Journal of evaluation in clinical practice
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GPs, at least in the United Kingdom, often run behind schedule in their clinics. This lateness is an inherently ethical problem due to the negative consequences it generates. ⋯ The major reasons for lateness can be classified as GP-related, patient-related, and third party-related. The major negative consequences of lateness in general practice might be classified as the potential disturbance to quality and safe care, the dissatisfaction of and inconvenience to subsequent patients, and the disruption of timely care. These negative consequences must be burdened by some party-either the patient who is related to the reason for the lateness, or other patients who are not. While a strict equality approach to managing such lateness does not consider patients' clinical needs, GPs compensating by actively 'catching up' in their clinics threatens quality and safety of care. The paper argues for minimising the negative consequences of lateness for all parties, while simultaneously promoting equity with regard to patients' clinical needs. The ethical status of each major reason for lateness in general practice is explored, and suggestions are offered for how each might be managed to minimise the negative consequences and promote equity.
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This paper examines the concept of centredness in health care, with a particular focus on person-centred care. While the principle of centring care is widely accepted, the concept of a 'centre' remains ambiguous, complicating its implementation. The paper defines centredness, questions the necessity of a central focus and explores alternative models. ⋯ Distributed care offers flexibility and inclusivity, but it raises challenges about coordination and the potential emergence of a new implicit centre: distribution itself. Hybrid models combining elements of centred and distributed care offer a path forward. Empirical research is needed to compare these approaches, with the aim of developing more responsive and adaptable systems to address diverse and complex needs for health care.
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An increasing number of UK residents are travelling overseas to access medical treatments, the negative health consequences of which are largely managed by NHS doctors. ⋯ Amongst other requirements, this paper finds that NHS doctors must counsel those considering medical tourism overseas on the risks of doing so, and existing efforts to do so should be increased to reflect the increasing prevalence of medical tourism overseas by UK residents and the associated negative health consequences.
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Today, hospital information systems (HISs) play an irreplaceable role in hospital management. At present, HIS construction projects in many hospitals have faced the setback of 'project quagmire' to varying degrees. The critical path method (CPM) mainly aims to find the critical path, thus managing project progress. ⋯ The CPM could effectively measure the completion and deviation of each stage of the registration system project, which provided an effective guarantee for the subsequent schedule compression to ensure that the project was completed as scheduled and was of sufficient quality. However, all conditions had to be considered comprehensively; doing otherwise would lead to increased risks and costs.