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Автор: Grafiati
Опубліковано: 15 червня 2024

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Статті в журналах з теми "Health care pathway":

1

Bronkhorst, Babette, and Brenda Vermeeren. "Safety climate, worker health and organizational health performance." International Journal of Workplace Health Management 9, no. 3 (September 12, 2016): 270–89. http://dx.doi.org/10.1108/ijwhm-12-2015-0081.

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Purpose The purpose of this paper is to investigate the relationship between organizational safety climate and organizational health performance outcomes (i.e. absenteeism, presenteeism, health care utilization) mediated by individual worker health. The authors used three pathways to examine this relationship: a physical pathway starting with physical safety climate and mediated by musculoskeletal disorders (MSDs), a psychosocial pathway starting with psychosocial safety climate and mediated by emotional exhaustion, and a combined pathway starting with psychosocial safety climate and mediated by both MSDs and emotional exhaustion. Design/methodology/approach Three mediational multilevel analyses were conducted using a sample of 8,761 employees working in 177 health care organizations. Findings Although the findings did not support the hypothesized physical pathway, they showed that the psychosocial pathway worked satisfactorily for two of the three health performance outcomes (absenteeism and presenteeism). The combined physical and psychosocial pathway explained differences in the third outcome: health care utilization. Originality/value This is one of the few studies to include both physical and psychosocial pathways that lead to employee health and organizational performance. The results underscore the importance of paying attention to psychological health and safety in the health care workplace. Not only for the psychological health of employees, but also to improve their physical health and subsequent organizational health performance.
2

Kingdon, D., and A. Gregoire. "Mental health care pathways." European Psychiatry 26, S2 (March 2011): 546. http://dx.doi.org/10.1016/s0924-9338(11)72253-2.

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IntroductionThe term, care pathway, has been used to describe multidisciplinary/ multi-agency outline of anticipated care, placed in an appropriate timeframe, to help a patient with a specific condition or set of symptoms move progressively through a clinical experience to positive outcomes. In practice, a multitude of disparate projects have produced outputs ranging from pages of interconnected boxes and arrows with rather basic entries to thick and indigestible wads of paper. Certainly the idea of a ‘mental health care pathway’ accessible and used by the general public, service users, carers, primary and secondary care has seemed overwhelmingly complex and unworkable.Aims & objectivesTo make relevant service and clinical information available when and where in a person's progress or a clinician treatment path it was needed.MethodWebsite hyperlinks allow linkage within websites and to other websites with relevant information (e.g. ICD10, NICE guidelines, and Patient information leaflets). A development prototype funded by the UK NHS has been established to form the basis for a website to be launched in mid-2011 (www.mentalhealth.southcentral.nhs.uk).ResultsThe prototype contains links to evidence-based information on maintaining mental health and on ‘coping with problems’. Service Pathways describe detail of processes occurring in mental health care. Diagnostic care pathways start as broad categories [Kingdon et al, 2010] with links to diagnosis, medication (e.g. connects to the National Formulary) and psychological management sites.ConclusionsWeb technology allows information about mental health care pathways to be accessed more systematically and readily and has application internationally.
3

Rady, Mohamed Y., and Joseph L. Verheijde. "Liverpool Care Pathway: life-ending pathway or palliative care pathway?" Journal of Medical Ethics 41, no. 8 (July 18, 2014): 644. http://dx.doi.org/10.1136/medethics-2014-102314.

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4

Glass, Katherine, Chad W. Cummings, Marc A. Shapiro, Dennis Urbanek, and Brian James Bolwell. "Data collection for care pathways in the Cleveland Clinic Health System." Journal of Clinical Oncology 34, no. 7_suppl (March 1, 2016): 115. http://dx.doi.org/10.1200/jco.2016.34.7_suppl.115.

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115 Background: Care pathways are established methods of reducing healthcare costs and disparities in oncology care. To demonstrate their impact, health systems must measure and report data on care pathway adherence and outcomes in near real-time. Automating data abstraction across a health system for oncology is difficult due to the amount and detail of data required. Manual abstraction of data is considered slow and costly. Many consider Electronic Medical Record (EMR) integration of care pathways essential in order to successfully implement and assess. Methods: 7 medical oncology care pathways and 45 medical oncologists across the health system were selected for a pilot study to assess the feasibility of implementing care pathways throughout the enterprise. The pilot study also allowed for testing of data collection capabilities. Patients eligible for the care pathways were prospectively identified by manual review of physician calendars. A small number of data points were manually abstracted from the patient EMR at the time of identification. Endpoints of interest, such as hospitalization rates, chemotherapy administered, time to treatment, and costs of care were reconciled through pre-existing databases within pharmacy, research, and finance. Tumor registry data identified a retrospective cohort. Results: Over 1,000 patients were prospectively identified for the care pathway pilot between 1/1/2014 and 12/31/2014. The tumor registry identified 700 additional retrospective patients. The rapid analyses possible as a result of these efforts demonstrated physician adherence, improved patient outcomes, and significant cost savings. In one example, a care pathway for metastatic non-small cell lung cancer reduced charges by more than $98,000/patient by recommending patients receive one standardized chemotherapeutic regimen. Conclusions: Timely data collection for oncology care pathways is feasible and cost effective without EMR integration. Manual identification of patients combined with pre-existing data sources allowed for near-real time analysis of care pathways and provided valuable information about care pathway impact. Institutions can implement and assess care pathways with resources already available to them.
5

Olsen, Cecilie Fromholt, Astrid Bergland, Jonas Debesay, Asta Bye, and Anne Gudrun Langaas. "Patient Flow or the Patient’s Journey? Exploring Health Care Providers’ Experiences and Understandings of Implementing a Care Pathway to Improve the Quality of Transitional Care for Older People." Qualitative Health Research 31, no. 9 (May 19, 2021): 1710–23. http://dx.doi.org/10.1177/10497323211003861.

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Internationally, the implementation of care pathways is a common strategy for making transitional care for older people more effective and patient-centered. Previous research highlights inherent tensions in care pathways, particularly in relation to their patient-centered aspects, which may cause dilemmas for health care providers. Health care providers’ understandings and experiences of this, however, remain unclear. Our aim was to explore health care providers’ experiences and understandings of implementing a care pathway to improve transitional care for older people. We conducted semistructured interviews with 20 health care providers and three key persons, along with participant observations of 22 meetings, in a Norwegian quality improvement collaborative. Through a thematic analysis, we identified an understanding of the care pathway as both patient flow and the patient’s journey and a dilemma between the two, and we discuss how the negotiation of conflicting institutional logics is a central part of care pathway implementation.
6

Hally, Jennifer D., and Nigel B. Pitts. "Developing the First Dental Care Pathway: The Oral Health Assessment." Primary Dental Care os12, no. 4 (October 2005): 117–21. http://dx.doi.org/10.1308/135576105774342947.

