scholarly journals Exploring Healthcare Professionals' Use of Narrative Mediation Approaches to Address Disclosure and Apology in the Aftermath of Medical Errors

2016 ◽  
Vol 3 (1) ◽  
pp. 24
Author(s):  
Gerald Monk ◽  
Stacey Sinclair ◽  
Michael Nelson
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Errors ◽  
Narrative Analysis ◽  
Health Care Professionals ◽  
Health Care Systems ◽  
The United States ◽  
Cultural Barriers ◽  
Care Providers ◽  
Care Systems

Despite the overwhelming evidence that suggests that patients, families and health care systems benefit from offering appropriate disclosures and apologies to patients and families following the aftermath of medical errors, few health care organizations in the U.S. invest in providing systemic training in disclosure and apology. Using a narrative analysis this paper explores the cultural barriers in the United States healthcare environment that impede health care providers from engaging in restorative conversations with patients and families when things go wrong. The paper identifies a handful of programs and models that provide disclosure and apology training and argues for the unique contributions of narrative mediation to assist health care professionals to disclose adverse events to patients and families to restore trust.

Integration vs separation in the provision of health care: 24 OECD countries compared

2018 ◽  
Vol 15 (2) ◽  
pp. 160-172 ◽  
Author(s):  
Federico Toth
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Systems ◽  
The United States ◽  
Oecd Countries ◽  
Integrated Model ◽  
Care Providers ◽  
Five Dimensions ◽  
Care Systems ◽  
The Uk

AbstractThis article proposes a classification of the different national health care systems based on the way the network of health care providers is organised. To this end, we present two rivalling models: on the one hand, the integrated model and, on the other, the separated model. These two models are defined based on five dimensions: (1) integration of insurer and provider; (2) integration of primary and secondary care; (3) presence of gatekeeping mechanisms; (4) patient's freedom of choice; and (5) solo or group practice of general practitioners. Each of these dimensions is applied to the health care systems of 24 OECD countries. If we combine the five dimensions, we can arrange the 24 national cases along a continuum that has the integrated model and the separated model at the two opposite poles. Portugal, Spain, New Zealand, the UK, Denmark, Ireland and Israel are to be considered highly integrated, while Italy, Norway, Australia, Greece and Sweden have moderately integrated provision systems. At the opposite end, Austria, Belgium, France, Germany, the Republic of Korea, Japan, Switzerland and Turkey have highly separated provision systems. Canada, The Netherlands and the United States can be categorised as moderately separated.

Who Tweets About Diabetic Foot on Twitter and Which Tweets Are More Attractive?

2020 ◽  
Vol 19 (3) ◽  
pp. 251-254 ◽  
Author(s):  
İrfan Karahan ◽  
Aybüke Yürekli ◽  
Ömer Recep Özcömert ◽  
Birhan Oktaş ◽  
Aydın Çifci
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Diabetic Foot ◽  
Health Care Professionals ◽  
Health Care Systems ◽  
Accurate Information ◽  
Care Providers ◽  
The People ◽  
Patients With Diabetes ◽  
Care Systems

Diabetic foot is a serious problem for health care systems. Twitter can provide communication between people and it might be an informative tool for health care management. The purpose of this study is detecting the people or organizations that tweet about diabetic foot and analyze the interactions of these tweets on Twitter. All tweets containing the keyword “diabetic foot” in April 2019 were collected. The users were separated into 7 groups: patients with diabetes, health care providers, nongovernmental organizations, information sites and communication media, private companies, medical students, and others. Health care professionals and nonprofessionals were evaluated in likes, mentions, and retweets. The major group was health care providers. By 2-group comparisons of professionals and nonprofessionals, all likes, mentions, and retweets were significantly different ( P = .02, P = .04, P < .001, respectively). We concluded that the tweets of health care professionals get more interaction than others. Twitter might be a useful tool to distinguish accurate information about diabetic foot. Also, health care professionals should use for making people aware of the diabetic foot and shed light on society.

scholarly journals Knowledge Translation in Oncology

2019 ◽  
Vol 153 (1) ◽  
pp. 5-13 ◽  
Author(s):  
Sarah Morgan ◽  
Jessica Hanna ◽  
George M Yousef
Keyword(s):  
Health Care ◽  
Knowledge Translation ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Best Practice ◽  
Health Care Systems ◽  
Scientific Evidence ◽  
Clinical Decision ◽  
Care Providers ◽  
Care Systems

