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https://www.readbyqxmd.com/read/28222715/the-characteristics-of-stroke-units-in-ontario-a-pan-provincial-survey
#1
Valeria E Rac, Yeva Sahakyan, Iris Fan, Luciano Ieraci, Ruth Hall, Linda Kelloway, Gabrielle van der Velde, Moira K Kapral, Mark Bayley, Murray Krahn
BACKGROUND: Previous studies have demonstrated that organized, multidisciplinary care is the cornerstone of current strategies to reduce the death and disability caused by stroke. Identification of stroke units and an understanding of their composition and operation would provide insight for the further actions required to improve stroke care. The objective of this study was to identify and survey stroke units in Canada's largest province, Ontario (population of 13 million) in order to describe availability, structure, staffing, processes of care, and type of population stroke units serve...
February 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28152949/improving-screening-and-prophylaxis-of-hepatitis-b-in-immunosuppressed-patients
#2
Violeta Rabrenovich, David M Baer, Joanne E Schottinger
: 139 Background: Kaiser Permanente (KP) is an integrated health care delivery system that provides clinical services to over 10 million members in nine states and the District of Columbia. Since 2007, KP oncology community collaborates at the national level to systematically improve safety and quality of care. Our improvements are accelerated by rapid adoption of evidence based protocols, leveraging of EMR and integration of quality improvement methods into clinical operations. METHODS: KP created a team that included oncologists, hepatologists, rheumatologist, pharmacy, and quality improvement experts to evaluate safety of existing practice...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152733/trends-in-cancer-care-with-the-affordable-care-act
#3
Robert Clell Miller
: 46 Background: Accountable Care Organizations (ACO), as proposed by the Affordable Care Act, will change the delivery of health care in the United States. ACO serve as a network of providers with primary care providers (PCP) set up as gate-keepers for referrals to specialists. Within the next several years, many trends will emerge and drive progress of change, requiring oncologist to take a lead role to adapt to the evolving landscape of health care. METHODS: Literature search of internet-based and academic sources for oncology and the Affordable Care, with a focus on ACO formation...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152693/assessing-the-cost-of-cancer-care-delivery-using-a-time-driven-activity-based-costing-software
#4
Alexis B Guzman, Yu-Ting Huang, Monica DelValle-Garza, Christian C Kolom, Xin Zhao, Danson N Mutua, Krishan Dhingra, Thomas W Feeley
: 25 Background: Poor costing systems and measurement have led to cross-subsidies and cost-shifting in health care. A large academic cancer center has adopted Robert Kaplan's bottom-up cost accounting methodology called time-driven, activity-based costing (TDABC). TDABC in health care has been proven to be an effective cost accounting tool to measure and improve care delivery by standardizing and creating transparency around patient care processes. The project aims to process map and identify event triggers associated with each process map, use a software applications to compute the costs and resource capacities...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152676/evaluation-of-resource-utilization-using-time-derived-activity-based-costing-tdabc-to-result-in-more-effective-processes-and-cost-reduction
#5
Elizabeth A Garcia, Kai E Lang, Valerie Villanueva, Shannon Neville Westin, Nicole D Fleming, Thomas W Feeley, Karen H Lu, Larissa Meyer
: 22 Background: Current changes in health care economics have led to a focus on value-based health care. TDABC is a systematic method to assess personnel utilization and the associated cost in the delivery of medical care. Based on baseline process maps and cost estimates in our outpatient center, cancer surveillance visits (CSV) were identified as inefficient, lengthy and high cost. The purpose of this study was to determine if reallocation of personnel was feasible, resulted in decrease cost and better value care...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28132720/kidney-disease-population-health-management-in-the-era-of-accountable-care-a-conceptual-framework-for-optimizing-care-across-the-ckd-spectrum
#6
Mallika L Mendu, Sushrut S Waikar, Sandhya K Rao
Since its passage in 2010, the Affordable Care Act has led to the creation of numerous accountable care organizations that face the challenge of transforming the traditional care delivery model to provide more patient-centered, high-quality, and low-cost care. Complex patients, including those with chronic kidney disease (CKD), present the most challenges and opportunities. CKD is a condition with significant morbidity, mortality, and cost and thought to be partly secondary to known gaps in care delivery. Successful population management for CKD requires consideration of the needs of patients at all phases of the disease...
