Cochlear Implants: How “Team Work” Can Take the “Guess Work” Out of Patient Care

2009 ◽  
Vol 10 (4) ◽  
pp. 115-122
Author(s):  
Avanti Lal ◽  
Stacy Simek ◽  
Jennifer Still ◽  
Lisa Weber
Keyword(s):  
Best Practices ◽  
Cochlear Implant ◽  
Patient Care ◽  
Cochlear Implants ◽  
Interdisciplinary Approach ◽  
Team Work ◽  
Comprehensive Care ◽  
Memorial Hospital ◽  
Team Model ◽  
Over Time

Abstract The Children's Memorial Hospital cochlear implant team believes an interdisciplinary approach is essential for the implementation of best practices when working with the pediatric cochlear implant population. Over time, we have developed a team model that builds relationships with members of the community to ensure comprehensive care for patients and their families.

scholarly journals Best Practices in Specialized Amyloidosis Centers in the United States: A Survey of Cardiologists, Nurses, Patients, and Patient Advocates

2021 ◽  
Vol 15 ◽  
pp. 117954682110152
Author(s):  
Jose Nativi-Nicolau ◽  
Nitasha Sarswat ◽  
Johana Fajardo ◽  
Muriel Finkel ◽  
Younos Abdulsattar ◽  
...  
Keyword(s):  
Best Practices ◽  
Patient Care ◽  
Nurse Practitioners ◽  
Healthcare Providers ◽  
Multidisciplinary Care ◽  
The United States ◽  
Comprehensive Care ◽  
Patient Support ◽  
Patient Support Group ◽  
Patient Advocates

Background: Because transthyretin amyloid cardiomyopathy (ATTR-CM) poses unique diagnostic and therapeutic challenges, referral of patients with known or suspected disease to specialized amyloidosis centers is recommended. These centers have developed strategic practices to provide multidisciplinary comprehensive care, but their best practices have not yet been well studied as a group. Methods: A qualitative survey was conducted by telephone/email from October 2019 to February 2020 among eligible healthcare providers with experience in the management of ATTR-CM at US amyloidosis centers, patients with ATTR-CM treated at amyloidosis centers, and patient advocates from amyloidosis patient support groups. Results: Fifteen cardiologists and 9 nurse practitioners/nurses from 15 selected amyloidosis centers participated in the survey, with 16 patients and 4 patient advocates. Among participating healthcare providers, the most frequently cited center best practices were diagnostic capability, multidisciplinary care, and time spent on patient care; the greatest challenges involved coordination of patient care. Patients described the “ideal” amyloidosis program as one that provides physicians with expertise in ATTR-CM, sufficient time with patients, comprehensive patient care, and opportunities to participate in research/clinical trials. The majority of centers host patient support group meetings, and patient advocacy groups provide support for centers with physician/patient education and research. Conclusions: Amyloidosis centers offer comprehensive care based on staff expertise in ATTR-CM, a multidisciplinary approach, advanced diagnostics, and time dedicated to patient care and education. Raising awareness of amyloidosis centers’ best practices among healthcare providers can reinforce the benefits of early referral and comprehensive care for patients with ATTR-CM.

Exploring Technology Evolution Using Patent Classification: A Case of Cochlear Implant Technology Patents

2017 ◽  
Vol 14 (01) ◽  
pp. 1740002 ◽  
Author(s):  
Srigowtham Arunagiri ◽  
Mary Mathew
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implants ◽  
Patent Data ◽  
Technology Evolution ◽  
Medical Products ◽  
Patent Classification ◽  
Analysis Technique ◽  
Dominant Classes ◽  
D Investment ◽  
Over Time

Understanding technology evolution through periodic landscaping is an important stage of strategic planning in R&D management. In fields like that of healthcare, where initial R&D investment is huge and good medical products serve patients better, activities of periodic landscaping become crucial for planning. Approximately 5% of the world’s population has hearing disabilities. Current hearing aid products meet less than 10% of the global needs. Patent data and classifications on cochlear implants from 1977–2010 show the technology evolution in the area of such an implant. We attempt to highlight emergence and disappearance of patent classes over a period of time indicating changes in growth of cochlear implant technologies. Using network analysis technique we explore and capture the technology evolution in patent classes by showing what emerged or disappeared over time. Dominant classes are identified. The sporadic influence of university research in cochlear implants is also discussed.

