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Ventres WB, Stone LA, Joslin TA, Saultz JW, Aldulaimi S, Gordon PR, Lane JC, Lee ER, Prunuske J, Gildenblatt L, Friedman MH, Fogarty CT, McDaniel SH, Rohrberg T, Odom A. Storylines of family medicine III: core principles-primary care, systems and family. Fam Med Community Health 2024; 12:e002790. [PMID: 38609081 PMCID: PMC11029207 DOI: 10.1136/fmch-2024-002790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024] Open
Abstract
Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'III: core principles-primary care, systems, and family', authors address the following themes: 'Continuity of care-building therapeutic relationships over time', 'Comprehensiveness-combining breadth and depth of scope', 'Coordination of care-managing multiple realities', 'Access to care-intersectional, systemic, and personal', 'Systems theory-a core value in patient-centered care', 'Family-oriented practice-supporting patients' health and well-being', 'Family physician as family member' and 'Family in the exam room'. May readers develop new understandings from these essays.
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Affiliation(s)
- William B Ventres
- Family and Preventive Medicine, University of Arkansas for Medical Sciences College of Medicine, Little Rock, Arkansas, USA
| | - Leslie A Stone
- Family and Preventive Medicine, University of Arkansas for Medical Sciences College of Medicine, Little Rock, Arkansas, USA
| | - Timothy A Joslin
- Family Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - John W Saultz
- Family Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Sommer Aldulaimi
- Family and Community Medicine, University of Arizona Medical Center-South Campus, Tucson, Arizona, USA
| | - Paul R Gordon
- Family and Community Medicine, University of Arizona Medical Center-University Campus, Tucson, Arizona, USA
| | - John C Lane
- UAMS West Regional Campus Family Medicine Residency Program, Fort Smith, Arkansas, USA
| | - Eric R Lee
- Medical College of Wisconsin-Central Wisconsin Campus, Wausau, Wisconsin, USA
| | - Jacob Prunuske
- Family and Community Medicine, Medical College of Wisconsin-Central Wisconsin Campus, Wausau, Wisconsin, USA
| | - Limor Gildenblatt
- Family Medicine, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA
| | - Michael H Friedman
- Family Medicine, Presence Saints Mary and Elizabeth Medical Center, Chicago, Illinois, USA
| | - Colleen T Fogarty
- Family Medicine, University of Rochester Medical Center, Rochester, New York, USA
| | - Susan H McDaniel
- Psychiatry and Family Medicine, University of Rochester Medical Center, Rochester, New York, USA
| | - Tessa Rohrberg
- Family and Community Medicine, University of Kansas School of Medicine-Wichita, Wichita, Kansas, USA
| | - Amy Odom
- Sparrow/Michigan State University Family Medicine Residency Program, Lansing, Michigan, USA
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Lamé G, Tako A, Kleinsmann M. Using participatory systems approaches to improve healthcare delivery. Health Syst (Basingstoke) 2024; 12:357-361. [PMID: 38235303 PMCID: PMC10791099 DOI: 10.1080/20476965.2023.2285555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024] Open
Affiliation(s)
- Guillaume Lamé
- Paris-Saclay University, CentraleSupélec, Laboratoire de Génie Industriel
| | - Antuela Tako
- Loughborough Business School, Loughborough University
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Mescouto K, Olson RE, Setchell J. Towards an ethical multiplicity in low back pain care: Practising beyond the biopsychosocial model. SOCIOLOGY OF HEALTH & ILLNESS 2023; 45:522-541. [PMID: 36541421 PMCID: PMC10947319 DOI: 10.1111/1467-9566.13598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
The biopsychosocial model is currently considered by most researchers and clinicians to be the best approach to low back pain (LBP) care. The model was popularised in LBP care in response to some clear deficiencies in earlier biomedical approaches and is now widely recommended in clinical guidelines and policy statements. Yet the biopsychosocial approach has also been critiqued for its narrow conceptualisation and application. In this article, we explore how attending to the multidimensionality of LBP in practice goes beyond a biopsychosocial approach. We engaged with 90 ethnographic observations of clinical practices, 22 collaborative dialogues with clinicians, and eight consultatory meetings with people with experience of LBP to consider the sociomaterialities of clinical practices in two settings: a private physiotherapy practice and a public multidisciplinary pain clinic. Drawing on the work of Annemarie Mol and Rosi Braidotti, our analyses suggest that sociomaterial practices, involving human and non-human actors, produced multiple objects of clinical attention and ethical concerns about how to attend to this multiplicity well. We argue that the multiplicity of LBP is attended well by reimagining: (1) clinical settings as 'becoming more-than-sterile environments' where objects, furniture and elements such as tears and laughter help to provide a relational, welcoming and comfortable space to all bodies with LBP; (2) differences through 'becoming minoritarian' where considering power relations allows actions towards connectiveness and belonging; and (3) disciplinary boundaries through 'becoming interdisciplinary within' where actions expand traditional scopes of practice. The flux of these multiple becomings moves clinical practice and conceptualisations beyond the biopsychosocial approach to consider a new ethico-onto-epistemological approach to LBP care. They invite clinical practices that engage with an ethical multiplicity of LBP care, providing a better understanding of how places, objects, emotions, power, bodies and professions are interconnected and come together in everyday practice.
