scholarly journals Non-Native English-Speaking Patients, Support Systems, and Patient Care Delivery: A Study of Secondary School Athletic Trainers

2021 ◽  
Author(s):  
Brea M. Stanton ◽  
Matthew J. Rivera ◽  
Zachary K. Winkelmann ◽  
Lindsey E. Eberman
Keyword(s):  
Secondary School ◽  
Support Systems ◽  
Care Delivery ◽  
Athletic Trainers ◽  
Language Barriers ◽  
The United States ◽  
Formal Training ◽  
Research Approach ◽  
Structured Interviews ◽  
Patient Centered

ABSTRACT Context: Non-native English speakers (NNES) in the United States have more than doubled since 1990, increasing the likelihood of NNESs seeking healthcare and experiencing language barriers. Language barriers in healthcare result in ineffective communication, decreased care, and reduction in overall provider satisfaction. Objective: To investigate experiences of secondary school athletic trainers (ATs) who provided care to patients that were NNES or communicated with their NNES support systems. Design: Qualitative. Setting: Semi-structured interviews. Patients or Other Participants: Fifteen secondary school ATs with experience communicating with NNES patients or their support systems. Data Collection and Analysis: Participants were interviewed and a 3-person data analysis team used the multi-phased consensual qualitative research approach to develop a consensus codebook with domains and categories identified from the transcripts. Trustworthiness was established through member checking, multiple researcher triangulation, and auditing. Results: Four domains emerged from the data: 1) communication, 2) welcoming environment, 3) cultural agility, and 4) resourcefulness. Participants enhanced communication by relying on nonverbal communication, translated resources, and interpreters. Participants discussed a difference in care delivery based on fluency. Participants explained efforts to create a welcoming environment by speaking in the NNESs native language, increasing comfort, and serving as an advocate within the healthcare system. Acknowledging customs, demonstrating respect, and understanding potential fear/shame associated with language barriers were discussed as ways to increase cultural agility. Participants identified a lack of formal training, which increased their on-the-job training and health information technology usage. Participants perceived spending increased amounts of time, initiation, effort, and adaptability while caring for and communicating with NNESs. Conclusions: Participants perceived they had little formal training, therefore, they became more resourceful and increased communication strategies to provide equitable care. Participants indicated adapting their care to meet cultural needs and creating a welcoming environment for NNESs was important when cultivating a patient-centered experience.

scholarly journals Veteran Patient Perspectives and Experiences During Implementation of a Patient-Centered Medical Home Model

2017 ◽  
Vol 5 (2) ◽  
pp. 107-113 ◽  
Author(s):  
Anaïs Tuepker ◽  
Summer Newell ◽  
Christina Nicolaidis ◽  
Marie-Elena Reyes ◽  
Maria Carolina González-Prats ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Medical Home ◽  
Care Delivery ◽  
Hybrid Approach ◽  
The United States ◽  
Patient Centered Medical Home ◽  
Veterans Health ◽  
Health Administration ◽  
Patient Centered

Background: The Veterans Health Administration (VA) has implemented the largest shift to a patient-centered medical home (PCMH) model of care in the United States to date. Objective: We interviewed veterans about their experiences of primary care to understand whether they observed changes in care during this period as well as to learn which characteristics of care mattered most to their experiences. Method: Qualitative interviews were conducted with 32 veterans receiving primary care at 1 of 8 VA clinics in the northwest United States. Interviews were analyzed using an inductive–deductive hybrid approach by an interdisciplinary team that included a veteran patient. Result: Participants noticed recent positive changes, including improved communications and shorter waits in clinic, but rarely were aware of VA’s PCMH initiative; a strong relationship with the primary care provider and feeling cared for/respected by everyone involved in care delivery were key components of quality care. The needs of the veteran community as a whole also shaped discussion of care expectations. Conclusion: The PCMH model may provide benefits even when invisible to patients. Veteran awareness of population needs suggests a promising role for veteran involvement in further PCMH transformation efforts.

scholarly journals An Examination of Policy and Procedure Practices of Secondary School Athletic Trainers

