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Patient-centered medical home

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https://www.readbyqxmd.com/read/28228653/drug-prescription-appropriateness-in-the-elderly-an-italian-study
#1
Nicola Allegri, Federica Rossi, Federica Del Signore, Paolo Bertazzoni, Roberto Bellazzi, Giorgio Sandrini, Tomaso Vecchi, Davide Liccione, Alessia Pascale, Stefano Govoni
PURPOSE: Correct drug prescription in the elderly is a difficult task that requires careful survey of the current pharmacological therapies. In this article, we reviewed the drug prescriptions provided to 860 persons aged 65 years or over, residing in a small city of Lombardy, Italy. METHODS: Subjects were recruited from a local nursing home, the Pavia and Vigevano Neuropsychological Center for Alzheimer's Disease, general practitioners' offices, and the local University of the Third Age...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28225374/characterizing-the-toxicity-and-dose-effect-profile-of-tramadol-ingestions-in-children
#2
Gina L Stassinos, Lawrence Gonzales, Wendy Klein-Schwartz
OBJECTIVES: Tramadol can cause life-threatening toxicity in overdose; however, data on its toxicity in children are lacking. This study investigates toxicity associated with tramadol ingestions in children. The hypothesis is that children will experience dose-related central nervous system and respiratory depression and seizures. METHODS: A retrospective evaluation of cases from the National Poison Center Data System between January 1, 2000, and December 31, 2013, was performed...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28222847/relying-on-the-national-mobile-disaster-hospital-as-a-business-continuity-strategy-in-the-aftermath-of-a-tornado-the-louisville-experience
#3
Randy D Kearns, Lew Stringer, James Craig, Regina Godette-Crawford, Paul S Black, David L Andra, James Winslow
On 28th April, 2014, a tornado left much of Louisville, MS and the local hospital, Winston Medical Center, in ruin. In the USA, temporary hospital solutions have been used to augment the mainstream healthcare system since the American Civil War. As memories fade, however, the necessary readiness for a temporary hospital also fades, at times leaving a patchwork of resources either underfunded or abandoned. With the creation of the Hospital Preparedness Program, several temporary hospital solutions were created in various states across the USA...
January 1, 2017: Journal of Business Continuity & Emergency Planning
https://www.readbyqxmd.com/read/28221672/can-braden-score-predict-outcomes-for-hospitalized-heart-failure-patients
#4
Brian Bandle, Kelsey Ward, Sung-Joon Min, Cynthia Drake, Colleen K McIlvennan, David Kao, Heidi L Wald
BACKGROUND: Braden score is a routine assessment of pressure ulcer risk hypothesized to identify the frail phenotype. OBJECTIVES: To investigate the predictive utility of the Braden score on outcomes of inpatients with heart failure (HF). DESIGN: Retrospective cohort study. SETTING: An academic medical center between January 1, 2012 and June 30, 2013. PARTICIPANTS: 642 inpatients with a primary diagnosis of HF (ICD-9 428)...
February 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28216856/feasibility-and-acceptability-of-implementing-the-integrated-care-plan-for-the-dying-in-the-indian-setting-survey-of-perspectives-of-indian-palliative-care-providers
#5
Naveen Salins, Jeremy Johnson, Stanley Macaden
INTRODUCTION: Capacity to provide end-of-life care in India is scored as 0.6/100, and very few people in India have access to palliative and end-of-life care. Lack of end-of-life care provision in India has led to a significant number of people receiving inappropriate medical treatment at the end of life, with no access to pain and symptom control and high treatment costs. The International Collaborative for the Best Care for the Dying Person is an initiative that offers the opportunity to apply international evidence on the key factors required to provide best care for the dying in the Indian context...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28212474/-zinc-phosphide-poisoning-in-pediatric-patients-from-a-toxicology-center-at-mexico-city
#6
María Carmen Socorro Sánchez-Villegas, Alejandro Bárcena-Ruiz
BACKGROUND: Zinc phosphide is a chemical compound that is frequently used as a rodenticide; it is a highly toxic product that is widely used, among other spaces, at home. Given that it is a highly commercialized pesticide and that there is no antidote, it is mandatory to establish favorably the clinical manifestations of the intoxication. The aim was to describe the epidemiological and clinical profile of children intoxicated with zinc phosphide attended in a toxicological center of a tertiary referral hospital...
2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28199266/practitioner-application-a-decision-support-approach-for-provider-scheduling-in-a-patient-centered-medical-home
#7
Pamela J Stoyanoff
No abstract text is available yet for this article.
