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1.
J Med Libr Assoc ; 109(3): 497-502, 2021 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-34629981

RESUMEN

Background: Prior to 2020, library orientation for first-year medical students at Weill Cornell Medicine took the form of an on-site treasure hunt competition. Due to the COVID-19 pandemic, the orientation for the MD class of 2024 was shifted to an all-virtual format. This shift mandated a full redesign of the library orientation. Case Presentation: The Samuel J. Wood Library sought to preserve the excitement and fun of the treasure hunt in the new virtual format. The competition was redesigned as a Zoom meeting using breakout rooms, with library faculty and staff serving as team facilitators. Tasks were rewritten, shifting the focus from the library's physical spaces to its virtual services and online resources. The redesigned orientation was evaluated using two data sources: a postsession survey of student participants and a debriefing of the library employees who participated. Student evaluations were positive, while the faculty and staff provided numerous suggestions for improving future virtual orientations. Conclusions: A successful virtual library orientation requires careful preparation, including testing the competition tasks, full rehearsal with library facilitators, and a thoughtful approach to technology and logistics. We have chosen to share the materials we developed for other academic health sciences libraries that may wish to take a similar approach to their own virtual orientations.


Asunto(s)
COVID-19 , Educación de Pregrado en Medicina/organización & administración , Bibliotecas Digitales/organización & administración , Bibliotecas Médicas/organización & administración , Estudios de Casos Organizacionales , Adulto , Femenino , Humanos , Masculino , New York , Pandemias , SARS-CoV-2 , Estudiantes de Medicina , Adulto Joven
2.
WMJ ; 120(2): 137-141, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34255954

RESUMEN

INTRODUCTION: The COVID-19 pandemic presented health care organizations with a unique challenge in determining effective management of a large-scale incident across an extended time period. CASE PRESENTATION: This report describes the response of a multisite integrated system to the COVID-19 pandemic through activation of the Hospital Incident Command System. DISCUSSION: A robust emergency response plan with multidisciplinary involvement can help to ensure clear lines of accountability and expedite decision-making. Consistent physician input across affected specialties allows for a robust understanding of impacted areas, peer-to-peer communication, and a sense of ownership across the medical staff. The necessity of effective communication with staff and patients during times of crisis cannot be understated. The potential for information overload in a pandemic is significant but can be overcome through consistent and transparent communication from leadership. CONCLUSION: Health systems should have a well-organized emergency response system prepared to launch in small-scale or large-scale situations. The threshold to implement the response system and accountability to make that decision must be a clearly defined organizational policy.


Asunto(s)
COVID-19/epidemiología , Sistemas de Apoyo a Decisiones Administrativas , Planificación en Desastres , Planificación Hospitalaria , Comunicación , Humanos , Estudios de Casos Organizacionales , Política Organizacional , Pandemias , SARS-CoV-2 , Capacidad de Reacción , Wisconsin/epidemiología
3.
Healthc Q ; 24(2): 33-37, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34297661

RESUMEN

Physician engagement is an important factor in improving care quality and patient safety, but engaging physicians is not easy. Winston Churchill's famous assertion about never wasting a crisis has defined the approach taken by many leaders during the COVID-19 pandemic. This paper describes three case studies of successful physician engagement across the continuum of acute care, chronic care and primary care settings during the pandemic. These examples offer insights on physician engagement within unique settings by leveraging intrinsic motivators and Spurgeon's model of medical engagement.


Asunto(s)
COVID-19/epidemiología , Atención a la Salud/organización & administración , Médicos/organización & administración , Participación de los Interesados , COVID-19/terapia , Cuidados Críticos/organización & administración , Humanos , Ontario/epidemiología , Estudios de Casos Organizacionales , Atención Primaria de Salud/organización & administración
4.
BMJ Open Qual ; 10(3)2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34244176