Abstract Objectives Knowledge translation (KT) is the dynamic process of mobilizing best-practice evidence to guide health care decisions. Methods Using a PubMed search, challenges were identified and milestones defined. Results Substantial challenges exist in integrating discoveries into patient care, including technical limitations related to genomic testing like turnaround time, standardization, reproducibility, and results interpretation. Other challenges include lack of proper training in genetic counseling for health care providers, clarity of scientific evidence, and ethical, legal and social considerations. In addition, most health care systems lack accessibility to genetic testing services. Moving forward, KT should be addressed at three main frontiers. The first is patients centered for proper understanding and decision making; the second is directed toward health care professionals, including clinical decision support and clarity of roles; and the third addresses resources of health care systems. Conclusions Implementing KT requires developing strategies to enhance awareness and promote behavioral changes congruent with research evidence, designing a systematic approach by health care providers and stakeholders to achieve patient-centered care.

scholarly journals The Challenges of the Health Care Providers in Refugee Settings: A Systematic Review

2019 ◽  
Vol 34 (02) ◽  
pp. 188-196 ◽  
Author(s):  
Nurtaç Kavukcu ◽  
Kerim Hakan Altıntaş
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Systems ◽  
Refugee Health ◽  
Cultural Barriers ◽  
Health Care Provision ◽  
Care Provision ◽  
Care Providers ◽  
Care Systems

Background:All over the world, migration is affecting millions of people who either choose or are forced to leave their countries of origin. Health is considered to be one of the important aspects of migration that is highly influenced by the circumstances created by mobility within or across countries. In the context of forced migration, it is well-established that refugees are susceptible to various diseases and other health conditions which might occur or deteriorate based on the health systems and health care provision in receiving countries. There is a considerable amount of research on the challenges encountered by refugees in receiving countries, in terms of health care systems and services. However, there seems to be little focus on the health care providers’ perspectives of the challenges in health care provision in refugee settings. This review aims to explore some of the articles discussing the challenging issues surrounding refugee health from a provider’s perspective.Methods:A systematic review was conducted through five main online databases: Medline (US National Library of Medicine, National Institutes of Health; Bethesda, Maryland USA); Science Direct (Elsevier; Amsterdam, Netherlands); Scopus (Elsevier; Amsterdam, Netherlands); Sage (Sage Publications; Thousand Oaks, California USA); and Google Scholar (Google Inc.; Mountain View, California USA), including only the articles published in English. In addition, grey literature resources available online were used.Results:Forty-eight articles were included in this review, mainly based on the amount of emphasis they placed on providers’ viewpoints in refugee health settings. Most of the articles were retrieved based on their availability in the databases which Hacettepe University (Ankara, Turkey) is subscribed to. Almost all of the articles mentioned the challenges caused by linguistic and cultural barriers, and some focused on providers’ limited knowledge and skills, as well as inefficient health care systems. There was little emphasis on ethical discussions, and the physical and emotional impact of caring for refugees on health care professionals. In the few articles discussing ethical and personal dimensions, issues concerning stress, burnout, and safety risks were found to be the recurring themes.Conclusions:Evidence gathered suggests that the challenges faced by health care providers involve a variety of factors that are specific to health care settings involving refugees, such as linguistic and cultural barriers, and a lack of proper support and training. It seems that the challenges that health care providers face in refugee settings could be further investigated both from professional and personal aspects for a better understanding of refugee health care.Kavukcu N, Altıntaş KH. The challenges of the health care providers in refugee settings: a systematic review. Prehosp Disaster Med. 2019;34(2):188–196

Improving Medication Management by Understanding Patient and Caregiver Preferences for Medication Packaging

2020 ◽  
Vol 35 (10) ◽  
pp. 446-464
Author(s):  
Joshua Chou ◽  
Merton Lee ◽  
Taylor Kaminsky ◽  
Tarlan Namvar ◽  
Catherine E. Cooke ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Medication Management ◽  
The United States ◽  
Community Dwelling ◽  
Care Providers ◽  
Font Size ◽  
Visual Appearance ◽  
June July

