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https://www.readbyqxmd.com/read/29792460/the-complexity-diversity-and-science-of-primary-care-teams
#1
Kevin Fiscella, Susan H McDaniel
This article examines the past, present and future of primary care and teamwork. It begins with a definition and description of primary care-its uniqueness, diversity and complexity, including the historical role of teams within primary care. The article then reviews the emergence of innovative primary care teams, including those grounded in new processes such as the Patient-Centered Medical Home and interprofessional teams that include new types of health professionals, particularly psychologists and other integrated behavioral health clinicians...
May 2018: American Psychologist
https://www.readbyqxmd.com/read/29792063/integrating-childhood-obesity-resources-into-the-patient-centered-medical-home-provider-perspectives-in-the-united-states
#2
Samareh G Hill, Thao-Ly T Phan, George A Datto, Jobayer Hossain, Lloyd N Werk, Diane Abatemarco
Pediatric primary care providers play a critical role in managing obesity yet often lack the resources and support systems to provide effective care to children with obesity. The objective of this study was to identify system-level barriers to managing obesity and resources desired to better managing obesity from the perspective of pediatric primary care providers. A 64-item survey was electronically administered to 159 primary care providers from 26 practices within a large pediatric primary care network. Bivariate analyses were performed to compare survey responses based on provider and practice characteristics...
January 1, 2018: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29790864/implementing-comprehensive-primary-care-referral-tracking-in-a-patient-centered-medical-home
#3
Jenny Spahr, Jennifer Coddington, Nancy Edwards, Sara McComb
The Patient-Centered Medical Home care model emphasizes efficient, coordinated care distributed among interdisciplinary team members. One key function to care coordination is referral/test tracking. This study evaluated the referral practices in a nurse-managed Patient-Centered Medical Home primary care clinic. The major findings corroborate the need for a well-organized referral-tracking system that is centralized and contains safety nets to reduce the number of delayed or missed referrals.
July 2018: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/29789318/impact-of-a-pharmacist-physician-collaborative-care-model-on-patient-outcomes-and-health-services-utilization
#4
Gary R Matzke, Leticia R Moczygemba, Karen J Williams, Michael J Czar, William T Lee
PURPOSE: The impact of a pharmacist-physician collaborative care model on patient outcomes and health services utilization is described. METHODS: Six hospitals from the Carilion Clinic health system in southwest Virginia, along with 22 patient-centered medical home (PCMH) practices affiliated with Carilion Clinic, participated in this project. Eligibility criteria included documented diagnosis of 2 or more of the 7 targeted chronic conditions (congestive heart failure, hypertension, hyperlipidemia, diabetes mellitus, asthma, chronic obstructive pulmonary disease, and depression), prescriptions for 4 or more medications, and having a primary care physician in the Carilion Clinic health system...
May 22, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29782601/patient-centered-medical-home-status-and-preparedness-to-assess-resident-milestones-a-cera-study
#5
Thad Wilkins, Wonsuk Yoo, Ralph A Gillies, Julie Dahl-Smith, Jacqueline Dubose, Joseph Hobbs, Selina Smith, Dean A Seehusen
Purpose: The patient-centered medical home (PCMH) model has been proposed as the ideal model for delivering primary care and is focused on improving patient safety and quality, reducing costs, and enhancing patient satisfaction. The mandated Accreditation Council for Graduate Medical Education educational milestones for evaluation of resident competency represent the skills graduates will utilize after graduation. Many of these skills are reflected in the PCMH model. We sought to determine if residency programs whose main family medicine (FM) practice sites have achieved PCMH recognition are therefore more prepared to evaluate milestones...
May 2018: PRiMER: peer-review reports in medical education research
https://www.readbyqxmd.com/read/29777334/patient-engagement-in-community-health-center-leadership-how-does-it-happen
#6
Anjana E Sharma, Beatrice Huang, Margae Knox, Rachel Willard-Grace, Michael B Potter
Patient engagement in primary care leadership is an important means to involve community voices at community health centers. Federally qualified health centers (FQHCs) are mandated to have patient representation within their governing boards, while practices seeking patient-centered medical home certification receive credit for implementing patient advisory councils (PACs). Our objective was to compare and contrast how community health centers engage patients in clinic management, decision-making and planning within governing boards versus PACs...
May 18, 2018: Journal of Community Health
https://www.readbyqxmd.com/read/29773935/factors-contributing-to-appropriate-sharps-disposal-in-the-community-among-patients-with-diabetes
#7
Li Huang, Svetlana Katsnelson, Jie Yang, Charalambos Argyrou, Marina M Charitou
Background: Proper disposal of sharps has been well studied in hospital settings but not often addressed in the home setting. This lack of attention has resulted in erratic use of proper sharps disposal techniques and thus increased risk of needle-stick injuries and infections. This study aimed to evaluate methods of disposal and patient demographic factors associated with correct disposal of diabetes-related sharps in the community. Methods: A survey was administered to diabetes patients at an endocrinology clinic of an academic tertiary care center...
