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https://www.readbyqxmd.com/read/29223193/quality-indicators-for-evaluating-prehospital-emergency-care-a-scoping-review
#1
Ian Howard, Peter Cameron, Lee Wallis, Maaret Castren, Veronica Lindstrom
Introduction Historically, the quality and performance of prehospital emergency care (PEC) has been assessed largely based on surrogate, non-clinical endpoints such as response time intervals or other crude measures of care (eg, stakeholder satisfaction). However, advances in Emergency Medical Services (EMS) systems and services world-wide have seen their scope and reach continue to expand. This has dictated that novel measures of performance be implemented to compliment this growth. Significant progress has been made in this area, largely in the form of the development of evidence-informed quality indicators (QIs) of PEC...
December 10, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29221501/lean-methodology-reduces-inappropriate-use-of-antipsychotics-for-agitation-at-a-psychiatric-hospital
#2
Joshana K Goga, Antonio Depaolo, Sunil Khushalani, J Ken Walters, Robert Roca, Marc Zisselman, Christopher Borleis
OBJECTIVE: To Evaluate the Effects of Applying Lean Methodology-Improving Quality Increasing Efficiency by Eliminating Waste and Reducing Costs-An Approach To Decrease the Prescribing Frequency of Antipsychotics for The Indication of Agitation. DESIGN: Historically Controlled Study. SETTING: Bheppard Pratt Health System is the Largest Private Provider of Psychiatric Care in Maryland With a Total Bed Capacity of 300. There Were 4 337 Patient Days From November 1 2012 to October 31 2013 on the Dementia Unit...
January 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29220589/first-year-internal-medicine-residents-reflections-on-nonmedical-home-visits-to-high-risk-patients
#3
Stephanie K Nothelle, Colleen Christmas, Laura A Hanyok
PROBLEM: Patients who are high utilizers of care often experience health-related challenges that are not readily visible in an office setting but paramount for residents to learn. A nonmedical home visit performed at the beginning of residency training may help residents better understand social underpinnings related to their patient's health and place subsequent care within the context of the patient's life. INTERVENTION: First-year internal medicine residents completed a nonmedical home visit to an at-risk patient prior to seeing the patient in the office for his or her first medical visit...
December 8, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29209899/when-behavioral-health-concerns-present-in-pediatric-primary-care-factors-influencing-provider-decision-making
#4
Elizabeth H Connors, Prerna Arora, Angela M Blizzard, Kelly Bower, Kelly Coble, Joyce Harrison, David Pruitt, Janna Steinberg, Lawrence Wissow
Primary care providers (PCPs) frequently encounter behavioral health (BH) needs among their pediatric patients. However, PCPs report variable training in and comfort with BH, and questions remain about how and when PCPs address pediatric BH needs. Existing literature on PCP decisions to address pediatric BH in-office versus referring to subspecialty BH is limited and findings are mixed. Accordingly, this study sought to examine parameters and contextual factors influencing PCP decisions and practices related to BH care...
December 5, 2017: Journal of Behavioral Health Services & Research
https://www.readbyqxmd.com/read/29189477/remaining-financially-viable-in-a-time-of-healthcare-transition
#5
Barry P Ronan
In an unstable healthcare environment, Western Maryland Health System has been demonstrating stability. We have responded to the many challenges that hospitals face and managed to thrive in the new, value-based world.We made the transition to value-based payment and care delivery models through innovations in Maryland's payment system. In 2010, we recognized that becoming a demonstration project for value-based care would benefit our health system as we dealt with an aging and shrinking regional population...
January 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/29152438/barriers-to-timely-completion-of-radiation-therapy-in-patients-with-cervical-cancer-in-an-urban-tertiary-care-center
#6
Justin Cohen, Amy Harper, Elizabeth M Nichols, Gautam G Rao, Pranshu Mohindra, Dana Marie Roque
Background In 2017, there will be an estimated 12,820 women diagnosed with cervical cancer in the United States, causing an estimation of 4,210 deaths. Among U.S. women, there is a 33% greater incidence and 71% higher cervical cancer mortality in high-poverty counties when compared to low-income counties [1]. In those dispositioned to chemoradiation, treatment time of less than eight weeks is associated with compromised pelvic control. We sought to identify patient or disease characteristics and socioeconomic or psychosocial barriers that contribute to delays in treatment completion in order to formulate new policies to address these needs...
September 12, 2017: Curēus
https://www.readbyqxmd.com/read/29129193/experiences-of-three-states-implementing-the-medicaid-health-home-model-to-address-opioid-use-disorder-case-studies-in-maryland-rhode-island-and-vermont
#7
Lisa Clemans-Cope, Jane B Wishner, Eva H Allen, Nicole Lallemand, Marni Epstein, Brenda C Spillman
PURPOSE: The United States is facing an unprecedented opioid epidemic. The Affordable Care Act (ACA) included several provisions designed to increase care coordination in state Medicaid programs and improve outcomes for those with chronic conditions, including substance use disorders. Three states-Maryland, Rhode Island, and Vermont - adopted the ACA's optional Medicaid health home model for individuals with opioid use disorder. The model coordinates opioid use disorder treatment that features opioid agonist therapy provided at opioid treatment programs (OTPs) and Office-based Opioid Treatment (OBOT) with medical and behavioral health care and other services, including those addressing social determinants of health...