RESUMEN

The globe is gripped by the COVID-19 pandemic. Mass population vaccination is seen as the solution. As vaccines become available, governments aim to deploy them as rapidly as possible. It is important, therefore, that the efficiency of vaccination processes is optimal.Operations management is concerned with improving processes and comprises systematic approaches such as Lean. Lean focuses explicitly on process efficiency through the elimination of non-value adding steps to optimise processes for those who use and depend on them.Technology-enhanced learning can be a strategy to build improvement capability at scale. A massive online programme to build capability in Lean has been developed by the regulator of England's National Health Service. Beta testing of this programme has been used by some test sites to refine their COVID-19 vaccination processes. The paper presents a case example of massive online learning supporting the use of Lean in the day-to-day operations management of COVID-19 vaccine processes.The case example illustrates the challenges that vaccination processes may present and the need for responsive and effective operations management. Building capability to respond rapidly and systematically in dynamic situations to optimise flow, safety and patient experience may be beneficial.Given the national imperative to achieve mass vaccination as rapidly as possible, systematic improvement methods such as Lean may have a contribution to make. Massive online programmes, such as that described here, may help with this effort by achieving timely knowledge transfer at large scale.


Asunto(s)
Tecnología Biomédica , Vacunas contra la COVID-19/uso terapéutico , COVID-19/prevención & control , Creación de Capacidad/métodos , Vacunación Masiva/organización & administración , Inglaterra , Humanos , Estudios de Casos Organizacionales , SARS-CoV-2 , Medicina Estatal
5.
HERD ; 14(3): 34-48, 2021 07.
Artículo en Inglés | MEDLINE | ID: mdl-34075789

RESUMEN

OBJECTIVE: This case study examines the implementation of inpatient telemedicine in COVID-19 intensive care units (ICUs) and explores the impact of shifting forms of visibility on the management of the unit, staff collaboration, and patient care. BACKGROUND: The COVID-19 crisis drove healthcare institutions to rapidly develop new models of care based on integrating digital technologies for remote care with transformations in the hospital-built environment. The Sheba Medical Center in Israel created COVID-19 ICUs in an underground structure with an open-ward layout and telemedicine control rooms to remotely supervise, communicate, and support the operations in the contaminated zones. One unit had a physical visual connection between the control room and the contaminated zone through a window, while the other had only a virtual connection with digital technologies. METHODS: The findings are based on semistructured interviews with Sheba medical staff, telemedicine companies, and the architectural design team and observations at the COVID-19 units during March-August 2020. RESULTS: The case study illustrates the implications of virtual and physical visibility on the management of the unit, staff collaboration, and patient care. It demonstrates the correlations between patterns of visibility and the users' sense of control, orientation in space, teamwork, safety, quality of care, and well-being. CONCLUSIONS: The case study demonstrates the limitations of current telemedicine technologies that were not designed for inpatient care to account for the spatial perception of the unit and the dynamic use of the space. It presents the potential of a hybrid model that balances virtual and physical forms of visibility and suggests directions for future research and development of inpatient telemedicine.


Asunto(s)
COVID-19/terapia , Unidades de Cuidados Intensivos/organización & administración , Telemedicina/métodos , COVID-19/prevención & control , Arquitectura y Construcción de Instituciones de Salud/métodos , Arquitectura y Construcción de Instituciones de Salud/normas , Humanos , Control de Infecciones/métodos , Israel , Estudios de Casos Organizacionales , Aislamiento de Pacientes/métodos , SARS-CoV-2 , Telemedicina/organización & administración
6.
Phys Ther ; 101(9)2021 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-34174072

RESUMEN

OBJECTIVE: The purpose of this case report is to describe the challenges that COVID-19 presented for therapists in a pediatric hospital and the response to these challenges. METHODS: The case report setting is a physical therapy and occupational therapy department (department) of an academic pediatric medical center that provides a range of health care services for children and youth. Challenges that COVID-19 presented to the department included (1) managing safety concerns for patients, their families, and staff; (2) continuing to provide high-quality therapy services within state-mandated restrictions; (3) triaging patients; and (4) keeping clinicians employed and working productively. RESULTS: The department therapists responded to these challenges by (1) increasing communication huddles; (2) developing procedures for staffing and triaging of patients; (3) developing procedures for telehealth therapy services; and (4) designing a remote work program for all department employees. The number of patients and staff on site were reduced by initiating telehealth services, triaging patients, and developing a remote work plan. Communication huddles, department meetings, and supervision meetings were converted to virtual meetings. Staffing rates, patient-care productivity, and department project work were maintained. CONCLUSION: In response to COVID-19, the department developed new protocols and provided information about the protocols, which might be helpful for other pediatric hospitals or outpatient settings when planning for future pandemics or other issues that challenge the ability to provide usual care. Increasing the frequency of verbal and written communication on operational topics is recommended. Primary sources of information from national organizations (eg, the American Physical Therapy Association and the American Occupational Therapy Association) can assist with determining the scope of practice and code of conduct during a pandemic. IMPACT: COVID-19 posed challenges to operations and delivery of patient care. Although this case report is specific to COVID-19, principles applied and lessons learned from this experience can be applied to other emergency situations.


