Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 38
Filter
1.
Pediatrics ; 149(3)2022 03 01.
Article in English | MEDLINE | ID: covidwho-1714832

ABSTRACT

The use of telehealth technology to connect with patients has expanded significantly over the past several years, particularly in response to the global coronavirus disease 2019 pandemic. This technical report describes the present state of telehealth and its current and potential applications. Telehealth has the potential to transform the way care is delivered to pediatric patients, expanding access to pediatric care across geographic distances, leveraging the pediatric workforce for care delivery, and improving disparities in access to care. However, implementation will require significant efforts to address the digital divide to ensure that telehealth does not inadvertently exacerbate inequities in care. The medical home model will continue to evolve to use telehealth to provide high-quality care for children, particularly for children and youth with special health care needs, in accordance with current and evolving quality standards. Research and metric development are critical for the development of evidence-based best practices and policies in these new models of care. Finally, as pediatric care transitions from traditional fee-for-service payment to alternative payment methods, telehealth offers unique opportunities to establish value-based population health models that are financed in a sustainable manner.


Subject(s)
Health Care Costs , Health Services Accessibility/organization & administration , Pediatrics/methods , Pediatrics/organization & administration , Quality of Health Care/organization & administration , Telemedicine/methods , Telemedicine/organization & administration , Adolescent , Child , Child, Preschool , Healthcare Disparities , Humans , Infant , Infant, Newborn , Patient-Centered Care/economics , Patient-Centered Care/organization & administration , Pediatrics/economics , Pediatrics/standards , Telemedicine/economics , Telemedicine/standards , United States
6.
Am J Trop Med Hyg ; 105(2): 372-374, 2021 Jun 15.
Article in English | MEDLINE | ID: covidwho-1371031

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has demanded rapid institutional responses to meet the needs of patients and employees in the face of a serious new disease. To support the well-being of frontline staff, a series of debriefing sessions was used to drive a rapid-cycle quality-improvement process. The goals were to confidentially determine personal coping strategies used by staff, provide an opportunity for staff cross-learning, identify what staff needed most, and provide a real-time feedback loop for decision-makers to create rapid changes to support staff safety and coping. Data were collected via sticky notes on flip charts to protect confidentiality. Management reviewed the data daily. Institutional responses to problems identified during debrief sessions were tracked, visualized, addressed, and shared with staff. More than 10% of staff participated over a 2-week period. Feedback influenced institutional decisions to improve staff schedules, transportation, and COVID-19 training.


Subject(s)
Adaptation, Psychological , COVID-19/epidemiology , Faith-Based Organizations/statistics & numerical data , Tertiary Healthcare/methods , Tertiary Healthcare/statistics & numerical data , Faith-Based Organizations/standards , Hospitals/standards , Hospitals/statistics & numerical data , Humans , Kenya/epidemiology , Medical Staff, Hospital/education , Medical Staff, Hospital/psychology , Medical Staff, Hospital/statistics & numerical data , Quality of Health Care/organization & administration , Quality of Health Care/statistics & numerical data , Tertiary Healthcare/standards
8.
Front Health Serv Manage ; 37(4): 4-16, 2021 Jul 01.
Article in English | MEDLINE | ID: covidwho-1243552

ABSTRACT

SUMMARY: Founded in 1897 as a 12-bed hospital and training school in Springfield, Illinois, Memorial Health System (MHS) today serves communities throughout central Illinois with five affiliated hospitals, ambulatory care services, and behavioral health programs. The system includes Memorial Medical Center in Springfield, Abraham Lincoln Memorial Hospital in Lincoln, Taylorville Memorial Hospital in Taylorville, Passavant Area Hospital in Jacksonville, Decatur Memorial Hospital in Decatur, and the Memorial Physician Services, Memorial Home Services, and Memorial Behavioral Health network across central Illinois. The evolution of MHS from a system in name only-lacking full integration of organizational functions-to its current status as an optimized health system has been marked by challenges, from the initial doubts of employees and the community to the upheaval caused by the COVID-19 pandemic. Systemness requires visionary and sure-handed leadership to identify and realize economies of scale, share best practices for operational improvements, and reduce unwanted variation to improve quality of care. As the MHS story illustrates, that all starts, grows, and endures with strategic planning.