December 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/29118081/perceptions-of-dental-hygienists-and-dentists-about-preventing-early-childhood-caries-a-qualitative-study
#8
Alice M Horowitz, Dushanka V Kleinman, Wendy Child, Sarah D Radice, Catherine Maybury
Purpose: The objective of this qualitative pilot study was to gain an in-depth understanding of dental hygienists and dentists perspectives regarding children's oral health and what needs to be done to prevent early childhood caries (ECC), the most frequent chronic disease of childhood.Methods: A skilled facilitator conducted four focus groups and four phone interviews with 20 dental hygienists and 17 dentists practicing in a variety of locations within the state of Maryland. The interview guide was based on results from previous state-wide surveys of dental hygienists and dentists...
August 2017: Journal of Dental Hygiene: JDH
https://www.readbyqxmd.com/read/29116823/infusing-adult-education-principles-into-a-health-insurance-literacy-program
#9
Virginia Brown
Health insurance literacy is an emerging concept in the health education and health promotion field. The passage of the Affordable Care Act highlighted the link between health insurance and health outcomes. However, the law does not specifically address how the public should be educated on choosing an appropriate health insurance plan. Research shows adults, regardless of previous health insurance status, are likely confused and uncertain about their selection. The University of Maryland Extension developed and created health insurance Smart Choice Health Insurance™ to reduce confusion and increase confidence and capability to make this decision...
April 1, 2017: Health Promotion Practice
https://www.readbyqxmd.com/read/29113636/evaluation-of-interventions-in-clinical-pharmacist-led-annual-medicare-wellness-visits-compared-with-usual-care
#10
Regine C Beliard, Jessica W Merrey
OBJECTIVE: Evaluate and compare the number and types of medication and non-medication-related interventions by clinical pharmacists and nonpharmacists conducting an Annual Medicare Wellness Visit (MWV). DESIGN: Multi-center, retrospective case-control study. SETTING: Two community primary care internal medicine clinics in urban Maryland. PARTICIPANTS: Patients who had a MWV performed January 2014 through October 2015...
November 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29073129/receipt-of-selected-preventive-health-services-for-women-and-men-of-reproductive-age-united-states-2011-2013
#11
Karen Pazol, Cheryl L Robbins, Lindsey I Black, Katherine A Ahrens, Kimberly Daniels, Anjani Chandra, Anjel Vahratian, Lorrie E Gavin
PROBLEM/CONDITION: Receipt of key preventive health services among women and men of reproductive age (i.e., 15-44 years) can help them achieve their desired number and spacing of healthy children and improve their overall health. The 2014 publication Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs (QFP) establishes standards for providing a core set of preventive services to promote these goals. These services include contraceptive care for persons seeking to prevent or delay pregnancy, pregnancy testing and counseling, basic infertility services for those seeking to achieve pregnancy, sexually transmitted disease (STD) services, and other preconception care and related preventive health services...
October 27, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/29045797/public-health-detailing-to-increase-routine-hiv-screening-in-baltimore-maryland-satisfaction-feasibility-and-effectiveness
#12
Amelia Greiner Safi, Jamie Perin, Andrea Mantsios, Christina Schumacher, C Patrick Chaulk, Jacky M Jennings
The objective of this study was to evaluate the satisfaction with, and the feasibility and effectiveness of, a public health detailing project focused on increasing routine human immunodeficiency virus (HIV) screening of people aged 13-64 by primary care providers working in areas of Baltimore City, Maryland, with high rates of HIV transmission (defined as a mean geometric viral load of ≥1500 copies/mL per census tract). In public health detailing, trained public health professionals (ie, detailers) visit medical practice sites to meet with providers and site staff members, with the intention of influencing changes in clinical practice policy and/or behavior...
November 2017: Public Health Reports
https://www.readbyqxmd.com/read/29035630/a-population-health-measurement-framework-evidence-based-metrics-for-assessing-community-level-population-health-in-the-global-budget-context
#13
Elham Hatef, Elyse C Lasser, Hadi H K Kharrazi, Chad Perman, Russ Montgomery, Jonathan P Weiner
Population health is one of the pillars of the Triple Aim to improve US health care. The authors developed a framework for population health measurement and a proposed set of measures for further exploration to guide the population health efforts in Maryland. The authors searched peer-reviewed, expert-authored literature and current public health measures. Using a semi-structured analysis, a framework was proposed, which consisted of a conceptual model of several domains and identified population health measures addressing them...
October 16, 2017: Population Health Management
https://www.readbyqxmd.com/read/29021009/optimizing-the-use-of-discharge-medication-lists-in-nursing-facilities
#14
Andrea C Backes, Patricia Cash, Jessica Jordan
OBJECTIVE: To highlight the need to optimize the use of discharge medication lists in nursing facilities. SETTING: In January 2014, the care transitions (CT) pharmacists at Frederick Memorial Hospital, Frederick, Maryland, began a pilot project in which they identified and followed high-risk patients transitioning from hospital to nursing facility and from nursing facility to home. PRACTICE DESCRIPTION: This pilot project served as a needs assessment to identify opportunities to improve patients' transition from nursing facility to home with the goal of reducing hospital readmissions...
