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Patient-centered medical home

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https://www.readbyqxmd.com/read/29243974/pediatric-cerebral-venous-sinus-thrombosis-or-compression-in-the-setting-of-skull-fractures-from-blunt-head-trauma
#1
David S Hersh, Nir Shimony, Mari L Groves, Gerald F Tuite, George I Jallo, Ann Liu, Tomas Garzon-Muvdi, Thierry A G M Huisman, Ryan J Felling, Joseph A Kufera, Edward S Ahn
OBJECTIVE Pediatric cerebral venous sinus thrombosis has been previously described in the setting of blunt head trauma; however, the population demographics, risk factors for thrombosis, and the risks and benefits of detection and treatment in this patient population are poorly defined. Furthermore, few reports differentiate between different forms of sinus pathology. A series of pediatric patients with skull fractures who underwent venous imaging and were diagnosed with intrinsic cerebral venous sinus thrombosis or extrinsic sinus compression is presented...
December 15, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29243823/pathways-to-medical-home-recognition-a-qualitative-comparative-analysis-of-the-pcmh-transformation-process
#2
Peter Mendel, Emily K Chen, Harold D Green, Courtney Armstrong, Justin W Timbie, Amii M Kress, Mark W Friedberg, Katherine L Kahn
OBJECTIVE: To understand the process of practice transformation by identifying pathways for attaining patient-centered medical home (PCMH) recognition. DATA SOURCES/STUDY SETTING: The CMS Federally Qualified Health Center (FQHC) Advanced Primary Care Practice Demonstration was designed to help FQHCs achieve NCQA Level 3 PCMH recognition and improve patient outcomes. We used a stratified random sample of 20 (out of 503) participating sites for this analysis. STUDY DESIGN: We developed a conceptual model of structural, cultural, and implementation factors affecting PCMH transformation based on literature and initial qualitative interview themes...
December 15, 2017: Health Services Research
https://www.readbyqxmd.com/read/29240371/meeting-the-needs-of-the-complex-older-adult-patient-with-urinary-retention-a-case-study
#3
Boss Goldstein, David S Goldfarb
This article presents a case study of how a homebound older adult patient with urinary retention is managed by a patient-centered medical home/transitional care model. A description of how a root cause analysis can effectively improve outcomes is also provided.
March 2017: Urologic Nursing
https://www.readbyqxmd.com/read/29238810/correlation-between-24-hour-predischarge-opioid-use-and-amount-of-opioids-prescribed-at-hospital-discharge
#4
Eric Y Chen, Andrew Marcantonio, Paul Tornetta
Importance: The United States is experiencing an opioid abuse epidemic. Opioid overprescription by physicians may contribute to this epidemic. Objectives: To determine if there was a correlation between a postoperative patient's 24-hour predischarge opioid use and the amount of opioids prescribed at hospital discharge and to determine the number of patients who used no opioids prior to discharge but were still prescribed opioids after hospital discharge. Design, Setting, and Participants: This cross-sectional study performed a retrospective record review of 18 343 postoperative patients at Boston Medical Center and Lahey Hospital and Medical Center-Burlington Campus who were discharged home after a postoperative inpatient admission of at least 24 hours...
December 13, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29237744/change-in-cognitive-function-in-the-month-after-hospitalization-for-acute-coronary-syndromes-findings-from-trace-core-transition-risks-and-actions-in-coronary-events-center-for-outcomes-research-and-education
#5
Jane S Saczynski, David D McManus, Molly E Waring, Darleen Lessard, Milena D Anatchkova, Jerry H Gurwitz, Jeroan Allison, Arlene S Ash, Richard H McManus, David C Parish, Robert J Goldberg, Catarina I Kiefe
BACKGROUND: Cognitive function is often impaired during hospitalization, but whether this impairment resolves or persists after discharge is unknown. METHODS AND RESULTS: We enrolled (April 2011-May 2013) and interviewed during hospitalization and 1-month post-discharge 1521 nondemented acute coronary syndrome survivors enrolled in TRACE (Transitions, Risks and Actions in Coronary Events). Cognitive function was assessed using the Telephone Interview of Cognitive Status (range: 0-41) at both time points...
December 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29237335/patient-centered-medical-home-measurement-in-school-based-health-centers
#6
Abbey Gregg, Li-Wu Chen, Jungyoon Kim, Hyo Jung Tak, Melissa Tibbits
School-based health centers (SBHCs) have been suggested as potential medical homes, yet minimal attention has been paid to measuring their patient-centered medical home (PCMH) implementation. The purposes of this article were to (1) develop an index to measure PCMH attributes in SBHCs, (2) use the SBHC PCMH Index to compare PCMH capacity between PCMH certified and non-PCMH SBHCs, and (3) examine differences in index scores between SBHCs based in schools with and without adolescents. A total of six PCMH dimensions in the SBHC PCMH Index were identified through factor analysis...
