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Being diagnosed with head and neck cancer has major impact on patients’ lives. Treatment is often invasive and interferes

This research evaluated the contribution of pharmacists in the emergency department and found that over 80% of pharmacist recommendations to initiate, cease, withhold, or change medication doses were adopted by emergency clinicians. While this retrospective study found no statistically significant difference in length of stay between older persons reviewed by the pharmacist and those who were not, exploration of staff perceptions highlighted the high value clinicians place on pharmacist review of patients presenting to the emergency department.

El objetivo de la presente investigación es identificar las percepciones individuales que tienen los responsables de la atención sanitaria sobre el concepto de generación de valor, con el propósito de proponer un mecanismo de alineación y medición orientado a la gestión del cuidado del paciente, mediante la aplicación de entrevistas semiestructuradas con un enfoque hermenéutico. La investigación tiene un sentido hermenéutico. Esto es, busca comprender el discurso de los entrevistados. La idea de esta metodología consiste en construir espirales hermenéuticas de posibles interpretaciones y apreciaciones de los documentos leídos y de las entrevistas realizadas. Para lograr el objetivo de la investigación se realizaron siete entrevistas semiestructuradas a los representantes de cada uno de los sectores involucrados en el proceso de atención al paciente: prestador, médicos, proveedor y pagador, aquellos encargados de las funciones de compras, negociación, finanzas y área comercial. Los hallazgos de las entrevistas fueron contratados usando como marco referencial el cuadro integral de mando. Con esta investigación se recolectaron los conocimientos individuales que existen sobre el concepto de generación de valor en la atención de la salud y posteriormente, a través de una comprensión y análisis, se ofreció un mecanismo de medición alineado a las expectativas de los involucrados. Finalmente, el documento proporciona recomendaciones para acelerar el cambio en los modelos de gestión sanitaria, donde proveedores de dispositivos médicos puedan tomar un rol protagonista y de compromiso en el proceso., The objective of the present investigation is to identify the individual perceptions that those responsible for health care have about the concept of value generation, with the purpose of proposing an alignment and measurement mechanism oriented to the management of patient care, through the application of semi-structured interviews with a hermeneutical approach. The research has a hermeneutical sense; that is, it seeks to understand the speech of the interviewees. The idea of this methodology is to build hermeneutical spirals of possible interpretations and appreciations of the documents read and the interviews carried out. To achieve the objective of the investigation, seven semi-structured interviews were conducted with the representatives of each of the sectors involved in the patient care process: provider, doctors, provider and payer, those in charge of purchasing, negotiation, finance and commercial area. The findings of the interviews were contracted using the Balance Scorecard Card as a reference framework. With this research, the individual knowledge that exists about the concept of generating value in health care was collected and subsequently, through an understanding and analysis, a measurement mechanism aligned to the expectations of those involved was offered. Finally, the document provides recommendations to accelerate the change in health management models, where medical device providers can take a leading role and commitment in the process.

Purpose: In the era of value-based healthcare, one strives for the most optimal outcomes and experiences from the perspective of the patient. So, patient experiences have become a key quality indicator for healthcare. While these are supposed to drive quality improvement (QI), their use and effectiveness for this purpose has been questioned. The aim of this systematic review was to provide insight into QI interventions used in a hospital setting and their effects on improving patient experiences, and possible barriers and promoters for QI work. Methods: Prisma guidelines were used to design this review. International academic literature was searched in Embase, Medline OvidSP, Web of Science, Cochrane Central, PubMed Publisher, Scopus, PsycInfo, and Google Scholar. In total, 3,289 studies were retrieved and independently screened by the first two authors for eligibility and methodological quality. Data was extracted on the study purpose, setting, design, targeted patient experience domains, QI strategies, results of QI, barriers, and promotors for QI. Results: Twenty-one pre–post intervention studies were included for review. The methodological quality of the included studies was assessed using a