October 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28971702/-we-re-just-not-prepared-for-eating-over-our-whole-life-a-mixed-methods-approach-to-understanding-dietary-behaviors-among-longer-term-cancer-survivors
#15
Ann Carroll Klassen, Katherine Clegg Smith, Michelle Shuster, Kisha I Coa, Laura E Caulfield, Kathy J Helzlsouer, Kimberly S Peairs, Lillie D Shockney, Dara Stoney, Susan Hannum
BACKGROUND: In many countries, there are growing numbers of persons living with a prior diagnosis of cancer, due to the aging population and more successful strategies for treatment. There is also growing evidence of the importance of healthful diet and weight management for survivorship, yet many long-term cancer survivors are not successfully following recommendations. METHODS: We explored this issue in a mixed methods study with 53 adult survivors of 3 cancers (breast, prostate, and non-Hodgkin's lymphoma), living in Maryland...
September 1, 2017: Integrative Cancer Therapies
https://www.readbyqxmd.com/read/28953066/maryland-s-all-payer-health-care-system-a-light-at-the-end-of-a-tunnel
#16
Lama Bakhamis, Taeko Matsumoto, Mary Tran, David P Paul, Alberto Coustasse
The state of Maryland, in collaboration with the Centers for Medicare & Medicaid Services, developed the first all-payer system model in the Unites States in 1971 and 35 years later in response to financial pressures undertook to modernize this program. The focus of the modernized program was to improve overall per-capita expenditure, quality of care, and the outcome of Marylanders' health. The financial status of Maryland hospitals was declining because of the rate setting of the Health Services Cost Review Commission while hospital admission rates and spending were increasing...
September 26, 2017: Health Care Manager
https://www.readbyqxmd.com/read/28947348/transition-from-pediatric-to-adult-care-by-young-adults-with-chronic-granulomatous-disease-the-patient-s-viewpoint
#17
Rachel Margolis, Lori Wiener, Maryland Pao, Harry L Malech, Steven M Holland, Patricia Driscoll
PURPOSE: Children with chronic illnesses are living longer, prompting health care provider attention to the transition from pediatric to adult care. Transition of care is successful when youth are independent in managing their health. The aims of this study were to identify the strengths and barriers to transition from pediatric to adult care and to determine strategies that could enhance the transition process. METHODS: A survey was administered via a structured interview to 33 young adult participants (19-27 years of age), living with chronic granulomatous disease all of whom transitioned from pediatric to adult care...
September 22, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28899995/hiv-seroconversion-among-baltimore-city-residents-tested-at-a-mobile-van-programme
#18
Sarah Puryear, Phyllis Burnett, Kathleen R Page, Ravikiran Muvva, Patrick Chaulk, Khalil G Ghanem, Anne Monroe
BACKGROUND: Many individuals with HIV in the USA are unaware of their diagnosis, and therefore cannot be engaged in treatment services, have worse clinical outcomes and are more likely to transmit HIV to others. Mobile van testing may increase HIV testing and diagnosis. Our objective was to characterise risk factors for HIV seroconversion among individuals using mobile van testing. METHODS: A case cohort study (n=543) was conducted within an HIV surveillance dataset of mobile van testing users with at least two HIV tests between September 2004 and August 2009 in Baltimore, Maryland...
September 12, 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28876286/investigation-of-early-syphilis-trends-among-men-who-have-sex-with-men-to-identify-gaps-in-screening-and-case-finding-in-baltimore-city-maryland
#19
Christina M Schumacher, Errol Fields, Aruna Chandran, Omeid Heidari, Yvonne Kingon, Patrick Chaulk, Jacky M Jennings
BACKGROUND: Syphilis incidence is increasing across the United States among men who have sex with men (MSM). Early latent (EL) versus primary and secondary (P&S) syphilis may be an indicator of delayed diagnosis and increased opportunity for transmission. To inform syphilis control strategies and identify potential gaps in case finding, we described recent syphilis trends among MSM and compared characteristics of syphilis cases by diagnosis stage. METHODS: We used public health surveillance data on P&S and EL syphilis diagnoses reported to the Baltimore City Health Department between 2009 and 2015...
August 28, 2017: Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/28844233/do-hospitals-support-second-victims-collective-insights-from-patient-safety-leaders-in-maryland
#20
Hanan H Edrees, Laura Morlock, Albert W Wu
BACKGROUND: Second victims-defined as health care providers who are emotionally traumatized after a patient adverse event-may not receive needed emotional support. Although most health care organizations have an employee assistance program (EAP), second victims may be reluctant to access this service because of worries about confidentiality. A study was conducted to describe the extent to which organizational support for second victims is perceived as desirable by patient safety officers in acute care hospitals in Maryland and to identify existing support programs...
September 2017: Joint Commission Journal on Quality and Patient Safety
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