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Determinants of health-related quality of life among patients with Ischemic heart disease 缺血性心脏病患者健康相关生活质量的决定因素
IF 1.8 Q2 Medicine Pub Date : 2023-11-16 DOI: 10.1080/20476965.2023.2275799
O. Jlassi, Amira Omrane, M. Ben Massoud, Taoufik Khalfallah, Lamia Bouzgarrou, Habib Gamra
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引用次数: 0
Taking a systems approach to promote posttraumatic growth: A position paper 采用系统方法促进创伤后成长:立场文件
Q2 Medicine Pub Date : 2023-10-30 DOI: 10.1080/20476965.2023.2275794
Megan E. Call, Heather R. Walker, Michael L. Good, Joe Borgenicht, Gretchen A. Case, Amy B. Locke
ABSTRACTAs health systems emerge from the pandemic, academic medical centres are motivated to have a healthy and resilient workforce. In the face of the collective traumas of the pandemic, we took a systems approach to infuse wellness into our culture by modelling collective recovery in a non-traditional town hall. Over a dozen senior leaders, faculty, staff, and students shared their personal experiences in a virtual forum, nearly 1000 attendees communally supported one another. Since the town hall, a recording of the experience has been broadly viewed, messaging from leaders proliferated, and smaller versions of the same exercise were implemented. At a time when academic medical centres faced multiple challenges, we chose to first value the well-being of our staff at a system-wide level. It is our hope that other academic medical centres leverage our story to hold space for the experiences of the people who make their work possible.KEYWORDS: COVID-19professional well-beingtrauma-informed Disclosure statementNo potential conflict of interest was reported by the author(s).Notes1. Members of this group developed the 3 R’s as a collaborative approach to system-level conversations and financial strategy. The 3 R’s influences the development and implementation of this project. More can be read about the 3 R’s here: https://uofuhealth.utah.edu/notes/postings/2021/05/town-hall-moving-forward.php#.YQCMuBNKi8U2. Because this town hall was intended as a community building and quality improvement event, the metrics we use to measure its success are rooted in attendance and participation. These primary goals reflect our hopes for broad institutional change marked by events such as these which – in theory – promise cultural shifts.
随着卫生系统从大流行中崛起,学术医疗中心有动力拥有一支健康和有弹性的劳动力队伍。面对大流行带来的集体创伤,我们采取了一种系统的方法,通过在一个非传统的市政厅模拟集体康复,将健康注入我们的文化。十几位高层领导、教职员工和学生在虚拟论坛上分享了他们的个人经历,近1000名与会者相互支持。自那次市政厅会议以来,有关这一经历的记录得到了广泛的关注,来自领导人的信息层出不穷,同样的练习也被实施了更小的版本。在学术医疗中心面临多重挑战的时候,我们选择首先在整个系统层面上重视员工的福祉。我们希望其他学术医疗中心利用我们的故事,为那些使他们的工作成为可能的人的经历留出空间。关键词:covid -19专业健康创伤知情披露声明作者未报告潜在利益冲突。这个小组的成员开发了3r作为系统级对话和财务战略的协作方法。3r影响这个项目的发展和实施。更多关于3r的信息可以在这里阅读:https://uofuhealth.utah.edu/notes/postings/2021/05/town-hall-moving-forward.php#.YQCMuBNKi8U2。因为这个市政厅的目的是作为一个社区建设和质量改进的事件,我们用来衡量其成功的指标是植根于出席和参与。这些主要目标反映了我们对以这些事件为标志的广泛制度变革的希望,这些事件在理论上预示着文化的转变。
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引用次数: 0
Fractured systems: a literature review of OR/MS methods applied to orthopaedic care settings and treatments 骨折系统:OR/MS方法应用于骨科护理设置和治疗的文献综述
Q2 Medicine Pub Date : 2023-10-09 DOI: 10.1080/20476965.2023.2264348
Matthew Howells, Paul Harper, Geraint Palmer, Daniel Gartner
Orthopaedic systems are facing an impending wave of increased pressures as a result of global ageing populations. This is compounded by the current stresses these services face, as a result of the COVID-19 pandemic, and increasing burden of musculoskeletal conditions. It is vital that measures are taken to alleviate the pressures on these systems, to ensure timely and quality access to care for patients. This literature review presents a taxonomic classification of the applications of Operational Research and Management Science (OR/MS) methodologies to orthopaedic care settings and treatments, covering the general, medical, and methodological context of each paper. Our structured search identified 492 relevant publications that have been included in our analysis. The results found a literature largely dominated by cost analysis applications, typically utilising Markov models or decision trees. Key gaps identified in this review include the lack of holistic modelling of orthopaedic systems and pathways, and limited applications to resource and capacity planning. The implications of our review are that researchers, healthcare professionals and managers can develop a research agenda to address these gaps, and enhance decision support in orthopaedics.
由于全球人口老龄化,骨科系统正面临着即将到来的压力浪潮。由于2019冠状病毒病大流行以及肌肉骨骼疾病负担日益加重,这些服务目前面临的压力使情况更加复杂。至关重要的是,必须采取措施减轻这些系统的压力,确保患者能够及时和高质量地获得护理。这篇文献综述介绍了运筹学和管理科学(OR/MS)方法在骨科护理设置和治疗中的应用的分类分类,涵盖了每篇论文的一般、医学和方法背景。我们的结构化搜索确定了492篇相关出版物已纳入我们的分析。结果发现,文献主要由成本分析应用程序主导,通常利用马尔可夫模型或决策树。本综述中发现的主要差距包括缺乏骨科系统和途径的整体建模,以及对资源和能力规划的有限应用。本综述的意义在于,研究人员、医疗保健专业人员和管理人员可以制定研究议程来解决这些差距,并加强骨科的决策支持。
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引用次数: 0
Beyond mathematics, statistics, and programming: data science, machine learning, and artificial intelligence competencies and curricula for clinicians, informaticians, science journalists, and researchers. 超越数学、统计学和编程:数据科学、机器学习和人工智能能力以及临床医生、信息学家、科学记者和研究人员的课程
IF 1.2 Q4 HEALTH POLICY & SERVICES Pub Date : 2023-07-18 eCollection Date: 2023-01-01 DOI: 10.1080/20476965.2023.2237745
William R Hersh, Robert E Hoyt, Steven Chamberlin, Jessica S Ancker, Aditi Gupta, Tara B Borlawsky-Payne

