Alcuni abstract di articoli che trattano argomenti relativi all'eHealth

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A Patient-Centered Primary Care Practice Approach Using Evidence-Based Quality Improvement: Rationale, Methods, and Early Assessment of Implementation

BACKGROUND: Healthcare systems and their primary care practices are redesigning to achieve goals identified in Patient-Centered Medical Home (PCMH) models such as Veterans Affairs (VA)’s Patient Aligned Care Teams (PACT). Implementation of these models, however, requires major transformation. Evidence-Based Quality Improvement (EBQI) is a multi-level approach for supporting organizational change and innovation spread. OBJECTIVE: To describe EBQI as an approach for promoting VA’s PACT and to assess initial implementation of planned EBQI elements. DESIGN: Descriptive. PARTICIPANTS: Regional and local interdisciplinary clinical leaders, patient representatives, Quality Council Coordinators, practicing primary care clinicians and staff, and researchers from six demonstration site practices in three local healthcare systems in one VA region. INTERVENTION: EBQI promotes bottom-up local innovation and spread within top-down organizational priorities. EBQI innovations are supported by a research-clinical partnership, use continuous quality improvement methods, and are developed in regional demonstration sites. APPROACH: We developed a logic model for EBQI for PACT (EBQI-PACT) with inputs, outputs, and expected outcomes. We describe implementation of logic model outputs over 18 months, using qualitative data from 84 key stakeholders (104 interviews from two waves) and review of study documents. RESULTS: Nearly all implementation elements of the EBQI-PACT logic model were fully or partially implemented. Elements not fully achieved included patient engagement in Quality Councils (4/6) and consistent local primary care practice interdisciplinary leadership (4/6). Fourteen of 15 regionally approved innovation projects have been completed, three have undergone initial spread, five are prepared to spread, and two have completed toolkits that have been pretested in two to three sites and are now ready for external spread. DISCUSSION: EBQI-PACT has been feasible to implement in three participating healthcare systems in one VA region. Further development of methods for engaging patients in care design and for promoting interdisciplinary leadership is needed. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s11606-013-2703-y) contains supplementary material, which is available to authorized users

Curriculum renewal for interprofessional education in health

In this preface we comment on four matters that we think bode well for the future of interprofessional education in Australia. First, there is a growing articulation, nationally and globally, as to the importance of interprofessional education and its contribution to the development of interprofessional and collaborative health practices. These practices are increasingly recognised as central to delivering effective, efficient, safe and sustainable health services. Second, there is a rapidly growing interest and institutional engagement with interprofessional education as part of pre-registration health professional education. This has changed substantially in recent years. Whilst beyond the scope of our current studies, the need for similar developments in continuing professional development (CPD) for health professionals was a consistent topic in our stakeholder consultations. Third, we observe what might be termed a threshold effect occurring in the area of interprofessional education. Projects that address matters relating to IPE are now far more numerous, visible and discussed in terms of their aggregate outcomes. The impact of this momentum is visible across the higher education sector. Finally, we believe that effective collaboration is a critical mediating process through which the rich resources of disciplinary knowledge and capability are joined to add value to existing health service provision. We trust the conceptual and practical contributions and resources presented and discussed in this report contribute to these developments.Office of Learning and Teaching Australi

Characterizing the Application of Design Ethnography Techniques to Improve Novice Human-Centered Design Processes.

Design is a central, distinguishing feature of engineering, requiring the development of technical solutions to societal problems. Successful design solutions must not only be technically sound, but also well-adapted to the context and culture in which they will be used. However, the most commonly used methods for eliciting and characterizing stakeholder preferences do not typically reveal critical stakeholder and contextual information. Through the studies described in this dissertation, I explore the use of design ethnography during front-end engineering design phases to capture both stakeholder preferences and contextual knowledge to inform engineering design decision making. Design ethnography is a set of primarily qualitative data collection and analysis techniques that have been adapted from the field of anthropology to augment the engineering design process. Studies from the fields of human-computer interaction and product development have demonstrated that design ethnography techniques are cost-effective and lead to more successful products. However, the design ethnography literature lacks critical understanding of the major barriers and factors that influence design ethnography success, methodologies for synthesizing and applying design ethnography data, best practices to engage with stakeholders, developmental trajectories of novice to expert skill acquisition, and case studies of how design ethnography has been implemented in diverse settings. The studies detailed in this dissertation employ a mixture of quantitative and qualitative research methods to address these gaps in the literature. Through this research, I have characterized novice design ethnography implementation strategies and identified internal and external factors that affect design ethnography execution; investigated correlations between information processing ability and the quality of product requirements developed; established a framework for evaluating and directing design ethnography stakeholder interviews; developed a case study within a global health design context; and interpreted the findings within a theoretically grounded model to represent novice to expert development. This body of work informs strategies and processes for engaging with stakeholders and understanding broader contexts in design work to improve design decision making within both design professional practice and engineering education.PhDMechanical EngineeringUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/133391/1/imohedas_1.pd

Usability analysis of contending electronic health record systems

In this paper, we report measured usability of two leading EHR systems during procurement. A total of 18 users participated in paired-usability testing of three scenarios: ordering and managing medications by an outpatient physician, medicine administration by an inpatient nurse and scheduling of appointments by nursing staff. Data for audio, screen capture, satisfaction rating, task success and errors made was collected during testing. We found a clear difference between the systems for percentage of successfully completed tasks, two different satisfaction measures and perceived learnability when looking at the results over all scenarios. We conclude that usability should be evaluated during procurement and the difference in usability between systems could be revealed even with fewer measures than were used in our study. © 2019 American Psychological Association Inc. All rights reserved.Peer reviewe