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In this paper the authors define the concept of care pathways and explain what they are and how they have been applied in various areas of healthcare. The authors discuss the benefits of the care pathway approach and outline the first national dental NHS (clinical) care pathway and its link to National Institute for Clinical Excellence (NICE) guidance on dental recall intervals. The authors go on to explain that as a result of one of the key recommendations of Options for Change, the concept of care pathways will be extended to the primary dental services of the NHS. The first care pathway will be the Oral Health Assessment (OHA). The authors describe the development of, and rationale for, the OHA and provide details of its planned introduction. The authors conclude that the OHA should act as the initial interface between the primary care team and the dental patient. In so doing it should enable a change in the focus of care, from treatment-based to more prevention-led, personalised care appropriate to the specific needs of individual patients.
7

Rosique, Ricard. "Do we need electronic support for pathways: the Spanish experience." International Journal of Care Pathways 13, no. 2 (November 2009): 67–74. http://dx.doi.org/10.1258/jicp.2009.009010.

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Care pathways are excellent tools for quality management in health care concerning the standardization of care processes, as they promote organized and efficient patient care established on evidence-based practice. The implementation of a care pathway project at any health-care setting means a change of the organizational culture. E-pathways (electronic pathways) are strategic resources in order to get the successful implementation of a care pathway project. The concept of e-pathway is recent enough and there are some different experiences worldwide. In 2000, the first electronic pathways were implemented at Hospital de Mataró, in Barcelona, Spain. The benefits of using e-pathways (Eira Healthcare Server) are very clear at Hospital de Mataró: immediate records with no transcriptions, information in the palm of your hand, no prints, and rigour and reliability. Another recent and interesting experience is the development and introduction of e-pathways at Hospital General de l'Hospitalet, in Barcelona, Spain, using an SAP integrated health-care solution. The strategy planning of hospital managers should take into account the need and priority of any pathway project linked to e-pathways. Some experiences in Spain have proven that we do really need electronic support for pathways. Electronic pathways are a basic support and should not be postponed when implementing care pathways.
8

Reymond, Liz, Fiona J. Israel, and Margaret A. Charles. "A residential aged care end-of-life care pathway (RAC EoLCP) for Australian aged care facilities." Australian Health Review 35, no. 3 (2011): 350. http://dx.doi.org/10.1071/ah10899.

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The objective of this study was to develop, implement and evaluate an end-of-life (terminal) care pathway and associated infrastructure suitable for Australian residential aged care facilities that improves resident and health system outcomes. The residential aged care end-of-life care pathway was developed by a multidisciplinary collaboration of government and non-government professionals and incorporated best clinical management for dying residents to guide care and increase palliative care capacity of generalist staff. Implementation included identifying and up-skilling Link Nurses to champion the pathway, networking facilities with specialist palliative care services, delivering education to generalists and commencing a Palliative Care Medication Imprest System in each facility. The primary outcome measure for evaluation was transfer to hospital; secondary measures included staff perceived changes in quality of palliative care provided and family satisfaction with care. Results indicated that the pathway, delivered within a care framework that guides provision of palliative care, resulted in improved resident outcomes and decreased inappropriate transfers to acute care settings. What is known about the topic? Residential aged care facilities (RACFs) are the hospices of today. Many RACF staff are not confident in the delivery of high quality palliative care, resulting in inappropriate transfers of dying residents to acute care facilities. Needs-based palliative care pathways are being used increasingly to direct care in a variety of healthcare environments. What does this paper add? Provides the first evidence in Australia that a residential aged care end-of-life care pathway (RAC EoLCP) improves outcomes of care for dying residents and results in fewer residents being inappropriately transferred to acute care facilities. What are the implications for practitioners? Use of the RAC EoLCP will improve resident and health system outcomes by guiding the delivery of high quality palliative care and improving the palliative care capacity of generalist health providers.
9

Deneckere, S., M. Euwema, C. Lodewijckx, M. Panella, W. Sermeus, and K. Vanhaecht. "Improving interprofessional teamwork with care pathways: challenges for pathway researchers and health-care managers." International Journal of Care Pathways 16, no. 2 (June 1, 2012): 37. http://dx.doi.org/10.1258/jicp.2012.012m05.

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10

Kwok, Chun Shing, David Waters, Thanh Phan, Phyo Kyaw Myint, and Gregory Y. H. Lip. "Should Audits Consider the Care Pathway Model? A New Approach to Benchmarking Real-World Activities." Healthcare 10, no. 9 (September 19, 2022): 1798. http://dx.doi.org/10.3390/healthcare10091798.

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Clinical audit is a method to assess the quality of healthcare services based on whether standards are met or not met. This approach is limited because it fails to recognize how decisions that take place over time and the natural progression of disease has an impact on what happens to patients and the care they receive. The aim of this paper is to introduce the concept of care pathway and explain how care pathways can be audited to better understand care. The care pathway is defined by clinically relevant events that take place within one or more healthcare institutions. The process begins with defining an ideal care pathway which is created by considering local expertise and guidelines. It is then possible to audit against the extent to which this ideal care pathway is achieved. This care pathway audit can enable identification of patterns in real-world care which can help with the of design interventions to help shift patients from the less to more desirable pathways. We conclude that through the process of the care pathway audit cycle, it is possible to learn about real-world activities, better utilize resources, promote safer care, improve quality of care, and help develop more effective interventions.
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Статті в журналах Дисертації Книги

Дисертації з теми "Health care pathway":

1

Wilson, Nicola Ann. "Modelling intermediate care services as part of an integrated care pathway." Master's thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/20290.

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This study explores the implications of implementing enhanced or redesigned intermediate care initiatives in the Western Cape of South Africa from the 2014/15 financial year onwards. Using a dynamic modelling methodology, we developed an empirical model of an integrated care system to explain the linkages, relationships and interactions among service components and analyse the implications of one of the proposed Healthcare 2030 policy interventions - intermediate care - on hospital admissions, waiting times and length of stay of all patients. We tested and compared a number of alternative intervention points using a simulation model parameterised with service component data from the Department of Health Information Systems. The findings from the study show the inconsistencies between the perceived structure and the available data from the respective service components that describe the resultant behavioural effects on an integrated care system, especially when care pathways cross organisational boundaries. The main managerial learning was around the existence and nature of organisational boundaries that require joint working and sharing of information. We conclude from the simulation results for the alternative scenarios tested that the implementation of enhanced or redesigned intermediate care initiatives can moderate the rate of growth in the demand for hospital services by reducing a percentage of hospital readmissions.
2

Jones, Karen. "The remodelling of patient care pathway for e-health." Thesis, Brunel University, 2009. http://bura.brunel.ac.uk/handle/2438/3975.

