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CHEN WTING, LIM SYONG, How S, TAN WSHIN, Leong IYO. Communities of Care Approach: Developing a Place-based Model of Care and Building Partnerships in the Communities in Central Singapore. Int J Integr Care 2024; 24:6. [PMID: 38618046 PMCID: PMC11012037 DOI: 10.5334/ijic.7727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 03/20/2024] [Indexed: 04/16/2024] Open
Abstract
The population in Singapore is ageing, adding pressure to community care as the health and social needs of its residents increase. This has accelerated the pace at which Regional Health Systems adopt and deliver its population health strategies from early prevention, chronic disease management, crisis care to end-of-life care. To this end, the Central Health Integrated Care Network (ICN) began its journey to develop Communities of Care (CoCs) with other health and social care partners to meet the needs of residents in the Central Zone of Singapore. This paper describes the processes and steps taken by Central Health ICN to build partnerships with other agencies and organisations to build place-based models of care in the local neighbourhoods. The faciliating factors and the barriers faced in the implementation of CoCs were described to allow sharing of such learnings on large scale change. Strategies in overcoming some of the challenges were also presented to demonstrate the iterative processes required in building integrated place-based models of care to meet the needs of the residents in different communities.
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Affiliation(s)
- Wei TING CHEN
- Division for Central Health, Tan Tock Seng Hospital, Singapore
| | - Sing YONG LIM
- Division for Central Health, Tan Tock Seng Hospital, Singapore
| | - Shermaine How
- Division for Central Health, Tan Tock Seng Hospital, Singapore
| | - Woan SHIN TAN
- Health Services & Outcomes Research, National Healthcare Group, Singapore
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Martin CL, Austin RR, Alexander S, Britt-Lalich M, Lee K, Monsen KA. Discovering Patterns in the Corpus of Omaha System Evidence-Based Guidelines: A Descriptive Visualization Analysis. Comput Inform Nurs 2024; 42:1-10. [PMID: 38194509 DOI: 10.1097/cin.0000000000001093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Affiliation(s)
- Christie L Martin
- Author Affiliations: School of Nursing, University of Minnesota (Drs Martin, Austin, and Monsen, and Ms Britt-Lalich), Minneapolis; College of Nursing, The University of Alabama in Huntsville (Dr Alexander); and University of Missouri (Dr Lee), Columbia
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Dunn Lopez K, Heermann Langford L, Kennedy R, McCormick K, Delaney CW, Alexander G, Englebright J, Carroll WM, Monsen KA. Future advancement of health care through standardized nursing terminologies: reflections from a Friends of the National Library of Medicine workshop honoring Virginia K. Saba. J Am Med Inform Assoc 2023; 30:1878-1884. [PMID: 37553233 PMCID: PMC10586049 DOI: 10.1093/jamia/ocad156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/22/2023] [Accepted: 07/31/2023] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVE To honor the legacy of nursing informatics pioneer and visionary, Dr. Virginia Saba, the Friends of the National Library of Medicine convened a group of international experts to reflect on Dr. Saba's contributions to nursing standardized nursing terminologies. PROCESS Experts led a day-and-a-half virtual update on nursing's sustained and rigorous efforts to develop and use valid, reliable, and computable standardized nursing terminologies over the past 5 decades. Over the course of the workshop, policymakers, industry leaders, and scholars discussed the successful use of standardized nursing terminologies, the potential for expanded use of these vetted tools to advance healthcare, and future needs and opportunities. In this article, we elaborate on this vision and key recommendations for continued and expanded adoption and use of standardized nursing terminologies across settings and systems with the goal of generating new knowledge that improves health. CONCLUSION Much of the promise that the original creators of standardized nursing terminologies envisioned has been achieved. Secondary analysis of clinical data using these terminologies has repeatedly demonstrated the value of nursing and nursing's data. With increased and widespread adoption, these achievements can be replicated across settings and systems.
