Littérature scientifique sur le sujet « Care and support pathways »
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Articles de revues sur le sujet "Care and support pathways"
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Rosique, Ricard. « Do we need electronic support for pathways : the Spanish experience ». International Journal of Care Pathways 13, no 2 (novembre 2009) : 67–74. http://dx.doi.org/10.1258/jicp.2009.009010.
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Care pathways are excellent tools for quality management in health care concerning the standardization of care processes, as they promote organized and efficient patient care established on evidence-based practice. The implementation of a care pathway project at any health-care setting means a change of the organizational culture. E-pathways (electronic pathways) are strategic resources in order to get the successful implementation of a care pathway project. The concept of e-pathway is recent enough and there are some different experiences worldwide. In 2000, the first electronic pathways were implemented at Hospital de Mataró, in Barcelona, Spain. The benefits of using e-pathways (Eira Healthcare Server) are very clear at Hospital de Mataró: immediate records with no transcriptions, information in the palm of your hand, no prints, and rigour and reliability. Another recent and interesting experience is the development and introduction of e-pathways at Hospital General de l'Hospitalet, in Barcelona, Spain, using an SAP integrated health-care solution. The strategy planning of hospital managers should take into account the need and priority of any pathway project linked to e-pathways. Some experiences in Spain have proven that we do really need electronic support for pathways. Electronic pathways are a basic support and should not be postponed when implementing care pathways.
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Ellis, Peter G., et Kathleen Lokay. « Pathways clinical decision support for appropriate use of key biomarker. » Journal of Clinical Oncology 32, no 30_suppl (20 octobre 2014) : 172. http://dx.doi.org/10.1200/jco.2014.32.30_suppl.172.
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172 Background: UPMC CancerCenter (UPMC) has utilized clinical pathways for almost ten years in an effort to ensure standardization to the evidence based care for its patients. UPMC oncologists participate in the various pathways disease committees that develop and maintain the pathways content and utilize the pathways through a web-based portal in their daily decision making and documentation. The pathways cover not only treatment recommendations but also guidance for work up such as recurrence risk tools (OncoType Dx) for node negative, HER2 negative, ER positive breast cancer who are candidates for chemotherapy. For patients with a low recurrence risk score, the pathways recommends hormonal therapy only, saving the patient both toxicities and costs of chemotherapy where appropriate. Methods: UPMC analyzed its use of chemotherapy in patients with a recurrence risk score of less than 19 through a retrospective review of physician-input data in its Via Pathways Portal for the twelve months ended May 31, 2014. During this time period, the Via Pathways recommended the recurrence risk test for node negative, HER2 negative, ER positive patients. For patients with a low risk score (less than 19), the Via Pathways recommended hormonal therapy only. For those low risk score patients receiving chemotherapy, the physician would document that an Off Pathway decision was being made, indicate the reason for going Off Pathway, and document the actual therapy delivered. Results: For the twelve months ended May 31, 2014, UPMC physicians documented 288 decisions for patient presentation of node negative, HER2 negative, ER positive patients with a recurrence risk score of less than 19. Of these decisions, 99% (n=284) were On Pathway for hormonal therapy. Of the remaining 1%, three (3) were for accrual to a clinical trial and one (1) was Off Pathway for chemotherapy. Conclusions: Pathways are a tool for promoting adherence to evidence based care by oncologists through the use of a point of care decision support system. Pathways have the potential to reduce costs and toxicities of treatment through the evidence based guidance developed by the pathways disease committees and the adherence to such guidance by oncologists utilizing the pathways decision support tool.
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Wells, Christine E., et Sarah J. Smith. « Diagnostic Care Pathways in Dementia ». Journal of Primary Care & ; Community Health 8, no 2 (22 novembre 2016) : 103–11. http://dx.doi.org/10.1177/2150131916678715.
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Objectives: Increasing diagnostic rates of dementia is a national health priority; to meet this priority, improvement needs to be made to diagnostic services. It has been increasingly recognized that primary can play a significant role in the diagnostic journey for people with dementia, with some diagnostic services entirely located in primary care. This article reviews the extent of the involvement of primary care in diagnostic care pathways for people presenting with memory complaints within England, and presents examples of innovative approaches, which may be of interest to practitioners. Method: A rapid review was undertaken to identify articles outlining diagnostic care pathways for dementia involving primary care in England. Results: Six articles relating to pathway evaluations and innovative approaches involving primary care were deemed suitable for inclusion in the review. Conclusions: The review found examples of diagnostic pathways and innovative practices being implemented in in primary care. These practices aligned to the strategic ambitions of the National Dementia Strategy. However, it was widely acknowledged that there is a need to improve postdiagnostic pathways; in particular, access to postdiagnostic support. This issue is being reflected in contemporary policy initiatives such as the Department of Health’s 2016 Joint Declaration on postdiagnostic dementia care and support.
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Lykins, Terri, Michael Peck, Robert Poole et Amy Andolina Fisher. « Using Clinical Pathways in Nutrition Support Patient Care ». Nutrition in Clinical Practice 13, no 6 (décembre 1998) : 298–309. http://dx.doi.org/10.1177/088453369801300607.
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Szcześniak, Dorota, Rose-Marie Dröes, Franka Meiland, Dawn Brooker, Elisabetta Farina, Rabih Chattat, Shirley B. Evans et al. « Does the community-based combined Meeting Center Support Programme (MCSP) make the pathway to day-care activities easier for people living with dementia ? A comparison before and after implementation of MCSP in three European countries ». International Psychogeriatrics 30, no 11 (13 février 2018) : 1717–34. http://dx.doi.org/10.1017/s1041610217002885.
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ABSTRACTBackground:The “pathway to care” concept offers a helpful framework for preparing national dementia plans and strategies and provides a structure to explore the availability and accessibility of timely and effective care for people with dementia and support for their informal carers. Within the framework of the JPND-MEETINGDEM implementation project the pathways to regular day-care activities and the Meeting Centers Support Programme (MCSP), an innovative combined support form for people with dementia and carers, was explored.Methods:An exploratory, descriptive, qualitative, cross-country design was applied to investigate the pathways to day care in several regions in four European countries (Italy, Poland, United Kingdom, and the Netherlands).Results:Before implementation of MCSP, of the four countries the United Kingdom had the most structured pathway to post-diagnostic support for people with dementia. MCSP introduction had a positive impact on the pathways to day-care activities in all countries. MCSP filled an important gap in post-diagnostic care, increasing the accessibility to support for both people with dementia and carers. Key elements such as program of activities, target group, and collaboration between healthcare and social services were recognized as success factors.Conclusions:This study shows that MCSP fills (part of) the gap between diagnosis and residential care and can therefore be seen as a pillar of post-diagnostic care and support. Further dissemination of Meeting Centers in Europe may have a multiple impact on the structure of dementia services in European countries and the pathways to day care for people with dementia and their carer(s).
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Brunton, Paul. « Developing Clinical Care Pathways ». Bulletin of the Royal College of Surgeons of England 94, no 9 (1 octobre 2012) : 315. http://dx.doi.org/10.1308/147363512x13448516926702.
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Clinical care pathways have existed for many years. Their origin is arguably in nursing and many will recall using a nursing care plan. Clinical care pathways are often denounced as 'tick-box' exercises as practitioners wrongly assume that they will result in a loss of clinical freedom. This is not the case; clinical care pathways do not seek to tell practitioners what to do, but to assist and support them in their decisions.
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Csik, Valerie Pracilio, Michael J. Ramirez, Adam F. Binder et Nathan Handley. « The value of pathways on drug costs. » Journal of Clinical Oncology 39, no 28_suppl (1 octobre 2021) : 327. http://dx.doi.org/10.1200/jco.2020.39.28_suppl.327.
