Digitalization of healthcare services. Backstage communication channels at HUS.

Digital technology has been transforming the way services are created, delivered and consumed. They support the everyday processes of organizations and have become a valuable asset in the competitive global economy. Public healthcare has a lot of challenges in adopting new technologies that are not directly related to patient care. The most puzzling dilemma is the distribution of limited resources. Public healthcare backstage — the part that supports the frontstage operations but is not visible from the outside — is in an urgent need of transformation. This master’s thesis observes and suggests possible ways to overcome this challenge. It presents the complexity of public healthcare service, studies the reasons for digitalizing the internal communication channels that are part of public healthcare service backstage. Next, the thesis explores the processes that might support digital transformation of public healthcare services and assumes the challenges and opportunities for digitalization for stakeholders of public healthcare service. The master thesis is supported by a case that was a study project in Aalto University School of Business. The project was a joint effort of Aalto University students and professors, representatives of Fjord and Accenture, and the clients from the Finnish public sector. The case for this thesis presents the project in collaboration with HUS (the Hospital District of Helsinki and Uusimaa). Service design methodologies and tools were used as a framework for the thesis. The author tries to clarify how service design methodology and its tools are able to help in the digital transformation of public healthcare services and, especially, the backstage part of those services

The temporal dimension of copresence in medical practice: the case of telestroke

This paper examines how co-presence is enacted in technology-mediated medical practices, particularly under time pressure. Extant literature highlights time (e.g. immediacy and duration of interactions) as a critical condition for copresence, but there has been little attention to the variation of copresence over time. In this paper, we investigate this variation through an ethnographic study in three emergency departments that are linked via a telemedicine system called Telestroke, which is used to diagnose and treat stroke patients at a distance. We draw on the sensemaking literature to uncover how copresence is enacted across different phases of technology-mediated medical practice. Our findings reveal four mechanisms that shape the variation of copresence across time, namely extracting cues, retrospection, perspective-taking, and selective attention.

Impact evaluation of international multidisciplinary tumor boards

Over the last 20 years, cancer clinicians have begun to improve the efficacy of cancer care through tumor boards, meetings of multidisciplinary patient care teams used to educate attendees and align treatment plans. In addition to the potential for collaboration between different disciplines, these meetings allow for the incorporation of information from peer-reviewed literature. Despite their use, very little research has been done on the effect of tumor boards on treatment efficacy. Within this small body of work, the indicators used are often inherently biased, and little concern is given to their confounding effects. This document will discuss alternative metrics that provide a less biased estimate of the impact of tumor boards. Given their educational aspects, tumor boards are beginning to be used in an international context to support clinicians in developing nations. Despite the relative lack of evidence supporting use of tumor boards, they provide a low-cost method for improving clinician education in a setting where treatment protocols vary greatly. Moreover, international tumor boards provide a way for low-resource hospitals to tap into facilities of high-resource hospitals, receive resource-sensitive guidelines for future practice, and collaborate with clinicians from other hospitals. However, there are serious barriers to implementing international tumor boards, including technological, logistical, linguistic, and oversight issues. This document outlines potential issues and methods to circumvent them, as well as benefits of international tumor boards (including future collaboration)

GW Nursing, Spring 2016

https://hsrc.himmelfarb.gwu.edu/son_gwnursmag/1007/thumbnail.jp

Advanced Practice Coordinator: Role Extension or Advanced Practice? A Canadian Multi-Case Study.

Introduction: Increasing demands for medical services concurrent with the shortage of healthcare personnel has forced a change in the delivery of healthcare services. In response to these challenges, allied health professions began expanding and extending their practices into the realms of medicine. A number of these emerging practices have been branded as advanced practice. One such practice is the advanced practice coordinator role in Ontario Canada, successfully implemented at two health institutions but failed at another. This research explores whether the advanced practice coordinator role is advanced practice or role extension and whether it influences patient outcomes. Further, the research objectives also included the development of a framework to inform the development and implementation of emerging practices in medical imaging along with informing advanced radiographic practice curricula. Professional practice designation is important as it contributes to professional identity, builds the professions’ body of knowledge, and influences professions’ scopes of practice, practitioners’ satisfaction, staff retention, and patient satisfaction. Further, the explicit designation of professional practice is needed for practitioners to provide a clear, concrete and consistent explanation of their professional roles and responsibilities to patients, the general public, other healthcare workers and healthcare policymakers. This research, therefore, contributes to knowledge in the areas of health sciences and higher education by informing the development of emerging practice roles and practice curricula. Methods: Three healthcare sites were studied using a mixed-methods multi-case study research strategy. Program documents, interviews of key stakeholders, surveys of advanced practice coordinators, and measures of patient wait times were gathered and analysed. Each case was studied as an independent case with subsequent cross-case analysis performed. Results: The advanced practice coordinator role was developed out of the need to better utilise technologists’ skills and competencies and the need to facilitate enhanced hours of diagnostic imaging services. The role has enjoyed some amount of success with recorded reductions in patient wait times, improved patient education and improvement in patient satisfaction. Additionally, the role failed at a third institution owing to local labour laws restrictions, and incompatibility between department layout and role functionality. More importantly, interviewees felt that the role was more consistent with the emerging practices of role extension than advanced practice. Conclusions: The advanced practice coordinator role as practice at two healthcare institutions in Ontario Canada did not meet the criteria for advanced practice designation. The practice is consistent with role extension. Nonetheless, the role does influence patient outcomes. Moreover, the findings of this research also assist in shaping the radio-graphic research landscape and improving the evidence-base practice approach of the radiographic profession. The findings also can possibly contribute to the development of advanced radiographic practice curricula that compliments clinical practice by providing form and structure to radiographic role development. Further, this research suggests two emerging practice frameworks - a collaborative approach to role extension and a frame-work to inform advanced practice in medical imaging. Keywords: Emerging practice, Advanced practice, Role extension, Advanced radio-graphic practice, Advanced practice coordinator, Medical radiation technology, Collaborative approach to role extension, Advanced radiographic practice framework

Vol. 42, No. 3: Fall 2017

https://commons.und.edu/ndm-archive/1009/thumbnail.jp

University of South Alabama College of Medicine Annual Report for 2020-2021

The 2020-21 annual report for the University of South Alabama College of Medicine catalogues the accomplishments of our faculty, staff and students relating to teaching, research, other scholarship and community service. Despite the COVID-19 pandemic continuing its prevalence, the accomplishments are significant.https://jagworks.southalabama.edu/com_report/1005/thumbnail.jp