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The interdependencies within the health care system are seldom taken into account prior to implementation of e-health projects, and there tends to be little change management as part of the plan. Our proposal offers a systems analysis model that gives e-health a framework to consider and manage the introduction, changes and outcomes. This research describes the use of a modified Patient Care Pathway as a method to design and implement e-health projects, presenting as a case study the pre-implementation phase of a teleradiology project in rural Thailand. The proposal is that a modified version of Patient Care Pathways can be used as a prospective design model for e-health services. The method adopts systems engineering principles and applies a ―whole systems approach‖ thereby providing a much richer schematic representation of the patient care pathway illustrating both the patient‘s journey through the system and also the information flow. Our method was applied to the design of a new teleradiology service that was to be established in Thailand, to connect GP‘s in a rural hospital to the radiology department in a tertiary hospital with a further connection to a specialist radiologist in a medical school in Bangkok. By comparing the pre-implementation Patient Care Pathway with the proposed pathway using the teleradiology, a systems analysis model was developed to identify critical points in the system and identify and anticipate how the system would support the changes in clinical practices. The method produced a valuable framework to better understand and thereby manage the implications of change prior to implementation of an e-health project.
3

Boynton, Anna Lee. "Help-seeking, pathway mapping and barriers to mental health care : a literature review /." Title page, table of contents and abstract only, 2004. http://web4.library.adelaide.edu.au/theses/09HS/09hsb7928.pdf.

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4

Bandong, Aila Nica. "Enabling change in whiplash management through a clinical pathway of care." Thesis, The University of Sydney, 2019. http://hdl.handle.net/2123/20845.

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Best practice recommendations for whiplash management have changed considerably over the past few decades; however, have not been widely adopted in clinical practice. Clinical pathways are a promising strategy to enable practice change. The aim of this thesis was to explore selected aspects of practice change to support the implementation of a clinical pathway of care for whiplash and the administration of a randomised controlled trial that tests the effectiveness of the pathway. This thesis used several research methods, including retrospective audit of insurer files, focus group discussions, process evaluation, and a clinical trial. The audit of files showed that many aspects of practice in whiplash management were inconsistent with the guidelines. Themes generated from the focus groups suggested that recommendations requiring significant change in practice were not well accepted, explaining an important potential barrier to adherence. Other barriers identified included lack of clarity in recommendations and perceived patient expectations about management. The focus groups also supported the potential for wider use of whiplash specialists in a peer review role by better meeting the needs of the referring health professional. This finding supports one of the key components of the clinical pathway of care for whiplash and strongly shaped the further development of the pathway as an intervention in the randomised controlled trial. The thesis delivered a new and acceptable online tool, My Whiplash Navigator, as a resource to promote best practice. Finally, the thesis provided preliminary evidence that implementation of the clinical pathway of care has enabled change in aspects of practice. This thesis generated new knowledge that informed the implementation and evaluation of the clinical pathway of care for whiplash. Further, this thesis identified mechanisms to enable best practice management of whiplash and more broadly other high burden musculoskeletal conditions.
5

Scheepers, Lorna Lorraine. "An exploratory study of the referral pathway of patients discharged from a tertiary hospital to home-based care in the Western Cape." University of the Western Cape, 2012. http://hdl.handle.net/11394/4628.

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Magister Curationis - MCur
The purpose of the study will be to explore the discharge referral pathway for patients that have been discharged from hospital to home in the Western Cape Province. A mix of quantitative and qualitative research, using a descriptive design will be undertaken. Quantitatively, following the patient paper trail from Tertiary Hospital to grassroots level. Qualitatively, to identify whether the referral pathway was user friendly. Records of discharged patients from the Tertiary Hospital will be used as the study population. Patient information will be accessed from patient files at the hospital. Interviews will be conducted with the relevant discharge liaison officers at the Tertiary Hospital, and Primary Health Care level. Relevant staff members within the non–governmental –organisations (NGOs), will also be interviewed in order to determine their perception of the discharge referral pathway. The findings of the study will be used to inform policy guidelines. Challenges encountered by staff members in referring patients for continuum of care, and the perception of consumers will also be described and documented.
6

Padilla, Danielle Jessica. "Cardiovascular and ventilatory limitations in the oxygen transport pathway." Diss., Kansas State University, 2005. http://hdl.handle.net/2097/137.

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Doctor of Philosophy
Department of Anatomy and Physiology
David C. Poole
The components of the O2 transport pathway can be divided into (along with their respective circulations) the pulmonary, cardiovascular, and skeletal muscle systems. They must operate in tight conjunction with one another, especially during dynamic exercise, to sustain ATP production within muscle mitochondria. Any limitation placed on the O2 transport pathway will result in decreased performance. The purpose of this dissertation is to present four novel studies which examine specific limitations on (1) the pulmonary system (i.e. lungs and circulation) within the highly athletic Thoroughbred horse (Studies A & B), and (2) within the peripheral circulation (i.e. microcirculation) within a disease model of Type II diabetes, the Goto-Kakizaki (GK) rat (Studies C & D). Study A demonstrates that locomotory respiratory coupling (LRC) is not requisite for the horse to achieve maximal minute ventilation (VE) during galloping exercise because VE remains at the peak exercising levels over the first ~13 s of trotting recovery (VE at end exercise: 1391±88; VE at 13 s: 1330±112 L/sec; P > 0.05). The horse also experiences exercise-induced pulmonary hemorrhage (EIPH) which has been linked mechanistically to increased pulmonary artery pressure (Ppa) during high intensity exercise. Therefore, in Study B, we hypothesized that endothelin-1 (ET-1), a powerful vasoconstricting hormone, would play a role in the augmented Ppa and therefore, EIPH. However, contrary to our hypothesis, an ET-1 receptor antagonist did not decrease Ppa nor prevent or reduce EIPH. Studies C and D examine potential mechanisms behind the exercise intolerance observed in humans with Type II diabetes. Utilizing phosphorescence quenching techniques (Study C) within the GK spinotrapezius muscle, we found lowered microvascular PO2 (PO2mv; Control: 28.8±2.0; GK: 18.4±1.8 mmHg; P<0.05) at rest and a PO2mv “undershoot” during muscle contractions. After conducting intravital microscopy within the same muscle (Study D), we discovered the percentage of RBC-perfused capillaries was decreased (Control: 93±3; GK: 66±5 %; P<0.05) and all three major hemodynamic variables (i.e. RBC velocity, flux, and capillary tube hematocrit) were significantly attenuated. Both studies (C & D) indicate that there is reduced O2 availability (via decreased O2 delivery; i.e. ↓QO2/VO2) within Type II diabetic muscle.
7

Wikström, Git. "Women’s Perspectives on Pathway to Diagnosis of Pulmonary Tuberculosis : Women Voices from Community Level in Uganda." Thesis, Nordic School of Public Health NHV, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:norden:org:diva-3116.