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327 Background: Oncology care represents a significant portion of US healthcare spending. Cost of Part B drugs has increased at a rate 5.7x that of overall Medicare spending. As a participant in the Oncology Care Model, drug costs represent a majority of our total costs. Pathways are a clinical decision-support tool that use evidence-based care maps accounting for efficacy, toxicity and cost. Our NCI-designated cancer center implemented pathways in July 2018 to reduce care variation and decrease costs. Methods: We reviewed costs related to pathway utilization over a two year period, analyzing differences in total annual drug cost for patients in three categories: On-Pathway (aligned with pathway recommendation), Off-Pathway (not aligned with recommendation), and No Pathway (not used). Per Member Per Month (PMPM) costs were calculated and a weighted average applied to account for changes in annual drug costs. Results: PMPM drug costs decreased -8% in year 1 (FY19) and -4% in year 2 (FY20) when pathways were used (On- and Off-Pathway). When pathways were followed (On-Pathway) in making treatment decisions, the drug costs were 11% lower than when pathways were not used. The annual impact on drug costs when pathways were used amounted to $2.45 million in year 1 and $1.77 million in year 2 (Table). Conclusions: Pathway use reduced drug costs, a significant variable in oncology value-based care models. This finding highlights the value of clinical decision support tools in reducing care variability, a known contributor to health care costs, in making treatment decisions. Further assessment is needed to determine if these results are similar at other cancer centers to fully realize the impact of pathways on drug costs.[Table: see text]
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Thompson, Juliana, Glenda Cook, Claire Masterman, Mark Parkinson et Lesley Bainbridge. « Rapid evidence review to understand effective frailty care pathways and their components in primary and community care ». International Journal of Health Governance 27, no 1 (11 novembre 2021) : 54–75. http://dx.doi.org/10.1108/ijhg-09-2021-0090.
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PurposeDifferent pathways of frailty care to prevent or delay progression of frailty and enable people to live well with frailty are emerging in primary and community care in the UK. The purpose of the study is to understand effective frailty care pathways and their components to inform future service development and pathway evaluation in primary- and community-care services.Design/methodology/approachA rapid evidence review was conducted: 11 research publications met the inclusion criteria and were analysed using narrative thematic synthesis.FindingsThere is strong evidence that resistance-based exercise, self-management support, community geriatric services and hospital at home (HAH) improve patient health and function. In general, evaluation and comparison of frailty care pathways, components and pathway operations is challenging due to weaknesses, inconsistencies and differences in evaluation, but it is essential to include consideration of process, determinant and implementation of pathways in evaluations.Originality/valueTo achieve meaningful evaluations and facilitate comparisons of frailty pathways, a standardised evaluation toolkit that incorporates evaluation of how pathways are operated is required for evaluating the impact of frailty pathways of care.
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Marinova, Petya, et Rali Marinova. « Patient-centred stoma care support : colostomy patients ». British Journal of Community Nursing 29, no 10 (2 octobre 2024) : 494–502. http://dx.doi.org/10.12968/bjcn.2024.0088.
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Colostomy patients have distinct needs that require specialised pathways for optimal care. Recognising that these needs vary, based on the type and configuration of the stoma, is crucial. Specialist nurses play a vital role in providing long-term support and expertise. While many stoma nursing services in the UK offer patient pathways, these often lack specificity for different stoma types. Tailoring pathways to colostomy patients can prevent complications, reduce hospital readmissions and enhance quality of life. Community nurses and other healthcare professionals are essential in supporting colostomy patients through individualised care. Their involvement ensures that patients receive appropriate preparation for life with a stoma and are adequately educated about their specific needs. This multidisciplinary approach fosters a comprehensive care environment, addressing both the physical and emotional aspects of living with a colostomy. By focusing on personalised care and life-long support, healthcare professionals can significantly improve patient outcomes and overall well-being.
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Fitzgerald, Rachel, Marguerite De Foubert, Siobhan Cahill, Finola Cronin, Bart Daly et Tim Dukelow. « Complex care forum for enhanced support across care settings ». International Journal of Integrated Care 25 (9 avril 2025) : 686. https://doi.org/10.5334/ijic.9503.
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Background: Enabling older adults to engage with and participate in their care planning requires specific geriatrician input to overcome the complex challenges facing frail patients in the community setting. Planning for future events is an integral component of the evolving collaboration between the older person, those closest to them and members of a multi-disciplinary team. Methods: I conducted a literature review using key terms on PubMed. I also reviewed the World Health Organisation’s (WHO) Integrated care for older people (ICOPE): Guidance for person-centred assessment and pathways in primary care1, as well as reviewing the guidelines and framework for the Irish National Integrated Care Programme for Older persons2. Observing and participating in complex cases in an ambulatory community setting showed the practical considerations involved in complex case management. Discussion: While standardised care pathways have always been a solution for ensuring patient safety, improving risk-adjusted patient outcomes, increasing patient satisfaction and optimising scarce resources, studies have shown that standardised care pathways are more effective in contexts with predictable care trajectories and low uncertainty and complexity3. A person-centred care plan engages older persons as stakeholders in their own care. Adopting the WHO’s ICOPE framework requires assessment of intrinsic capacity and promptly diagnosing and managing losses, both functional and cognitive. Early identification of complex cases involving multi-morbidity, polypharmacy and advancing frailty allows an integrated care team to pool expertise and facilitate patient autonomy in the decision-making process. Specific ambulatory community geriatrician hubs within Community Healthcare Organisations (CHO) enables complex cases to be individually managed in conjunction with a multi-disciplinary team. Identifying unrecognised or unvoiced needs and taking proactive steps to plan for preventative, personalised care is a key component of a multi-modal service. Conclusion: A shift towards an integrated, people-centred approach demands increased community level interventions with coordinated services, such as screening, assessment and management. On personal reflection, it appears that the majority of older persons linked in with an ambulatory hub benefit hugely from specialist MDT input. However, a subsection of older persons in the community need more in-depth specialist support, highlighting the need for increased support in an integrated care model. Establishing the concept of shared care requires transfer of information and knowledge pooling. There is undoubtedly a gap for complex case discussion in the community. A solution to this could include virtual case conferences, facilitating collaboration and coordination between services that provide community led support to older persons and other service providers. Further strengthening of pathways and systems to ensure care plan suitability requires reciprocal buy-in from tertiary centres.
Thèses sur le sujet "Care and support pathways"
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Eshareturi, Cyril. « Mapping the offender health pathway : challenges and opportunities for support through community nursing ». Thesis, University of Wolverhampton, 2016. http://hdl.handle.net/2436/614998.
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The current context of offender health in England and Wales indicates that offenders re-enter their communities with limited pre-release preparation for the continuity of access to healthcare and an increased risk of release with a health condition and very little support to cope in the community. This study was aimed at mapping the ex-offender health pathway towards identifying ‘touch points’ in the community for the delivery of a nurse led intervention. The study was a qualitative case study underpinned by ‘The Silences Framework’ which enabled it to gain theoretically by situating power with offenders, thus, aiding their ‘Silences’ to be heard, explored and brought to light. Participants meeting the study inclusion criteria were quantitatively ranked on the basis of poor health with those scoring the lowest and confirming their ranking through a confirmation of a health condition selected as cases and interviewed over the course of six months. These interview narratives were confirmed by interviewing individuals in the professional networks of offenders. The study identified the site of post-release supervision as the ‘touch point’ where a nurse led intervention could be delivered. With regards to the delivery of the health intervention, the study indicated that the nurse led intervention be provided as an advisory and signposting service structured on a drop-in and appointment basis. Furthermore, the study indicated that pre-release, offenders were not prepared in prison for the continuity in access to healthcare in the community on release. On-release, offenders’ on-release preparation did not enquire as a matter of procedure on whether offenders were registered with a GP or had the agency to register self with a GP practice in the community. Post release, the study uncovered a disparity between services which address the physical health needs of offenders and those which address their mental and substance misuse health needs.
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Gatuguta, A. « Pathways of care for sexual violence survivors and the benefits and drawbacks of using community health workers to provide support health services to sexual violence survivors : a systematic review and case study in Kenya ». Thesis, London School of Hygiene and Tropical Medicine (University of London), 2018. http://researchonline.lshtm.ac.uk/4646633/.
