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Biomedical subjects

Rosemary Kennedy

Publications and source records attributed to Rosemary Kennedy.

5 recordsLinked to original sources

Knowledge enabled plan of care and documentation prototype.

There exist significant challenges in integrating the plan of care into documentation and point of care operational processes. A plan of care is often a static artifact that meets regulatory standards with limited influence on supporting goal-directed care delivery processes. Although this prototype is applicable to many clinical disciplines, we will highlight nursing processes in demonstrating a knowledge-driven computerized solution that fully integrates the plan of care within documentation. The knowledge-driven solution reflects evidenced-based practice; is an effective tool for managing problems, orders/interventions, and the patient's progress towards expected outcomes; meets regulatory standards; and drives quality and process improvement. The knowledge infrastructure consists of fully represented terminology, structured clinical expressions utilizing the controlled terminology and clinical knowledge representing evidence-based practice.

Documentation↗

General practitioner, specialist providers case conferences in palliative care--lessons learned from 56 case conferences.

OBJECTIVE: To describe the utility and acceptability to general practitioners and palliative care staff of case conferences in palliative care. METHOD: Research focussed on case conferences conducted between GPs and staff of three specialist palliative care units (in an inner urban, outer metropolitan and regional setting), at the time of referral of patients to the service. Telephone interviews were conducted with all GPs who participated in a case conference, and focus groups were conducted with palliative care staff. RESULTS: For most GPs, case conferences by teleconference were a time effective and immediate means of information transfer. The best instances for a conference were at time of patient referral, time of discharge to the community, or where the case was complex. General practitioners appreciated access to multiple professionals simultaneously. Workload pressures were a drawback of participation for both GPs and specialists. Palliative care team members thought case conferences gave GPs an appreciation of a team approach, and reduced professional isolation. The usefulness of the case conferences depended on the willingness of the GP to participate. General practitioners would participate again provided they did not have to organise the case conference. Specialist staff were concerned by the financial cost of organising case conferences. DISCUSSION: Case conferences provide useful information exchange between GPs and specialist staff, and are acceptable to both parties. Much depends on the individual GPs attitude toward participation, as well as the timing of the conferences in the course of the patient's illness. Organisation needs to be a task of the specialist units, who would need administrative support to organise them.

Attitude of Health Personnel↗

General practitioner attitudes to case conferences: how can we increase participation and effectiveness?

OBJECTIVES: To identify general practitioners' views on the barriers to using case conferencing (as outlined in the Medical Benefits Schedule (MBS) Enhanced Primary Care package) and to develop a set of principles to encourage greater GP participation in case conferences. DESIGN: Qualitative study, involving semistructured questions administered to focus groups of GPs, conducted between April and July 2001 as part of a broader study of case coordination in palliative care. PARTICIPANTS: 29 GPs from urban, regional, and rural areas of Queensland. PRINCIPAL FINDINGS: Many of the GPs' work practices militated against participation in traditionally structured case conferences. GPs thought the range of MBS item numbers should be expanded to cover alternative methods of liaison (eg, phone consultations with other service providers). The onerous bureaucratic processes required to claim reimbursement were an additional disincentive. CONCLUSIONS: GPs would probably be more likely to participate in case conferences if they were initiated by specialist services and arranged more flexibly to suit GP work schedules.

Attitude of Health Personnel↗

Modeling nursing interventions in the act class of HL7 RIM Version 3.

The proposed Health Level 7 Reference Information Model (HL7 RIM) Version 3 is the foundation for expressing data to be communicated across health care information systems. The general objective of this analysis was to examine whether the RIM supports the expression of nursing interventions, considering both terminological and structural perspectives. The Nursing Terminology Summit Interventions Group focused on patient education about breast cancer, an intervention that differs sufficiently from other medical processes already considered by HL7 and represents issues surrounding both definition and execution of nursing process. Relevant actors, actions, and action relationships were culled from use cases and modeled into the proposed RIM structure and attributes by using modified instance diagrams. This method was effective and reproducible, and the RIM proved to be an adequate model for supporting breast cancer education. Additional interventions must be studied to fully assess the adequacy of the model to support all aspects of nursing process and terminology.

Computational Biology↗