Base de dados : MEDLINE
Pesquisa : N02.278.216.500.990 [Categoria DeCS]
Referências encontradas : 2147 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 215 ir para página                         

  1 / 2147 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28599190
[Au] Autor:Hershenfeld SA; Maki K; Rothfels L; Murray CS; Nixon S; Schimmer AD; Doherty MC
[Ad] Endereço:Princess Margaret Cancer Center, University Health Network, 610 University Ave, Toronto, Ontario, Canada M5G 2M9.
[Ti] Título:Sharing post-AML consolidation supportive therapy with local centers reduces patient travel burden without compromising outcomes.
[So] Source:Leuk Res;59:93-96, 2017 Aug.
[Is] ISSN:1873-5835
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Acute myeloid leukemia (AML) is frequently treated with induction and consolidation chemotherapy. Consolidation chemotherapy can be delivered on an ambulatory basis, requiring some patients to travel long distances for treatment at specialized centers. We developed a shared care model where patients receive consolidation chemotherapy at a quaternary center, but post-consolidation supportive care at local hospitals. To evaluate the impact of our model on patient travel and outcomes we conducted a retrospective analysis of AML and acute promyelocytic leukemia patients receiving consolidation over four years at our quaternary center. 73 patients received post-consolidation care locally, and 344 at the quaternary center. Gender, age and cytogenetic risk did not significantly differ between groups. Shared care patients saved mean round trip distance of 146.5km±99.6 and time of 96.7min±63.4 compared to travelling to quaternary center. There was no significant difference in overall survival between groups, and no increased hazard of death for shared care patients. 30, 60, and 90day survival from start of consolidation was 98.6%, 97.2%, and 95.9% for shared care and 98.8%, 97.1%, and 95.3% for quaternary center patients. Thus, a model utilizing regional partnerships for AML post-consolidation care reduces travel burden while maintaining safety.
[Mh] Termos MeSH primário: Centros Comunitários de Saúde
Quimioterapia de Consolidação/métodos
Serviços Hospitalares Compartilhados/normas
Leucemia Mieloide Aguda/terapia
Viagem
[Mh] Termos MeSH secundário: Centros Comunitários de Saúde/economia
Centros Comunitários de Saúde/utilização
Quimioterapia de Consolidação/economia
Quimioterapia de Consolidação/mortalidade
Serviços Hospitalares Compartilhados/economia
Seres Humanos
Leucemia Mieloide Aguda/mortalidade
Estudos Retrospectivos
Taxa de Sobrevida
Viagem/economia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170610
[St] Status:MEDLINE


  2 / 2147 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:27119396
[Au] Autor:Kennewell S; Baker L
[Ad] Endereço:Nutrition and Dietetics, Sydney Local Health District, Sydney, Australia.
[Ti] Título:Benefits and risks of shared services in healthcare.
[So] Source:J Health Organ Manag;30(3):441-56, 2016 May 16.
[Is] ISSN:1758-7247
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Purpose - The purpose of this paper is to explore the experiences of staff in a large, public health service involved in transitioning support services to a shared services model. It aims to understand their perceptions of the benefits and risks arising from this change. Design/methodology/approach - Thematic analysis of qualitative data from semi-structured interviews with both service provider and customer agency staff was used to identify, analyze and report patterns of benefits and risks within data. Findings - Staff expressed the need for relevant subject-matter-experts to work within customer agencies to facilitate effective communication between the customer agency and shared services provider, reflecting observations found in out-sourcing literature. Research limitations/implications - Results point to significant challenges continuing to occur for shared services in healthcare. Risks identified suggest a more intimate relationship between clinical and support services than previously discussed. Originality/value - Previous discussion of the shared services model has not considered the skills, knowledge and ability required by staff in the customer agency. This research indicates that in the absence of such consideration, the concepts of the shared services model are weakened.
[Mh] Termos MeSH primário: Serviços Hospitalares Compartilhados
Medição de Risco
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Entrevistas como Assunto
Masculino
Pesquisa Qualitativa
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170612
[Lr] Data última revisão:
170612
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:160428
[St] Status:MEDLINE
[do] DOI:10.1108/JHOM-03-2014-0044