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Objectives:  A qualitative study to explore the perceptions and ideas of women at community level in Uganda, about factors influencing their health care-seeking behaviour when symptoms that could indicate pulmonary tuberculosis. To let the women identify barriers to health care-seeking and to let them present ideas how to overcome barriers. Method:  Focus Group Discussions (72 informants) and In Depth Interviews (19 informants) were conducted in rural Uganda with women of reproductive age. For triangulation purposes discussions and interviews also included health care providers, traditional healers and a few men. Main Results: The data showed a wide range of health care-seeking behaviours including no action at all, self-treatment using traditional herbs or western medicines, consulting traditional healers and consulting various formal or informal healthcare facilities. The data also identified many barriers that could prevent women from getting a proper diagnosis, including lack of financial resources, lack of power, male supremacy in decision-making, lack of knowledge, perceived corruption in healthcare facilities, fear of stigma and this fear heavily boosted by the idea that PTB equates HIV/AIDS. Conclusion: These data support the idea that successfully fighting PTB among Ugandan women and increasing case finding, demands recognition that tuberculosis is a multifaceted disease: economical, social, psychological and medical. Therefore, approaches to eradicating tuberculosis must target different sectors and reach all levels of society

ISBN 978-91-86739-19-5

8

Webster, Sayumporn. "Maze to care : the process of pathway to initial care of young adults aged 18-25 with their first presentation of a mental disorder /." Access electronically, 2004. http://www.library.uow.edu.au/adt-NWU/public/adt-NWU20050307.111731/index.html.

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9

Eshareturi, Cyril. "Mapping the offender health pathway : challenges and opportunities for support through community nursing." Thesis, University of Wolverhampton, 2016. http://hdl.handle.net/2436/614998.

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The current context of offender health in England and Wales indicates that offenders re-enter their communities with limited pre-release preparation for the continuity of access to healthcare and an increased risk of release with a health condition and very little support to cope in the community. This study was aimed at mapping the ex-offender health pathway towards identifying ‘touch points’ in the community for the delivery of a nurse led intervention. The study was a qualitative case study underpinned by ‘The Silences Framework’ which enabled it to gain theoretically by situating power with offenders, thus, aiding their ‘Silences’ to be heard, explored and brought to light. Participants meeting the study inclusion criteria were quantitatively ranked on the basis of poor health with those scoring the lowest and confirming their ranking through a confirmation of a health condition selected as cases and interviewed over the course of six months. These interview narratives were confirmed by interviewing individuals in the professional networks of offenders. The study identified the site of post-release supervision as the ‘touch point’ where a nurse led intervention could be delivered. With regards to the delivery of the health intervention, the study indicated that the nurse led intervention be provided as an advisory and signposting service structured on a drop-in and appointment basis. Furthermore, the study indicated that pre-release, offenders were not prepared in prison for the continuity in access to healthcare in the community on release. On-release, offenders’ on-release preparation did not enquire as a matter of procedure on whether offenders were registered with a GP or had the agency to register self with a GP practice in the community. Post release, the study uncovered a disparity between services which address the physical health needs of offenders and those which address their mental and substance misuse health needs.
10

Bimerew, Million S. "Developing a framework for a district-based information management system for mental health care in the Western Cape." Thesis, University of Western Cape, 2013. http://hdl.handle.net/11394/3324.

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Philosophiae Doctor - PhD
A review of the literature has shown that there is a lack of mental health information on which to base planning of mental health services and decisions concerning programme development for mental health services. Several studies have indicated that the use of an evidence-based health information system (HIS) reduces inappropriate clinical practices and promotes the quality of health care services. This study was aimed at developing a framework for a district-based mental health information management system, utilising the experiences of health care providers and caregivers about a district mental health information system (DMHIS). Activity Theory was used as the philosophical foundation of the information system for the study. A qualitative approach was employed using semi-structured individual interviews, Focus Group Discussions (FGDs), systematic review and document analysis. The intervention research design and development model of Rothman and Thomas (1994) was used to guide the study, which was conducted in the Cape Town Metropole area of the Western Cape. A purposive, convenient sampling method was employed to select study participants. Ethical clearance for the study was obtained from the University of the Western Cape, and permission to use the health facilities from the Department of Health. The data collection process involved 62 individual interview participants, from mental health nurses to district health managers, health information clerks, and patient caregivers/families and persons with stable mental conditions. Thirteen caregivers took part in the FGDs. Document review was conducted at three community mental health centres. The data were analysed manually using content analysis. Core findings of the interviews were lack of standardized information collection tools and contents for mental health, information infrastructure, capacity building, and resources. Information processing in terms of collection, compiling, analysing, feedback, access and sharing information were the major problems. Results from document analysis identified inconsistencies and inaccuracies of information recording and processing, which in turn affected the quality of information for decision making. Results from the systematic review identified five functional elements: organizational structure; information infrastructure; capacity building; inputs, process, output and feedback; and community and stakeholders’ participation in the design and implementation of a mental health information system (MHIS). The study has contributed a framework for a DMHIS based on the findings of the empirical and systematic review. It is recommended that there is a need to establish a HIS committee at district health facility level for effective implementation of the framework and quality information processing. There is a need to ensure that staffs have adequate knowledge and skills required for effective implementation of an information system. It is recommended that higher education institutions include a course on HISs in their curriculum. It is suggested that the South African Mental Health Policy be reviewed to include an MHIS and ensure involvement of the community and stakeholders in this system as well as adequate budget allocation.
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Книги з теми "Health care pathway":

1

Langridge, Eleanor. Health and social care for adult pathway. Cheltenham: Nelson Thornes, ., 2006.

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2

Bridgers, William F. Health care reform: The dilemma and a pathway for the health care system. St. Louis, MO: GW Manning, 1992.

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Wall, Deborah K. Critical pathway development guide: A team-oriented approach for developing critical pathways. Chicago: Precept Press, 1998.

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Wall, Deborah K. Critical pathway implementation guide: A methodology for managing critical pathways. Chicago: Precept Press, 1997.

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Catholic Health Association of the United States. Continuing the commitment: A pathway to health care reform. St. Louis, MO: Catholic Health Association, 2000.

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6

Goldberg, David. Mental illness in the community: The pathway to psychiatric care. London: Routledge, 2001.

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Sale, Diana N. T. Quality assurance: A pathway to excellence. Basingstoke: Macmillan, 2000.

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8

United States. Congress. Senate. Committee on Health, Education, Labor, and Pensions. Integrative care: A pathway to a healthier nation : hearing of the Committee on Health, Education, Labor, and Pensions, United States Senate, One Hundred Eleventh Congress, first session, on examining integrative care, focusing on a pathway to a healthier nation, February 26, 2009. Washington: U.S. G.P.O., 2010.

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9

Murer, Cherilyn G. Clinical co-management: A bridge to clinical Integration and pathway to bundled payments. Boca Raton: CRC Press / Taylor & Francis Group, 2016.

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Jarrett, Louise. The role of the nurse in the management of spasticity: [a care pathway for health and social care professionals in the community]. Letchworth: Multiple Sclerosis Trust, 2001.

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Частини книг з теми "Health care pathway":

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Dykgraaf, Ramon, Allard van den Hoven, and Helen Mijnarends-Akkermans. "Value-Based Health-Care Pathway for Patients with Turner Syndrome." In Personalized Specialty Care, 79–86. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-63746-0_11.

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Heß, Michael, Monika Kaczmarek, Ulrich Frank, Lars-Erik Podleska, and Georg Taeger. "Towards a Pathway-Based Clinical Cancer Registration in Hospital Information Systems." In Knowledge Representation for Health Care, 80–94. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-26585-8_6.