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Background: Research shows that sexual violence is widespread and has multiple adverse health consequences. Globally, majority of sexual violence survivors either do not access care or access care late. Many of those who access care are lost to treatment follow-up before they can fully realise the benefits of medical care. Evidence suggests that community health workers (CHWs) have the potential to improve healthcare for survivors. There is limited data however, on how to deliver these services effectively. Aim: To explore sexual violence survivors’ experience of seeking healthcare and experiences through the continuum of care in Kenya; and, to understand the benefits and drawbacks of using CHWs to provide support health services to sexual violence survivors. Methods: A mixed methods approach was used: 1) a systematic literature review of CHWs services for sexual violence to explore the existing models of services as well as the benefits and drawbacks; 2) records for 543 survivors were reviewed and key informant interviews conducted with healthcare providers in two referral hospitals. These hospital data were compared with national-level data on survivors from the Kenya Demographic and Health Survey 2014, and the Violence Against Children Survey 2010; 3) survivors were interviewed on their care pathways, current experience of services, perceived health service’s needs and experience of CHWs services; 4) CHWs, healthcare workers and other stakeholder’s with expertise in providing care for sexual violence were interviewed on their experiences and views on CHWs services for sexual violence. Results: There are multiple barriers to healthcare and missed treatment opportunities for survivors, both at the community and hospital level. Children, men, partnered or ever-partnered survivors and survivors experiencing violence from intimate partners are more likely to miss treatment. CHWs are already involved in sexual violence healthcare pathways carrying out awareness creation, identifying survivors, linking survivors to care and providing psychosocial support. However, training, better definition of roles and support from the healthcare system is needed. Conclusions: This thesis has identified specific barriers to services for sexual violence survivors and specific groups at risk of missing treatment. CHWs can form a part of interventions aimed to address the current barriers to treatment; however, more research is required to inform designing the models of services.
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Smeds, Magdalena. « Managing care pathways for patients with complex care needs ». Licentiate thesis, Linköpings universitet, Logistik- och kvalitetsutveckling, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-156836.
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One of the central challenges for the healthcare system today is how to manage care for patients with complex needs. This patient group is not well-defined but covers patients with serious diseases and comorbidities, or with a limited ability to perform basic daily functions due to physical, mental or psychosocial challenges. This group has a high service and resource utilisation resulting in high costs for the healthcare system and, typically, poor health outcomes. To improve care for these patients, it is necessary to implement strategies to manage the differentiated care needs, the additional support needs, the uncertainty in care delivery, and the coordination needs of the involved providers and the patient. Care pathways are increasingly used internationally to make care more patient-centred and to structure and design care processes for individual patient groups. Important elements in care pathways include structuring care activities, by defining their content and sequence; coordinating between providers and professionals; and involving patients in their care process. In this thesis, care pathways are proposed as the overall strategy for managing care for patients with complex care needs. The purpose of this thesis is thus to contribute with knowledge on how care pathways can be managed for patients with complex care needs. This is achieved by analysing how the practices coordination, standardisation, customisation and personalisation can support management of care pathways and by discussing how these practices influence quality of care. The quality of care dimensions discussed are accessible, timely, equitable, and patient-centred care. The empirical context in this thesis is the Standardised Cancer Care Pathways (CCPs) which were implemented in Sweden from 2015 to 2018. CCPs is the umbrella term for the national initiative to shorten waiting times, decrease regional differences and reduce fragmentation in care processes. CCPs include elements such as diagnosis-specific pathways and guidelines, introduction of CPP coordinators, and mandatory reporting of waiting times. Focus has been on implementing care pathways for 31 cancer diagnoses in all Swedish healthcare regions. Both qualitative and quantitative research methods have been used. A case study was conducted to examine standardised and customised care pathways, and coordination and multidisciplinary work in care pathways. A document study of regional reports on CCPs was analysed to study effects of care pathways on accessibility, timeliness and equitability. Finally, a national survey was conducted to deepen the understanding of the role of coordination, as performed by coordinators, in care pathways. This thesis argues that standardised and customised care pathways should be combined to manage care for patients with complex care needs. The customised pathway in particular benefits patients with serious unspecific symptoms, unknown primary tumour or more complex care needs, while patients with care needs that can be treated independently of the main diagnosis benefit from following a standardised care pathway. Coordinators are an important means to manage coordination, customisation and personalisation in the care pathway. The coordinators’ role is twofold: the first role is to manage care pathways by customising the care pathway and coordinating involved providers; the second role is to support and guide patients through the care pathway. This can be achieved by adapting interpersonal communication with patients through personalisation. This thesis further argues that care pathways have most potential to positively influence accessibility, timeliness, equitability, and patient-centredness. Accessibility has been positively influenced, especially for patients with ambiguous symptoms where symptoms indicating cancer have improved their chances of accessing cancer diagnostics. A negative aspect of prioritising patients who follow CCPs has been the potentially longer waiting times for other patient groups in equal need of urgent care. Notwithstanding, prioritised access to care is perceived to positively influence timeliness for patients following CCPs. Care pathways are perceived to have positively influenced patient-centredness by shifting the focus from what to deliver to how to deliver it.
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Brown, Christine S. H. « Pathways into High Security Psychiatric Care ». Thesis, University of Exeter, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.486662.
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Bekele, Yilma Yitayew. « Pathways to psychiatric care in Ethiopia ». Master's thesis, University of Cape Town, 2005. http://hdl.handle.net/11427/10132.
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Includes bibliographical references.It is recognized that the pathways patients take en route to psychiatric services vary between countries and socio-cultural groups. Delay along the pathway to care is not a mere reflection of organization of health care and referral systems but also of availability and accessibilty of services. Studies have shown associations between delay and various sociodemographic, clinical and service related factors. Understanding the pathway to psychiatric care, and recognition od delay points along the pathway, is a crucial step for the development of intervention programs geared at improving the provision of mental health care.
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Alsalamah, Hessah. « Supporting integrated care pathways with workflow technology ». Thesis, Cardiff University, 2012. http://orca.cf.ac.uk/28816/.
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Modern healthcare has moved to a focus on providing patient centric care rather than disease centred care. This new approach is provided by a unique care team which is formed to treat a patient. At the start of the treatment, the care team decide on the treatment pathway for the patient. This is a series of treatment stages where at the end of each stage, the care team use the patient’s current condition to decide whether the treatment moves to the next stage, continues in the treatment stage, or moves to an unanticipated stage. The initial treatment pathway for each patient is based on the clinical guidelines in an Integrated Care Pathway (ICP) [1] modified to suit the patient state. This research mapped a patient ICP decided by the healthcare providers into a Workflow Management System (WFMS) [2]. The clinical guidelines reflect the patient-centric flow to create an IT system supporting the care team. In the initial stage of the research the IT development team at Velindre Hospital identified that team communication and care coordination were obstacles hindering the implementation of a patient-centric delivery model. This was investigated to determine the causes, which were identified as difficulty in accessing the medical information held in dispersed legacy systems. Moreover, a major constraint in the domain is the need to keep legacy systems in operation and so there is a need to investigate approaches to enhance their functionalities. These information systems cannot be changed across all healthcare organisations and their complete autonomy needs to be retained as they are in constant use at the sites. Using workflow technology, an independent application representing an ICP was implemented. This was used to construct an independent layer in the software architecture to interact with legacy Clinical Information Systems (CISs) and so evolve their offered functionalities to support the teams. This was used to build a Virtual Organisation (VO) [3, 4] around a patient which facilitates patient-centric care. Moreover, the VO virtually integrates the data from legacy systems and ensures its availability (as needed) at the different treatment stages along the care pathway. Implications of the proposal include: formalising the treatment process, filtering and gathering the patient’s information, ensuring care continuity, and pro-acting to change. Evaluation of the proposal involved three stages; First, usefulness evaluation by the healthcare providers representing the users; Second, setup evaluation by developers of CISs; and Finally, technical evaluation by the community of the technology. The evaluation proved; the healthcare providers’ need for an adaptive and a proactive system, the possibility of adopting the proposed system, and the novelty and innovation of the proposed approach. The research proposes a patient-centric system achieved by creating a version of an ICP in the system for each patient. It also provides focussed support for team communication and care coordination, by identifying the treatment stages and providing the care team requirements at each stage. It utilises the data within the legacy system to be proactive. Moreover, it makes these required data for the actions available from the running legacy system which is required for patient-centred care. In the future the worth could be extended by mapping other ICPs into the system. This work has been published in four full papers. It found acceptance in the health informatics community [5, 6, 7] as well as the BPM community [8, 9]. It is also the winner of the 2011 “Global Award of Excellence in Adaptive Case Management (ACM)” in “Medical and Healthcare” [10] of the Workflow Management Coalition (WFMC) [11].
