Objective To assess the impact of reorganisation of neonatal specialist care services in England after a UK Department of Health report in 2003.Design A population-wide observational comparison of outcomes over two epochs, before and after the establishment of managed clinical neonatal networks.
This review aimed to identify research that described how eHealth facilitates interdisciplinary cancer care and to understand the ways in which eHealth innovations are being used in this setting. An integrative review of eHealth interventions used for interdisciplinary care for people with cancer was conducted by systematically searching research databases in March 2015, and repeated in September 2016. Searches resulted in 8531 citations, of which 140 were retrieved and scanned in full, with twenty-six studies included in the review. Analysis of data extracted from the included articles revealed five broad themes: (i) data collection and accessibility; (ii) virtual multidisciplinary teams; (iii) communication between individuals involved in the delivery of health services; (iv) communication pathways between patients and cancer care teams; and (v) health professional-led change. Use of eHealth interventions in cancer care was widespread, particularly to support interdisciplinary care. However, research has focused on development and implementation of interventions, rather than on long-term impact. Further research is warranted to explore design, evaluation, and long-term sustainability of eHealth systems and interventions in interdisciplinary cancer care. Technology evolves quickly and researchers need to provide health professionals with timely guidance on how best to respond to new technologies in the health sector.
This paper reviews the accreditation requirements for six Allied Health (AH) degree programs in Australia to understand the range of accreditation requirements and approaches, with a particular focus on requirements around clinical education in AH education. Strengths of current approaches and further requirements are identified. Of particular interest are those areas where accreditation could better support educational goals and processes, including the preparation of work ready graduates and the encouragement of the use of currently underutilized opportunities for preparing the AH workforce for future healthcare needs. The findings suggest that the accreditation criteria perform well for the development of students' conceptual and procedural knowledge. However, there are several opportunities for improvement where accreditation could better support preparation of graduates to meet current and future needs of healthcare. These opportunities include increased emphasis on biopsychosocial perspectives of health as healthcare models shift from hospital to community-based settings, increased emphasis on development of interprofessional skills, encouragement of diverse supervision models, explicitness about intentions and interpretations of accreditation requirements, and increased employer representation on accreditation panels. Constraints on universities' uses of new educational approaches imposed by or arising from non-explicit accreditation requirements are outlined. Arising from this analysis, a summary of considerations for AH accreditation bodies is provided.
There is increasing recognition of the role eHealth will play in the effective and efficient delivery of healthcare. This research challenges the assumption that students enter university as digital natives, able to confidently and competently adapt their use of information and communication technology (ICT) to new contexts. This study explored health sciences students' preparedness for working, and leading change, in eHealth-enabled environments. Using a cross-sectional study design, 420 undergraduate and postgraduate students participated in an online survey investigating their understanding of and attitude towards eHealth, frequency of online activities and software usage, confidence learning and using ICTs, and perceived learning needs. Although students reported that they regularly engaged with a wide range of online activities and software and were confident learning new ICT skills especially where they have sufficient time or support, their understanding of eHealth was uncertain or limited. Poor understanding of and difficulty translating skills learned in personal contexts to the professional context may impair graduates ability to confidently engage in the eHealth-enabled workplace. These results suggest educators need to scaffold the learning experience to ensure students build on their ICT knowledge to transfer this to their future workplaces.
Background: As modern medicine extends the life expectancy of patients with life-limiting illnesses and health system resource pressures intensify, palliative care physicians increasingly need to transfer stable patients from specialist palliative care units to nursing homes. The experience of palliative care physicians in decision-making and communicating with patients and families about the need for this transition is underexplored in the literature. Aim: This study aimed to explore the experiences of and communication techniques used by palliative care physicians as they consider and discuss nursing home placements for their patients. Design: A qualitative approach using semi-structured interviews was used. Interviews were transcribed verbatim and analysed using thematic analysis. Setting/participants: Purposive sampling was used to recruit 18 Australian palliative care physicians known for their interest or strength in communication skills across a range of palliative care settings. Results: Themes emerged from domains of physician experience (abandonment, systemic pressures, prognostic uncertainty, exacerbation of loss, and restoring resilience) and communication strategies (forecasting, checking in, provide context, and acknowledging grief). Conclusion: This study highlights the tension Australian palliative care physicians experience when transferring palliative care patients to nursing home and the complexity involved in decision-making. Physicians identified several communication strategies to engage patients and families to ease the transition.
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