January 1, 2017: Journal of School Nursing: the Official Publication of the National Association of School Nurses
https://www.readbyqxmd.com/read/29233313/pharmacy-student-involvement-in-a-transition-of-care-program
#7
Raquel Hertig, Rina Ackerman, Brenda Zagar, Serina Tart
BACKGROUND AND PURPOSE: Cape Fear Valley Medical Center (CFVMC) implemented a Community Paramedic Program (CPP) to improve the transition of hospitalized patients to the home setting. In this program, paramedics conduct home visits for 30 days after qualifying patients are discharged. This article describes pharmacy services provided to CPP patients by fourth-year pharmacy students on Advanced Pharmacy Practice Experiences (APPE) that assisted with home visits. EDUCATIONAL ACTIVITY AND SETTING: Students were oriented to the CPP and patient interview technique was assessed through a role-play scenario...
September 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29228882/medical-education-and-human-trafficking-using-simulation
#8
Hanni Stoklosa, Michelle Lyman, Carrie Bohnert, Olivia Mittel
Healthcare providers have the potential to play a crucial role in human trafficking prevention, identification, and intervention. However, trafficked patients are often unidentified due to lack of education and preparation available to healthcare professionals at all levels of training and practice. To increase victim identification in healthcare settings, providers need to be educated about the issue of trafficking and its clinical presentations in an interactive format that maximizes learning and ultimately patient-centered outcomes...
2017: Medical Education Online
https://www.readbyqxmd.com/read/29216831/validity-of-mobile-electronic-data-capture-in-clinical-studies-a-pilot-study-in-a-pediatric-population
#9
Belinda von Niederhäusern, Ramon Saccilotto, Sabine Schädelin, Victoria Ziesenitz, Pascal Benkert, Marie-Luise Decker, Anya Hammann, Julia Bielicki, Marc Pfister, Christiane Pauli-Magnus
BACKGROUND: Clinical studies in children are necessary yet conducting multiple visits at study centers remains challenging. The success of "care-at-home" initiatives and remote clinical trials suggests their potential to facilitate conduct of pediatric studies. This pilot aimed to study the feasibility of remotely collecting valid (i.e. complete and correct) saliva samples and clinical data utilizing mobile technology. METHODS: Single-center, prospective pilot study in children undergoing elective tonsillectomy at the University of Basel Children's Hospital...
December 8, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/29212990/-what-to-learn-from-the-patient-centered-medical-home
#10
(no author information available yet)
No abstract text is available yet for this article.
2017: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/29210814/caregiver-education-reduces-the-incidence-of-community-acquired-clabsis-in-the-pediatric-patient-with-intestinal-failure
#11
Barbie Drews, Michelle Macaluso, Hannah Piper, Nandini Channabasappa
Pediatric patients with intestinal failure often require central venous catheters for extended periods of time for parenteral nutrition, blood sampling, and medication administration, increasing morbidity, mortality, and costs. In 2007, we reported a central line-associated bloodstream infection rate of 7.0 per 1,000 catheter line-days in our pediatric patients with intestinal failure. On the basis of this high rate of catheter-associated infections, we developed and implemented a central line care curriculum for patients/family caregivers and home health nurses...
November 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/29207939/tocilizumab-for-the-management-of-immune-mediated-adverse-events-secondary-to-pd-1-blockade
#12
Chipman Rg Stroud, Aparna Hegde, Cynthia Cherry, Abdul R Naqash, Nitika Sharma, Srikala Addepalli, Sulochana Cherukuri, Teresa Parent, Jessica Hardin, Paul Walker
Background Immune checkpoint inhibitors are poised to revolutionize the management of a growing number of malignancies. Unfortunately, the management of steroid-refractory immune mediated adverse events is based on a paucity of randomized data and limited to single center experiences. Our initial experience with the IL-6 receptor antagonist tocilizumab showed clinical improvement in a wide variety of irAEs. As a result, we adopted the use of tocilizumab for the management of steroid refractory irAEs. Methods The character and clinical course of irAEs were abstracted from the medical record and analyzed...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29204975/characteristics-and-disparities-among-primary-care-practices-in-the-united-states
#13
David Michael Levine, Jeffrey A Linder, Bruce E Landon
BACKGROUND: Despite new incentives for US primary care, concerns abound that patient-centered practice capabilities are lagging. OBJECTIVE: Describe the practice structure, patient-centered capabilities, and payment relationships of US primary care practices; identify disparities in practice capabilities. DESIGN: Analysis of the 2015 Medical Organizations Survey (MOS), part of the nationally representative Medical Expenditure Panel Survey (MEPS)...
December 4, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29202782/studying-de-implementation-in-health-an-analysis-of-funded-research-grants
#14
Wynne E Norton, Amy E Kennedy, David A Chambers
BACKGROUND: Studying de-implementation-defined herein as reducing or stopping the use of a health service or practice provided to patients by healthcare practitioners and systems-has gained traction in recent years. De-implementing ineffective, unproven, harmful, overused, inappropriate, and/or low-value health services and practices is important for mitigating patient harm, improving processes of care, and reducing healthcare costs. A better understanding of the state-of-the-science is needed to guide future objectives and funding initiatives...
