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1.
Rev. bras. cir. plást ; 34(4): 517-523, oct.-dec. 2019. ilus
Artigo em Inglês, Português | LILACS | ID: biblio-1047918

RESUMO

A atenção e zelo do médico no período pré e pós-operatório é de extrema importância para a manutenção da boa relação médico/paciente. A organização e o adequado registro documental, contribui para a obtenção de um bom vínculo e assegura importante ferramenta jurídica ao médico. Hoje, com os avanços tecnológicos, o prontuário eletrônico é uma forma segura e democrática de lidar com estas informações. Nas instituições públicas o governo tem buscado implementar este sistema, mas os resultados são ainda discretos, talvez pela falta principalmente de recursos para investimento nesta área. Diante deste cenário e da grande relevância de um prontuário médico prático, informativo e dinâmico, objetivamos apresentar a nossa experiência com o uso complementar de um recurso digital sem custos. Associado ao prontuário médico de uso habitual dos serviços, descreve-se um sistema complementar, utilizando-se uma plataforma digital de armazenamento de dados na "nuvem". Por meio desse sistema é possível fornecer informações adicionais sobre cada paciente, incluindo o seguimento ambulatorial, assim como o registro fotográfico do pré, intra e pós-operatório, além de viabilizar um acesso rápido, sincronizado e remoto por meio da internet. O sistema gera economia de recursos, planejamento cirúrgico e melhora na relação médico/paciente. Favorece maior integração da equipe médica, discussão dos casos e distribuição das cirurgias por preceptor e residente. Assim, é um recurso alternativo para incrementar os prontuários médicos com dados importantes para a atuação das equipes médicas, com especial atenção às peculiaridades da cirurgia plástica.


The attention and enthusiasm of doctors in the pre- and postoperative period is of extreme importance in maintaining good doctor/patient relationships. An adequate organization and documentary record contributes to achieving a good relationship and ensures an important legal tool for physicians. With current technological advances, the electronic medical record is a secure and democratic way to deal with this information. The government has sought to implement this system in public institutions; however, results are still modest, perhaps mainly due to the lack of resources for investment in this area. In light of this, and given the relevance of practical, informative, and dynamic medical records, we aim to present our experience with the use of a complementary digital resource that is commonly associated with medical records and uses a free of cost digital platform for storing data in the "cloud". This system can provide additional information about each patient, including outpatient follow-up, as well as photographic records of the pre-, intra-, and post-operative periods, and also facilitates quick, synchronized, and remote access through the internet. The system generates optimization of resources, surgical planning, and improvement in patient/ doctor relationships. It also leads to greater integration of the medical team, particularly in the discussion of cases and distribution of surgeries by preceptors and residents. Thus, it is an alternative resource to improve medical charts with important data regarding the performance of medical teams, paying special attention to the peculiarities of plastic surgery.


Assuntos
Humanos , História do Século XXI , Cirurgia Plástica , Administração de Serviços de Saúde , Registros Médicos , Inovação , Assistência ao Paciente , Cirurgia Plástica/organização & administração , Administração de Serviços de Saúde/normas , Registros Médicos/normas , Assistência ao Paciente/métodos , Assistência ao Paciente/normas
2.
Artigo em Russo | MEDLINE | ID: mdl-31884771

RESUMO

The controllability (the grade of management decision implementation) is one of the integral indices of management efficiency for each company or organization. The purpose of the study is to investigate controllability of medical organizations and to stipulate the directions for its optimization. MATERIAL AND METHODS: The anonymous questionnaire survey was carried on involving 92 medical managers selected by such criteria as professional experience, competence and agreement dimensions. THE RESULTS: The controllability in medical organization management was assessed including differential estimation by medical areas with the following outcomes. Most regularly, the decisions are taken by management staff are associated with treatment and diagnostic process, economic and financial areas. The role of the structure of non-effected decisions (44.3±5.2% - unexpected adverse events, 31.8±4.9 - low-levelled executive discipline, 23.9±4.5 - decision-making defects) was emphasized and such corresponding optimization directions as executive discipline enforcement; professional retraining of decision-makers; retrieval of timely, and complete information for decision-making; reinforced control of decision quality and implementation; improved motivation system for executives; inclusion of executes into decision-making process; increased innovative decision segment; maximally avoided double organizing measures and exclusion for decision documentation of purely mobilizing appeals; the combination of various management styles in the implementation process; the improvement of coordination of organizing mechanisms as well. DISCUSSION: The obtained results significantly contribute to the notion of medical institution controllability, directions and prospects of its optimization. CONCLUSION: The results of study can be implemented in everyday practice of medical institutions as well as in professional training of health care managers.


