Medical Education in the 21st Century

2011 ◽  
pp. 528-535
Author(s):  
Stefane M. Kabene ◽  
Jatinder Takhar ◽  
Raymond Leduc ◽  
Rick Burjaw

As with many disciplines, the fields of healthcare in general and medicine, in particular, have made vast strides in improving patient outcomes and healthcare delivery. But, have healthcare professionals and medical academia been able to maximize the utilization of new technologies to improve the delivery of the right knowledge, to the right people, at the right time across geographical boundaries? In order to provide the best quality of care, regardless of patient or provider location, specific issues must be addressed.

Author(s):  
Stefane M. Kaben ◽  
Jatinder Takhar ◽  
Raymond Leduc ◽  
Rick Burjaw

As with many disciplines, the fields of healthcare in general and medicine, in particular, have made vast strides in improving patient outcomes and healthcare delivery. But, have healthcare professionals and medical academia been able to maximize the utilization of new technologies to improve the delivery of the right knowledge, to the right people, at the right time across geographical boundaries? In order to provide the best quality of care, regardless of patient or provider location, specific issues must be addressed.


2011 ◽  
pp. 178-185
Author(s):  
Stefane M. Kabene

As with many disciplines, the fields of healthcare in general and medicine, in particular, have made vast strides in improving patient outcomes and healthcare delivery. But, have healthcare professionals and medical academia been able to maximize the utilization of new technologies to improve the delivery of the right knowledge, to the right people, at the right time across geographical boundaries? In order to provide the best quality of care, regardless of patient or provider location, specific issues must be addressed. Healthcare consumers and providers recognize that the system is often over worked, time constrained, poorly funded and desperately in need of a means to maintain up-to-date knowledge and efficient skills in order to deliver the best quality of care (Health Canada, 1998). We also know that there is a large disparity in both the quality and types of healthcare available between developed and developing countries (Lown, Bukuchi & Xavier, 1998). Within a single country there are also differences in healthcare services based upon location (rural vs. urban areas), wealth, age, gender and a host of other factors (Health Canada, 2004). However, because Information and Communication Technologies (ICT) can be a simple and cost effective tool, it can make desperately needed medical knowledge available to developing coun tries (Pakenham-Walsh, Smith & Priestly, 1997). Furthermore, it is becoming more difficult to get physicians and extended healthcare professionals to participate in face-to-face seminars in order to learn about the progress and changes in the delivery of healthcare. Time, travel requirements and cost are the biggest barriers to overcome. For rural areas and developing countries these issues are even more evident (Ernst and Young, 1998). Today, many institutions and countries are exploring and implementing ICT solutions to help reduce these inequities. The fact remains however that in the case of developing countries, a critical shortage of healthcare professionals remains (Fraser and McGrath, 2000). Adding to the problem is the fact that the telecommunications network, the backbone of ICT, in Africa is the least developed in the world (Coeur de Roy, 1997) This article concentrates on two main aspects of ICT. First, it examines ways in which ICT can assist in information and knowledge transfer and second, it explores the challenges of ICT implementation.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fatma Al-Jabri ◽  
Tarja Kvist ◽  
Reijo Sund ◽  
Hannele Turunen

