May 2020, Volume XXXIV, Number 2
Implementation science
The systematic uptake of change
According to Martin Eccles and Brian Mittman in their introduction to the new journal Implementation Science in 2006, implementation science is “the scientific study of methods to promote the systematic uptake of research findings and other evidence-based practices into routine practice, and, hence, to improve the quality and effectiveness of health services.”
May 2020, Volume XXXIV, Number 2
interview
Preserving independent practice
Owen O’Neill, MD
Infinite Health Collaborative
Implementation science: The systematic uptake of change
By Hildi Hagedorn, PhD, LP
According to Martin Eccles and Brian Mittman in their introduction to the new journal Implementation Science in 2006, implementation science is “the scientific study of methods to promote the systematic uptake of research findings and other evidence-based practices into routine practice, and, hence, to improve the quality and effectiveness of health services.”
cover story two
Diagnostic accuracy: A dose of insight
By Robert Hanscom, JD; Maryann Small, MBA; and Ann Lambrecht, RN, BSN, JD, FASHRM
Nearly 84% of adults and 93% of children will have contact with a health care professional each year in the United States. (See https://tinyurl.com/mp-stats.) These patients and their caregivers are ultimately asking for two things—an accurate diagnosis and an appropriate treatment plan. While arriving at a timely and accurate diagnosis for every single patient may not always be possible, it is always the goal.
Patient Communications
Sharing a life-threatening diagnosis with children: Developing best practices
By Vaida Kazlauskaite, MS, LAMFT; Tai Mendenhall, Ph.D., LMFT; and Kirby Clark, MD
Disclosing a cancer diagnosis is likely one of the hardest conversations that a parent ever has to have with their child. Many are unsure about how, when, and how much to tell their children. Worries about inducing fear, anxiety, and sadness in children lead many parents to keep their diagnosis a secret altogether. The following is a summary of what we know from extant (albeit limited) research, alongside a call-to-action for providers and scholars to further develop best practices for this critical life event.
Targeted drug delivery: Feedback from patients
By David Schultz, MD
Nura Pain Clinic manages approximately 650 Minnesota patients who have had a “pain pump” (Medtronic Synchromed II or Flowonix Prometra) implanted and/or re-implanted for Targeted Drug Delivery (TDD) at some time over the past 25 years. We have long believed that opioids targeted to the spinal cord are far preferable to systemic opioids targeted to the brain when treating complex chronic pain that has failed to respond to all other treatments. With the opioid crisis raging across the country, our preference for spinal over systemic opioids has only been reinforced.
Professional Liability
Medical directorships: Due diligence prior to accepting an offer
By Antonio “Tony” Fricano, JD
The licensure requirement to practice medicine acts as an entry barrier to prevent individuals from performing tasks that our regulators deem to require a certain level of knowledge, skill, and medical training. While some business-minded individuals and entrepreneurs in nonclinical settings might see this requirement simply as a box that needs to be checked, it is more than that. This issue has been a serious one in the medical spa industry for some time, and it will take on added significance in the coming year within the assisted living space as the focus on clinical services in facilities expands.
Addressing patient stress during a pandemic: How physicians can help
By Todd Archbold, LSW, MBA
Finding ways to balance the physical risks and emotional distress caused by COVID-19 is important for both health care personnel and patients. The mental health needs of entire communities are on the rise. The best practices that we are promoting to keep people safe from the virus are completely contrary to the practices we rely on to stay mentally well and emotionally resilient. “Social distancing,” the pillar of these efforts, has led to fear and isolation for many people.
Health care facility design: Lessons learned from the pandemic
By Mike McMahan and Alena Sakalouski Johnson, AIA, ACHA
Multiple factors, including internal dynamics and outside forces, have in recent years created a tipping point in the health care industry. The Affordable Care Act, private equity, tax reform, payer disruptions, new health care industry entrants, and skilled worker shortages have created new challenges for health organizations across the United States.
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