A National Framework and Preferred Practices for Palliative and Hospice Care

Establishes the framework for a set of preferred practices that can be implemented to provide palliative and hospice care that is safe, beneficial, timely, patient-centered, efficient, and equitable

A training needs analysis of health care providers within Malta’s Primary Health Department : a boon or a bane?

In 2009, the Practice Development Unit and the Specialist Training Programme in Family Medicine within Malta’s Primary Health Department carried out a training needs analysis of health care providers working in government primary health centres and clinics so as to investigate their educational requirements. Method: After a questionnaire was developed as a tool, a pilot study was conducted in a particular health centre to test its validity. The amended version of the questionnaire was then mailed individually to all health providers working at that time in the various health centres and peripheral clinics. Out of the 498 questionnaires sent, 215 were completed and returned, with a resulting response rate of 43%. One main finding was that, irrespective of one’s discipline, the programme topic and the lecturer were the important decisive factors of whether one attended a training course or not. On the other hand, specific obstacles to training emerged that are directly related to one’s profession: these included shortage of staff, lack of time and other commitments. From the information revealed by the training needs analysis, the department revamped its training strategy to consist of three-monthly Saturday seminars dealing with topics relevant to primary health care, with such activities being oversubscribed and well-received. In this manner a thriving continuing professional development programme was designed and delivered for health care professionals within Malta’s Primary Health Departmentpeer-reviewe

University of Vermont, College of Medicine Bulletin

1974https://scholarworks.uvm.edu/dmlcatalog/1112/thumbnail.jp

Value Creation in Health Care: The Case of the Princesse Grace Hospital (CHPG) Monaco

Health care has to make transitions to be truly effective in the modern world. A change in paradigm is needed. This requires that value - defined as the health outcome for a particular medical condition per unit of cost expended - must be applied and added to health care, and health care itself must be treated as a business that performs in a competitive environment to ultimately provide client or customer satisfaction. Health care today is typically service specific, necessitating that the client or patient visits different medical or clinical departments to get the range of treatment prescribed for his/her condition. We argue – following Porter and Teisberg - that health care should be patient-centric and that organization and treatment should be planned accordingly. Such planning must take into account the provision of a range of services directly accessible or networked regionally taking full advantage of technological advances in the field of medical technology and informational systems. We examine whether such principles are currently being applied in Monaco (specifically in the Centre Hospitalier Princesse Grace) taking into account both Monaco’s unique positioning and its geographical context in relation to the French health system as well as the resulting interaction in networking relationships. We explore how value in healthcare is currently being added and investigate plans for augmenting such efforts. Aspects of preventative and innovative initiatives are also discussed as a means of enhancing value. Finally, we offer a set of recommendations that in the context of the local situation might be successfully applied. Continuous review of performance and the application of best practice and technologies are proposed to ensure that the provision of health care services can compete with the best in the world.Health care; value creation in health care; Monaco; Southern France