Assuntos
Administração de Serviços de Saúde , Tomada de Decisões , Humanos
4.
Br J Nurs ; 28(18): S12-S16, 2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31597067

RESUMO

This article outlines the role of the clinical nurse specialist in establishing a Scotland-wide national designated service for prostate cryotherapy for patients with radiation-recurrent prostate cancer. The service was established in 2009 and provides prostate cryotherapy across Scotland. This article reviews and discusses the challenges involved in setting up a new service for tertiary treatment as well as highlighting the key achievements of the service. The challenges have included introducing the cryotherapy procedure in a safe and quality assured manner, developing and refining the referral process, educating both primary and secondary care teams on salvage prostate cryotherapy as a treatment modality and surgical procedure, as well as managing of complications following salvage prostate cryotherapy. The article also outlines the achievements of both the service and the treatment as well as how the service has developed since 2009.


Assuntos
Crioterapia/enfermagem , Administração de Serviços de Saúde , Enfermeiras Clínicas , Papel do Profissional de Enfermagem , Neoplasias da Próstata/terapia , Humanos , Masculino , Neoplasias da Próstata/enfermagem , Escócia
5.
Artigo em Inglês | MEDLINE | ID: mdl-31500288

RESUMO

The aim of this study is to measure universal health coverage in Emerging 7 (E7) economies. Within this framework, five different dimensions and 14 different criteria are selected by considering the explanations of World Health Organization and United Nations regarding universal health coverage. While weighting the dimensions and criteria, the Decision-making Trial and Evaluation Laboratory (DEMATEL) is considered with the triangular fuzzy numbers. Additionally, Multi-Objective Optimization on the basis of Ratio Analysis (MOORA) approach is used to rank E7 economies regarding Universal Health Coverage (UHC) performance. The novelty of this study is that both service and financial based factors are taken into consideration at the same time. Additionally, fuzzy DEMATEL and MOORA methodologies are firstly used in this study with respect to the evaluation of universal health coverage. The findings show that catastrophic out of pocket health spending, pushed below an international poverty line and annual growth rate of real Gross Domestic Product (GDP) per capita are the most significant criteria for universal health coverage performance. Moreover, it is also concluded that Russia is the country that has the highest universal health coverage performance whereas China, India and Brazil are in the last ranks. It can be understood that macroeconomic conditions play a very significant role on the performance of universal health coverage. Hence, economic conditions should be improved in these countries to have better universal health coverage performance. Furthermore, it is necessary to establish programs that provide exemptions or lower out-of-pocket expenditures which will not prevent the use of health services. This situation can protect people against the financial risks related to health expenditures. In addition to them, it is also obvious that high population has also negative influence on the countries such as, China and India. It indicates that it would be appropriate for these countries to make population planning for this purpose.


Assuntos
Gastos em Saúde/estatística & dados numéricos , Administração de Serviços de Saúde/estatística & dados numéricos , Cobertura Universal do Seguro de Saúde/organização & administração , Cobertura Universal do Seguro de Saúde/estatística & dados numéricos , Tomada de Decisões , Humanos , Organização Mundial da Saúde
6.
BMC Health Serv Res ; 19(1): 648, 2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31492139

