Journal of evaluation in clinical practice
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To assess treatment patterns of statin and/or ezetimibe and possible statin intolerance among patients initiating statin or statin plus ezetimibe and with clinical atherosclerotic cardiovascular disease (ASCVD) or diabetes mellitus (DM) in Taiwan. ⋯ Large number of patients with either ASCVD or DM discontinued lipid-lowering therapies with suboptimal adherence and persistence among Taiwanese population. There is a large unmet medical need to provide safe and more effective therapies, which can be used in combination with statins or alone, to reduce the risk of CV events and improve outcomes in high-risk patients.
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Programmatic assessment has been identified as a system-oriented approach to achieving the multiple purposes for assessment within Competency-Based Medical Education (CBME, i.e., formative, summative, and program improvement). While there are well-established principles for designing and evaluating programs of assessment, few studies illustrate and critically interpret, what a system of programmatic assessment looks like in practice. This study aims to use systems thinking and the 'two communities' metaphor to interpret a model of programmatic assessment and to identify challenges and opportunities with operationalization. ⋯ The findings of this research suggest that program stakeholders can benefit from a systems perspective regarding how their assessment practices contribute to the efficacy of the system as a whole. Academic Advisors are well positioned to support educational development efforts focused on overcoming challenges with operationalizing programmatic assessment.
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To investigate diabetes outcomes by long-term trajectories of patients' care settings among diabetes patients with regular follow-up. ⋯ Diabetes patients who were persistently treated in generalized care settings had health outcomes comparable to those who were persistently treated in specialized care settings. However, for elderly and less stable patients, regular diabetes care in specialized care settings was preferable.
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Failure mode and effects analysis (FMEA) is a valuable reliability management tool that can preemptively identify the potential failures of a system and assess their causes and effects, thereby preventing them from occurring. The use of FMEA in the healthcare setting has become increasingly popular over the last decade, being applied to a multitude of different areas. The objective of this study is to review comprehensively the literature regarding the application of FMEA for healthcare risk analysis. ⋯ FMEA has high practicality for healthcare quality improvement and error reduction and has been prevalently employed to improve healthcare processes in hospitals. This research supports academics and practitioners in effectively adopting the FMEA tool to proactively reduce healthcare risks and increase patient safety, and provides an insight into its state-of-the-art.