2020 ◽  
Author(s):  
Micaela Dunbar-Gaynor ◽  
Ericka Zimmerman ◽  
Victor Liberi
Keyword(s):  
Risk Management ◽  
Secondary School ◽  
Management Practices ◽  
Athletic Trainers ◽  
The United States ◽  
Current Status ◽  
Policies And Procedures ◽  
The Status ◽  
Written Form ◽  
Policy And Procedure

Purpose: The purpose of this study was to identify and describe the status of P&P practices of secondary school athletic trainers. Methods: Following an online informed consent confirmation, participants completed a Policies and Procedures Status questionnaire, including demographics. This was distributed to certified athletic trainers currently employed in the secondary school setting in the United States. The survey consisted of 49 questions about the status of P&Ps using one of the following responses: the practice is in operation and it appears in written form; the practice is in operation but does not appear in written form; the practice is not in operation but does appear in written form; and the practice is not in operation and it does not appear in written form. This study utilized descriptive statistics, consisting of means, frequencies, and percentages, to report results that described the current status of policies and procedures Results: There was a total of 232 participants. 72.6% of secondary school athletic trainers had existing P&P manuals and 37.9% reported the P&P manual existed when they acquired the position. 31.9% who did not have an existing P&P manual upon starting their position never developed a manual. 45.7% of all P&Ps were reported to exist in both written and operational form and 25.9% reported having neither written nor operational forms of P&Ps. 54.5% used the BOC Guiding Principles for AT Policy and Procedure Development and 45.2% used the BOC Facility Principles document. Conclusion: The results revealed almost half of participants reported the risk management practices in the P&P manual were in operational and written form. P&Ps that have been described in NATA Position Statements were more likely to be in both written and operational form when compared to those that were not. Secondary school athletic trainers may have limited guidance and training in risk management, with even less guidance on resources specifically for developing and reviewing P&Ps.

scholarly journals Emergency Action Planning in Secondary School Athletics: A Comprehensive Evaluation of Current Adoption of Best Practice Standards

2019 ◽  
Vol 54 (1) ◽  
pp. 99-105 ◽  
Author(s):  
Samantha E. Scarneo ◽  
Lindsay J. DiStefano ◽  
Rebecca L. Stearns ◽  
Johna K. Register-Mihalik ◽  
Craig R. Denegar ◽  
...  
Keyword(s):  
Secondary School ◽  
Action Plan ◽  
Athletic Trainers ◽  
The United States ◽  
Position Statement ◽  
Full Time ◽  
Web Based ◽  
Adoption And Implementation ◽  
Part Time ◽  
Emergency Equipment

Context Emergency action plans (EAPs) are policies that improve response times and ensure access to emergency equipment for the management of patients with acute injuries and medical conditions, yet the extent to which EAP standards are adopted and implemented is unknown. Objective To describe the extent of EAP adoption and implementation in secondary school (SS) athletics with athletic trainer (AT) services in the United States. Design Cross-sectional study. Setting Web-based questionnaire. Patients or Other Participants A national sample of ATs (n = 9642) was invited to participate in a Web-based questionnaire. Main Outcome Measure(s) Twelve components of EAP minimum best practices were derived from the “National Athletic Trainers' Association (NATA) Position Statement: Emergency Planning in Athletics.” Emergency action plan components were analyzed using descriptive statistics with 95% confidence intervals (CIs) around proportions. Contingency tables (2 × 2) were used to calculate odds ratios (with 95% CIs) to assess adoption of the components (dichotomized as yes or no), employment factors (eg, full time versus part time, employed by clinic/district), and access to emergency equipment. Results The response rate for the questionnaire was 13.2% (n = 1273). A majority of ATs (89.1%) reported having an EAP; however, only 9.9% described implementing all 12 components cited in the NATA position statement. Athletic trainers stated that they created the EAP in 62.8% (95% CI = 60.1%, 65.4%) of schools with an EAP. Athletic trainers employed full time were at greater odds of adopting 9 or more components of the EAP compared with ATs employed part time (odds ratio = 2.42 [95% CI = 1.66, 3.53]). A total of 85.7% of ATs noted access to an automated external defibrillator. Conclusions Although a majority of SSs had EAPs, the EAPs were often incomplete and lacked the necessary components for full compliance with the NATA position statement. These findings demonstrate the need for efforts to promote the adoption and implementation of comprehensive EAPs in SS athletics.