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Affiliation(s)
- Karen Dunn Lopez
- Division of Acute and Critical Care, The University of Iowa, College of Nursing, Iowa City, IA, USA
| | | | | | | | | | - Greg Alexander
- Columbia University, School of Nursing, New York, NY, USA
| | | | - Whende M Carroll
- Healthcare Information Management and Systems Society (HIMSS), Chicago, IL, USA
| | - Karen A Monsen
- University of Minnesota School of Nursing, Minneapolis, MN, USA
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Zhang X, Li Y, Li H, Zhao Y, Ma D, Xie Z, Sun J. Application of the OMAHA System in the education of nursing students: A systematic review and narrative synthesis. Nurse Educ Pract 2021; 57:103221. [PMID: 34649129 DOI: 10.1016/j.nepr.2021.103221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 09/14/2021] [Accepted: 09/26/2021] [Indexed: 11/26/2022]
Abstract
AIM The aim of this systematic review was to synthesize evidence on the application of the Omaha System in the education of nursing students and to provide advice for educators to apply the Omaha System to practice and research effectively and meaningfully. BACKGROUND It is a necessary part of nursing education to provide students with informatics experience. The Omaha System is a standardized nursing terminology designed to enhance practice, documentation, and information management. DESIGN A systematic review and narrative synthesis. METHODS Studies from eight databases (PubMed, Web of Science, Embase, CINAHL, PsycINFO, China Biology Medicine disc, CNKI, Wanfang Data) were systematically retrieved. Twenty-three articles were found and synthesized. RESULTS Existing studies showed that the Omaha System was mainly applied in student community practice as a tool for guiding practice and collecting information, and the practice data were used by educators to analyse the outcomes of nursing education. Recently, the Omaha System was introduced into the classroom environment and achieved positive results in terms of teaching. Students' feedback on the use of the Omaha System was generally positive. CONCLUSIONS The Omaha System can be an active teaching and learning tool for nursing education, and further research is needed to explore and realize its potential in the field of education.
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Affiliation(s)
- Xu Zhang
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun 130021, Jilin, People's Republic of China.
| | - Yijing Li
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun 130021, Jilin, People's Republic of China.
| | - Huanhuan Li
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun 130021, Jilin, People's Republic of China.
| | - Yingnan Zhao
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun 130021, Jilin, People's Republic of China.
| | - Dongfei Ma
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun 130021, Jilin, People's Republic of China.
| | - Zongting Xie
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun 130021, Jilin, People's Republic of China.
| | - Jiao Sun
- School of Nursing, Jilin University, No.965 Xinjiang Street, Changchun 130021, Jilin, People's Republic of China.
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Abstract
Standardized care plans have the potential to enhance the quality of nursing records in terms of content and completeness, thereby better supporting workflow, easing the documentation process, facilitating continuity of care, and permitting systematic data gathering to build evidence from practice. Despite these potential benefits, there may be challenges associated with the successful adoption and use of standardized care plans in municipal healthcare information practices. Using a participatory approach, two workshops were conducted with nurses and nursing leaders (n = 11) in two Norwegian municipalities, with the objective of identifying success criteria for the adoption and integration of standardized care plans into practice. Three themes were found to describe the identified success criteria: (1) "facilitating system level support for nurses' workflow"; (2) "engaged individuals creating a culture for using standardized care plans"; and (3) "developing system level safety nets." The findings suggest success criteria that could be useful to address to facilitate the integration of standardized care plans in municipal healthcare information practice and provide useful knowledge for those working with implementation and further development of standardized care plans.
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Schenk E, Schleyer R, Jones CR, Fincham S, Daratha KB, Monsen KA. Impact of Adoption of a Comprehensive Electronic Health Record on Nursing Work and Caring Efficacy. ACTA ACUST UNITED AC 2018; 36:331-9. [DOI: 10.1097/cin.0000000000000441] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Eardley DL, Krumwiede KA, Secginli S, Garner L, Deblieck C, Cosansu G, Nahcivan NO. The Omaha System as a Structured Instrument for Bridging Nursing Informatics With Public Health Nursing Education: A Feasibility Study. ACTA ACUST UNITED AC 2018; 36:275-83. [DOI: 10.1097/cin.0000000000000425] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Monsen KA, Vanderboom CE, Olson KS, Larson ME, Holland DE. Care Coordination From a Strengths Perspective: A Practice-Based Evidence Evaluation of Evidence-Based Practice. Res Theory Nurs Pract 2018; 31:39-55. [PMID: 28196576 DOI: 10.1891/1541-6577.31.1.39] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE It is critical to accurately represent strengths interventions to improve data and enable intervention effectiveness research from a strengths perspective. However, it is challenging to understand strengths interventions from the multiple perspectives of computerized knowledge representation, evidence-based practice guidelines, and practice-based evidence narratives. Intervention phrases abstracted from nurse care coordinator practice narratives described strengths interventions with community-dwelling elders. This project aims were to (a) compare nurse care coordinator use of evidence-based interventions as described in the two guidelines (what to do and how to do it), (b) analyze nurse care coordinator intervention tailoring (individualized care), and (c) evaluate the usefulness of the Omaha System for comparison of narrative phrases to evidence-based guidelines. METHODS Phrases from expert nurse care coordinators were mapped to the Omaha System for comparison with the guidelines interventions and were analyzed using descriptive statistics. Venn diagrams were used to visually depict intervention overlap between the guidelines and the phrases. RESULTS Empirical evaluation of 66 intervention phrases mapped to 14 problems using 3 category terms and 19 target terms showed alignment between guidelines and the phrases, with the most overlap across two guidelines and the phrases in categories, and the most diversity in care descriptions. CONCLUSION These findings demonstrate the value in having both standardized guidelines and expert clinicians who see the whole person and can synthesize and apply guidelines in tailored ways. There is potential to create a feedback loop between practice-based evidence and evidence-based practice by expanding this approach to use of practice-generated Omaha System data as practice-based evidence. Further research is needed to refine and advance the use of these methods with additional practices and guidelines.
