scholarly journals Using Health Care Resources Wisely After the COVID-19 Pandemic: Recommendations to Reduce Low-Value Care

2021 ◽  
Vol 1 (5) ◽  
Author(s):  
Sinwan Basharat ◽  
Karen Born
Keyword(s):  
Health Care ◽  
Long Term Care ◽  
Health Care Systems ◽  
Care Quality ◽  
Choosing Wisely ◽  
Limited Resources ◽  
Term Care ◽  
Health Care Resources ◽  
Care Systems

Low-value tests, treatments, and procedures are an important health care quality problem in Canada and across the world because they provide little clinical benefit, may be harmful for patients, and waste limited resources. Due to the COVID-19 pandemic, health care systems face increased challenges of limited resources, reduced capacity, and a growing backlog of surgeries and other procedures. The pandemic has compelled health care professionals to make challenging decisions to prioritize health care services while coping with increased demand. As Canada emerges from the pandemic and health care systems rebuild and begin to address the backlog of delayed or cancelled services, there is an imperative to introduce lasting changes to reduce low-value care and ensure high-quality care is available to everyone. To help inform efforts for using health care resources wisely and to support decision-making, CADTH and Choosing Wisely Canada convened a 10-member multi-disciplinary panel of clinicians, patient representatives, and health policy experts to review areas of low-value care that can be reduced or limited. This panel reviewed, deliberated, and prioritized 19 recommendations of the more than 400 Choosing Wisely Canada recommendations, the implementation of which can help ensure high-value care after the pandemic. Examples of the 19 recommendations include: Avoiding unnecessary transfers for patients in long-term care to hospitals unless there is an urgent medical need. Limiting blood tests and imaging unless required to answer a specific clinical question or guide treatment. Not transfusing red blood cells for hemodynamically stable patients in the intensive care unit. Not delaying palliative care for patients with serious illness because they are pursuing disease-directed treatment. Moreover, the panel’s discussion highlighted how the selected recommendations can advance key priorities, including improving health equity and access to care, appropriately using limited resources, emphasizing patient-focused care, and addressing challenges the pandemic has presented for long-term care.

Health and Care of an Ageing Population: Alignment of Health and Social Systems to Address the Need

2021 ◽  
pp. 097206342199499
Author(s):  
Sangay Thinley
Keyword(s):  
Health Care ◽  
Older People ◽  
Long Term Care ◽  
Health Care Systems ◽  
Population Ageing ◽  
Demographic Shift ◽  
Term Care ◽  
The Social ◽  
Care Systems

Population ageing is both an achievement and challenge, an achievement as longevity is the result of successful prevention and control of diseases, decreasing fertility rates and overall socio-economic development. It is at the same time a challenge as the increasing number of older people and the resultant demographic shift are accompanied by the need to adjust and scale up the social and health care systems. The challenges are of particular relevance to the developing world where the demographic shift is occurring much faster. Comprehensive efforts based on country contexts are required in the following areas: (a) older persons and development, (b) health and well-being and (c) enabling and supportive environments to address population ageing needs. This article, however, focuses only on three most crucial issues, that is, livelihood, health care systems and care of the older dependent people. Measures to sustain the livelihood of older people, to align the health systems to provide care and to develop long-term care systems are highlighted. Person-centred care, integration and functional capacity are advocated. Further, ageing in place or living in one’s own home, community or a place with the closest fit with the person’s needs and preferences is considered very important for healthy ageing. In terms of enhancing livelihood, major policy changes and reforms to improve the social security systems and expanding coverage as well as increasing the amounts to minimum subsistence levels are highlighted. Another area which needs to be strengthened is the tradition of existing family support systems. The health systems alignment required are reflected for each health system building block, and focuses mainly on (a) developing and ensuring access to services that provide older-person-centred care; (b) shifting the clinical focus from disease to intrinsic capacity; and (c) developing or reorienting the health workforce to provide care as per alignment. Long-term care systems would best meet the needs of dependent older people if families, communities, civil society organisations and private sector are equally involved while governments play leadership roles in setting up and monitoring quality.