Asunto(s)
COVID-19/prevención & control , Hospitales Pediátricos/organización & administración , Control de Infecciones/organización & administración , Servicio de Terapia Ocupacional en Hospital/organización & administración , Servicio de Fisioterapia en Hospital/organización & administración , Rehabilitación/organización & administración , COVID-19/epidemiología , COVID-19/transmisión , Protocolos Clínicos , Humanos , Massachusetts , Estudios de Casos Organizacionales , Selección de Paciente , Telemedicina/organización & administración , Triaje
7.
Med Ref Serv Q ; 40(2): 188-204, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33970820

RESUMEN

The UCLA Science Libraries improved upon our single service points by creating a team-based, tiered research assistance model to foster student employee skill development. This model was further developed to expand training for public services staff, enabling librarians and student research assistants to move beyond desk-based services. This multi-phased approach involved restructured training and the development of collaborative, tiered services. Librarians utilized train-the-trainer sessions, detailed documentation toolkits, and a robust outreach plan to ensure success. After initial implementation of this new model, librarians observed above average use of the service and excellent user feedback. Its versatility has also played a direct role in the successful transition from physical to virtual services in light of the COVID-19 pandemic.


Asunto(s)
COVID-19/epidemiología , Bibliotecas Médicas/organización & administración , Bibliotecología/educación , Modelos Organizacionales , Humanos , Capacitación en Servicio , Los Angeles/epidemiología , Estudios de Casos Organizacionales , Admisión y Programación de Personal , Desarrollo de Programa , Mejoramiento de la Calidad , SARS-CoV-2
8.
Med Ref Serv Q ; 40(2): 151-167, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33970824

RESUMEN

Between 2018 and 2019, the librarians at the Strauss Health Sciences Library improved the efficiency and reach of their reference service by implementing four small-scale changes. These changes included revising the method of collecting statistics, creating FAQs, utilizing an appointment scheduler, and launching proactive chat. This case study will provide the background and research to support these changes, details on how the changes were implemented using Springshare tools, as well as the results and implications. Finally, the librarians will share their lessons learned along with recommendations for institutions interested in adopting similar changes.


Asunto(s)
Difusión de la Información/métodos , Bibliotecas Médicas/organización & administración , Modelos Organizacionales , Colorado , Humanos , Estudios de Casos Organizacionales
9.
Public Health ; 194: 270-273, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-34000651

RESUMEN

OBJECTIVES: The aim of the report is to summarise the progress made during a six-month pilot project expanding arts therapies provision from an inpatient service to community services, in a National Health Service health board's Older Adult Mental Health Services, in response to the need for direct therapy with older adults who have severe cognitive impairment and communication difficulties arising from dementia and/or complex mental health difficulties. STUDY DESIGN: This is a case report on a pilot project. METHODS: The level of need for the service was explored, and indicators of effectiveness were gathered using evaluation forms-observer feedback forms and ARM-5 (Agnew Relationship Measure - 5) - to indicate the therapeutic alliance, team review and feedback from colleagues. RESULTS: To gather indications about the level of need, we recorded the following: number of referrals (n = 125) and waiting list numbers at the end of the project (n = 34). CONCLUSIONS: This pilot project indicates that there is need for psychological interventions in older adult community mental health services that arts therapies provision can help address. The number of referrals is one indicator of the level of need, and positive feedback from clients, families and colleagues, is an indicator that the team delivered effectively. The areas of client need addressed in sessions as documented in observer feedback forms indicate that for these clients, arts therapies was a valuable resource in addressing challenges arising from mental health difficulties and/or dementia.