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Njeru, Mercy Karimi, Maureen Mackintosh, Richard Ngilangwa, Sharon Mokua, Richard Mutisya Arun, and Jane Mukami. "Access to Cancer Care: Navigating the Maze." In Cancer Care in Pandemic Times: Building Inclusive Local Health Security in Africa and India, 69–92. Cham: Springer International Publishing, 2024. http://dx.doi.org/10.1007/978-3-031-44123-3_4.

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AbstractThis chapter analyses narratives from over 450 patients in Kenya and Tanzania, describing their cancer “pathways”, drawing also on views from carers and health workers. We characterise patients’ experiences as, too often, finding themselves in a “maze” after they first visit a health facility. Rather than a smooth clinical pathway from symptoms to diagnosis, patients had found themselves struggling to find money to move through a confusing health system maze, largely without maps or guides to aid their search for information, diagnosis and treatment. The chapter describes patterns of experience within the maze, and implications for access to care.
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Brattgjerd, Marianne. "Rethinking nurses' mindlines about the Liverpool Care Pathway." In Knowledge Transformation in Health and Social Care, 93–105. London: Routledge, 2022. http://dx.doi.org/10.4324/9781003158721-7.

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van Furth, Wouter, and Nienke Biermasz. "Personal Attention to the Patient in the Pituitary Tumor Health-Care Pathway." In Personalized Specialty Care, 31–39. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-63746-0_5.

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Small, Neil. "The fall of the Liverpool Care Pathway and the challenges in end-of-life care." In Failures in Health and Social Care, 62–113. London: Routledge, 2023. http://dx.doi.org/10.4324/9781003332428-3.

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Haugdahl, Hege Selnes, Ingeborg Alexandersen, and Gørill Haugan. "Health Promotion Among Long-Term ICU Patients and Their Families." In Health Promotion in Health Care – Vital Theories and Research, 245–68. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-63135-2_18.

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AbstractFew patients are as helpless and totally dependent on nursing as long-term intensive care (ICU) patients. How the ICU nurse relates to the patient is crucial, both concerning the patients’ mental and physical health and well-being. Even if nurses provide evidence-based care in the form of minimum sedation, early mobilization, and attempts at spontaneous breathing during weaning, the patient may not have the strength, courage, and willpower to comply. Interestingly, several elements of human connectedness have shown a positive influence on patient outcomes. Thus, a shift from technical nursing toward an increased focus on patient understanding and greater patient and family involvement in ICU treatment and care is suggested. Accordingly, a holistic view including the lived experiences of ICU care from the perspectives of patients, family members, and ICU nurses is required in ICU care as well as research.Considerable research has been devoted to long-term ICU patients’ experiences from their ICU stays. However, less attention has been paid to salutogenic resources which are essential in supporting long-term ICU patients’ inner strength and existential will to keep on living. A theory of salutogenic ICU nursing is highly welcome. Therefore, this chapter draws on empirical data from three large qualitative studies in the development of a tentative theory of salutogenic ICU nursing care. From the perspective of former long-term ICU patients, their family members, and ICU nurses, this chapter provides insights into how salutogenic ICU nursing care can support and facilitate ICU patients’ existential will to keep on living, and thus promoting their health, survival, and well-being. In a salutogenic perspective on health, the ICU patient pathway along the ease/dis-ease continuum reveals three stages; (1) The breaking point, (2) In between, and (3) Never in my mind to give up. The tentative theory of salutogenic long-term ICU nursing care includes five main concepts: (1) the long-term ICU patient pathway (along the salutogenic health continuum), (2) the patient’s inner strength and willpower, (3) salutogenic ICU nursing care (4), family care, and (5) pull and push. The salutogenic concepts of inner strength, meaning, connectedness, hope, willpower, and coping are of vital importance and form the essence of salutogenic long-term ICU nursing care.
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Brugha, Traolach S., and Fiona Lindsay. "Quality of Mental Health Service Care: The Forgotten Pathway From Process to Outcome." In Mental Health Outcome Measures, 93–109. Berlin, Heidelberg: Springer Berlin Heidelberg, 2010. http://dx.doi.org/10.1007/978-3-642-80202-7_7.

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AlSalamah, Hessah, Alex Gray, and David Morrey. "Mapping the Integrated Care Pathway into BPM for Health Case Management." In S-BPM ONE - Education and Industrial Developments, 106–20. Berlin, Heidelberg: Springer Berlin Heidelberg, 2012. http://dx.doi.org/10.1007/978-3-642-29294-1_8.

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Hamana, Sabri, Vincent Augusto, and Xiaolan Xie. "Modelling Interactions Between Health Institutions in the Context of Patient Care Pathway." In Risks and Resilience of Collaborative Networks, 448–55. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-24141-8_41.

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Тези доповідей конференцій з теми "Health care pathway":

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Keen, Justin. "What is a care pathway?" In 2012 4th International Workshop on Software Engineering in Health Care (SEHC). IEEE, 2012. http://dx.doi.org/10.1109/sehc.2012.6227000.

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2

Petersone, Mara, Karlis Ketners, and Dainis Krievins. "Integrate health care system performance assessment for value-based health care implementation in Latvia." In Research for Rural Development 2021 : annual 27th International scientific conference proceedings. Latvia University of Life Sciences and Technologies, 2021. http://dx.doi.org/10.22616/rrd.27.2021.018.

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Every year, efforts are applied worldwide, particularly in the European Union, to improve health care systems by increasing the added value of resources already available for health care financing by increasing the performance of health care systems. According to experts of the World Health Organisation (WHO) and the Organisation for Economic Cooperation and Development (OECD), 20–40% of the resources are used for complications that could be avoided, for unnecessary treatment or administrative inefficiency. Therefore, a new initiative to improve health performance – the value-based health care concept (VBHC) is becoming increasingly popular in the world, and particularly in Europe. This scientific article aims to explore the possibilities of applying VBHC in Latvia and the interaction between various management tools in the field of health care. Application of the VBHC concept in Latvia is offered for discussion, where the outcome of the corresponding measure would be identified for each health service provider as part of a one-patient (care) pathway involving several independent health service providers. Based on the Health Care System Performance Assessment (HSPA), clinical (patient) pathways and indicators, to initiate an integrated VBHC model in four priority areas: circulatory system diseases, oncology, mental health, maternal and child health. Meta-analysis of the research is based on the use of qualitative data sources – the existing data sources from policies implemented by the Ministry of Health in Latvia and examples of the introduction of VBHC initiatives worldwide summarised by the VBHC Center Europe. The deductive research is based on the Value-Based Healthcare concept introduced by Porter and Teisberg (2007)
3

Mecham, C., B. Schimmoller, S. Smith, and M. Wheeler. "219. Using Measured Contaminant Concentrations Versus Modeling Results for CERCLA-Related Air Pathway Risk Assessments." In AIHce 1996 - Health Care Industries Papers. AIHA, 1999. http://dx.doi.org/10.3320/1.2764884.