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Affiliation(s)
- Karime Mescouto
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQueenslandAustralia
| | | | - Jenny Setchell
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQueenslandAustralia
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Findley PA, Wiener RC, Mitra S, Wang H, Shen C, Sambamoorthi U. Whole Health in Parts: Omissions from National Data Sets. Popul Health Manag 2023; 26:22-28. [PMID: 36799933 PMCID: PMC10081708 DOI: 10.1089/pop.2022.0197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
Background: The Whole Health model is a holistic approach to facilitate whole health practices by addressing (1) the physical, mental, and social health of individuals and (2) associated support systems. Several national organizations such as the Institute for Healthcare Improvement's (IHI) Age-Friendly Health Systems (AFHS) movement and, the U.S. Department of Veterans Affairs have implemented whole health frameworks with many common elements and promoted whole health practice and skills. However, implementing a Whole Health model across communities and health systems will require evidence of effectiveness. Generating evidence on the effectiveness of the Whole Health model's effect on health outcomes requires data-driven intelligence. Methods: We identified the national public-use data sets that are most often used in health research with a machine-assisted literature search of PubMed and Scopus for peer-reviewed journal articles published from 2010 through the end of 2021, including preprints, using Python [3.7]. We then assessed if the 8 most commonly used datasets include variables associated with whole health. Results: The number of publications examining whole health has increased annually in the last decade, with more than 2800 publications in 2020 alone. Since 2010, 24,811 articles have been published using 1 of these data sets. However, we also found a lack of data (ie, data set includes all of the whole health variables) to examine whole health in national data sets. Conclusions: We support a call to expand data collection and standardization of critical measures of whole health.
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Affiliation(s)
| | - R. Constance Wiener
- Department of Dental Public Health and Professional Practice, West Virginia University, Morgantown, West Virginia, USA
| | - Sophie Mitra
- Department of Economics, Research Consortium on Disability, Fordham University, Bronx, New York, USA
| | - Hao Wang
- Department of Emergency Medicine, JPS Health Network, Integrative Emergency Services, Fort Worth, Texas, USA
| | - Chan Shen
- Department of Surgery, Penn State Cancer Institute, Hershey, Pennsylvania, USA
| | - Usha Sambamoorthi
- Department of Pharmacotherapy, College of Pharmacy, “Vashisht” Professor for Health Disparities, HEARD Scholar, Texas Center for Health Disparities, University of North Texas Health Science Center, Fort Worth, Texas, USA
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Khudchenko AG, Brodskaya TA, Goncharov KV. Development of a quality and safety management system for medical activities in the Primorsky Region. Public Health 2022. [DOI: 10.21045/2782-1676-2021-2-3-50-63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The article presents the experience of organizing a system for managing the quality and safety of medical activities in the Primorsky Region, its development in accordance with current trends in the national policy of protecting the health of citizens in the Russian Federation. In accordance with the regional healthcare development strategy, a pilot project has been implemented since 2018, which includes a number of reasonable interrelated activities. A regional Competence Center in the field of quality and safety of medical activity was organized, closely interacting with the National Institute of Quality, mechanisms for financing the quality management system were developed. As part of the implementation of the regional project, a system for recording undesirable events in the Primorsky Region was developed and implemented. A regional model of the system for managing the quality and safety of medical activities has been adopted, and the principles of organizing the healthcare system in Primorsky Region have been described. The successes and difficulties of the project implementation are analyzed, the prospects for the development of a quality and safety management system for medical activities in the Primorsky Region are presented, taking into account the specifics of the geopolitical situation and demographic trends in the region.
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Affiliation(s)
| | - T. A. Brodskaya
- Federal State Autonomous Educational Institution of Higher Education “Far Eastern Federal University”
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