Here Comes Price Transparency.

The public reporting of clinical and operational performance measures is old news for chief nurse executives (CNEs). Since the advent of value-based purchasing and patient experience measures, CNEs have partnered with other executives to ensure organizational readiness and success with the performance measures being publicly shared. In 2018, healthcare organizations face a new wave of public reporting expectations-price. Once again, executives will need to ensure organizational readiness. Chief nurse executives must analyze the impact of this trend on the nursing enterprise and carefully consider how to best prepare for healthcare price transparency.

Managers' role in maximising investment in continuing professional education.

Healthcare organisations face the challenge of delivering care in increasingly complex environments. To do so they depend on competent professionals, and continuing professional education (CPE) plays a major part in ensuring that staff maintain and develop their knowledge and skills. However, there is limited evidence of the effect of CPE on healthcare outcomes, and an emphasis on outcomes has overlooked the contribution of the processes that underlie effective CPE. This article reports the results of a study that explored a range of stakeholders' perceptions of the processes that maximise the positive effects of CPE on practice. Analysis of results shows that CPE can help improve care when supported by positive organisational cultures, effective partnership working between stakeholders and supportive learning environments that enable individuals to maximise their learning. This article discusses how managers play a pivotal role in creating positive cultures in which CPE can flourish by being role models and change agents, ensuring organisational strategic objectives are aligned with personal development plans, and by working collaboratively with education colleagues to ensure that learning from CPE is embedded in practice.

Eficacia en la aplicación de las medidas de formación para los deportistas de alto nivel en el territorio español / Efficiency of the application of academic training policies for spanish top athletes / Eficácia na aplicação de medidas de formação para desportistas de alto rendimento em território espanhol

La formación académica y la planificación son fundamentales para una exitosa inserción laboral de los atletas de élite. El objetivo de este estudio fue detectar el nivel de aplicación de las medidas de formación por los diferentes agentes que participan en el sistema. Al analizar el proceso de información se apreciaron ciertas carencias en el mismo. El cambio de fechas de exámenes con motivo de competiciones/concentraciones oficiales fue el aspecto más demandado por los diferentes deportistas. Dado que el periodo de los 20 a los 30 años es crítico para la formación, sería necesario aportar un servicio de cobertura total para la población de deportistas de Alto Nivel, con el fin de dar un asesoramiento permanente y trazar una línea continua desde la vida deportiva a la vida laboral en los deportistas

Academic training and planning are fundamental in ensuring the integration of elite athletes into the labour market. The main goal of this study was to analyse the extent to which academic measures are applied by the system’s different stakeholders. When the information process was analysed, certain shortcomings were noted. Most calls by athletes were for the dates of exams to be changed due to their coincidence with an official competition, as confirmed by requests to all bodies. The period from 20 to 30 years of age is critical in academic terms and a fully comprehensive service should be ensured for these top athletes in order to provide ongoing guidance

A formação académica e a planificação são fundamentais para uma bem sucedida inserção laboral dos atletas de elite. O objectivo deste estudo foi detectar o nível de aplicação de medidas de formação pelos diferentes agentes desportivos que participam no sistema. Ao analisar o processo de informação foram identificadas algumas carências no mesmo. A mudança das datas dos exames por motivos de competições/concentrações oficiais foi o aspecto mais pedido pelos diferentes desportistas. Dado que o período dos 20 aos 30 anos é crítico para a formação, seria necessário adicionar um serviço de cobertura total para a população de desportistas de Alto Rendimento, com o objectivo de assessorar permanentemente e traçar uma linha contínua desde a vida desportiva à vida laboral dos desportistas

Impact of a productivity-based compensation system on faculty clinical teaching scores, as evaluated by anesthesiology residents.