Public-Private Partnership in Health and Long-Term Care

2018 ◽  
pp. 103-124
Author(s):  
Wing Tung Ho ◽  
Ben Yuk Fai Fong
Keyword(s):  
Hong Kong ◽  
Long Term Care ◽  
Health Care Systems ◽  
Public Private Partnership ◽  
Term Care ◽  
Related Services ◽  
Private Partnership ◽  
Aging Populations ◽  
Care Systems

An exponential growth in elderly population reflects a proportional increase in recourses that are unaffordable and unsustainable to the economy. This rapid demand for health services and long-term care not only leads to non-financial implication like shortage of manpower and long waiting time, but this also creates a large burden on health and related services in the public sector. Involving the private sector to provide better and more efficient facilities and services and to encourage innovation will enhance productivity, speed up project and service delivery, and increase opportunities for investment in health. This chapter examines existing problems within health care systems in aging populations such as Hong Kong, explores the advantages and challenges of Public Private Partnership (PPP), identifies successful factors in establishing PPPs models, reviews the PPP projects in Hong Kong and elsewhere and recommends methods in promoting PPP in health and long-term care as sustainable solutions.

scholarly journals Utilization of Health Care Resources by Long-term Care Residents as a Function of Pain Status

2020 ◽  
Vol 36 (6) ◽  
pp. 472-479
Author(s):  
Harminder Guliani ◽  
Thomas Hadjistavropoulos ◽  
Shan Jin ◽  
Lisa Lix
Keyword(s):  
Health Care ◽  
Long Term Care ◽  
Term Care ◽  
Health Care Resources ◽  
Pain Status

scholarly journals COVID-19 Infections in Long-Term Care Facilities in Wuhan, China: Challenges and Lessons

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 18-18
Author(s):  
Yi Cai ◽  
Jing Wang ◽  
Bei Wu
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Living Arrangements ◽  
Long Term Care ◽  
Care Quality ◽  
Term Care ◽  
Frontline Workers ◽  
Precautionary Measures ◽  
The Impact

Abstract The impact of the COVID-19 infection on older residents and the direct frontline workers in long-term care (LTC) facilities in Wuhan, China deserves close attention. The fatality rate for older residents infected by the COVID-19 is among the highest in China Viral outbreaks are likely to occur in LTC facilities due to group-living arrangements, lack of precautionary measures, and older residents’ vulnerability to diseases. In this study, we aimed to explore different stakeholders’ experiences and challenges in the midst of the spread of the virus in LTC facilities. We conducted telephone interviews with four groups from two LTC facilities and two hospitals: twelve older residents (Four suspected cases and two infected), ten family members, four direct frontline workers (two infected), two nursing home managers, and four health care professionals working in the two hospitals that infected older residents were transferred to. We found that the gap in the transition of care quality between LTC facilities and local hospitals was widened during the COVID-19 outbreak. LTC facilities were slow to take precautionary measures and underprepared to handle the crisis after the infections occurred. The wellbeing of older residents was significantly impacted during the transition, particularly for those with dementia. Health care professionals in local hospitals were under tremendous stress providing treatments for older residents while ensuring their safety. There is an urgent need to improve transitional care and the capacity in preventing and handling this type of crisis for older residents in LTC.

scholarly journals Supporting employees' work-family needs improves health care quality: Longitudinal evidence from long-term care

2016 ◽  
Vol 157 ◽  
pp. 111-119
Author(s):  
Cassandra A. Okechukwu ◽  
Erin L. Kelly ◽  
Janine Bacic ◽  
Nicole DePasquale ◽  
David Hurtado ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Long Term Care ◽  
Care Quality ◽  
Family Needs ◽  
Term Care ◽  
Work Family

scholarly journals Learning and improving in long-term care internationally: the International Prevalence Measurement of Care Quality (LPZ)

2021 ◽  
Vol 15 ◽  
Author(s):  
Irma H. J. Everink ◽  
Adam L. Gordon ◽  
Suzanne Rijcken ◽  
Selvedina Osmancevic ◽  
Jos M. G. A. Schols
Keyword(s):  
Quality Assurance ◽  
Long Term Care ◽  
Care Quality ◽  
Multidisciplinary Teams ◽  
Term Care ◽  
Regulatory Systems ◽  
Health And Social Care ◽  
Care Facilities ◽  
Care Systems