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Debbage, Samantha D. « Do integrated care pathways improve patient outcomes ? » Thesis, University of Sheffield, 2009. http://etheses.whiterose.ac.uk/14949/.
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The purpose of the study was to determine if the use of an Integrated Care Pathway (ICP) was associated with more positive outcomes than traditional methods of care. The effectiveness of the ICP had not previously been tested (in relation to traditional methods of care) to determine if it made any difference, at a patient, staff or system (healthcare organisation) level. In February 2001 (as part of the NHS modernisation agenda) the gynaecology services within one UK city were re-organised and two separate units were merged into one new larger unit. Prior to the reorganisation, the two units offered similar treatments and were managed collectively; however, one site had developed and implemented ICPs and the other site had continued to use traditional methods of care delivery. ICPs are multidisciplinary plans for organising and delivering patient care. The plan of care is outlined in a sequential manner including all interventions with expected patient outcomes. The literature suggests that ICPs result in improved patient outcomes and lower hospital costs by decreasing length of stay and improving observations i.e. detecting signs of infection in a timelier manner. ICPs are recognised to facilitate the multidisciplinary partnerships in planning of patient care. However the literature was primarily anecdotal or non generalisable, and therefore additional local research was deemed essential. To ensure the research problem could be answered, three specific research questions were developed for testing: (1) What effect does an /~ / ICP have on the outcomes of gynaecological patients attending for major abdominal surgery? (2) What factors, including the use of an ICP contribute to the variance in length of stay for gynaecological patients? (3) What are the opinions of the staff who have used the ICP, of the ICP itself? Relevant directional hypothesis were derived from each research question. A quasi-experimental design was used to answer the first research question. Subjects were attached to one of two groups, a treatment group, which used the ICP, and a comparison group, which continued to deliver care based on traditional methods. Descriptive correlation was used to answer research question two and for the third research question descriptive exploration was used. Variables of interest from a patient, staff and system (health care organisational) level were collected to determine the effectiveness of the ICP compared with traditional methods. One of the difficulties faced with ICP research is the number of variables that can potentially influence patient care. Holzemer's model (1994, based on the work of Donabedian, 1966) was used to conceptualise the variables (and therefore the data collection instruments) into the category of structure, process or outcome at either a patient, provider or systems (health care organisation) level. This in turn helped to theorise the linkage between the variables within this study, identifying conceptual and functional relationships. The abdominal surgery ICP supported improvements in cost and efficiency through a reduction in length of stay (treatment site = 5.29 days, comparison site = 6.16 days) and a positive return to patients' perception of health. However, there was a reduction in patient satisfaction with nursing care with the introduction of the ICP and this needs further study. Involving patients in future developments and evaluations could promote long-term patient satisfaction.
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Hall, Julie. « Using integrated care pathways in mental health care : a case study ». Thesis, University of Nottingham, 2010. http://eprints.nottingham.ac.uk/12749/.
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Background: Integrated Care Pathways (ICPs) are prearranged processes of care which are being increasingly used to deliver mental health services. The literature reveals difficulties in their development and implementation, and a lack of empirical evidence to support their use. Aims: The aim of this research was to investigate how an ICP has been used to manage mental health care in one selected mental health Trust in England. Methods: A case study approach was adopted with several units of analysis. The views of healthcare professionals using semi structured interviews; the experiences of service users and carers using focus groups; contrasting hospital episode and performance statistics with a comparison Trust and documentary analysis of the ICP. Findings & Discussion: Of the healthcare professions, only nurses used the ICP. No professionals used the ICP to support clinical decision making and risk management. However, just over two-thirds (67.2%) of the interventions described in the pathway were delivered. There was no statistically significant difference when comparing performance indicators for an equivalent episode of care between the ICP Trust and non ICP Trust. Service user and carers' experiences revealed that peopled did not feel that their care was individualised to them, although amongst them they had different perceptions of the care process. Conclusions: Mental health ICPs need to reflect the relationships between stakeholders, variability of illness and individual ways of living if they are to provide a framework for managing care in the future that accords with the needs of people using mental health services.
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O'Brien, Sarah Victoria. « Impact of care pathways on the care of people with diabetes mellitus ». Thesis, University of Liverpool, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.428994.
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This thesis aimed to develop care pathways for the management of in-patients and outpatients with diabetes in an acute NHS Trust, to review the evidence-base for existing care pathways and to evaluate the impact of care pathways on the management of in-patients with diabetes and patients with Diabetic Nephropathy. A comprehensive literature review (using the principles of a systematic review) was completed to determine whether care pathways improved the management and or outcome of hospital in-patients with a medical or surgical condition. From this review it appears that the main potential benefits associated with the introduction of a care pathway are a reduction in length of stay, reduced costs and possible improvements in the quality of patient care. However, these findings are limited because of the poor methodology used in all of the papers reviewed and there is a need for more robust research concerning care pathways. This work has provided a systematic process for developing diabetes care pathways and examples of diabetes care pathways that could be used and adapted by other clinicians managing patients with diabetes. A randomised controlled trial examined the impact of the in-patient diabetes care pathway on HbA1c, length of stay, re-admissions within 12 months, nurse knowledge and the quality of in-patient care. In terms of the primary endpoint of HbA 1c, the null hypothesis cannot be rejected as there was no difference between the study groups. In the main, secondary endpoints improved, but limitations in the design and execution of the study preclude excessive weight being attached to these findings. Furthermore, completion of the care pathway was poor and sustaining its ongoing use outside of a research study may be difficult, further work is needed to assess the cost of wider implementation of this care pathway. A care pathway-driven Diabetic Nephropathy service was developed, implemented and evaluated to examine whether it resulted in improvements in the management of Diabetic Kidney Disease (DKD). The results demonstrated successful implementation of six key evidence-based interventions for DKD and more importantly both surrogate and hard endpoints were comparable to those achieved in recent large clinical trials, in particular, the rate of doubling of serum creatinine, progression to End Stage Renal Failure and Death. This thesis demonstrates that in some circumstances care pathways can improve implementation of evidence-based diabetes care and lead to improvements in patient outcomes. Care pathways appear to be particularly useful when used by a dedicated, appropriately trained team dealing primarily with one condition, and can be an effective tool for the implementation of evidence-based diabetes care. Further work examining the impact of care pathways in all areas of health care would be useful.
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Baker, Timothy Alan. « Oregon Primary Care Physicians' Support for Health Care Reform ». PDXScholar, 1994. https://pdxscholar.library.pdx.edu/open_access_etds/4755.
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This dissertation studies Oregon primary care physicians' attitudes toward health care reform. Two models of reform are examined: one, health care rationing such as that proposed by the Oregon Health Plan (OHP); and, two, support for national health insurance (NHI).
This work examines the necessity for changing the present health care system, traced from the early origins of the medical profession to the present day health care "crisis." The high cost of health care is examined and an overview of the OHP is provided, including citations from John Kitzhaber, M.D., author of the plan.
Overall, Oregon primary care physicians overwhelmingly supported health care rationing policies. Just under 75 percent of the physicians expressed support for health care rationing policies such as that proposed by the Oregon Health Plan. However, just under 48 percent of the same physicians expressed support for national health insurance (NHI). Internal medicine physicians were most supportive of health care rationing policies and OB/GYN physicians were least supportive. Conversely, pediatricians were most supportive of NHI and OB/GYN physicians were least supportive.
Regression analyses explained 11.5 percent of variation in support for health care rationing policies and 20.9 percent of their support for national health insurance (NHI).
While strong support measures were found for health reform such as that proposed by the Oregon Health Plan (OHP), no similar measures of support for NHI emerged. Almost universal support for health care reform such as the OHP was found among primary care physicians across the state, however similar patterns were not found for NHI. It appears from the research's findings that attempts to change the health care system that include the physician's ability to ration care would be more successful than a more systematic change such as would occur under a national health insurance program.
This dissertation points out that physicians represent strong supporting forces and/or opposing forces for health care reform. Their attitudes toward such reform must be considered if successful change is to occur in the U.S. health care system.
Livres sur le sujet "Care and support pathways"
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Luc, Kathryn De. Developing care pathways. Abingdon : Radcliffe Medical Press, 2001.
