Toward a National Conversation on Health: Disruptive Intervention and the Transformation from Health Care to Health

Diffusion of Precision Health Into a Baccalaureate Nursing Curriculum

BACKGROUND

Precision health (PH) and precision medicine are emerging approaches to health care promising more individualized care for health consumers. This improved type of care management uses innovation in science and technology to accurately identify diseases, treatments, and environmental influences to provide effective and efficient care. Multiple industries are supporting this venture, including nursing.

METHOD

To respond to the national call to integrate PH in nursing curricula, a small urban university in Southern California proposed to integrate concepts of PH into six select courses in the baccalaureate curriculum.

RESULTS

This curriculum revision launched in fall 2020; it was the first time PH concepts were introduced to Bachelor of Science in Nursing students in the department of nursing. Student outcomes will be measured using the nine competencies developed.

CONCLUSION

Nurse educators shape future practice. It is incumbent upon them to adopt the opportunities for transformation presented by the emergent phenomenon of PH. Only then will students be prepared with the knowledge, skills, and attitudes foundational for precise care. [J Nurs Educ. 2021;60(2):107-110.].

Fit to fight - from military hygiene to wellbeing in the British Army

This paper reviews the historical evolution of the language and organization surrounding the health of personnel in the British Army from 'hygiene' through  to 'wellbeing'. It starts by considering the health of the army in the mid-nineteenth century and the emergence of military hygiene as a professional subject. It continues by looking at advances in military hygiene in the two world wars. Hygiene was replaced by the term 'health' in the 1950s as the collective noun used by professionals working in this field. This unity split when the professions of occupational medicine and public health established separate faculties and training pathways. However, the health issues for the armed forces remain fundamentally unchanged. Going forward, the term 'wellbeing' is helping to refresh the close relationships between executives, their medical advisers and those within the population of health professions charged with keeping the British Army healthy. The core theme is the collaborations between civil society, executive leadership and medical services in maximizing the health of the military population from recruitment through to life as a veteran.

Essential role of laboratory physicians in transformation of laboratory practice and management to a value-based patient-centric model

The laboratory is a vital part of the continuum of patient care. In fact, there are few programs in the healthcare system that do not rely on ready access and availability of complex diagnostic laboratory services. The existing transactional model of laboratory "medical practice" will not be able to meet the needs of the healthcare system as it rapidly shifts toward value-based care and precision medicine, which demands that practice be based on total system indicators, clinical effectiveness, and patient outcomes. Laboratory "value" will no longer be focused primarily on internal testing quality and efficiencies but rather on the relative cost of diagnostic testing compared to direct improvement in clinical and system outcomes. The medical laboratory as a "business" focused on operational efficiency and cost-controls must transform to become an essential clinical service that is a tightly integrated equal partner in direct patient care. We would argue that this paradigm shift would not be necessary if laboratory services had remained a "patient-centric" medical practice throughout the last few decades. This review is focused on the essential role of laboratory physicians in transforming laboratory practice and management to a value-based patient-centric model. Value-based practice is necessary not only to meet the challenges of the new precision medicine world order but also to bring about sustainable healthcare service delivery.