scholarly journals Descriptive Analysis of Level of Implementation in Allied Health Educational Institutions of IOM Recommended Core Competencies

2009 ◽  
Author(s):  
James Blagg
Keyword(s):  
Health Care Professionals ◽  
Allied Health ◽  
Core Competencies ◽  
Descriptive Analysis ◽  
Educational Institutions ◽  
Integrative Approach ◽  
Institute Of Medicine ◽  
Patient Centered ◽  
Allied Health Professions ◽  
Centered Care

A signal report of the Institute of Medicine (IOM) in 2003 stated that profound changes were needed in how health systems are designed, and postulated that such redesign could not take place without properly preparing health care professionals to take on this task. It established a set of core competencies (competence in patient-centered care, interdisciplinary teaming, evidence-based practice, quality improvement, and informatics) that future professionals should possess. The current study was conducted to determine the extent to which these core competencies have been incorporated into curricula by colleges/schools of allied health. A survey was e-mailed to 112 institutional representatives of the member institutions of the Association of Schools of Allied Health Professions for completion online. Thirty (26.8%) responded, and results were tabulated by Zoomerang software. Results indicated high desire to integrate the competencies and moderate to strong success in doing so. Most often, the competencies were included via integration throughout the curriculum, and rarely in standalone courses. This curriculum integrative approach makes sense, in the opinion of the author, as it has students apply the recommended competencies in concert with each other to various areas of content and scenarios rather than applying each in isolation within single standalone courses.

An Integrative Approach to Abdominal Pain

2019 ◽  
pp. 339-362
Author(s):  
Marika Alois ◽  
Terry Kit Selfe ◽  
Irene M. Estores
Keyword(s):  
Health Care ◽  
Abdominal Pain ◽  
Health Care Professionals ◽  
Gastrointestinal Disease ◽  
Integrative Approach ◽  
Patient Centered ◽  
Integrative Health ◽  
Bowel Diseases ◽  
Centered Care ◽  
Functional Gastrointestinal Disease

This chapter discusses abdominal pain in the context of functional gastrointestinal disease (FGID) and some chronic inflammatory bowel diseases, recognizing the huge burden it places on the health care system and emotional costs to patients and health care professionals. It presents a review of several modalities that include mind–body medicine practices, natural products, botanicals, manual and movement-based therapies, and pharmaceuticals that can be used as part of an integrative health plan for patients presenting with FGID and abdominal pain. It describes an integrative approach that weaves in concepts of patient-centered care, effective communication, empathic listening, mindfulness, and evidence-informed practice.

Improving patient-centered care for people with dementia in medical encounters: an educational intervention for old age psychiatrists

2009 ◽  
Vol 22 (1) ◽  
pp. 129-138 ◽  
Author(s):  
Louise Robinson ◽  
Claire Bamford ◽  
Ruth Briel ◽  
John Spencer ◽  
Paula Whitty
Keyword(s):  
Old Age ◽  
Communication Skills ◽  
Educational Intervention ◽  
Health Care Professionals ◽  
Video Recording ◽  
Patient Centered Care ◽  
Patient Centered ◽  
People With Dementia ◽  
Centered Care ◽  
Subsequent Behavior

ABSTRACTBackground: Health care professionals are recommended to deliver patient-centered care in dementia; however, guidance and training on how to do this in practice is currently lacking. The aim of this study was to develop and evaluate pragmatically an educational intervention for old age psychiatrists to promote patient-centered care in their consultations with people with dementia and their carers.Methods: We used a range of methods to (i) identify the theoretical components of patient-centered care (literature review) and (ii) observe actual practice (video recording of 53 consultations between old age psychiatrists and people with dementia and their family carers). We also interviewed participants from (ii) including 7 old age psychiatrists, 25 people with dementia and 44 carers. From this we developed a workshop for old age psychiatrists and piloted and evaluated it. Pre- and post-workshop questionnaires were completed; the latter included an assessment of planned and subsequent behavior change by participants.Results: The educational workshop, attended by 41 old age psychiatrists, focused on how best to structure the consultation and the most effective communication skills to use in consultation with people with dementia. Three months after the workshop, 59% had made one or more changes to the structure of their consultations, 71% had used new communication skills and 56% had reflected further on their practice.Conclusions: We developed an educational intervention with both a theoretical and empirical basis. The workshops resulted in many changes to self-reported practice; whether this was noticeable to patients and carers requires further study.