January 23, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28132168/delivery-and-payment-redesign-to-reduce-disparities-in-high-risk-postpartum-care
#7
Elizabeth A Howell, Norma A Padrón, Susan J Beane, Joanne Stone, Virginia Walther, Amy Balbierz, Rashi Kumar, José A Pagán
Purpose This paper describes the implementation of an innovative program that aims to improve postpartum care through a set of coordinated delivery and payment system changes designed to use postpartum care as an opportunity to impact the current and future health of vulnerable women and reduce disparities in health outcomes among minority women. Description A large health care system, a Medicaid managed care organization, and a multidisciplinary team of experts in obstetrics, health economics, and health disparities designed an intervention to improve postpartum care for women identified as high-risk...
January 28, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28094909/integrated-working-for-enhanced-health-care-in-english-nursing-homes
#8
Glenda Cook, Anne McNall, Juliana Thompson, Philip Hodgson, Lynne Shaw, Daniel Cowie
BACKGROUND: The increasingly complex nature of care home residents' health status means that this population requires significant multidisciplinary team input from health services. To address this, a multisector and multiprofessional enhanced healthcare programme was implemented in nursing homes across Gateshead Council in Northern England. STUDY AIMS: To explore the views and experiences of practitioners, social care officers, and carers involved in the enhanced health care in care home programme, in order to develop understanding of the service delivery model and associated workforce needs for the provision of health care to older residents...
January 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28086871/the-integrated-care-pathway-for-post-stroke-patients-icapps-a-shared-care-approach-between-stakeholders-in-areas-with-limited-access-to-specialist-stroke-care-services
#9
Aznida Firzah Abdul Aziz, Nor Azlin Mohd Nordin, Mohd Fairuz Ali, Noor Azah Abd Aziz, Saperi Sulong, Syed Mohamed Aljunid
BACKGROUND: Lack of intersectoral collaboration within public health sectors compound efforts to promote effective multidisciplinary post stroke care after discharge following acute phase. A coordinated, primary care-led care pathway to manage post stroke patients residing at home in the community was designed by an expert panel of specialist stroke care providers to help overcome fragmented post stroke care in areas where access is limited or lacking. METHODS: Expert panel discussions comprising Family Medicine Specialists, Neurologists, Rehabilitation Physicians and Therapists, and Nurse Managers from Ministry of Health and acadaemia were conducted...
January 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28062019/care-delivery-patterns-processes-and-outcomes-for-primary-ovarian-cancer-surgery-a-population-based-review-using-a-national-administrative-database
#10
Saad Shakeel, Laurie Elit, Noori Akhtar-Danesh, Laura Schneider, Christian Finley
OBJECTIVES: In this pan-Canadian study, we sought to elucidate the current state of surgical care for primary ovarian cancers and factors influencing selected short-term outcomes; these were in-hospital mortality (IHM), major complications (MCs), failure-to-rescue (FTR), and hospital length of stay (LOS). METHODS: We created a population cohort using inpatient admission records from the Canadian Institute of Health Information data set (2004-2012). Multilevel logistic regression and flexible parametric survival analyses, adjusted for hospital clustering effect, were conducted to determine the effect of patient-specific factors (i...
