Improving patient care from the rheumatology perspective

2021 ◽  
Author(s):  
Global Rheumatology by PANLAR
Keyword(s):  
Outpatient Care ◽  
Traffic Accidents ◽  
Hospital Setting ◽  
The United States ◽  
Care Process ◽  
Institute Of Medicine ◽  
Effective Interventions ◽  
Hospital Patients ◽  
Improving Patient Care ◽  
Rheumatology Practice

In early 2000, the Institute of Medicine of the United States published the results of an investigation carried out on medical errors in hospital patients. The report, entitled “To Err is Human”, concluded that between 44,000 and 98,000 people died annually in U.S. hospitals as a result of errors that occurred in the care process. This figure was even higher than the mortality caused by traffic accidents, breast cancer or HIV at the time. Since then, highly effective interventions have been developed and adopted to prevent these safety-related outcomes for our patients, extending beyond the hospital setting to include outpatient care and, of course, the rheumatology practice.

Patient Centric Healthcare InformationSystems in the U.S.

2011 ◽  
pp. 498-506
Author(s):  
Nilmini Wickramasinghe
Keyword(s):  
Quality Of Healthcare ◽  
The United States ◽  
Final Report ◽  
Institute Of Medicine ◽  
High Quality ◽  
Quality Healthcare ◽  
Improving Patient Care ◽  
The U.S ◽  
Patient Centric

Healthcare expenditure is increasing exponentially, and reducing this expenditure (i.e., offering effective and efficient quality healthcare treatment) is becoming a priority not only in the United States, but also globally (Bush, 2004; Oslo Declaration, 2003;Global Medical Forum, 2005). In the final report compiled by the Committee on the Quality of Healthcare in America (Institute of Medicine, 2001), it was noted that improving patient care is integrally linked to providing high quality healthcare.

Racial and Ethnic Disparities in the Treatment of Chronic Pain

Pain Medicine ◽  
2020 ◽  
Author(s):  
Mary E Morales ◽  
R Jason Yong
Keyword(s):  
Chronic Pain ◽  
Racial Differences ◽  
Current Literature ◽  
Ethnic Disparities ◽  
The United States ◽  
Cross Sectional ◽  
Effective Interventions ◽  
Sociodemographic Profile

Abstract Objective To summarize the current literature on disparities in the treatment of chronic pain. Methods We focused on studies conducted in the United States and published from 2000 and onward. Studies of cross-sectional, longitudinal, and interventional designs were included. Results A review of the current literature revealed that an adverse association between non-White race and treatment of chronic pain is well supported. Studies have also shown that racial differences exist in the long-term monitoring for opioid misuse among patients suffering from chronic pain. In addition, a patient’s sociodemographic profile appears to influence the relationship between chronic pain and quality of life. Results from interventional studies were mixed. Conclusions Disparities exist within the treatment of chronic pain. Currently, it is unclear how to best combat these disparities. Further work is needed to understand why disparities exist and to identify points in patients’ treatment when they are most vulnerable to unequal care. Such work will help guide the development and implementation of effective interventions.

scholarly journals Hybrid intelligence in hospitals: towards a research agenda for collaboration

2021 ◽  
Author(s):  
Milad Mirbabaie ◽  
Stefan Stieglitz ◽  
Nicholas R. J. Frick
Keyword(s):  
Hospital Setting ◽  
Care Process ◽  
Future Research ◽  
Conversational Agents ◽  
Actual Application ◽  
Reasonable Approach ◽  
Hybrid Intelligence ◽  
Application Of Cas ◽  
Successful Collaboration

AbstractSuccessful collaboration between clinicians is particularly relevant regarding the quality of care process. In this context, the utilization of hybrid intelligence, such as conversational agents (CAs), is a reasonable approach for the coordination of diverse tasks. While there is a great deal of literature involving collaboration, little effort has been made to integrate previous findings and evaluate research when applying CAs in hospitals. By conducting an extended and systematic literature review and semi-structured expert interviews, we identified four major challenges and derived propositions where in-depth research is needed: 1) audience and interdependency; 2) connectivity and embodiment; 3) trust and transparency; and 4) security, privacy, and ethics. The results are helpful for researchers as we discuss directions for future research on CAs for collaboration in a hospital setting enhancing team performance. Practitioners will be able to understand which difficulties must be considered before the actual application of CAs.

scholarly journals Methodological and Measurement Advances in Social Determinants of HIV: View from NIH

2021 ◽  
Author(s):  
Gregory Greenwood ◽  
Paul Gaist ◽  
Ann Namkung ◽  
Dianne Rausch
Keyword(s):  
Social Determinants ◽  
Social Dynamics ◽  
The United States ◽  
Lessons Learned ◽  
Structural Determinants ◽  
Effective Interventions ◽  
Suboptimal Care ◽  
The Social ◽  
Hiv Acquisition ◽  
Ecological Momentary