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Schenk E, Schleyer R, Jones CR, Fincham S, Daratha KB, Monsen KA. Time motion analysis of nursing work in ICU, telemetry and medical-surgical units. J Nurs Manag 2017; 25:640-646. [DOI: 10.1111/jonm.12502] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Elizabeth Schenk
- College of Nursing; Washington State University; Spokane Washington USA
| | - Ruth Schleyer
- Informatics; Academics & Education; Providence Health & Services; Renton Washington USA
| | - Cami R. Jones
- College of Nursing; Washington State University; Spokane Washington USA
| | - Sarah Fincham
- College of Nursing; Washington State University; Spokane Washington USA
| | - Kenn B. Daratha
- College of Nursing; Washington State University; Spokane Washington USA
| | - Karen A. Monsen
- Center for Nursing Informatics; School of Nursing; University of Minnesota; Minneapolis Minnesota USA
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Kvarme LG, Monsen KA, Eboh WO. Evidence-based solution-focused care for school-age children experiencing cyberbullying: using the Omaha System to guide and document psychiatric nursing interventions. J Psychosoc Nurs Ment Health Serv 2013; 52:34-41. [PMID: 24200914 DOI: 10.3928/02793695-20131029-02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 08/13/2013] [Indexed: 01/20/2023]
Abstract
Cyberbullying is a global phenomenon. The experiences of bullied children are the same across cultures and languages, and psychiatric nursing interventions are known to be effective. It is critical to widely disseminate effective interventions to identify and address cyberbullying. Therefore, evidence-based care plans addressing cyberbullying at the individual and community levels were developed using the Omaha System, a terminology that is used internationally to guide and document care. This article presents a case study in which an evidence-based intervention was used to help a bullied child arrive at a solution, and demonstrates the use of the Omaha System to document evidence-based cyberbullying interventions with individuals and communities.
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Erdogan S, Secginli S, Cosansu G, Nahcivan NO, Esin MN, Aktas E, Monsen KA. Using the Omaha System to Describe Health Problems, Interventions, and Outcomes in Home Care in Istanbul, Turkey: A Student Informatics Research Experience. Comput Inform Nurs 2013; 31:290-8. [DOI: 10.1097/nxn.0b013e318282eala] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Monsen KA, Elsbernd SA, Barnhart L, Stock J, Prock CE, Looman WS, Nardella M. A statewide case management, surveillance, and outcome evaluation system for children with special health care needs. ISRN Nurs 2013; 2013:793936. [PMID: 23533804 DOI: 10.1155/2013/793936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Accepted: 01/22/2013] [Indexed: 11/25/2022]
Abstract
Objectives. To evaluate the feasibility of implementing a statewide children with special health care needs (CSHCN) program evaluation, case management, and surveillance system using a standardized instrument and protocol that operationalized the United States Health and Human Services CSHCN National Performance Measures. Methods. Public health nurses in local public health agencies in Washington State jointly developed and implemented the standardized system. The instrument was the Omaha System. Descriptive statistics were used for the analysis of standardized data. Results. From the sample of CSHCN visit reports (n = 127), 314 problems and 853 interventions were documented. The most common problem identified was growth and development followed by health care supervision, communication with community resources, caretaking/parenting, income, neglect, and abuse. The most common intervention category was surveillance (60%), followed by case management (24%) and teaching, guidance, and counseling (16%). On average, there were 2.7 interventions per problem and 6.7 interventions per visit. Conclusions. This study demonstrates the feasibility of an approach for statewide CSHCN program evaluation, case management, and surveillance system. Knowledge, behavior, and status ratings suggest that there are critical unmet needs in the Washington State CSHCN population for six major problems.
