Care that Matters: Quality Measurement and Health Care

Saver, Barry G.; Martin, Stephen A.; Adler, Ruth; Candib, Lucy M.; Deligiannidis, Konstantinos; Golding, Jeremy; Mullin, Daniel; Roberts, Michèle; Topolski, Stefan

doi:10.1371/journal.pmed.1001902

Cited by 93 publications

(73 citation statements)

References 47 publications

(37 reference statements)

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“…This may help address limitations of managerialist thinking noted earlier by emphasizing instead, the ‘use value’ of nursing care that provides alternative ways to render visible and calculable the care that nurses provide while taking patient and family perspectives in account. In addition, this course of action makes explicit how nurses and patient's knowledge and need of time can be applied to institutionalized caring in ways that honour the patient's values and preferences and adapts to the pace and needs of an older person with altered cognitive abilities (Tronto, ; Saver et al ., ). As McCormack & McCance () p. 2 observed, ‘…a review of the evidence reveals a greater emphasis on areas of nursing and midwifery that can be quantified, for example pressure ulcer incidence, rates of health care associated infections and incidence of falls generally referred to as metrics.…”

Section: The Fashion Of Time Can Be Changed: Plurotemporalism and Permentioning

confidence: 99%

Reconciling concepts of time and person‐centred care of the older person with cognitive impairment in the acute care setting

Rushton

Edvardsson

2016

Nursing Philosophy

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The aim of this analysis was to examine the concept of time to rejuvenate and extend existing narratives of time within the nursing literature. In particular, we hope to promote a new trajectory in nursing research and practice which focuses on time and person-centred care, specifically of older people with cognitive impairment hospitalized in the acute care setting. We consider the explanatory power of concepts such as clock time, process time, fast care, slow care and time debt for elucidating the relationship between 'good care' and 'time use'. We conclude by offering two additional concepts of time, plurotemporality and person-centred time (PCT) which we propose will help advance of nursing knowledge and practice. Nurse clinicians and researchers can use these alternative concepts of time to explore and describe different temporal structures that honour the patient's values and preferences using experiential, observation-based nursing research approaches.

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Section: The Fashion Of Time Can Be Changed: Plurotemporalism and Permentioning

confidence: 99%

Reconciling concepts of time and person‐centred care of the older person with cognitive impairment in the acute care setting

Rushton

Edvardsson

2016

Nursing Philosophy

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“…Successful models implementing dental interventions (examples in Table 1 and 4) may be similarly responsive but require portability assessment. Incorporation of additional patient-centric performance measures to balance current metrics has been promoted 53 and quality measure implementation is essential to tracking efficacy of ICM implementation.…”

Section: Current Status Of Integrating Oral Health Into Primary Care mentioning

confidence: 99%

Status Update on Translation of Integrated Primary Dental-Medical Care Delivery for Management of Diabetic Patients

2017

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Escalating prevalence of both diabetes and periodontal disease, two diseases associated with bi-directional exacerbation, has been reported. Periodontal disease represents a modifiable risk factor that may reduce diabetes onset or progression, and integrated models of cross-disciplinary care are needed to establish and manage glycemic control in affected patients. An ad-hoc environmental scan of current literature and media sought to characterize factors impacting status of integrated care models based on review of the existing evidence base in literature and media surrounding: (1) current cross-disciplinary practice patterns, (2) epidemiological updates, (3) status on risk assessment and screening for dysglycemia in the dental setting, (4) status on implementation of quality metrics for oral health, (5) care model pilots, and (6) public health perspectives. The survey revealed: escalating prevalence of diabetes and periodontitis globally; greater emphasis on oral health assessment for diabetic patients in recent medical clinical practice guidelines; high knowledgeability surrounding oralsystemic impacts on diabetes and growing receptivity to medical-dental integration among medical and dental providers; increasing numbers of programs/studies reporting on positive impact of emerging integrated dental-medical care models on diabetic patient healthcare access and health outcomes; a growing evidence base for clinically significant rates of undiagnosed dysglycemia among dental patients reported by point-of-care pilot studies; no current recommendation for population-based screening for dysglycemia in dental settings pending a stronger evidence base; improved definition of true periodontitis prevalence in (pre)/diabetics; emerging recognition of the need for oral health quality indicators and tracking; evidence of persistence in dental access disparity; updated status on barriers to integration. The potential benefit of creating clinically-applicable integrated care models to support holistic management of an escalating diabetic population by targeting modifiable risk factors including periodontitis is being recognized by the health industry. Cross-disciplinary efforts supported by high quality research are needed to mitigate previously-and newly-defined barriers of care integration and expedite development and implementation of integrated care models in various practice settings. Implementation of quality monitoring in the dental setting will support definition of the impact and efficacy of interventional clinical care models on patient outcomes.

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“…As the use of electronic medical records proliferates and measurement science advances, [17][18][19] there will be increasing pressure to practice check box medicine (providing data for population-based inquiry). Resist this influence.…”

Section: Be Inquisitivementioning

confidence: 99%

Global Family Medicine: A ‘UNIVERSAL’ Mnemonic

Ventres

2017

J Am Board Fam Med

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In this essay, I borrow the idea of universal precautions from infection control and suggest that family physicians use a set of considerations, based on the mnemonic UNIVERSAL, to nurture cultural humility, enter a metaphoric "space-in-between" in cross-cultural encounters, and foster global fluency. These UNIVERSAL considerations I base on my experiences in global family medicine, attending to economically poor and socially marginalized patients in both international and domestic settings.

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Care that Matters: Quality Measurement and Health Care

Abstract: Barry Saver and colleagues caution against the use of process and performance metrics as health care quality measures in the United States.

Cited by 93 publications

References 47 publications

Reconciling concepts of time and person‐centred care of the older person with cognitive impairment in the acute care setting

Reconciling concepts of time and person‐centred care of the older person with cognitive impairment in the acute care setting

Status Update on Translation of Integrated Primary Dental-Medical Care Delivery for Management of Diabetic Patients

Global Family Medicine: A ‘UNIVERSAL’ Mnemonic

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