34,023 research outputs found
Elucidating the input of notch ligand delta-like 4 (dll4) in zebrafish blood stem cell ontogeny
Get PDFMultipotent haematopoietic stem cells (HSCs) supply the organism with mature blood cells of all lineages throughout adult life. These cells first originate in the dorsal aorta (DA) of the vertebrate embryo, and a multitude of signalling pathways regulate their specification in the embryo. The emergence of HSCs is dependent on appropriate arterial specification and vessel maturation, processes which are heavily dependent on Notch signalling. This arterial involvement of Notch obscures its later roles in HSC specification. The Notch ligand dll4 is crucially involved in arterial development in the mammalian embryo, while zebrafish embryos deficient for dll4 activity only exhibit minor arterial defects at the time of HSC emergence. Here, the zebrafish model has been exploited to reveal the first specific evidence for a role of dll4 in HSC specification. Dll4 is required for the expression of runx1, a transcription factor (TF) required for HSC specification, prior to any observed effects on vascular development. HSCs and all their derivatives are depleted in dll4 morphants. To disentangle the genetic requlatory cascade downstream of dll4 and upstream of runx1, RNA-seq was employed to discover downstream effectors of this signalling. Expression and functional screening of best candidate genes revealed seven genes with novel roles in HSC development. Foxc1b is a dll4 target predominantly mirroring the dll4 phenotype, and is thus likely to be the downstream effector of dll4, upstream of runx1. Interestingly, foxc1b also has a later dll4-independent role in HSC development, remarkably similar to that of cmyb. Taken together I show here for the first time a requirement of dll4 upstream of runx1 in HSC specification, mediated by foxc1b, followed by a later dll4-independent phase in HSC development
The Legitimacy of the Patient Story: The Unofficial Autoethnography
Get PDFWhile communication is the foundation of patient experience, survey data and comments are the primary source of results. The focus on data, though meaningful, reduces humans to text on reports. With a focus of autoethnography in both her baccalaureate and post-graduate studies, the author, (a fulltime patient experience professional) shares her professional focus on the value of the data and comments, esteeming it all as valuable research given by the only people who can report patient experience – patients. She compares her stance regarding patient experience before and after receiving a diagnosis of breast cancer. The author shares how the experience as a patient with a life-threatening illness impacted her professional beliefs, including demonstrating purposeful, personal concern for patients, valuing patient experience data and comments, and encouraging others to do the same
The perioperative patient experience of hand and wrist surgical patients: An exploratory study using patient journey mapping
Get PDFPatient-centred care is becoming more important in healthcare. The success of patient-centred care can be assessed by exploring the patient experience through a patient journey map. As the number of outpatient surgeries is increasing, it is important to reveal the specific characteristics of this type of surgery. The perioperative patient experience is considered very important for outpatient surgery, because all perioperative activities are condensed in one day. To investigate this experience, we performed a case study of hand and wrist surgery. Six teams of two industrial design engineering students interviewed 40 patients in total in two private and two public hospitals in the Netherlands. All teams created a patient journey map, describing the patient experience. These maps were analysed by the authors to identify common themes among the six journeys. Four time-independent themes and four time-dependent themes were identified. Insecurity, reassurance by staff, loneliness, and lack of information were associated with the whole patient experience. Before surgery, lack of control was the most prominent experience. During surgery, acceptance and curiosity were present. After surgery, relief was the dominant experience. No significant differences between the public and private hospitals were discovered. Several suggestions are given on how to facilitate positive experiences and how to resolve negative experiences in outpatient surgery. These include suggestions for hospital policy and design interventions.Applied Ergonomics and Desig
Informative material for patient empowerment in sensitive situations
Get PDFWomen diagnosed with HPV face a hard-to-understand disease that may impact their psychological and physical health and may pose challenges communicating with healthcare providers in sensitive settings. We posit patient empowerment through targeted educational materials can improve sensitive communication and lead to better health outcomes. This study measured the impact of a patient-empowerment process used in a gynecology clinic for HPV patients to improve sensitive communication during medical-related meetings and on subsequent patient empowerment outcomes. The empowerment process was based on expert-vetted informative material made accessible in the physician’s waiting room on tablet devices. Communication between physicians and patients was measured during medical visits via a direct observation, encoding process. Empowerment items were tested following medical visits. The results were compared to a control group that received non-medical, lifestyle material. 237 female, gynecology patients from a large, private clinic participated. Using expert-vetted, relevant material to enhance patient education in a clinical setting results in higher levels of patient empowerment. Physician interaction impacts patient empowerment as do various communication behaviors and this can lead to positive health outcomes.