Data science, machine learning and artificial intelligence applications impact clinicians, informaticians, science journalists, and researchers. Most biomedical data science training focuses on learning a programming language in addition to higher mathematics and advanced statistics. This approach is appropriate for graduate students but greatly reduces the number of individuals in healthcare who can be involved in data science. To serve these four stakeholder audiences, we describe several curricular strategies focusing on solving real problems of interest to these audiences. Relevant competencies for these audiences include using intuitive programming tools that facilitate data exploration with minimal programming background, creating data models, evaluating results of data analyses, and assessing data science research reports, among others. Offering the curricula described here more broadly could broaden the stakeholder groups knowledgeable about and engaged in data science.

数据科学、机器学习和人工智能应用影响着临床医生、信息学家、科学记者和研究人员。大多数生物医学数据科学培训的重点是学习编程语言以及高等数学和高级统计学。这种方法适合研究生,但却大大减少了医疗保健行业中能够参与数据科学的人员数量。为了服务于这四个利益相关者,我们介绍了几种课程策略,重点是解决这些受众感兴趣的实际问题。与这些受众相关的能力包括:使用直观的编程工具(这些工具可在最低限度的编程背景下促进数据探索)、创建数据模型、评估数据分析结果以及评估数据科学研究报告等。更广泛地提供本文所述课程可以扩大了解和参与数据科学的利益相关者群体。
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引用次数: 0
Applying a participatory systems and value approach in a transdisciplinary exercise: on assessing the impact of training and education initiatives. 在跨学科工作中应用参与制度和价值方针:评估培训和教育措施的影响
IF 1.8 Q2 Medicine Pub Date : 2023-07-11 eCollection Date: 2023-01-01 DOI: 10.1080/20476965.2023.2230632
Emmanuel A Akinluyi, Anne Greenough, Keith Ison, P John Clarkson

