scholarly journals Powerful Lessons from Cuban Medical Education Programs: Fostering the Social Contract in Athletic Training Programs

2019 ◽  
Vol 14 (4) ◽  
pp. 275-282
Author(s):  
Kimberly S. Peer ◽  
Chelsea L. Jacoby
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Patient Care ◽  
Educational Reform ◽  
Athletic Training ◽  
Training Programs ◽  
Health Care Systems ◽  
The United States ◽  
Education And Health ◽  
Care Systems

Context The Cuban medical education and health care systems provide powerful lessons to athletic training educators, clinicians, and researchers to guide educational reform initiatives and professional growth. Objective The purpose of this paper is to provide a brief overview of the Cuban medical education system to create parallels for comparison and growth strategies to implement within athletic training in the United States. Background Cubans have experienced tremendous limitations in resources for decades yet have substantive success in medical education and health care programs. As a guiding practice, Cubans focus on whole-patient care and have established far-reaching research networks to help substantiate their work. Synthesis Cuban medical education programs emphasize prevention, whole-patient care, and public health in a unique approach that reflects disablement models recently promoted in athletic training in the United States. Comprehensive access and data collection provide meaningful information for quality improvement of education and health care processes. Active community engagement, education, and interventions are tailored to meet the biopsychosocial needs of individuals and communities. Results Cuban medical education and health care systems provide valuable lessons for athletic training programs to consider in light of current educational reform initiatives. Strong collaborations and rich integration of disablement models in educational programs and clinical practice may provide meaningful outcomes for athletic training programs. Educational reform should be considered an opportunity to expand the athletic training profession by embracing the evolving role of the athletic trainer in the competitive health care arena. Recommendation(s) Through careful consideration of Cuban medical education and health care initiatives, athletic training programs can better meet the contract with society as health care professionals by integrating the Accreditation Council for Graduate Medical Education's core competencies of patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice now promoted in the Commission on Accreditation of Athletic Training Education's 2020 Standards for Accreditation of Professional Athletic Training Programs. Conclusion(s) Educational and health care outcomes drive change. Quality improvement efforts transcend both education and health care. Athletic training can learn valuable lessons from the Cubans about innovation, preventative medicine, patient-centered community outreach, underserved populations, research initiatives, and globalization. Not unlike Cuba, athletic training has a unique opportunity to embrace the challenges associated with change to create a better future for athletic training students and professionals.

Continental Divide? The Attitudes of US and Canadian Oncologists on the Costs, Cost-Effectiveness, and Health Policies Associated With New Cancer Drugs

2010 ◽  
Vol 28 (27) ◽  
pp. 4149-4153 ◽  
Author(s):  
Scott R. Berry ◽  
Chaim M. Bell ◽  
Peter A. Ubel ◽  
William K. Evans ◽  
Eric Nadler ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Cost Effectiveness ◽  
Health Care Systems ◽  
The United States ◽  
Drug Costs ◽  
Cancer Drug ◽  
Cancer Drugs ◽  
Care Systems ◽  
Effective Treatments

Purpose Oncologists in the United States and Canada work in different health care systems, but physicians in both countries face challenges posed by the rising costs of cancer drugs. We compared their attitudes regarding the costs and cost-effectiveness of medications and related health policy. Methods Survey responses of a random sample of 1,355 United States and 238 Canadian medical oncologists (all outside of Québec) were compared. Results Response rate was 59%. More US oncologists (67% v 52%; P < .001) favor access to effective treatments regardless of cost, while more Canadians favor access to effective treatments only if they are cost-effective (75% v 58%; P < .001). Most (84% US, 80% Canadian) oncologists state that patient out-of-pocket costs influence their treatment recommendations, but less than half the respondents always or frequently discuss the costs of treatments with their patients. The majority of oncologists favor more use of cost-effectiveness data in coverage decisions (80% US, 69% Canadian; P = .004), but fewer than half the oncologists in both countries feel well equipped to use cost-effectiveness information. Majorities of oncologists favor government price controls (57% US, 68% Canadian; P = .01), but less than half favor more cost-sharing by patients (29% US, 41% Canadian; P = .004). Oncologists in both countries prefer to have physicians and nonprofit agencies determine whether drugs provide good value. Conclusion Oncologists in the United States and Canada generally have similar attitudes regarding cancer drug costs, cost-effectiveness, and associated policies, despite practicing in different health care systems. The results support providing education to help oncologists in both countries use cost-effectiveness information and discuss drug costs with their patients.

scholarly journals Η επίδραση του θεσμικού, πολιτικού και διοικητικού περιβάλλοντος στη μεταρρύθμιση του τομέα της υγείας στην Ελλάδα, 1950-2005

2013 ◽  
Author(s):  
Ηλίας Γορανίτης
Keyword(s):  
Health Care ◽  
Health Care Reform ◽  
Health Care Systems ◽  
Implementation Process ◽  
The United States ◽  
International Experience ◽  
Health Care Reforms ◽  
Care Systems ◽  
Veto Points ◽  
Theories Of Change

