Integrating Macro–Micro Practice

Social work sets itself apart in the “helping professions” in recognizing the significance of its students and practitioners engaging with the theoretical knowledge and practice experiences sufficient for fluency across macro to micro settings. This practice integration assures comprehensive understanding of person-in-environment, from casework to complex systems work, and is raised to an ethical standard in the National Association of Social Work Code of Ethics and in the International Federation of Social Work Principles. Yet macro-oriented scholars have accused social work educators and professionals of abandoning their obligation to social justice and policy participation and of focusing their energy instead on micro practice. This literature is helpful in addressing how integrated practice can be achieved and informs the development of social workers who solidly embrace a commitment to macro knowledge and participation.

Decentralizing healthcare in Norway to improve patient-centered outpatient clinic management of rheumatoid arthritis – a conceptual model

A growing population of older adults and improved effective treatments for inflammatory rheumatic diseases will increase the demand for more healthcare resources that already struggle with staggering outpatient clinic waiting times. Transformative delivery care models that provide sustainable healthcare services are urgently needed to meet these challenges. In this mini-review article, a proposed Lifelong Treatment Model for a decentralized follow-up of outpatient clinic patients living with rheumatoid arthritis is presented and discussed.Our conceptual model follows four steps for a transformative care delivery model supported by an Integrated Practice Unit; (1) Diagnosis, (2) Treatment, (3) Patient Empowered Disease Management, and (4) Telehealth. Through an Integrated Practice Unit, a multidisciplinary team could collaborate with patients with rheumatoid arthritis to facilitate high-value care that addresses most important outcomes of the patients; (1) Early Remission, (2) Decentralization, (3) Improved Quality of Life, and (4) Lifelong Sustain Remission.The article also addresses the growing challenges for the healthcare delivery system today for patients with rheumatoid arthritis and proposes how to reduce outpatient clinic visits without compromising quality and safety.

Research on build exercises that integrate knowledge to solve practical problems in teaching high school students

Based on one of the viewpoints of building the Biology curriculum, which is integrated education and sustainable development education, helps students strengthen and develop the competency to mobilize and apply integrated knowledge, skills in many different fields to effectively solve problems in study and their’ life. Practical problems in teaching Biology are very diverse, associated with daily life and related to other subjects such as environmental protection, health care, response to the Covid-19 epidemic. ..... The article proposes the process of designing and using integrated practice exercises in teaching Biology in high school in order to develop students' competency to solve practical problems

Oncology patient and provider preferences regarding rapid radiology result release to online portals.

1544 Background: Spurred by changes in legislation and technology, rapid patient access to medical results has never been higher. Many health systems now release results of radiology tests within 24 hours of completion, meaning patients may see results before being able to discuss them with the ordering provider. Generally, surveys have demonstrated that patients are in favor of rapid result availability, but research on rapid result release to oncology patients with distinct concerns is scant. Methods: Starting in February 2020, oncology providers throughout Sanford Health, a multi-site primarily rural integrated practice in the upper Midwest were invited to complete an online survey regarding their opinions on rapid result release. Starting in February 2020, oncology patients were invited to complete a similar survey. This survey was open until August 2020, when 100 patients had completed the survey; both surveys contained both categorical and narrative results. Results: Oncology providers had a generally more negative opinion of rapid radiology result release to online portals compared to patients. 65% of patients believed radiology results should be released within 24 hours of resulting; only 12% of providers shared this view. 66% of providers shared that they did not feel comfortable with patients’ ability to interpret radiology results and only 13% felt that “normal” results should be released immediately to an online portal; this number decreased to 3% when results were “abnormal”. Patient opinions on appropriate result release were impacted by test results as well. For “normal” radiology results, 50% of patients favored initial communication be via online portal without discussion with a provider; for “abnormal” results, this number decreased to 28%. 43% of patients had learned of an “abnormal” result via online portal before discussion with a provider; 66% of these patients felt that this was a positive which allowed them to process information prior to the visit; 33% felt that it created undue anxiety. 94% of providers reported having a patient contact them regarding a test result prior to a planned visit, with 60% providers sharing this happens at least once weekly. When asked what improvements could be made to the system currently in place at Sanford, 80% of providers suggested holding radiology results until direct communication with the provider can occur; only 8% of patients suggested the same intervention. Conclusions: Rapid result release is generally a patient satisfier, although oncology patients do distinguish abnormal from normal results in terms of rapid release. It is a dissatisfier for providers both due to concerns regarding patients’ ability to interpret results and due to excess work created by rapid release. Ongoing work should focus on ways to allow patients to access resources to make medical results more interpretable if reviewed prior to provider visits.

Integrated Practice of Metacognitive Strategies And Second Language Writing

Writing is a cardinal skill for effective communication practised extensively from primary education, but the students are not exhibiting adequate writing proficiency in their higher education and at their workplace. This experimental study focuses on enhancing the students’ writing skills by promoting metacognitive strategies in the classroom. The participants of this study are 51 pre-final year Diploma students belonging to the Department of Instrumentation and Control Engineering of an autonomous polytechnic institute in Tamil Nadu. The teacher-researcher has facilitated students’ cognizance with metacognitive strategies employed in the writing tasks administered during the course. The results have exhibited improvement apropos of coherence and unity in the students’ writing skill. It implies the indispensable role of metacognitive strategies in developing the capacity of the learners’ strategic thinking and guiding them to plan, progress, and process their writing into a coherent text.

The new strategic agenda for value transformation

The model for value-based healthcare introduced in 2006 by Porter and Teisberg is still relevant, but it is incomplete. Porter and Teisberg put a strong focus on measuring outcomes, but how to use these measurements to actually improve quality of care has not been described. In addition, value-based healthcare as originally introduced neglects that a true shift from volume to patient value requires a change in culture and way of working of healthcare professionals. The original strategic agenda for value transformation (in short: ‘value agenda’) consists of six elements: organize into Integrated Practice Units (1), measure outcomes and costs for every patient (2), move to bundled payments for care cycles (3), integrate care delivery systems (4), expand geographic reach (5), and build an enabling information technology platform (6). For value-based healthcare to become a reality, the strategic agenda needs to be extended with four elements. First, healthcare providers need to set up a systematic approach for value-based quality improvement. Second, value needs to be integrated in patient communication. Third, we should invest in a culture of value delivery. And fourth, we should build learning platforms for healthcare professionals based on patient outcome data. Best practices on value-based healthcare implementation are working on these four elements in addition to the original value agenda. In conclusion, a new strategic agenda for value transformation is proposed that combines the vision of the founders of value-based healthcare with implementation experience in order to support healthcare providers in their shift to become value-based.