584 Maintaining Success in Patient Safety and Quality Metrics Through Teamwork and Contextual Modification

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S133-S134
Author(s):  
Mini Thomas ◽  
Aemilio W Ha ◽  
Victor C Joe ◽  
Theresa L Chin ◽  
Nicole O Bernal
Keyword(s):  
Best Practices ◽  
Patient Care ◽  
Quality Metrics ◽  
Team Work ◽  
The Other ◽  
Patient Harm ◽  
Improvement Project ◽  
Quality Metric ◽  
Hospital Leadership ◽  
Burn Unit

Abstract Introduction Hospitals constantly invest heavily in improving patient quality and safety metrics. Oftentimes, success is achievable for a single parameter but becomes challenging to achieve in all quality metrics. Our Burn Unit aimed for overarching principles of teamwork and contextual modification to obtain outstanding quality metrics in all six areas of patient quality. This quality improvement project aimed at reducing patient harms related to CLABSI, CAUTI, VTE, C.Diff, Falls, and HAPI. Methods Hospital leadership launched a dashboard of all six patient harm areas that is updated and reported daily during the leadership huddle. Apart from ensuring best practices for each quality metric, Burn Unit focused on teamwork and contextual modifications. Team work: Utilizing engaged multidisciplinary team, apparent cause analysis of identified cases helped in detecting fallibilities. Additionally, proactive actions were implemented for high risk patients by routine audits and discussions during daily rounds. Frequent reminders, appreciations, and celebration of success were also helpful strategies. Contextual modification: Unit and population specific interventions were actively sought for each quality metric. For HAPI, delineating existing burns or skin conditions from that of hospital acquired pressure injury helped to eliminate false positives. Identification and modification of patient care environment was vital in reducing the number of falls. Chlorhexidine gluconate bathing of burn wounds reduced the bioburden to help decrease CAUTI/CLABSIs. Results Burn Unit events related to CLABSI, CAUTI, VTE, C.Diff, Falls, and HAPI were compared to other ICUs, Step down, Telemetry, and Med-Surg units. The BICU was below national benchmarks for all six quality indicators and had outstanding success within the hospital. Our last patient harm was 328 days ago compared to the other 11 units which averaged 32 days. In the non-ICU units, Falls were the most frequent patient harm compared to CLABSI or CAUTIS for the ICUs. In Comparing to previous year, in 2019, BICU progressed in CAUTI, Falls, and HAPI while sustaining 2018 excellence in the other three areas. Conclusions Quality metrics can be simultaneously achieved by strengthening team work and contextual modifications beyond following best practices and protocols. Applicability of Research to Practice Quality metrics can be simultaneously achieved by strengthening team work and contextual modifications beyond following best practices and protocols. Strong teamwork from engaged staff and contextual modifications should be intertwined with scientific evidences for obtaining quality metrics in patient care.

Vowel and Diphthong Production by Young Users of Cochlear Implants and the Relationship Between the Phonetic Level Evaluation and Spontaneous Speech

1993 ◽  
Vol 36 (3) ◽  
pp. 488-502 ◽  
Author(s):  
Nancy Tye-Murray ◽  
Karen Iler Kirk
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implants ◽  
Predictive Value ◽  
Scoring System ◽  
Spontaneous Speech ◽  
Test Session ◽  
Prelingual Deafness ◽  
The Relationship ◽  
Over Time

This investigation assessed how the vowel and diphthong production of young users of cochlear implants varied over time and how performance on the Phonetic Level Evaluation (PLE, Ling, 1976) corresponded with vowel and diphthong production during spontaneous speech. Eight children with prelingual deafness were tested with the PLE on five occasions: before receiving a Cochlear Corporation Nucleus cochlear implant and at the following points after receiving a cochlear implant: 6 months, 12 months, 18 months, and 24 or 36 months. An audiovideo recording of spontaneous speech was obtained at each test session. Performance on the PLE was scored with the scoring system designed by Kirk and Hill-Brown (1985). Performance during spontaneous speaking was scored by referencing a transcription of the spoken message to a transcription of the signed message. The correlations between the PLE and the spontaneous speech measures were weak, suggesting that performance on the PLE has low predictive value for vowel and diphthong production during spontaneous speaking. The results from the spontaneous speech samples collected over time suggest that two changes occurred: (a) vowel and diphthong production became more diverse and (b) production became more accurate. It is suggested that increased access to formant information enables subjects to enlarge their system of phonological performance and refine their motoric ability to establish vowel and diphthong targets.