Abstract Background Oman’s healthcare system has rapidly transformed in recent years. A recent Report of Quality and Patient Safety has nevertheless highlighted decreasing levels of patient safety and quality culture among healthcare professionals. This indicates the need to assess the quality of care and patient safety from the perspectives of both patients and healthcare professionals. Objectives This study aimed to examine (1) patients’ and healthcare professionals’ perspectives on overall quality of care and patient safety standards at two tertiary hospitals in Oman and (2) which demographic characteristics are related to the overall quality of care and patient safety. Methods A cross-sectional study design was employed. Data were collected by two items: overall quality of care and patient safety, incorporated in the Revised Humane Caring Scale, and Healthcare Professional Core Competency Instrument. Questionnaires were distributed to (1) patients (n = 600) and (2) healthcare professionals (nurses and physicians) (n = 246) in three departments (medical, surgical and obstetrics and gynaecology) at two tertiary hospitals in Oman towards the end of 2018 and the beginning of 2019. Descriptive statistics and binary logistic regression were used for data analysis. Results A total of 367 patients and 140 healthcare professionals completed the questionnaires, representing response rates of 61.2% and 56.9%, respectively. Overall, quality of care and patient safety were perceived as high, with the healthcare professionals rating quality of care (M = 4.36; SD = 0.720) and patient safety (M = 4.39; SD = 0.675) slightly higher than the patients did (M = 4.23; SD = 0.706), (M = 4.22; SD = 0.709). The findings indicated an association between hospital variables and overall quality of care (OR = 0.095; 95% CI = 0.016–0.551; p = 0.009) and patient safety (OR = 0.153; 95% CI = 0.027–0.854; p = 0.032) among healthcare professionals. Additionally, an association between the admission/work area and participants’ perspectives on the quality of care (patients, OR = 0.257; 95% CI = 0.072–0.916; p = 0.036; professionals, OR = 0.093; 95% CI = 0.009–0.959; p = 0.046) was found. Conclusions The perspectives of both patients and healthcare professionals showed that they viewed both quality of care and patient safety as excellent, with slight differences, indicating a high level of patient satisfaction and competent healthcare delivery professionals. Such perspectives can provide meaningful and complementary insights on improving the overall standards of healthcare delivery systems.


2020 ◽  
pp. archdischild-2019-318677
Author(s):  
Steven Hirschfeld ◽  
Florian B Lagler ◽  
Jenny M Kindblom

Children have the right to treatment based on the same quality of information that guides treatment in adults. Without the proper evaluation of medicinal products and devices in paediatric clinical trials that are designed to meet the rigorous standards of the competent authorities, children are discriminated from advances in medicine. There are regulatory, scientific and ethical incentives to address the knowledge gap regarding efficacy and safety of medicines in the paediatric population. High-quality clinical trials involving children of all ages can generate data that will ultimately close the knowledge gaps and support decision making.For clinical trials that enrol children, the needs are specialised and often resource intensive. Prerequisites for successful paediatric clinical trials are personnel with training in both paediatrics and neonatology and expertise in clinical trials in these populations. Moreover, national and international networks for efficient collaboration, dissemination of information, and sharing of resources and expertise are also needed, together with competent, efficient and high-quality local infrastructure with effective processes. Monitoring and oversight bodies with the relevant competence, including expertise in paediatrics, is also an important prerequisite for paediatric clinical trials. Compromise in any of these components will compromise the downstream results.This paper discusses the structures and competences needed in order to perform effective, high-quality paediatric clinical trials with the ultimate goal of better medicines and treatments for children. We propose a model of examining the process as a series of components that each has to be optimised, then all the components are actively optimised to function together as an ecosystem, and the resulting ecosystem functions well with the general research system and the healthcare delivery system.


2021 ◽  
Author(s):  
Oliver T. Nguyen ◽  
Amir Alishahi Tabriz ◽  
Jinhai Huo ◽  
Karim Hanna ◽  
Christopher M. Shea ◽  
...  

BACKGROUND E-visits involve asynchronous communication between providers and patients through a secure web-based platform, such as a patient portal, to elicit symptoms and determine a diagnosis and treatment plan. E-visits are now reimbursable through Medicare due to the COVID-19 pandemic. The state of the evidence regarding e-visits, such as the impact on clinical outcomes and healthcare delivery, is unclear. OBJECTIVE To address this gap, this systematic review examines how e-visits have impacted clinical outcomes and healthcare quality, access, utilization, and costs. METHODS MEDLINE, Embase, and Web of Science were searched from January 2000 through October 2020 for peer-reviewed studies that assessed e-visits’ impact on clinical and healthcare delivery outcomes. RESULTS Out of 1,858 papers, 19 studies met the inclusion criteria. E-visit usage was associated with improved or comparable clinical outcomes, especially for chronic disease management (e.g., diabetes care, blood pressure management). The impact on quality of care varied across conditions. Quality of care was equivalent or better for chronic conditions but variable quality was observed in infection management (e.g., appropriate antibiotic prescribing). Similarly, the impact on healthcare utilization varied across conditions (e.g., lower utilization for dermatology) but mixed impact in primary care. Healthcare costs were lower for e-visits for a wide-range of conditions (e.g., dermatology and acute visits). No studies examined the impact of e-visits on healthcare access. Available studies are observational in nature and it is difficult to draw firm conclusions about effectiveness or impact on care delivery. CONCLUSIONS Overall, the evidence suggests e-visits may provide comparable clinical outcomes to in-person care and reduce healthcare costs for certain healthcare conditions. At the same time, there is mixed evidence on healthcare quality, especially regarding infection management (e.g., sinusitis, urinary tract infections, conjunctivitis). Further studies are needed to test implementation strategies that might improve delivery (e.g., clinical decision support for antibiotic prescribing) and to assess which conditions are amenable to e-visits and which conditions require in-person or face-to-face care (e.g., virtual visit). CLINICALTRIAL not applicable