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4

Garg, Lalit, Sally McClean, Maria Barton, Brian Meenan, and Ken Fullerton. "An extended phase type survival tree for patient pathway prognostication." In 2010 IEEE Workshop on Health Care Management (WHCM). IEEE, 2010. http://dx.doi.org/10.1109/whcm.2010.5441242.

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Bartlett, James. "Examining a Competency-Based Apprenticeship in Health Care: A Pathway for Immigrants." In 2020 AERA Annual Meeting. Washington DC: AERA, 2020. http://dx.doi.org/10.3102/1583685.

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6

Tyagi, Vipin, Hannah Goodge, Liz Stevens, Vana Gandhi, Archana Joshi, and Sreeni Tekki-Rao. "652 Integrated seizure care pathway- a RCPCH EQIP project." In Royal College of Paediatrics and Child Health, Abstracts of the RCPCH Conference–Online, 15 June 2021–17 June 2021. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2021. http://dx.doi.org/10.1136/archdischild-2021-rcpch.121.

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7

Ciriaco, Debora, Alexandre Pessoa, Lais Salvador, and Renata Wassermann. "Semantic Data Integration for Public Health in Brazil." In LatinX in AI at International Conference on Machine Learning 2019. Journal of LatinX in AI Research, 2019. http://dx.doi.org/10.52591/lxai2019061514.

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The lack of semantic information is a big challenge, even in context-driven areas like Healthcare, characterized by established terminologies. Here, semantic data integration is the solution to provide precise information and answers to questions like: What is the care pathway of newborns diagnosed with a congenital anomaly in consequence of congenital syphilis in the city of Sao Paulo? This project will use a semantic data integration technique, ontology based data integration, to integrate three health databases from the city of Sao Paulo - Brazil: mortality, live births and hospital information system. It is expected that the integration of public health databases will help to map patient care pathways, predict public resource needs and minimize unnecessary spending.
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Kwok, Chanel, Katherine Lajkosz, Carole Madeley, Mona Jabbour, Teresa To, and M. Diane Lougheed. "Effects of a standardized Emergency Department asthma care pathway on health services utilization." In ERS International Congress 2018 abstracts. European Respiratory Society, 2018. http://dx.doi.org/10.1183/13993003.congress-2018.oa5155.

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Lim, Yinru, Oliver Walker, Aishin Lok, and Nandiran Ratnavel. "745 Cooling for transfer: an integrated care pathway for London (cooltrip)." In Royal College of Paediatrics and Child Health, Abstracts of the RCPCH Conference–Online, 15 June 2021–17 June 2021. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2021. http://dx.doi.org/10.1136/archdischild-2021-rcpch.175.

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Chatoo, Zaynab, Joseph Machta, Bhavik Gami, Aashish Bansal, and Claire Miller. "897 Caught in the Net – an integrated care quality improvement initiative standardising safety-netting across the urgent care pathway." In Royal College of Paediatrics and Child Health, Abstracts of the RCPCH Conference, Glasgow, 23–25 May 2023. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2023. http://dx.doi.org/10.1136/archdischild-2023-rcpch.683.

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Звіти організацій з теми "Health care pathway":

1

Adebayo, Oliver, Joanna Aldoori, William Allum, Noel Aruparayil, Abdul Badran, Jasmine Winter Beatty, Sanchita Bhatia, et al. Future of Surgery: Technology Enhanced Surgical Training: Report of the FOS:TEST Commission. The Royal College of Surgeons of England, August 2022. http://dx.doi.org/10.1308/fos2.2022.

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Over the past 50 years the capability of technology to improve surgical care has been realised and while surgical trainees and trainers strive to deliver care and train; the technological ‘solutions’ market continues to expand. However, there remains no coordinated process to assess these technologies. The FOS:TEST Report aimed to (1) define the current, unmet needs in surgical training, (2) assess the current evidence-base of technologies that may be beneficial to training and map these onto both the patient and trainee pathway and (3) make recommendations on the development, assessment, and adoption of novel surgical technologies. The FOS:TEST Commission was formed by the Association of Surgeons in Training (ASiT), The Royal College of Surgeons of England (RCS England) Robotics and Digital Surgery Group and representatives from all trainee specialty associations. Two national datasets provided by Health Education England were used to identify unmet surgical training needs through qualitative analysis against pre-defined coding frameworks. These unmet needs were prioritised at two virtual consensus hackathons and mapped to the patient and trainee pathway and the capabilities in practice (CiPs) framework. The commission received more than 120 evidence submissions from surgeons in training, consultant surgeons and training leaders. Following peer review, 32 were selected that covered a range of innovations. Contributors also highlighted several important key considerations, including the changing pedagogy of surgical training, the ethics and challenges of big data and machine learning, sustainability, and health economics. This summates to 7 Key Recommendations and 51 concluding statements. The FOS:TEST Commission was borne out of what is a pivotal point in the digital transformation of surgical training. Academic expertise and collaboration will be required to evaluate efficacy of any novel training solution. However, this must be coupled with pragmatic assessments of feasibility and cost to ensure that any intervention is scalable for national implementation. Currently, there is no replacement for hands-on operating. However, for future UK and ROI surgeons to stay relevant in a global market, our training methods must adapt. The Future of Surgery: Technology Enhanced Surgical Training Report provides a blueprint for how this can be achieved.
2

Lawson, Louise, Ade Kearns, Mhairi Mackenzie, and Tanya Wilson. Women in Multiple Low-paid Employment: Pathways Between Work, Care and Health. Final Report. University of Glasgow, May 2024. http://dx.doi.org/10.36399/gla.pubs.326795.

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3

Moore, Gabriel, Greer Dawson, and Chloe Gao. Transfer of care programs focusing on Aboriginal people. The Sax Institute, June 2018. http://dx.doi.org/10.57022/wols2976.

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This review aimed to identify promising models for transfer of care initiatives in Australia that have been designed and implemented with an Aboriginal perspective to meet the needs of Aboriginal communities. These initiatives aim to improve transfer of care for Aboriginal patients to and from hospital care and back to primary care (GP and community). The reviews findings are reported under: studies focusing on transfer of care, studies focusing on care pathways, and early intervention principles. Specific programs focusing on different health conditions are summarised, and barriers and facilitators to success were identified and included. The review was commissioned by the Agency for Clinical Innovation who have identified improving transfer of care for Aboriginal people as a priority to improve health outcomes for Aboriginal people.
4

Ryland, Howard, and Sarah Bunn. Reforming the Mental Health Act - Approaches to Improve Patient Choice. Parliamentary Office of Science and Technology, UK Parliament, May 2023. http://dx.doi.org/10.58248/pn695.