Reliability of cochlear implants

2005 ◽  
Vol 132 (5) ◽  
pp. 746-750 ◽  
Author(s):  
Jan Maurer ◽  
Nicolaos Marangos ◽  
E. Ziegler
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implants ◽  
Survival Rates ◽  
Implant Survival ◽  
Cumulative Survival ◽  
Indirect Trauma ◽  
Long Time ◽  
Head Neck ◽  
Over Time

BACKGROUND: The long-term reliability of cochlear implants over time is an important issue for patients and cochlear implant teams. The calculation of cumulative survival rates including all hard failures of cochlear implants is suitable to report objectively about cochlear implant reliability. METHODS: This is a report of 192 cochlear implants from different manufacturers in adults (n = 58) and children (n = 134). RESULTS: The overall cumulative implant survival rate was 91.7% for a period of 11 years. The main reasons for hard failures were design errors of the products and direct or indirect trauma to the cochlea implant site (especially in children) with consecutive breaks of the implant body or electrodes. CONCLUSIONS: To improve our knowledge about reliability of cochlear implants more studies on cumulative long time survival of cochlear implants are needed, where functional failures and complications for whatever reason (design, mechanical, electronic, medical) are included. Cochlear implant reliability data should be considered during the choice of an implant for each individual patient. (Otolaryngol Head Neck Surg 2005;132:746-50.)

Cochlear Implants in Children

1987 ◽  
Vol 96 (1_suppl) ◽  
pp. 136-138 ◽  
Author(s):  
W. M. Luxford ◽  
K. I. Berliner ◽  
L. S. Eisenberg ◽  
W. F. House
Keyword(s):  
Cochlear Implant ◽  
Speech Production ◽  
Cochlear Implants ◽  
Deaf Children ◽  
Younger Age ◽  
Total Communication ◽  
Motor Tests ◽  
Improved Performance ◽  
Implant System ◽  
Over Time

The House 3M cochlear implant system is currently undergoing clinical trials in profoundly deaf children aged 2 through 18 years. Although the use of the implant in children continues to be controversial, the evidence to date indicates that this prosthesis can provide significant benefit for a selected population of profoundly deaf children. As of August 1985, a total of 189 children have received the cochlear implant. The majority of these children were deafened by bacterial meningitis. The children as a group show significant improvement of hearing performance and speech production abilities over time. Children implanted at a younger age (under 5 years) show an even more significant improvement in speech skills. Significantly improved speech production occurs in both the oral/aural children (most cases postlingually deaf) and the total communication children (most cases prelingually deaf). Psychological tests have shown improved performance on intelligence measures, perceptual motor tests, and academic achievement ratings. Surgical and postoperative complications have been minimal, with few measurable adverse effects.

Adult and Pediatric Cochlear Implant Programs at the University of Michigan

1996 ◽  
Vol 5 (1) ◽  
pp. 9-19 ◽  
Author(s):  
Teresa A. Zwolan ◽  
Paul R. Kileny ◽  
Susan Zimmerman-Phillips ◽  
Steven A. Telian
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implants ◽  
Clinical Care ◽  
Team Work ◽  
Team Approach ◽  
University Of Michigan ◽  
Rehabilitation Process ◽  
The Past ◽  
The University

The Cochlear Implant Program at the University of Michigan has evolved over the past several years and is strongly dependent on a team approach to clinical care. Members of the team work closely together to assist patients and their families as they participate in the implant evaluation and rehabilitation process. We feel fortunate that we have been able to help so many profoundly deaf individuals and look forward to continued growth and future advances that will inevitably come about in the field of cochlear implants.