  3 / 2147 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:26667212
[Au] Autor:McGinley KF; Sun X; Howard LE; Aronson WJ; Terris MK; Kane CJ; Amling CL; Cooperberg MR; Freedland SJ
[Ad] Endereço:Division of Urology, Department of Surgery, Duke University, Durham, North Carolina, USA.
[Ti] Título:Utilization and impact of surgical technique on the performance of pelvic lymph node dissection at radical prostatectomy: Results from the Shared Equal Access Regional Cancer Hospital database.
[So] Source:Int J Urol;23(3):241-6, 2016 Mar.
[Is] ISSN:1442-2042
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate performance of pelvic lymph node dissection during radical prostatectomy within an equal access care setting over a period of time, and stratified by prostate cancer risk group and surgical technique. METHODS: We identified men in the Shared Equal Access Regional Cancer Hospital database who had open or robotic-assisted radical prostatectomy from 2006 to 2013. Univariable logistic regression was used to test the association between age, race, body mass index, total biopsy cores, number of positive biopsy cores, risk group, year, center, surgical volume and surgical technique on pelvic lymph node dissection use. Multivariable logistic analysis was used to examine surgical technique and pelvic lymph node dissection performance. Spearman's correlation examined temporal changes in pelvic lymph node dissection utilization stratified by risk group and surgical technique. RESULTS: A total of 1425 men met inclusion criteria; 67% of them underwent pelvic lymph node dissection. On multivariable analysis, robotic-assisted radical prostatectomy was associated with an 92% decreased use of pelvic lymph node dissection in low-risk, 84% decreased in intermediate-risk and 91% decreased in high-risk men (all P < 0.001). In robotic-assisted radical prostatectomy, there was a trend for increased pelvic lymph node dissection utilization over time in high-risk men (Spearman; P = 0.077) reaching ~85% in 2012-2013, which was accompanied by increased use in low-risk men (P = 0.016). For open radical prostatectomy, fewer pelvic lymph node dissections were carried out in low-risk men over time, decreasing to ~35% (P = 0.047) in 2012-2013, whereas rates remained high for high-risk men throughout (~95%; P = 0.621). CONCLUSION: Regardless of risk group, pelvic lymph node dissection is carried out significantly less during robotic-assisted radical prostatectomy. For robotic-assisted radical prostatectomy, pelvic lymph node dissection utilization increased over time for high-risk men, but rates also increased for low-risk men. Further attention to the discrepancy between provided and guideline recommended pelvic lymph node dissection performance is required to improve prostate cancer care.
[Mh] Termos MeSH primário: Excisão de Linfonodo/métodos
Excisão de Linfonodo/utilização
Pelve/cirurgia
Prostatectomia/métodos
Neoplasias da Próstata/cirurgia
Procedimentos Cirúrgicos Robóticos/métodos
[Mh] Termos MeSH secundário: Idoso
Institutos de Câncer/estatística & dados numéricos
Bases de Dados Factuais
Serviços Hospitalares Compartilhados
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Guias de Prática Clínica como Assunto
Neoplasias da Próstata/patologia
Estudos Retrospectivos
Fatores de Risco
Estados Unidos
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151216
[St] Status:MEDLINE
[do] DOI:10.1111/iju.13027


