My work focuses on health research methodology and health services research. I am particularly interested in patient-centered outcomes through the methods of synthesizing, evaluating, testing, and implementing the best available evidence about interventions in practice to deliver sustainable and effective healthcare. My goal is to help in reshaping healthcare to one that pursues the goals of the patients using the best available evidence and shared decision approaches guided by the expertise of clinicians and researchers while minimizing the footprint and burden of illness and treatment on patients, their caregivers, clinicians, and the healthcare system. To help achieving this goal, I have worked and developed expertise in rigorously evaluating …show more content…
I present MDM as a cutting-edge and novel model of care that takes in consideration the needs and values of the patients while delivering the best available evidence as guided by the expertise of clinicians to minimize the burden of disease and treatment, and the footprint of healthcare on patients, their caregivers, clinicians, and healthcare systems (Abu Dabrh and Gallacher 2015).8 MDM focuses on finding best approaches that increase capacity (i.e. abilities/resources) and decrease the workload (i.e. demands) that patients shoulder while taking care of themselves. These approaches, for example, include SDM, resiliency training, coaching, patient engagement, and/or de-prescribing or simplifying treatment regimens, as a few examples. Building on this work, I collaborated with a team of researchers and clinicians from Peru, and looked into resilience as a construct that supports patient capacity. We summarized the evidence about the impact of resiliency training on vulnerable populations with type 2 diabetes mellitus and hypertension.9 In the ongoing MDM projects, I am using methods of behavioral and social (qualitative) science research like surveys, data coding and analysis to understand patient capacity and workload. That will provide insight on how capacity and workload imbalance might hinder the effectiveness of the care provided to patients in clinical practice, and how that imbalance increase nonadherence to treatments and worsens
As our health care system continues to evolve and become more focused on a preventive and coordinated approach to patient care, we too must progress and create programs that follow such principles. The Patient-Centered Medical Home (PCMH) model follows similar ideologies and recently has gained increasing support. The patient’s primary care physician, who will provide preventive and continuing care for the patient, directs this medical model. The PCMH model of care is comprised of a health care team working together to serve their patient and provide quality care.1 The model works to empower the patient by promoting communication with not only the physician but with the nursing staff, specialists, and other health care providers. Every patient
West, S. L., & O'Neal, K. K. (2004). Project D.A.R.E. outcome effectiveness revisited. American Journal of Public Health. doi:10.2105/AJPH.94.6.1027
Through the appropriate educating of healthcare professionals in preventative and coping measures towards stress, communication is improved as well as worker self-awareness, allowing for increased patient care and safety (Pipe et al., 2011). This is often achieved through workplace seminars and/or general employee availability to workplace counsellors, promoting risk awareness and planning and preparation (Castleden, McKee, Murray, & Leonardi, 2011), allowing for the self-management of psychological health in events of shock and trauma. Training in resilience also promotes problem solving and persistence through encouraged self-reflection (Chen & 陳季員, 2011), characteristics crucial in the support of patient health. By self-reflecting, healthcare can recognise and solve psychological factors that may be inhibiting their work and/or their balance of their life outside of work. One example could be a nurse that has recently had a family member diagnosed with cancer, and as a result they had been neglecting regular clinical observations with one of their chemotherapy patients. Through the utilisation of resilient problem solving, the nurse is able to ask to swap patients with a co-worker, until they feel capable to professionally interact with the patient. Resilient responses, however , are not entirely fixed in consistency; they are often dictated by environment and resources (e.g. family members available, general physical health) and as a result of this subjective processing, responses will vary between patients (Southwick, 2011). This individual maintenance of resilience as a personal quality further justifies healthcare workers trained in effective coping mechanisms in order to provide an unbiased environment for unrestricted, unique, positive psychological responses. Overall, the
When performing evidence based practice research, the Iowa Model uses a team or individual approach to assist nurses in the journey to quality care. The Iowa Model begins by offering a process of selecting a proper clinical topic, which is often a recurring problematic issue (Polit & Beck, 2012). This topic is formulated as a question to improve a technique or procedure. Once the researcher determines that an ample amount of reported investigation exists on the desired question, information may be gathered and presented for approval (Polit & Beck, 2012). The research may lead to a gradual change in nursing practice.
According to the Healthy People Database, in 2010 the aging population was estimated at 40 million, this number is expected rise to nearly 70 million by the year 2030 (National Center for Health Statistics, 2000). At the forefront of health concerns for this aging population will be the intervention, management and treatment of chronic diseases. This increase in both this specific population as well as the required medical care will place a significant amount of stress on an already distressed healthcare system, which in turn will affect the availability of recourses and costs. Including patients in their self care with strategic health promotion such as encouragement and education geared towards specific socioeconomic groups will be more cost effective and beneficial in the management of chronic disease. Studies indicate that patients involved in self management of disease processes often have better patient outcomes.