STUDY OBJECTIVE: To determine whether financial incentives given to faculty members for favorable teaching scores improve the quality of clinical education. DESIGN: Retrospective analysis. SETTING: Large U.S. academic anesthesiology department. STUDY SUBJECTS: 61 academic and 72 clinical faculty members. MEASUREMENTS: Since, academic year (AY) 2004, as part of a comprehensive clinical and academic productivity-based compensation system, academic faculty members receiving higher operating room (OR) teaching evaluation scores from the residents have been rewarded financially. Clinical Faculty members also have been rated, but have not received incentives based on scores. Annual averaged OR teaching scores of each faculty member on a 0-9 scale, where 9 = best, were gathered anonymously with faculty classification (academic or clinical). Average overall scores and percentage of faculty with each score category (8.51-9.00, 8.01-8.50, 7.00-8.00, or <7.00) were compared between the pre-implementation (AY2002-AY2003) and post-implementation (AY2004-AY2005) periods. Scores between the academic and clinical faculty also were compared. MAIN RESULTS: No significant difference was noted in the average scores between the pre-implementation and post-implementation periods in a paired comparison (academic: 7.83 ± 0.48 vs 7.85 ± 0.50, P = 0.61; clinical: 7.54 ± 0.75 vs 7.66 ± 0.60, P = 0.21). No statistically significant change was noted in the composition of score categories in the academic (P = 0.63) or clinical faculty (P = 0.20) members. Overall, the academic faculty received significantly higher scores than the clinical faculty (7.84 ± 0.49 vs 7.60 ± 0.67, P = 0.0003). CONCLUSIONS: A productivity-based faculty compensation system did not appear to influence faculty OR teaching scores.

Societal perspectives on community pharmacy services in West Bank - Palestine / Perspectivas sociales de los servicios de farmacia comunitaria en West Bank-Palestina

Understanding the public's view of professional competency is extremely important; however little has been reported on the public’s perception of community pharmacists in Palestine Objectives: To determine the perception of Palestinian consumers of the community pharmacist and the services they offer Method: This project used the survey methodology administered by structured interviews to consumers who attended the 39 randomly selected pharmacies, in six main cities in Palestine. The questionnaire had range of structured questions covering: Consumers’ patronage patterns, consumers’ interaction with community pharmacists, consumers’ views on how the pharmacist dealt with personal health issues, procedure with regard to handling private consultations. Results: Of 1,017 consumers approached, 790 consumers completed the questionnaire (77.7 %). Proximity to home and presence of knowledgeable pharmacist were the main reasons for patients to visit the same pharmacy. Physicians were identified as the preferred source of advice by 57.2% and pharmacists by 23.8%. Only 17% of respondents considered pharmacists as health professionals who know a lot about drugs and are concerned about and committed to caring for the public. In addition, 49% indicated that pharmacists spoke more quietly cross the counter during counseling and almost one third reported that the pharmacist used a private area within the pharmacy. The majority of respondents would be happy to receive different extended services in the community pharmacy like blood pressure monitoring. Conclusions: Palestinian consumers have a positive overall perception of community pharmacists and the services they offer. Awareness should be created amongst the public about the role of pharmacist and the added value they can provide as health care professional. There is a need to consider privacy when giving patient counseling to increase user satisfaction (AU)

Entender la visión del público de la competencia profesional es extremamente importante; sin embargo, se ha comunicado poco sobre la percepción del público sobre la farmacia comunitaria en Palestina. Objetivos: Determinar la percepción de los consumidores palestinos de farmacias comunitarias y los servicios que éstas ofrecen. Métodos: Este proyecto utilizó la metodología de encuesta administrada a través de entrevistas estructuradas a consumidores que visitaron 39 farmacias aleatoriamente seleccionadas en las seis principales ciudades de Palestina. El cuestionario tenía una serie de preguntas estructuradas que cubrían: patrones de clientela de los consumidores, interacción de los consumidores con los farmacéuticos comunitarios, visión de los consumidores de como los farmacéuticos tratan sus problemas personales, procedimientos relativos al manejo de las consultas privadas. Resultados: De los 1017 consumidores que se aproximaron, 790 completaron el cuestionario (77,7%). La proximidad a casa y la presencia de un farmacéutico reconocido fueron las dos razones principales de que los pacientes visitasen la misma farmacia. Los médicos fueron identificados como la fuente preferida de consejo por el 52,2% y los farmacéuticos por el 23,8%. Sólo el 17% de los respondentes consideró a los farmacéuticos con profesionales de la salud que sabían mucho sobre medicamentos y que se preocupaban y se comprometían en cuidar del público. Además, el 49% hablaba más bajo sobre el mostrador durante el consejo y casi un tercio comunicó que el farmacéutico usó un área privada en la farmacia. La mayoría de los entrevistados estarían contentos por recibir varios servicios ampliados de las farmacias comunitarias con la monitorización de presión arterial. Conclusiones: Los consumidores palestinos tienen una percepción general positiva de los farmacéuticos comunitarios y los servicios que ofrecen. Se debería aumentar el conocimiento del público sobre el papel del farmacéutico y el valor añadido que pueden proporcionar como profesionales de la salud. Para aumentar la satisfacción del usuario, es necesario considerar la privacidad cuando se proporciona consejo (AU)