Societies are plagued by growing healthcare expenditures and budgetary constraints. The strategy for solving the issue has been heavily debated, with proposed solutions such as Valuebased healthcare (VBHC), Public-Private Partnerships (PPP) and improved medical treatments. A novel concept that aims to improve medical treatment is strategic biobanking. Strategic biobanking is the act of saving biological samples and clinical data for future research. Access to strategic samples can speed up future clinical trials and studies, provide researchers with more useful research material, enable more thorough analyses of biomarkers, facilitate faster drug development, and increase the power of both retrospective analyses and precision medicine. This thesis studies the shared value effects of a strategic biobanking PPP by drawing on the theoretical fields of VBHC, PPP and Creating Shared Value (CSV). Specifically, the effects of hospital organisational structure, regulatory framework and public interest on strategic biobanking PPPs was studied. The research was carried out through a single holistic case study of Karolinska University Hospital in Stockholm, Sweden and multiple pharmaceutical companies, and data was collected through semi-structured interviews. Data analysis was carried out in accordance with the grounded theory framework. The researchers find that regulatory structure can limit the options when crafting the business model and the industry value proposition for a strategic biobanking PPP. Some strategies on how to deal with these restraints are outlined. Furthermore, the research highlights the importance of longitudinal data-sets and how a hospital organised according to the VBHC principles is more suitable for implementation of longitudinal sampling routines. Finally, the research shows that that the concept of CSV can act as guidance for private partner decision making to increase public interest. By adopting principles of transparency regarding financial in, Samhällen plågas av skenande sjukvårdskostnader och budgetåtstramningar. Vilken strategi som kan lösa problemet har debatterats flitigt. Lösningar så som Value-based Healthcare (VBHC), Public-Private Partnerships (PPPs) och mer avancerad vård har alla föreslagits som alternativ. Ett nytt koncept som ämnar att förbättra sjukvården är strategisk biobankning. Strategisk biobankning innebär att spara biologiska prover och klinisk data inför framtiden. Detta kan snabba på framtida kliniska prövningar och studier, förse forskare med mer användbart forskningsmaterial, möjliggöra mer grundliga analyser av biomarkörer, snabbare utveckling av mediciner, samt öka potensen hos både retrospektiva studier och precision medicine. Denna uppsats studerar gemensamma värdeeffekter hos ett PPP inom strategisk biobanking genom att använda sig av de teoretiska fälten VBHC, PPP och Creating Shared Value (CSV). Mer specifikt studeras hur PPP inom strategisk biobankning påverkas av sjukhusets organisationsstruktur, rådande regelverk och allmänintresse. Forskningen utfördes genom en enkel, holistisk, fallstudie av Karolinska Universitetssjukhuset i Stockholm, Sverige. Data samlades genom semi-strukturerade intervjuer och analyserades senare enligt ramverket för Grounded Theory. Forskarna finner även att rådande regelverk begränsar möjligheten för utveckling av affärsmodell och värdeerbjudande gentemot privata partners. Några strategier för att hantera dessa begränsningar tas upp i uppsatsen. Vidare belyses vikten av longitudinella dataset, och att ett sjukhus vars organisation är strukturerad enligt VBHC-principer är mer lämpligt för implementation av longitudinell provsamling. Slutligen finner forskarna att privata CSV-conceptet utgör bra vägledning för privata partners för att skapa allmänintresse. Genom att anamma principer som premierar transparans gentemot sina ekonomiska och strategiska incitament så kan förtroende byggas gentemot allmänheten. De gemensamma värdeeffekterna är tydliga