AbstractSocial determinants are increasingly understood as key contributors to patterns of heightened risk for HIV acquisition and suboptimal care and treatment outcomes. Yet, the ability to rigorously model, map and measure these nuanced social dynamics has been a challenge, resulting in limited examples of effective interventions and resource allocation. In 2016, the United States National Institute of Mental Health (NIMH) and the National Institute of Allergy and Infectious Diseases (NIAID) issued a Request for Applications calling for methodological innovations around the social determinants of HIV. In May of 2019, NIMH, in collaboration with American University’s Center on Health, Risk and Society and the DC Center for AIDS Research, sponsored a symposium to bring together the funded teams to share accomplishments, distill lessons learned and reflect on the state of the science with other key stakeholders. Presentations focused on causal inference, multi-level analysis and mathematical modeling (Models); geospatial analytics and ecological momentary assessments (Maps); and measurement of social and structural determinants including inequalities and stigmas (Measures). Cross-cutting and higher-level themes were discussed and largely focused on the importance of critical and careful integration of social theory, community engagement and mixed methodologies into research on the social determinants of HIV.

CHILDREN IN TRAFFIC ACCIDENTS

PEDIATRICS ◽  
1969 ◽  
Vol 44 (5) ◽  
pp. 847-854
Author(s):  
G. Anthony Ryan
Keyword(s):  
Lower Limb ◽  
Traffic Accidents ◽  
The United States ◽  
Rear Seat ◽  
Age Group ◽  
Front Seat ◽  
Severe Injuries ◽  
Rural Highways ◽  
Points Of View ◽  
Seating Position

The part that children play in traffic accidents has been studied by numerous workers from differing points of view. Slätis,1 in a study of 5,291 persons injured in traffic accidents and receiving medical treatment in Sweden, found that 16.3% were less than 15 years of age. An examination by Mackay2 of a series of 250 accidents investigated at the scene in Birmingham, England, found that children less than 16 years of age formed 6.2% of the 464 persons involved. In Brisbane, Australia, Jamieson and Tait3 found that children less than 15 years old formed 10.9% of a group of 1,000 admissions or deaths from traffic accidents. Gädeke4 in Germany, found children less than 15 years old were injured more often in rural accidents, that traffic accidents formed 35 to 40% of all fatal accidents in children, and that injuries to the head and lower limb were most common. In Sweden, Ekström, et al.5 found that the majority of children involved in accidents they studied were pedestrians or pedal cyclists, and 40% were between 5 and 9 years old. Moore and Lilienfeld6 reported on 31,001 occupants of known age in 14,520 automobiles involved in injury-producing accidents on rural highways in the United States. They found that children less than 12 years of age formed 9%, adolescents age 12 to 18 years formed 16%, and adults of more than 18 years formed 75%. They found that children received fewer and less severe injuries than adolescents or adults, in each seating position. Front seat passengers in each age group were injured more often and more severely than rear seat passengers.

Implementation of Wireless “Intelligent” Pump IV Infusion Technology in a Not-for-Profit Academic Hospital Setting

2007 ◽  
Vol 42 (9) ◽  
pp. 832-840 ◽  
Author(s):  
Lor Siv-Lee ◽  
Linda Morgan
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Hospital Setting ◽  
The United States ◽  
Main Campus ◽  
For Profit ◽  
Not For Profit ◽  
Drug Concentrations ◽  
Wireless Infrastructure ◽  
Infusion System

Purpose This paper describes the implementation of wireless “intelligent” pump intravenous (IV) infusion technology in a not-for-profit academic, multicampus hospital system in the United States. Methods The process of implementing a novel infusion system in a multicampus health care institution (main campus plus three satellite campuses) is described. Details are provided regarding the timelines involved, the process for the development of the drug libraries, and the initial implementation within and across campuses. Results In early 2004, with the end of the device purchase contract period nearing, a multidisciplinary committee evaluated potential IV infusion pumps for hospital use. In April 2004, the committee selected the Plum A+ infusion system with Hospira MedNet software and wireless capabilities (Hospira Inc., Lake Forest, IL). Implementation of the single-channel IV infusion system took place July through October 2005 following installation of the wireless infrastructure throughout the multicampus facility. Implementation occurred in July, one campus at a time; the three smaller satellite campuses went “live” before the main campus. Implementation of the triple-channel IV infusion system took place in March 2006 when the wireless infrastructure was completed and fully functional throughout the campuses, software was upgraded, and drug library revisions were completed and uploaded. Conclusion “Intelligent” pump technology provided a framework to standardize drug concentrations used in the intensive care units. Implementation occurred transparently without any compromise of patient care. Many lessons were learned during implementation that explained the initial suboptimal compliance with safety software use. In response, the committee developed strategies to increase software utilization rates, which resulted in improved acceptance by nursing staff and steadily improving compliance rates. Wireless technology has supported remote device management, prospective monitoring, the avoidance of medication error, and the timely education of health care professionals regarding potential medication errors.