Experience Framework
This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/). Access other PXJ articles related to this lens. Access other resources related to this lens
The patient ombudsperson’s experience of patient partnership and mutual understanding of rights
Get PDFMutual understanding between the patient and the healthcare professional can be considered a key factor of a positive patient experience in the care relationship. Mutual understanding can be promoted through patient partnership, which, in this personal and professional narrative, the author (a patient ombudsperson, known as patient ombudsman, and researcher of patient experience) describes as participation through patient rights during care. In the relationship between the patient and the healthcare professional (i.e., who acts as a care provider in the patient's care), medical treatment decisions and related patient rights go hand in hand. Even in difficult care situations of mutual understanding, the patient and care provider can make decisions that are acceptable to both parties. These decisions are usually related to various shortcomings in care, access to information, and treatment by and behavior of care providers. The task of the patient ombudsperson as a third party is to support the realization of mutual understanding and partnership in treatment by advising patients on their rights. The purpose of patient partnership is to provide pre-known and equal practices for forming mutual understanding between the actors in the care relationship through patient rights
September 2019-Printed Issue
No full textWelcome to the first issue of Patient Safety!
Brought to you by the Patient Safety Authority, an independent agency of the Commonwealth of Pennsylvania, this brand-new journal is unlike any other you’ve seen. Since patients are at the heart of everything we do, each issue not only publishes original, peer-reviewed research and data analyses, but also gives patients a voice—on the page and behind the scenes.
Patient Safety has no subscription fees or author fees: It’s available now to read online, as well as free to publish in. Once you’ve looked over this issue, send us your own research articles, essays, studies, and other submissions. If your manuscript will help advance patient safety, we want to see it!
Read articles from the September 2019 issue online or download the full issue as a PDF for printing and sharing. Remember to subscribe to receive future issues and news about Patient Safety. Submit your work to us and tell your friends and colleagues all about the new journal on the block.
Together we can save lives.</p
Customer service vs. Patient care
Get PDFIn a competitive market where financial resources are limited, many of the popular approaches to improving the patient experience involve large capital investments in such things as hotel style amenities and expensive technology. The author argues that marketing based on a model of the patient as a traditional ‘customer’ is ill conceived and contributes unnecessarily to the high cost of healthcare while lacking a true understanding of, or an appropriate response to, the most basic needs of hospitalized patients that lead to patient satisfaction.
Experience Framework
This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens
December 2020-Printed Issue
No full textThe winter 2020 issue of _Patient Safety_ is available to read online and download at no charge.
Each issue features the latest evidence-based research, thoughtful commentaries and editorials, interviews with healthcare leaders and safety advocates, and powerful patient stories.
An in-depth study of variables associated with wrong-site surgeries in Pennsylvania, demonstrating that this “never event” still happens all too often
An interview with Queen Quet, head of state of the Gullah/Geechee Nation, about life on the Sea Islands, overcoming racial disparities in healthcare, and more
A focus on sepsis, a severe condition that is difficult to distinguish from the flu and COVID-19
A polio survivor who never had the choice to take the vaccine shares her struggles with the aftereffects of the disease since she contracted it in childhood
Researchers delve into wrong-patient errors related to health information technology
A timely look at risks involved with using prone positioning to treat patients for acute respiratory distress syndrome, a common complication of COVID-19 and other infections
Thank you to our authors, peer reviewers, editorial board members, and Patient Safety Authority staff, who all play a part in the success of our journal and in advancing patient safety everywhere. Patient Safety is fully open access (no subscription fees or author fees), so please consider sending us your next original manuscript and sharing our journal with your colleagues, students, families, friends, and patients. Together we save lives.
Why human resources policies and practices are critical to improving the patient experience
Get PDFWhile providing patient-centered care seems to be a goal for many organizations, delivering on this goal requires practices which are embedded in the organization, which incent patient-centered behavior. The author argues Human Resources (HR) policies, procedures and programs are key to supporting an organizations’ vision and culture. This means an HR executive partnering with the CEO who sets the vision and HR builds programs to support the vision. As the organization understands what is important to patients and how to best serve them, HR can build patient care improvement into every aspect of the organization. The author describes how competency based hiring, training and development, performance reviews, compensation and retention strategies should reflect patient-centered values
The paradigm of patient must evolve: Why a false sense of limited capacity can subvert all attempts at patient involvement
Get PDFThis essay reviews the role of paradigms in molding the thoughts of a scientific field and looks rigorously at what two key terms mean – empowered and engaged – and how their interaction points to a new way forward, requiring a re-examination of our “paradigm of patient.” Five years ago, the Institute of Medicine’s Best Care at Lower Cost declared that patient-clinician partnerships are a cornerstone of a learning health system, a declaration that’s foundational to the era of involvement. How can we engineer that era correctly if our conception of “patient” is out of date? And how can we validate whether our model works? In the past eight years, the author has spoken at or participated in over 500 events in sixteen countries, and although declaring himself “just a patient,” he has observed persistent cultural patterns that make one thing clear: there is a need to change our understanding of the role of the patient in achieving best possible care
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