RESUMO

BACKGROUND: Commissioning innovative health technologies is typically complex and multi-faceted. Drawing on the negotiated order perspective, we explore the process by which commissioning organisations make their decisions to commission innovative health technologies. The empirical backdrop to this discussion is provided by a case study exploring the commissioning considerations for a new photoplethysmography-based diagnostic technology for peripheral arterial disease in primary care in the UK. METHODS: The research involved an empirical case study of four Clinical Commissioning Groups (CCGs) involved in the commissioning of services in primary and secondary care. Semi-structured in-depth interviews (16 in total) and two focus groups (a total of eight people participated, four in each group) were conducted with key individuals involved in commissioning services in the NHS including (i) senior NHS clinical leaders and directors (ii) commissioners and health care managers across CCGs and (iii) local general practitioners. RESULTS: Commissioning of a new diagnostic technology for peripheral arterial disease in primary care involves high levels of protracted negotiations over funding between providers and commissioners, alliance building, conflict resolution and compromise of objectives where the outcomes of change are highly contingent upon interventions made across different care settings. Our evidence illustrates how reconfigurations of inter-organisational relations, and of clinical and related work practices required for the successful implementation of a new technology could become the major challenge in commissioning negotiations. CONCLUSIONS: Innovative health technologies such as the diagnostic technology for peripheral arterial disease are commissioned in care pathways where the value of such technology is realised by those delivering care to patients. The detail of how care pathways are commissioned is complex and involves high degrees of uncertainty concerning such issues as prioritisation decisions, patient benefits, clinical buy-in, value for money and unintended consequences. Recent developments in the new care models and integrated care systems (ICSs) in the UK offer a unique opportunity for the successful commissioning arrangements of innovative health technologies in primary care such as the new diagnostic technology for peripheral arterial disease.


Assuntos
Tecnologia Biomédica/estatística & dados numéricos , Medicina Geral/estatística & dados numéricos , Invenções , Tecnologia Biomédica/organização & administração , Difusão de Inovações , Grupos Focais , Medicina Geral/organização & administração , Clínicos Gerais/organização & administração , Clínicos Gerais/estatística & dados numéricos , Administração de Serviços de Saúde , Humanos , Negociação , Atenção Primária à Saúde/organização & administração , Atenção Primária à Saúde/estatística & dados numéricos , Medicina Estatal
7.
BMC Health Serv Res ; 19(1): 546, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31382974

RESUMO

BACKGROUND: Healthcare middle managers play a central role in reducing harm, improving patient safety, and strengthening the quality of healthcare. The aim of this systematic review was to identify the present knowledge and critically discuss how healthcare middle managers experienced to develop the capacity and capability for leadership in a healthcare system characterized by high complexity. METHODS: This comprehensive systematic review provided evidence of healthcare middle managers' experiences in developing the capacity and capability for leadership in public healthcare. The three-step literature search was based on six databases and led by a PICo question. The review had a critical hermeneutic perspective and was based on an a priori published, protocol. The methods were inspired by the Joanna Briggs Institute and techniques from Kvale and Brinkmann. The results were illustrated by effect size, inspired by Sandelowski and Barroso. RESULTS: Twenty-three studies from four continents and multiple contexts (hospitals and municipal healthcare) published from January 2005-February 2019 were included. Based on experiences from 482 healthcare middle managers, 2 main themes, each with 2 subthemes, were identified, and from these, a meta-synthesis was developed: Healthcare middle managers develop capacity and capability through personal development processes empowered by context. The main themes included the following: 1. personal development of capacity and capability and 2. a need for contextual support. From a critical hermeneutic perspective, contrasts were revealed between how healthcare middle managers experienced the development of their capacity and capability and what they experienced as their typical work situation. CONCLUSIONS: This review provides evidence of the need for a changed approach in healthcare in relation to criticisms of present organizational structures and management methods and suggestions for how to strengthen healthcare middle managers' capacity and capability for leadership in a healthcare system characterized by high complexity. Evidence of how leadership development affected the clinical context and, thus, the quality of healthcare was found to be a field requiring further research. PROSPERO REGISTRATION NUMBER: CRD42018084670.


Assuntos
Assistência à Saúde/normas , Pessoal de Saúde/normas , Administração de Serviços de Saúde/normas , Pessoal Administrativo/normas , Fortalecimento Institucional , Humanos , Liderança
8.
Implement Sci ; 14(1): 70, 2019 07 08.
Artigo em Inglês | MEDLINE | ID: mdl-31286964