Resilience is an individual’s ability to properly recover from stress or adversity. It is the process of adapting well in the face of trauma, tragedy or threats coming from many sources including family and relationship problems, health issues and workplace or financial stressors. This essay shows the concept of resilience from the perspective of the consumer and health care professional. Working in healthcare is stressful, and it takes a toll a persons physical, emotional and mental levels. To effectively care for others, you must be able to care for yourself, showing resilience.
To conclude this essay, the writer has established that there is lots of information available to suggest that evidence based practice is an important tool and plays a vital role within all elements of a healthcare setting.
The ignorance of available research evidence, health care delivery loses opportunity to provide benefit to the patients and may harm significantly (Dawes et al 2005). Therefore, health care professionals are now adopting new innovative evidence based practices in addition to traditional practices. Moreover, evidence based practice (EBP) is rapidly gaining popularity because of its ability to manage clinical issues and deliver effective patient care (Majid et al 2011). EBP is the conscientious amalgamation of best research knowledge with clinician’s expertise and patient values and requirements in the delivery of better health care (Burns and Grove 2009: 16). Florence Nightingale initiated EBP in nursing practice since 150 years back (Burns and Grove 2009: 16) and it is “essential for nurses to establish who they are, what they do, and what effect they have on patient outcomes” (Richardson, Miller and Potter 2002: 44). Historically, knowledge gained from medical colleges, peer interaction and preferences of medical providers were driven nurses for clinical decision making (McKnight 2006). Knowledge is one of the dimensions for implementing EBP (Shaneyfelt et al. 2006) therefore, evidence based knowledge required to be transferred for the improvement of patient outcomes.
Evidence-based practice is important to consider when researching for interventions, further knowledge, or help to guide a new idea in the health professions. Evidence-based practice is comprised of three significant concepts: respect and awareness for the targeted population’s values, previous clinical practice or experience with that population, and systematic research to establish a better understanding of what is already known about the study’s focus. These concepts are all taken into consideration when designing and conducting a study because it provides a more valid and credible source for others.
Evidence-based practice integrates best current evidence with clinical expertise and patient/family preferences and values for the delivery of optimal health care (qsen.org). Like most medical professions, nursing is a constantly changing field. With new studies being done and as we learn more about different diseases it is crucial for the nurse to continue to learn even after becoming an RN. Using evidence-based practice methods are a great way for nurses and other medical professionals learn new information and to stay up to date on new ways to practice that can be used to better assess
As health care professionals we strive to provide the best care that we can daily. But what drives the care that we give? Where do the protocol stem from? How do we know that we are using the best practice to give care to patients? We know through evidence base practice and evidence based management. We then need to use the knowledge that we gain to develop Innovative Care Delivery models to bring about changes for the betterment of the patient, and to help us provide the best patient centered care possible.
Tunis S., Stryer D., Clancy C. Increasing the Value of Clinical Research for Decision Making in Clinical and Health Policy. JAMA. 2003;290(12): 1624-1632
Research in multidisciplinary public health can be challenging. There can be serious tension generated among the participants in the research process concerning which approaches are best suitable for the research. Also, the choice of methods to be considered from a compendium of methods that best suits a study could be a herculean task to overcome owing to the differences in the interests and views of the various disciplines involved in public health research (Saks, 2013). This could result in a pyramid of research approaches where an approach is seen by professionals as more scientific and more relevant to public health than others. Research approaches have been observed in the past to have a vertical relationship with each other. In today’s multidisciplinary public health, there is a need to consider them as a spectrum having a horizontal rather than a vertical relationship. This could present a challenge to a new researcher in the field who does not know all the approaches are available and the best applicable to a study. Also, the experienced researcher who already has a particular approach of preference and considers others as inferior may not be applying the best approach available to a study owing to this bias. There is a need for researchers in public heath to be dexterous in research methodology by moving beyond the limits of one’s discipline and gaining skills in a spectrum of approaches available and probably use a blend of methods so as to effectively conduct research (Daly, 1997). As such, I will be discussing Ethnography and Participatory Action research approaches relevant to multidisciplinary public health. I will examine their theoretical and epistemological basis and reflect on their strengths and weaknesses.
In health care, evidence-based research is crucial. Nurses revolve their practice on evidence so that they may provide the best health care. Without research, there would be no evidence to prove health care related findings (Shmidt & Brown, 2012). With appropriate
Walshe,K. & Rundall,T. 2001, Evidence based management:From theory to practice in health care ,Milbank Quarterly, Vol.79, PP.429-457