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Luc, Kathryn De. Developing care pathways. Abingdon : Radcliffe Medical Press, 2001.
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1967-, Locke Rachel, et Salter Elizabeth 1947-, dir. Continence care pathways. Chichester, West Sussex, U.K : John Wiley, 2009.
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RGN, Johnson Sue, dir. Pathways of care. Oxford : Blackwell Science, 1997.
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1950-, Sloan M. Daniel, dir. Analyzing clinical care pathways. New York : McGraw Hill, 1999.
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Mulhall, John P., Peter J. Stahl et Doron S. Stember. Clinical Care Pathways in Andrology. New York, NY : Springer New York, 2014. http://dx.doi.org/10.1007/978-1-4614-6693-2.
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Luc, Kathryn De. Developing care pathways : The handbook. Abingdon : Radcliffe Medical, 2001.
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Mulhall, John P. Clinical care pathways in andrology. New York : Springer, 2014.
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Samuels, Miracle Vickie Ann, dir. Critical care interdisciplinary outcome pathways. Philadelphia : Saunders, 1998.
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Clinics, Western States Chiropractic College. Conservative care pathways : Procedures and protocols. Portland, OR : WSCC Clinics, 1996.
Trouver le texte intégralChapitres de livres sur le sujet "Care and support pathways"
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Bida, Meshack, Mpho Kgomo, Bahoueli Gaudji, Demetra Demetriou et Zodwa Dlamini. « AI-Pathway Companion in Clinical Decision Support : Enabling Personalized and Standardized Care Along Care Pathways in Oncology ». Dans Artificial Intelligence and Precision Oncology, 277–91. Cham : Springer Nature Switzerland, 2023. http://dx.doi.org/10.1007/978-3-031-21506-3_14.
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Tánfani, Elena, et Angela Testi. « A simulation-based decision support tool to analyze clinical pathways in hospital ». Dans Advanced Decision Making Methods Applied to Health Care, 191–211. Milano : Springer Milan, 2012. http://dx.doi.org/10.1007/978-88-470-2321-5_12.
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Keller, Heather, Susan Slaughter, Leah Gramlich, Ashwini Namasivayam-MacDonald et Jack J. Bell. « Multidisciplinary Nutrition Care : Benefitting Patients with Malnutrition Across Healthcare Sectors ». Dans Perspectives in Nursing Management and Care for Older Adults, 177–88. Cham : Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-63892-4_13.
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AbstractGeriatric malnutrition prevention, detection, and treatment benefit from a multidisciplinary approach, regardless of the care setting. Nutrition care pathways have been created to support multidisciplinary care for hospitals and for transitions and primary care. Conceptual models for supporting nutrition in long-term care emphasize a multidisciplinary approach.
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Polus, Manria, Pantea Keikhosrokiani, Johanna Uusimaa, Jonna Komulainen-Ebrahim, Johanna Annunen, Sehrish Khan, Woubshet Behutiye, Päivi Vieira et Minna Isomursu. « The Role of Digital Care Pathway for Epilepsy on Patients’ Treatment Burden : Clinicians’ Perspective ». Dans Communications in Computer and Information Science, 257–68. Cham : Springer Nature Switzerland, 2024. http://dx.doi.org/10.1007/978-3-031-59080-1_19.
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AbstractEpilepsy is a chronic neurological disorder, requiring long-term treatment. The workload and impact of treatment causes a significant burden to patients. Digital care pathways may have potential for reducing treatment burden, but there also may be concerns of additional burden caused by digital healthcare. The aim of this study is to investigate the role of digital care pathway on treatment burden for patients with epilepsy. This was a single case study with the digital care pathway for epilepsy in the Wellbeing Services County of North Ostrobothnia (Pohde), in Finland, as a unit of analysis. The data was collected by observing an expert meeting of three clinicians. The meeting focused on five pre-defined domains of treatment burden: Medication burden, Time and travel burden, Financial burden, Social and emotional burden, and Healthcare access burden. The data was analyzed qualitatively and organized based on the pre-defined categories. The results suggest that the digital care pathway supports patients with treatment burden for all the pre-defined domains. Reported benefits include reduced travel, options for remote appointments, providing informational support and easier ways to contact healthcare professionals (HCPs). The main concerns clinicians had was could the use of digital care pathway cause rushed treatment decisions, difficulties of building trust and seeking support from HCPs, and difficulties of using the digital systems. A new theme emerged from the data, Diverse burdens, highlighting the variety of patients with epilepsy with differing needs for treatment.
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Miller, Sherrill. « Family Caregiver Perspective : Navigating the Palliative Care Pathway—How an Email Chronicle Eased the Journey ». Dans Hospice Palliative Home Care and Bereavement Support, 17–33. Cham : Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-19535-9_2.
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Kotelchuck, Milton. « The Impact of Father’s Health on Reproductive and Infant Health and Development ». Dans Engaged Fatherhood for Men, Families and Gender Equality, 31–61. Cham : Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-75645-1_3.
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AbstractThe importance of father’s health and health behaviors during the perinatal period is an under-appreciated, but critical, topic for enhancing reproductive and infant health and development, and ultimately men’s own lifetime health. This chapter brings together the existing scattered reproductive fatherhood health literature and articulates a new conceptual framework that identifies eight direct and indirect pathways of potential paternal impact. Three pathways reflect pre-conception to conception influences; paternal planned and wanted pregnancies (family planning); paternal biologic and genetic contributions; and paternal epigenetic contributions. Three pathways reflect father-mother perinatal interactions: paternal reproductive health practices that may alter their partner’s health behaviors and self-care practices; paternal reproductive biologic and social health that may alter their partner’s reproductive health biology; and paternal support for maternal delivery and post-partum care. And two pathways reflect systemic influences: paternal mental health influences; and paternal contributions to the family’s social determinants of health. This chapter pushes back the time frame for the father’s developmental importance for his child into the antenatal period, if not earlier; it encourages more gender equitable parental roles and opportunities; and it provides a stronger scientific knowledge base to support new fatherhood programs, policies and research that encourages father’s more active, healthier and earlier reproductive health involvement.
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Hanh, Jacky, Philip Hazell et Isabelle Feijo. « The Pharmacist and Pharmacotherapy ». Dans Longer-Term Psychiatric Inpatient Care for Adolescents, 153–60. Singapore : Springer Nature Singapore, 2022. http://dx.doi.org/10.1007/978-981-19-1950-3_17.
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AbstractClinical pharmacy services aim to optimise health outcomes and improve patient safety throughout all steps of the medicines management pathway, by ensuring the quality use of medicines and minimising medication-related problems. The role of the pharmacist includes gathering and documenting medication histories, performing medication reconciliation and undertaking clinical medication reviews. These services support collaborative approaches between patients, carers and the multidisciplinary team to develop patient-centred medication management plans. The practice of pharmacotherapy at the Walker Unit shares features in common with prescribing in acute child and adolescent mental health inpatient units, but there are some differences. This chapter will in particular seek to highlight the characteristics of pharmacotherapy that are distinct to longer stay intensive psychiatric care.
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Mournet, Annabelle M., Nathan J. Lowry et Lisa M. Horowitz. « Utilizing Suicide Risk Screening as a Prevention Technique in Pediatric Medical Settings ». Dans SpringerBriefs in Psychology, 63–70. Cham : Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-06127-1_7.
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AbstractSuicide risk screening for youth in medical settings, especially in primary care, is supported and encouraged by The Joint Commission, the American Academy of Pediatrics, and the National Action Alliance for Suicide Prevention. Implementing suicide risk screening and assessment with evidence-based tools can enhance feasibility of screening programs without overburdening busy systems of care. This chapter will highlight existing research on suicide risk screening and assessment in medical settings, discuss the importance of utilizing clinical pathways to effectively manage youth who screen positive for suicide risk, and provide recommendations on best practices for implementing suicide risk screening in medical settings.
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Rasche, Leo, Luca Vago et Tuna Mutis. « Tumour Escape from CAR-T Cells ». Dans The EBMT/EHA CAR-T Cell Handbook, 15–22. Cham : Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-94353-0_4.
