HealthPartners: Consumer-Focused Mission and Collaborative Approach Support Ambitious Performance Improvement Agenda

Presents a case study of a nonprofit healthcare organization that exhibits the six attributes of an ideal healthcare delivery system as defined by the Fund, including information continuity, care coordination and transitions, and system accountability

HealthCare Partners: Building on a Foundation of Global Risk Management to Achieve Accountable Care

Describes the progress of a medical group and independent practice association in forming an accountable care organization by working with insurers as part of the Brookings-Dartmouth ACO Pilot Program. Lists lessons learned and elements of success

A Study of Technology Innovations and Applications in Transforming Safety and Security in Healthcare Facility Management

The increasing complexity of construction projects has transformed the Architecture, Engineering, and Construction (AEC) industry through technology adoption over the last decade. But, Facility Management (FM) as an industry has been slow in technology adoption. Growing market competition, corporate demands and new ways of attracting clients for owners are compelling FM professionals to be more efficient. This requirement is driving technology adoption by FM professionals. This study identifies technologies adopted by Healthcare Facility Management (HFM) professionals for improving safety and security of users that have capabilities and conceived and/or developed applications that can or in some cases are at present used in HFM. Simultaneously, it also looks into potentials and capabilities of a handful of other technologies in further improving safety and security. Using Literature-Based Discovery (LBD), the technology applications and innovations aimed towards safety and security are discovered from the literature that falls within the purview of HFM to form a picture of how these technologies enhance the practice of FM. The study aims at detecting how technologies have contributed towards transforming user experience. Also, this study identifies existing technologies and innovation demands (knowledge and gaps in knowledge), a general understanding of technology, its use and capabilities, and its recognition by users and industry professionals (adoption/rejection). They serve to illustrate how and to what degree the technologies will come to be used in facility management. Technologies, as they mature, will come to be used by facility managers in similar functions and hypothetically, entirely new ones. One should create a better user experience tailored to the functionality demanded. It is important for facility managers to partner with technology companies presenting innovative solutions to create a platform that is tailored to user-specific needs. Acceptance of a unified process, together with input from users, facility managers, and an assessment of current technologies and new advances in practice are productive ways to develop technologies that drive user satisfaction. This paper works to illustrate a future vision of HFM based on these technologies. Healthcare facility managers will have a reference that assembles multiple technological proficiencies that can function in their practice going forward

Organizing for Higher Performance: Case Studies of Organized Delivery Systems

Offers lessons learned from healthcare delivery systems promoting the attributes of an ideal model as defined by the Fund: information continuity, care coordination and transitions, system accountability, teamwork, continuous innovation, and easy access

Deconstructing match-fixing: a holistic framework for sport integrity policies

On the 1st of September 2019, the Council of Europe Convention against the Manipulation of Sports Competitions entered into force. This official mandate appears to confirm the significance of the issue on the political agenda. For sports governance bodies, the problem is one of the biggest threats against the integrity and sustainability of their industry. Despite this political-institutional situation, the phenomenon still remains under-studied in the academic world and several authors have emphasized the need for more and better empirical research to verify the premises (sometimes unfounded) on which the official preventive narrative of the problem is built. This special issue, Deconstructing Match-fixing, comes to light to address this issue. Systematizing the evidence presented along the contributions, this introductory article attempts to dispel some ‘myths’ in the official preventive narrative, offers some lessons for a better understanding of the phenomenon, and promotes recommendations for establishing more evidence-based public policies and educational campaigns.info:eu-repo/semantics/acceptedVersio

