scholarly journals Case-Based Learning and its Application in Medical and Health-Care Fields: A Review of Worldwide Literature

2016 ◽  
Vol 3 ◽  
pp. JMECD.S20377 ◽  
Author(s):  
Susan F. McLean
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Literature Search ◽  
Web Based ◽  
Advantages And Disadvantages ◽  
Education Levels ◽  
Case Based Learning ◽  
Care Outcomes ◽  
The Impact ◽  
Case Based

Introduction Case-based learning (CBL) is a newer modality of teaching healthcare. In order to evaluate how CBL is currently used, a literature search and review was completed. Methods A literature search was completed using an OVID© database using PubMed as the data source, 1946-8/1/2015. Key words used were “Case-based learning” and “medical education”, and 360 articles were retrieved. Of these, 70 articles were selected to review for location, human health care related fields of study, number of students, topics, delivery methods, and student level. Results All major continents had studies on CBL. Education levels were 64% undergraduate and 34% graduate. Medicine was the most frequently represented field, with articles on nursing, occupational therapy, allied health, child development and dentistry. Mean number of students per study was 214 (7–3105). The top 3 most common methods of delivery were live presentation in 49%, followed by computer or web-based in 20% followed by mixed modalities in 19%. The top 3 outcome evaluations were: survey of participants, knowledge test, and test plus survey, with practice outcomes less frequent. Selected studies were reviewed in greater detail, highlighting advantages and disadvantages of CBL, comparisons to Problem-based learning, variety of fields in healthcare, variety in student experience, curriculum implementation, and finally impact on patient care. Conclusions CBL is a teaching tool used in a variety of medical fields using human cases to impart relevance and aid in connecting theory to practice. The impact of CBL can reach from simple knowledge gains to changing patient care outcomes.

scholarly journals The Role of Electronic Medical Records in Reducing Unwarranted Clinical Variation in Acute Health Care: Systematic Review (Preprint)

2021 ◽  
Author(s):  
Tobias Hodgson ◽  
Andrew Burton-Jones ◽  
Raelene Donovan ◽  
Clair Sullivan
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Patient Care ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Health Care Outcomes ◽  
Quadruple Aim ◽  
Care Outcomes ◽  
Clinical Variation ◽  
The Impact

BACKGROUND The use of electronic medical records (EMRs)/electronic health records (EHRs) provides potential to reduce unwarranted clinical variation and thereby improve patient health care outcomes. Minimization of unwarranted clinical variation may raise and refine the standard of patient care provided and satisfy the quadruple aim of health care. OBJECTIVE A systematic review of the impact of EMRs and specific subcomponents (PowerPlans/SmartSets) on variation in clinical care processes in hospital settings was undertaken to summarize the existing literature on the effects of EMRs on clinical variation and patient outcomes. METHODS Articles from January 2000 to November 2020 were identified through a comprehensive search that examined EMRs/EHRs and clinical variation or PowerPlans/SmartSets. Thirty-six articles met the inclusion criteria. Articles were examined for evidence for EMR-induced changes in variation and effects on health care outcomes and mapped to the quadruple aim of health care. RESULTS Most of the studies reported positive effects of EMR-related interventions (30/36, 83%). All of the 36 included studies discussed clinical variation, but only half measured it (18/36, 50%). Those studies that measured variation generally examined how changes to variation affected individual patient care (11/36, 31%) or costs (9/36, 25%), while other outcomes (population health and clinician experience) were seldom studied. High-quality study designs were rare. CONCLUSIONS The literature provides some evidence that EMRs can help reduce unwarranted clinical variation and thereby improve health care outcomes. However, the evidence is surprisingly thin because of insufficient attention to the measurement of clinical variation, and to the chain of evidence from EMRs to variation in clinical practices to health care outcomes.

scholarly journals The Impact of a Web-Based Course Concerning Patient Education for Mental Health Care Professionals: Quasi-Experimental Study (Preprint)

2018 ◽  
Author(s):  
Anna Laine ◽  
Maritta Välimäki ◽  
Eliisa Löyttyniemi ◽  
Virve Pekurinen ◽  
Mauri Marttunen ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Self Efficacy ◽  
Self Esteem ◽  
Team Climate ◽  
Post Intervention ◽  
Web Based ◽  
Advantages And Disadvantages ◽  
The Impact ◽  
The Web

