Interdisciplinary Team Based Pastoral Care: A Potentially Adaptable Model for Estonian Healthcare

This article aims to build a potentially adaptable model of clinical pastoral care for Estonia’s healthcare institutions. To help the development of spiritual support provision in Estonian healthcare institutions, we are currently working on creating a model of clinical pastoral care that would be in accordance with the local circumstances. Preparatory research in the matter has addressed the socio-cultural and institutional context that shows the great need for interdisciplinary teamwork. The current article offers concrete proposals in the following main points: a) presentation of the pastoral caregiver; b) main actors; c) forms of cooperation; and c) education and internal trainings. The model construction draws information from international research and considers it in Estonia’s local context. Spiritual support provision in Estonia’s healthcare has not yet been taken for granted and the concept is not fully understood. Secularity and religious diversity also set complex frames. Therefore, the model is suggested in guiding proposals, not in a rigorous structure. As such, the model could also be useful for healthcare spiritual support developments in other countries with similar characteristics. The article also poses possible questions of the implementation potential of the model

Evidence-Based Healthcare: The Importance of Effective Interprofessional Working for High Quality Veterinary Services, a UK Example

<p class="AbstractSummary"><strong>Objective: </strong></p><p class="AbstractSummary">To highlight the importance of evidence-based research, not only for the consideration of clinical diseases and individual patient treatment, but also for investigating complex healthcare systems, as demonstrated through a focus on veterinary interprofessional working.</p><p class="AbstractSummary"><strong>Background:</strong></p><p class="AbstractSummary">Evidence-Based Veterinary Medicine (EBVM) was developed due to concerns over inconsistent approaches to therapy being delivered by individuals. However, a focus purely on diagnosis and treatment will miss other potential causes of substandard care including the holistic system. Veterinary services are provided by interprofessional teams; research on these teams is growing.</p><p class="AbstractSummary"><strong>Evidentiary value:</strong></p><p class="AbstractSummary">This paper outlines results from four articles, written by the current authors, which are unique in their focus on interprofessional practice teams in the UK. Through mixed methods, the articles demonstrate an evidence base of the effects of interprofessional working on the quality of service delivery.</p><p class="AbstractSummary"><strong>Results:</strong></p><p class="AbstractSummary">The articles explored demonstrate facilitators and challenges of the practice system on interprofessional working and the outcomes, including errors. The results encourage consideration of interprofessional relationships and activities in veterinary organisations. Interprofessional working is an example of one area which can affect the quality of veterinary services.</p><p class="AbstractSummary"><strong>Conclusion: </strong></p><p class="AbstractSummary">The papers presented on veterinary interprofessional working are an example of the opportunities for future research on various topics within evidence-based healthcare.</p><p class="AbstractSummary"><strong>Application:</strong></p><p class="AbstractSummary">The results are pertinent to members of veterinary teams seeking to improve their service delivery, to educators looking to enhance their students’ understanding of interprofessional working, and to researchers, who will hopefully be encouraged to consider evidence-based healthcare more holistically. </p><br /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" /

A qualitative study of the views of patients with long-term conditions on family doctors in Hong Kong

&lt;b&gt;Background&lt;/b&gt; Primary care based management of long-term conditions (LTCs) is high on the international healthcare agenda, including the Asia-Pacific region. Hong Kong has a 'mixed economy' healthcare system with both public and private sectors with a range of types of primary care doctors. Recent Hong Kong Government policy aims to enhance the management of LTCs in primary care possibly based on a 'family doctor' model. Patients' views on this are not well documented and the aim of the present study was to explore the views of patients with LTCs on family doctors in Hong Kong.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Methods&lt;/b&gt; The views of patients (with a variety of LTCs) on family doctors in Hong Kong were explored. Two groups of participants were interviewed; a) those who considered themselves as having a family doctor, b) those who considered themselves as not having a family doctor (either with a regular primary care doctor but not a family doctor or with no regular primary care doctor). In-depth individual semi-structured interviews were carried out with 28 participants (10 with a family doctor, 10 with a regular doctor, and 8 with no regular doctor) and analysed using the constant comparative method.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Results&lt;/b&gt; Participants who did not have a family doctor were familiar with the concept but regarded it as a 'luxury item' for the rich within the private healthcare system. Those with a regular family doctor (all private) regarded having one as important to their and their family's health. Participants in both groups felt that as well as the more usual family medicine specialist or general practitioner, traditional Chinese medicine practitioners also had the potential to be family doctors. However most participants attended the public healthcare system for management of their LTCs whether they had a family doctor or not. Cost, perceived need, quality, trust, and choice were all barriers to the use of family doctors for the management of their LTCs.&lt;p&gt;&lt;/p&gt; &lt;b&gt;Conclusions&lt;/b&gt; Important barriers to the adoption of a 'family doctor' model of management of LTCs exist in Hong Kong. Effective policy implementation seems unlikely unless these complex barriers are addressed

Health Coaching Case Report: Optimizing Employee Health and Wellbeing in Organizations

Abstract Health and wellbeing of employees has a direct correlation to organizational performance. It is essential that organizations and successful leaders prioritize the health and wellbeing of all employees – from the C-suite to entry level positions. As rates of stress, chronic illness, and unhealthy lifestyle choices continue to increase, it is imperative that organizations discover strategies that cultivate employee wellbeing. Employees with high wellbeing are more engaged, productive, and energized and directly affect a company’s bottom line; it is in the best interest of employers to invest in human capital and wellbeing of employees. Health and wellness coaching demonstrates encouraging potential as a cost-effective catalyst to optimize employee wellbeing. Rooted in science-based research with the foundation in relationships, communication, and connection, health coaches partner with employees as they build self-awareness around a holistic view of health. As employees build self-awareness, they increasingly recognize the importance of managing stress and self-care, connecting to their vision and values, taking active steps towards change, and addressing barriers and obstacles. With these strategies, individuals build resilience as they gain energy, empowerment, and work towards positive growth. This paper outlines the challenges that leaders and employees are facing, describes the intervention of health and wellness coaching, and provides a group coaching case study that demonstrates how health and wellness coaching can foster employee wellbeing. This case study provides evidence that health coaching shows promise as an intervention to optimize employee health and wellbeing. Keywords: employee health and wellbeing, wellness, stress management, health and wellness coaching, group coaching, leader wellbeing, self-awareness, case repor