The Greek NHS, thirty years after its establishment, faces important performance deficiencies. With an ongoing economic crisis placing a further burden, a call for national health care reform is urgent. This doctoral thesis drawing upon (a) political theories of change, (b) institutional, political and administrative developments in Greece as well as (c) international experience, aims to provide a framework, in terms of planning and implementation process, for health care reform in Greece. The existing order of things, in every public policy system, impedes change and forces policies along specific paths, the deviation from which to a new policy paradigm is extremely difficult. The Greek NHS has never deviated from this path indicating the existence of strong interest groups, institutions with high set-up cost and limited political willingness or ability for strategic approach to overcome the ‘veto points’ of the reform in the system. In this thesis the way forward in reforming fragmented and path-dependent health care systems like the Greek NHS has been identified. By addressing big questions such as: How the Greek NHS reached this low performing level? What are the ingredients of a well performing health care system? What factors impede or promote successful reforms? How health care reforms in systems with multiple ‘veto points’ should be implemented? Political science and international experience from Spain, Portugal, Italy, the Netherlands and the United States provide important insights to our study.

scholarly journals Initial experiences of US neurologists in practice during the COVID-19 pandemic via survey

Neurology ◽  
2020 ◽  
Vol 95 (5) ◽  
pp. 215-220 ◽  
Author(s):  
Akanksha Sharma ◽  
Christina R. Maxwell ◽  
Jill Farmer ◽  
Diana Greene-Chandos ◽  
Kathrin LaFaver ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
The United States ◽  
Survey Study ◽  
Practice Model ◽  
Safety Measures ◽  
Public Health Emergencies ◽  
Care Workers ◽  
Rapid Changes ◽  
Care Systems

ObjectiveTo test the hypothesis that US neurologists were experiencing significant challenges with lack of personal protective equipment (PPE), rapid changes in practice, and varying institutional protocols, we conducted this survey study. The current coronavirus disease of 2019 (COVID-19) pandemic has caused widespread disease and death. Rapid increases in patient volumes have exposed weaknesses in health care systems and challenged our ability to provide optimal patient care and adequate safety measures to health care workers (HCWs).MethodsA 36-item survey was distributed to neurologists around the United States through various media platforms.ResultsOver a 1-week period, 567 responses were received. Of these, 56% practiced in academia. A total of 87% had access to PPE, with 45% being asked to reuse PPE due to shortages. The pandemic caused rapid changes in practice, most notably a shift toward providing care by teleneurology, although a third experienced challenges in transitioning to this model. Wide variations were noted both in testing and in the guidance provided for the exposed, sick, or vulnerable HCWs. Notably, 59% of respondents felt that their practices were doing what they could, although 56% did not feel safe taking care of patients.ConclusionsResults from our survey demonstrate significant variability in preparedness and responsiveness to the COVID-19 pandemic in neurology, affected by region, health care setting, and practice model. Practice guidelines from professional societies and other national entities are needed to improve protection for physicians and their patients, promote recommended practice changes during a pandemic, and optimize future preparedness for public health emergencies.

scholarly journals Return to Normalcy? Principles on Resuming Surgical Services in the COVID-19 Era

OTO Open ◽  
2020 ◽  
Vol 4 (2) ◽  
pp. 2473974X2093665
Author(s):  
Taher S. Valika ◽  
Kathleen R. Billings
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Systems ◽  
Lessons Learned ◽  
Drastic Reduction ◽  
The Public ◽  
Surgical Services ◽  
Outpatient Visits ◽  
Care Systems ◽  
Full Capacity

The rapidly changing health care climate related to coronavirus disease 2019 (COVID-19) has resulted in numerous changes to health care systems and in practices that protect both the public and the workers who serve in hospitals around the country. As a result, these past few months have seen a drastic reduction in outpatient visits and surgical volumes. With phased reopening and appropriate guidance, health care systems are attempting to return to normal. Our institution has had the unique opportunity to already return operations back to full capacity. The experiences and lessons learned are described, and we provide guiding principles to allow for a safe and effective return to patient care.

Utilization of Health Care Coalitions and Resiliency Forums in the United States and United Kingdom: Different Approaches to Strengthen Emergency Preparedness

2015 ◽  
Vol 10 (1) ◽  
pp. 161-164 ◽  
Author(s):  
John Walsh ◽  
Allan Graeme Swan
Keyword(s):  
United States ◽  
Health Care ◽  
United Kingdom ◽  
Emergency Management ◽  
Emergency Preparedness ◽  
Health Care Systems ◽  
Management Strategies ◽  
The United States ◽  
The United Kingdom ◽  
Care Systems

ABSTRACTThe process for developing national emergency management strategies for both the United States and the United Kingdom has led to the formulation of differing approaches to meet similar desired outcomes. Historically, the pathways for each are the result of the enactment of legislation in response to a significant event or a series of events. The resulting laws attempt to revise practices and policies leading to more effective and efficient management in preparing, responding, and mitigating all types of natural, manmade, and technological hazards. Following the turn of the 21st century, each country has experienced significant advancements in emergency management including the formation and utilization of 2 distinct models: health care coalitions in the United States and resiliency forums in the United Kingdom. Both models have evolved from circumstances and governance unique to each country. Further in-depth study of both approaches will identify strengths, weaknesses, and existing gaps to meet continued and future challenges of our respective disaster health care systems. (Disaster Med Public Health Preparedness. 2016;10:161–164)

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