December 4, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29198634/intraoperative-administration-of-4-factor-prothrombin-complex-concentrate-reduces-blood-requirements-in-cardiac-transplantation
#15
Gina H Sun, Visal Patel, Ingrid Moreno-Duarte, Farhad Zahedi, Eric Ursprung, Greg Couper, Fred Y Chen, Ian J Welsby, Raymond Comenzo, Grace Kao, Frederick C Cobey
OBJECTIVE: Assessing the efficacy of intraoperative 4-factor prothrombin complex concentrate (4F-PCC) use in blood product utilization, time to chest closure, intensive care unit (ICU) and hospital length of stay (LOS), thromboembolic complications, renal injury and mortality in left ventricular assist device (LVAD) patients on home anticoagulation therapy with warfarin, undergoing orthotopic heart transplantation (OHT). DESIGN: Retrospective analysis of OHT patients at Tufts Medical Center from May 2013 to October 2016...
August 3, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29194594/development-and-validation-of-a-short-form-safety-net-medical-home-scale
#16
Robert S Nocon, Kathryn E Gunter, Yue Gao, Sang Mee Lee, Marshall H Chin
OBJECTIVE: To develop a short-form Safety Net Medical Home Scale (SNMHS) for assessing patient-centered medical home (PCMH) capability in safety net clinics. DATA SOURCES/STUDY SETTING: National surveys of federally qualified health centers (FQHCs). Interviews with FQHC directors. STUDY DESIGN: We constructed three short-form SNMHS versions and examined correlations with full SNMHS and related primary care assessments. We tested usability with FQHC directors and reviewed scale development with an advisory group...
December 1, 2017: Health Services Research
https://www.readbyqxmd.com/read/29189045/the-effects-of-baduanjin-exercise-on-fatigue-and-quality-of-life-in-patients-with-heart-failure-a-randomized-controlled-trial
#17
Dai-Mei Chen, Wen-Chung Yu, Huei-Fong Hung, Jen-Chen Tsai, Hsiao-Ying Wu, Ai-Fu Chiou
AIMS: The purpose of this study was to examine the effects of Baduanjin exercise on fatigue and quality of life in patients with heart failure. METHODS: The study was a randomized controlled trial. Participants diagnosed with heart failure were recruited from two large medical centers in northern Taiwan. Participants were randomly assigned to the intervention ( n=39) or control ( n=41) groups. Patients in the intervention group underwent a 12-week Baduanjin exercise program, which included Baduanjin exercise three times per week for 12 weeks at home, a 35-minute Baduanjin exercise demonstration video, a picture-based educational brochure, and a performance record form...
November 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29182358/diabetes-care-improvement-in-pharmacist-versus-nurse-supported-patient-centered-medical-homes
#18
Lillian Min, Christine T Cigolle, Steven J Bernstein, Kathleen Ward, Tisha L Moore, Jinkyung Ha, Caroline S Blaum
OBJECTIVES: In 2009 and 2010, 17 primary care sites within 1 healthcare system became patient-centered medical homes (PCMHs), but the sites trained different personnel (pharmacists vs nurses) to improve diabetes care using self-management support (SMS). We report the challenges and successes of our efforts to: 1) assemble a new multipayer (Medicare, Medicaid, commercial) claims dataset linked to a clinical registry and 2) use the new dataset to perform comparative effectiveness research on implementation of the 2 SMS models...
November 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29182352/patients-perspectives-of-care-management-a-qualitative-study
#19
Ann S O'Malley, Deborah Peikes, Claire Wilson, Rachel Gaddes, Victoria Peebles, Timothy J Day, Janel Jin
OBJECTIVES: Risk-stratified care management is a cornerstone of patient-centered medical home models, but studies on patients' perspectives of care management are scarce. We explored patients' experiences with care management, what they found useful, and what needs improvement. STUDY DESIGN: Semi-structured qualitative telephone interviews. METHODS: We interviewed 43 high-risk patients or their caregivers who were receiving care management from 11 practices in CMS' Comprehensive Primary Care initiative, provided by nurse care managers (9 practices) or the physician (2 [solo] practices)...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29180558/using-drug-prescribing-patterns-to-identify-stewards-of-cost-conscious-care
#20
Nicole Michele Gastala, Peter Wingrove, Winston Liaw, Stephen Petterson, Andrew Bazemore
PURPOSE: To characterize family physicians (FPs) who are stewards of care by consistently prescribing omeprazole over esomeprazole. METHODS: Cross-sectional analysis of physicians prescribing omeprazole or esomeprazole under Medicare Part D in 2014. RESULTS: There was a regional trend with 49% of Western FPs but only 6% of Southern FPs rarely prescribing esomeprazole. Physicians had increased odds of being a steward if they worked with a care coordinator (P < ...
November 2017: Journal of the American Board of Family Medicine: JABFM
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