RESUMO
This chapter discusses the notion of 'bidirectional health literacy' between the patient/care partner and the care team, and its impact on the quadruple aim: the care experience, population health, engagement, and the cost of care. It provides a brief historical perspective of the quadruple aim along with its relationships to value and health literacy. It overviews the responsibilities of health care organizations and highlights best practices, such as bidirectional care opportunities in patient-centered medical homes, with a focus on improving provider and care team communication. The chapter's aim is to provide a new bidirectional perspective on health literacy. It illuminates for readers that the focus of health literacy should not just be about patients' understanding of and engagement in their own health and health care, but instead, a partnership where care teams become equally 'literate' about the patient/care partner, by learning what they value, the contextual and social determinants that impact their ability to engage in self-care, and by demonstrating cultural humility in all of their care efforts. Various models that support bidirectional literacy and care are provided.
Assuntos
Letramento em Saúde , Comunicação , Atenção à Saúde , Humanos , Assistência Centrada no PacienteRESUMO
Globally, antimicrobial resistance (AMR) is a serious problem causing 700,000 deaths annually. By 2050, AMR is expected to cause approximately 10 million deaths globally each year if allowed to increase at the present rate. Many individuals have limited knowledge regarding appropriate antibiotic use and AMR. Most antibiotic use occurs in the outpatient setting, with approximately 30% of antibiotics prescribed deemed unnecessary. Antimicrobial stewardship (AMS) is a means to reduce inappropriate antibiotic use and AMR. While existing AMS efforts generally focus on the inpatient setting, a significant gap is present in the outpatient setting. A common theme across various national action plans to reduce AMR is the need for education and awareness. The importance of communicating information in a manner easily comprehended by the patient in addition to productive clinician-patient dialogue cannot be overestimated. Enhancing the public's and patients' AMS health literacy is an underrecognized approach to help address AMR. We describe Four Core Elements of Enhancing AMS Health Literacy in the Outpatient Setting, utilizing the Centers for Disease Control and Prevention's framework: (1) leadership commitment, (2) intervention/action, (3) tracking/reporting, and (4) education/expertise. We call upon leaders in outpatient settings to embrace this approach to curb inappropriate antimicrobial use.
Assuntos
Antibacterianos/uso terapêutico , Gestão de Antimicrobianos , Infecções Bacterianas/tratamento farmacológico , Farmacorresistência Bacteriana , Letramento em Saúde , Promoção da Saúde/métodos , Pacientes Ambulatoriais/educação , Pacientes Ambulatoriais/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados UnidosRESUMO
Performance measures (PMs) are specified metrics by which a health-care provider's care can be compared with national benchmarks. The use of PMs is a key component of efforts to improve the quality and value of health care. The National Quality Forum (NQF) is the federally recognized endorser of PMs. From 2006 to 2009, the Quality Improvement Committee (QIC) of the American College of Chest Physicians engaged in the review of proposed PMs as a member of the NQF. This article provides a review of the QIC's experience with PMs and NQF membership and the lessons learned, an overview of the enhancements made to the NQF endorsement process in 2010 and 2011, and a discussion of the next steps that would further strengthen the measure development and endorsement processes and increase the likelihood of measurement leading to better patient outcomes.
Assuntos
Medicina , Avaliação de Processos e Resultados em Cuidados de Saúde , Sociedades Médicas , Benchmarking , Congressos como Assunto , Fidelidade a Diretrizes , Planejamento em Saúde , Humanos , Indicadores de Qualidade em Assistência à Saúde , Estados UnidosAssuntos
Serviço Hospitalar de Emergência/economia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Mau Uso de Serviços de Saúde/economia , Mau Uso de Serviços de Saúde/estatística & dados numéricos , Emergências , Medicina de Emergência/organização & administração , Custos Hospitalares , Humanos , Avaliação de Processos e Resultados em Cuidados de Saúde , Admissão do Paciente/economia , Admissão do Paciente/estatística & dados numéricos , Estados UnidosRESUMO
Increasing attention has been directed in healthcare today to the importance of performance measurement, (i.e., the implementation of measurable methods to demonstrate that practitioners are engaged in high-quality, evidence-based medicine). Many medical specialties, as well as many state medical licensing boards, now require that candidates submit performance measurement data, to be eligible for maintenance of board certification or medical licensure. National organizations such as the National Quality Forum and the Physicians Consortium for Performance Improvement of the American Medical Association are active collaborators with federal, state, and medical specialty initiatives to improve healthcare. These developing efforts are summarized here, with a specific focus on the status of these efforts in the field of psychiatry.