Asunto(s)
Terapia con Arte/organización & administración , Disfunción Cognitiva/terapia , Servicios Comunitarios de Salud Mental/organización & administración , Demencia/terapia , Medicina Estatal/organización & administración , Anciano , Consejo Directivo , Humanos , Evaluación de Necesidades , Estudios de Casos Organizacionales , Proyectos Piloto , Resultado del Tratamiento , Gales
10.
J Gerontol Soc Work ; 64(6): 643-655, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33882782

RESUMEN

Older adults' relationship to information and communications technology (ICT) is often discussed in terms of the digital divide or technology gap. Older persons, those 65 years of age and older, are seen as excluded or marginally represented in the digital sphere, even though data show their use of technology is increasing. Challenges in technology adoption and models for improving digital inclusion are both well-known, but the COVID pandemic and its general shift to digital life have created a critical need to increase digital inclusion of older persons. A case study of Older Adults Technology Services (OATS) and the organization's migration from in-person to virtual programming is used as an example of reframing the way the relationship of older adults to technology is seen in the field and in practice. Policy and programming implications of this new view of technology are discussed in the conclusion.


Asunto(s)
COVID-19/epidemiología , Tecnología Digital/educación , Relaciones Interpersonales , Interfaz Usuario-Computador , Comunicación por Videocoferencia , Anciano , Anciano de 80 o más Años , Empoderamiento , Femenino , Humanos , Masculino , Estudios de Casos Organizacionales , SARS-CoV-2
11.
Emerg Radiol ; 28(4): 705-711, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33813649

RESUMEN

PURPOSE: During the first peak of the COVID-19 pandemic, the activity of Emergency Departments worldwide changed dramatically, focusing on diagnosis and care of the Sars-Cov-2 associated disease. These major changes also involved the activity of the Emergency Radiology Department (ERD). This study aimed to analyse the impact of the COVID-19 pandemic on imaging studies, both in terms of the amount, frequency and subspecialty of different imaging modalities requested to the ERD of the Maggiore della Carità Hospital in Novara (Italy). METHODS: To this end, our observational study took into account the imaging studies requested by the emergency department during three-time spans. These were defined as phase 0 (pre-pandemic), phase 1 (pandemic peak with complete lockdown) and phase 2 (post-pandemic peak with partial lifting of restrictive measures), as derived from Italian urgent decrees by the President of the Council of Ministers (DPCM) which established the duration and entity of the lockdown measures throughout the pandemic. The dataset was processed and then compared with Pearson's chi-squared test. RESULTS: During the pandemic peak, our data showed a significant drop in the total number of studies requested and a significant rise in computed tomography (CT) studies. In particular, a statistically significant increase in chest CT studies was found, probably due to the high sensitivity of this imaging method in identifying pulmonary involvement during respiratory tract infection of possible viral etiology (SARS-Cov-2). Moreover, we observed a statistically significant decrease of X-ray (XR) and ultrasound (US) studies during phase 1 compared to phase 0 and phase 2 probably due to a reduction in the numbers of ER visits for minor traumas given the mobility restrictions and people hesitancy in visiting the ER due to fear of contagion. CONCLUSIONS: We can conclude that the activity of the ERD was heavily impacted by the SARS-Cov-2 pandemic. Further studies will be needed to estimate the impact of the pandemic on public health in terms of excess mortality related to delayed diagnosis and care of non-COVID diseases.


Asunto(s)
COVID-19/epidemiología , Diagnóstico por Imagen/estadística & datos numéricos , Servicio de Urgencia en Hospital/organización & administración , Neumonía Viral/epidemiología , Necesidades y Demandas de Servicios de Salud , Planificación Hospitalaria , Humanos , Italia/epidemiología , Estudios de Casos Organizacionales , Pandemias , Neumonía Viral/virología , SARS-CoV-2
12.
J Am Med Inform Assoc ; 28(7): 1555-1563, 2021 07 14.
Artículo en Inglés | MEDLINE | ID: mdl-33713131