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The Mental Health Act 1983 has been criticised as being overly restrictive, with inadequate scope for patient choice and autonomy. The Government’s Draft Mental Health Bill proposes reforms to improve patient choice. A joint parliamentary committee report on the draft Bill recommended further changes to enhance choice, including a statutory duty to offer patients advance choice documents. Reports to date suggest that advance care planning could offer some benefits, but uptake can be low. Proposals to replace the Nearest Relative who has certain powers under the Act, with a Nominated Person of the patient’s choosing, have been widely welcomed. There are questions about operationalisation and safeguarding. Alongside the reforms, the Government is piloting ‘culturally appropriate advocacy’, which preliminary findings suggest could help advocates better support patients from ethnic minority backgrounds. The draft Bill removes learning disabilities and autism as grounds for detention under Section 3 of the Act. Stakeholders have raised concerns about unintended diversion to more restrictive pathways, such as the criminal justice system. A range of stakeholders share the view that careful implementation is needed to maximise the benefits of proposed reforms. The Government has not announced when the Bill will be introduced.
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Hartoto, Annisa Sabrina, and Ken M. P. Setiawan. Membuka Jalan untuk Pembangunan Inklusif Gender di Daerah Perdesaan Indonesia: Bunga Rampai Kajian Aksi Kolektif Perempuan dan Pengaruhnya pada Pelaksanaan Undang-Undang Desa [Forging Pathways for Gender-inclusive Development in Rural Indonesia: Case Studies of Women’s Collective Action and Influence on Village Law Implementation]. Edited by Amalinda Savirani and Rachael Diprose. University of Melbourne with Universitas Gadjah Mada and MAMPU, 2020. http://dx.doi.org/10.46580/124328.

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An edited volume (180K) of 12 analysis case studies (what we call stories of change - SOCs but these are village/region stories not individual stories). The case studies draw on multiple sources of data. These were originally written in Bahasa Indonesia, with abstracts in both English and Bahasa Indonesia. The volume also has an introductory analysis article that has its own analysis and illustrates core points from the case studies – separate and citable (see below). Case studies are organised by the five sectoral themes of the work covered by CSOs (e.g. supporting migrant workers, targeting reproductive health and nutrition, targeting social protection, targeting reductions in domestic and other gender-based violence, and support for informal sector workers who work at home).
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Hartoto, Annisa Sabrina, and Ken M. P. Setiawan. Membuka Jalan untuk Pembangunan Inklusif Gender di Daerah Perdesaan Indonesia: Bunga Rampai Kajian Aksi Kolektif Perempuan dan Pengaruhnya pada Pelaksanaan Undang-Undang Desa [Forging Pathways for Gender-inclusive Development in Rural Indonesia: Case Studies of Women’s Collective Action and Influence on Village Law Implementation]. Edited by Amalinda Savirani and Rachael Diprose. University of Melbourne with Universitas Gadjah Mada and MAMPU, 2020. http://dx.doi.org/10.46580/124328.

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An edited volume (180K) of 12 analysis case studies (what we call stories of change - SOCs but these are village/region stories not individual stories). The case studies draw on multiple sources of data. These were originally written in Bahasa Indonesia, with abstracts in both English and Bahasa Indonesia. The volume also has an introductory analysis article that has its own analysis and illustrates core points from the case studies – separate and citable (see below). Case studies are organised by the five sectoral themes of the work covered by CSOs (e.g. supporting migrant workers, targeting reproductive health and nutrition, targeting social protection, targeting reductions in domestic and other gender-based violence, and support for informal sector workers who work at home).
7

Dale, Naomi, Aneesa Khan, and Sophie Dale. Early intervention for vision and neurodevelopment in infants and very young children with visual impairment: a systematicreview. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, August 2022. http://dx.doi.org/10.37766/inplasy2022.8.0080.

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Review question / Objective: Research question - What is the effectiveness of Early Childhood Intervention (ECI) in the first 3 years of life? Population (P) Infants and very young children with diagnosed visual impairment. Intervention (I) ECI programmes that includes vision and developmental stimulation, play, learning and responsive parenting Comparison (C) Standard care or control Outcomes (O) Primary: Vision function or and/or neurodevelopment and/or parent-child interaction outcomes Secondary: Parental context factors eg parental wellbeing and mental health, parental satisfaction with service provision. Condition being studied: Childhood congenital or very early visual impairment arising from congenital disorders of the peripheral or anterior visual system or cerebral-based vision disorders. This includes all vision disorders of the globe, retina and anterior optic nerve and all vision disorders that are considered cerebral based along visual pathways that are retro-chiasmatic and include central brain regions and networks involved in vision processing.
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Smit, Amelia, Kate Dunlop, Nehal Singh, Diona Damian, Kylie Vuong, and Anne Cust. Primary prevention of skin cancer in primary care settings. The Sax Institute, August 2022. http://dx.doi.org/10.57022/qpsm1481.