Participatory systems approaches are readily used in multi- and inter-disciplinary exploration of shared processes, but are less-commonly applied in trans-disciplinary efforts eliciting principles that generalise across contexts. The authors were charged with developing a transdisciplinary framework for prospectively or retrospectively assessing initiatives to improve education and training within a multifaceted organisation. A common System Impact Model (SIM) was developed in a series of workshops involving thirty participants from different disciplines, clinical specialisms, and organisations. The model provided a greater understanding of the interrelationships between factors influencing the benefits of education and training and development as seen from various stakeholder perspectives. It was used to create a system for assessing the impact of initiatives on service-users/patients, trainees, and organisations. It was shown to enable a range of participants to connect on common challenges, to maximise cross-, multi-, and inter-disciplinary learning, and to uncover new strategies for delivering value, as system designers.

参与式系统方法很容易用于多学科和跨学科的共同过程探索,但较少应用于跨学科的工作中,因为跨学科的工作需要总结出能在不同情况下通用的原则。作者们负责开发一个跨学科框架,用于前瞻性或回顾性地评估在一个多元组织内改进教育和培训的举措。在一系列研讨会上,来自不同学科、临床专业和组织的 30 名参与者开发了一个通用的系统影响模型 (SIM)。从不同利益相关者的角度来看,该模型使人们对影响教育培训和发展效益的各种因素之间的相互关系有了更深入的了解。该模型被用于创建一个系统,以评估各项举措对服务用户/患者、受训人员和机构的影响。事实证明,作为系统设计者,该系统能够使各种参与者就共同的挑战建立联系,最大限度地进行跨学科、多学科和跨学科学习,并发现实现价值的新战略。
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引用次数: 0
Towards a better understanding of mental health care delivery systems: From stories to system components. 更好地理解心理健康护理提供系统:从故事到系统组件
IF 1.8 Q2 Medicine Pub Date : 2023-06-27 eCollection Date: 2023-01-01 DOI: 10.1080/20476965.2023.2229391
Alexander Komashie, Sarah Rae, P John Clarkson

The growing demand for better quality of care, together with an increasing awareness of limited resources, is bringing attention to the need for design in healthcare. In mental health, considered the largest single cause of disability in the UK, the need is great. Existing services often fail to meet current levels of demand and do not consistently deliver good quality care for all service users. The design of better delivery systems has the potential to improve service user experience and care outcomes. This paper reports how through the interactive and participatory method of storytelling, the key components of a mental health delivery system were identified. We explain each of the ten components and discuss their implications for system understanding and service design. A model of a mental health delivery system has also been proposed.

人们对更高质量的医疗服务的需求日益增长,同时也越来越意识到资源的有限性,这使人们开始关注医疗保健领域对设计的需求。心理健康被认为是英国最大的单一致残原因,其需求也非常大。现有的服务往往不能满足当前的需求水平,也不能始终如一地为所有服务使用者提供高质量的医疗服务。设计更好的服务系统有可能改善服务用户的体验和护理效果。本文报告了如何通过互动和参与式的讲故事方法,确定心理健康服务体系的关键组成部分。我们将逐一解释这十个组成部分,并讨论它们对系统理解和服务设计的影响。我们还提出了一个心理健康服务体系模型。
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引用次数: 0
Estimating the workload of a multi-disciplinary care team using patient-level encounter histories 利用患者层面的就诊历史估算多学科护理团队的工作量
IF 1.8 Q2 Medicine Pub Date : 2023-06-12 DOI: 10.1080/20476965.2023.2215848
Ekin Koker, H. Balasubramanian, Rebecca Castonguay, Aliecia Bottali, A. Truchil
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引用次数: 0
Exploratory analysis using discrete event simulation modelling of the wait times and service costs associated with the maximum wait time guarantee policy applied in a rheumatology central intake clinic 探索性分析使用离散事件模拟建模的等待时间和服务成本与最大等待时间保证政策应用于风湿病中心门诊
IF 1.8 Q2 Medicine Pub Date : 2023-06-01 DOI: 10.1080/20476965.2023.2219293
T. Tagimacruz, Monica Cepoiu-Martin, D. Marshall
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引用次数: 1
The role of Hospital-Based Cancer Registries (HBCRs) as information systems in the delivery of evidence-based integrated cancer care: a scoping review. 基于医院的癌症登记处(HBCR)作为信息系统在提供循证综合癌症护理中的作用:范围界定综述
IF 1.2 Q4 HEALTH POLICY & SERVICES Pub Date : 2023-05-27 eCollection Date: 2024-01-01 DOI: 10.1080/20476965.2023.2216749
Sheela Tripathee, Sara Jane MacLennan, Amudha Poobalan, Muhammad Imran Omar, Aravinda Meera Guntupalli

