scholarly journals Shared-care model for complex chronic haematological malignancies

2021 ◽  
Vol 31 (2) ◽  
pp. 165-174
Author(s):  
Verna Cheung ◽  
Nancy Siddiq ◽  
Rebecca Devlin ◽  
Caroline McNamara ◽  
Vikas Gupta

Myeloproliferative neoplasms (MPNs) are a group of rare Philadelphia-negative chronic leukemias. Disease rarity has resulted in limited expertise concentrated in specialist centres. Patients are often referred to such expert centres for diagnostic issues, complex decision-making, access to novel drugs through clinical trials, and supportive care. Attending such appointments may increase financial and travel burden, increase caregiver stress, and negatively impact quality of life. To address this, the MPN program at Princess Margaret (PM) Cancer Centre has implemented a shared-care model, working with local healthcare providers to provide ongoing management, and supportive care for MPN patients closer to home. This decreases patient travel burden, while maintaining high-quality patient-centered care. In this article we share our experience implementing the shared-care model. This model is potentially applicable to other chronic hematological malignancies and rare chronic diseases. The ultimate goal of shared-care is not to centralize care, but instead to build a community of accessible care for the patient.

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Jacqueline J Loonen ◽  
Nicole MA Blijlevens ◽  
Judith Prins ◽  
Desiree JS Dona ◽  
Jaap Den Hartogh ◽  
...  

2021 ◽  
Vol 14 ◽  
pp. 117863292110224
Author(s):  
Lisanne I van Lier ◽  
Henriëtte G van der Roest ◽  
Vjenka Garms-Homolová ◽  
Graziano Onder ◽  
Pálmi V Jónsson ◽  
...  

This study aims to benchmark mean societal costs per client in different home care models and to describe characteristics of home care models with the lowest societal costs. In this prospective longitudinal study in 6 European countries, 6-month societal costs of resource utilization of 2060 older home care clients were estimated. Three care models were identified and compared based on level of patient-centered care (PCC), availability of specialized professionals (ASP) and level of monitoring of care performance (MCP). Differences in costs between care models were analyzed using linear regression while adjusting for case mix differences. Societal costs incurred in care model 2 (low ASP; high PCC & MCP) were significantly higher than in care model 1 (high ASP, PCC & MCP, mean difference €2230 (10%)) and in care model 3 (low ASP & PCC; high MCP, mean difference €2552 (12%)). Organizations within both models with the lowest societal costs, systematically monitor their care performance. However, organizations within one model arranged their care with a low focus on patient-centered care, and employed mainly generalist care professionals, while organizations in the other model arranged their care delivery with a strong focus on patient-centered care combined with a high availability of specialized care professionals.


2018 ◽  
Vol 36 (5) ◽  
pp. 387-395 ◽  
Author(s):  
Frances R. Nedjat-Haiem ◽  
Tamara J. Cadet ◽  
Anup Amatya ◽  
Shiraz I. Mishra

Background: Advance care planning for end-of-life care emerged in the mid-1970’s to address the need for tools, such as the advance directive (AD) legal document, to guide medical decision-making among seriously ill patients, their families, and healthcare providers. Objective: Study aims examine providers’ perspectives on AD education that involve examining (1) a range of attitudes about educating patients, (2) whether prior knowledge was associated with practice behaviors in educating patients, and (3) specific factors among healthcare providers such as characteristics of work setting, knowledge, attitudes, and behaviors that may influence AD education and documentation. Design: To examine providers’ views, we conducted a cross-sectional, online survey questionnaire of healthcare providers using social media outreach methods for recruitment. Methods: This study used a cross-sectional survey design to examine the proposed aims. Healthcare providers, recruited through a broad approach using snowball methods, were invited to participate in an online survey. Logistic regression analyses were used to examine providers’ views toward AD education. Results: Of 520 participants, findings indicate that most healthcare providers said that they were knowledgeable about AD education. They also viewed providing education as beneficial to their practice. These findings suggest that having a positive attitude toward AD education and experiencing less organizational barriers indicate a higher likelihood that providers will educate patients regarding ADs. Conclusion: Various disciplines are represented in this study, which indicates that attitudes and knowledge influence AD discussions. The importance of AD discussions initiated by healthcare providers is critical to providing optimal patient-centered care.


Author(s):  
Michelle Krawczyk

People with disabilities use various assistance devices to improve their capacity to lead independent and fulfilling lives. Service dogs can be crucial lifesaving companions for their owners. As the use of service dogs increases, nurses are more likely to encounter them in healthcare settings. Service dogs are often confused with therapy or emotional support dogs. While some of their roles overlap, service dogs have distinct protection under the American Disabilities Act (ADA). Knowing the laws and proper procedures regarding service dogs strengthens the abilities of healthcare providers to deliver holistic, patient-centered care. This article provides background information about use of dogs, and discusses benefits to patients and access challenges for providers. The author reviews ADA laws applicable to service dog use and potential challenges and risks in acute care settings. The role of the healthcare professional is illustrated with an exemplar, along with recommendations for future research and nursing implications related to care of patients with service dogs.


2020 ◽  
Vol 33 (4) ◽  
pp. 358-360
Author(s):  
Jacqueline Fawcett

The purpose of this essay is to explore the meanings of the widely used terms compliance and adherence and the less widely used term concordance and to raise questions about the appropriateness of these terms when used to describe individuals’ or groups’ health-related behaviors. Discussion focuses on how recognition of how the meanings of these terms has uncovered the failure to honor nursing’s emphasis on person/patient-centered care due to power imbalances between healthcare providers and patents and the subsequent lack of patient autonomy. Consideration of these problems with existing terms could facilitate identification of a potentially more appropriate term based on the language of a nursing conceptual model and/or theory.


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