RESUMEN

OBJECTIVE: The study sought to develop an in-depth understanding of how hospitals with a long history of health information technology (HIT) use have responded to the COVID-19 (coronavirus disease 2019) pandemic from an HIT perspective. MATERIALS AND METHODS: We undertook interviews with 44 healthcare professionals with a background in informatics from 6 hospitals internationally. Interviews were informed by a topic guide and were conducted via videoconferencing software. Thematic analysis was employed to develop a coding framework and identify emerging themes. RESULTS: Three themes and 6 subthemes were identified. HITs were employed to manage time and resources during a surge in patient numbers through fast-tracked governance procedures, and the creation of real-time bed capacity tracking within electronic health records. Improving the integration of different hospital systems was identified as important across sites. The use of hard-stop alerts and order sets were perceived as being effective at helping to respond to potential medication shortages and selecting available drug treatments. Utilizing information from multiple data sources to develop alerts facilitated treatment. Finally, the upscaling/optimization of telehealth and remote working capabilities was used to reduce the risk of nosocomial infection within hospitals. DISCUSSION: A number of the HIT-related changes implemented at these sites were perceived to have facilitated more effective patient treatment and management of resources. Informaticians generally felt more valued by hospital management as a result. CONCLUSIONS: Improving integration between data systems, utilizing specialized alerts, and expanding telehealth represent strategies that hospitals should consider when using HIT for delivering hospital care in the context of the COVID-19 pandemic.


Asunto(s)
COVID-19/terapia , Administración Hospitalaria , Sistemas de Información en Hospital/organización & administración , Informática Médica , Sistemas de Registros Médicos Computarizados , Manejo de Atención al Paciente , Actitud del Personal de Salud , Registros Electrónicos de Salud , Humanos , Control de Infecciones , Entrevistas como Asunto , Estudios de Casos Organizacionales , Personal de Hospital , Telemedicina , Reino Unido , Estados Unidos
13.
Int J Prison Health ; ahead-of-print(ahead-of-print)2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33709638

RESUMEN

PURPOSE: New South Wales (NSW) correctional system houses 30% of prisoners in Australia and at this time has only had a single documented case of COVID-19 amongst its prisoner population. The coordinated response by Justice Health and Forensic Mental Health Network (The Network) undertaken with the support of NSW Ministry of Health, in partnership with Corrective Services NSW (CSNSW), Youth Justice and private jails has ensured that the NSW correctional system has remained otherwise COVID-free. DESIGN/METHODOLOGY/APPROACH: A research study of how a range of partners which support the operations of NSW Correctional System developed an effective approach for the prevention a COVID-19 epidemic amongst its inmates. FINDINGS: Establishment of effective partnerships, early coordination of representatives from all aspects of the NSW correctional system, limited access to the correctional environment, reduced prison population and strict isolation of all new receptions have all contributed to maintaining this COVID-free status despite other NSW settings with similar risk profiles, such as aged care facilities and cruise ship arrivals, experiencing serious outbreaks. RESEARCH LIMITATIONS/IMPLICATIONS: Although Australia/New Zealand context of suppressed community infection rates for COVID-19 (which are approaching elimination in some jurisdictions) is in contrast to the situation in other parts of the world, the principles described in this paper will be useful to most other correctional systems. PRACTICAL IMPLICATIONS: Modelling was used to underline our approach and reinforced the veracity of following this approach. ORIGINALITY/VALUE: The Network and CSNSW has been able to mount an effective, integrated response to the COVID-19 pandemic, which has been sustainable through the first peak of COVID-19 cases. This case study catalogues the process of developing this response and details each intervention implemented with inventive use of tables to demonstrate the impact of the range of interventions used.


Asunto(s)
COVID-19/epidemiología , COVID-19/prevención & control , Control de Infecciones/organización & administración , Prisiones/organización & administración , Adulto , Femenino , Humanos , Masculino , Nueva Gales del Sur/epidemiología , Estudios de Casos Organizacionales , Pandemias , SARS-CoV-2
15.
J Prim Care Community Health ; 12: 21501327211000235, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33729044