scholarly journals Hospice care providers experiences of grappling with medical assistance in dying in a hospice setting: a qualitative descriptive study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Shannon Freeman ◽  
Davina Banner ◽  
Valerie Ward
Keyword(s):  
Care Provider ◽  
Hospice Care ◽  
Care Delivery ◽  
Patient Choice ◽  
Care Providers ◽  
Medical Assistance ◽  
Structured Interviews ◽  
Patient Centered ◽  
Medical Assistance In Dying ◽  
Qualitative Descriptive

Abstract Background Rapid implementation of Medical Assistance in Dying (MAiD) across care settings has challenged providers and organizations, including hospices, to develop and implement new modes of practice. The aim of this study was to examine the effects that legalization of MAiD has had on hospice care provider roles within the non-provider context. Methods Eight in-depth semi-structured interviews were conducted and a qualitative descriptive approach used to examine hospice care providers experiences in a small western Canadian city. In the study context, patients who choose MAiD are cared for until immediately prior to the procedure when they are transferred off-site to undergo MAiD. Inductive and thematic analyses were undertaken. Results Participants experienced practical, philosophical, and professional challenges. Despite the overwhelming desire to support patient autonomy and decision-making, some interpreted patient choice for MAiD as rejection of the natural death experience at the hospice. Patient choice for MAiD initiated a new and different pathway of end-of-life care. While participants felt uncertain how best to support patients undergoing MAiD, they shared mixed optimism on how their care provider roles were evolving as their level of experience broadened. While implementation of MAiD was rapid, the introduction of practical and professional supports has remained slow to materialize, leaving many providers to navigate their own personal and professional positions and practices. Conclusion Care providers require a multi-faceted range of clinical, legal, and logistical supports at the practice, organizational, and health system levels, to facilitate care delivery to those requesting and undergoing MAiD and to promote coordinated and holistic patient-centered care. The different pathway for those who chose MAiD may lead care providers to struggle with relational challenges and interpersonal unease. Further research may address how to support those undergoing MAiD within the hospice context.

scholarly journals Alignment of Community Pharmacy Foundation Grant Funding and the Evolution of Pharmacy Practice in the United States of America

Pharmacy ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. 63 ◽  
Author(s):  
Brittany Hoffmann-Eubanks ◽  
Anne Marie Kondic ◽  
Brian J. Isetts
Keyword(s):  
United States ◽  
Community Pharmacy ◽  
United States Of America ◽  
Care Delivery ◽  
Pharmacy Practice ◽  
The United States ◽  
Grant Funding ◽  
Patient Centered ◽  
Community Pharmacy Practice

The Community Pharmacy Foundation is a non-profit organization dedicated to the advancement of community pharmacy practice and patient care delivery through grant funding and resource sharing. Since 2002, CPF has awarded 191 grants and over $9,200,000 (US dollars) in research and project grants. The purpose of this manuscript is to highlight the evolution of pharmacy practice and pharmacy education in the United States through the presentation of exemplary cases of Community Pharmacy Foundation funding that is aligned with new care delivery models and approaches to the advancement of patient-centered pharmacy care. Pharmacy began in colonial America as the United States of America was just beginning to form with apothecary shops and druggists. Over time, the pharmacy industry would be revolutionized as America became urbanized, and drug products became commercially produced. The role of the pharmacist and their education evolved as direct patient care became a clear expectation of the general public. By the 1990s, the pharmacy profession had carved out a new path that focused on pharmacist-led, patient-centered pharmaceutical care and medication therapy management services. The Community Pharmacy Foundation grant funding has aligned with this evolution since its founding in 2000, and multiple exemplary grants are presented as support. As the role of pharmacists again transitions from a fee-for-service model to a value-based model, the Community Pharmacy Foundation continues to provide grant funding for research and projects that support the advancement of community pharmacy practice, education, and expanded training of pharmacists.

scholarly journals Easier Said Than Done: Healthcare Professionals’ Barriers to the Provision of Patient-Centered Primary Care to Patients with Multimorbidity

