scholarly journals Health-System Introductory Pharmacy Practice Experience as an online course in the United States

2020 ◽  
pp. 11-12
Author(s):  
M. Kawaguchi-Suzuki ◽  
J. Merlo ◽  
S. White ◽  
R. Gibbard ◽  
L. Ly ◽  
...  

Introductory Pharmacy Practice Experiences (IPPEs) provide early experiential education in the Doctor of Pharmacy (Pharm.D.) curriculum in the United States (US). In response to Oregon's ‘Stay Home, Save Lives’ executive order issued during the COVID-19 pandemic, an online health-system IPPE course was developed to simulate the practice experiences that have historically been conducted in person. This case study describes experience from the online health-system IPPE course offered for incoming second-year student pharmacists enrolled in a three-year Pharm.D. programme at Pacific University in Oregon, US. The goals of the course were: 1) to expose students to pharmacy practice common in health-system settings in the US; and 2) for students to earn 50 experiential clock hours through simulation activities.

2021 ◽  
Author(s):  
Jiban Khuntia ◽  
Xue Ning ◽  
Wayne Cascio ◽  
Rulon Stacey

BACKGROUND The COVID-19 pandemic, with all its virus variants, remains a serious situation. Health systems across the United States are trying their best to respond. The healthcare workforce remains relatively homogenous, even though they are caring for a highly diverse array of patients (6-12). It is a perennial problem in the US healthcare workforce that has only been accentuated during the COVID-19 pandemic. Medical workers should reflect the variety of patients they care for and strive to understand their mindsets within the larger contexts of culture, gender, sexual orientation, religious beliefs, and socioeconomic realities. Along with talent and skills, diversity and inclusion (D&I) are essential for maintaining a workforce that can treat the myriad needs and populations that health systems serve. Developing hiring strategies in a post-COVID-19 “new normal” that will help achieve greater workforce diversity remains a challenge for health system leaders. OBJECTIVE Our primary objectives are (1) to explore the characteristics and perceived benefits of US health systems that value D&I; (2) to examine the influence of a workforce strategy designed to balance talent and D&I; and (3) to explore three pathways to better equip workforces and their relative influences on business- and service-oriented benefits: (a) improving D&I among existing employees (IMPROVE), (b) using multiple channels to find and recruit a workforce (RECRUIT), and (c) collaborating with universities to find new talent and establish plans to train students (COLLABORATE). METHODS During February–March 2021, we surveyed 625 health system chief executive officers, in the United States, 135 (22%) of whom responded. We assessed workforce talent and diversity-relevant factors. We collected secondary data from the Agency for Healthcare Research and Quality’s (AHRQ) Compendium of the US. Health Systems, leading to a matched data set of 124 health systems for analysis. We first explored differences in talent and diversity benefits across the health systems. Then, we examined the relationship between IMPROVE, RECRUIT, and COLLABORATE pathways to equip the workforce. RESULTS Health system characteristics, such as size, location, ownership, teaching, and revenue, have varying influences on D&I and business and service outcomes. RECRUIT has the most substantial mediating effect on diversity-enabled business- and service-oriented outcomes of the three pathways. This is also true of talent-based workforce acquisitions. CONCLUSIONS Diversity and talent plans can be aligned to realize multiple desired benefits for health systems. However, a one-size-fits-all approach is not a viable strategy for improving D&I. Health systems need to follow a multipronged approach based on their characteristics. To get D&I right, proactive plans and genuine efforts are essential.


Author(s):  
Dawn Langan Teele

This chapter presents a case study of women's enfranchisement in the United States. It argues that the formation of a broad coalition of women, symbolized by growing membership in a large non-partisan suffrage organization, in combination with competitive conditions in state legislatures, was crucial to securing politicians' support for women's suffrage in the states. The chapter first gives a broad overview of the phases of the US suffrage movement, arguing that the salience of political cleavages related to race, ethnicity, nativity, and class influenced the type of movement suffragists sought to build. It then describes the political geography of the Gilded Age, showing how the diversity of political competition and party organization that characterized the several regions mirrors the pattern of women's enfranchisement across the states.


Author(s):  
Holly M. Mikkelson

This chapter traces the development of the medical interpreting profession in the United States as a case study. It begins with the conception of interpreters as volunteer helpers or dual-role medical professionals who happened to have some knowledge of languages other than English. Then it examines the emergence of training programs for medical interpreters, incipient efforts to impose standards by means of certification tests, the role of government in providing language access in health care, and the beginning of a labor market for paid medical interpreters. The chapter concludes with a description of the current situation of professional medical interpreting in the United States, in terms of training, certification and the labor market, and makes recommendations for further development.