Out-of-Hospital Resuscitation: Have We Gone Too Far?

2006 ◽  
Vol 21 (6) ◽  
pp. 445-450 ◽  
Author(s):  
Corita Grudzen
Keyword(s):  
Cardiac Arrest ◽  
Prehospital Care ◽  
Sudden Cardiac Arrest ◽  
Hospital Setting ◽  
The United States ◽  
Spontaneous Circulation ◽  
Emergency Medical ◽  
Clinical Scenarios ◽  
Life Sustaining Treatment ◽  
Future Policy

AbstractAmericans are living longer and are more likely to be chronically or terminally ill at the time of death. Although surveys indicate that most people prefer to die at home, the majority of people in the United States die in acute care hospitals. Each year, approximately 400,000 persons suffer sudden cardiac arrest in the US, the majority occurring in the out-of-hospital setting. Mortality rates are high and reach almost 100% when prehospital care has failed to restore spontaneous circulation. Nonetheless, patients who receive little benefit or may wish to forgo life-sustaining treatment often are resuscitated. Risk versus harm of resuscitation efforts can be differentiated by various factors, including cardiac rhythm. Emergency medical services policy regarding resuscitation should consider its utility in various clinical scenarios. Patients, family members, emergency medical providers, and physicians all are important stakeholders to consider in decisions about out-of-hospital cardiac arrest. Ideally, future policy will place greater emphasis on patient preferences and quality of life by including all of these viewpoints.

The School Counselor and STEM Career Development

2016 ◽  
Vol 44 (4) ◽  
pp. 359-374 ◽  
Author(s):  
Lia D. Falco
Keyword(s):  
United States ◽  
Career Development ◽  
School Counselors ◽  
School Counselor ◽  
Positive Impact ◽  
Underrepresented Students ◽  
The United States ◽  
Effective Interventions ◽  
Stem Career Development ◽  
Stem Career

There is an increasing concern that the demand for science, technology, engineering, and math (STEM) workers in the United States will exceed the supply. In the United States, very few students, and underrepresented students in particular, are pursuing STEM educational and occupational goals that underscores the need for school counselors to understand how to maximize opportunities for student success in STEM. Understanding the factors that influence students’ academic and career choices early on is necessary in order to provide effective interventions and responsive services that will have a positive impact on students’ future STEM career outcomes. Using social-cognitive career theory as a framework, this article synthesizes pertinent research on student STEM engagement, so that school counselors will be better able to support STEM career development for all students, especially those from historically underrepresented groups. Implications for school counseling practice are discussed.

scholarly journals Planning Nutritionally Adequate Diets for Groups: Methods Used to Develop Recommendations for a Child and Adult Care Food Program

2020 ◽  
Author(s):  
Suzanne P Murphy ◽  
Ann L Yaktine ◽  
Alicia L Carriquiry
Keyword(s):  
Age Groups ◽  
The United States ◽  
Adult Day Care ◽  
Institute Of Medicine ◽  
Nutrient Intakes ◽  
Adult Care ◽  
Or Education ◽  
Feeding Programs ◽  
Low Prevalence ◽  
Large Groups

ABSTRACT Planning nutritionally adequate intakes for large groups of people presents many challenges. Because of between-person variations in both food choices and nutrient requirements, it is necessary to examine nutrient intake distributions and select a Target Median Intake (TMI) that will lead to a low prevalence of inadequate nutrient intakes. The TMI may then be used to guide a feeding or education program. A comprehensive report from the Institute of Medicine evaluated nutrient intakes from the NHANES and recommended new meal patterns for all age groups (other than infants) served by the Child and Adult Day Care Food Program, which provides meals and snacks to children and adults in a variety of care settings. The Estimated Average Requirement, a DRI value, for each nutrient of interest was used to estimate both the prevalence of inadequate intakes as well as the changes in the intake distribution that are needed to reduce unacceptably high levels of inadequacy. For nutrients with an Adequate Intake (AI), the prevalence of inadequacy could not be estimated, but the AI could be used as the TMI. Simultaneously, it was important to ensure that the new intake distributions did not result in intakes that exceeded the Tolerable Upper Intake Level for any nutrient. Data for 2- to 4-y-old children are presented in detail to illustrate this process. Of 18 nutrients examined, analyses showed that intakes of vitamin E, potassium, and fiber should be increased, while intakes of sodium should be decreased. If more recent nutrient standards are used, revised assessments show that calcium intake should also be increased, while potassium intake is adequate. These methods and results should be useful when designing feeding programs for other population groups within the United States, as well as in other countries.

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