scholarly journals What Do Clinicians Who Deliver Maternity Services Think Patient-Centered Care Is and How Is That Different for Vulnerable Women? A Qualitative Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Ted Adams ◽  
Dana Sarnak ◽  
Joy Lewis ◽  
Jeff Convissar ◽  
Scott S. Young
Keyword(s):  
Qualitative Study ◽  
Primary Care Physicians ◽  
Health Management ◽  
Physician Assistants ◽  
Patient Centered Care ◽  
Fee For Service ◽  
Institute Of Medicine ◽  
Patient Centered ◽  
Maternity Services ◽  
Centered Care

Background. Patient-centered care is said to have a myriad of benefits; however, there is a lack of agreement on what exactly it consists of and how clinicians should deliver it for the benefit of their patients. In the context of maternity services and in particular for vulnerable women, we explored how clinicians describe patient-centered care and how the concept is understood in their practice. Methods. We undertook a qualitative study using interviews and a focus group, based on an interview guide developed from various patient surveys focused around the following questions: (i) How do clinicians describe patient-centered care? (ii) How does being patient-centered affect how care is delivered? (iii) Is this different for vulnerable populations? And if so, how? We sampled obstetricians and gynecologists, midwives, primary care physicians, and physician assistants from a health management organization and fee for service clinician providers from two states in the US covering insured and Medicaid populations. Results. Building a relationship between clinician and patient is central to what clinicians believe patient-centered care is. Providing individually appropriate care, engaging family members, transferring information from clinician to patient and from patient to clinician, and actively engaging with patients are also key concepts. However, vulnerable women did not benefit from patient-centered care without first having some of their nonmedical needs met by their clinician. Discussion. Most providers did not cite the core concepts of patient-centered care as defined by the Institute of Medicine and others.

Can opioid vigilance and patient-centered care coexist? A qualitative study of communicative tensions encountered by surgical trainees

2020 ◽  
Vol 16 (2) ◽  
pp. 91-101
Author(s):  
Elizabeth Troutman Adams, MA ◽  
Elisia L. Cohen, PhD ◽  
Andrew Bernard, MD ◽  
Whittney H. Darnell, PhD ◽  
Douglas R. Oyler, PharmD
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Medical Profession ◽  
Descriptive Analysis ◽  
Skills Training ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Opioid Prescribing ◽  
Surgical Trainees ◽  
Centered Care

Objective: The American health care system's adoption of the patient-centered care (PCC) model has transformed how medical providers communicate with patients about prescription pain medication. Concomitantly, the nation's opioid epidemic has necessitated a proactive response from the medical profession, requiring providers who frequently dispense opioids for acute pain to exercise vigilance in monitoring and limiting outpatient prescriptions. This qualitative study explores how surgical trainees balance PCC directives, including shared decision making, exchanging information with patients, and relationship maintenance, with opioid prescribing vigilance.Design: Investigators conducted interviews with 17 surgical residents and fellows (trainees) who routinely prescribe opioids at an academic medical center.Results: A qualitative descriptive analysis produced four codes, which were reduced to themes depicting problematic intersections between PCC imperatives and opioid vigilance during post-operative opioid-prescribing communication: (a) sharing the decision-making process contended with exerting medical authority, (b) reciprocating information contended with negotiating opioid prescribing terms with patients, (c) maintaining symbiotic relationships contended with prescribing ethics, and (d) achieving patient satisfaction contended with safeguarding opioid medications.Conclusion: Surgical training programs must supply trainees with post-surgical prescribing guidelines and communication skills training. Training should emphasize how PCC directives may work in tandem with--not in opposition to--opioid vigilance.

scholarly journals Postprofessional Athletic Training Students' Perceptions Concerning the Health Care Competencies

2018 ◽  
Vol 13 (4) ◽  
pp. 309-323 ◽  
Author(s):  
Cailee E. Welch Bacon ◽  
Bonnie L. Van Lunen ◽  
Dorice A. Hankemeier
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Athletic Training ◽  
Core Competencies ◽  
Likert Scale ◽  
Athletic Training Students ◽  
Patient Centered ◽  
Health Care Informatics ◽  
Centered Care ◽  
Care Informatics