2021 ◽  
Vol 18 (11) ◽  
pp. 6057
Author(s):  
Sanne J. Kuipers ◽  
Anna P. Nieboer ◽  
Jane M. Cramm
Keyword(s):  
Primary Care ◽  
Nurse Practitioners ◽  
Financial Incentives ◽  
Healthcare Professionals ◽  
Time Pressure ◽  
Care Delivery ◽  
Structured Interviews ◽  
Implementation Barriers ◽  
Patient Centered ◽  
Primary Care Delivery

Patient-centered care (PCC) has the potential to entail tailored primary care delivery according to the needs of patients with multimorbidity (two or more co-existing chronic conditions). To make primary care for these patients more patient centered, insight on healthcare professionals’ perceived PCC implementation barriers is needed. In this study, healthcare professionals’ perceived barriers to primary PCC delivery to patients with multimorbidity were investigated using a constructivist qualitative design based on semi-structured interviews with nine general and nurse practitioners from seven general practices in the Netherlands. Purposive sampling was used, and the interview content was analyzed to generate themes representing experienced barriers. Barriers were identified in all eight PCC dimensions (patient preferences, information and education, access to care, physical comfort, emotional support, family and friends, continuity and transition, and coordination of care). They include difficulties achieving mutual understanding between patients and healthcare professionals, professionals’ lack of training and education in new skills, data protection laws that impede adequate documentation and information sharing, time pressure, and conflicting financial incentives. These barriers pose true challenges to effective, sustainable PCC implementation at the patient, organizational, and national levels. Further improvement of primary care delivery to patients with multimorbidity is needed to overcome these barriers.

Avenues to integrate and improve care: Surgeon attitudes toward end-of-life care.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 16-16
Author(s):  
Jonathan Bergman ◽  
Karl A. Lorenz ◽  
Charles D. Scales ◽  
Gery Ryan ◽  
Christopher Saigal ◽  
...  
Keyword(s):  
End Of Life ◽  
Multidisciplinary Team ◽  
End Of Life Care ◽  
Formal Education ◽  
The United States ◽  
Life Care ◽  
Structured Interviews ◽  
Patient Centered ◽  
Urologic Oncology ◽  
Sorting Technique

16 Background: To examine urology trainees’ views about the quality and current practices of end-of-life care, and to explore strategies for improving integration and quality of care. Methods: We conducted semi-structured interviews with 20 urology trainees from four institutions in different regions of the United States. Stage of training ranged from intern to senior urologic oncology fellow; all were clinically active at busy academic institutions caring for many patients with advanced malignancies. Open-ended questions allowed participants to express themselves independently, and follow-up discussions explored their perception of current end-of-life practices, as well as avenues for future integration and improvement. We analyzed transcripts using a multi-stage, cutting-and-sorting technique in an inductive approach based on grounded theory analysis. Results: Clinicians unanimously agreed that their patients do not currently receive ideal care and were unanimously interested in joining a team geared towards improving care at the end-of-life. They expressed a preference for a multidisciplinary team, although the precise role each wanted to play within the team varied. Better identification of depression, pain, and patient-centered goals to allow value-congruent care were high in priorities for improvement. Trainees sited the lack of an educational curriculum on end-of-life care as a barrier to improving care, and expressed a desire for formal education on this topic. Conclusions: Urology trainees do not think that current care at the end-of-life is ideal for patients, and are interested in participating as part of a multidisciplinary team to better care for these individuals. There was a unanimous consensus that end-of-life care should be formally taught to all intern and resident physicians, and care at the end-of-life must be integrated to pursue value-congruent care for each patient. In response to the information gathered, we built a web-based, interactive, self-directed learning module emphasizing high-quality end-of-life care, issues to address with patients during clinic visits, and integration of end-of-life care. We have also integrated palliative care into the team caring for our patients with advanced disease.

