Articles: professional-practice.
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Bmc Health Serv Res · Jan 2017
Developing a framework to guide the de-adoption of low-value clinical practices in acute care medicine: a study protocol.
Healthcare systems have difficulty incorporating scientific evidence into clinical practice, especially when science suggests that existing clinical practices are of low-value (e.g. ineffective or harmful to patients). While a number of lists outlining low-value practices in acute care medicine currently exist, less is known about how best to initiate and sustain the removal of low-value clinical practices (i.e. de-adoption). This study will develop a comprehensive list of barriers and facilitators to the de-adoption of low-value clinical practices in acute care facilities to inform the development of a framework to guide the de-adoption process. ⋯ There is a growing body of literature suggesting that the de-adoption of ineffective or harmful practices from patient care is integral to the delivery of high quality care and healthcare sustainability. The framework developed in this study will map barriers and facilitators to de-adoption to the most appropriate interventions, allowing stakeholders to effectively initiate, execute and sustain this process in an evidence-based manner.
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Occup Ther Health Care · Jan 2017
Diversity and Inclusion in Occupational Therapy: Where We Are, Where We Must Go.
Diversity is a fundamental element of the AOTA Centennial Vision and a critical aspect for the visibility, growth, and sustainability of the occupational therapy profession. In this article, the authors suggest that, while the profession has been aware of the need for a diverse workforce and has taken steps to increase diversity and cultural competency, a more structured, comprehensive, and action-oriented approach must be considered to address an issue which impacts professional roles and client engagement, satisfaction, and well-being. Informed by the value-added and mutual accommodation models of cultural diversity, the authors provide specific strategies and actions which promote diversity and inclusion at the personal, institutional/organizational, and professional levels.
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Cochrane Db Syst Rev · Dec 2016
ReviewExternal inspection of compliance with standards for improved healthcare outcomes.
Inspection systems are used in healthcare to promote quality improvements (i.e. to achieve changes in organisational structures or processes, healthcare provider behaviour and patient outcomes). These systems are based on the assumption that externally promoted adherence to evidence-based standards (through inspection/assessment) will result in higher quality of healthcare. However, the benefits of external inspection in terms of organisational-, provider- and patient-level outcomes are not clear. This is the first update of the original Cochrane review, published in 2011. ⋯ The review highlights the paucity of high-quality controlled evaluations of the effectiveness and the cost-effectiveness of external inspection systems. If policy makers wish to understand the effectiveness of this type of intervention better, there needs to be further studies across a range of settings and contexts and studies reporting outcomes important to patients.
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The medication-use system in hospitals is very complex. To improve the health professionals' awareness of the risks of errors related to the medication-use system, a simulation of medication errors was created. The main objective was to assess the medical, nursing and pharmacy staffs' ability to identify errors related to the medication-use system using a simulation. The secondary objective was to assess their level of satisfaction. ⋯ We implemented a realistic medication-use system errors simulation in a mother-child hospital, with a wide audience. This simulation was an effective, relevant and innovative tool to raise the health care professionals' awareness of critical processes.