Certifying clinical ethics consultants: who pays?

The movement advocating the formal certification of clinical ethics consultants may result in major changes to the field of clinical ethics consultation by creating a new standard of care. The actual certification process is still in the development phase, but unanswered questions include: What will certification cost, and, Who will pay? Currently there is little salary support for ethics consultants and no regulation requiring healthcare institutions to offer clinical ethics consultation. Without the support of healthcare administrators and accreditation bodies, this may remain unchanged. Healthcare administrators may be unwilling to pay for certification or professional services if accreditation bodies do not require healthcare institutions to provide certified ethics consultants' services. If consultants will not be reimbursed or paid, they may not seek certification. If certified consultants are required, healthcare administrators may look for ways to cover the costs for providing this service, including insurance or third-party reimbursement and direct billing of patients for consultations, which may affect who performs and who participates in ethics consultation. However, this is less than ideal, as bioethicists believe ethics consultation should be available to all as part of providing safe, quality ethical care and support and guidance for patients, families, and healthcare staff. Going forward, bioethicists should study quality improvement, patient safety, and cost-savings resulting from certification-eligible clinical ethics consultants' activities. Administrators and financial personnel can be surveyed regarding their support for the certification process. Bioethicists should enlist the help of patient rights and safety advocacy groups, professional medical associations, and healthcare administrators. Bioethicists should invite accreditation bodies, healthcare administrators, and financial personnel to collaborate in the development of the certification process. Without their support, certification may be of value only to the bioethics community, and may have little standing in actual clinical healthcare institution settings.

Cost analysis and feasibility of high-fidelity simulation based radiology contrast reaction curriculum.

RATIONALE AND OBJECTIVES: Radiology residents have variable training in managing acute nonrenal adverse reactions to iodinated contrast media because of their rarity. Preliminary results show positive feedback and knowledge gain with high-fidelity simulation-based training. Financial costs and the time required to implement a high-fidelity simulation curriculum are higher than for a lecture series. The objective of this study was to provide a financial and time cost-benefit analysis for high-fidelity simulation training of acute adverse reactions to iodinated contrast media. MATERIALS AND METHODS: Forty-four radiology residents were divided into lecture and simulation groups. Five simulation scenarios were created, with core education content mirrored in the lecture. Lengths of faculty time commitment and resident training were recorded. Financial costs, including manikin and simulation facility rates, were recorded and divided by the number of residents to obtain per resident simulation and lecture costs. A written evaluation of the experience, with Likert-type items and unstructured response items, was conducted. RESULTS: Cost per resident for simulation training setup was $259.76, and $203.46 for subsequent years, compared to <$5 for lecture. Faculty time was 7 academic days for simulation versus 2 days for lecture format. Resident simulation commitment was 3 hours 30 minutes. Time to train technologists to run the simulation was 3 hours. All residents provided positive feedback regarding the simulation curriculum, with mean feedback scores statistically higher than lecture group (P < .05). CONCLUSIONS: This study illustrates that financial costs of implementation are low compared to the potential cost of morbidity associated with the life-threatening event of an acute adverse reaction to iodinated contrast media.