January 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28043961/stakeholder-engagement-in-diabetes-self-management-patient-preference-for-peer-support-and-other-insights
#11
Bethany M Kwan, Bonnie Jortberg, Meredith K Warman, Ilima Kane, Robyn Wearner, Romona Koren, Thomas Carrigan, Vincent Martinez, Donald E Nease
BACKGROUND: Self-management support (SMS) for patients with diabetes can improve adherence to treatment, mitigate disease-related distress, and improve health outcomes. Translating this evidence into real-world practice is needed, as it is not clear which SMS models are acceptable to patients, and feasible and sustainable for primary care practices. OBJECTIVE: To use the Boot Camp Translation (BCT) method to engage patient, practice, community resource and research stakeholders in translation of evidence about SMS and diabetes distress into mutually acceptable care models and to inform patient-centred outcomes research (PCOR)...
January 1, 2017: Family Practice
https://www.readbyqxmd.com/read/28025929/hemophilia-management-via-data-collection-and-reporting-initial-findings-from-the-comprehensive-care-sustainability-collaborative
#12
Michael D Tarantino, Vanita K Pindolia
BACKGROUND: Despite being a rare disorder, hemophilia represents a significant driver of health care resource utilization and requires expert hematologic and multidisciplinary services to achieve optimal outcomes. Since their inception nearly 40 years ago, hemophilia treatment centers (HTCs) have served as centers of excellence in providing the intensive care and ancillary services necessary for this unique patient base; however, the full capabilities of these centers may be underused in the current framework of managed care, largely because of a lack of communication and information shared between payers and HTC stakeholders...
January 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28024313/utilisation-of-home-based-physician-nurse-and-personal-support-worker-services-within-a-palliative-care-programme-in-ontario-canada-trends-over-2005-2015
#13
Zhuolu Sun, Audrey Laporte, Denise N Guerriere, Peter C Coyte
With health system restructuring in Canada and a general preference by care recipients and their families to receive palliative care at home, attention to home-based palliative care continues to increase. A multidisciplinary team of health professionals is the most common delivery model for home-based palliative care in Canada. However, little is known about the changing temporal trends in the propensity and intensity of home-based palliative care. The purpose of this study was to assess the propensity to use home-based palliative care services, and once used, the intensity of that use for three main service categories: physician visits, nurse visits and care by personal support workers (PSWs) over the last decade...
December 26, 2016: Health & Social Care in the Community
https://www.readbyqxmd.com/read/27929664/paradigm-shifts-in-breast-care-delivery-impact-of-imaging-in-a-multidisciplinary-environment
#14
REVIEW
Savitri Krishnamurthy, Therese Bevers, Henry M Kuerer, Benjamin Smith, Wei Tse Yang
OBJECTIVE: The practice of breast imaging in a collaborative multidisciplinary environment adds significant value to outcomes in women's health care. In this article, we describe multidisciplinary considerations in breast cancer screening and early detection, the impact of imaging and histopathologic findings in the diagnostic evaluation and management of breast abnormalities, and the contribution of imaging to surgical and radiation therapy planning for the breast cancer patient. CONCLUSION: The multidisciplinary delivery of breast care for women that incorporates screening, diagnosis of borderline and high-risk lesions, and management of the breast cancer patient adds considerable value to outcomes in health care...