A tale of four practices

2017 ◽  
Vol 31 (6) ◽  
pp. 630-646 ◽  
Author(s):  
Michelle Miller-Day ◽  
Janelle Applequist ◽  
Keri Zabokrtsky ◽  
Alexandra Dalton ◽  
Katherine Kellom ◽  
...  
Keyword(s):  
Diabetes Care ◽  
Care Delivery ◽  
Glycosylated Hemoglobin ◽  
Clear Understanding ◽  
Structured Interviews ◽  
Patient Centered ◽  
Content Type ◽  
Management Of Technology ◽  
Practice Performance ◽  
Comparison Groups

Purpose The Patient-Centered Medical Home (PCMH) has become a dominant model of primary care re-design. This transformation presents a challenge to many care delivery organizations. The purpose of this paper is to describe attributes shaping successful and unsuccessful practice transformation within four medical practice groups. Design/methodology/approach As part of a larger study of 25 practices transitioning into a PCMH, the current study focused on diabetes care and identified high- and low-improvement medical practices in terms of quantitative patient measures of glycosylated hemoglobin and qualitative assessments of practice performance. A subset of the top two high-improvement and bottom two low-improvement practices were identified as comparison groups. Semi-structured interviews were conducted with diverse personnel at these practices to investigate their experiences with practice transformation and data were analyzed using analytic induction. Findings Results show a variety of key attributes facilitating more successful PCMH transformation, such as empanelment, shared goals and regular meetings, and a clear understanding of PCMH transformation purposes, goals, and benefits, providing care/case management services, and facilitating patient reminders. Several barriers also exist to successful transformation, such as low levels of resources to handle financial expense, lack of understanding PCMH transformation purposes, goals, and benefits, inadequate training and management of technology, and low team cohesion. Originality/value Few studies qualitatively compare and contrast high and low performing practices to illuminate the experience of practice transformation. These findings highlight the experience of organizational members and their challenges in practice transformation while providing quality diabetes care.

scholarly journals Bahamians as International Adult Learners Determined for Academic Success

2019 ◽  
Vol 9 (4) ◽  
pp. 1038-1054
Author(s):  
Yvonne Hunter-Johnson ◽  
Yuanlu Niu
Keyword(s):  
Academic Success ◽  
Adult Learners ◽  
Support Systems ◽  
The United States ◽  
Influential Factors ◽  
Perceived Support ◽  
Structured Interviews ◽  
Caribbean Students ◽  
Open Coding ◽  
Faculty Mentors

The purpose of this study is to explore the factors that impact the experience of Caribbean nontraditional adult learners encounter while pursuing higher education in the United States and perceived support systems needed by Caribbean adult learners to be successful. On this premise, this qualitative study was conducted. A total of 15 Bahamian students participated. Data was collected via semi-structured interviews and analyzed utilizing open coding. The major themes that emerged with regards to influential factors that impacted their experiences were: (a) financial constraints, (b) lack of support, and (c) cultural differences and adaptation. As it relates to support systems needed by Caribbean students, the major themes that emerged were: (a) family, (b) faculty/mentors, and (c) a network of friends.

A Needs Assessment for Southern Manitoba Physicians for Palliative Care Education

2002 ◽  
Vol 18 (3) ◽  
pp. 175-184 ◽  
Author(s):  
Cheryl Barnabé ◽  
Peter Kirk
Keyword(s):  
Palliative Care ◽  
Rural Communities ◽  
Needs Assessment ◽  
Rural Areas ◽  
Care Delivery ◽  
Physician Education ◽  
Structured Interviews ◽  
Patient Centered ◽  
Care Education ◽  
Palliative Care Education

Recent calls for increased palliative care education of physicians and a need to improve the effectiveness of palliative care delivery in rural areas are the stimuli for this study. The needs assessment evaluated educational needs and preferences of physicians practicing in three Regional Health Authorities in southern Manitoba in 2000, as well as semi-structured interviews with health care workers in seven rural communities. Physicians report their knowledge of symptom management issues as adequate, although for other issues in palliative care such as bereavement, psychosocial aspects of dying, and professional issues, they have less confidence. Physicians prefer learning through case studies, lectures, and self-directed learning, in settings close to their community, on the weekend. Qualitative analysis from the semi-structured interviews revealed themes related to the role of physicians in rural palliative care: i) a need for physician education, ii) physician participation within the palliative care team, and iii) physician involvement in patient-centered care.

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