BACKGROUND Continuing education has an important role in supporting the competence of health care professionals. Although Web-based education is a growing business in various health sectors, few studies have been conducted in psychiatric settings to show its suitability in demanding work environments. OBJECTIVE We aimed to describe the impact of a Web-based educational course to increase self-efficacy, self-esteem, and team climate of health care professionals. Possible advantages and disadvantages of the Web-based course are also described. METHODS The study used nonrandomized, pre-post intervention design in 1 psychiatric hospital (3 wards). Health care professionals (n=33) were recruited. Self-efficacy, self-esteem, and team climate were measured at 3 assessment points (baseline, 8 weeks, and 6 months). Possible advantages and disadvantages were gathered with open-ended questions at the end of the course. RESULTS Our results of this nonrandomized, pre-post intervention study showed that health care professionals (n=33) had higher self-efficacy after the course, and the difference was statistically significant (mean 30.16, SD 3.31 vs mean 31.77, SD 3.35; P=.02). On the other hand, no differences were found in the self-esteem or team climate of the health care professionals before and after the course. Health care professionals found the Web-based course useful in supporting their work and relationships with patients. The tight schedule of the Web-based course and challenges in recruiting patients to use the patient education program with health care professionals were found to be the disadvantages. CONCLUSIONS Web-based education might be a useful tool to improve the self-efficacy of health care professionals even in demanding work environments such as psychiatric hospitals. However, more studies with robust and sufficiently powered data are still needed.

scholarly journals The Role of Electronic Medical Records in Reducing Unwarranted Clinical Variation in Acute Health Care: Systematic Review

10.2196/30432 ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. e30432
Author(s):  
Tobias Hodgson ◽  
Andrew Burton-Jones ◽  
Raelene Donovan ◽  
Clair Sullivan
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Patient Care ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Health Care Outcomes ◽  
Quadruple Aim ◽  
Care Outcomes ◽  
Clinical Variation ◽  
The Impact

Background The use of electronic medical records (EMRs)/electronic health records (EHRs) provides potential to reduce unwarranted clinical variation and thereby improve patient health care outcomes. Minimization of unwarranted clinical variation may raise and refine the standard of patient care provided and satisfy the quadruple aim of health care. Objective A systematic review of the impact of EMRs and specific subcomponents (PowerPlans/SmartSets) on variation in clinical care processes in hospital settings was undertaken to summarize the existing literature on the effects of EMRs on clinical variation and patient outcomes. Methods Articles from January 2000 to November 2020 were identified through a comprehensive search that examined EMRs/EHRs and clinical variation or PowerPlans/SmartSets. Thirty-six articles met the inclusion criteria. Articles were examined for evidence for EMR-induced changes in variation and effects on health care outcomes and mapped to the quadruple aim of health care. Results Most of the studies reported positive effects of EMR-related interventions (30/36, 83%). All of the 36 included studies discussed clinical variation, but only half measured it (18/36, 50%). Those studies that measured variation generally examined how changes to variation affected individual patient care (11/36, 31%) or costs (9/36, 25%), while other outcomes (population health and clinician experience) were seldom studied. High-quality study designs were rare. Conclusions The literature provides some evidence that EMRs can help reduce unwarranted clinical variation and thereby improve health care outcomes. However, the evidence is surprisingly thin because of insufficient attention to the measurement of clinical variation, and to the chain of evidence from EMRs to variation in clinical practices to health care outcomes.

scholarly journals Survey on Recommended Health Care for Adult Patients with Myelodysplastic Syndromes Identifies Areas for Improvement

2020 ◽  
Vol 17 (24) ◽  
pp. 9562
Author(s):  
Ioannis Chanias ◽  
C. Wilk ◽  
Rudolf Benz ◽  
Michael Daskalakis ◽  
Georg Stüssi ◽  
...  
Keyword(s):  
Health Care ◽  
Risk Stratification ◽  
Patient Care ◽  
Myelodysplastic Syndromes ◽  
Germ Line ◽  
Immunosuppressive Treatment ◽  
Response Assessment ◽  
Web Based ◽  
Treatment Response Assessment ◽  
The Impact