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AbstractOver the past decade, CAR-T cells have emerged as one of the most powerful cellular immune therapy approaches in the battle against haematological malignancies. Nonetheless, similar to other immunotherapeutic approaches, tumour cells develop strategies to evade CAR-T cell therapy, often with the support of a highly immunosuppressive and protective tumour microenvironment. To date, antigen loss, immune dysfunction, exhaustion and (microenvironment-mediated) upregulation of antiapoptotic pathways have been identified as major modes of tumour escape from CAR-T cell therapy. This chapter will focus on our current understanding of these modes of immune escape from CAR-T cells.
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Misra, Tania Nayar. « The Public Health Response to COVID-19 in the UK : A View from the Frontline ». Dans Global Perspectives of COVID-19 Pandemic on Health, Education, and Role of Media, 409–36. Singapore : Springer Nature Singapore, 2023. http://dx.doi.org/10.1007/978-981-99-1106-6_20.
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AbstractThe author charts the experience of working on the frontline public health response during the pandemic. The UK’s initial public health response to the pandemic comprised a delayed lockdown, shortages of personal protective equipment (PPE), insufficient testing capacity, and ambivalence about mask wearing. The pandemic’s first wave ravaged the health and care sectors. Subsequently, with experience and tight testing regimes, management of COVID-19 in the care sector was improved enormously. Hospitals reduced their workload to a bare minimum initially, followed by designing separate pathways to facilitate elective work, underpinned by testing and infection control. In addition to the elderly and frail, those on the fringes of society—for example, homeless, refugees, asylum seekers, and prison populations experienced high rates of infection and mortality. Nation-wide restrictions on movement were propped by an economic support program. The new school year in 2020 began amid rising cases, as people struggled to interpret confusing policies. Workplaces did not emerge from remote working till mid-2021 and remain a hub of infection transmission. The tussle between maintaining economic activity and education versus preventing the spread of cases continues, while the focus of the public health response moves to high vaccination coverage, rapid testing, and responding robustly to emerging variants of concern.
Actes de conférences sur le sujet "Care and support pathways"
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Pappa, Dimitra, Emmanouil Zoulias, Barbara Mpoutopulou et Vasiliki Matziou. « NURSING EDUCATION : INNOVATIVE TRAINING FOR CLINICAL CARE PATHWAYS ». Dans 17th annual International Conference of Education, Research and Innovation, 7529–35. IATED, 2024. https://doi.org/10.21125/iceri.2024.1818.
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Redavid, Domenico, et Stefano Ferilli. « An Holistic Approach to Diagnostic and Therapeutic Care Pathways Management ». Dans 16th International Conference on Knowledge Engineering and Ontology Development, 252–59. SCITEPRESS - Science and Technology Publications, 2024. http://dx.doi.org/10.5220/0013076200003838.
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Tirosh, Oren, Muhammad Nadeem Shuakat, John Zelcer et Nilmini Wickramasinghe. « Clinical Tele-Assessment : The Missing Piece in Health Care Pathways for Orthopaedics ». Dans Digital Support from Crisis to Progressive Change. University of Maribor Press, 2021. http://dx.doi.org/10.18690/978-961-286-485-9.4.
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An aging population coupled with longer life expectancy has resulted in an exponential growth in total hip and total knee replacements (THR) (TKR). Especially during the 2020 COVID-19 pandemic, support for patients recovering form THR and TKR was difficult due to reduction in face-toface visits. To address this and enable Australians to have a better patient experience, the following proffers a tele-assessment solution, ARIADNE (Assist foR hIp AnD kNEe), that can provide high quality care, with access for all and support for high value outcomes.
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Manget, J., et A. Sutcliffe. « 106 Development of an apprenticeship pathway for CYP healthcare support workers ». Dans Great Ormond Street Hospital Conference 2018 : Continuous Care. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2018. http://dx.doi.org/10.1136/goshabs.106.
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Tosi, Francesca, Claudia Becchimanzi et Mattia Pistolesi. « Design for digital ecosystems and telemedicine services to improve the quality of care pathways for frail older adults. » Dans 15th International Conference on Applied Human Factors and Ergonomics (AHFE 2024). AHFE International, 2024. http://dx.doi.org/10.54941/ahfe1004889.
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Global population aging is one of the most critical factors in the coming decades (Eurostat, 2019). In Italy, international trends are confirmed: the average age of residents, which was 32 in 1952, increased to 46.2 years at the beginning of 2022 (Istat, 2022). The overall effects of aging on the health and welfare system are considerable. Indeed, with ageing is associated with an increase in chronic pathological conditions, co-morbidities, or the inability to perform basic daily activities independently, and this leads to an increase in the care and assistance needs of the elderly. The European health interview survey (2019) finds that there in Italy there are about 4.6 million elderly people with severe or moderate difficulties in ADLs (Activities of Daily Living) and IADLs (Instrumental Activities of Daily Living), such that they need help and support to carry them out. However, the need for help is not always fully met: more than 2 million people over 65 with impaired independence do not feel adequately helped (Istat, 2022b).A distinctive factor of the new generation of elders is their approach to technologies, a factor that can greatly expand the possibilities of access to care and assistance, communication and information services (Istat, 2019). To provide, as far as possible, the continuity of care and assistance people need, telemedicine services can ensure safe and efficient care pathways while maintaining a strong patient-physician relationship. For example, in Italy before the health emergency caused by the Covid-19 virus, the use of telemedicine services was very limited. The pandemic emergency accelerated the diffusion of telemedicine applications and services, especially aimed at bridging the difficulties of performing health care services in person and minimizing hospital admissions when unnecessary. Before that time, home-based telemedicine services were used for the management of asthma, hypertension, pulmonary disease, and congestive heart failure (Chan et al., 2003; Benatar et al., 2003; Maiolo et al., 2003; Hersh et al., 2006; Panicacci et al., 2021).Digital technologies are thus a resource to support care and assistance at home. Design, and in particular the Human-Centred Design approach, can have a crucial role both in understanding the elderly population's needs and in translating these needs into digital products that are more suitable and relevant to their purpose.This article presents the first results of the research conducted by the Laboratory of Ergonomics & Design (LED) of the University of Florence as part of Spoke 3 of the project "THE - Tuscany Health Ecosystem" of the PNRR (National Recovery and Resilience Plan), funded by the Italian government with Next Generation EU funds - Mission 4 (Education and Research) - Component 2 "From Research to Enterprise". The THE project involves the participation of 22 partners including universities, research centers and companies in the Tuscany Region, organized in 10 Spokes. The goal is to develop guidelines for the design of interfaces and products for telemedicine services in digital diagnosis and therapy for neurodegenerative diseases.This article will discuss the research questions, applied research methodology, results and future developments.
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Green, Freddy, Erna Buitendam, Hannah Charles, John Saunders, Mateo Prochazka, Kate Folkard et Katy Sinka. « P57 Developing a syphilis care pathway to support local service improvement and syphilis control ». Dans BASHH 2022 Abstracts. BMJ Publishing Group Ltd, 2022. http://dx.doi.org/10.1136/sextrans-bashh-2022.103.
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Lester, James, Erna Buitendam, Kate Donohoe, Veronique Martin, John Saunders, Kate Folkard et Alison Brown. « P047 Developing an HIV care pathway to support local implementation of the HIV action plan ». Dans BASHH 2023 Abstracts. BMJ Publishing Group Ltd, 2023. http://dx.doi.org/10.1136/sextrans-bashh-2023.86.
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Ulapane, Nalika, Abdur Rahim Mohammad Forkan, Prem Prakash Jayaraman, Penelope Schofield, Kate Burbury et Nilmini Wickramasinghe. « Mobile Clinical Decision Support Systems : A Pathway from Design to Commercialization ». Dans 36th Bled eConference – Digital Economy and Society : The Balancing Act for Digital Innovation in Times of Instability. University of Maribor Press, 2023. http://dx.doi.org/10.18690/um.fov.6.2023.27.
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A smartphone-based clinical decision support system (CDSS) has been designed for perioperative patient management in cancer care. A systematic design approach to ensure fit-for-purpose of such mobile CDSSs is lacking. This study attempts to fill that void by reporting on the pathway we took from design to commercialization. Our pathway is governed by the design science research methodology and the theory of task technology fit. Our experiences are generalizable and can provide guidance to many mobile clinical decision support solutions in healthcare.