RESUMEN

BACKGROUND: To characterize the experience of converting a geriatrics clinic to telehealth visits in early stages of a pandemic. DESIGN: An organizational case study with mixed methods evaluation from the first 8 weeks of converting a geriatrics clinic from in-person visits to video and telephone visits. SETTING: Veteran's Health Administration in Northern California Participants Community-dwelling older Veterans receiving care at VA Palo Alto Geriatrics clinic. Veterans had a mean age of 85.7 (SD = 6.8) and 72.1% had cognitive impairment. INTERVENTION: Veterans with face-to-face appointments were converted to video or telephone visits to mitigate exposure to community spread of COVID-19. MEASUREMENTS: Thirty-two patient evaluations and 80 clinician feedback evaluations were completed. This provided information on satisfaction, care access during pandemic, and travel and time savings. RESULTS: Of the 62 scheduled appointments, 43 virtual visits (69.4%) were conducted. Twenty-six (60.5%) visits were conducted via video, 17 (39.5%) by telephone. Virtual visits saved patients an average of 118.6 minutes each. Patients and providers had similar, positive perceptions about telehealth to in-person visit comparison, limiting exposure, and visit satisfaction. After the telehealth appointment, patients indicated greater comfort with using virtual visits in the future. Thirty-one evaluations included comments for qualitative analysis. We identified 3 main themes of technology set-up and usability, satisfaction with visit, and clinical assessment and communication. CONCLUSION: During a pandemic that has limited the ability to safely conduct inperson services, virtual formats offer a feasible and acceptable alternative for clinically-complex older patients. Despite potential barriers and additional effort required for telehealth visits, patients expressed willingness to utilize this format. Patients and providers reported high satisfaction, particularly with the ability to access care similar to in-person while staying safe. Investing in telehealth services during a pandemic ensures that vulnerable older patients can access care while maintaining social distancing, an important safety measure.


Asunto(s)
Instituciones de Atención Ambulatoria/organización & administración , COVID-19/prevención & control , Geriatría/organización & administración , Telemedicina/organización & administración , Servicios de Salud para Veteranos/organización & administración , Adulto , Anciano , Anciano de 80 o más Años , COVID-19/epidemiología , California/epidemiología , Demencia/terapia , Accesibilidad a los Servicios de Salud , Humanos , Persona de Mediana Edad , Estudios de Casos Organizacionales , Atención Primaria de Salud/organización & administración , Investigación Cualitativa , Teléfono , Comunicación por Videocoferencia
16.
Int J Health Plann Manage ; 36(S1): 58-70, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33647168

RESUMEN

While policy-makers in many jurisdictions are paying increasing attention to health workforce issues, human resources remain at best only partially aligned with population health needs. This paper explores the governance of human resources during the pandemic, looking at the Quebec health system as a revelatory case. We identify three issues related to health human resource (HHR) policies: working conditions, recognition at work and scope of practice. We empirically probe these issues based on an analysis of popular media, policy reports and participant observation by the lead authors in various forums and research projects. Using an integrated model of HHR, we identify major vulnerabilities in this domain. Persistent labour shortages, endemic deficiencies in working environments and inequity across occupational categories limit the ability to address critical HHR issues. We propose three ways to eliminate HHR vulnerabilities: reorganize work through participatory initiatives, implement joint policy making to rebalance power across the health workforce, and invest in the development of capacities at all system levels.


Asunto(s)
COVID-19 , Salud Global , Fuerza Laboral en Salud/organización & administración , Humanos , Estudios de Casos Organizacionales , Pandemias , Quebec , SARS-CoV-2
17.
J Occup Environ Med ; 63(5): 411-421, 2021 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-33560069

RESUMEN

OBJECTIVES: To describe the process used to build capacity for wider dissemination of a Total Worker Health® (TWH) model using the infrastructure of a health and well-being vendor organization. METHODS: A multiple-case study mixed-methods design was used to learn from a year-long investigation of the experiences by participating organizations. RESULTS: Increased capacity for TWH solutions was observed as evidenced by the participation, plans of action, and experience ratings of the participating organizations. The planning process was feasible and acceptable, although the challenges of dealing with the COVID-19 pandemic only afforded two of the three worksites to deliver a comprehensive written action plan. CONCLUSIONS: A suite of services including guidelines, trainings, and technical assistance is feasible to support planning, acceptable to the companies that participated, and supports employers in applying the TWH knowledge base into practice.