The impact on health care of patients with myelodysplastic syndromes (MDS) is continuously rising. To investigate the perception of hemato-oncologists concerning the recommended MDS patient care in Switzerland, we conducted a web-based survey on diagnosis, risk-stratification and treatment. 43/309 physicians (13.9%) replied to 135 questions that were based on current guidelines between 3/2017 and 2/2018. Only questions with feedback-rates >50% were further analysed and ratios >90% defined “high agreement”, 70–90% “agreement”, 30–70% “insufficient agreement” and <30% “disagreement”. For diagnosis, we found insufficient agreement on using flow-cytometry, classifying MDS precursor conditions, performing treatment response assessment after hypomethylating agents (HMA) and evaluating patients with suspected germ-line predisposition. For risk-stratification, we identified agreement on using IPSS-R but insufficient agreement for IPSS and patient-based assessments. For treatment, we observed disagreement on performing primary infectious prophylaxis in neutropenia but agreement on using only darbepoetin alfa in anaemic, lower-risk MDS patients. For thrombopoietin receptor agonists, insufficient agreement was found for the indication, preferred agent and triggering platelet count. Insufficient agreement was also found for immunosuppressive treatment in hypoplastic MDS and HMA dose adjustments. In conclusion, we identified areas for improvement in MDS patient care, in need of further clinical trials, information, and guiding documents.

Unfunded Public Employee Health Care Benefits and GASB No. 45

2007 ◽  
Vol 21 (3) ◽  
pp. 245-263 ◽  
Author(s):  
Elizabeth K. Keating ◽  
Eric S. Berman
Keyword(s):  
Health Care ◽  
Financial Reporting ◽  
Full Range ◽  
Financial Reports ◽  
Employment Benefits ◽  
Care Plans ◽  
Advantages And Disadvantages ◽  
Government Accounting ◽  
The Government ◽  
The Impact

The Government Accounting Standards Board (GASB) recently released Statement No. 45, Accounting and Financial Reporting by Employers for Post-Employment Benefits Other Than Pensions and its companion Statement No. 43 for pooled stand-alone health care plans, which will profoundly affect American governmental finance. The goal of this article is to encourage governments to consider carefully a full range of options in funding and restructuring other post-employment benefits (OPEB). This article will review Statement No. 45's potential impact on governments and review existing disclosures in financial reports as well as bond offering statements. The article will discuss the statement's impact on budgets and governmental operations, including collective bargaining. Funding options under Statement No. 45 will be detailed, including the advantages and disadvantages of irrevocable trusts and OPEB bonds. The article will also discuss the impact of Medicare Part D subsidies received by governments, as well as the bond rating implications of policy decisions surrounding OPEB. As the largest government entities are just now implementing GASB Statement No. 45, estimates of the magnitude of unfunded OPEB liabilities are limited as are the strategies likely to be adopted to cover these obligations. This article offers a summary of the unfunded OPEB liabilities reported by states and major cities and suggests some measures for assessing the ability of these entities to address these costs.

scholarly journals Building capacity for implementation—the KT Challenge

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Agnes T. Black ◽  
Marla Steinberg ◽  
Amanda E. Chisholm ◽  
Kristi Coldwell ◽  
Alison M. Hoens ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Qualitative Data ◽  
Practice Change ◽  
Evidence Based ◽  
Science Literature ◽  
Health Care Settings ◽  
Improvement Programs ◽  
The Impact

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity, and practice change. Methods The evaluation used a mixed-methods retrospective pre-post design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, 6 months into implementation, and at the end of the 2-year funded projects) to measure KT capacity (knowledge, skills, and confidence) and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analyzed using non-parametric statistics. Results Participants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. Conclusions The KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.

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.