RESUMO

BACKGROUND: Many interventions used in health care lack evidence of effectiveness and may be unnecessary or even cause harm, and should therefore be de-implemented. Lists of such ineffective, low-value practices are common, but these lists have little chance of leading to improvements without sufficient knowledge regarding how de-implementation can be governed and carried out. However, decisions regarding de-implementation are not only a matter of scientific evidence; the puzzle is far more complex with political, economic, and relational interests play a role. This project aims at exploring the governance of de-implementation of low-value practices from the perspectives of national and regional governments and senior management at provider organizations. METHODS: Theories of complexity science and organizational alignment are used, and interviews are conducted with stakeholders involved in the governance of low-value practice de-implementation, including national and regional governments (focusing on two contrasting regions in Sweden) and senior management at provider organizations. In addition, an ongoing process for governing de-implementation in accordance with current recommendations is followed over an 18-month period to explore how governance is conducted in practice. A framework for the governance of de-implementation and policy suggestions will be developed to guide de-implementation governance. DISCUSSION: This study contributes to knowledge about the governance of de-implementation of low-value care practices. The study provides rich empirical data from multiple system levels regarding how de-implementation of low-value practices is currently governed. The study also makes a theoretical contribution by applying the theories of complexity and organizational alignment, which may provide generalizable knowledge about the interplay between stakeholders across system levels and how and why certain factors influence the governance of de-implementation. The project employs a solution-oriented perspective by developing a framework for de-implementation of low-value practices and suggesting practical strategies to improve the governance of de-implementation. The framework and strategies can thereafter be evaluated for validity and impact in future studies.


Assuntos
Tomada de Decisões , Assistência à Saúde/normas , Fechamento de Instituições de Saúde/métodos , Administração de Serviços de Saúde , Autonomia Profissional , Qualidade da Assistência à Saúde/normas , Humanos , Entrevistas como Assunto , Modelos Teóricos , Política Organizacional , Formulação de Políticas , Suécia
9.
Health Care Manag (Frederick) ; 38(3): 211-219, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31261198

RESUMO

Something important seems to have been lost that once made adversity in the health care workplace tolerable or even enjoyable. Many of the same tasks that used to be surrounded by fun no longer have that aura. This article explores eight structural factors that collectively explain why health care managers report having much less fun at work recently. It suggests redefining what having fun at work means in the first instance and proposes a new conception focused on pursuing worthwhile health care goals. Health care managers should abandon many former notions of fun, let fun evolve from the work itself, and trust staff members to determine what they consider to be fun at work.


Assuntos
Atitude do Pessoal de Saúde , Administração de Serviços de Saúde , Satisfação no Emprego , Local de Trabalho/psicologia , Assistência à Saúde , Emoções , Humanos
10.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 11(4): 1048-1052, jul.-set. 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem, Repositório RHS | ID: biblio-1005611

RESUMO

Objetivo: Analisar a percepção de graduandos de enfermagem sobre as competências gerenciais do enfermeiro na Estratégia Saúde da Família. Métodos: Trata-se de pesquisa descritiva, participante com abordagem qualitativa, em que foram empregadas as técnicas de observação participante e entrevista. Os dados foram submetidos à análise temática de conteúdo. Resultados: O planejamento e a organização revelaram-se como as competências mais importantes para a prática gerencial do enfermeiro e o empreendedorismo como a competência menos importante. Conclusão: Os conhecimentos limitados dos estudantes de enfermagem sobre as competências gerenciais, indispensáveis à prática qualificada e autônoma do enfermeiro gerente da Estratégia Saúde da Família, revelaram a necessidade, no contexto formativo desse estudo, de ações pedagógicas interdisciplinares que visem um preparo maior do aluno para executar tais funções no cotidiano da vida no território


Objective: To analyze the perception of nursing undergraduates about the managerial competencies of nurses in the Family Health Strategy. Methods: descriptive research, participant with a qualitative approach, using participant observation and interview techniques. The data were submitted to content thematic analysis. Results: Planning and organization proved to be the most important competencies for managerial practice of nurses and entrepreneurship as the least important competence. Conclusion: The limited knowledge of nursing students about managerial competences, indispensable to the qualified and autonomous practice of the nurse manager of the Family Health Strategy, revealed the need, in the formative context of this study, for interdisciplinary pedagogical actions aimed at a better student preparation to perform such functions in the daily life of the territory


Objetivo: Analizar la percepción de los graduandos de enfermería sobre las competencias gerenciales del enfermero en la Estrategia Salud de la Familia. Métodos: investigación descriptiva, participante con abordaje cualitativo, en que se emplearon las técnicas de observación participante y entrevista. Los datos se sometieron al análisis temático de contenido. Resultados: La planificación y la organización se revelaron como las competencias más importantes para la práctica gerencial del enfermero y el emprendedorismo como la competencia menos importante. Conclusión: Los conocimientos limitados de los estudiantes de enfermería sobre las competencias gerenciales, indispensables a la práctica calificada y autónoma del enfermero gerente de la Estrategia Salud de la Familia, revelaron la necesidad, en el contexto formativo de este estudio, de acciones pedagógicas interdisciplinares que visen una preparación mayor del alumno para ejecutar tales funciones en el cotidiano de la vida en el territorio