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Swa,, Annette, Faith Mwangi, Rachel Jumwa, Francis Nanga, Happiness Oruko, John Kutna, Dr Philip Masauloi et Jane Muthegi. « Strengthening Integrated Management of Acute Malnutrition : Enhancing Capacity of Health Care Workforce and Systems on IMAM in Kwale County ». Dans 4th International Nutrition and Dietetics Scientific Conference. KENYA NUTRITIONISTS AND DIETICIANS INSTITUTE, 2024. http://dx.doi.org/10.57039/jnd-conf-abt-2024-mbesm-09.
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Kwale County, comprising five sub-counties faces significant challenges related to acute malnutrition, with notable rates of stunting, underweight, and wasting. According to the Long Rain Assessment 2022, integrated Phase Classification acute malnutrition was classified in the Alert Phase (IPC Phase 2) in both livelihood zones. In 2022, County Stunting levels dropped from 34.2% reported in 2012 to 29.5% reported in 2022 which remains at a high prevalence level compared to the national level where 22.7% of children under-5 are stunted (KDHS, 2022). Therefore, integrated management of acute malnutrition (IMAM) services is crucial in addressing malnutrition, with 137 health facilities implementing these services alongside other nutrition interventions. However, the effectiveness of these interventions depends on the capacity of healthcare workers. Thus, through the USAID Stawisha Pwani Project, which supported capacity building for 180 healthcare workers for effective nutrition assessment and management. The overall objective was to equip the healthcare workers with the necessary capacity to manage early detection and treatment of acute malnutrition, prevent malnutrition through public health interventions and education, use appropriate measurements for identification and referral of malnourished children, and strengthen referral pathways for IMAM programs. The methodology involved conducting training sessions for healthcare workers focusing on IMAM principles and emerging evidence on the management of at-risk mothers and infants under six months of age. The Results reveal that an improved screening and early identification of acute malnutrition cases, with more children enrolled in the IMAM program. Non-cured children in outpatient therapeutic programs also showed a downward trend, suggesting improved quality of care. In conclusion, sustaining efforts to address acute malnutrition requires ongoing training, mentorship and on-the-job support for healthcare workers. This approach not only enhances retention of skills but also expands the pool of trained staff, thereby improving health outcomes for mothers and children. Such strategies are vital for achieving sustainable development goals and realizing national objectives for health and nutrition and therefore continued investment in training and support programs is essential for reducing malnutrition and promoting the well-being of communities in Kwale County and beyond. Keywords; Malnutrition, Integrated Management of Acute Malnutrition, Long Rain Assessment
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Neiland, Jo. « P-151 Designing a palliative care pathway to support an effective patient journey for non-cancer respiratory disease patients ». Dans Hospice Care for all, for now, forever. Hospice UK National Conference, 26 – 28 November 2024, A67.1—A67. British Medical Journal Publishing Group, 2024. http://dx.doi.org/10.1136/spcare-2024-hunc.169.
Texte intégralRapports d'organisations sur le sujet "Care and support pathways"
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Caldera, Selena, Rita Choula, Courtney Hedderman, Lori Hendren et Sonja Gibbons-Reed. Pathways to Care : Experiences with Long-Term Services and Supports in Illinois. Washington, DC : AARP Public Policy Institute, avril 2024. http://dx.doi.org/10.26419/ppi.00226.001.
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Shahid, Shaouli, Brandon Lau, Jacqui Holub et Nicola O’Neil. Support along the cancer pathway for Aboriginal People. The Sax Institute, novembre 2021. http://dx.doi.org/10.57022/nscx4826.
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This Evidence Check Review, commissioned by the Cancer Institute NSW, reviewed recent evidence relating to cancer care for Aboriginal and Torres Strait Islander (ATSI) peoples and Indigenous peoples from New Zealand and Canada. It aimed to identify barriers to accessing screening, diagnosis, treatment, and management; and effective approaches and interventions for improving access to and coordination of care. The review identifies a number of barriers and summarises effective approaches to improving care. It includes identified strategies and models, and presents a set of key considerations and principles that should be at the forefront of all efforts, policies and initiatives to improve cancer outcomes for ATSI Australians.
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Ringler, Claudia, Sawsan Abdulrahim, May Adra, Muzna Fatima Alvi, Zahid ul Arefin Choudhury, Hagar ElDidi, Patrick Kilby et al. Gender-Sensitive Risks and Options Assessment for Decision Making (ROAD) to Support WiF2. Centre for Excellence and Development Impact and Learning (CEDIL), avril 2023. http://dx.doi.org/10.51744/crpp8.
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The Gender-Sensitive Risks and Options Assessment for Decision Making (ROAD) to Support WiF-2 (ROAD migration project), a partnership coordinated by the International Food Policy Research Institute (IFPRI), Australian National University, American University Beirut, Lincoln University, and University of Dhaka, evaluated the ILO-DFID Partnership Programme on Fair Recruitment and Decent Work for Women Migrant Workers in South Asia and the Middle East (Work in Freedom, Phase 2 project [WiF-2]), which operated from 2018 to 2023. The WiF-2 project specifically aimed “to reduce vulnerability to trafficking and forced labour of women and girls across migration pathways leading to the care sector and textiles, clothing, leather and footwear industries (TCLFI) of South Asia and Arab States” (ToC WiF-2).
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Hollick, Rosemary J., Michelle Stevenson, Michael Parker, Mike Seabourne, Kevin Stelfox, Rebecca Pedrick-Case, Rich Fry et al. Mapping for Better Care : Supporting service planning for people with rheumatic and musculoskeletal conditions. RHEUMAPS study / University of Aberdeen, février 2025. https://doi.org/10.57064/2164/25119.
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Rheumatic and musculoskeletal disorders (RMDs) affect approximately one-third of the UK population, yet access to timely and equitable care remains inconsistent. National audits have highlighted significant variations in service provision and health outcomes, shaped by individual socio-demographic characteristics and place-based factors. Rural populations, comprising around 20% of the UK, face unique challenges due to geographic remoteness, centralised specialist services, and an ageing demographic. Workforce constraints and service accessibility further exacerbate these disparities, limiting the ability of local health systems to meet the needs of their populations effectively. The RHEUMAPS study was designed to address key evidence gaps by exploring patient priorities for care, measuring the geographical prevalence of RMDs, and assessing health outcomes across Scotland and Wales using national healthcare data. Specifically, the study examined differences in outcomes between rural and urban populations and the extent to which these disparities could be attributed to socio-economic factors. Additionally, it assessed how historical rural healthcare policies in Scotland and Wales have shaped service delivery and identified opportunities for future policy direction. Findings from the study revealed that people living with RMDs share common care priorities, including pain and fatigue management, maintaining physical activity, sustaining social connections, and participating in work and daily activities. Access to multidisciplinary, integrated, and locally available care was highly valued, yet many participants expressed dissatisfaction with existing services due to long travel distances, fragmented care pathways, and a lack of accessible information. Structural barriers, such as limited local healthcare provision and travel challenges, disproportionately affected rural communities, further widening health inequalities. To support data-driven and place-sensitive healthcare planning, the study developed interactive geospatial maps, integrating information on RMD prevalence, socio-demographic factors, and service accessibility. These tools provide timely, actionable insights to inform local, regional, and national decision-making, helping policymakers and healthcare providers design services that better align with patient needs. Additionally, the study highlighted the need for a more integrated approach to rural healthcare policy, moving beyond historically siloed strategies that have addressed health, transport, housing, and workforce issues in isolation. This report offers critical evidence and resources to support a transition toward sustainable, equitable, and person-centred healthcare for people living with RMDs. By leveraging real-world data and patient insights, the findings underscore the importance of developing adaptable, learning healthcare systems that respond to the evolving needs of diverse populations across urban and rural settings.
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Lidmo, Johannes, Maja Brynteson et Ágúst Bogason. National Support Initiatives in Nordic Spatial Planning. Nordregio, mars 2024. http://dx.doi.org/10.6027/r2024:61403-2503.