  4 / 2147 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:26619028
[Au] Autor:Meyer J; Paré G
[Ad] Endereço:From the Department of Information Technology, HEC Montréal, Montreal, Quebec, Canada.
[Ti] Título:Telepathology Impacts and Implementation Challenges: A Scoping Review.
[So] Source:Arch Pathol Lab Med;139(12):1550-7, 2015 Dec.
[Is] ISSN:1543-2165
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CONTEXT: Telepathology is a particular form of telemedicine that fundamentally alters the way pathology services are delivered. Prior reviews in this area have mostly focused on 2 themes, namely technical feasibility issues and diagnosis accuracy. OBJECTIVES: To synthesize the literature on telepathology implementation challenges and broader organizational and societal impacts and to propose a research agenda to guide future efforts in this domain. DATA SOURCES: Two complementary databases were systematically searched: MEDLINE (PubMed) and ABI/INFORM (ProQuest). Peer-reviewed articles and conference proceedings were considered. The final sample consisted of 159 papers published between 1992 and 2013. CONCLUSIONS: This review highlights the diversity of telepathology networks and the importance of considering these distinctions when interpreting research findings. Various network structures are associated with different benefits. Although the dominant rationale in single-site projects is financial, larger centralized and decentralized telepathology networks are targeting a more diverse set of benefits, including extending access to pathology to a whole region, achieving substantial economies of scale in workforce and equipment, and improving quality by standardizing care. Importantly, our synthesis reveals that the nature and scale of encountered implementation challenges also varies depending on the network structure. In smaller telepathology networks, organizational concerns are less prominent, and implementers are more focused on usability issues. As the network scope widens, organizational and legal issues gain prominence.
[Mh] Termos MeSH primário: Redes de Comunicação de Computadores/organização & administração
Telepatologia
[Mh] Termos MeSH secundário: Serviços Hospitalares Compartilhados/organização & administração
Seres Humanos
Telepatologia/organização & administração
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1605
[Cu] Atualização por classe:151201
[Lr] Data última revisão:
151201
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:151201
[St] Status:MEDLINE
[do] DOI:10.5858/arpa.2014-0606-RA


  5 / 2147 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:26614882
[Au] Autor:Vest JR; Jung HY; Ostrovsky A; Das LT; McGinty GB
[Ad] Endereço:Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, New York. Electronic address: joshvest@iu.edu.
[Ti] Título:Image Sharing Technologies and Reduction of Imaging Utilization: A Systematic Review and Meta-analysis.
[So] Source:J Am Coll Radiol;12(12 Pt B):1371-1379.e3, 2015 Dec.
[Is] ISSN:1558-349X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Image sharing technologies may reduce unneeded imaging by improving provider access to imaging information. A systematic review and meta-analysis were conducted to summarize the impact of image sharing technologies on patient imaging utilization. METHODS: Quantitative evaluations of the effects of PACS, regional image exchange networks, interoperable electronic heath records, tools for importing physical media, and health information exchange systems on utilization were identified through a systematic review of the published and gray English-language literature (2004-2014). Outcomes, standard effect sizes (ESs), settings, technology, populations, and risk of bias were abstracted from each study. The impact of image sharing technologies was summarized with random-effects meta-analysis and meta-regression models. RESULTS: A total of 17 articles were included in the review, with a total of 42 different studies. Image sharing technology was associated with a significant decrease in repeat imaging (pooled effect size [ES] = -0.17; 95% confidence interval [CI] = [-0.25, -0.09]; P < .001). However, image sharing technology was associated with a significant increase in any imaging utilization (pooled ES = 0.20; 95% CI = [0.07, 0.32]; P = .002). For all outcomes combined, image sharing technology was not associated with utilization. Most studies were at risk for bias. CONCLUSIONS: Image sharing technology was associated with reductions in repeat and unnecessary imaging, in both the overall literature and the most-rigorous studies. Stronger evidence is needed to further explore the role of specific technologies and their potential impact on various modalities, patient populations, and settings.
[Mh] Termos MeSH primário: Diagnóstico por Imagem/utilização
Eficiência Organizacional/estatística & dados numéricos
Registros Eletrônicos de Saúde/utilização
Uso Excessivo de Produtos e Serviços de Saúde/prevenção & controle
Uso Excessivo de Produtos e Serviços de Saúde/estatística & dados numéricos
Sistemas de Informação em Radiologia/utilização
[Mh] Termos MeSH secundário: Serviços Hospitalares Compartilhados/utilização
Internacionalidade
Revisão da Utilização de Recursos de Saúde
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Em] Mês de entrada:1609
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151129
[St] Status:MEDLINE


