Impact of telehealth versus traditional visits on pain management patients utilizing medical cannabis during the COVID-19 pandemic

Alternatives to traditional office visits have become a necessity with the recent COVID-19 outbreak, resulting in an unmatched surge in telehealth adoption. The present study was an investigation of the impact of telehealth versus traditional office visits in medical cannabis clinics treating patients for chronic pain. With 50,000,000 American adults experiencing pain and over 750,000 overdoses attributed to opioid usage, collecting research-driven evidence to increase the availability of safe, effective, and nonopioid treatment options will create positive social change. The Donabedian model was applied to measure the quality of care, focusing on structure (cannabis clinics), process (telehealth vs. traditional office visits), and outcome (visual analog scale [VAS]). The study utilized a quasi-experimental, retrospective analysis of data using multiple linear regression comparing the impact of telemedicine visits versus traditional office visits on treating five pain types in a medical cannabis clinic during a pandemic. The main finding of this study indicated that telemedicine visits were as effective as traditional office visits in treating pain. However, there was not statistically significant data to suggest that cannabis-derived medicines resulted in improved outcomes in the five pain types studied (general, back, arthritic, cancer, and migraine). Across all pain types and subjects there was an overall decrease in pain from initial visit (7.44) to follow-up visit (6.29) a decrease of 15.4% on the VAS. Expanding healthcare service treatment options that are safe, effective, and accessible in caring for chronic pain will prevent disease, improve health outcomes, and improve quality of care all leading to positive social change. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Factors determining the quality of health services provided to COVID-19 patients from the perspective of healthcare providers: Based on the Donabedian model.

Objectives: The present study aims to explain factors determining the quality of health services provided to COVID-19 patients from the perspective of healthcare providers based on the Donabedian model. Method: This qualitative study was conducted at a referral hospital on COVID-19 patients in Tehran, in 2020. The data were collected through individual and semi-structured interviews from 20 participants using the purposive sampling method. Besides, data analysis was conducted simultaneously using the directed content analysis method. Results: Data analysis results produced 850 primary codes in three predetermined categories of the Donabedian model, including the structure (organizational readiness and continuous training), the process (effective management and leadership, safe care, and comprehensive care measures) and outcomes (professional excellence, quantitative and qualitative improvements in hospital services, and acceptability of healthcare professionals). Conclusion: The results of this study can help managers better understand how a public health crisis affects the structure of organizations providing care and treatment, quality of treatment processes in the organization, and the consequences. In addition, this study can be used as a model for optimizing the structures and processes to improve outcomes.

The Effect of Burnout on Quality of Care Using Donabedian's Framework.

Donabedian's framework offers a model to evaluate the relationship between patient outcomes, influenced by clinical care delivery structures and processes. Applying this model proposes that adequate and appropriate structures and processes within organizations are necessary to realize optimal outcomes; it is imperative that leadership focuses on those structures and processes to reduce the risk of burnout. Current research cannot determine whether burnout causes decreased quality or working in a setting with decreased quality causes burnout. The follow-up question is whether curtailing burnout will improve quality or whether improving quality of care will reduce provider burnout?

Use of the Donabedian Model as a Framework for COVID-19 Response at a Hospital in Suburban Westchester County, New York: A Facility-Level Case Report.

The purpose of this facility-level case report was to describe our facility's leadership process of applying the Donabedian model to structure an early response to the coronavirus disease pandemic relative to emergency care. Using the Donabedian model as a guide, both structure and process changes were implemented to maintain high-quality clinical outcomes as well as ED staff safety and engagement. Rapid changes to the model of care, both architecturally and through the expansion of universal precautions through personal protective equipment, created the foundation for what was to follow. Clinical, service quality, and staff safety outcomes were evaluated to demonstrate that the collaborative changes that follow a known process improvement model can be used to address the coronavirus disease pandemic. Further study is needed to compare the outcomes of this facility-level case study with those of others to evaluate the success of the measures outlined.

Evaluating quality in clinical care.

Defining and maintaining quality is essential to surgical practice. It is only through structured approaches to assessing outcomes that we can ensure that optimal care is delivered. This article will define quality in healthcare and discuss assessment models with reference to pertinent surgical literature. National initiatives are discussed with a critical appraisal of their role and effectiveness. We discuss the aim of quality improvement initiatives and comment on reporting of outcomes. The difficult question of how to maintain quality during a crisis, such as an infectious disease pandemic, is addressed.