Author(s):  
Steve Chi-Yin Yuen ◽  
Harrison Hao Yang

Enhancing the substantial interaction in e-learning courses can be a challenge to instructors. The chapter gave an overview of online interaction, portfolios development, and blogs use in education. It then discussed the potential uses of Weblog-based portfolio for e-learning courses in supporting interactions among students and instructors, and presented a case study on how a blogfolio approach was implemented into three hybrid courses and one fully online course at two universities in the United States. The effectiveness of the blogfolio approach on interactions in both fully online and hybrid courses has been assessed and confirmed in this study.


1999 ◽  
Vol 41 (1) ◽  
pp. 1-30 ◽  
Author(s):  
Robert H. Holden

The US.-sponsored programs of military and police collaboration with the Central American governments during the Cold War also contributed to the surveillance capacity of those states during the period when the Central American state formation process was being completed. Guatemala is used as a case study. Washington’s contribution was framed by the conventional discourse of “security against communism” but also by an underlying technocratic ethos in which “modernization” and “security” were higher priorities than democratization.


2009 ◽  
Vol 44 (4) ◽  
pp. 312-324 ◽  
Author(s):  
Brian Meissner ◽  
Winnie Nelson ◽  
Rodney (Rod) Hicks ◽  
Vanja Sikirica ◽  
Josh Gagne ◽  
...  

Purpose To estimate the rates and costs of intravenous patient-controlled analgesia (IV PCA) errors from the hospital or integrated health system perspective. Methods This study used a cost-accounting methodology to estimate the costs attributable to IV PCA errors in the United States. Data for the study were obtained from the MEDMARX and Manufacturer and User Facility Device Experience (MAUDE) datasets, published literature, and expert opinions. MEDMARX is a voluntary, anonymous, medication-error-reporting database owned and operated by the United States Pharmacopeia. MAUDE is a mandatory, device-error-reporting database maintained by the US Food and Drug Administration. Levels of care rendered as a result of the IV PCA errors were estimated by applying clinical assumptions (validated by an expert advisory panel) to each of the 7 error consequences considered in this analysis. Variable and opportunity costs (2006 values) were considered, including medication, laboratory, lost revenue, and labor. The corresponding costs were applied to the error consequences to derive the estimated mean cost for each error cause. The numbers of errors documented in each dataset and the published literature were used to extrapolate the rate of IV PCA errors annually. Results The average cost per error event was $733 in the MEDMARX dataset and $552 in the MAUDE dataset. Harmful IV PCA errors were 120 to 250 times more costly than nonharmful errors. The annual error rates were estimated as 407 IV PCA-related errors and 17 device-related errors per 10,000 people within the United States. Conclusion: Analysis of 2 datasets, MEDMARX and MAUDE, revealed that IV PCA medication- and device-related errors are costly to hospitals and integrated health systems and represent a significant burden on the US health system. This study provided a novel approach to estimating the associated costs of undesired IV PCA-related events. Additional research is needed to validate the methodology (as applied to this area) and results.


Author(s):  
Elina Reponen ◽  
Thomas G Rundall ◽  
Stephen M Shortell ◽  
Janet C Blodgett ◽  
Ritva Jokela ◽  
...  

Abstract Background Healthcare organizations around the world are striving to achieve transformational performance improvement, often through adopting process improvement methodologies such as Lean management. Indeed, Lean management has been implemented in hospitals in many countries. But despite a shared methodology and the potential benefit of benchmarking lean implementation and its effects on hospital performance, cross-national Lean benchmarking is rare. Healthcare organisations in different countries operate in very different contexts, including different healthcare system models, and these differences may be perceived as limiting the ability of improvers to benchmark Lean implementation and related organisational performance. However, there is no empirical research available on the international relevance and applicability of Lean implementation and hospital performance measures. To begin to understand the opportunities and limitations related to cross-national benchmarking of Lean in hospitals, we conducted a cross-national case study of the relevance and applicability of measures of Lean implementation in hospitals and hospital performance. Methods We report an exploratory case study of the relevance of Lean implementation measures and the applicability of hospital performance measures using quantitative comparisons of data from Hospital District of XX XX University Hospital in Finland and a sample of 75 large academic hospitals in the United States. Results The relevance of Lean-related measures was high across the two countries: almost 90% of the items developed for a US survey were relevant and available from XX. A majority of the US-based measures for financial performance (66.7%), service provision/utilisation (100.0%), and service provision/care processes (60.0%) were available from XX. Differences in patient satisfaction measures prevented comparisons between XX and the US. Of 18 clinical outcome measures, only four (22%) were not comparable. Clinical outcome measures were less affected by the differences in healthcare system models than measures related to service provision and financial performance. Conclusions Lean implementation measures are highly relevant in healthcare organisations operating in the United States and Finland, as is the applicability of a variety of performance improvement measures. Cross-national benchmarking in Lean healthcare is feasible, but a careful assessment of contextual factors, including the healthcare system model, and their impact on the applicability and relevance of chosen benchmarking measures is necessary. The differences between the US and Finnish healthcare system models is most clearly reflected in financial performance measures and care process measures.