February 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27923227/optimal-role-of-the-nephrologist-in-the-intensive-care-unit
#15
D J Askenazi, Michael Heung, Michael J Connor, Rajit K Basu, Jorge Cerdá, Kent Doi, Jay L Koyner, Azra Bihorac, Ladan Golestaneh, Anitha Vijayan, Mark D Okusa, Sarah Faubel
As advances in Critical Care Medicine continue, critically ill patients are surviving despite the severity of their illness. The incidence of acute kidney injury (AKI) has increased, and its impact on clinical outcomes as well as medical expenditures has been established. The role, indications and technological advancements of renal replacement therapy (RRT) have evolved, allowing more effective therapies with less complications. With these changes, Critical Care Nephrology has become an established specialty, and ongoing collaborations between critical care physicians and nephrologist have improved education of multi-disciplinary team members and patient care in the ICU...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27893503/impacting-care-and-treatment-of-the-burn-patient-conversion-to-electronic-documentation
#16
Holly M Hampe, Terri Keeling, Michelle Fontana, Debbie Balcik
Improving patient care through enhanced electronic communication among health care providers is aimed at reducing the number of medication and medical errors. The American Reinvestment and Recovery Act (ARRA) was signed into law in 2009, supporting the federal government's commitment to the improvement of health care quality, safety, and efficiency through requirements to implement an electronic health record by October 2015 or hospitals and eligible providers potentially realizing penalties or reduced reimbursement rates...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27886946/building-multidisciplinary-health-workforce-capacity-to-support-the-implementation-of-integrated-people-centred-models-of-care-for-musculoskeletal-health
#17
REVIEW
M J Chehade, T K Gill, D Kopansky-Giles, L Schuwirth, J Karnon, P McLiesh, J Alleyne, A D Woolf
To address the burden of musculoskeletal (MSK) conditions, a competent health workforce is required to support the implementation of MSK models of care. Funding is required to create employment positions with resources for service delivery and training a fit-for-purpose workforce. Training should be aligned to define "entrustable professional activities", and include collaborative skills appropriate to integrated and people-centred care and supported by shared education resources. Greater emphasis on educating MSK healthcare workers as effective trainers of peers, students and patients is required...
June 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27884311/understanding-kidney-care-needs-and-implementation-strategies-in-low-and-middle-income-countries-conclusions-from-a-kidney-disease-improving-global-outcomes-kdigo-controversies-conference
#18
Vivekanand Jha, Mustafa Arici, Allan J Collins, Guillermo Garcia-Garcia, Brenda R Hemmelgarn, Tazeen H Jafar, Roberto Pecoits-Filho, Laura Sola, Charles R Swanepoel, Irma Tchokhonelidze, Angela Yee Moon Wang, Bertram L Kasiske, David C Wheeler, Goce Spasovski
Evidence-based cinical practice guidelines improve delivery of uniform care to patients with and at risk of developing kidney disease, thereby reducing disease burden and improving outcomes. These guidelines are not well-integrated into care delivery systems in most low- and middle-income countries (LMICs). The KDIGO Controversies Conference on Implementation Strategies in LMIC reviewed the current state of knowledge in order to define a road map to improve the implementation of guideline-based kidney care in LMICs...
December 2016: Kidney International
https://www.readbyqxmd.com/read/27864163/developing-a-web-based-weight-management-program-for-childhood-cancer-survivors-rationale-and-methods
#19
Fang Fang Zhang, Susan Meagher, Michael Scheurer, Sara Folta, Emily Finnan, Kerry Criss, Christina Economos, ZoAnn Dreyer, Michael Kelly
BACKGROUND: Due to advances in the field of oncology, survival rates for children with cancer have improved significantly. However, these childhood cancer survivors are at a higher risk for obesity and cardiovascular diseases and for developing these conditions at an earlier age. OBJECTIVE: In this paper, we describe the rationale, conceptual framework, development process, novel components, and delivery plan of a behavioral intervention program for preventing unhealthy weight gain in survivors of childhood acute lymphoblastic leukemia (ALL)...
November 18, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27860051/the-professional-psychiatric-mental-health-nurse-skills-competencies-and-supports-required-to-adopt-recovery-orientated-policy-in-practice
#20
E Cusack, F Killoury, L E Nugent
: WHAT IS KNOWN ON THE SUBJECT?: Nationally and internationally there has been a movement away from the traditional medical model towards a more holistic recovery-oriented approach to mental health care delivery. At every level of service provision the emphasis is firmly on recovery and on facilitating active partnership working and involvement of service users, their carers and family members. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study to identify on a national level specific areas of care that are addressed most or least by psychiatric and mental health nurses in care planning for mental health service users in Ireland...
November 18, 2016: Journal of Psychiatric and Mental Health Nursing
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