Assuntos
Humanos , Masculino , Feminino , Adulto , Competência Profissional , Estudantes de Enfermagem , Tomada de Decisões Gerenciais , Estratégia Saúde da Família , Administração de Serviços de Saúde
11.
Z Evid Fortbild Qual Gesundhwes ; 143: 8-14, 2019 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-31153810

RESUMO

RATIONALE, AIMS AND OBJECTIVES: The hospital sector is under considerable pressure to change. On the one hand, demographic change plays an important role and, on the other hand, the rapid development of medicine and nursing care can be attributed to the pressure to change. The Lean Management concept, which originated in the automotive sector, represents a successful management method for meeting these growing challenges. The aim of this work therefore was to use interviews with experts from the healthcare sector to find out which leadership philosophy hospitals need in order to successfully implement the lean management approach in their organisational culture. METHODS: A semi-qualitative approach was chosen as a survey instrument for the present study of the expert interviews. The interview guideline was divided into four categories: hospital management, knowledge, practice and implementation. Four experts were interviewed for approx. 45minutes each. All four interviewees are male and hold intermediate- or top-level management positions in a hospital. The evaluation method used is based on the content analysis according to Mayring. RESULTS: In category 1, a high pressure for change was indicated. The reasons cited were different financing arrangements, changes in the framework and the unregulated flow of patients into the hospital. Managers in hospitals are not recruited for their management skills, but exclusively for their medical knowledge. Category 2 shows that managers in hospitals have never learned to lead or manage. The term 'Lean Management' is sometimes interpreted differently. In category 3, the interviewees cited different reasons for implementing the lean management approach. Among other things, they see the possibility of increasing quality for the patient, employee satisfaction and safety. In category 4, it was confirmed that employees and management play a key role in implementation. In a hospital, the 'patient-first' approach should be prioritised. CONCLUSION: A critical analysis of the results shows that implementing the lean management approach in a hospital will pose a major challenge. The functional, hierarchical structure as well as the understanding of leadership and the organizational culture are critical success factors.


Assuntos
Assistência à Saúde , Eficiência Organizacional , Administração Hospitalar , Áustria , Assistência à Saúde/métodos , Assistência à Saúde/normas , Alemanha , Administração de Serviços de Saúde , Humanos , Masculino , Garantia da Qualidade dos Cuidados de Saúde/organização & administração
12.
J Emerg Manag ; 17(3): 177-179, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31245828

RESUMO

While the increasing professionalism of the Emergency Management (EM) field has brought great benefits and opportunities, increasingly the bar to entry into the profession has been on a steep incline with ever increasing mandatory and preferred requirements for EM job applicants it seems. For the EM student or new EM graduate with limited experience opportunities, this can be a severe handicap in the quest to secure a viable entry level EM position. Experiential Learning provides an excellent solution to this problem.


Assuntos
Administradores de Instituições de Saúde/educação , Administração de Serviços de Saúde , Aprendizagem Baseada em Problemas/métodos , Humanos
14.
Gac. sanit. (Barc., Ed. impr.) ; 33(3): 293-295, mayo-jun. 2019. mapas, graf
Artigo em Espanhol | IBECS | ID: ibc-183752

RESUMO

El objetivo de este trabajo es analizar el desempeño de la salud pública por las comunidades autónomas en España a partir de la información accesible en sus documentos anuales de revisión de gestión. Se realizó una búsqueda de sus memorias anuales, que se localizaron en 9 de las 17 comunidades autónomas. De su análisis se desprenden algunas diferencias en las estructuras de salud pública, así como en los contenidos publicados y en la utilización de indicadores de gestión. No siempre se aprecia una explicitación de la cartera de servicios, de los objetivos ni de los recursos adscritos. Si la evaluación de los servicios públicos y su difusión son ejercicios básicos de transparencia y de calidad de gestión, su práctica tiene amplio margen de mejora. La realización de memorias anuales por los servicios de salud pública no es sistemática, y las publicadas aportan poca información para una comparación de su actividad, efectividad y eficiencia


