scholarly journals Test Utilization Management in Today's Healthcare Environment

2015 ◽  
Vol 8 (1) ◽  
pp. 3-3
Author(s):  
E. Blair Holladay
Keyword(s):  
Utilization Management ◽  
Healthcare Environment

Cardiology Fellowship Education in the Era of High-density Training, Data Tracking, and Quality Measures

2011 ◽  
Vol 9 (2) ◽  
pp. 99
Author(s):  
Alex J Auseon ◽  
Albert J Kolibash ◽  
◽  
Keyword(s):  
Ohio State University ◽  
Training Data ◽  
State University ◽  
Training Requirements ◽  
Healthcare Environment ◽  
Medical Centers ◽  
Work Hour ◽  
The Ohio State University ◽  
Data Tracking

Background:Educating trainees during cardiology fellowship is a process in constant evolution, with program directors regularly adapting to increasing demands and regulations as they strive to prepare graduates for practice in today’s healthcare environment.Methods and Results:In a 10-year follow-up to a previous manuscript regarding fellowship education, we reviewed the literature regarding the most topical issues facing training programs in 2010, describing our approach at The Ohio State University.Conclusion:In the midst of challenges posed by the increasing complexity of training requirements and documentation, work hour restrictions, and the new definitions of quality and safety, we propose methods of curricula revision and collaboration that may serve as an example to other medical centers.

scholarly journals More comprehensively measuring quality of life in life-threatening illness: the McGill Quality of Life Questionnaire – Expanded

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
S. Robin Cohen ◽  
Lara B. Russell ◽  
Anne Leis ◽  
Javad Shahidi ◽  
Pat Porterfield ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Second Order ◽  
Model Fit ◽  
Life Questionnaire ◽  
Quality Of Life Questionnaire ◽  
Healthcare Environment ◽  
Life Threatening Illness ◽  
Life Threatening ◽  
Order Factor

Abstract Background Domains other than those commonly measured (physical, psychological, social, and sometimes existential/spiritual) are important to the quality of life of people with life-threatening illness. The McGill Quality of Life Questionnaire (MQOL) – Revised measures the four common domains. The aim of this study was to create a psychometrically sound instrument, MQOL – Expanded, to comprehensively measure quality of life by adding to MQOL-Revised the domains of cognition, healthcare, environment, (feeling like a) burden, and possibly, finance. Methods Confirmatory factor analyses were conducted on three datasets to ascertain whether seven new items belonged with existing MQOL-Revised domains, whether good model fit was obtained with their addition as five separate domains to MQOL-Revised, and whether a second-order factor representing overall quality of life was present. People with life-threatening illnesses (mainly cancer) or aged > 80 were recruited from 15 healthcare sites in seven Canadian provinces. Settings included: palliative home care and inpatient units; acute care units; oncology outpatient clinics. Results Good model fit was obtained when adding each of the five domains separately to MQOL-Revised and for the nine correlated domains. Fit was acceptable for a second-order factor model. The financial domain was removed because of low importance. The resulting MQOL-Expanded is a 21-item instrument with eight domains (fit of eight correlated domains: Comparative Fit Index = .96; Root Mean Square Error of Approximation = .033). Conclusions MQOL-Expanded builds on MQOL-Revised to more comprehensively measure the quality of life of people with life-threatening illness. Our analyses provide validity evidence for the MQOL-Expanded domain and summary scores; the need for further validation research is discussed. Use of MQOL-Expanded will enable a more holistic understanding of the quality of life of people with a life-threatening illness and the impact of treatments and interventions upon it. It will allow for a better understanding of less commonly assessed but important life domains (cognition, healthcare, environment, feeling like a burden) and their relationship to the more commonly assessed domains (physical, psychological, social, existential/spiritual).

Evaluations for New Healthcare Environment Commissioning and Operational Decision Making Using Simulation and Human Factors: A Case Study of an Interventional Trauma Operating Room

2021 ◽  
pp. 193758672199966
Author(s):  
Mirette Dubé ◽  
Jason Laberge ◽  
Elaine Sigalet ◽  
Jonas Shultz ◽  
Christine Vis ◽  
...  
Keyword(s):  
Decision Making ◽  
Human Factors ◽  
Operating Room ◽  
Healthcare Services ◽  
Healthcare Team ◽  
Healthcare Environment ◽  
New Process ◽  
Timely Access ◽  
Operational Decision Making

Purpose: The aim of this article is to provide a case study example of the preopening phase of an interventional trauma operating room (ITOR) using systems-focused simulation and human factor evaluations for healthcare environment commissioning. Background: Systems-focused simulation, underpinned by human factors science, is increasingly being used as a quality improvement tool to test and evaluate healthcare spaces with the stakeholders that use them. Purposeful real-to-life simulated events are rehearsed to allow healthcare teams opportunity to identify what is working well and what needs improvement within the work system such as tasks, environments, and processes that support the delivery of healthcare services. This project highlights salient evaluation objectives and methods used within the clinical commissioning phase of one of the first ITORs in Canada. Methods: A multistaged evaluation project to support clinical commissioning was facilitated engaging 24 stakeholder groups. Key evaluation objectives highlighted include the evaluation of two transport routes, switching of operating room (OR) tabletops, the use of the C-arm, and timely access to lead in the OR. Multiple evaluation methods were used including observation, debriefing, time-based metrics, distance wheel metrics, equipment adjustment counts, and other transport route considerations. Results: The evaluation resulted in several types of data that allowed for informed decision making for the most effective, efficient, and safest transport route for an exsanguinating trauma patient and healthcare team; improved efficiencies in use of the C-arm, significantly reduced the time to access lead; and uncovered a new process for switching OR tabletop due to safety threats identified.

