Background: Psoriasis is a chronic inflammatory skin condition that affects millions of individuals worldwide, impacting their physical and emotional well-being. The management of psoriasis requires effective communication and a strong physician-patient relationship. Objective: We aim to develop a novel algorithm to enhance patient well-being and care in moderate-to-severe psoriasis, considering the time constraints that dermatologists have in public hospitals. Methods: This project employed a multidisciplinary approach, involving collaboration between 14 experienced dermatologists (referred to as Key Opinion Leaders: KOLs) and a psychologist. During three separate meetings (an initial virtual session, a face-to-face meeting, and a final virtual meeting), an algorithm (Embracing Patients\' Well-being in their Journey of Moderate-to-Severe psoriasis: EMPATHY), describing the patient\'s reception through the entire first visit and follow-up visits, was developed and refined. Results: The EMPATHY algorithm provides a step-by-step approach from the moment the patient arrives at reception, through the first visit and on to subsequent visits. This algorithm fills a critical gap in the existing guidelines by specifically addressing how to foster empathy during psoriasis patient visits within time-limited consultations. The algorithm outlines patient-centered strategies at each visit. Key aspects include creating a welcoming environment, active listening, respecting privacy, tailoring communication styles, and managing patient expectations. Conclusions: The EMPATHY algorithm represents a novel and promising approach to improving patient care and well-being in moderate-to-severe psoriasis. Developed together by dermatologists and a psychologist, this algorithm offers healthcare providers practical guidance for managing both initial and follow-up patient visits. While further validation is necessary, the potential for adapting the EMPATHY algorithm to diverse healthcare settings and patient populations holds promise for improving patient outcomes across various chronic conditions.

BACKGROUND: Person-centred care (PCC) is associated with improved patient well-being and higher levels of satisfaction with care but its impact on individuals living with obesity is not well-established. The main aim of this study was to assess the relationship between PCC and the physical and social well-being of patients living with obesity, as well as their satisfaction with care.
METHODS: This study is based on a cross-sectional, web-based survey administered among a representative panel of Dutch individuals living with obesity. The primary outcomes were physical and social well-being and satisfaction with care. The primary exposure was a rating of overall PCC, encompassing its eight dimensions. In addition, covariates considered in the analyses included sex, age, marital status, education level, BMI, and chronic illness. The data from a total of 590 participants were analysed using descriptive statistics, correlation analyses, and multiple regression analyses.
RESULTS: Among PCC dimensions, participants rated \'access to care\' the highest (M 4.1, SD 0.6), while \'coordination of care\' (M 3.5, SD 0.8) was rated lower than all other dimensions. Participants\' overall PCC ratings were positively correlated with their physical (r = 0.255, P<0.001) and social well-being (r = 0.289, P<0.001) and their satisfaction with care (r = 0.788, P<0.001), as were the separate dimension scores. After controlling for sex, age, marital status, education level, BMI, and chronic illness in the regression analyses, participants\' overall PCC ratings were positively related to their physical (β = 0.24, P<0.001) and social well-being (β = 0.26, P<0.001), and satisfaction with care (β = 0.79, P<0.001).
CONCLUSIONS: PCC holds promise for improved outcomes among patients living with obesity, both in terms of physical and social well-being, as well as satisfaction with care. This is an important finding, particularly when considering the profound physical, social, and psychological consequences associated with obesity. In addition to highlighting the potential benefits of PCC in the healthcare of individuals living with obesity, the findings offer valuable insights into strategies for further refining the provision of PCC to meet the specific needs of these patients.

Hospitals play a crucial role in providing medical care to patients, but they also have a significant environmental impact due to their high energy consumption and resource use. In recent years, there has been growing interest in the concept of green hospital design, which aims to reduce the environmental footprint of hospitals while simultaneously improving patient outcomes.10 articles were finalized for review and were coded in QDA Miner qualitative analysis software for descriptive and link analysis. Results indicated a strong correlation between green design aspects of hospital and patient well-being, it failed to provide any evidence of concrete relation between relation between green hospital design and lower operation cost.\"

Crawfurd Hospital (CFH) set up a Transitional Care Facility (TCF) in November 2022 as an interim holding facility for medically stable patients awaiting a long-term discharge disposition. The team invented the SAFE score, to monitor 4 main domains commonly impacted in long-term stays - namely Skin, Action (Behaviour), Function and Emotion. A sample size of 50 patients met the inclusion criteria and were scored by the nurses on day 7, day 14, and monthly thereafter during their TCF stay, and once more within 72 h prior to their discharge. There was no significant improvement or worsening noted across all 4 domains in this pilot study, suggesting that the TCF has achieved its goal of maintaining its patients in all these domains. The scores at the various time points were also useful for the team to immediately identify changes in individual patient scores and act on these findings to ensure optimal patient care. Through this pilot study, we identified further minor improvements which can be made to the and the score, and such a scoring system may further be applicable to various intermediate to long-term care homes to oversee these domains of care.

