Bmc Health Serv Res
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Bmc Health Serv Res · Jun 2019
The migration-related language barrier and professional interpreter use in primary health care in Switzerland.
With increased international migration, language barriers are likely becoming more relevant in primary care. The aim of this study was to investigate the language barrier in paediatric and adult primary care, present its consequences, reveal how it is overcome, as well as highlight the use of and potential unmet needs for professional interpreters, using Switzerland as a case study. ⋯ Language barriers are relevant in primary care. Improved access to professional interpreters is warranted.
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Bmc Health Serv Res · Jun 2019
Process evaluation of specialist nurse implementation of a soft opt-out organ donation system in Wales.
Wales introduced a soft opt-out organ donation system on 1st December 2015 with the aim of improving consent rates. In the first 18 months consent rates improved but the difference could not solely be attributed to the soft opt-out system when compared with similar improvements in consent rates in other UK nations. ⋯ This is the first comprehensive process evaluation of implementing a soft opt-out system of organ donation. Specific elements of good implementation practice (such as investment in the retraining programme and the responsiveness of Specialist Nurses in Organ Donation and managers to feedback) were identified. The key message is that despite retraining, nursing practice did not radically change overnight to accommodate the new soft opt-out system. Policy makers and health service managers should not assume that nurses simply need more time to implement the soft-out as intended. Additional responsive modification of processes, ongoing training and support is required to help with implementation as originally intended. Scotland, England and the Netherlands are introducing soft opt-out systems. There is an opportunity to learn from initial implementation in Wales, by acknowledging gaps, good practice and opportunities to further improve processes and nursing practices.
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Bmc Health Serv Res · Jun 2019
Deployment of Critical Incident Reporting System (CIRS) in public Styrian hospitals: a five year perspective.
To increase patient safety, so-called Critical Incident Reporting Systems (CIRS) were implemented. For Austria, no data are available on how CIRS is used within a healthcare facility. Therefore, the aim of this study was to present the development of CIRS within one of the biggest hospital providers in Austria. ⋯ In summary, CIRS has been used for 5 years and 2.504 CIRS-cases were reported. There is a steady increase of reported CIRS cases per year. It became also obvious that disregarding guidelines or standards are a very common reason for reporting a CIRS case. CIRS can be regarded as a helpful supportive tool in clinical risk management and supports organizational learning and thereby collective knowledge management.
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Bmc Health Serv Res · Jun 2019
Effectiveness of Medicare cost-sharing elimination for Cancer screening on utilization.
The Patient Protection and Affordable Care Act (ACA) eliminated the cost-sharing requirement for several preventive cancer screenings. This study examined the cancer screening utilization of mammogram, Pap smear and colonoscopy in Medicare fee-for-service (FFS) under the ACA. ⋯ Removing out-of-pocket costs for screenings did not provide enough incentives to increase the screening rates among Medicare beneficiaries.
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Bmc Health Serv Res · Jun 2019
Multicenter StudyPediatric urgent care education: a survey-based needs assessment.
There is an increasing number of pediatric urgent care centers that are largely staffed by pediatric residency graduates. It is unclear if pediatric residency adequately prepares a physician to fully and successfully provide care in an urgent care setting. The goal of this study is to conduct an assessment of urgent care directors' perceptions of recent pediatric residency graduates' preparedness to successfully provide pediatric urgent care after graduation. ⋯ Despite the growing number pediatric residency graduates staffing pediatric urgent care centers, the majority of surveyed pediatric emergency medicine division chiefs and pediatric urgent care directors do not think that pediatric residency adequately prepares graduates to successfully provide urgent care to pediatric patients. We recommend further exploration of gaps in knowledge of recent pediatric residency graduates as a next step towards developing systems for further training for pediatric residency graduates to gain competency in urgent care management.