scholarly journals A Risk Exchange: Health and Mobility in the Context of Climate and Environmental Change in Bangladesh—A Qualitative Study

2021 ◽  
Vol 18 (5) ◽  
pp. 2629
Author(s):  
Patricia Nayna Schwerdtle ◽  
Kate Baernighausen ◽  
Sayeda Karim ◽  
Tauheed Syed Raihan ◽  
Samiya Selim ◽  
...  
Keyword(s):  
Climate Change ◽  
Mental Health ◽  
Quality Of Care ◽  
Health Risks ◽  
Thematic Analysis ◽  
Health Determinants ◽  
Physical And Mental Health ◽  
Health And Wellbeing ◽  
Healthcare Environment

Background: Climate change influences patterns of human mobility and health outcomes. While much of the climate change and migration discourse is invested in quantitative predictions and debates about whether migration is adaptive or maladaptive, less attention has been paid to the voices of the people moving in the context of climate change with a focus on their health and wellbeing. This qualitative research aims to amplify the voices of migrants themselves to add nuance to dominant migration narratives and to shed light on the real-life challenges migrants face in meeting their health needs in the context of climate change. Methods: We conducted 58 semi-structured in-depth interviews with migrants purposefully selected for having moved from rural Bhola, southern Bangladesh to an urban slum in Dhaka, Bangladesh. Transcripts were analysed using thematic analysis under the philosophical underpinnings of phenomenology. Coding was conducted using NVivo Pro 12. Findings: We identified two overarching themes in the thematic analysis: Firstly, we identified the theme “A risk exchange: Exchanging climate change and health risks at origin and destination”. Rather than describing a “net positive” or “net negative” outcome in terms of migration in the context of climate change, migrants described an exchange of hazards, exposures, and vulnerabilities at origin with those at destination, which challenged their capacity to adapt. This theme included several sub-themes—income and employment factors, changing food environment, shelter and water sanitation and hygiene (WaSH) conditions, and social capital. The second overarching theme was “A changing health and healthcare environment”. This theme also included several sub-themes—changing physical and mental health status and a changing healthcare environment encompassing quality of care and barriers to accessing healthcare. Migrants described physical and mental health concerns and connected these experiences with their new environment. These two overarching themes were prevalent across the dataset, although each participant experienced and expressed them uniquely. Conclusion: Migrants who move in the context of climate change face a range of diverse health risks at the origin, en route, and at the destination. Migrating individuals, households, and communities undertake a risk exchange when they decide to move, which has diverse positive and negative consequences for their health and wellbeing. Along with changing health determinants is a changing healthcare environment where migrants face different choices, barriers, and quality of care. A more migrant-centric perspective as described in this paper could strengthen migration, climate, and health governance. Policymakers, urban planners, city corporations, and health practitioners should integrate the risk exchange into practice and policies.

scholarly journals Pediatric intrathecal baclofen management during the COVID-19 pandemic in the US and Canada

2020 ◽  
Vol 13 (3) ◽  
pp. 379-384
Author(s):  
Sruthi P. Thomas ◽  
Christina K. Hardesty ◽  
Kristin A. Buxton ◽  
Andrew B. Collins ◽  
Jessica Pruente ◽  
...  
Keyword(s):  
Rehabilitation Medicine ◽  
Intrathecal Baclofen ◽  
Healthcare Systems ◽  
Pediatric Rehabilitation ◽  
Medicine Management ◽  
Healthcare Environment ◽  
The Us ◽  
The World ◽  
Pediatric Rehabilitation Medicine

The COVID-19 pandemic has been a challenge to healthcare systems around the world. Within pediatric rehabilitation medicine, management of intrathecal baclofen has been particularly challenging. This editorial reviews how programs in the US and Canada coped with the quickly changing healthcare environment and how we can learn from this pandemic to be prepared for future crises.

Adaptive Evolution in Rapid Assessments: A 25-Year Perspective

2019 ◽  
Vol 35 (2) ◽  
pp. 77-81
Author(s):  
Paula Corabian ◽  
Bing Guo ◽  
Carmen Moga ◽  
N. Ann Scott
Keyword(s):  
Best Practice ◽  
Health Technology ◽  
Developmental Changes ◽  
Symbiotic Relationship ◽  
Health Ministry ◽  
The Past ◽  
Healthcare Environment ◽  
Dynamic Relationship ◽  
Alberta Health ◽  
Over Time

AbstractObjectivesThis article retrospectively examines the evolution of rapid assessments (RAs) produced by the Health Technology Assessment (HTA) Program at the Institute of Health Economics over its 25-year relationship with a single requester, the Alberta Health Ministry (AHM).MethodsThe number, types, and methodological attributes of RAs produced over the past 25 years were reviewed. The reasons for developmental changes in RA processes and products over time were charted to document the push–pull tension between AHM needs and the HTA Program's drive to meet those needs while responding to changing methodological benchmarks.ResultsThe review demonstrated the dynamic relationship required for HTA researchers to meet requester needs while adhering to good HTA practice. The longstanding symbiotic relationship between the HTA Program and the AHM initially led to increased diversity in RA types, followed by controlled extinction of the less fit (useful) “transition species.” Adaptations in RA methodology were mainly driven by changes in best practice standards, requester needs, the healthcare environment, and staff expertise and technology.ConclusionsRAs are a useful component of HTA programs. To remain relevant and useful, RAs need to evolve according to need within the constraints of HTA best practice.

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