  6 / 2147 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:26556934
[Au] Autor:Mitchell K; Halse T; Kohlerschmidt D; Bennett T; Vanner C; King E; Musser K; Escuyer V
[Ad] Endereço:New York State Department of Health, Wadsworth Center, Albany, NY.
[Ti] Título:A Model of Shared Mycobacteriology Testing Services: Lessons Learned.
[So] Source:Public Health Rep;130(6):623-31, 2015 Nov-Dec.
[Is] ISSN:1468-2877
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The need for public health laboratories (PHLs) to prioritize resources has led to increased interest in sharing diagnostic services. To address this concept for tuberculosis (TB) testing, the New York State Department of Health Wadsworth Center and the Rhode Island State Health Laboratories assessed the feasibility of shared services for the detection and characterization of Mycobacterium tuberculosis complex (MTBC). METHODS: We assessed multiple aspects of shared services including shipping, testing, reporting, and cost. Rhode Island State Health Laboratories shipped MTBC-positive specimens and isolates to Wadsworth Center. Average turnaround times were calculated and cost analysis was performed. RESULTS: Testing turnaround times were similar at both PHLs; however, the availability of conventional drug susceptibility testing (DST) results for Rhode Island primary specimens and isolates were extended by approximately four days of shipping time. An extended molecular testing panel was performed on every specimen submitted from Rhode Island State Health Laboratories to Wadsworth Center, and the total cost per specimen at Wadsworth Center was $177.12 less than at Rhode Island State Health Laboratories, plus shipping. Following a mid-study review, Wadsworth Center provided testing turnaround times for detection (same day), species determination of MTBC (same day), and molecular DST (2.5 days). CONCLUSION: The collaboration between Wadsworth Center and Rhode Island State Health Laboratories to assess shared services of TB testing highlighted a successful model that may serve as a guideline for other PHLs. The provision of additional rapid testing at a lower cost demonstrated in this study could potentially improve patient management and result in significant cost and resource savings if used in similar models across the country.
[Mh] Termos MeSH primário: Serviços Hospitalares Compartilhados/economia
Laboratórios/economia
Fenômenos Microbiológicos
[Mh] Termos MeSH secundário: Técnicas Bacteriológicas
Custos e Análise de Custo
Eficiência
Estudos de Viabilidade
Mycobacterium tuberculosis/isolamento & purificação
Micologia
New York
Rhode Island
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, U.S. GOV'T, P.H.S.
[Em] Mês de entrada:1602
[Cu] Atualização por classe:170214
[Lr] Data última revisão:
170214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:151112
[St] Status:MEDLINE


  7 / 2147 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:26521635
[Au] Autor:Brokloff M; McDermott P; Hegwer LR
[Ti] Título:How Sutter Health Built a Shared Services Organization Focused on the Future.
[So] Source:Revenue-cycle Strateg;12(7):1-4, 2015 Sep.
[Is] ISSN:1549-0858
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Administração Hospitalar
Serviços Hospitalares Compartilhados/organização & administração
[Mh] Termos MeSH secundário: California
Competição Econômica
Modelos Organizacionais
Estudos de Casos Organizacionais
Objetivos Organizacionais
Qualidade da Assistência à Saúde
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1512
[Cu] Atualização por classe:151102
[Lr] Data última revisão:
151102
[Sb] Subgrupo de revista:H
[Da] Data de entrada para processamento:151103
[St] Status:MEDLINE