Subject(s)
COVID-19/diagnosis , COVID-19/therapy , Delivery of Health Care/organization & administration , Organizational Innovation , Organizational Objectives , Quality of Health Care/organization & administration , Humans , Illinois , Pandemics , SARS-CoV-2
9.
Front Health Serv Manage ; 37(4): 17-27, 2021 Jul 01.
Article in English | MEDLINE | ID: covidwho-1243551

ABSTRACT

SUMMARY: While the term systemness has been used in the healthcare sector for decades, its definition varies from organization to organization. Still, the goals are consistent: to improve patient experience, lower costs, reduce risk, and provide insights into a wide range of care and management issues. Most health systems face similar challenges, such as margin enhancement, quality improvement, increased access, and fending off disruptive competition. Systemness is a way to address these challenges while improving the overall interdependence of the organization. Although embraced by and advantageous to healthcare organizations, systemness efforts often fail. The obstacles are surmountable when organizations thoroughly analyze the achievable scale of systemness, community resources, and current mindset regarding the good of the whole. Leaders must play a vital role in promoting systemness by providing education and a routine review of day-to-day organizational activities. Sometimes, systemness requires a change in leadership or an updating of leadership skills.Organizations must recognize and assess their culture as it relates to principles of independence versus interdependence, and refocus clinical standardization through best-practice protocols and policies as COVID-19 affects the already-fractured healthcare sector. Fortunately, current and developing artificial intelligence, wearables, at-home testing, and improved technologies promise to provide a needed break for a contracting physician field and fatigued front line, and they present an opportunity for those organizations poised to meet the systemness challenge.


Subject(s)
COVID-19/diagnosis , COVID-19/therapy , Delivery of Health Care/organization & administration , Intersectoral Collaboration , Patient-Centered Care/organization & administration , Quality Assurance, Health Care/organization & administration , Quality of Health Care/organization & administration , Humans , Organizational Culture , Organizational Objectives , SARS-CoV-2
11.
Nurs Outlook ; 69(5): 735-743, 2021.
Article in English | MEDLINE | ID: covidwho-1164278

ABSTRACT

COVID-19 has exposed the longstanding internal problems in nursing homes and the weak structures and policies that are meant to protect residents. The Centers for Medicare and Medicaid Services convened the Coronavirus Commission for Safety and Quality in NHs in April, 2020 to address this situation by recommending steps to improve infection prevention and control, safety procedures, and the quality of life of residents in nursing homes. The authors of this paper respond to the Final Report of the Commission and put forth additional recommendations to federal policymakers for meaningful nursing home reform: 1) ensuring 24/7 registered nurse (RN) coverage and adequate compensation to maintain total staffing levels that are based on residents' care needs; 2) ensuring RNs have geriatric nursing and leadership competencies; 3) increasing efforts to recruit and retain the NH workforce, particularly RNs; and 4) supporting care delivery models that strengthen the role of the RN for quality resident-centered care.


Subject(s)
COVID-19/epidemiology , COVID-19/prevention & control , Infection Control/organization & administration , Nursing Homes/organization & administration , Nursing Staff/organization & administration , Quality of Health Care/organization & administration , Aged , COVID-19/transmission , Humans , Personnel Staffing and Scheduling , United States
12.
Int J Qual Health Care ; 33(1)2021 Mar 05.
Article in English | MEDLINE | ID: covidwho-1127340

ABSTRACT

The challenges for health care continue to grow and in the 21st century healthcare policymakers and providers will need to respond to the developing impact of global warming and the environmental impact of healthcare service delivery. This cannot be viewed apart from the current Coronavirus disease (COVID-19) pandemic, which is likely to be linked to the climate crisis.


Subject(s)
COVID-19/epidemiology , Climate Change , Conservation of Natural Resources , Quality of Health Care/organization & administration , Health Promotion/organization & administration , Humans , Internationality , Pandemics , SARS-CoV-2
17.
Semergen ; 47(2): 122-130, 2021 Mar.
Article in Spanish | MEDLINE | ID: covidwho-997527

ABSTRACT

Public health emergencies, such as the current SARS-CoV-2 coronavirus pandemic, have led to tragic resource constraints that prevent lives from being saved. This has led to tensions in patient-centered care as the backbone of the system in normal conditions and the same care in emergencies originating in the COVID-19. In this review we address some of the healthcare, organizational and ethical problems that this scenario has caused in primary care such as: cancellation of programmed activities; scarce home care and follow-up of elderly, chronically ill and immobilized patients; shortage of PPE and the exposure to risk of healthcare professionals, and finally the problems associated with telemedicine and telephone attention to patients.