2021 ◽  
Vol 2021 (6) ◽  
pp. 5435-5440
Author(s):  
VLADIMIRA SCHINDLEROVA ◽  
◽  
IVANA SAJDLEROVA ◽  

Maintenance is a complex, extensive and important issue in terms of its impact on the quality of manufactured products or services provided in all areas of industry. The importance of predictive maintenance for the industry in the 21st century is crucial. However, the right approach to maintenance management is often underestimated in many companies today, although it can have a very positive effect on the company’s efficiency. Using the example of a practical application, the paper includes a comparison of three main maintenance concepts – classical (reactive), planned, predictive through the simulation software Witness. Maintenance concepts are compared in terms of their ability to solve and eliminate failures that occur in production facilities during operation.


2020 ◽  
Vol 7 (1) ◽  
pp. 14
Author(s):  
Howard Stuart ◽  
Nilay Ozen ◽  
Vivian Petropoulos

In the fall of 2014 the Quebec Health Ministry announced plans for a broad restructuring of the entire Healthcare network, implemented shortly thereafter in 2015. The effect on institutions was dramatic and immediate. Local  management was eradicated, concentrating and centralizing control of the entire system ultimately into the office of the Minister. With the abrupt reorganization of services came relocation of large numbers of personnel. Management at a distance became the norm. In many institutions, the commonly held view among physicians with regard to relations with management can be summarized as, “Suddenly there was no one to talk to.”Confusion and tension were prevalent and palpable. In this context, in attempt to have a voice, a group of physicians at one community hospital formed an independent organization. It developed into an influential body which continues to remain active. This workshop will use the experiences and reflections of physicians from that organization as a basis to explore questions such as: -Is there a difference between Health Services and Health Care? Do we care? -Does worker engagement matter in Healthcare delivery? Or are good systems and modern equipment all we really need? -Does sense of community matter within a healthcare institution? If so why?If it matters, is it just for the benefit of those working for the organization? Or is there a benefit for the users too? -What is the basis for sense of community? Where does it come from? Can it be destroyed? Can it be developed? -Is there an importance to the quality of relationships between people working within Healthcare? Do these relationships have impact on quality of care? -Should the perspective of those working in the system be incorporated input Management decision making? If so how? -What can physicians, nurses and other allied Healthcare professionals do in order to have a voice? 


Author(s):  
Vassiliki Koufi ◽  
Flora Malamateniou ◽  
George Vassilacopoulos

Homecare is an important component of the continuum of care as it provides the potential to improve quality of life and quality of healthcare delivery while containing costs. Personal Health Record (PHR) systems are intended to reach patients outside of care settings and influence their behaviors thus allowing for more effective homecare services. To this end, these systems need to evolve well beyond providing a consolidated patient record, in ways that make it more widely applicable and valuable to health systems. The development of applications on top of PHR systems can allow them to function as a platform for both patients and healthcare professionals to exchange information and interact with the health system. This paper presents a prototype PHR-based system that aims at supporting chronic disease management at any point of care or decision making through familiar environments such as Google’s Android. In particular, it assists healthcare professionals in assessing an individual’s condition and in forming the appropriate treatment plan for him/her while it provides individuals with step-to-step guidance to their treatment plans.


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