OBJECTIVE: To assess older adults' perceptions and preferences when comparing multi-medication packaging products.<br/> DESIGN: Qualitative study involving focus group interviews (FGIs) and key informant interviews (KIIs).<br/> SETTING: Interviews were conducted in multiple cities within the United States during June-July 2019.<br/> PATIENTS, PARTICIPANTS: FGI participants (N=36) included community dwelling adults, 65 years of age or older, who took 5+ chronic medications, or their caregivers. KII participants (N=15) included health care professionals caring for similar populations.<br/> INTERVENTIONS: Participants were given samples of blister packs and pouches and asked about medication management and appearance and usability of medication packaging. Interviews were audio-recorded with participants' consent, then transcribed and coded using Atlas. ti. Recurrent and emergent themes were identified, and selected quotes served as examples of identified themes.<br/> MAIN OUTCOME MEASURE: Participants' perceptions regarding medication packaging.<br/> RESULTS: Participants' preferences varied for different multi-medication packaging systems. Similarly, most FGI participants did not communicate a strong attitude for or against their existing management systems. However, many FGI participants perceived a need for larger font size than seen on the either of the multimedication packaging samples. KII participants also preferred a larger font size on both packagings. KII participants thought the blister packs offered better visual organization and enabled caregivers to quickly assess adherence. However, KII participants expressed concern about integrating as-needed and short-term use medications and noted difficulty opening both types of packages.<br/> CONCLUSION: Visual appearance is important to both patients and health care providers. Continued research in this area is vital for tailoring packaging types and technology to patients.

Improving Patient Safety with Information Technology

2010 ◽  
pp. 144-152 ◽  
Author(s):  
James G. Anderson
Keyword(s):  
Health Care ◽  
Information Technology ◽  
Medication Errors ◽  
Health Care Providers ◽  
Adverse Drug Events ◽  
Health Care Systems ◽  
Simulation Models ◽  
Care Providers ◽  
Care Systems ◽  
Computer Simulation Models

Over three-quarters of a million people are injured or die in hospitals annually from adverse drug events. The majority of medication errors result from poorly designed health care systems rather than from negligence on the part of health care providers. Health care systems, in general, rely on voluntary reporting which seriously underestimates the number of medication errors and adverse drug events (ADEs) by as much as 90%. This chapter reviews the literature on (1) the incidence and costs of medication errors and ADEs; (2) detecting and reporting medication errors and related ADEs; (3) and the use of information technology to reduce the number of medication errors and ADEs in health care settings. Results from an analysis of data on medication errors from a regional data sharing consortium and from computer simulation models designed to analyze the effectiveness of information technology (IT) in preventing medication errors are summarized.

Patient Choice and Patient Empowerment in Northern European Health Systems: A Conceptual Framework

1994 ◽  
Vol 24 (2) ◽  
pp. 201-229 ◽  
Author(s):  
Richard B. Saltman
Keyword(s):  
Health Care ◽  
Health Systems ◽  
Health Care Providers ◽  
Health Care Systems ◽  
Patient Empowerment ◽  
Patient Choice ◽  
Care Providers ◽  
Care Systems ◽  
European Health ◽  
The Impact

The issue of patient choice presents a complicated challenge to publicly operated health systems. Increased patient choice can strengthen the citizen's commitment to traditional welfare state objectives, or alternatively, it can severely damage that commitment, depending upon the design of the choice mechanism and the structural context within which patient choice occurs. For patient choice to be linked to true empowerment, choice must reinforce rather than undercut the accountability of health care providers to the population they serve. This article explores the basic issues involved in empowering patients within publicly operated health systems. The author first reviews the conceptual components that could or should be incorporated within the notion of empowered patients, then examines what would be required to actually empower patients within health systems, defined in terms of expanding not only logistical choice but also clinical influence and decision-making participation. The article concludes with a wide-ranging analysis of the impact of potential policies and mechanisms on the long-term objectives of achieving democratically accountable health care systems.

scholarly journals A Consensus-Based Set of Measures for Oral Health Care

2017 ◽  
Vol 96 (8) ◽  
pp. 881-887 ◽  
Author(s):  
F. Baâdoudi ◽  
A. Trescher ◽  
D. Duijster ◽  
N. Maskrey ◽  
F. Gabel ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Health Care Providers ◽  
Health Care Systems ◽  
Routine Data ◽  
Oral Health Care ◽  
Care Providers ◽  
Patient Centered ◽  
Dental Practitioners ◽  
Care Systems