May 2018: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29773431/preoperative-frailty-assessment-predicts-loss-of-independence-after-vascular-surgery
#8
Graham W Donald, Amir A Ghaffarian, Farid Isaac, Larry W Kraiss, Claire L Griffin, Brigitte K Smith, Mark R Sarfati, Julie L Beckstrom, Benjamin S Brooke
OBJECTIVE: Frailty, a clinical syndrome associated with loss of metabolic reserves, is prevalent among patients who present to vascular surgery clinics for evaluation. The Clinical Frailty Scale (CFS) is a rapid assessment method shown to be highly specific for identifying frail patients. In this study, we sought to evaluate whether the preoperative CFS score could be used to predict loss of independence after major vascular procedures. METHODS: We identified all patients living independently at home who were prospectively assessed using the CFS before undergoing an elective major vascular surgery procedure (admitted for >24 hours) at an academic medical center between December 2015 and December 2017...
May 14, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29770549/importance-of-frailty-evaluation-in-the-prediction-of-the-prognosis-of-patients-with-chronic-subdural-hematoma
#9
Kiyoharu Shimizu, Takashi Sadatomo, Takeshi Hara, Shumpei Onishi, Kiyoshi Yuki, Kaoru Kurisu
AIM: The present study aimed to clarify the relationship between frailty and prognosis of patients with chronic subdural hematoma. METHODS: This retrospective study involved 211 patients aged ≥65 years with chronic subdural hematoma, who underwent surgery at Higashihiroshima Medical Center, Hiroshima, Japan, between July 2011 and May 2017. The study outcome was the patient's modified Rankin Scale score at 3 months after surgery. A logistic regression analysis was carried out to analyze factors that influenced the outcome...
May 17, 2018: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29767402/connecting-refugees-to-medical-homes-through-multi-sector-collaboration
#10
Lemaat Michael, Alexandra K Brady, Greg Russell, Scott D Rhodes, Shahla Namak, Laura Cody, Andrea Vasquez, Andrea Caldwell, Jennifer Foy, Julie M Linton
As increasing numbers of refugees have resettled globally, an interdisciplinary group of stakeholders in Forsyth, North Carolina, recognized obstacles preventing coordinated medical care, which inspired the development of our Refugee Health Collaborative. This study assessed the Collaborative's impact on access to coordinated care within patient-centered medical homes (PCMH). A Collaborative-developed novel algorithm guided the process by which refugees establish care in PCMHs. All refugees who established medical care in the two primary health systems in our county (n = 285) were included...
May 16, 2018: Journal of Immigrant and Minority Health
https://www.readbyqxmd.com/read/29763409/the-patient-centered-medical-home-expensive-and-in-need-of-repair
#11
Peter Boland
On the one hand, the PCMH is an admirable effort to gather in one place all the disparate and disorganized clinical and social supports the patient needs. At the same time, though, medical homes employ provider-defined business models and conventional performance measures, belying the patient-centered in the name.
May 2018: Managed Care
https://www.readbyqxmd.com/read/29762292/a-dedicated-satellite-trauma-orthopaedic-program-operating-room-safely-increases-capacity
#12
Peter M Waters, Brian W Yang, Doreen White, Ellen Barth, Vincent Chiang, Arielle Mizrahi-Arnaud, William Sparks
BACKGROUND: Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center without jeopardizing patient safety. METHODS: In addition to the daily emergency surgical room on the main campus, a dedicated orthopaedic trauma surgery OR was established in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29759257/developing-a-medical-scribe-program-at-an-academic-hospital-the-hennepin-county-medical-center-experience
#13
Marc L Martel, Brian H Imdieke, Kayla M Holm, Sara Poplau, William G Heegaard, Jon L Pryor, Mark Linzer
BACKGROUND: Medical scribes are frequently incorporated into the patient care model to improve provider efficiency and enable providers to refocus their attention to the patient rather than the electronic health record (EHR). The medical scribe program was based on four pillars (objectives): (1) provider satisfaction, (2) standardized documentation, (3) documentation components for risk adjustment, and (4) revenue enhancement. METHODS: The medical scribe program was deployed in nine non-resident-supported clinics (internal medicine, ophthalmology, orthopedics, hematology/oncology, urology), with the medical scribes (who have no clinical duties) supporting both physicians and advanced practice providers (nurse practitioners and physician assistants)...
May 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29759058/impact-of-medical-homes-on-expenditures-and-utilization-for-beneficiaries-with-behavioral-health-conditions
#14
Melissa A Romaire, Vincent Keyes, William J Parish, Konny Kim
OBJECTIVE: Individuals with behavioral health conditions may benefit from enhanced care management provided by a patient-centered medical home (PCMH). In late 2011 and early 2012 Medicare began participating in PCMH initiatives in eight states through the Multi-Payer Advanced Primary Care Practice (MAPCP) demonstration. This study examined how the initiatives addressed the needs of patients with behavioral health conditions and the impacts of the demonstration on expenditures and utilization for this population...