University of Vermont, College of Medicine Bulletin

1975https://scholarworks.uvm.edu/dmlcatalog/1113/thumbnail.jp

East Midlands Research into Ageing Network (EMRAN) Discussion Paper Series

Academic geriatric medicine in Leicester . There has never been a better time to consider joining us. We have recently appointed a Professor in Geriatric Medicine, alongside Tom Robinson in stroke and Victoria Haunton, who has just joined as a Senior Lecturer in Geriatric Medicine. We have fantastic opportunities to support students in their academic pursuits through a well-established intercalated BSc programme, and routes on through such as ACF posts, and a successful track-record in delivering higher degrees leading to ACL post. We collaborate strongly with Health Sciences, including academic primary care. See below for more detail on our existing academic set-up. Leicester Academy for the Study of Ageing We are also collaborating on a grander scale, through a joint academic venture focusing on ageing, the ‘Leicester Academy for the Study of Ageing’ (LASA), which involves the local health service providers (acute and community), De Montfort University; University of Leicester; Leicester City Council; Leicestershire County Council and Leicester Age UK. Professors Jayne Brown and Simon Conroy jointly Chair LASA and have recently been joined by two further Chairs, Professors Kay de Vries and Bertha Ochieng. Karen Harrison Dening has also recently been appointed an Honorary Chair. LASA aims to improve outcomes for older people and those that care for them that takes a person-centred, whole system perspective. Our research will take a global perspective, but will seek to maximise benefits for the people of Leicester, Leicestershire and Rutland, including building capacity. We are undertaking applied, translational, interdisciplinary research, focused on older people, which will deliver research outcomes that address domains from: physical/medical; functional ability, cognitive/psychological; social or environmental factors. LASA also seeks to support commissioners and providers alike for advice on how to improve care for older people, whether by research, education or service delivery. Examples of recent research projects include: ‘Local History Café’ project specifically undertaking an evaluation on loneliness and social isolation; ‘Better Visits’ project focused on improving visiting for family members of people with dementia resident in care homes; and a study on health issues for older LGBT people in Leicester. Clinical Geriatric Medicine in Leicester We have developed a service which recognises the complexity of managing frail older people at the interface (acute care, emergency care and links with community services). There are presently 17 consultant geriatricians supported by existing multidisciplinary teams, including the largest complement of Advance Nurse Practitioners in the country. Together we deliver Comprehensive Geriatric Assessment to frail older people with urgent care needs in acute and community settings. The acute and emergency frailty units – Leicester Royal Infirmary This development aims at delivering Comprehensive Geriatric Assessment to frail older people in the acute setting. Patients are screened for frailty in the Emergency Department and then undergo a multidisciplinary assessment including a consultant geriatrician, before being triaged to the most appropriate setting. This might include admission to in-patient care in the acute or community setting, intermediate care (residential or home based), or occasionally other specialist care (e.g. cardiorespiratory). Our new emergency department is the county’s first frail friendly build and includes fantastic facilities aimed at promoting early recovering and reducing the risk of hospital associated harms. There is also a daily liaison service jointly run with the psychogeriatricians (FOPAL); we have been examining geriatric outreach to oncology and surgery as part of an NIHR funded study. We are home to the Acute Frailty Network, and those interested in service developments at the national scale would be welcome to get involved. Orthogeriatrics There are now dedicated hip fracture wards and joint care with anaesthetists, orthopaedic surgeons and geriatricians. There are also consultants in metabolic bone disease that run clinics. Community work Community work will consist of reviewing patients in clinic who have been triaged to return to the community setting following an acute assessment described above. Additionally, primary care colleagues refer to outpatients for sub-acute reviews. You will work closely with local GPs with support from consultants to deliver post-acute, subacute, intermediate and rehabilitation care services. Stroke Medicine 24/7 thrombolysis and TIA services. The latter is considered one of the best in the UK and along with the high standard of vascular surgery locally means one of the best performances regarding carotid intervention

University of Oregon Medical School Catalog 1935-1936

44 page

Payment by results and demand management: learning from the South Yorkshire laboratory

The need for effective demand management has become more transparent following the introduction of Payment by Results, Patient Choice and other reforms. This report details the findings of an empirical study exploring the South Yorkshire experience of demand management. By being ahead of the game in introducing PbR for all activity in all its acute trusts in the South Yorkshire area, the experience in South Yorkshire has the potential to inform the national roll-out of Payment by Results and Choose and Book. Specific objectives included: • assessing local perceptions of the nature and scale of changes in demand and whether this will be affected as other reforms, specifically Patient Choice, are implemented; • identifying what strategies are being developed locally to manage demand effectively; • documenting any benefits and drawbacks of different strategies for patients, PCTs, providers and the wider health economy; • identifying any facilitators and barriers to developing effective approaches for managing demand; • eliciting opinions on how current demand management strategies could be improved or adapted

Allied health integration: Collaborative care for arthritis and other musculoskeletal conditions

Musculoskeletal conditions, including rheumatoid arthritis, osteoarthritis and osteoporosis, are prevalent in the Australian population, and they impose a substantial burden on the health care system and the community, reflected by their status as a national health priority area. They are the main cause of impaired physical functioning globally. These conditions have high chronicity rates and often have a long term impact, leading to reduced mobility and dexterity, chronic pain, reduced capacity for employment, and negative impact on family and social life. Much of the care for these conditions is provided in primary health care (PHC) settings