scholarly journals Applying Elinor Ostrom’s Design Principles to Guide Co-Design in Health(care) Improvement: A Case Study with Citizens Returning to the Community from Jail in Los Angeles County

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Glenn Robert ◽  
Oli Williams ◽  
Bertil Lindenfalk ◽  
Peter Mendel ◽  
Lois M. Davis ◽  
...  
Keyword(s):  
Health Care ◽  
Los Angeles ◽  
Los Angeles County ◽  
Design Principles ◽  
Health Care Improvement ◽  
Care Improvement

Prehospital Emergency Provider’s Knowledge of and Comfort With Pediatric and Special Needs Cases: A Cross-Sectional Study in Los Angeles County

2021 ◽  
pp. 016327872110039
Author(s):  
Christopher J. Rogers ◽  
Marianne Gausche-Hill ◽  
Laurie Lee Brown ◽  
Rita V. Burke
Keyword(s):  
Health Care ◽  
Los Angeles ◽  
Continuing Education ◽  
Los Angeles County ◽  
Special Health Care Needs ◽  
Health Care Needs ◽  
Care Needs ◽  
Special Health Care ◽  
The Relationship ◽  
Special Health

The current study assesses the relationship between continuing education (CE) with a focus on pediatrics and children with special heath care needs and how CE influences the knowledge and comfort levels of prehospital providers who treat these cases. Data are survey responses provided by paramedic and emergency medical technician (EMT) level providers (N = 575) in Los Angeles County. Regression models assessed the relationship between pediatric-focused continuing education and EMTs’ knowledge of and comfort with pediatric cases, adjusting for relevant covariates. EMTs’ participation in continuing education focusing on pediatrics and special health care needs was significantly associated with an increase in perceived comfort and knowledge. Among EMTs who did not receive continuing education focused on either pediatrics or special health care needs, the most frequently reported barrier to education was a perceived lack of availability. The impact of continuing education on perceived comfort and knowledge was more pronounced than the effect of prior experience, especially considering the limited prevalence of provider exposure to pediatric and childhood special health care needs cases compared to adult cases. Expanding educational opportunities is a promising approach to increasing the comfort and knowledge of EMTs who transport and care for pediatric cases.

Assessing Blood Administering Practices

1999 ◽  
Vol 123 (7) ◽  
pp. 595-598 ◽  
Author(s):  
Ira A. Shulman ◽  
Sunita Saxena ◽  
Lois Ramer
Keyword(s):  
Health Care ◽  
Los Angeles ◽  
Los Angeles County ◽  
Medical Center ◽  
Health Care Financing ◽  
Vital Signs ◽  
Data Driven ◽  
Blood Component ◽  
University Of Southern California ◽  
Health Care Financing Administration

Abstract The risk that a red blood cell unit will be associated with an ABO-incompatible transfusion is currently slightly greater than the aggregate risk of acquiring human immunodeficiency virus, human T-cell lymphotropic virus, hepatitis B virus, or hepatitis C virus by transfusion. Since the most common cause for ABO-incompatible transfusion is the failure of transfusionists to properly identify a patient or a blood component before a transfusion, transfusion services are encouraged to evaluate and monitor the processes of dispensing and administering blood. In addition, a proposal of the Health Care Financing Administration of the Department of Health and Human Services would require hospitals to use a data-driven quality assessment and performance improvement program that evaluates the dispensing and administering of blood and that ensures that each blood product and each intended recipient is positively identified before transfusion. The Los Angeles County+University of Southern California Medical Center assesses the blood dispensing and administering process as proposed by the Health Care Financing Administration. During the fourth quarter of 1997, 85 blood transfusions were assessed for compliance with the Los Angeles County+University of Southern California Medical Center policies and procedures: 55 transfusion episodes had no variance from institutional protocol and 30 had one or more variances. Of the transfusions with at least one variance, 16 had one or more variances involving the identification of the patient, the component, or the paperwork. The remaining 14 transfusions had one or more variances involving other criteria (nonidentification items). The most frequent variance was the failure to document vital signs during the first 15 minutes after a transfusion was started or after 50 mL of a component had been transfused. No variances in patient or blood component identification were noted in nursing units whose staff routinely performed self-assessment of blood administering practices. Based on these findings, a corrective action plan was implemented. Follow-up assessments (n = 63) were conducted after 3 months (during the second quarter of 1998). The compliance with the pretransfusion identification protocol improved from 81% to 95%. The most common reason for noncompliance continued to be a lack of checking vital signs. This report demonstrates the value of using a data-driven program that assesses blood administering practices.

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