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28199265/a-decision-support-approach-for-provider-scheduling-in-a-patient-centered-medical-home
#8
Renata Konrad, Sarah Ficarra, Catherine Danko, Rachel Wallace, Cliona Archambeault
The patient-centered medical home (PCMH) has been proposed as a viable and medically effective model of primary care delivery. The fundamental principles of a PCMH address increased access and offer new ways to organize a practice. Creating provider schedules able to satisfy the operational and organizational constraints imposed by this type of delivery model is a challenging, complex, and time-consuming task.This article presents a two-step approach for scheduling providers and prospectively assessing the consequences of various schedules on patient throughput without experimenting on the real-world system...
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28186453/effects-of-distance-and-transport-method-on-intervention-and-mortality-in-aneurysmal-subarachnoid-hemorrhage
#9
Jonathan Weyhenmeyer, Cristian F Guandique, Adam Leibold, Stephen Lehnert, Jonathan Parish, Woody Han, Chad Tuchek, Janit Pandya, Thomas Leipzig, Troy Payner, Andrew DeNardo, John Scott, Aaron A Cohen-Gadol
OBJECTIVE Most patients suffering from aneurysmal subarachnoid hemorrhage (aSAH) initially present to a hospital that lacks a neurosurgical unit. These patients require interhospital transfer (IHT) to tertiary facilities capable of multidisciplinary neurosurgical intervention. Yet, little is known about the effects of IHT on the outcomes of patients suffering from aSAH. In this study, the authors examined the effects of IHT and transport method on the timing of treatment, rebleed rates, and overall outcomes of patients who have experienced aSAH...
February 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28186016/collaborators-and-communication-channels-in-eight-patient-centered-medical-homes
#10
Dian A Chase, David A Dorr, Deborah J Cohen, Joan S Ash
BACKGROUND: The patient-centered medical home (PCMH) concept requires collaboration among clinicians both within the medical home clinic, and outside the clinic. As we redesign health information technology (HIT) to support transformation to the PCMH, we need to better understand these collaboration patterns. This study provides quantitative data describing these collaborations in order to facilitate the design of systems to allow for more efficient collaboration. APPROACH: Eighty-four clinicians in eight clinics identified their two most recent significant collaborators - one each within the clinic and in the medical neighborhood...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28183346/study-protocol-improving-the-transition-of-care-from-a-non-network-hospital-back-to-the-patient-s-medical-home
#11
Roman A Ayele, Emily Lawrence, Marina McCreight, Kelty Fehling, Jamie Peterson, Russell E Glasgow, Borsika A Rabin, Robert Burke, Catherine Battaglia
BACKGROUND: The process of transitioning Veterans to primary care following a non-Veterans Affairs (VA) hospitalization can be challenging. Poor transitions result in medical complications and increased hospital readmissions. The goal of this transition of care quality improvement (QI) project is to identify gaps in the current transition process and implement an intervention that bridges the gap and improves the current transition of care process within the Eastern Colorado Health Care System (ECHCS)...
February 10, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28178085/the-patient-portal-considerations-for-nps
#12
Elizabeth C Elkind, Kathleen M Higgins
Hospitals, patient-centered medical homes, and provider practices have either introduced or are in the process of planning for patient portals. The NP plays an important role in the patient engagement initiative. This article explores patient portal strategies and resources to support this technology integration and practice change.
March 7, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28169976/the-impact-of-alternative-payment-in-chronically-ill-and-older-patients-in-the-patient-centered-medical-home
#13
Claudia A Salzberg, Asaf Bitton, Stuart R Lipsitz, Cal Franz, Shimon Shaykevich, Lisa P Newmark, Japneet Kwatra, David W Bates
BACKGROUND: Patient-centered medical home (PCMH) has gained prominence as a promising model to encourage improved primary care delivery. There is a paucity of studies that evaluate the impact of payment models in the PCMH. OBJECTIVES: We sought to examine whether coupling coordinated, team-based care transformation plan with a novel reimbursement model affects outcomes related to expenditures and utilization. RESEARCH DESIGN: Interrupted time-series model with a difference-in-differences approach to assess differences between intervention and control groups, across time periods attributable to PCMH transformation and/or payment change...
February 6, 2017: Medical Care
https://www.readbyqxmd.com/read/28166580/outcomes-of-embedded-care-management-in-a-family-medicine-residency-patient-centered-medical-home
#14
Robert J Newman, Richard Bikowski, Kristy Nakayama, Tina Cunningham, Pam Acker, Dana Bradshaw
BACKGROUND AND OBJECTIVES: Much attention is devoted nationally to preventing hospital readmissions and emergency department (ED) use, given the high cost of this care. There is a growing body of evidence from the Patient Centered Primary Care Collaborative that a patient-centered medical home (PCMH) model successfully lowers these costs. Our study evaluates a specific intervention in a family medicine residency PCMH to decrease readmissions and ED utilization using an embedded care manager...