The objective of this study is to analyze the performance of regional public health services in Spain using the information accessible in their annual reports. A search of these was conducted, and 9 were obtained from the 17 Autonomous Communities. Their analysis shows some variation in the structure of the organizations providing public health services, as well as in the published contents and in the indicators used for management. The service portfolio, annual objectives and resources allocated are not always detailed. If the evaluation of public services and its dissemination are basic for transparency and quality management, there is much room for improvement. The compilation of annual reports by public health services is not systematic, and those that exist provide insufficient information for a comparative analysis of their activity, effectiveness and efficiency


Assuntos
Humanos , Administração de Serviços de Saúde/tendências , Relatórios Anuais como Assunto , Administração em Saúde Pública/tendências , Tomada de Decisões Gerenciais , Sistemas de Informação Hospitalar/organização & administração
15.
BMC Health Serv Res ; 19(1): 279, 2019 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-31046748

RESUMO

BACKGROUND: In Malawi, as in many low-and middle-income countries, health facility committees (HFCs) are involved in the governance of health services. Little is known about the approaches they use and the challenges they face. This study explores how HFCs monitor the quality of health services and how they demand accountability of health workers for their performance. METHODS: Documentary analysis and key informant interviews (7) were complemented by interviews with purposefully selected HFC members (22) and health workers (40) regarding their experiences with HFCs. Data analysis was guided by a coding scheme informed by social accountability concepts complemented by inductive analysis to identify participants' perceptions and meanings of processes of social accountability facilitated by HFCs. RESULTS: The results suggest that HFCs address poor health worker performance (such as absenteeism, poor treatments and informal payments), and report severe misconduct to health authorities. The informal and constructive approach that most HFCs use is shaped by formal definitions and common expectations of the role of HFCs in service delivery as well as resource constraints. The primary function of social accountability through HFCs appears to be co-production: the management of social relations around the health facility and the promotion of a minimum level of access and quality of services. CONCLUSIONS: Policymakers and HFC support programs should take into account the broad task description of HFCs and integrate social accountability approaches in existing quality of care programs. The study also underscores the need to clarify accountability arrangements and linkages with upward accountability approaches in the system.


Assuntos
Comitês Consultivos , Assistência à Saúde/organização & administração , Administração de Instituições de Saúde , Pessoal de Saúde , Relações Profissional-Paciente , Responsabilidade Social , Países em Desenvolvimento , Recursos em Saúde , Administração de Serviços de Saúde , Humanos , Malaui , Atenção Primária à Saúde/organização & administração
16.
Int J Circumpolar Health ; 78(1): 1617019, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31084408

RESUMO

Ten percent of all deaths in Greenland are caused by suicide. The aim of this study was to explore if applicable risk factors could be identified among the suicide victims within the health care system up to 6 months prior to the suicide. The study was performed as an age- and gender-matched case control study including all suicides in Greenland from 2012 to 2015, based on review of medical records for risk factors including suicide ideation, suicide attempts, incidence of alcohol intoxication, incidence of violence and treatment for psychiatric illness within the 6 month period leading up to the suicide. In total, 160 cases and 160 controls were included. Presence of any risk factors were observed in around a third of all suicide cases compared a tenth among the controls. The highest odds ratios for suicide were observed for suicide ideation and suicide attempts. However, no contact with the health care system was observed for two thirds of the suicides victims. Thus, focus on suicide ideation and suicide attempts among patients could help health care professionals to assess suicide risk and initiate prevention. Additional preventive strategies targeting the majority without contact to the health care system need to be explored.


Assuntos
Inuítes/estatística & dados numéricos , Suicídio/etnologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Intoxicação Alcoólica/etnologia , Regiões Árticas/epidemiologia , Estudos de Casos e Controles , Feminino , Groenlândia/epidemiologia , Administração de Serviços de Saúde , Humanos , Masculino , Transtornos Mentais/etnologia , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco , Distribuição por Sexo , Ideação Suicida , Tentativa de Suicídio/etnologia , Violência/etnologia , Adulto Jovem
17.
Int J Circumpolar Health ; 78(1): 1612703, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31072273