Commentary on Chaplain-Physician Interactions From the Chaplain’s Perspective: A Mixed Method Analysis

2021 ◽  
pp. 104990912110030
Author(s):  
Rev George Handzo ◽  
Rev Brian Hughes
Keyword(s):  
Best Practices ◽  
Health System ◽  
Patient Care ◽  
Health Systems ◽  
Mixed Method ◽  
Effective Strategies ◽  
Optimal Patient Care ◽  
Relationship Of ◽  
The Relationship ◽  
Method Analysis

Gomez and her colleagues have presented a helpful study of the relationship of the chaplains in her health system to physicians which highlights several barriers to a well-integrated relationship and thus to more optimal patient care. We have seen these same barriers as we have consulted with health systems nationally and have also identified many best practices that mediate or even eliminate many of these barriers. This commentary describes some of what we have seen as chaplain-generated causes of those barriers and effective strategies that have been employed to overcome them. We also provide some resources for chaplains who wish to institute some of these best practices themselves.

scholarly journals Qualitative assessment of YouTube videos as a source of patient information for cochlear implant surgery

2021 ◽  
pp. 1-4
Author(s):  
C Thomas ◽  
J Westwood ◽  
G F Butt
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implants ◽  
Qualitative Assessment ◽  
Supplementary Information ◽  
Implant Surgery ◽  
Critical Elements ◽  
Positive Elements ◽  
Cochlear Implant Surgery ◽  
Youtube Videos

Abstract Background YouTube is increasingly used as a source of healthcare information. This study evaluated the quality of videos on YouTube about cochlear implants. Methods YouTube was searched using the phrase ‘cochlear implant’. The first 60 results were screened by two independent reviewers. A modified Discern tool was used to evaluate the quality of each video. Results Forty-seven videos were analysed. The mean overall Discern score was 2.0 out of 5.0. Videos scored higher for describing positive elements such as the benefits of a cochlear implant (mean score of 3.4) and scored lower for negative elements such as the risks of cochlear implant surgery (mean score of 1.3). Conclusion The quality of information regarding cochlear implant surgery on YouTube is highly variable. These results demonstrated a bias towards the positive attributes of cochlear implants, with little mention of the risks or uncertainty involved. Although videos may be useful as supplementary information, critical elements required to make an informed decision are lacking. This is of particular importance when patients are considering surgery.

scholarly journals Ethical Considerations on Pediatric Genetic Testing Results in Electronic Health Records

2020 ◽  
Vol 11 (05) ◽  
pp. 755-763
Author(s):  
Shibani Kanungo ◽  
Jayne Barr ◽  
Parker Crutchfield ◽  
Casey Fealko ◽  
Neelkamal Soares
Keyword(s):  
Genetic Testing ◽  
Best Practices ◽  
Health Care Providers ◽  
Genetic Information ◽  
Ethical Issues ◽  
Interdisciplinary Approach ◽  
Care Providers ◽  
Ethical Considerations ◽  
Electronic Health ◽  
Genetic Results

Abstract Background Advances in technology and access to expanded genetic testing have resulted in more children and adolescents receiving genetic testing for diagnostic and prognostic purposes. With increased adoption of the electronic health record (EHR), genetic testing is increasingly resulted in the EHR. However, this leads to challenges in both storage and disclosure of genetic results, particularly when parental results are combined with child genetic results. Privacy and Ethical Considerations Accidental disclosure and erroneous documentation of genetic results can occur due to the nature of their presentation in the EHR and documentation processes by clinicians. Genetic information is both sensitive and identifying, and requires a considered approach to both timing and extent of disclosure to families and access to clinicians. Methods This article uses an interdisciplinary approach to explore ethical issues surrounding privacy, confidentiality of genetic data, and access to genetic results by health care providers and family members, and provides suggestions in a stakeholder format for best practices on this topic for clinicians and informaticians. Suggestions are made for clinicians on documenting and accessing genetic information in the EHR, and on collaborating with genetics specialists and disclosure of genetic results to families. Additional considerations for families including ethics around results of adolescents and special scenarios for blended families and foster minors are also provided. Finally, administrators and informaticians are provided best practices on both institutional processes and EHR architecture, including security and access control, with emphasis on the minimum necessary paradigm and parent/patient engagement and control of the use and disclosure of data. Conclusion The authors hope that these best practices energize specialty societies to craft practice guidelines on genetic information management in the EHR with interdisciplinary input that addresses all stakeholder needs.

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