January 2017: Family Medicine
https://www.readbyqxmd.com/read/28156625/clinical-and-health-care-setting-of-patients-admitted-at-pain-control-center-hospice-of-solofra-a-feasibility-model-of-end-of-life-care-in-the-avellino-province-of-italy
#15
Carmela Fasano, Luisa M Rizzo, A M Strollo, Elena De Vinco, Vincenzo Landolfi, Elena Altieri, Mario Nicola Vittorio Ferrante, Sergio Canzanella, Giuseppe Servillo, Lucia Genua, Maddalena Zampi, Gaetano D'Onofrio
: 59 Background: The Pain Control Center Hospice of Solofra (Italy) is managed with a mixed public / private, the first experience in the Campania region.We have evaluated the treatment procedures and the clinical outcome to make a comparison by between 123 evaluable patients in palliative care in 2015 and 232 evaluable patients in the biennium 2012-2014. METHODS: The following characteristics: patient gender, mean hospitalization time, differentiation between cancer and non cancer patients, medical weapon use, venous access type, enteral and parenteral feeding, pain killer use,Karnofsky scale...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156492/food-as-medicine-a-randomized-controlled-trial-rct-of-home-delivered-medically-tailored-meals-hdmtm-on-quality-of-life-qol-in-metastatic-lung-and-non-colorectal-gi-cancer-patients
#16
Raymond Mailhot Vega, Lisa Zullig, Alissa Wassung, Dorella Walters, Noah Berland, Kevin Lee Du, Jiyoung Ahn, Cynthia G Leichman, Deirdre Jill Cohen, Ping Gu, Abraham Chachoua, Lawrence P Leichman, Karen Pearl, Peter B Schiff
: 155 Background: Malnutrition incidence in cancer approaches 85%, disproportionately burdening those with lung, GI, and advanced stage cancers. Malnourished patients have impaired chemotherapy response, shorter survival, longer hospital stays, and decreased QoL. Home delivered meals are nutritional interventions that improve patient well-being, nutrition, and lower healthcare costs in the elderly but have not been studied as an intervention in cancer patients. HDMTM are nutritionist prescribed home delivered meals tailored to patient's symptoms, co-morbidities, and health needs...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156485/palliative-care-interventions-and-end-of-life-care-outcomes-for-hepatocellular-patients-pts-at-two-veterans-affairs-va-medical-centers
#17
Sarah Lee, Sejal Kothadia, Yucai Wang, Victor Tsu-Shih Chang, Yeun-Hee Anna Park, Ellen Olson, David Klein, Fengming Zhong
: 164 Background: Palliative care interventions and their effect on EOL outcomes for liver cancer pts have not been described. We investigated the association between palliative care intervention and EOL care outcomes. METHODS: We reviewed the charts of pts with hepatocellular carcinoma and who were seen by palliative care at 2 VA medical centers from 2006 to 2012. We investigated the association between EOL outcomes (number of ER visits, ICU visits, chemotherapy, place of death, number of hospitalizations during their last 30 days), and interventions such as early referral (within 30 days of diagnosis), defined goals of care, holding a family meeting, and symptom assessment and management...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156478/using-touch-based-technology-to-screen-patients-in-the-icu
#18
Matthew J Loscalzo, Rupinder Sidhu, David Horak, Sorin Buga
: 76 Background: The intensive care unit (ICU) is associated with high mortality rates, significant costs, along with occasionally futile and non-indicated care. Surveys of patients indicate the majority wish to focus on comfort and being at home at the end of life as opposed to the aggressive interventions received in the hospital. Although a small percentage of patients may be awake, medical teams look to the families to provide the direction of care for a patient in the ICU. City of Hope National Medical Center has utilized tablet-based screening of caregivers for years, and now in conjunction with delirium screening has started to roll out tablet-based screening for patients who are awake and do not have delirium...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152868/compliance-with-national-comprehensive-cancer-network-guidelines-for-antiemesis-in-cisplatin-regimens
#19
Dana Ann Little
: 280 Background: The members of a network of community cancer centers affiliated with an academic medical center report following National Comprehensive Cancer Network (NCCN) guidelines. To determine guideline compliance, cisplatin regimens were audited. Cisplatin was selected because of its wide use, high emetic potential, and the impact on QOL for patients with unmanaged nausea and vomiting.The community cancer centers affiliated with an academic medical center report following National Comprehensive Cancer Network (NCCN) guidelines for treatment plans...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152802/integrating-nursing-into-oral-chemotherapy-education
#20
Nancy Weinstein, Jessica A Zerillo
: 81 Background:The shift of chemotherapy administration from the oncology infusion suite to the home has unwound systems and left patients vulnerable to errors. Many of the safeguards for parenteral chemotherapy, including education by an oncology nurse, are absent for oral chemotherapy. The 2013 American Society of Clinical Oncology/Oncology Nursing Society Standards served as the framework for improving the initiation of oral chemotherapy at Beth Israel Deaconess Medical Center. METHODS: Clinicians caring for patients with melanoma and renal cell cancer were surveyed...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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