Context: Over a decade ago, the Institute of Medicine indicated that all health care professionals should be educated in several health care competency areas (quality improvement, health care informatics, interprofessional education and collaborative practice, evidence-based practice, and patient-centered care). Despite this initiative, athletic training has only recently incorporated these competencies throughout education. Objective: To assess postprofessional athletic training students' perceived abilities and importance regarding 6 core competencies. Design: Cross-sectional. Setting: Self-reported paper survey. Patients or Other Participants: A total of 221 from a convenience sample of 258 postprofessional athletic training students (85.7%) completed the survey (82 males, 138 females; age = 23.29 ± 2.05 years). Main Outcome Measure(s): The survey consisted of several concept statements for each competency, and perceptions were collected via Likert-scale items (range 1–4). Composite perceived ability and importance Likert-scale scores were achieved by tabulating all values and then averaging the scores back to the Likert scale. Higher scores indicated that participants perceived themselves to have greater ability and that the concepts were more important for implementation in clinical practice. Results: Overall, postprofessional athletic training students perceived they were able to implement the concepts of the competencies into their daily practice and perceived all of the competencies to be moderately to extremely important for implementation. However, while participants globally perceived they were able to implement the competencies, they disagreed or strongly disagreed they were able to implement some concepts, particularly within health care informatics and patient-centered care, as a part of their clinical practice. Conclusions: Postprofessional athletic training students recognize the importance of the core competencies and perceive they are able to implement these competencies throughout clinical practice. However, as postprofessional athletic training students continue to advance their skills as clinicians, the benefits of health care informatics and incorporating real-time electronic patient data to support their clinical decisions should be emphasized.

scholarly journals A Brief Survey on Six Basic and Reduced eHealth Indicators in Seven Countries in 2017

2018 ◽  
Vol 09 (03) ◽  
pp. 704-713 ◽  
Author(s):  
Reinhold Haux ◽  
Elske Ammenwerth ◽  
Sabine Koch ◽  
Christoph Lehmann ◽  
Hyeoun-Ae Park ◽  
...  
Keyword(s):  
Health Care ◽  
Information Processing ◽  
Health Care Professionals ◽  
The United States ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Political Will ◽  
Record Data ◽  
Centered Care ◽  
Future Work

Background Holistic, ubiquitous support of patient-centered health care (eHealth) at all health care institutions and in patients' homes through information processing is increasingly supplementing institution-centered care. While eHealth indicators may measure the transition from institution-centered (e.g., hospital-centered) information processing to patient-centered information processing, collecting relevant and timely data for such indicators has been difficult. Objectives This article aims to design some basic eHealth indicators, which are easily collected and measure how well information processing supports holistic patient-centered health care, and to evaluate penetrance of patient-centered health as measured by the indicators internationally via an expert survey. Methods We identified six basic indicators that measure access of health care professionals, patients, and caregivers to the patient's health record data and the ability of providers, patients, and caregivers to add information in the patient's record. In a survey of international informatics experts, these indicators' penetrance were evaluated for Austria, Finland, Germany, Hong Kong, South Korea, Sweden, and the United States in the summer of 2017. Results The eHealth status measured by the indicators varied significantly between these seven countries. In Finland, most practices measured by the indicators were fully implemented whereas in Germany only one practice was partially realized. Conclusion Progress in the implementation of practices that support patient-centered care could mainly be observed in those countries where the “political will” focused on achieving patient-centered care as opposed to an emphasis on institution-centered care. The six eHealth indicators seem to be useful for measuring national progress in patient-centered care. Future work will extend the number of countries analyzed.

Exploring Quality of Primary Care for Patients Who Experience Homelessness and the Clinicians Who Serve Them: What Are Their Aspirations?

2020 ◽  
Vol 30 (6) ◽  
pp. 865-879 ◽  
Author(s):  
Allyson L. Varley ◽  
Ann Elizabeth Montgomery ◽  
Jocelyn Steward ◽  
Erin Stringfellow ◽  
Erika L. Austin ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care Professionals ◽  
Care Setting ◽  
Medical Decision ◽  
Institute Of Medicine ◽  
Patient Centered ◽  
Quality Of Primary Care ◽  
Template Analysis ◽  
Semistructured Interviews

To develop and evaluate an effective model of patient-centered, high-quality, homeless-focused primary care, our team explored key domains of primary care that may be important to patients. We anchored our conceptual framework in two reports from the Institute of Medicine (IOM) that defined components of primary care and quality of care. Using questions developed from this framework, we conducted semistructured interviews with 36 homeless-experienced individuals with past-year primary care engagement and 24 health care professionals (clinicians and researchers) who serve homeless-experienced patients in the primary care setting. Template analysis revealed factors important to this population. These included stigma, respect, and perspectives on patient control of medical decision-making in regard to both pain and addiction. For patients experiencing homelessness, the results suggest that quality primary care may have different meanings for patients and professionals, and that services should be tailored to meet homeless-specific needs.

scholarly journals The Learners' Perceptions Survey—Primary Care: Assessing Resident Perceptions of Internal Medicine Continuity Clinics and Patient-Centered Care

2013 ◽  
Vol 5 (4) ◽  
pp. 587-593 ◽  
Author(s):  
John M. Byrne ◽  
Barbara K. Chang ◽  
Stuart C. Gilman ◽  
Sheri A. Keitz ◽  
Catherine P. Kaminetzky ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Primary Care ◽  
Health Care Professionals ◽  
Clinical Training ◽  
Patient Centered Care ◽  
Family Centered Care ◽  
Patient Centered ◽  
Centered Care ◽  
The University ◽  
Family Centered

