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  • 1. Dunn, Patrick M.
    et al.
    Arnetz, Bengt B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Christensen, John F.
    Homer, Louis
    Meeting the imperative to improve physician well-being: assessment of an innovative program2007In: Journal of general internal medicine, ISSN 0884-8734, E-ISSN 1525-1497, Vol. 22, no 11, p. 1544-1552Article in journal (Refereed)
    Abstract [en]

    BACKGROUND  Improving physician health and performance is critical to successfully meet the challenges facing health systems that increasingly emphasize productivity. Assessing long-term efficacy and sustainability of programs aimed at enhancing physician and organizational well-being is imperative. OBJECTIVE  To determine whether data-guided interventions and a systematic improvement process to enhance physician work-life balance and organizational efficacy can improve physician and organizational well-being. DESIGN AND PARTICIPANTS  From 2000 to 2005, 22–32 physicians regularly completed 3 questionnaires coded for privacy. Results were anonymously reported to physicians and the organization. Data-guided interventions to enhance physician and organizational well-being were built on physician control over the work environment, order in the clinical setting, and clinical meaning. MEASUREMENTS  Questionnaires included an ACP/ASIM survey on physician satisfaction, the Maslach Burnout Inventory (MBI), and the Quality Work Competence (QWC) survey. RESULTS  Emotional and work-related exhaustion decreased significantly over the study period (MBI, p = 0.002; QWC, p = 0.035). QWC measures of organizational health significantly improved initially and remained acceptable and stable during the rest of the study. CONCLUSIONS  A data-guided program on physician well-being, using validated instruments and process improvement methods, enhanced physician and organizational well-being. Given the increases in physician burnout, organizations are encouraged to urgently create individual and systems approaches to lessen burnout risk.

  • 2.
    Gadbois, Emily A
    et al.
    Center for Gerontology and Healthcare Research Brown University School of Public Health Providence USA.
    Tyler, Denise A
    RTI International Research Triangle Park USA.
    Shield, Renee
    Center for Gerontology and Healthcare Research Brown University School of Public Health Providence USA.
    McHugh, John
    Mailman School of Public Health Columbia University New York USA.
    Winblad, Ulrika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Teno, Joan M
    Division of General Internal Medicine & Geriatrics Oregon Health Sciences University Portland USA.
    Mor, Vincent
    Center for Gerontology and Healthcare Research Brown University School of Public Health Providence USA.
    Lost in Transition: a Qualitative Study of Patients Discharged from Hospital to Skilled Nursing Facility2019In: Journal of general internal medicine, ISSN 0884-8734, E-ISSN 1525-1497, Vol. 34, no 1, p. 102-109Article in journal (Refereed)
    Abstract [en]

    Objective

    This research aimed to understand the experiences of patients transitioning from hospitals to skilled nursing facilities (SNFs) by eliciting views from patients and hospital and skilled nursing facility staff.

    Design

    We conducted semi-structured interviews with hospital and skilled nursing facility staff and skilled nursing facility patients and their family members in an attempt to understand transitions between hospital and SNF. These interviews focused on all aspects of the discharge planning and nursing facility placement processes including who is involved, how decisions are made, patients' experiences, hospital-SNF communication, and the presence of programs to improve the transition process.

    Participants

    Participants were 138 staff in 16 hospitals and 25 SNFs in 8 markets across the country, and 98 newly admitted, previously community-dwelling SNF patients and/or their family members in five of those markets.

    Approach

    Interviews were qualitatively analyzed to identify overarching themes.

    Key Results

    Patients reported they felt rushed in making their SNF decisions, did not feel they were appropriately prepared for the hospital-SNF transition or educated about their post-acute needs, and experienced transitions that felt chaotic, with complications they associated with timing and medications. Hospital and SNF staff expressed similar opinions, stating that transitions were rushed, there were problems with the timing of the discharge, with information transfer and medication reconciliation, and that patients were not appropriately prepared for the transition. Staff at some facilities reported programs designed to address these problems, but the efficacy of these programs is unknown.

    Conclusions

    Results indicate problematic transitions stemming from insufficient care coordination and failure to appropriately prepare patients and their family members. Previous research suggests that problematic or hurried transitions from hospital to SNF are associated with medication errors and unnecessary rehospitalizations. Interventions to improve transitions from hospital to SNF that include a focus on patients and families are needed.

  • 3. Thompson, Rachel
    et al.
    Johnston, Louise
    Taruscio, Domenica
    Monaco, Lucia
    Beroud, Christophe
    Gut, Ivo G.
    Hansson, Mats G.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    't Hoen, Peter-Bram A.
    Patrinos, George P.
    Dawkins, Hugh
    Ensini, Monica
    Zatloukal, Kurt
    Koubi, David
    Heslop, Emma
    Paschall, Justin E.
    Posada, Manuel
    Robinson, Peter N.
    Bushby, Kate
    Lochmueller, Hanns
    RD-Connect: An Integrated Platform Connecting Databases, Registries, Biobanks and Clinical Bioinformatics for Rare Disease Research2014In: Journal of general internal medicine, ISSN 0884-8734, E-ISSN 1525-1497, Vol. 29, no S3, p. S780-S787Article, review/survey (Refereed)
    Abstract [en]

    Research into rare diseases is typically fragmented by data type and disease. Individual efforts often have poor interoperability and do not systematically connect data across clinical phenotype, genomic data, biomaterial availability, and research/trial data sets. Such data must be linked at both an individual-patient and whole-cohort level to enable researchers to gain a complete view of their disease and patient population of interest. Data access and authorization procedures are required to allow researchers in multiple institutions to securely compare results and gain new insights. Funded by the European Union's Seventh Framework Programme under the International Rare Diseases Research Consortium (IRDiRC), RD-Connect is a global infrastructure project initiated in November 2012 that links genomic data with registries, biobanks, and clinical bioinformatics tools to produce a central research resource for rare diseases.

  • 4. Thompson, Rachel
    et al.
    Johnston, Louise
    Taruscio, Domenica
    Monaco, Lucia
    Beroud, Christophe
    Gut, Ivo G.
    Hansson, Mats G.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Centre for Research Ethics and Bioethics.
    't Hoen, Peter-Bram A.
    Patrinos, George P.
    Dawkins, Hugh
    Ensini, Monica
    Zatloukal, Kurt
    Koubi, David
    Heslop, Emma
    Paschall, Justin E.
    Posada, Manuel
    Robinson, Peter N.
    Bushby, Kate
    Lochmueller, Hanns
    RD-Connect: An Integrated Platform Connecting Databases, Registries, Biobanks and Clinical Bioinformatics for Rare Disease Research2014In: Journal of general internal medicine, ISSN 0884-8734, E-ISSN 1525-1497, Vol. 29, p. S780-S787Article, review/survey (Refereed)
    Abstract [en]

    Research into rare diseases is typically fragmented by data type and disease. Individual efforts often have poor interoperability and do not systematically connect data across clinical phenotype, genomic data, biomaterial availability, and research/trial data sets. Such data must be linked at both an individual-patient and whole-cohort level to enable researchers to gain a complete view of their disease and patient population of interest. Data access and authorization procedures are required to allow researchers in multiple institutions to securely compare results and gain new insights. Funded by the European Union's Seventh Framework Programme under the International Rare Diseases Research Consortium (IRDiRC), RD-Connect is a global infrastructure project initiated in November 2012 that links genomic data with registries, biobanks, and clinical bioinformatics tools to produce a central research resource for rare diseases.

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