Journal of evaluation in clinical practice
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This study is a case study that aims to evaluate community-based mental health services from the perspective of health providers and service recipients through SWOT analysis. ⋯ Community-based mental health services contain strengths, weaknesses, opportunities and threats according to the views of both health providers and service recipients, and the views of the groups overlap with each other within the supply-demand mechanism. It can be said that the effectiveness of community-based mental health services will increase by preventing threats by improving weaknesses and increasing the visibility of opportunities by recognizing strengths.
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Observational Study
The Effect of Lean Hospital Practices on Nurses' Direct Care Activities: Time and Motion Study.
This study investigates the effects of lean management practices on nurses' direct patient care activities and the interruptions they encounter in healthcare settings. The literature indicates that lean management enhances efficiency and improves patient care. Increased nursing time per patient correlates with better outcomes; however, rising patient loads and frequent interruptions hinder nurses' ability to deliver effective care, jeopardising patient safety. Addressing these inefficiencies is essential, given nurses' critical role in ensuring quality care. ⋯ Lean management effectively reduces waste and improves direct patient care time, enhancing patient safety and care quality. Continuous improvement initiatives in nursing practices are essential for success.
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The potential applications of large language models (LLMs)-a form of generative artificial intelligence (AI)-in medicine and health care are being increasingly explored by medical practitioners and health care researchers. ⋯ Accordingly, this paper finds a strong case for the incorporation of LLMs into clinical practice and, if their risk of patient harm is sufficiently mitigated, this incorporation might be ethically required, at least according to principlism.
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This article identifies and offers a response to several problems that affect the quality of both clinical education and health care services. These matters are: that in clinical training and practice, health, as lived by patients (persons), is not properly considered, and is equated reductively with treating diseases/disorders; that health is seen through disease, and as restricted to a single model defined by an organism's meeting (or being returned to) biochemical or functional standards; that intellectual assumptions instilled in schools of Medicine and Psychology about realities pertaining to healthcare determine an understanding of chronic illness or life with chronic challenges focused on impairment and suffering, and not on the fuller experience of living with illness, disability or neuropsychological challenges that patients have as persons; that arts-based education reflects the same focus in understanding 'illness', and thus neglects giving attention to the creation of personal health states of those living with challenging or debilitating long-term conditions; that, consequently, the arts are instrumentalized to serve these predefined educational purposes, rather than allowed to inform clinical training through that which is intrinsic or more specific to them. As a way out of these limitations and as an illustration of how things could be done differently, Vincent Van Gogh's paintings of the Sunflowers are used as visual inspiration for how we could change the way we see, and construct new mental representations of 'health', 'chronic illness' or 'chronic challenges', 'patient as person' or even 'person as non-patient', 'the clinician's role' and 'the identity of clinical practice'. Relying on Van Gogh's depictions of the sunflowers as an example and a visual basis, the article shows how characteristics typical to art (transformation, alternative generation, etc.) can be transferred into the perception and conceptualisation of clinically relevant realities, and discusses the benefits of these changes for 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.