UNASSIGNED: This study aims (1) to understand the needs and challenges of the current intensive care unit (ICU) environments in supporting patient well-being from the perspective of healthcare professionals (HCPs) and (2) to explore the new potential of ICU environments enabled by technology.
UNASSIGNED: Evidence-based design has yielded how the design of environments can advocate for patient well-being, and digital technology offers new possibilities for indoor environments. However, the role of technology in facilitating ICU patient well-being has been unexplored.
UNASSIGNED: This study was conducted in two phases. First, a mixed-method study was conducted with ICU HCPs from four Dutch hospitals. The study investigated the current environmental support for care activities, as well as the factors that positively and negatively contribute to patient experience. Next, a co-creation session was held involving HCPs and health technology experts to explore opportunities for technology to support ICU patient well-being.
UNASSIGNED: The mixed-method study revealed nine negative and eight positive patient experience factors. HCPs perceived patient emotional care as most challenging due to the ICU workload and a lack of environmental support in fulfilling patient emotional needs. The co-creation session yielded nine technology-enabled solutions to address identified challenges. Finally, drawing from insights from both studies, four strategies were introduced that guide toward creating technology to provide holistic and personalized care for patients.
UNASSIGNED: Patient experience factors are intertwined, necessitating a multifactorial approach to support patient well-being. Viewing the ICU environment as a holistic unit, our findings provide guidance on creating healing environments using technology.

This paper explores the dilemma faced by mental healthcare professionals in balancing treatment of mental disorders with promoting patient well-being and flourishing. With growing calls for a more explicit focus on patient flourishing in mental healthcare, we address two inter-related challenges: the lack of consensus on defining positive mental health and flourishing, and how professionals should respond to patients with controversial views on what is good for them. We discuss the relationship dynamics between healthcare providers and patients, proposing that \'liberal\' approaches can provide a pragmatic framework to address disagreements about well-being in the context of flourishing-oriented mental healthcare. We acknowledge the criticisms of these approaches, including the potential for unintended paternalism and distrust. To mitigate these risks, we conclude by suggesting a mechanism to minimize the likelihood of unintended paternalism and foster patient trust.

There is growing evidence that America is experiencing a Medical Care Crisis where patient well-being is no longer the priority. When we define \"patient well-being\" as the patient\'s positive experience while receiving medical care (meeting the shared health goals between the doctor and patient), we find that while America has the world\'s best and most resourced hospitals, doctors and universities, it paradoxically has the lowest patient satisfaction rate (12%-27% satisfaction). The Crisis is manifested by a lack of availability (even when there is access) to clinical services, clinical burnout/loss of doctor autonomy, corporatization of medical care (financial profit motives supersede patient well-being), depersonalization, non-clinicians performing clinical care and inadequate communication. Evidence suggests the cause of the Crisis to be an imbalance in our medical care environment; doctors, hospitals, payors and universities/innovators no longer work in concert to prioritize patient well-being. It calls for leaders to address burnout, communication, academic unawareness, and industry partner engagement. We must reestablish the reason for medical care: patient well-being.

The CREATION Model is a whole-person wellness model facilitating patient-provider partnerships for health promotion. CREATION is an acronym that represents eight whole-person health principles: Choice, Rest, Environment-Interpersonal Relationships, Activity, Trust, Outlook, and Nutrition, all focusing on the relationship between individual choice and physical, psychological, social, and spiritual health. This study develops and tests the psychometric properties of the CREATION Health Assessment Tool for Patients (CHAT-P). A 125-item-bank using a 5-point Likert scale with 1 to 5 rating was generated through focus-groups of clinicians, patients, and healthcare leaders. An expert panel assessed content adequacy, reducing items to 82. Patient survey data (n = 599) from 15 inpatient medical units were randomly divided into two datasets. Exploratory Factor Analysis applied to Dataset 1 resulted in a 7-factor (Choice/Rest/Environment-Interpersonal Relationships/Activity/Trust/Outlook/Nutrition) and 28-item tool with factor loading 0.47-0.86. The model structure was confirmed by Structural Equation Modeling on Dataset 2 with goodness-of-fit test results: X2/df = 2.41 < 5.0, RMSEA = 0.05 < 0.08, GFI = 0.91 and AGFI = 0.90. Cronbach\'s Alpha = 0.83 showed satisfactory reliability. The final CHAT-P totals ranged from 28-140 (higher scores indicating better health/well-being). When assessing the effectiveness of educational/behavioral interventions, this tool can measure the improvement of a patient\'s overall mind-body-spirit well-being or measure well-being for individual CREATION principle(s). It fills that gap and facilitates healthcare providers\' ability to assess and plan interventions to support holistic well-being.