Long-term care (LTC) for older adults is an essential part of how health and social care systems respond to population ageing. Different long-term care systems in different countries have taken differing approaches to quality assurance, ranging from inspection-based regulatory systems to data and reporting-based regulatory systems. The significant variability in the ability of long-term care facilities to respond to the COVID-19 pandemic has led to increased recognition of the role of standardized data in informing structured approaches to quality assurance. The International Prevalence Measurement of Care Quality (in Dutch: Landelijke Prevalentiemeting Zorgkwaliteit – LPZ) was developed to guide continuous quality improvement in long-term care facilities. This special article describes the LPZ tool, developed to provide input for the learning and improvement cycle of multidisciplinary teams in the LTC sector and to help improve care quality.

scholarly journals Improving End-of-Life Care for People with Dementia in LTC Homes During the COVID-19 Pandemic and Beyond

2021 ◽  
Vol 24 (3) ◽  
pp. 164-169
Author(s):  
Sharon Kaasalainen ◽  
Lynn Mccleary ◽  
Shirin Vellani ◽  
Jose Pereira
Keyword(s):  
Health Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Task Force ◽  
Life Care ◽  
Term Care ◽  
Health Care Resources ◽  
People With Dementia

COVID-19 pandemic has resulted in a significant increase in deaths in long-term care homes (LTCH). People with dementia living in LTCHs represent one of the most frail and marginal­ized populations in Canada. The surge of COVID-19 cases in LTCHs and rationing of health-care resources during the pandemic have amplified the pre-existing need for improve­ments in palliative and end-of-life care in LTCHs. This pos­ition statement, created by a task force commissioned by the Alzheimer Society of Canada, provides recommendations for a multipronged coordinated approach to improving palliative and end-of-life care of people with dementia living in LTCHs during the COVID-19 pandemic and beyond.

Public-Private Partnership in Health and Long-Term Care

2019 ◽  
pp. 276-297
Author(s):  
Wing Tung Ho ◽  
Ben Yuk Fai Fong
Keyword(s):  
Hong Kong ◽  
Long Term Care ◽  
Health Care Systems ◽  
Public Private Partnership ◽  
Term Care ◽  
Related Services ◽  
Private Partnership ◽  
Aging Populations ◽  
Care Systems

An exponential growth in elderly population reflects a proportional increase in recourses that are unaffordable and unsustainable to the economy. This rapid demand for health services and long-term care not only leads to non-financial implication like shortage of manpower and long waiting time, but this also creates a large burden on health and related services in the public sector. Involving the private sector to provide better and more efficient facilities and services and to encourage innovation will enhance productivity, speed up project and service delivery, and increase opportunities for investment in health. This chapter examines existing problems within health care systems in aging populations such as Hong Kong, explores the advantages and challenges of Public Private Partnership (PPP), identifies successful factors in establishing PPPs models, reviews the PPP projects in Hong Kong and elsewhere and recommends methods in promoting PPP in health and long-term care as sustainable solutions.

A Stepwise Approach for Surgical Management of Diabetic Foot Infections

2010 ◽  
Vol 100 (5) ◽  
pp. 401-405 ◽  
Author(s):  
Timothy K. Fisher ◽  
Christy L. Scimeca ◽  
Manish Bharara ◽  
Joseph L. Mills ◽  
David G. Armstrong
Keyword(s):  
Health Care ◽  
Surgical Management ◽  
Diabetic Foot ◽  
Health Care Systems ◽  
Term Care ◽  
Stepwise Approach ◽  
Care Plans ◽  
Diabetic Foot Infections ◽  
Care Systems

Diabetic foot disease frequently leads to substantial long-term complications, imposing a huge socioeconomic burden on available resources and health-care systems. Peripheral neuropathy, repetitive trauma, and peripheral vascular disease are common underlying pathways that lead to skin breakdown, often setting the stage for limb-threatening infection. Individuals with diabetes presenting with foot infection warrant optimal surgical management to affect limb salvage and prevent amputation; aggressive short-term and meticulous long-term care plans are required. In addition, the initial surgical intervention or series of interventions must be coupled with appropriate systemic metabolic management as part of an integrated, multidisciplinary team. Such teams typically include multiple medical, surgical, and nursing specialties across a variety of public and private health-care systems. This article presents a stepwise approach to the diagnosis and treatment of diabetic foot infections with emphasis on the appropriate use of surgical interventions and includes the following key elements: incision, wound investigation, debridement, wound irrigation and lavage, and definitive wound closure. (J Am Podiatr Med Assoc 100(5): 401–405, 2010)

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