Journal of evaluation in clinical practice
-
Multicenter Study
Empathy and burnout: A multicentre comparative study between residents and specialists.
The prevalence of burnout among medical doctors and its negative effect on empathy can influence therapeutic success. The aim of this study was to compare the levels of empathy and burnout between residents and specialists as well as to study the correlation between empathy and burnout. ⋯ Our findings suggest that there is a significant difference in burnout subscales scores between residents and specialists and that these have a negative correlation with empathy level. These exploratory results draw attention to the importance of preventing burnout in hospital and health care centres professionals, in particular in residents, through the implementation of individual and organizational structured measures.
-
We strive to maximize outcomes that are relevant to the women who deliver in our hospital. We demonstrate a practical method of using value-based health care (VBHC) concepts to analyse how care can be improved. ⋯ Defining, measuring, and comparing relevant outcomes enable care providers to identify improvements. Collection and comparison of readily available data can provide insights in where care can be improved. Insights from literature and comparison of care practices and processes can lead to how care can be improved. Continuous monitoring of outcomes and expanding the set of outcomes that is readily available are key in the process towards value-based care provision.
-
The majority of hospitalized nonsurgical medical patients receive pharmacological prophylaxis for venous thromboembolism (VTE), and reassessment of changes in thrombosis and bleeding risk factors during hospital admission may represent an opportunity to discontinue unnecessary or unsafe therapy. The use of validated, clinically derived risk assessment models (RAMs) represents a shift towards an individualized, patient-centred approach to VTE prophylaxis. We are interested in using these tools to assess whether risk categories for VTE and bleeding change during admission and to assess whether such changes result in discontinuation of prophylaxis. Our primary objective was to determine whether VTE and bleed risk categories changed during the course of admission to warrant discontinuation of VTE prophylaxis, using the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE) VTE and Bleed RAMs, respectively. Secondary objectives were to determine the number of patients whose risk categorizations for VTE and bleeding warranted discontinuation of VTE prophylaxis and to survey whether prophylaxis was continued or discontinued. ⋯ Risk categories for VTE and bleeding for medical patients did not appreciably change throughout hospital admission. Use of VTE RAMs at admission and prior to initiation of therapy should reduce unnecessary prophylaxis in the majority of medical patients who are at low risk of VTE.
-
Multiple outcomes measures including exercise capacity and quality of life are necessary to get complete and accurate picture of cystic fibrosis (CF) progression. In this pilot study, we investigated these measures in CF longitudinally for a year to determine (a) minimal clinically important difference (MCID) for 6-minute walk distance (6MWD) and CF Health-Related Quality of Life Questionnaire (CFQ-R) domains and (b) how 6MWD, CFQ-R, and spirometry change during times of exacerbation and baseline health and their relationship among each other. ⋯ In this pilot study, MCIDs for 6MWD and CFQ-R domains were calculated for the first time to facilitate their use as additional outcome measures in CF. The disparity among multiple outcome measures highlights that these measures together may provide a more complete picture in CF than any single measure alone.
-
Secondary care pharmacists are well positioned within the healthcare system to communicate with patients and provide guidance and advice regarding drug treatments. They are able to broaden the opportunities to raise the profile of Clinical Trials of Investigational Medicinal Products (CTIMPs) and positively influence research. This research aimed to investigate the perceived benefits and barriers of secondary care pharmacists being involved in CTIMPs, their current role, and the perceived benefits and barriers of developing their role in facilitating patient participation for CTIMPs (eg, by identifying or recruiting potential participants). ⋯ Most respondents do not currently have a role in identifying or recruiting potential participants. Despite this, being involved in CTIMPs and the facilitation of patient participation was suggested to offer several benefits. Given many participants agreed there are barriers to their involvement, future research should focus on exploring organizational and individual challenges with the aim of enabling pharmacists to support recruitment activities.