length Of Stay ◽  
Period 2 ◽  
Hospital Bed

Background: The CDC NHSN surveillance coverage includes central-line–associated bloodstream infections (CLABSIs) in acute-care hospital intensive care units (ICUs) and select patient-care wards across all 50 states. This surveillance enables the use of CLABSI data to measure time between events (TBE) as a potential metric to complement traditional incidence measures such as the standardized infection ratio and prevention progress. Methods: The TBEs were calculated using 37,705 CLABSI events reported to the NHSN during 2015–2018 from medical, medical-surgical, and surgical ICUs as well as patient-care wards. The CLABSI TBE data were combined into 2 separate pairs of consecutive years of data for comparison, namely, 2015–2016 (period 1) and 2017–2018 (period 2). To reduce the length bias, CLABSI TBEs were truncated for period 2 at the maximum for period 1; thereby, 1,292 CLABSI events were excluded. The medians of the CLABSI TBE distributions were compared over the 2 periods for each patient care location. Quantile regression models stratified by location were used to account for factors independently associated with CLABSI TBE, such as hospital bed size and average length of stay, and were used to measure the adjusted shift in median CLABSI TBE. Results: The unadjusted median CLABSI TBE shifted significantly from period 1 to period 2 for the patient care locations studied. The shift ranged from 20 to 75.5 days, all with 95% CIs ranging from 10.2 to 32.8, respectively, and P < .0001 (Fig. 1). Accounting for independent associations of CLABSI TBE with hospital bed size and average length of stay, the adjusted shift in median CLABSI TBE remained significant for each patient care location that was reduced by ∼15% (Table 1). Conclusions: Differences in the unadjusted median CLABSI TBE between period 1 and period 2 for all patient care locations demonstrate the feasibility of using TBE for setting benchmarks and tracking prevention progress. Furthermore, after adjusting for hospital bed size and average length of stay, a significant shift in the median CLABSI TBE persisted among all patient care locations, indicating that differences in patient populations alone likely do not account for differences in TBE. These findings regarding CLABSI TBEs warrant further exploration of potential shifts at additional quantiles, which would provide additional evidence that TBE is a metric that can be used for setting benchmarks and can serve as a signal of CLABSI prevention progress.Funding: NoneDisclosures: None

It’s Time to Talk to Prehospital Providers: Feedback Disparities among Ground-Based Emergency Medical Services Providers and its Impact on Job Satisfaction

2021 ◽  
pp. 1-9
Author(s):  
Sarayna S. McGuire ◽  
Anuradha Luke ◽  
Aaron B. Klassen ◽  
Lucas A. Myers ◽  
Aidan F. Mullan ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Patient Care ◽  
Emergency Medical Services ◽  
Performance Feedback ◽  
Life Support ◽  
Clinical Care ◽  
Medical Services ◽  
The Past ◽  
Emergency Medical ◽  
Overall Job Satisfaction

Abstract Objective: Performance feedback on clinical care and patient outcomes is a cornerstone of medical education, yet it remains lacking in the prehospital environment. Research seeking to establish the quantity of feedback provided to Emergency Medical Services (EMS) has been limited and studies focused on complimentary feedback or how feedback relates to EMS job satisfaction are lacking. The objectives of this study were to measure the frequency and nature of feedback received by EMS agencies and to identify the importance of receiving feedback as it relates to EMS job satisfaction. Methods: This was an anonymous, survey-based study of twenty-nine Basic Life Support (BLS) and fifteen Advanced Life Support (ALS) agencies located in Southeastern Minnesota (USA). Descriptive statistics and Fisher exact tests were used. The study was deemed exempt by the Mayo Clinic Institutional Review Board. Results: Ninety-four responses were included from nineteen different EMS agencies, including sixty-one (64.9%) paramedics and thirty-three (35.1%) emergency medical technicians (EMTs). One-half of all respondents reported that they had not received any type of feedback in the past 30 days, while another 43.6% of respondents indicated that they had only received feedback one to three times in the same time period. Twenty (60.6%) EMTs reported receiving no feedback in the past 30 days, compared with twenty-seven (44.3%) paramedics (P = .123). Of respondents receiving feedback, 65.9% reported never or rarely receiving positive reinforcing feedback and 60.6% reported never or rarely receiving constructive criticism or feedback regarding something that did not go well with patient care or transport. The majority of respondents were dissatisfied with the quantity (86.1%) and quality (73.4%) of feedback received. An overwhelming majority (93.6%) indicated that feedback on patient care or outcomes was important in influencing their overall job satisfaction. This high importance was maintained across all demographic groups. Conclusion: Within the cohort of survey respondents, a paucity of feedback received by EMS personnel is a source of dissatisfaction for EMS providers. Feedback on patient care strongly relates to overall job satisfaction. These findings suggest system-wide opportunities for structured feedback processes, focusing upon both quality and quantity of delivered feedback, to improve both patient care and staff satisfaction.

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