Cancer is a leading cause of mortality, with 10 million deaths in 2020. With the number of people impacted by cancer projected to increase, a better-integrated cancer care is needed. Evidence suggests that Hospital-Based Cancer Registries (HBCRs) that collect administrative and clinical data could improve integrated and equitable evidence-based care. However, the state and HBCR's role in the delivery of integrated cancer care for improved health outcomes, particularly in low- and middle-income countries (LMICs), is poorly understood and is assessed in this scoping review. A systematic search was conducted in April 2020. Thirty articles were included. This review found that while HBCRs have been implemented in several countries, few studies have evaluated the quality and effectiveness of registries, especially in LMICs. HBCRs in LMICs function more as data collection tools than information systems to influence clinical care decisions and monitoring, missing the opportunity to guide cancer care priorities and policies.

癌症是导致死亡的主要原因,2020 年将有 1 000 万人死于癌症。预计受癌症影响的人数将会增加,因此需要更好的综合癌症护理。有证据表明,收集行政和临床数据的医院癌症登记处(HBCR)可以改善综合、公平的循证医疗。然而,人们对国家和 HBCR 在提供综合癌症治疗以改善健康结果方面所起的作用了解甚少,尤其是在中低收入国家(LMICs)。2020 年 4 月进行了一次系统性检索。共纳入 30 篇文章。本综述发现,虽然已有多个国家实施了健康分类登记,但很少有研究对登记的质量和有效性进行评估,尤其是在低收入国家。在低收入国家,HBCR 更多地是作为数据收集工具,而非信息系统来影响临床护理决策和监测,从而错失了指导癌症护理优先事项和政策的机会。
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引用次数: 0
Assessment of implementation barriers of blockchain technology in public healthcare: evidences from developing countries. 区块链技术在公共医疗领域的实施障碍评估:来自发展中国家的证据。
IF 1.8 Q2 Medicine Pub Date : 2023-05-23 eCollection Date: 2023-01-01 DOI: 10.1080/20476965.2023.2206446
Sudhanshu Joshi, Manu Sharma

The widespread use of Blockchain technology (BT) in nations that are developing remains in its early stages, necessitating a more comprehensive evaluation using efficient and adaptable approaches. The need for digitalization to boost operational effectiveness is growing in the healthcare sector. Despite BT's potential as a competitive option for the healthcare sector, insufficient research has prevented it being fully utilised. This study intends to identify the main sociological, economical, and infrastructure obstacles to BT adoption in developing nations' public health systems. To accomplish this goal, the study employs a multi-level analysis of blockchain hurdles using hybrid approach. The study's findings provide decision- makers with guidance on how to proceed, as well as insight into implementation challenges.

区块链技术在发展中国家的广泛使用仍处于早期阶段,因此需要使用高效和适应性强的方法进行更全面的评估。医疗保健行业对数字化以提高运营效率的需求正在增长。尽管英国电信有潜力成为医疗保健行业的竞争选择,但研究不足阻碍了它的充分利用。本研究旨在确定发展中国家公共卫生系统采用BT的主要社会学、经济和基础设施障碍。为了实现这一目标,本研究采用混合方法对区块链障碍进行了多层次分析。该研究的发现为决策者提供了如何进行的指导,以及对实施挑战的见解。
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引用次数: 0
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Health Systems
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