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Monsen KA, Swanberg HL, Oancea SC, Westra BL. Exploring the value of clinical data standards to predict hospitalization of home care patients. Appl Clin Inform 2012; 3:419-36. [PMID: 23646088 DOI: 10.4338/aci-2012-05-ra-0016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2012] [Accepted: 11/09/2012] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND There is a critical need to reduce hospitalizations for Medicare patients and electronic health record (EHR) home care data provide new opportunities to evaluate risk of hospitalization for patients. OBJECTIVES The objectives of this study were to 1) develop a measure to predict risk of hospitalization among home care patients, the Hospitalization Risk Score (HRS), and 2) compare it with an existing severity of illness measure, the Charlson Index of Comorbidity (CIC). METHODS A convenience sample of clinical data from 14 home care agencies' EHRs, representing 1,643 home care patient episodes was used for the study. The development of the HRS was based on review of the literature, and expert panel evaluation to construct the HRS. Descriptive statistics and generalized linear models were used for comparative analysis; areas under curve (AUC) values were compared for receiver operating curves (ROC), and cut points predicting hospitalization were evaluated. RESULTS The HRS for this sample ranged from 0 to 5.6, with a median of 1.25. The CIC for this sample ranged from 0 to 9 and with a median of 0. Nearly three fourths of the sample was hospitalized at an HRS of 2, and a CIC of 1. AUC values for ROC were 0.63 for HRS and 0.59 for the CIC. The ROC curves were significantly different (t = -7.59, p <0.003). CONCLUSIONS This preliminary study demonstrates the potential value of the HRS using Omaha System EHR data. There was a statistically significant difference for predicting hospitalization of home care patients with the HRS versus the CIC; however the AUC values for both were low. Continued research is needed to further refine the HRS, determine whether it is more sensitive for particular subgroups of patients, and combine it with additional risk factors in understanding rehospitalization.
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Hong O, Monsen KA, Kerr MJ, Chin DL, Lytton AB, Martin KS. Firefighter hearing health: an informatics approach to screening, measurement, and research. Int J Audiol 2012; 51:765-70. [PMID: 22998414 DOI: 10.3109/14992027.2012.705902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the use of a standardized interface terminology, the Omaha System, with respect to noise-induced hearing loss (NIHL). DESIGN A descriptive, correlational design was employed for this secondary analysis with the data from an ongoing hearing protection intervention study. STUDY SAMPLE A total of 346 firefighters were included. RESULTS First, an evidence-based standardized care plan (EB-SCP) for hearing screening was developed and validated by clinical experts. Second, occupational health records were used to compute Omaha System Knowledge, Behavior, and Status outcomes. Third, research data were mapped to Omaha System rating scales. For Knowledge, the mean score was close to 'adequate' (3.7). For Behavior, the mean score was close to 'rarely appropriate' (2.2). For Status, the mean score was close to 'minimal sign/symptom' (4.4). Significant positive relationships were found between Knowledge and Behavior (Spearman's rho =.13, p =.01), and between Behavior and hearing Status (Spearman's rho =.12, p =.02). CONCLUSIONS Findings support the validity of the new Knowledge, Behavior, and hearing Status. Informatics methods such as the standardized NIHL EB-SCP and outcome data sets will create opportunities for clinical decision support and data exchange across various health care settings, thus supporting population-based hearing health assessments and outcomes.
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Affiliation(s)
- OiSaeng Hong
- School of Nursing, University of California, San Francisco, San Francisco, CA 94143-0608, USA.
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Monsen KA, Neely C, Oftedahl G, Kerr MJ, Pietruszewski P, Farri O. Feasibility of encoding the Institute for Clinical Systems Improvement Depression Guideline using the Omaha System. J Biomed Inform 2012; 45:719-25. [DOI: 10.1016/j.jbi.2012.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 06/08/2012] [Accepted: 06/11/2012] [Indexed: 10/28/2022]
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Monsen KA, Westra BL, Paitich N, Ekstrom D, Mehle SC, Kaeding M, Abdo S, Natarajan G, Ruddarraju UKR. Developing a personal health record for community-dwelling older adults and clinicians: technology and content. J Gerontol Nurs 2012; 38:21-5. [PMID: 22715956 DOI: 10.3928/00989134-20120605-03] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
To empower older consumers and improve health outcomes, a consumer-friendly personal health record (PHR) is needed. The purpose of this article was to evaluate PHR technology and content for older community-dwelling consumers. Specific aims were to: (a) develop a secure, web-based application for a PHR to enable interoperable exchanges of data between consumers and clinicians; (b) develop structured, evidence-based shared care plan content for the PHR using an interface terminology standard; and (c) validate the shared care plans with consumers. An interoperable web-based form was developed. The standardized PHR content was developed by expert panel consensus using the Omaha System problem list and care plans, and validated by consumer interviews. Evidence-based shared care plans for 21 problems common among community-dwelling older adults were developed and encoded with Omaha System terms for data capture in the PHR. An additional problem, Neighborhood-workplace safety, was identified by consumers and will be added to the care plans.
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