scholarly journals Valuing variance: the importance of variance analysis in clinical pathways utilisation

2007 ◽  
Vol 31 (4) ◽  
pp. 565 ◽  
Author(s):  
Kate L Hyett ◽  
Mike Podosky ◽  
Nick Santamaria ◽  
Jenni C Ham
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Clinical Pathways ◽  
Service Planning ◽  
Practice Change ◽  
Variance Analysis ◽  
Analysis Software ◽  
Health Service Planning ◽  
Management Techniques ◽  
Clinical Practice Change

Variations from the anticipated course of events in clinical pathways provide valuable information that could be used to improve clinical practice and health service planning. Surprisingly, variance data are rarely collected in health care organisations using clinical pathways. This paper describes a project which aimed to improve reporting and analysis of variance data in a large regional and a smaller rural hospital using clinical pathways for a number of surgical, medical and obstetric procedures. The project used change management techniques and a variance analysis software program to inform clinical practice change.

scholarly journals The Dimensions of Tokenism in Patient and Family Engagement: A Concept Analysis of the Literature

2020 ◽  
Vol 7 (6) ◽  
pp. 1610-1620
Author(s):  
Umair Majid
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
International Association ◽  
Concept Analysis ◽  
Service Planning ◽  
Decision Makers ◽  
Power Relationships ◽  
Health Service Planning ◽  
The Public ◽  
Professional Goals

Patient engagement (PE) has become embedded in discussions about health service planning and quality improvement, and the goal has been to find ways to observe the potential beneficial outcomes associated with PE. Patients and health care professionals use various terms to depict PE, for example, partnership and collaboration. Similarly, tokenism is consistently used to describe PE that has gone wrong. There is a lack of clarity, however, on the meanings and implications of tokenism on PE activities. The objective of this concept analysis was to examine the peer-reviewed and gray literature that has discussed tokenism to identify how we currently understand and use the concept. This review discusses 4 dimensions of tokenism: unequal power, limited impact, ulterior motives, and opposite of meaningful PE. These dimensions explicate the different components, meanings, and implications of tokenism in PE practice. The findings of this review emphasize how tokenism is primarily perceived as negative by supporters of PE, but this attribution depends on patients’ preferences for engagement. In addition, this review compares the dimensions of tokenism with the levels of engagement in the International Association of the Public Participation spectrum. This review suggests that there are 2 gradations of tokenism; while tokenism represents unequal power relationships in favor of health care professionals, this may lead to either limited or no meaningful change or change that is primarily aligned with the personal and professional goals of clinicians, managers, and decision-makers.

scholarly journals PMC12 MODELLING THE VALUE FOR MONEY OF CLINICAL PRACTICE CHANGE: A STOCHASTIC APPLICATION IN DIABETES CARE

2008 ◽  
Vol 11 (6) ◽  
pp. A562-A563
Author(s):  
T Hoomans ◽  
K Abrams ◽  
SMAA Evers ◽  
AJHA Ament ◽  
JL Severens
Keyword(s):  
Clinical Practice ◽  
Diabetes Care ◽  
Practice Change ◽  
Value For Money ◽  
Clinical Practice Change

Modeling the Value for Money of Changing Clinical Practice Change

Medical Care ◽  
2009 ◽  
Vol 47 (10) ◽  
pp. 1053-1061 ◽  
Author(s):  
Ties Hoomans ◽  
Keith R. Abrams ◽  
Andre J. H. A. Ament ◽  
Silvia M. A. A. Evers ◽  
Johan L. Severens
Keyword(s):  
Clinical Practice ◽  
Practice Change ◽  
Value For Money ◽  
Clinical Practice Change

scholarly journals Improving clinical management for consumers with co-existing mentalhealth and substance use disorders

2001 ◽  
Vol 24 (3) ◽  
pp. 118 ◽  
Author(s):  
Margaret J Tobin ◽  
Beth Matters ◽  
Luxin Chen ◽  
Roisin Smith ◽  
Cynthia Stuhlmiller
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Quality Improvement ◽  
Clinical Practice ◽  
Substance Use Disorders ◽  
National Policy ◽  
Practice Change ◽  
Drug Misuse ◽  
Improvement Project ◽  
Clinical Practice Change

Using Quality Improvement project methodology, complex organisational and clinical practice change was broughtabout to improve services for people with co-existing mental health and alcohol and drug misuse. The project describeslocal uptake and adaptation of national and state policy to achieve change that is sustainable within existing resources.Emphasis on engagement of staff and consumers and carers throughout the change was an essential component. Theproject has implications for the introduction of changes in response to other national policy directives.

scholarly journals Development of the Tiers of Service framework to support system and operational planning for children’s healthcare services

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sina Waibel ◽  
Janet Williams ◽  
Yasmin Tuff ◽  
Joanne Shum ◽  
Jennifer Scarr ◽  
...  
Keyword(s):  
Health Care ◽  
British Columbia ◽  
Health Service ◽  
Healthcare Services ◽  
Service Planning ◽  
Health Determinants ◽  
Health Service Planning ◽  
Study Objective ◽  
Final Version ◽  
Service Framework

Abstract Background Providing access to pediatric healthcare services in British Columbia, Canada, presents unique challenges given low population densities spread across large geographic distances combined with a lack of availability of specialist providers in remote areas, leading to quality of care shortcomings and inequalities in care delivery. The study objective was to develop a framework that provides a common language and methodology for defining and planning child and youth healthcare services across the province. Methods The framework was developed in two phases. In Phase 1, a literature and jurisdictional review was completed using the following inclusion criteria: (i) description of a framework focusing on organizing service delivery systems (ii) that supports health service planning, (iii) includes specialty or subspecialty services and (iv) has been published since 2008. In Phase 2, a series of meetings with key provincial stakeholders were held to receive feedback on the developed Tiers of Service framework versions that were based on the literature and jurisdictional review and adjusted to the British Columbian health care context. The final version was endorsed by the Child Health BC Steering Committee. Results Ten medical articles and thirteen jurisdictional papers met the established selection criteria and were included in this study. Most frameworks were developed by the Australian national or state jurisdictions and published in jurisdictional papers (n = 8). Frameworks identified in the medical literature were mainly developed in Canada (n = 3) and the US (n = 3) and focused on maternity, neonatal, critical care and oncology services. Based on feedback received from the expert group, the framework was expanded to include community-based services, prevention and health determinants. The final version of the Tiers of Service framework describes the specific services to be delivered at each tier, which are categorized as Tier 1 (community services) through Tier 6 (sub-specialized services). Two consecutive steps were identified to effectively use the framework for operational and system planning: (i) development of a ‘module’ outlining the responsibilities and requirements to be delivered at each tier; and (ii) assessment of services provided at the health care facility against those described in the module, alignment to a specific tier, identification of gaps at the local, regional and provincial level, and implementation of quality improvement initiatives to effectively address the gaps. Conclusions The benefits of the Tiers of Service framework and accompanying modules for health service planning are being increasingly recognized. Planning and coordinating pediatric health services across the province will help to optimize flow and improve access to high-quality services for children living in British Columbia.

scholarly journals Implementing a Clinical Practice Change: Adopting the Nutrition Care Process

2018 ◽  
Author(s):  
Andrea Carpenter ◽  
Jordan Mann ◽  
Dianna Yanchis ◽  
Alison Campbell ◽  
Laura Vresk
Keyword(s):  
Clinical Practice ◽  
Practice Change ◽  
Care Process ◽  
Nutrition Care ◽  
Nutrition Care Process ◽  
Clinical Practice Change
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