Texte intégralRésumé :
The Nordic countries share many cross-sectoral targets at the national level to meet ambitious environmental, social, sustainable and innovative development goals and standards. When it comes to spatial planning, central governments in the Nordic countries often have limited power to influence local-level priorities, particularly with respect to regulating land use and adopting a range of policies that impact sustainable urban development. In parallel, various new planning approaches, as well as a range of nationwide support mechanisms have emerged in the Nordic countries, often with the aim of supporting and steering municipalities’ efforts to achieve sustainable urban development. Our report aims to better understand such initiatives and how they are connected to spatial planning efforts in Nordic municipalities by examining one national support initiative in each Nordic country, illustrated with learnings from municipal case studies. We examined FutureBuilt in Norway, the Partnership for Vibrant City Centres in Denmark, the Borgarlína project in Iceland, the Sustainable City programme in Finland and Visions: in the North in Sweden. As shown by the findings from our case studies, different perspectives on external governance – such as state intervention versus municipal self-governance in Nordic countries – highlight challenges in influencing local urban development due to limited state mandates. National support initiatives emerge as an alternative means to guide local development. They may serve to foster collaboration and inclusivity, particularly when inspiring local, strategic spatial planning, as seen in the Swedish case study. National support initiatives are viewed as complementary tools to spatial planning that support sustainable urban development processes and projects. Though they take various forms, their purpose and impact should be understood within the overall context. Collaboration and lessons learned from national support initiatives have the potential to enhance legislation or state intervention. However, an imbalance in municipalities’ access to support poses a challenge in each Nordic country. It is therefore crucial to assess the appropriateness and purpose of support, recognising that municipal pathways are influenced by the way in which support is designed. Striking a balance with respect to state-municipal governance is essential. In short, we can draw the following recommendations: A partnership-based approach with collaboration between various stakeholders enhances inclusivity. New ways of working that are agile and flexible and focus on the local context should be emphasised for effective outcomes. The importance of long-term commitments and policy coherence in the field of sustainable urban development should be emphasised at both national and municipal levels. Efforts should be made to ensure continuity in sustainable urban development initiatives beyond the duration of the given programme. A more formal and institutionalised way of obtaining government funding for sustainable urban development projects at the local level should be developed in some countries. That could level the playing field for municipalities with varying resources, knowledge and lobbying capabilities. In other countries, capacity building – including training and resources – can be provided to help municipalities navigate support options and apply for them. It is beneficial to create platforms providing information about support for sustainable urban development and to make municipalities aware of upcoming calls well in advance.
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Shah, Tavseef Mairaj, Olivia Riemer, Nadia El-Hage Scialabba et Alexander Müller. The Agri-Food Systems Transformation Protocol : Mapping the Agents and Drivers of Transformation. TMG Research gGmbH, 2023. http://dx.doi.org/10.35435/1.2023.4.
Texte intégralRésumé :
There is a broad consensus that agri-food systems need to be transformed to address the mounting global challenges including food and nutrition security, environmental degradation, and socioeconomic inequities. However, agreement is lacking on what is needed to drive this transformation. This report builds on a sustainability analysis of different proposed pathways and approaches to address transformative needs. It also serves as a study of the drivers and agents that support the implementation of these proposed pathways in different cases around the globe. We recommend the adoption of a multi-level governance framework to coordinate the transformation of agri-food systems, guaranteeing the attainment of transformation goals across all levels. This includes global agreements and international goals at the international level, national transformation pathways at the country level, and the operational level embedded in local governance. This report introduces the Agri-food Systems Transformation Protocol as a decision-support protocol at the desired operational level serving different actors within agri-food systems. The Agri-food Systems Transformation Protocol proposes a four-stage and nine-step iterative process that can guide the development of transformation pathways in different contexts and at different levels of implementation. It was conceived during a workshop of the Expert Advisory Group of the Assessment and Communication of Climate Impacts of Food (CLIF) project in June 2023. The aim was to develop a step-by-step guide to transforming food systems that is not prescriptive and follows a rights-based, place-based, systems approach. The protocol was informed by background research on different case studies from the agri-food sector and advances the three principles of preserving the rights of people, ecosystem integrity, and integrity of the process. The background study identified the main drivers and agents of transformation by analysing 14 case studies from five continents, a selection that was finalized at the expert workshop. A transformation matrix that maps the agents and drivers with different steps of transformation process is also presented to aid the implementation of the protocol. This protocol is intended to be the first step in developing a transformative theory of change for agri-food systems, with the methodologies for each step being the subject of further development.
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Crisp, Helen, Amanda Watt, Bryan Jones, Daphne Amevenu et Will Warburton. Improving flow along care pathways. The Health Foundation, novembre 2020. http://dx.doi.org/10.37829/hf-2020-i04.
Texte intégral
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Boehm, Mirko, Hilary Carter et Cailean Osborne. Pathways to Cybersecurity Best Practices in Open Source : How the Civil Infrastructure Platform, Yocto Project, and Zephyr Project are Closing the Gap to Meeting the Requirements of the Cyber Resilience Act. The Linux Foundation, mars 2025. https://doi.org/10.70828/updc4713.
Texte intégralRésumé :
This case study report from the Linux Foundation investigates the impacts of the Cyber Resilience Act on open source software, including new cybersecurity obligations and the role of manufacturers and stewards. The analysis highlights the security practices of Linux Foundation projects and notes challenges like long-term support, regulatory uncertainty, and standardization gaps. The report recommends investing in security tools, fostering collaboration, and addressing emerging threats such as AI-driven risks. By featuring the cybersecurity practices of three LF projects—Yocto Project, Zephyr, and Civil Infrastructure Platform—this report provides tried-and-tested pathways for the rest of the open source community to consider when preparing for this new regulatory landscape.
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Ryland, Howard, et Sarah Bunn. Reforming the Mental Health Act - Approaches to Improve Patient Choice. Parliamentary Office of Science and Technology, UK Parliament, mai 2023. http://dx.doi.org/10.58248/pn695.
Texte intégralRésumé :
The Mental Health Act 1983 has been criticised as being overly restrictive, with inadequate scope for patient choice and autonomy. The Government’s Draft Mental Health Bill proposes reforms to improve patient choice. A joint parliamentary committee report on the draft Bill recommended further changes to enhance choice, including a statutory duty to offer patients advance choice documents. Reports to date suggest that advance care planning could offer some benefits, but uptake can be low. Proposals to replace the Nearest Relative who has certain powers under the Act, with a Nominated Person of the patient’s choosing, have been widely welcomed. There are questions about operationalisation and safeguarding. Alongside the reforms, the Government is piloting ‘culturally appropriate advocacy’, which preliminary findings suggest could help advocates better support patients from ethnic minority backgrounds. The draft Bill removes learning disabilities and autism as grounds for detention under Section 3 of the Act. Stakeholders have raised concerns about unintended diversion to more restrictive pathways, such as the criminal justice system. A range of stakeholders share the view that careful implementation is needed to maximise the benefits of proposed reforms. The Government has not announced when the Bill will be introduced.
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Radcliffe, Joel, Friederike Gadow, Hannah Leary et Rory Kelly. Doing Consent Differently : A University Practitioners’ Reflection on Delivering Large-Scale Respect and Consent Education. Journal of the Australian and New Zealand Student Services Association, avril 2024. http://dx.doi.org/10.30688/janzssa.2024-1-05.
Texte intégralRésumé :
Sexual assault and sexual harassment (SASH) remain pressing issues on university campuses, making it imperative for higher education institutions to develop prevention strategies. Within this context, education plays a pivotal role in addressing the underlying factors contributing to SASH, while also providing crucial information about care and support pathways for survivors. This paper, authored by practitioners from the Australian National University’s (ANU) Respectful Relationships Unit (RRU), reflects on the conceptualisation, implementation, and evaluation of a large-scale respect and consent education program. Tailored to ANU's context, the program utilised a multi-modal approach including an online module, face-to-face workshops, and residential hall pilots. Challenges, such as engagement and sustainability, were addressed through collaborative partnerships and continuous improvement efforts. Evaluation, conducted in collaboration with social scientists from the ANU Centre for Social Research and Methods (CSRM), provided insights for refinement and future directions. ANU's ongoing commitment to community engagement, innovation, equity, and evaluation underscores its dedication to fostering safer and more inclusive campus environments. Through collaboration and a shared commitment to prevention, ANU aims to make meaningful progress towards a campus free of sexual harm.