Intervenções para reduzir a prescrição de medicamentos inapropriados para idosos

OBJETIVO: Identificar e avaliar criticamente revisões sistemáticas sobre a efetividade de intervenções para reduzir a prescrição de medicamentos potencialmente inapropriados para pacientes idosos. MÉTODOS: Overview de revisões sistemáticas. A busca e a seleção dos estudos foram feitas nas bases de dados Medline, Biblioteca Cochrane, Embase, CINAHL, Biblioteca Virtual em Saúde e Web of Science, combinando os termos aged, prescriptions, inappropriate prescribing e potentially inappropriate medication list com seus sinônimos remissivos e outros descritores associados até junho de 2017. Foram incluídas revisões sistemáticas com ou sem metanálise, que tenham abordado a efetividade de qualquer intervenção ou a combinação de intervenções para reduzir a prescrição de medicamentos potencialmente inapropriados para pacientes idosos, sem restrição quanto ao desenho dos estudos primários, idioma ou data de publicação. Para avaliação da qualidade metodológica das revisões sistemáticas selecionadas, foi utilizado o instrumento A MeaSurement Tool to Assess systematic Reviews. A seleção e a avaliação da qualidade metodológica foram realizadas por dois avaliadores independentes. As divergências foram superadas por consenso. Os principais achados foram agrupados em categorias temáticas, definidas com base em análise de conteúdo e discutidas qualitativamente na forma de síntese narrativa. RESULTADOS: Vinte e quatro revisões sistemáticas foram incluídas no estudo. Quanto ao desenho do estudo e à avaliação da qualidade metodológica, prevaleceram revisões sistemáticas de ensaios clínicos controlados randomizados e estudos de qualidade moderada, respectivamente. As intervenções foram analisadas em cinco categorias temáticas: serviços de revisão de medicamentos, intervenções farmacêuticas, sistemas informatizados, intervenções educacionais e outras. As intervenções estudadas apresentaram bons resultados e a maioria contribuiu para reduzir a prescrição de medicamentos inapropriados para pacientes idosos. CONCLUSÕES: As revisões sistemáticas incluídas nesse overview apontaram benefícios potenciais de diferentes intervenções. No entanto, não foi possível determinar qual a mais efetiva. É provável que intervenções multifacetadas alcancem resultados melhores do que intervenções isoladas.OBJECTIVE: Identify and critically evaluate systematic reviews addressing the effectiveness of interventions to reduce the number of prescriptions of potentially inappropriate medication to older patients. METHODS: This is an overview of systematic reviews. The studies were searched and selected from Medline, Cochrane Library, Embase, CINAHL, Virtual Health Library, and Web of Science databases, combining the terms aged, prescriptions, inappropriate prescribing and potentially inappropriate medication list with their entry terms and other related descriptors, published by June 2017. This study included systematic reviews with or without meta-analysis that addressed the effectiveness of any intervention or combined interventions to reduce the number of prescriptions of potentially inappropriate medications to older patients, without restriction in terms of design, language or date of publication of primary studies. AMSTAR – A MeaSurement Tool to Assess systematic Reviews – was used to evaluate the methodological quality of selected systematic reviews. Study selection and the methodological quality evaluation were performed by two independent evaluators, who resolved any divergence by consensus. The main findings were grouped into thematic categories, defined after a content analysis and discussed qualitatively as narrative synthesis. RESULTS: This study analyzed 24 systematic reviews. In terms of study design and methodological quality evaluation, most were systematic reviews of randomized controlled clinical trials and studies of moderate quality, respectively. The interventions were analyzed in five thematic categories: medication review services, pharmaceutical interventions, computerized systems, educational interventions, and others. The interventions analyzed showed good results and most of them helped reduce the number of prescriptions of potentially inappropriate medication to older patients. CONCLUSIONS: The systematic reviews included in this overview showed potential benefits of different interventions. However, it was not possible to determine the most effective intervention. Combined interventions are likely to provide better results than isolated interventions

Framework for Understanding the Relationship between Lean and Safety in Construction

Safety and lean aim at similar goals in making the construction process faster, better and safer (Main et al. 2008). This research intends to answer the basic question: “Is there a relationship between lean and safety principles to help in reduction of waste and incidents?” The primary objective of this research is to understand the relationship of lean and safety through risk and uncertainty reduction. A qualitative analysis of lean methods and safety practices in the construction industry will be derived. Relationships between lean methods and safety practices will also be studied and the impacts of safety on lean methods will be analyzed. A framework that expresses the relationship of lean and safety theories will yield an understanding of the relations. The proposed framework will provide a larger picture of the association of lean and safety will explore the common grounds used in the minimization of waste and risk. The limitation of this research lies in qualitative findings from the data collected. A quantitative analysis involving the documentation of project processes and safety data would further strengthen the relationships identified. On the contrary, a quantitative approach would not provide a perspective on a larger scale. The principles of lean and safety are aligned and the construction industry could benefit by their integration A relationship has been established between lean methods and safety programs. Lean methods add value and eliminate waste, and safety helps in risk mitigation. Thus, it is widely evident that lean and safety have a synergy that can be harnessed to create a safe, productive workplace

Can Standardizing CABG care with Clinical Pathways Reduce Length of Stay and Hospital Acquired Infections?

Clinical pathways are a common component in the quest to improve the quality of health. Clinical pathways are used to reduce variation, improve quality of care and maximize the outcomes for specific groups of patients (Lawal, et al., 2016). The purpose of this project is to develop and initiate a Coronary Artery Bypass Grafting (CABG) clinical pathway to reduce variation in care as a way to improve quality of care and patient outcomes for CABG patients CABG surgery is considered a high risk, high cost, yet highly profitable surgery with considerable post-operative complications that affect numerous quality metrics including Length of Stay (LOS), hospital acquired infections (HAI), mortality rate, readmission rates and patient satisfaction. The importance of delivering high quality clinical management of CABG patients and minimizing postoperative complications is essential for the growth of a Center of Excellence and for financial sustainability. Therefore, implementation of CABG Clinical Pathways (CPW) will improve quality of care delivered to patients who undergo coronary revascularization via CABG. As a result of the implementation of the CABG clinical pathway there was a reduction in HAI including central line associated blood stream infection, catheter associated urinary tract infection and surgical site infection. In addition to the reduction of HAI the CABG clinical pathway also presented an initial reduction in the LOS of CABG patients

Information security, data breaches, and protecting cardholder information: facing up to the challenges

On September 13 and 14, 2006, the Payment Cards Center of the Federal Reserve Bank of Philadelphia and the Electronic Funds Transfer Association (EFTA) hosted a conference entitled “Information Security, Data Breaches, and Protecting Cardholder Information: Facing Up to the Challenges.” The two-day event was designed to bring together a diverse set of stakeholders from the U.S. payments industry to discuss a framework to guide industry practices and inform public policy. This paper summarizes key highlights from this event. Conference participants emphasized that the industry must address two fundamental issues: (1) increasingly dangerous threats to sensitive consumer information and (2) public perception and understanding of the risks from data breaches. These challenges are related but need different solutions. A consensus emerged that while the situation is not yet dire, it is serious, and warrants attention from all payments stakeholders.Data protection ; Payment systems ; Computer security