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Quality Indicators in Endometriosis Surgery
Published in Nazar N. Amso, Saikat Banerjee, Endometriosis, 2022
Caryl M. Thomas, Richard J. Penketh
This report led to a worldwide recognition of the need to improve data collection and effectively monitor the quality and safety of care delivered by healthcare providers (1). Measuring performance in healthcare is a way of evaluating the success of the organization, attaining patient satisfaction and comparing actual versus expected outcomes (7). Key performance indicators (KPIs) are specific and measurable elements of practice used to assess the performance of current standards against the desired, evidence-based standards (8) (e.g., hospital readmission rates, patient waiting times until treatment). They are quantitative measures designed to systematically monitor, evaluate and improve care (8). KPIs are not designed to directly measure quality; instead, they are used as tools to alert the system of areas in which performance could be improved (9).
Ethics of Medical Product Development
Published in Howard Winet, Ethics for Bioengineering Scientists, 2021
There are external pressures that challenge the success of a medical product. One challenge is the constant threat of liability lawsuits that may or may not have merit, but in any case, increase the cost of producing the product. Another challenge is the pressure to sell the product in the face of competition. This challenge may lead to overselling that will raise expectations of patients beyond the capabilities of the product. A human reaction to a product’s failure to fulfill expectations is disappointment that may lead to what is essentially a “false advertising” lawsuit.
The Patient Ergonomics Approach to Care Transitions
Published in Rupa S. Valdez, Richard J. Holden, The Patient Factor, 2021
Nicole E. Werner, Rachel A. Rutkowski, Alicia I. Arbaje
Much of the current structure of the healthcare system does not facilitate care transitions. For example, the fragmented nature of the healthcare system, where healthcare organizations and healthcare providers often function in ways that are independent from one another, makes communication and coordination a challenge and often leads to ambiguity as to who is responsible for care transition success (Schoenborn et al., 2013). Further, incentives and reimbursement structures are such that provider time spent coordinating care is not financially beneficial for organizations. The healthcare system technological structure also does not support care transitions in that electronic health record systems are often not interoperable across settings and processes of information transfer differ between organizations. For example, even if a healthcare provider makes an effort to share pertinent patient information with a subsequent healthcare provider, studies have found that only a fraction of the sender’s intended message and information is received by the receiving entity (Anderson & Helms, 1995). Without either a universal platform for sharing patient information or provider willingness or ability to follow patients across healthcare settings, the burden of facilitating care transitions continually falls on patients and caregivers (Scott et al., 2017).
“Ego massaging that helps”: a framework analysis study of internal medicine trainees’ interprofessional collaboration approaches
Published in Medical Education Online, 2023
Joanne Kerins, Samantha Eve Smith, Victoria Ruth Tallentire
This study uses the framework for interprofessional collaboration (IPC) outlined by Bainbridge and Regehr in 2015 as its conceptual backbone [23]. Bainbridge and Regehr argue that ‘individual ways of thinking’ should be considered to promote IPC, shifting the focus from team behaviours [23]. Four domains are included for training in IPC: building social capital; perspective taking; negotiating priorities and resources; and conflict management. To date, there has been little empirical testing of how such individual approaches to developing collaborative networks might translate to the workplace. Alternative perspectives on IPC, such as competency frameworks, have been developed including domains such as communication and teamwork [28]. However, how to succeed in these domains, and specifically how to train healthcare professionals to succeed, remains elusive. Bainbridge and Regehr’s framework was chosen for this study due to its tangible approaches to collaboration in practice, such as negotiation strategies [23].
Physiotherapists’ perceptions of implementing evidence-based practice for patients with low back pain through the Enhanced Transtheoretical Model Intervention: a qualitative study
Published in Physiotherapy Theory and Practice, 2023
Ron Feldman, Sharon Haleva-Amir, Tamar Pincus, Noa Ben Ami
Our findings indicate that PTs are willing to adopt ETMI in a broad, patient-centered, evidence-based treatment approach that aligns with current clinical guidelines. Yet there are some significant barriers to overcome such as PTs communication and education, individual’s reluctance to change their daily routine, inter professional collaboration and health care complexity. According to the PTs, the adoption of ETMI can be achieved by a fundamental change in their role perception and professional identity. Success in implementation relies heavily on a deeper understanding and acceptance of the current clinical guidelines, addressing personal and professional barriers such as lack of confidence in conveying a clear and reassuring message, lack of psychosocial skills, and an inter-collegial collaboration with physicians. These align with the current literature, which emphasizes the importance of PTs psychosocial qualification as well as reassurance capabilities, in the success of implementation (Cowell et al., 2018; Holopainen et al., 2020; Kongsted et al., 2019).
Unanticipated 30-day readmission following rectosigmoid resection at the time of cytoreductive surgery in patients with advanced stage ovarian cancer
Published in Journal of Obstetrics and Gynaecology, 2021
Brooke E. Sanders, Samah Saharti, Katharina Laus, Robert E. Bristow, Ramez N. Eskander
Previously identified risk factors for readmission include the presence of comorbid conditions, increased estimated blood loss at time of surgery, protein-calorie malnutrition, American Society of Anaesthesiologists score of 3 or higher, ascites and post-operative complications at initial admission (Fauci et al. 2011; AlHilli et al. 2015). Common causes for readmission include ileus, thromboembolic events, pleural effusions/ascites, surgical site infection/wound complications (Fauci et al. 2011; AlHilli et al. 2015). Identifying which patients are at higher risk for these morbidities, and perhaps developing interventions to prevent readmission, is important in the care of ovarian cancer patients. Further, in the current health care environment, quality of care metrics are increasingly salient to the success of physician practices and hospital systems. It has been estimated that unanticipated readmissions account for over 40 billion dollars each year (Jencks et al. 2009; Berwick and Hackbarth 2012). Thus, avoiding unanticipated hospital admissions has beneficial implications not only for patient and provider, but also for the health care system in general.