Subject(s)
COVID-19/prevention & control , Health Care Rationing/ethics , Health Services Accessibility/ethics , Infection Control/methods , Primary Health Care/ethics , Telemedicine/ethics , COVID-19/epidemiology , Health Care Rationing/methods , Health Care Rationing/organization & administration , Health Services Accessibility/organization & administration , Health Services for the Aged/ethics , Health Services for the Aged/organization & administration , Humans , Infection Control/instrumentation , Infection Control/organization & administration , Pandemics , Personal Protective Equipment/supply & distribution , Primary Health Care/methods , Primary Health Care/organization & administration , Quality of Health Care/ethics , Quality of Health Care/organization & administration , Spain/epidemiology , Telemedicine/methods , Telemedicine/organization & administration
18.
BMC Health Serv Res ; 20(1): 1144, 2020 Dec 20.
Article in English | MEDLINE | ID: covidwho-992478

ABSTRACT

BACKGROUND: Approximately 10% of patients with Covid-19 experience symptoms beyond 3-4 weeks. Patients call this "long Covid". We sought to document such patients' lived experience, including accessing and receiving healthcare and ideas for improving services. METHODS: We held 55 individual interviews and 8 focus groups (n = 59) with people recruited from UK-based long Covid patient support groups, social media and snowballing. We restricted some focus groups to health professionals since they had already self-organised into online communities. Participants were invited to tell their stories and comment on others' stories. Data were audiotaped, transcribed, anonymised and coded using NVIVO. Analysis incorporated sociological theories of illness, healing, peer support, clinical relationships, access, and service redesign. RESULTS: Of 114 participants aged 27-73 years, 80 were female. Eighty-four were White British, 13 Asian, 8 White Other, 5 Black, and 4 mixed ethnicity. Thirty-two were doctors and 19 other health professionals. Thirty-one had attended hospital, of whom 8 had been admitted. Analysis revealed a confusing illness with many, varied and often relapsing-remitting symptoms and uncertain prognosis; a heavy sense of loss and stigma; difficulty accessing and navigating services; difficulty being taken seriously and achieving a diagnosis; disjointed and siloed care (including inability to access specialist services); variation in standards (e.g. inconsistent criteria for seeing, investigating and referring patients); variable quality of the therapeutic relationship (some participants felt well supported while others felt "fobbed off"); and possible critical events (e.g. deterioration after being unable to access services). Emotionally significant aspects of participants' experiences informed ideas for improving services. CONCLUSION: Suggested quality principles for a long Covid service include ensuring access to care, reducing burden of illness, taking clinical responsibility and providing continuity of care, multi-disciplinary rehabilitation, evidence-based investigation and management, and further development of the knowledge base and clinical services. TRIAL REGISTRATION: NCT04435041.


Subject(s)
COVID-19/complications , COVID-19/therapy , Adult , Aged , Female , Focus Groups , Health Personnel/psychology , Health Personnel/statistics & numerical data , Health Services Research , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Qualitative Research , Quality of Health Care/organization & administration , Time Factors , United Kingdom
20.
Turk J Med Sci ; 50(8): 1760-1770, 2020 12 17.
Article in English | MEDLINE | ID: covidwho-945992

ABSTRACT

Background/aim: The aim of this research is to evaluate the relationship between the quality of health and accreditation standards with the Covid-19 process and to reveal the importance of quality and accreditation in health care in the process of combating coronavirus. Materials and methods: The relationship between hospital accreditation standards of Turkish Healthcare Quality and Accreditation Institute and the Covid-19 process was evaluated. The standards were analyzed within the framework of the technical guidance areas provided by the World Health Organization for countries for the Covid-19 process. Results: The standards were found to be 79,6% related to the Covid-19 process. The standard set including risk management, health and safety of employees, patient safety, end of life services, prevention of infections, drug management, sterilization management, laboratory services, waste management, outsourcing, material and device management, adverse event reporting, corporate communication, and social responsibilities sections are 100% related to the Covid-19 process. Conclusion: Studies on quality and accreditation in health services are important in terms of being prepared for Covid-19 and similar epidemic and pandemic situations, and to carry out planned and effective management of the process.


Subject(s)
Accreditation/standards , COVID-19 , Quality of Health Care/organization & administration , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19/therapy , Civil Defense/methods , Civil Defense/organization & administration , Health Services Needs and Demand , Humans , Infection Control/methods , Infection Control/organization & administration , Risk Management/methods , Safety Management/methods
SELECTION OF CITATIONS
SEARCH DETAIL