May 15, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29757890/pediatric-carbon-monoxide-poisoning-in-southern-israel-a-cross-sectional-study
#15
Yariv Fruchtman, Zvi H Perry, Tom Leibson, Liat Vered Cohen, Matitiahu Lifshitz, Eugene Leibovitz
OBJECTIVES: This study aimed to describe the epidemiology and clinical burden of unintended carbon monoxide (CO) poisoning among children in the Negev region of southern Israel. METHODS: This was a cross-sectional retrospective study of CO poisoning patients admitted to Soroka University Medical Center in 2011 through 2015. RESULTS: Overall, 43 cases of CO poisoning were recorded among children younger than 18 years. Five patients died, all upon admission...
May 2, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29755216/yoga-for-heart-failure-a-review-and-future-research
#16
REVIEW
Paula R Pullen, William S Seffens, Walter R Thompson
Background: Complementary and alternative medicine is a rapidly growing area of biomedical inquiry. Yoga has emerged in the forefront of holistic medical care due to its long history of linking physical, mental, and spiritual well-being. Research in yoga therapy (YT) has associated improved cardiovascular and quality of life (QoL) outcomes for the special needs of heart failure (HF) patients. Aim: The aim of this study is to review yoga intervention studies on HF patients, discuss proposed mechanisms, and examine yoga's effect on physiological systems that have potential benefits for HF patients...
May 2018: International Journal of Yoga
https://www.readbyqxmd.com/read/29743228/implementation-of-the-geriatric-patient-aligned-care-team-model-in-the-veterans-health-administration-va
#17
Jennifer L Sullivan, Rina Eisenstein, Thomas Price, Samantha Solimeo, Kenneth Shay
BACKGROUND: Here, we describe the implementation of a specialty primary care medical home (PCMH) model called Geriatric Patient-Aligned Care Teams (GeriPACT) in the Veterans' Health Administration (VA) that is focused on serving older complex patients. In particular, our aims in this article are to describe how the GeriPACT model was developed and implemented in VA sites, provide a closer look at how GeriPACT functions by presenting a case study, and highlight data showing national variation in the implementation of GeriPACT staffing models and PCMH practices...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743217/strategies-for-addressing-the-challenges-of-patient-centered-medical-home-implementation-lessons-from-oregon
#18
Sherril Gelmon, Nicole Bouranis, Billie Sandberg, Shauna Petchel
BACKGROUND: Patient-centered medical homes (PCMHs) are at the forefront of the transformation of primary care as part of health systems reform. Despite robust literature describing implementation challenges, few studies describe strategies being used to overcome these challenges. This article addresses this gap through observations of exemplary PCMHs in Oregon, where the Oregon Health Authority supports and recognizes Patient-Centered Primary Care Homes (PCPCH). METHODS: Twenty exemplary PCPCHs were selected using program scores, with considerations for diversity in clinic characteristics...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29739735/effectiveness-of-a-blended-multidisciplinary-intervention-for-patients-with-moderate-medically-unexplained-physical-symptoms-parasol-protocol-for-a-cluster-randomized-clinical-trial
#19
Paula Elisabeth van Westrienen, Martijn F Pisters, Suze Aj Toonders, Marloes Gerrits, Cindy Veenhof, Niek J de Wit
BACKGROUND: Medically unexplained physical symptoms are an important health problem in primary care, with a spectrum from mild to chronic. The burden of chronic medically unexplained physical symptoms is substantial for patients, health care professionals, and society. Therefore, early identification of patients with moderate medically unexplained physical symptoms is needed in order to prevent chronicity. The preventive screening of medically unexplained physical symptoms (PRESUME) screening method was developed using data from the electronic medical record of the patients' general practitioner and demonstrated its prognostic accuracy to identify patients with moderate medically unexplained physical symptoms...
May 8, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29736114/exploring-education-and-training-needs-in-palliative-care-among-family-physicians-in-mumbai-a-qualitative-study
#20
Anuja Damani, Arunangshu Ghoshal, Manjiri Dighe, Sunil Dhiliwal, Maryann Muckaden
Context: Patients with chronic life-limiting conditions on palliative care (PC) prefer to be treated at home. Medical care by family physicians (FPs) reduces demand on costly and busy hospital facilities. Working of PC team in collaboration with FPs is thus helpful in home-based management of patients. Aims: This study aimed at exploring the extent of knowledge of FPs about PC and the need for additional training. Settings and Design: Semi-structured interviews were conducted with ten FPs from two suburbs of Mumbai, currently served by home care services of a tertiary cancer care center...
April 2018: Indian Journal of Palliative Care
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