Increasingly more responsive and accountable health care systems are demanded, which is characterized by transparency and explicit demonstration of competence by health care providers and the systems in which they work. This study aimed to establish measures of oral health for transparent and explicit reporting of routine data to facilitate more patient-centered and prevention-oriented oral health care. To accomplish this, an intermediate objective was to develop a comprehensive list of topics that a range of stakeholders would perceive as valid, important, and relevant for describing oral health and oral health care. A 4-stage approach was used to develop the list of topics: 1) scoping of literature and its appraisal, 2) a meeting of experts, 3) a 2-stage Delphi process (online), and 4) a World Café discussion. The aim was to create consensus through structured conversations via a range of stakeholders (general dental practitioners, patients, insurers, and policy makers) from the Netherlands, Germany, the United Kingdom, Ireland, Hungary, and Denmark. The study was part of the ADVOCATE project, and it resulted in a list of 48 topics grouped into 6 clusters: 1) access to dental care, 2) symptoms and diagnosis, 3) health behaviors, 4) oral treatments, 5) oral prevention, and 6) patient perception. All topics can be measured, as they all have a data source with defined numerators and denominators. This study is the first to establish a comprehensive and multiple-stakeholder consented topic list designed for guiding the implementation of transparent and explicit measurement of routine data of oral health and oral health care. Successful measurement within oral health care systems is essential to facilitate learning from variation in practice and outcomes within and among systems, and it potentiates improvement toward more patient-centered and prevention-oriented oral health care.

Linking School Nurses With Health Care Systems Using EHRs: An Integrative Review

2020 ◽  
pp. 105984052091332
Author(s):  
Christina Baker ◽  
Bonnie Gance-Cleveland
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Systems ◽  
Health Care Team ◽  
School Nurses ◽  
Care Providers ◽  
Health Records ◽  
School Aged Children ◽  
Team Care ◽  
Care Systems

School-aged children spend around 1,080 hr at school each year and many of them have chronic diseases; therefore, it is imperative to include school nurses as part of the health care team. Care coordination between health care providers and school nurses is currently hindered by communication that relies on an inadequate system of fax, phone, and traditional mail. Using electronic health records (EHRs) to link school nurses and health care systems is usually limited in scope despite EHRs advancement in these health care systems. No literature is currently available showing the number of hospitals and health care systems that provide EHR access to school nurses. The purpose of this article was to present a literature review on EHR access for school nurses nationally. This review along with the legal and logistical considerations for this type of implementation will be discussed.

Dancing With Death in the Dust of Coronavirus: The Lived Experience of Iranian Nurses

2020 ◽  
Vol 26 (4) ◽  
pp. e82-e89
Author(s):  
Fatemeh Bahramnezhad ◽  
Parvaneh Asgari
Keyword(s):  
Health Care ◽  
Lived Experience ◽  
Health Care Providers ◽  
Health Care Systems ◽  
Phenomenological Approach ◽  
Care Providers ◽  
Care Systems ◽  
Interpretative Phenomenological Approach ◽  
Communication Challenges ◽  
Novel Coronavirus

The novel coronavirus disease (COVID-19) pandemic as a public health emergency poses dramatic challenges for health-care systems. The experiences of health-care workers are important in planning for future outbreaks of infectious diseases. This study explored the lived experiences of 14 nurses in Tehran, Iran caring for coronavirus patients using an interpretative phenomenological approach as described by Van Manen. In-depth interviews were audio-recorded between March 10 and May 5, 2020. The essence of the nurses' experiences caring for patients with COVID-19 was categorized as three themes and eight subthemes: (a) Strong pressure because of coronavirus: initial fear, loneliness, communication challenges, exhaustion. (b) Turn threats into opportunities: improvement of nursing image, professional development. (c) Nurses' expectations: expectations of people, expectations of government. The findings of this study showed that identifying the challenges and needs of health-care providers is necessary to create a safe health-care system and to prepare nurses and expand their knowledge and attitudes to care for patients in new crises in the future.

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