Abstract Background In 2010, the Department of Veterans Affairs (VA) implemented a national patient-centered care initiative that organized primary care into interdisciplinary teams of health care professionals to provide patient-centered, continuous, and coordinated care. Objective We assessed the discriminate validity of the Learners' Perceptions Survey—Primary Care (LPS-PC), a tool designed to measure residents' perceptions about their primary and patient-centered care experiences. Methods Between October 2010 and June 2011, the LPS-PC was administered to Loma Linda University Medical Center internal medicine residents assigned to continuity clinics at the VA Loma Linda Healthcare System (VALLHCS), a university setting, or the county hospital. Adjusted differences in satisfaction ratings across settings and over domains (patient- and family-centered care, faculty and preceptors, learning, clinical, work and physical environments, and personal experience) were computed using a generalized linear model. Results Our response rate was 86% (77 of 90). Residents were more satisfied with patient- and family-centered care at the VALLHCS than at either the university or county (P < .001). However, faculty and preceptors (odds ratio [OR]  =  1.53), physical (OR  =  1.29), and learning (OR  =  1.28) environments had more impact on overall resident satisfaction than patient- and family-centered care (OR  =  1.08). Conclusions The LPS-PC demonstrated discriminate validity to assess residents' perceptions of their patient-centered clinical training experience across outpatient primary care settings at an internal medicine residency program. The largest difference in scores was the patient- and family-centered care domain, in which residents rated the VALLHCS much higher than the university or county sites.

The Commission on Cancer’s survivorship care plan standard: Implementation is underway.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 72-72
Author(s):  
Nina S. Miller
Keyword(s):  
Cancer Patients ◽  
Patient Centered Care ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Institute Of Medicine ◽  
Survivorship Care ◽  
Psychosocial Needs ◽  
Patient Centered ◽  
Cancer Program ◽  
Centered Care

72 Background: The American College of Surgeons Commission on Cancer established a patient-centered standard regarding the delivery of a survivorship care plan to cancer patients. In response to recommendations from the 2006 National Academy of Sciences, Institute of Medicine report, From Cancer Patient to Cancer Survivor: Lost in Transition, a working group developed a set of Continuum of Care standards to address the psychosocial needs of cancer patients. In 2009 Commission on Cancer members had met to discuss a strategic plan for addressing a major shift in accreditation standards from process to patient-centered care with a focus on patient outcomes. According to Cancer Program Standards: Ensuring Patient-Centered Care, the cancer program must implement a process to disseminate a comprehensive care summary and follow-up plan to patients with cancer who are completing cancer treatment. Programs are in full implementation mode and surveys monitoring this Survivorship Care Plan Standard have begun this year. The care plan provides guidance and recommendations for survivors and their healthcare providers to address the medical and psychosocial problems that may arise post-treatment. By delivering a plan, the patient is empowered with information about the treatment they have received, the recommendations for their care going forward, and recommended resources. Methods: Programs submit documentation to describe their process for delivery of care through an electronic activity report. Documentation of this standard includes method of delivery, identification of eligible patients, implementation process and tracking. This presentation will summarize program submissions for 2015-2016 and include an analysis of the details of the standard compliance as reported by accredited programs. Results: This analysis will include responses from all Commission on Cancer accredited programs reporting on this standard. The analysis will provide information about the trends in program implementation and compliance with the standard. Conclusions: This analysis will inform future decisions about the content of plans, the value of plan delivery to the provider and to the patient and summarize current practice.

Neurosurgical practice and health care reform: moving toward quality-based health care delivery

2013 ◽  
Vol 34 (1) ◽  
pp. E1 ◽  
Author(s):  
Rachel F. Groman ◽  
Koryn Y. Rubin
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Physician Patient Relationship ◽  
Patient Centered ◽  
Patient Protection ◽  
The Us ◽  
Us Government ◽  
Centered Care ◽  
The Cost

In an effort to rein in spending and improve patient outcomes, the US government and the private sector have adopted a number of policies over the last decade that hold health care professionals increasingly accountable for the cost and quality of the care they provide. A major driver of these efforts is the Patient Protection and Affordable Care Act of 2010 (ACA or Pub.L. 111–148), which aims to change the US health care system from one that rewards quantity to one that rewards better value through the use of performance measurement. However, for this strategy to succeed in raising the bar on quality and efficiency, it will require the development of more standardized and accurate methods of data collection and further streamlined federal regulations that encourage enhanced patient-centered care instead of creating additional burdens that interfere with the physician-patient relationship.

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