Asunto(s)
Creación de Capacidad/organización & administración , Promoción de la Salud/organización & administración , Modelos Organizacionales , Creación de Capacidad/métodos , Estudios de Factibilidad , Guías como Asunto , Promoción de la Salud/métodos , Humanos , Estudios de Casos Organizacionales , Proyectos Piloto
18.
Perspect Health Inf Manag ; 18(Winter): 1n, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33633524

RESUMEN

Northeast Alabama Regional Medical Center (RMC) in Anniston, Alabama purchased a smaller hospital in 2017. Staff at the two hospitals were tasked with merging the two Electronic Medical Record (EMR) systems into one unified system. From the outset, there were two systems with different medical record number specifications and patient identification systems as well as two different patient name parameters. The merging of these records and systems meant dealing with different vendor EMR systems and ancillary systems to produce a single unified record within RMC's EMR and the document imaging system that housed the legal medical record for each patient. This case study describes the process and procedures of merging the patient records from both hospitals to create one Enterprise Master Patient Index (EMPI); and the collaboration between the Health Information Management and Information Technology departments to accomplish this goal. It also reviews the impact and challenges related to the system's development, as well as lessons learned while completing the project.


Asunto(s)
Registros Electrónicos de Salud/organización & administración , Administración Hospitalaria , Sistemas de Identificación de Pacientes/organización & administración , Registros Electrónicos de Salud/normas , Humanos , Estudios de Casos Organizacionales , Sistemas de Identificación de Pacientes/normas
19.
J Am Board Fam Med ; 34(Suppl): S196-S202, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33622838

RESUMEN

INTRODUCTION: Our university hospital-based primary care practices transitioned a budding interest in telehealth to a largely telehealth-based approach in the face of the COVID-19 pandemic. INITIAL WORK: Implementation of telehealth began in 2017. Health system barriers, provider and patient reluctance, and inadequate reimbursement prevented widespread adoption at the time. COVID-19 served as the catalyst to accelerate telehealth efforts. IMPLEMENTATION: COVID-19 resulted in the need for patient care with "social distancing." In addition, due to the pandemic, the Centers for Medicare and Medicaid Services and other insurers began expanded reimbursement for telehealth. More than 2000 providers received virtual health training in less than 2 weeks. In March 2020, we provided 2376 virtual visits, and in April 5293, which was more than 75 times the number provided in February; 73% of all visits in April were virtual (up from 0.5% in October 2019). As COVID-19 cases receded in May, June, and July, patient demand for virtual visits decreased, but 28% of visits in July were still virtual. LESSONS LEARNED: Several key lessons are important for future efforts regarding clinical implementation: (1) prepare for innovation, (2) cultivate an innovation mindset, (3) standardize (but not too much), (4) technological innovation is necessary but not sufficient, and (5) communicate widely and often.


Asunto(s)
COVID-19/epidemiología , Atención Primaria de Salud/organización & administración , Telemedicina/estadística & datos numéricos , Colorado/epidemiología , Humanos , Estudios de Casos Organizacionales , Pandemias , Distanciamiento Físico , Atención Primaria de Salud/economía , SARS-CoV-2 , Telemedicina/economía , Telemedicina/tendencias , Estados Unidos
20.
J Hosp Palliat Nurs ; 23(2): 120-127, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33633091

RESUMEN

Outbreaks of COVID-19 among nursing homes, assisted living facilities, and other long-term care facilities in the United States have had devastating effects on residents. Restrictions such as banning visitors, sequestering residents, and testing health care staff have been implemented to mitigate the spread of the virus. However, consequences include a decline in mental and physical health, decompensation, and a sense of hopelessness among residents. We present and explore a case study at an assisted living facility addressing the ethical issues in balancing the management of the community versus the resident's right to autonomy and self-determination. A team of palliative care experts was brought into assisted living facilities to manage patients, care for well residents, and provide input in advance care planning and symptom management. The principles of self-determination and autonomy, stewardship, and distributive justice were explored. The use of nursing skills in triage and assessment, principles in public health, and the 8 domains of palliative care provided a comprehensive framework for structuring emergency operations. Palliative interventions and the role of palliative care nurses played an integral part in addressing ethical challenges in the containment of the virus and the deleterious effects of social isolation among the elderly.


Asunto(s)
Instituciones de Vida Asistida/ética , COVID-19/enfermería , Brotes de Enfermedades , Enfermería de Cuidados Paliativos al Final de la Vida/ética , Salud Pública/ética , Anciano , Instituciones de Vida Asistida/organización & administración , COVID-19/epidemiología , Humanos , Cuidados a Largo Plazo/ética , Estudios de Casos Organizacionales , Estados Unidos/epidemiología
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