Documentation of goals of care (GOC) by medical oncologists is associated with improved oncology patient end-of-life (EOL) care outcomes.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1507-1507
Author(s):  
Han Xiao ◽  
Michael Riley ◽  
Richard Donopria ◽  
Steven Martin ◽  
Judith Eve Nelson ◽  
...  
Keyword(s):  
Patient Care ◽  
Linear Regression Analysis ◽  
Cancer Center ◽  
Oncology Patient ◽  
Patient Goals ◽  
Medical Oncologists ◽  
Hospice Referral ◽  
Care Outcomes ◽  
Eol Care ◽  
The Impact

1507 Background: Documenting GOC is integral to patient care and quality performance but has been underutilized by oncologists due to many barriers. As oncologists play a key role in initiating GOC discussions, we implemented a clinical initiative to improve their GOC documentation and evaluated the impact of such documentation on patient care during the EOL (last 30 days of life). Methods: We launched the initiative among 270 medical oncologists in an academic cancer center in 4/2020. A newly formulated GOC note to ease documentation was embedded in oncology outpatient and inpatient notes. Oncologists completed components in the GOC note that applied to their communication about GOC with the patient: 1) cancer natural history, 2) patient goals, and 3) EOL discussion: patient resuscitation preferences and, when pertinent, receptivity to hospice referral. GOC notes were pulled to a centralized location in the electronic health record (EHR) that displays documents relevant to patients’ values, goals and preferences. A dashboard allowed continual monitoring of documentation performance. We evaluated the association between GOC notes and outcomes of patient care at EOL. We further analyzed the impact of EOL discussion on EOL care. Results: The GOC note completion rate steadily rose after implementation. GOC notes were present in EHR for 46% of 10,006 patients who were either seen in outpatient clinic or discharged from hospital during the 1st week of January 2021. Among 1790 patients who died between 7/1/20 and 12/31/20 and had either at least an outpatient visit or hospitalization during EOL, the median days from first GOC note and first EOL discussion to the patient’s death were 71 days and 24 days, respectively. Linear regression analysis demonstrated that patients who had GOC note 60 days before death spent less time as inpatient during EOL (0.4 day less/patient, from 8.1 to 7.7, P = 0.01). When EOL discussion was documented 30 days before death, patients also spent less time in the hospital (1.2 days less/patient, from 9.7 to 8.5, P < 0.001) and in the ICU (0.3 days less/patient, from 1.7 to 1.4 ICU days, P = 0.04), and were 4% less likely to receive chemotherapy (from 38% to 34%, P = 0.004) at EOL. During the same period, among 1,009 patients with hospital admission in the last 30 days of life, those with a prior documented EOL discussion had shorter inpatient stay (7.7 vs 13.1 days, P < 0.001) and were more likely to be discharged to hospice (34% vs 22%, P = 0.003). Conclusions: During the COVID-19 pandemic, we successfully implemented GOC documentation by medical oncologists that is easily visible by the full care team. Documentation of GOC including EOL discussion was associated with fewer days in the hospital and ICU, increased hospice referral, and lower likelihood of receiving chemotherapy during patients’ last 30 days of life.

Multidisciplinary Group Case-Based Learning Environment

2018 ◽  
pp. 262-277
Author(s):  
Despo Ktoridou ◽  
Epaminondas Epaminonda ◽  
Achilleas Karayiannis
Keyword(s):  
Teaching And Learning ◽  
Core Element ◽  
Innovation And Technology ◽  
Case Based Learning ◽  
Market Opportunities ◽  
New Type ◽  
Multidisciplinary Group ◽  
The University ◽  
The Impact ◽  
Case Based

Technological, economic, and social developments represent dynamic changes for businesses across industries, creating opportunities for young entrepreneurs to build profitable companies. A key consideration relates to the need to recognize market opportunities and understand when and how to capitalize on them, whether starting a new type of business or growing on existing ideas; entrepreneurial thinking is a central attribute in cultivating an answer to this consideration. This chapter examines the impact of case-based learning introduced in a multidisciplinary undergraduate course, “Management of Innovation and Technology,” at the University of Nicosia. A core element in this process are the students' and lecturers' experiences, benefits, and challenges of cultivating entrepreneurial thinking. The findings can be useful for academics teaching entrepreneurship-related topics and seeking ways to incorporate innovative approaches in their teaching and learning processes in order to motivate students towards the development of entrepreneurial thinking in their professional engagements.

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