2009 ◽  
Vol 27 (4) ◽  
pp. 684-697 ◽  
Author(s):  
David P Dolowitz ◽  
Dale Medearis

Not enough has been written about the import, adaptation, and application of urban environmental and planning policies from abroad into the United States. Even less has been written about the voluntary cross-national transfer and application of environmental policies by American subnational actors and institutions. It is our intent to begin redressing this by discussing the transfer of urban environmental and planning policies from Germany to the United States during the early part of the 21st century. This discussion is informed by data drawn from governmental reports and planning statements and over thirty-five interviews with US urban environmental and planning practitioners operating in Germany and the United States. What we discover is that, unlike more rational models of policy transfer, the voluntary importation of environmental and planning policies into the US is seldom a problem-focused, goal-oriented process. Rather, what we find is that a better depiction of the transfer and adoption process is of a relatively anarchic situation. This appears to occur due to a range of institutional and cultural filters that predispose American policy makers against gathering (and using) information and experiences from abroad. We find that this filtering process tends to encourage policy makers to discount (or reject outright) the usefulness of overseas models and that, when they do engage in this process, any information gathered appears to be based less upon well-researched and analyzed data than embedded ‘tacit’ knowledge.


2019 ◽  
Vol 2019 ◽  
Author(s):  
Jakob Linaa Jensen ◽  
Axel Bruns ◽  
Tim Graham ◽  
Daniel Angus ◽  
Anders Olof Larsson ◽  
...  

In this panel we combine longitudinal and cross-national studies of social media in election campaigns, expanding the time span as well as number of countries compared to former studies. The four papers present longitudinal studies, covering multiple election cycles from four different countries: Australia, the United States of America, Denmark and Sweden. By including these cases we focus on countries considered to be “first movers” when it comes to the digitization and internetization of the political life. As such, they are “most similar cases”. However, they also have different political systems: the US and Australia are characterized by a Westminster system dominated by a few large parties and a tradition of strong confrontation between government and opposition, whereas Denmark and Sweden are multi-party systems with a tradition of collaboration and coalition governments. Further, the countries’ media systems, as defined by Hallin & Mancini (2004), differ significantly; the US is characterized by a commercialized American media system with little role for public service broadcasters, Denmark and Sweden have very strong public service media, and Australia has elements of both these systems. Technologically, the four countries might be similar, but politically and in terms of media systems, they differ. Thus, studies of the four countries form a diverse yet solid set of cases for exploring the growing (and changing) role of social media in national elections. The papers address such issues by various methods and perspectives, from large-scale big data analyses of tweets to content analyses of Facebook pages and surveys among citizens. From different angles, the four papers circle around the same topics: do social media contribute to narrowing or widening the often-discussed gap between citizens and politicians? Does the increasing use (and changing character) of social media in election campaigns facilitate increased trust or rather a radicalized and more negative discourse? And do citizens feel more empowered and enlightened in a democratic sense? The Australian case study is based on a comprehensive analysis of interactions around candidates’ Twitter accounts, drawing on state-of-the-art methods. It stretches across three election cycles. It presents new evidence both on the use of Twitter in political campaigning in Australia, and on the public response to this use, not at least in the light of the overall context of a decline in trust towards the political system, in Australia and elsewhere. The US case study examines negativity, incivility, and intolerance expressed by candidates running for governor in 2014 as compared with 2018. In between those two election cycles, the United States had the remarkable presidential campaign of 2016, with an unprecedented volume and style of negative campaigning unseen in modern campaigning. This study thus asks whether the 2018 candidates were more negative and uncivil than their counterparts who ran in 2014. Results will illuminate the nature of political incivility and whether there is a coarseness of political discourse in the United States. The Danish case study is based on surveys of citizens’ Internet use / social media use across four elections, covering a time span of 12 years. It adds to an understanding of the growing use of social media but more importantly it investigates how citizens experienced effects of social media as tools for agenda-setting and efficacy, the latter understood as increased reflection and enlightenment. The Swedish case study covers three Swedish national elections, in 2010, 2014 and 2018. The research question is: how are viral posts from political parties on Facebook changing over time? By answering that question, the author can track the consequences of increased platformization of politics as well as an increased targeting towards the needs and wants of the audience, through what some will call populism. The studies all cover more or less the last decade. This represents a time span during which social media have matured and have come to play an increasing role in citizens’ daily lives. The contributions are interesting country-based case studies in themselves, but through this panel we seek to engage the audience in a discussion of the developments expected for the coming years.  


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