Current opinion in obstetrics & gynecology
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Curr. Opin. Obstet. Gynecol. · Dec 2013
ReviewThe role of simulation training in obstetrics: a healthcare training strategy dedicated to performance improvement.
In this review, the role of simulation as a strategy for training and performance improvement is reviewed. The review is timely, as providing safe and high-quality healthcare is the goal of every healthcare system and soon reimbursement will be tied to quality measures. Simulation has emerged as a strategic approach that can result in improved quality and safety through training of individuals and teams, improvement in healthcare systems, and determination of competence. The rationale for this approach will be presented and discussed. ⋯ There is a rapidly developing body of literature supporting the use of simulation in healthcare. Although research is still needed to demonstrate the effectiveness of simulation for evaluation, healthcare systems should develop strategies to implement and maintain simulation training.
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Curr. Opin. Obstet. Gynecol. · Dec 2013
ReviewOver-the-counter access to oral contraceptives as a reproductive healthcare strategy.
The aim of this review is to summarize the current evidence on the safety and effectiveness of moving oral contraceptives from prescription-only to over-the-counter (OTC) status. The review also examines women's interest in OTC access to oral contraceptives, as well as potential barriers and facilitators to an OTC switch. ⋯ OTC access to oral contraceptives could help to reduce unintended pregnancy by increasing the number of pill users, improve continuation and reduce gaps in use. It is critical that a future OTC pill be made available at an accessible price, and it should be covered by insurance without a prescription. Research suggests that common concerns about the safety of oral contraceptives OTC and a potential negative effect on women's use of preventive services are largely unsupported.
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Despite global progress towards reducing maternal mortality, sepsis remains a leading cause of preventable maternal death. This review focuses on current measurement challenges, trends, causes and efforts to curb maternal death from sepsis in high and low-income countries. ⋯ The need for robust data with subsequent analyses is apparent. This will significantly increase our understanding of risk factors and their causal pathways, which are critical to informing effective treatment strategies in consideration of resource availability.
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Curr. Opin. Obstet. Gynecol. · Apr 2013
ReviewHypertensive disease of pregnancy and maternal mortality.
The incidence of hypertensive disorders in pregnancy is increasing and is associated with maternal mortality worldwide. This review provides the obstetrician with an update of the current issues concerning hypertension and maternal mortality. ⋯ Hypertensive disorders in pregnancy are a leading cause of maternal mortality worldwide. The incidence of hypertension in pregnancy continues to increase. Currently, we are unable to determine which patient will develop superimposed preeclampsia or identify subsets of preeclampsia syndrome. Opportunities for research in this area exist to better define treatment aimed at improving maternal outcomes.
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Curr. Opin. Obstet. Gynecol. · Dec 2012
ReviewThe patient-centered medical home and accountable care organizations: an overview.
As the crisis regarding the cost of medical care in the United States continues to spiral out of control, new models of care are being touted as a means to fix the economics of healthcare. This review will examine newly proposed models of healthcare. ⋯ Healthcare reform will require implementation of new models of care. The PCMH and ACO are two such models. Although both models have their share of supporters as well as detractors, both will play a significant role in the next chapter of healthcare reform in this country.