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Overview Skin cancer prevention is a component of the new Cancer Plan 2022–27, which guides the work of the Cancer Institute NSW. To lessen the impact of skin cancer on the community, the Cancer Institute NSW works closely with the NSW Skin Cancer Prevention Advisory Committee, comprising governmental and non-governmental organisation representatives, to develop and implement the NSW Skin Cancer Prevention Strategy. Primary Health Networks and primary care providers are seen as important stakeholders in this work. To guide improvements in skin cancer prevention and inform the development of the next NSW Skin Cancer Prevention Strategy, an up-to-date review of the evidence on the effectiveness and feasibility of skin cancer prevention activities in primary care is required. A research team led by the Daffodil Centre, a joint venture between the University of Sydney and Cancer Council NSW, was contracted to undertake an Evidence Check review to address the questions below. Evidence Check questions This Evidence Check aimed to address the following questions: Question 1: What skin cancer primary prevention activities can be effectively administered in primary care settings? As part of this, identify the key components of such messages, strategies, programs or initiatives that have been effectively implemented and their feasibility in the NSW/Australian context. Question 2: What are the main barriers and enablers for primary care providers in delivering skin cancer primary prevention activities within their setting? Summary of methods The research team conducted a detailed analysis of the published and grey literature, based on a comprehensive search. We developed the search strategy in consultation with a medical librarian at the University of Sydney and the Cancer Institute NSW team, and implemented it across the databases Embase, MEDLINE, PsycInfo, Scopus, Cochrane Central and CINAHL. Results were exported and uploaded to Covidence for screening and further selection. The search strategy was designed according to the SPIDER tool for Qualitative and Mixed-Methods Evidence Synthesis, which is a systematic strategy for searching qualitative and mixed-methods research studies. The SPIDER tool facilitates rigour in research by defining key elements of non-quantitative research questions. We included peer-reviewed and grey literature that included skin cancer primary prevention strategies/ interventions/ techniques/ programs within primary care settings, e.g. involving general practitioners and primary care nurses. The literature was limited to publications since 2014, and for studies or programs conducted in Australia, the UK, New Zealand, Canada, Ireland, Western Europe and Scandinavia. We also included relevant systematic reviews and evidence syntheses based on a range of international evidence where also relevant to the Australian context. To address Question 1, about the effectiveness of skin cancer prevention activities in primary care settings, we summarised findings from the Evidence Check according to different skin cancer prevention activities. To address Question 2, about the barriers and enablers of skin cancer prevention activities in primary care settings, we summarised findings according to the Consolidated Framework for Implementation Research (CFIR). The CFIR is a framework for identifying important implementation considerations for novel interventions in healthcare settings and provides a practical guide for systematically assessing potential barriers and facilitators in preparation for implementing a new activity or program. We assessed study quality using the National Health and Medical Research Council (NHMRC) levels of evidence. Key findings We identified 25 peer-reviewed journal articles that met the eligibility criteria and we included these in the Evidence Check. Eight of the studies were conducted in Australia, six in the UK, and the others elsewhere (mainly other European countries). In addition, the grey literature search identified four relevant guidelines, 12 education/training resources, two Cancer Care pathways, two position statements, three reports and five other resources that we included in the Evidence Check. Question 1 (related to effectiveness) We categorised the studies into different types of skin cancer prevention activities: behavioural counselling (n=3); risk assessment and delivering risk-tailored information (n=10); new technologies for early detection and accompanying prevention advice (n=4); and education and training programs for general practitioners (GPs) and primary care nurses regarding skin cancer prevention (n=3). There was good evidence that behavioural counselling interventions can result in a small improvement in sun protection behaviours among adults with fair skin types (defined as ivory or pale skin, light hair and eye colour, freckles, or those who sunburn easily), which would include the majority of Australians. It was found that clinicians play an important role in counselling patients about sun-protective behaviours, and recommended tailoring messages to the age and demographics of target groups (e.g. high-risk groups) to have maximal influence on behaviours. Several web-based melanoma risk prediction tools are now available in Australia, mainly designed for health professionals to identify patients’ risk of a new or subsequent primary melanoma and guide discussions with patients about primary prevention and early detection. Intervention studies have demonstrated that use of these melanoma risk prediction tools is feasible and acceptable to participants in primary care settings, and there is some evidence, including from Australian studies, that using these risk prediction tools to tailor primary prevention and early detection messages can improve sun-related behaviours. Some studies examined novel technologies, such as apps, to support early detection through skin examinations, including a very limited focus on the provision of preventive advice. These novel technologies are still largely in the research domain rather than recommended for routine use but provide a potential future opportunity to incorporate more primary prevention tailored advice. There are a number of online short courses available for primary healthcare professionals specifically focusing on skin cancer prevention. Most education and training programs for GPs and primary care nurses in the field of skin cancer focus on treatment and early detection, though some programs have specifically incorporated primary prevention education and training. A notable example is the Dermoscopy for Victorian General Practice Program, in which 93% of participating GPs reported that they had increased preventive information provided to high-risk patients and during skin examinations. Question 2 (related to barriers and enablers) Key enablers of performing skin cancer prevention activities in primary care settings included: • Easy access and availability of guidelines and point-of-care tools and resources • A fit with existing workflows and systems, so there is minimal disruption to flow of care • Easy-to-understand patient information • Using the waiting room for collection of risk assessment information on an electronic device such as an iPad/tablet where possible • Pairing with early detection activities • Sharing of successful programs across jurisdictions. Key barriers to performing skin cancer prevention activities in primary care settings included: • Unclear requirements and lack of confidence (self-efficacy) about prevention counselling • Limited availability of GP services especially in regional and remote areas • Competing demands, low priority, lack of time • Lack of incentives.
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Tipton, Kelley, Brian F. Leas, Nikhil K. Mull, Shazia M. Siddique, S. Ryan Greysen, Meghan B. Lane-Fall, and Amy Y. Tsou. Interventions To Decrease Hospital Length of Stay. Agency for Healthcare Research and Quality (AHRQ), September 2021. http://dx.doi.org/10.23970/ahrqepctb40.

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Background. Timely discharge of hospitalized patients can prevent patient harm, improve patient satisfaction and quality of life, and reduce costs. Numerous strategies have been tested to improve the efficiency and safety of patient recovery and discharge, but hospitals continue to face challenges. Purpose. This Technical Brief aimed to identify and synthesize current knowledge and emerging concepts regarding systematic strategies that hospitals and health systems can implement to reduce length of stay (LOS), with emphasis on medically complex or vulnerable patients at high risk for prolonged LOS due to clinical, social, or economic barriers to timely discharge. Methods. We conducted a structured search for published and unpublished studies and conducted interviews with Key Informants representing vulnerable patients, hospitals, health systems, and clinicians. The interviews provided guidance on our research protocol, search strategy, and analysis. Due to the large and diverse evidence base, we limited our evaluation to systematic reviews of interventions to decrease hospital LOS for patients at potentially higher risk for delayed discharge; primary research studies were not included, and searches were restricted to reviews published since 2010. We cataloged the characteristics of relevant interventions and assessed evidence of their effectiveness. Findings. Our searches yielded 4,364 potential studies. After screening, we included 19 systematic reviews reported in 20 articles. The reviews described eight strategies for reducing LOS: discharge planning; geriatric assessment or consultation; medication management; clinical pathways; inter- or multidisciplinary care; case management; hospitalist services; and telehealth. All reviews included adult patients, and two reviews also included children. Interventions were frequently designed for older (often frail) patients or patients with chronic illness. One review included pregnant women at high risk for premature delivery. No reviews focused on factors linking patient vulnerability with social determinants of health. The reviews reported few details about hospital setting, context, or resources associated with the interventions studied. Evidence for effectiveness of interventions was generally not robust and often inconsistent—for example, we identified six reviews of discharge planning; three found no effect on LOS, two found LOS decreased, and one reported an increase. Many reviews also reported patient readmission rates and mortality but with similarly inconsistent results. Conclusions. A broad range of strategies have been employed to reduce LOS, but rigorous systematic reviews have not consistently demonstrated effectiveness within medically complex, high-risk, and vulnerable populations. Health system leaders, researchers, and policymakers must collaborate to address these needs.
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Wang, Ying yuan, Zechang Chen, Luxin Zhang, Shuangyi Chen, Zhuomiao Ye, Tingting Xu, and Yingying Zhang c. A systematic review and network meta-analysis: Role of SNPs in predicting breast carcinoma risk. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, February 2022. http://dx.doi.org/10.37766/inplasy2022.2.0092.

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Review question / Objective: P: Breast cancer patient; I: Single nucleotide polymorphisms associated with breast cancer risk; C: Healthy person; O: By comparing the proportion of SNP mutations in the tumor group and the control group, the effect of BREAST cancer risk-related SNP was investigated; S: Case-control study. Condition being studied: Breast cancer (BC) is one of the most common cancers among women, and its morbidity and mortality have continued to increase worldwide in recent years, reflecting the strong invasiveness and metastasis characteristics of this cancer. BC is a complex disease that involves a sequence of genetic, epigenetic, and phenotypic changes. Polymorphisms of genes involved in multiple biological pathways have been identified as potential risks of BC. These genetic polymorphisms further lead to differences in disease susceptibility and severity among individuals. The development of accurate molecular diagnoses and biological indicators of prognosis are crucial for individualized and precise treatment of BC patients.

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