Purpose: In the era of value-based healthcare, one strives for the most optimal outcomes and experiences from the perspective of the patient. So, patient experiences have become a key quality indicator for healthcare. While these are supposed to drive quality improvement (QI), their use and effectiveness for this purpose has been questioned. The aim of this systematic review was to provide insight into QI interventions used in a hospital setting and their effects on improving patient experiences, and possible barriers and promoters for QI work. Methods: Prisma guidelines were used to design this review. International academic literature was searched in Embase, Medline OvidSP, Web of Science, Cochrane Central, PubMed Publisher, Scopus, PsycInfo, and Google Scholar. In total, 3,289 studies were retrieved and independently screened by the first two authors for eligibility and methodological quality. Data was extracted on the study purpose, setting, design, targeted patient experience domains, QI strategies, results of QI, barriers, and promotors for QI. Results: Twenty-one pre–post intervention studies were included for review. The methodological quality of the included studies was assessed using a Critical Appraisal Skills Program (CASP) Tool. QI strategies used were staff education, patient education, audit and feedback, clinician reminders, organizational change, and policy change. Twenty studies reported improvement in patient experience, 14 studies of the 21 included studies reported statistical significance. Most studies (n=17) reported data-related barriers (eg, questionnaire quality), professional, and/or organizational barriers (eg, skepticism among staff), and 14 studies mentioned specific promoters (eg, engaging staff and patients) for QI. Conclusions: Several patient experience domains are targeted for QI using diverse strategies and methodological approaches. Most studies reported at least one improvement and also barriers and promoters that may influence

In this paper, we present a method for the development and implementation of Value Based Care Pathways. The method is based on an integration of three existing care pathway development methods, the concepts of the Value Based Healthcare paradigm, and practical knowledge obtained from interviews with experts in care pathway development in practice. This paper furthermore presents an interactive toolbox that facilitates the use of the method in practice and an expert evaluation of the toolbox.

Commentary

Neue innovative Technologien bieten zahlreiche Möglichkeiten, die Qualität der Behandlung von Patienten und den Behandlungserfolg zu steigern [1]. Neue technologiebasierte Diagnosemethoden, wie z. B. die Computertomografie oder die Magnet-Resonanz-Tomografie ebneten den Weg zur frühzeitigen Erkennung kritischer Erkrankungen wie Krebs oder Durchblutungsstörungen. Die Einführung neuer Methoden und Technologien für die Behandlung akuter Erkrankungen reduzierte die Mortalität und verbesserte die Lebensqualität zahlloser Patienten [2]. Auf der anderen Seite stiegen die Gesundheitsausgaben im Vergleich zum Bruttosozialprodukt in nahezu allen Industrieländern [3]. Der Grund für diesen unverhältnismäßigen Anstieg liegt in der steigenden Lebenserwartung, einer durch den demografischen Wandel verursachten zunehmenden Anzahl an Patienten, häufiger auftretenden Langzeit- oder chronischen Erkrankungen und einer zunehmenden Spezialisierung der Medizin [4]. Als einer der bedeutendsten Treiber von steigenden Gesundheitsausgaben wird häufig die Entwicklung und Implementierung von innovativen Medizintechnologien genannt [5, 6, 7]. Als Resultat der Einführung neuer Technologien kann eine stetige Steigerung des Angebotes medizinischer Dienstleistungen beobachtet werden, was insbesondere bei Krankenhäusern Auswirkungen auf das erforderliche Budget hat. Krankenhäuser als wichtiger Bestandteil des Gesundheitssystems müssen sich dabei einer Reihe strategischer Herausforderungen stellen. Wie jedes andere Unternehmen müssen sie qualitativ hochwertige Dienstleistungen anbieten und gleichzeitig auf ihre Kosten achten. Die Adoption neuer Technologien ist notwendig, um mit anderen Krankenhäusern und Gesundheitsversorgern zu konkurrieren, gleichzeitig müssen sie aber auch mit schrumpfenden Investitions-Budgets und steigenden Kosten umgehen [8]. Im Verlauf dieses Beitrages werden zwei Konzepte näher beleuchtet, die helfen können, mit diesem Dilemma umzugehen. Zum einen wird ein Modell des Technolo