The Future of Disability in Alaska Summit & Follow-up Survey

The Future of Disability in Alaska Summit was held in Anchorage in the summer of 2013, May 9-10. The purpose was to gather perspectives from a diverse group of stakeholders to inform a vision of the future for people with disabilities in Alaska in five broad topical areas: 1) Housing Arrangements, 2) Advocacy, 3) Relationships, 4) Economic Wellbeing, and 5) Health. About 76 stakeholders participated in the summit including people with disabilities, family members, advocates, service providers, policymakers, and others. A follow-up online survey was conducted to gather information from a broader range of stakeholders and to get a sense of the highest priorities in each area. The purpose of the report and other products coming out of this effort is to inspire stakeholders to periodically reflect, individually and in groups, on how they are working toward the vision in a relevant area and taking action in the context of advocacy, policy/regulation, funding, and services/resources. The report states a vision for each of the five topical areas and includes many suggested strategies to accomplish it.Funded in part by Grant Number T7320663 from the Maternal and Child Health Bureau, Health Resources and Services Administration; and Grant Number 90DD0009-02-00 from the Administration on Intellectual and Developmental Disabilities, Administration for Community Living; both in the U.S. Department of Health and Human ServicesList of Tables / Executive Summary / Introduction / Method / Participants / Result

What does it take to make integrated care work? A ‘cookbook’ for large-scale deployment of coordinated care and telehealth

The Advancing Care Coordination & Telehealth Deployment (ACT) Programme is the first to explore the organisational and structural processes needed to successfully implement care coordination and telehealth (CC&TH) services on a large scale. A number of insights and conclusions were identified by the ACT programme. These will prove useful and valuable in supporting the large-scale deployment of CC&TH. Targeted at populations of chronic patients and elderly people, these insights and conclusions are a useful benchmark for implementing and exchanging best practices across the EU. Examples are: Perceptions between managers, frontline staff and patients do not always match; Organisational structure does influence the views and experiences of patients: a dedicated contact person is considered both important and helpful; Successful patient adherence happens when staff are engaged; There is a willingness by patients to participate in healthcare programmes; Patients overestimate their level of knowledge and adherence behaviour; The responsibility for adherence must be shared between patients and health care providers; Awareness of the adherence concept is an important factor for adherence promotion; The ability to track the use of resources is a useful feature of a stratification strategy, however, current regional case finding tools are difficult to benchmark and evaluate; Data availability and homogeneity are the biggest challenges when evaluating the performance of the programmes

Care and compassion at the end of life

Aim: To examine the provision of the ‘end of life care strategy’ and the perception of provision by patients and carers. Introduction: In determining what constitutes excellence in care at the end of life, one must firstly acknowledge ‘what care and compassion is’. Following this it should be established what one should expect as a minimum standard of care. The end of life care strategy was initiated by the Department of Health in 2008. This guidance was intended to drive forward end of life care provision where patients were seen as the priority and encouraged to engage in all decision making at each point in their journey. Standards suggested by NICE (2011) further support patient empowerment and inclusivity in care planning. Method: A literature search was conducted in order to determine whether there has been a change in provision and to identify whether patients and their carers perceive an excellence in the care that has been delivered. Results: The literature is limited but the underlying issues of pre-end of life care strategy (2008) remain apparent. Patients and their carers continue to lack the autonomy they deserve and decisions are made about them rather than by them. Owing to the lack of direction which should come from the patient, care may be fragmented with numerous members of a multidisciplinary team being involved. Conclusion: Patient involvement is paramount. Early discussions relating to choices at the end of life need to be achieved in a timely manner. This should ensure that the patient and carer experience a high standard of excellent care which has been planned with inclusivity in min

Palliative and end-of-life care for adults with advanced chronic obstructive pulmonary disease: a rapid review focusing on patient and family caregiver perspectives.

Purpose of review: The aim of the review was to explore patient and family caregiver perspectives on key issues for ensuring quality of end-of-life care for people with chronic obstructive pulmonary disease (COPD). The growing evidence on the value of specialist palliative care services demonstrates significant improvements in treatments and provisions; however, much of the literature is generic in nature or centred on people with a cancer diagnosis. In this review, we examine the literature to ascertain the views and needs of patients and carers affected by advanced COPD, a highly debilitating condition that can have a profoundly negative impact on the quality of end-of-life experience. Recent findings: A total of 19 papers were included in the review. The main themes in the literature were Holistic Care, Illness Trajectory and Technology. Summary: Areas of unmet need emphasized across physical, psychosocial and spiritual domains were identified, particularly in relation to appropriate and timely conversations. Positive developments in the care and treatment of advanced COPD include the use of the STIOLTO Respimat inhaler, a brief educative and psychosocial intervention based on cognitive-behavioural therapy, and high-intensity exercise training. There is some evidence regarding the use of technology in end-stage COPD

Spirituality in nursing practice

Spirituality is an important aspect of holistic care which is frequently overlooked owing to difficulty conceptualising spirituality and confusion about how to integrate it into nursing care. This article seeks to understand what is meant by spirituality and spiritually competent practice, it explores some of the attitudes towards spirituality and describes some of issues affecting integration of spirituality into nursing care