Health and well-being are promoted when primary care teams partner with patients and provide care coordination to mitigate risks and promote optimal health. Identification of patients for care coordination is typically based on claim-driven risk assessments. Evidence shows that social determinants of health (SDOH) drive risk for adverse health outcomes but are omitted from existing risk tools. Missed opportunities for care coordination contribute to increased healthcare costs, poorer health outcomes and reduced patient well-being. To address the gap of risk-informed care coordination that includes SDOH, the aim of this project was to implement process improvement of a system\'s care coordination program through refined patient selection and customised engagement in intensive care coordination. A non-randomised care coordination quality improvement project was conducted at a community health centre in 2020. Inclusion criteria (i.e. presence of risk attribution score, SDOH questionnaire completed) resulted in 540 patients being offered care coordination services; Patients having at least one month of care coordination were included in the analysis (N = 216). Analysis included the 216 patients that chose participation and the 324 patients that maintained usual care. Descriptive statistics were generated to distinguish patient demographics, frequency of care coordination contact, and specific SDOH insecurities for both the study and comparison groups. Paired t-tests were incorporated to evaluate statistical significance of the intervention group. Impact on well-being, SDOH barriers, appointment adherence and health outcomes were assessed in both conditions. Intervention condition patients reported improvement in well-being [feeling anxious (t = 4.051; p < 0.000)] and reduced SDOH barriers [food access (t = 4.662; p < 0.000); housing (t = 2.203; p = 0.008)] that were significantly different from the usual care condition in the expected directions. Care coordination based on factors including SDOH risks shows promise in improving patient well-being. Future research should refine this approach for comprehensive risk assessment to intervene and support patient health and well-being.

BACKGROUND: The economic pressure in the healthcare system has noticeably increased in the past few years. The manifestation of an \"economization in medicine\" development raises questions about the compatibility of physicians\' duties and economic incentives in the healthcare system.
OBJECTIVE: Against this background the article analyzes areas of conflict in the German healthcare system and surgery in particular. The main questions focus on: what lines of conflict can arise between ethical duties and economic requirements and what possibilities for conflict resolution can provide orientation on the macrolevel and microlevel?
METHODS: The article is based on the analysis of normative regulations, guidelines and statements from the self-administrative institutions and multidisciplinary literature from medicine, medical ethics and health economics. Core issues in the conflict area between \"humanity-ethics-economics\" are structured and recommendations for action are derived.
CONCLUSIONS: Superordinate regulatory framework conditions and their subsequent incentives must not conflict with the ethical principles of medical care, especially the primary orientation to patient welfare. Institutional and individual healthcare providers have a responsibility towards patients first and only secondarily for an economically appropriate spending of public resources. The provision of medical care for people must enable an adequate livelihood. Institutional maximization of profits is to be avoided, especially concerning financial investors. In the corona pandemic, economic disincentives are becoming apparent and necessitate readjustments. Possible recommendations for action are the empowerment of the medical profession and management to engage in a qualified exchange.
UNASSIGNED: HINTERGRUND: Der ökonomische Druck im Gesundheitswesen hat in den zurückliegenden Jahren spürbar zugenommen. Die sich manifestierende „Ökonomisierung in der Medizin“ wirft die Frage nach der Vereinbarkeit ärztlicher Pflichten mit den wirtschaftlichen Anreizen im Gesundheitssystem auf.
UNASSIGNED: Vor diesem Hintergrund analysiert der Beitrag Spannungsfelder im deutschen Gesundheitswesen und speziell in der Chirurgie. Zu den wesentlichen Fragestellungen gehören: Welche Konfliktlinien verlaufen zwischen ethischen Pflichten und ökonomischen Anforderungen, welche Orientierungsmöglichkeiten können auf der Makro- und Mikroebene zur Konfliktlösung beitragen?
METHODS: Der Beitrag basiert auf der Analyse normativer Regelungen, Leitlinien und Stellungnahmen von Institutionen der Selbstverwaltung sowie multidisziplinärer Literatur – aus der Medizin, Medizinethik und Gesundheitsökonomie. Kernthemen des Spannungsfeldes „Humanität-Ethik-Ökonomie“ werden strukturiert aufbereitet und Handlungsoptionen abgeleitet.
UNASSIGNED: Übergeordnete Rahmenbedingungen und von ihnen ausgehende Anreize dürfen nicht mit ethischen Grundsätzen ärztlichen Handelns, besonders der primären Orientierung am Patientenwohl im Konflikt stehen. Institutionelle und individuelle Akteur*innen üben ihre Verantwortung zunächst gegenüber Patient*innen und nachrangig im Hinblick auf die sachgerechte, sparsame Verausgabung von Pflichtbeiträgen aus. Mit der medizinischen Versorgung von Menschen muss ein adäquates Auskommen möglich sein. Institutionelle Gewinnmaximierung verbietet sich – besonders für Finanzinvestoren. In der Corona-Pandemie werden ökonomische Fehlanreize deutlich und Nachjustierungen erforderlich. Handlungsoptionen zeigen sich in der Befähigung von Ärzteschaft und Management zu einem qualifizierten Austausch.