  8 / 2147 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:26402267
[Au] Autor:Fletcher L
[Ad] Endereço:Linda Fletcher, BSN, RN Richland, MI.
[Ti] Título:Magnet Collaboration.
[So] Source:Am J Nurs;115(10):12, 2015 Oct.
[Is] ISSN:1538-7488
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Comportamento Cooperativo
Serviços Hospitalares Compartilhados/organização & administração
Relações Interinstitucionais
Serviço Hospitalar de Enfermagem/organização & administração
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:LETTER
[Em] Mês de entrada:1512
[Cu] Atualização por classe:150925
[Lr] Data última revisão:
150925
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:150925
[St] Status:MEDLINE
[do] DOI:10.1097/01.NAJ.0000471920.79967.58


  9 / 2147 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:26402266
[Au] Autor:Elliott J
[Ad] Endereço:Jana Elliott, BSN, RN Reno, NV.
[Ti] Título:Magnet Collaboration.
[So] Source:Am J Nurs;115(10):12, 2015 Oct.
[Is] ISSN:1538-7488
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Benchmarking/organização & administração
Serviços Hospitalares Compartilhados/organização & administração
Pesquisa em Enfermagem/organização & administração
Recursos Humanos de Enfermagem no Hospital/organização & administração
Supervisão de Enfermagem/normas
Garantia da Qualidade dos Cuidados de Saúde/organização & administração
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:COMMENT; LETTER
[Em] Mês de entrada:1512
[Cu] Atualização por classe:150925
[Lr] Data última revisão:
150925
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:150925
[St] Status:MEDLINE
[do] DOI:10.1097/01.NAJ.0000471919.79967.d5


  10 / 2147 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:26110956
[Au] Autor:Centrella-Nigro AM; Faber K; Wiklinski B; Bognar L; Flynn DL; LaForgia M
[Ad] Endereço:Andrea Marie Centrella-Nigro is an evidence-based practice research specialist at Holy Name Medical Center in Teaneck, NJ, and assistant professor of nursing at Ramapo College of New Jersey in Mahwah. Kathy Faber is a clinical nurse leader at St. Joseph's Regional Medical Center in Paterson, NJ. Barbara Wiklinski is a professional practice educator at Englewood Hospital and Medical Center in Englewood, NJ. Lora Bognar is director, clinical partnerships and nursing programs at the Valley Hospital in Ridgewood, NJ. Donna Lee Flynn is assistant professor in the nursing department at Ramapo College of New Jersey. Mabel LaForgia is director of research in the nursing department at Jersey City Medical Center in Jersey City, NJ. Contact author: Andrea Marie Centrella-Nigro, centrella-nigro@holyname.org. The authors have disclosed no potential conflicts of interest, financial or otherwise.
[Ti] Título:Effective Collaboration Among Magnet Hospitals: A Win-Win for Nurses and Institutions.
[So] Source:Am J Nurs;115(7):50-4, 2015 Jul.
[Is] ISSN:1538-7488
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Benchmarking/organização & administração
Serviços Hospitalares Compartilhados/organização & administração
Pesquisa em Enfermagem/organização & administração
Recursos Humanos de Enfermagem no Hospital/organização & administração
Supervisão de Enfermagem/normas
Garantia da Qualidade dos Cuidados de Saúde/organização & administração
[Mh] Termos MeSH secundário: American Nurses' Association
Benchmarking/métodos
Benchmarking/normas
Comportamento Cooperativo
Serviços Hospitalares Compartilhados/tendências
Seres Humanos
Relações Interinstitucionais
Relações Interprofissionais
Liderança
New Jersey
Pesquisa em Enfermagem/normas
Recursos Humanos de Enfermagem no Hospital/normas
Recursos Humanos de Enfermagem no Hospital/tendências
Supervisão de Enfermagem/tendências
Estudos de Casos Organizacionais
Garantia da Qualidade dos Cuidados de Saúde/métodos
Garantia da Qualidade dos Cuidados de Saúde/normas
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1509
[Cu] Atualização por classe:151214
[Lr] Data última revisão:
151214
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:150626
[St] Status:MEDLINE
[do] DOI:10.1097/01.NAJ.0000467279.13447.ea



página 1 de 215 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde