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1.
BMJ Glob Health ; 7(12)2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36517112

RESUMO

A combination of public health campaigns and routine primary healthcare services are used in many countries to maximise the number of people reached with interventions to prevent, control, eliminate or eradicate diseases. Health campaigns have historically been organised within vertical (disease-specific) programmes, which are often funded, planned and implemented independently from one another and from routinely offered primary healthcare services. Global health agencies have voiced support for enhancing campaign effectiveness, including campaign efficiency and equity, through collaboration among vertical programmes. However, limited guidance is available to country-level campaign planners and implementers about how to effectively integrate campaigns. Planning is critical to the implementation of effective health campaigns, including those related to neglected tropical diseases, malaria, vitamin A supplementation and vaccine-preventable diseases, including polio, measles and meningitis. However, promising approaches to planning integrated health campaigns have not been sufficiently documented. This manuscript highlights promising practices for the collaborative planning of integrated health campaigns that emerged from the experiences of eight project teams working in three WHO regions. Adoption of the promising practices described in this paper could lead to enhanced collaboration among campaign stakeholders, increased agreement about the need for and anticipated benefits of campaign integration, and enhanced understanding of effective planning of integrated health campaigns.


Assuntos
Comportamento Cooperativo , Planejamento em Saúde , Promoção da Saúde , Humanos , Saúde Global , Promoção da Saúde/organização & administração , Estudos de Casos Organizacionais , Planejamento em Saúde/organização & administração
2.
Br J Community Nurs ; 27(Sup12): S6-S10, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36519485

RESUMO

Pressure ulcers are injuries to the skin requiring integrated care, particularly when patients are at home. Pressure ulcers have been a nursing concern for years, and several strategies have been proposed for its prevention and management. Nursing theory, which is essential for nursing practice, recommends plausible approaches to health problems. However, literature describing steps to integrate nursing theory into pressure ulcer care has not yet been explored. For this reason, this article discusses the six steps on how to apply nursing theory in community practice. A case study is also discussed to help gain a better understanding of these steps.


Assuntos
Enfermagem em Saúde Comunitária , Teoria de Enfermagem , Lesão por Pressão , Humanos , Lesão por Pressão/enfermagem , Estudos de Casos Organizacionais , Enfermagem em Saúde Comunitária/organização & administração
3.
Malawi Med J ; 34(3): 213-219, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36406092

RESUMO

Background: Pragmatic clinical trials generally rely on real world data and have the potential to generate real world evidence. This approach arose from concerns that many trial results did not adequately inform real world practice. However, maintaining the real world setting during the conduct of a trial and ensuring adequate protection for research participants can be challenging. Best practices in research oversight for pragmatic clinical trials are nascent and underdeveloped, especially in developing countries. Methods: We use the PRECIS-2 tool to present a case study from Lilongwe in Malawi to describe ethical and regulatory challenges encountered during the conduct of a pragmatic trial and suggest possible solutions. Results: In this article, we highlight the following six issues: (1) one public facility hosting several pragmatic trials within the same period; (2) research participants refusing financial incentives; (3) inadequate infrastructure and high workload to conduct research; (4) silos among partner organisations involved in delivery of health care; (5) individuals influencing the implementation of revised national guidelines; (6) difficulties with access to electronic medical records. Conclusion: Multiple stakeholder engagement is critical to the conduct of pragmatic trials, and even with careful stakeholder engagement, continuous monitoring by gatekeepers is essential. In the Malawian context, active engagement of the district research committees can complement the work of the research ethics committees (RECs).


Assuntos
Ensaios Clínicos Pragmáticos como Assunto , Humanos , Atenção à Saúde/organização & administração , Malaui , Ensaios Clínicos Pragmáticos como Assunto/ética , Ensaios Clínicos Pragmáticos como Assunto/legislação & jurisprudência , Estudos de Casos Organizacionais
4.
Prof Case Manag ; 27(5): 229-238, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35901254

RESUMO

PURPOSE/OBJECTIVES: The purpose of this case study is to describe the movement of spiritual care into outpatient, managed care and population health settings, as it has evolved in a major not-for-profit health care system in the United States. The objective is to begin to establish the effectiveness of integrating spiritual care as a part of the interdisciplinary team (IDT) in these contexts. PRIMARY PRACTICE SETTINGS: The case study presents two practice settings: a remote patient monitoring program for patients with complex medical conditions, and integration into population health as a part of a Medicare Advantage Insurance program that is a cooperative venture between the health care system (Ascension) and an established insurance program (Centene). FINDINGS/CONCLUSIONS: The cases presented suggest that the integration of spiritual care into the outpatient, managed care and population health contexts has a threefold benefit: enhancing patient care, increasing the effectiveness of the IDT, and providing for the care and support of the members of the IDTs themselves. IMPLICATIONS FOR CASE MANAGEMENT PRACTICE: The cases presented suggest inclusion of spiritual care in the care management/population health approach to patient care is viable and valuable both for the benefit of the patient and the functioning of the care team.


Assuntos
Atenção à Saúde , Saúde da População , Terapias Espirituais , Idoso , Atenção à Saúde/organização & administração , Humanos , Medicare , Estudos de Casos Organizacionais , Terapias Espirituais/organização & administração , Estados Unidos
5.
Soc Sci Med ; 301: 114975, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35461081

RESUMO

Frameworks for understanding integrated care risk underemphasizing the complexities of the development of integrated care in a local context. The objectives of this article are to (1) present a novel strategy for conceptualizing integrated care as developing through a series of milestones at the organizational level, and (2) present a typology of milestones empirically generated through the analysis of four cases of integrated community-based primary health care (ICBPHC) in Canada and New Zealand. Our paper reports on an analysis of 4 specific organizational case studies within a large dataset generated for an international multiple case study project of exemplar models of ICBPHC. Drawing on earlier analyses of 359 qualitative interviews with patients, caregivers, health care providers, managers, and policymakers, in this article we present a detailed analysis of 28 interviews with managers and leaders of local models of integrated care. We generated a detailed timeline of the development of integrated care as expressed by each participant, and synthesized themes across timelines within each case to identify specific milestone events. We then synthesized across cases to generate the broader milestone categories to which each event belongs. We generated 5 milestone categories containing 12 more specific milestone events. The milestone categories include (1) strategic relational, (2) strategic process change, (3) internal structural, (4) inter-organizational structural, and (5) external milestones. We propose a comprehensive framework of developmental milestones for integrated care. Milestones represent a compelling strategy for conceptualizing the development of integrated care. Practically, policymakers and health care leaders can support the implementation of integrated care by examining the history and context of a given model of care and identifying strategies to achieve milestones that will accelerate integrated care. Further research should document additional milestone events and advance the development of dynamic frameworks for integrated care.


Assuntos
Serviços de Saúde Comunitária , Prestação Integrada de Cuidados de Saúde , Canadá , Humanos , Nova Zelândia , Estudos de Casos Organizacionais
6.
Public Health Rep ; 137(2): 226-233, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35060805

RESUMO

For more than 30 years, the network of Centers for Disease Control and Prevention (CDC)-funded Prevention Research Centers (PRCs) has worked with local communities and partners to implement and evaluate public health interventions and policies for the prevention of disease and promotion of health. The COVID-19 pandemic tested the PRC network's ability to rapidly respond to multiple, simultaneous public health crises. On April 28, 2020, to assess the network's engagement with activities undertaken in response to the early phase of the pandemic, PRC network leadership distributed an online survey to the directors of 34 currently or formerly funded PRCs, asking them to report their PRCs' engagement with predetermined activities across 9 topical areas and provide case studies exemplifying that engagement. We received responses from 24 PRCs, all of which reported engagement with at least 1 of the 9 topical areas (mean, 5). The topical areas with which the greatest number of PRCs reported engagement were support of frontline agencies (21 of 24, 88%) and support of activities related to health care (21 of 24, 88%). The mean number of activities with which PRCs reported engagement was 11. The PRCs provided more than 90 case studies exemplifying their work. The results of the survey indicated that the PRCs mobilized their personnel and resources to support the COVID-19 response in less than 6 weeks. We posit that the speed of this response was due, in part, to the broad and diverse expertise of PRC personnel and long-standing partnerships between PRCs and the communities in which they work.


Assuntos
COVID-19/prevenção & controle , Participação da Comunidade , Pesquisa sobre Serviços de Saúde/organização & administração , Serviços Preventivos de Saúde/organização & administração , Saúde Pública , Centers for Disease Control and Prevention, U.S. , Pesquisa sobre Serviços de Saúde/estatística & dados numéricos , Humanos , Colaboração Intersetorial , Estudos de Casos Organizacionais , Serviços Preventivos de Saúde/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos
7.
Hum Resour Health ; 20(1): 8, 2022 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-35033109

RESUMO

BACKGROUND: Nigeria's health sector aims to ensure that the right number of health workers that are qualified, skilled, and distributed equitably, are available for quality health service provision at all levels. Achieving this requires accurate and timely health workforce information. This informed the development of the Nigeria Health Workforce Registry (NHWR) based on the global, regional, and national strategies for strengthening the HRH towards achieving universal health coverage. This case study describes the process of conceptualizing and establishing the NHWR, and discusses the strategies for developing sustainable and scalable health workforce registries. CASE PRESENTATION: In designing the NHWR, a review of existing national HRH policies and guidelines, as well as reports of previous endeavors was done to learn what had been done previously and obtain the views of stakeholders on how to develop a scalable and sustainable registry. The findings indicated the need to review the architecture of the registry to align with other health information systems, develop a standardized data set and guidance documents for the registry including a standard operating procedure to ensure that a holistic process is adopted in data collection, management and use nationally. Learning from the findings, a conceptual framework was developed, a registry managed centrally by the Federal Ministry of Health was developed and decentralized, a standardized tool based on a national minimum data was developed and adopted nationally, a registry prototype was developed using iHRIS Manage and the registry governance functions were integrated into the health information system governance structures. To sustain the functionality of the NHWR, the handbook of the NHWR that comprised of an implementation guide, the standard operating procedure, and the basic user training manual was developed and the capacity of government staff was built on the operations of the registry. CONCLUSION: In establishing a functional and sustainable registry, learning from experiences is essential in shaping acceptable, sustainable, and scalable approaches. Instituting governance structures that include and involve policymakers, health managers and users is of great importance in the design, planning, implementation, and decentralization stages. In addition, developing standardized tools based on the health system's needs and instituting supportable mechanisms for data flow and use for policy, planning, development, and management is essential.


Assuntos
Mão de Obra em Saúde , Sistema de Registros , Humanos , Nigéria , Estudos de Casos Organizacionais , Cobertura Universal do Seguro de Saúde
8.
Public Health Rep ; 137(2): 208-212, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34969322

RESUMO

The COVID-19 pandemic created unprecedented strain on the personal protective equipment (PPE) supply chain. Given the dearth of PPE and consequences for transmission, GetMePPE Chicago (GMPC) developed a PPE allocation framework and system, distributing 886 900 units to 274 institutions from March 2020 to July 2021 to address PPE needs. As the pandemic evolved, GMPC made difficult decisions about (1) building reserve inventory (to balance present and future, potentially higher clinical acuity, needs), (2) donating to other states/out-of-state organizations, and (3) receiving donations from other states. In this case study, we detail both GMPC's experience in making these decisions and the ethical frameworks that guided these decisions. We also reflect on lessons learned and suggest which values may have been in conflict (eg, maximizing benefits vs duty to mission, defined in the context of PPE allocation) in each circumstance, which values were prioritized, and when that prioritization would change. Such guidance can promote a values-based approach to key issues concerning distribution of PPE and other scarce medical resources in response to the COVID-19 pandemic and related future pandemics.


Assuntos
COVID-19 , Estudos de Casos Organizacionais , Equipamento de Proteção Individual/provisão & distribuição , Alocação de Recursos/ética , Chicago , Tomada de Decisões Gerenciais , Humanos , SARS-CoV-2 , Estudantes de Medicina , Voluntários
9.
J Health Organ Manag ; ahead-of-print(ahead-of-print)2021 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-34873898

RESUMO

PURPOSE: The purpose of this paper is to explore the appropriation of control rooms based on value-based integrated performance management tools implemented in all publicly funded health organizations in Quebec (Canada) as a form of legitimate sociomaterial work. DESIGN/METHODOLOGY/APPROACH: Multi-site organizational ethnographic case studies in two Integrated health and social services centers, with narrative process analysis of triangulated qualitative data collected through non-participant observation (163 h), individual semi-structured interviews (N = 34), and document review (N = 143). FINDINGS: Three types of legitimate sociomaterial work are accomplished when actors appropriate control rooms: 1) reformulating performance management work; 2) disrupting accountability work and; 3) effecting value-based integrated performance management. Each actor (tools, institutions and people) follows recurrent institutional work-paths: tools consistently engage in disruptive work; institutions consistently engage in maintaining work, and people consistently engage in creation work. The study reveals the potential of performance management tools as "effective integrators" of the technological, managerial, policy and delivery levels of data-driven health system performance and improvement. PRACTICAL IMPLICATIONS: This paper draws on theoretically informed empirical insights to develop actionable knowledge around how to better design, implement and adapt tool-driven health system change: 1) Packaging the three agents of data-driven system change in health care: tools, institutions, people; 2) Redefining the search for performance in health care in the context of value creation, and; 3) Strengthening clinical and managerial relevance in health performance management practice. ORIGINALITY/VALUE: The authors aim to stimulate new and original scholarship around the under-theorized concept of sociomaterial work, challenging theoretical, ontological and practical conceptions of work in healthcare organizations and beyond.


Assuntos
Antropologia Cultural , Instalações de Saúde , Canadá , Atenção à Saúde , Humanos , Estudos de Casos Organizacionais
10.
Healthc Q ; 24(2): 33-37, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34297661

RESUMO

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.


Assuntos
COVID-19/epidemiologia , Atenção à Saúde/organização & administração , Médicos/organização & administração , Participação dos Interessados , COVID-19/terapia , Cuidados Críticos/organização & administração , Humanos , Ontário/epidemiologia , Estudos de Casos Organizacionais , Atenção Primária à Saúde/organização & administração
11.
Value Health ; 24(7): 983-994, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34243842

RESUMO

OBJECTIVES: Decision makers adopt health technologies based on health economic models that are subject to uncertainty. In an ideal world, these models parameterize all uncertainties and reflect them in the cost-effectiveness probability and risk associated with the adoption. In practice, uncertainty assessment is often incomplete, potentially leading to suboptimal reimbursement recommendations and risk management. This study examines the feasibility of comprehensive uncertainty assessment in health economic models. METHODS: A state transition model on peripheral arterial disease treatment was used as a case study. Uncertainties were identified and added to the probabilistic sensitivity analysis if possible. Parameter distributions were obtained by expert elicitation, and structural uncertainties were either parameterized or explored in scenario analyses, which were model averaged. RESULTS: A truly comprehensive uncertainty assessment, parameterizing all uncertainty, could not be achieved. Expert elicitation informed 8 effectiveness, utility, and cost parameters. Uncertainties were parameterized or explored in scenario analyses and with model averaging. Barriers included time and resource constraints, also of clinical experts, and lacking guidance regarding some aspects of expert elicitation, evidence aggregation, and handling of structural uncertainty. The team's multidisciplinary expertise and existing literature and tools were facilitators. CONCLUSIONS: While comprehensive uncertainty assessment may not be attainable, improvements in uncertainty assessment in general are no doubt desirable. This requires the development of detailed guidance and hands-on tutorials for methods of uncertainty assessment, in particular aspects of expert elicitation, evidence aggregation, and handling of structural uncertainty. The issue of benefits of uncertainty assessment versus time and resources needed remains unclear.


Assuntos
Economia Médica , Incerteza , Análise Custo-Benefício , Estudos de Viabilidade , Estudos de Casos Organizacionais , Avaliação da Tecnologia Biomédica
12.
BMJ Open Qual ; 10(3)2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34244176

RESUMO

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.


Assuntos
Tecnologia Biomédica , Vacinas contra COVID-19/uso terapêutico , COVID-19/prevenção & controle , Fortalecimento Institucional/métodos , Vacinação em Massa/organização & administração , Inglaterra , Humanos , Estudos de Casos Organizacionais , SARS-CoV-2 , Medicina Estatal
13.
WMJ ; 120(2): 137-141, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34255954

RESUMO

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.


Assuntos
COVID-19/epidemiologia , Sistemas de Apoio a Decisões Administrativas , Planejamento em Desastres , Planejamento Hospitalar , Comunicação , Humanos , Estudos de Casos Organizacionais , Política Organizacional , Pandemias , SARS-CoV-2 , Capacidade de Resposta ante Emergências , Wisconsin/epidemiologia
14.
HERD ; 14(3): 34-48, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34075789

RESUMO

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.


Assuntos
COVID-19/terapia , Unidades de Terapia Intensiva/organização & administração , Telemedicina/métodos , COVID-19/prevenção & controle , Arquitetura de Instituições de Saúde/métodos , Arquitetura de Instituições de Saúde/normas , Humanos , Controle de Infecções/métodos , Israel , Estudos de Casos Organizacionais , Isolamento de Pacientes/métodos , SARS-CoV-2 , Telemedicina/organização & administração
15.
Phys Ther ; 101(9)2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34174072

RESUMO

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.


Assuntos
COVID-19/prevenção & controle , Hospitais Pediátricos/organização & administração , Controle de Infecções/organização & administração , Serviço Hospitalar de Terapia Ocupacional/organização & administração , Serviço Hospitalar de Fisioterapia/organização & administração , Reabilitação/organização & administração , COVID-19/epidemiologia , COVID-19/transmissão , Protocolos Clínicos , Humanos , Massachusetts , Estudos de Casos Organizacionais , Seleção de Pacientes , Telemedicina/organização & administração , Triagem
16.
Public Health ; 194: 270-273, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34000651

RESUMO

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.


Assuntos
Arteterapia/organização & administração , Disfunção Cognitiva/terapia , Serviços Comunitários de Saúde Mental/organização & administração , Demência/terapia , Medicina Estatal/organização & administração , Idoso , Conselho Diretor , Humanos , Determinação de Necessidades de Cuidados de Saúde , Estudos de Casos Organizacionais , Projetos Piloto , Resultado do Tratamento , País de Gales
17.
Med Ref Serv Q ; 40(2): 188-204, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33970820

RESUMO

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.


Assuntos
COVID-19/epidemiologia , Bibliotecas Médicas/organização & administração , Biblioteconomia/educação , Modelos Organizacionais , Humanos , Capacitação em Serviço , Los Angeles/epidemiologia , Estudos de Casos Organizacionais , Admissão e Escalonamento de Pessoal , Desenvolvimento de Programas , Melhoria de Qualidade , SARS-CoV-2
18.
Med Ref Serv Q ; 40(2): 151-167, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33970824

RESUMO

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.


Assuntos
Disseminação de Informação/métodos , Bibliotecas Médicas/organização & administração , Modelos Organizacionais , Colorado , Humanos , Estudos de Casos Organizacionais
19.
Risk Anal ; 41(7): 1204-1212, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33960513

RESUMO

This article describes an interdisciplinary community resilience research project and presents a case study that supports bringing researchers together before a disaster to develop plans, procedures, and preapproved Institutional Review Board (IRB) protocols. In addition, this article explains how researchers from various academic institutions and their federal agency partners can effectively collaborate by creating an IRB Authorization Agreement (IAA). Such preparations can support interdisciplinary rapid response disaster fieldwork that is timely, ethically informed, and scientifically rigorous. This fieldwork preplanning process can also advance interdisciplinary team formation and data collection efforts over the long term.


Assuntos
Planejamento em Desastres/organização & administração , Comitês de Ética em Pesquisa , Pesquisa Interdisciplinar/organização & administração , Pesquisadores , Humanos , Estudos de Casos Organizacionais
20.
Emerg Radiol ; 28(4): 705-711, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33813649

RESUMO

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.


Assuntos
COVID-19/epidemiologia , Diagnóstico por Imagem/estatística & dados numéricos , Serviço Hospitalar de Emergência/organização & administração , Pneumonia Viral/epidemiologia , Necessidades e Demandas de Serviços de Saúde , Planejamento Hospitalar , Humanos , Itália/epidemiologia , Estudos de Casos Organizacionais , Pandemias , Pneumonia Viral/virologia , SARS-CoV-2
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