RESUMO

BACKGROUND: Citizens of Norway have free and equal access to healthcare. Nurses are expected to be culturally sensitive and have cultural knowledge in encounters with patients. Culturally safe care is considered both a process and an outcome, evaluated by whether the patients feel safe, empowered and cared for, or not. All patients request equal access to quality care in Norway, also Sami patients. OBJECTIVES: The aim of the study is to identify whether Sami patients and relatives feel culturally safe in encounters with healthcare, and if not, what are the main concerns. METHODS: This qualitative study used semi-structured interviews in the North Sami language, with 11 North Sami participants.The transcribed data were analysed through a lens of cultural safety by content analysis. FINDINGS: Data analysis explicated themes including: use of Sami language, Sami identity and cultural practices, connections to positive health outcomes to enhance cultural safe care and well-being for North-Sami people encountering the Norwegian health-care system. CONCLUSION: Culturally safe practices at the institutional, group and individual levels are essential to the well-being of Sami people. An engagement in culturally safe practices will facilitate (or) fulfil political and jurisdictional promises made to the Sami people, consequently improving positive impact of healthcare.


Assuntos
Características Culturais , Competência Cultural/organização & administração , Grupos Étnicos/psicologia , Administração de Serviços de Saúde/normas , Adulto , Idoso , Regiões Árticas , Atitude do Pessoal de Saúde , Feminino , Acesso aos Serviços de Saúde , Humanos , Entrevistas como Assunto , Linguagem , Masculino , Saúde Mental , Pessoa de Meia-Idade , Noruega , Pesquisa Qualitativa , Fatores Socioeconômicos , Adulto Jovem
18.
Rev Peru Med Exp Salud Publica ; 36(1): 116-122, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31116324

RESUMO

A historical account of the 30 years of the medical major of Health Management at Universidad Nacional Mayor de San Marcos is presented. The major was created in 1988 as Comprehensive General Medicine in response to the shortage of management specialists. The name of the major remained until 1994, when it changed to Integral Medicine and Health Management to emphasize its managerial orientation. In 2002, the curricular plan was modified considering the importance of having an exclusive medical specialization in management for the health sector. The specialty is a pioneer in a gradual education in three levels: micro-management, meso-management, and macro-management. The new curricular plan allowed residents the possibility to access better rotations at public and private institutions. Since 2007, the major is labeled Health Management, and its specialists maintain their solid training that enables them to perform in the decision-making, management, administration, and operation processes of the health systems. The vision of the creators of this major is current to this day; Health Management specialists work in the different institutions of the health system, contributing their knowledge and skills, and generating an impact on the health of the Peruvian population.


Assuntos
Educação Médica , Administração de Serviços de Saúde , Faculdades de Medicina , Universidades , Currículo , Educação Médica/história , Administração de Serviços de Saúde/história , História do Século XX , História do Século XXI , Peru , Fatores de Tempo
19.
Artigo em Inglês | MEDLINE | ID: mdl-31137472

RESUMO

Frail elderly people refer to multi-diseased and vulnerable patients in need of medication and healthcare. These patients require healthcare from several different healthcare organizations, including hospital care, primary care, and municipal care services. This situation is challenging the capacity of healthcare organizations to manage inter-professional collaboration for person-centered care. This paper aims to identify challenges associated with collaboration between different healthcare organizations, related to the use of IT systems in the daily work practice. The paper was based on a qualitative study, which included three focus group interviews, each lasting for two hours. Each focus group consisted of a hospital physician, a primary care physician, a hospital nurse, a primary care nurse, a municipal home care nurse or an assistant officer, a physical or occupational therapist, and a family member representative. The interviews were analyzed with thematic analysis. Challenges identified in the study include insufficient information exchange, inconsistencies in communication, differences in the use of IT systems, and deficient coordination. The work processes that aim to promote collaboration between different healthcare organizations need to be better organized, and the use of IT systems needs to be better aligned.


Assuntos
Comportamento Cooperativo , Administração de Serviços de Saúde , Sistemas de Informação , Idoso , Idoso de 80 Anos ou mais , Comunicação , Família , Feminino , Grupos Focais , Idoso Fragilizado , Pessoal de Saúde , Hospitais , Humanos , Relações Interprofissionais , Masculino , Atenção Primária à Saúde , Pesquisa Qualitativa , Comportamento Social
20.
Health Care Manag (Frederick) ; 38(2): 99-100, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31008889
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