system has faced a difficult situation because of the lack of medical resources and the unequal medical resource distribution between the BHs and BLHs. BH doctors are tremendously busy with both serious and minor illnesses while BLH medical providers are worried about a sufficient source of patients. This study aims to find the potential feasibility of a new service model in managing diabetes which will solve these medical problems. The study was conducted using an extensive literature review in addition to employing an interview and survey method to explore the perception and current situation in workload and income of medical providers from one BH and one BLH in China. Furthermore, this study tried to understand the acceptance of online medical technology in these medical provider groups. The results showed that doctors in the BH do not have the time needed to engage in extra work. This population is not satisfied with their work responsibilities and income structure. They want to engage in diagnosing and prescribing tasks, with respect to diabetes management. They would like to distribute the management work to BLH. On the other hand, medical providers in BLH have extra time and enthusiasm in doing extra work to improve their income. They are not satisfied with their workload and income, and want to change it. BLHs are willing to do the management work assisting the BH doctors. Additionally, the study showed that online medical technology requires a broader user education for medical providers from both big and BLHs. The conclusion can be summarized as design research advice for future service design in healthcare management. The proposed online medical service should meet different level medical providers' position and requirements regarding time, payment, and value. BH doctors are more suitable for diagnosing and prescribing and BLH medical providers are more suitable for follow-up service. This service should reflect the value of the BH doctors' professional service and the value of BLH medical providers' health management service. (discuss how design can improve this situation through app development)
It is well known that the lack of care coordination in the healthcare system causes numerous problems including cost inefficiency and inconsistent care, specifically for complex pediatric and adult patients. Many pediatric patients have complex medical and social service needs which can be expensive for both the patient’s parents and the general healthcare system. Therefore, it is difficult for the healthcare system to deliver the highest quality care possible, due to the number of appointments that have to be scheduled (with some being out of state), the large volume of physical health records, and overall lack of time parents have to coordinate this care while also caring for themselves and other family members. It is integral to find a more efficient way to coordinate care for these patients, in order to improve overall care, cost efficiency, and outcomes. <br/>A number of stakeholders in Arizona came together to work on this problem over several years. They were funded through a PCORI Eugene Washington Engagement grant to investigators at ASU. This project, Take Action for Arizona's Children through Care Coordination: A Bridge to Action was developed in order to further develop a research agenda and build the network (PCOR). Regional conferences were conducted in Flagstaff, Yuma, Phoenix, and Tucson, as well as a final capstone conference held in Phoenix. At these conferences, frustrations, suggestions, and opinions regarding Children with Special Health Care Needs (CSHCN) and navigating the healthcare system were shared and testimonials were transcribed.<br/>This study focused on the capstone conference. The study design was a strategic design workshop; results of the design analysis were analyzed qualitatively using descriptive content analysis. Themes described parent’s common experiences navigating the system, impacts resulting from such experiences, and desires for the care coordination system. Quotes were then grouped into major themes and subthemes for the capstone conference. After these themes were determined, the overarching goals of stakeholders could be assessed, and implementation projects could be described.
COVID-19 has been challenging for nearly everyone in different ways. Healthcare organizations have had to quickly change policy, modify operations, reorganize facilities, hire, and train staff to overcome COVID-19 related challenges to be able to still provide care for patients, all while being mindful of the protection of their staff. Some healthcare organizations have responded particularly well, perhaps due to preparedness, planning, or exceptional leadership in times of crisis. To explore this, we invited seven healthcare system leaders from three different organizations in Arizona to talk about how they overcame challenges at the beginning of this pandemic with effective strategies and any leadership tips they had for the future. After the interviews were conducted, the interviews were transcribed, coded qualitatively, and separated into themes and categories to analyze their answers to the questions asked. The results and conclusions included strategies such as having open and honest communication, teamwork, rapidly developing communicating policies, and widely adopting new work practices like Telemedicine, Zoom, and working at home as crucial. This report is designed to assist in aiding and inspiring future or other leaders to be better prepared for solving various challenges with other emergencies that arise in the future.
Purpose: The purpose of this study was to understand how implementing EIM influenced provider behaviors in a university-based healthcare system, using a process evaluation.
Methods: A multiple baseline, time series design was used. Providers were allocated to three groups. Group 1 (n=11) was exposed to an electronic medical record (EMR) systems change, EIM-related resources, and EIM training session. Group 2 (n=5) received the EMR change and resources but no training. Group 3 (n=6) was only exposed to the systems change. The study was conducted across three phases. Outcomes included asking about patient physical activity (PA) as a vital sign (PAVS), prescribing PA (ExRx), and providing PA resources or referrals. Patient surveys and EMR data were examined. Time series analysis, chi-square, and logistic regression were used.
Results: Patient survey data revealed the systems change increased patient reports of being asked about PA, χ2(4) = 95.47, p < .001 for all groups. There was a significant effect of training and resource dissemination on patients receiving PA advice, χ2(4) = 36.25, p < .001. Patients receiving PA advice was greater during phase 2 (OR = 4.7, 95% CI = 2.0-11.0) and phase 3 (OR = 2.9, 95% CI = 1.2-7.4). Increases were also observed in EMR data for PAVS, χ2(2) = 29.27, p <. 001 during implementation for all groups. Increases in PA advice χ2(2) = 140.90, p < .001 occurred among trained providers only. No statistically significant change was observed for ExRx, PA resources or PA referrals. However, visual analysis showed an upwards trend among trained providers.
Conclusions: An EMR systems change is effective for increasing the collection of the PAVS. Training and resources may influence provider behavior but training alone increased provider documentation. The low levels of documented outcomes for PA advice, ExRx, resources, or referrals may be due to the limitations of the EMR system. This approach was effective for examining the EIM Solution and scaled-up, longer trials may yield more robust results.
The purpose of this Honors Thesis was to first, understand the implications of social isolation and loneliness on an individuals’ physical and mental health and second, uncover successful strategies that individuals used to overcome social isolation and loneliness. This thesis used two primary data sets to draw conclusions about individuals’ subjective feelings of loneliness and isolation and to further understand what strategies were used to overcome these feelings. The results from this thesis demonstrated that individuals who successfully avoided feelings of social isolation and loneliness during the COVID-19 pandemic took up new activities, used strategies to facilitate communication, participated in community engagement, completed acts of service, practiced mindfulness and reflection, and made new connections.