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Patient-centered medical home

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https://www.readbyqxmd.com/read/29657087/the-pediatric-aerodigestive-center-as-a-tertiary-care-based-medical-home-a-proposed-model
#1
Meghan M Galligan, Tara W Bamat, Annique K Hogan, Joseph Piccione
Children with special healthcare needs have been identified nationally as a population whose health care is associated with unmet needs; increased morbidity; fragmentation of care and medical errors; caregiver dissatisfaction; and disproportionately high costs. A subset of these children are medically fragile, with medical complexity that requires a reliance on tertiary care-based services-including subspecialty appointments, surgical procedures, and care coordination resources. For medically complex patients affected by upper and lower respiratory tract and gastrointestinal disorders, multidisciplinary aerodigestive centers have emerged at tertiary care centers across the United States to facilitate coordinated, high-quality, and high value care...
April 12, 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29655553/transitional-care-post-tavi-a-pilot-initiative-focused-on-bridging-gaps-and-improving-outcomes
#2
Sandra Wong, Lorraine Montoya, Bonnie Quinlan
Interventions focused on ensuring safe transitions for patients from hospital to home can assist in providing continuity of care, preventing readmissions, and reducing duplication of services. Patients undergoing a Transcatheter Aortic Valve Implantation (TAVI) procedure are often frail, elderly, and have multiple co-morbidities. A pilot initiative evaluating transitional care strategies through telephone follow up was implemented in a tertiary centre with the aim to identify gaps and intervene, preventing re-admission and improving patient outcomes...
April 11, 2018: Geriatric Nursing
https://www.readbyqxmd.com/read/29649400/impact-of-inpatient-palliative-care-on-quality-of-end-of-life-care-and-downstream-acute-and-postacute-care-utilization
#3
Peter S Khang, Susan E Wang, In-Lu Amy Liu, Heather L Watson, Sandra Y Koyama, Dan N Huynh, Janet S Lee, Huong Q Nguyen
BACKGROUND: Additional evidence is needed regarding the impact of inpatient palliative care (IPC) on the quality of end-of-life care and downstream utilization. AIM: Examine the effects of IPC on quality of end-of-life care and acute and postacute care use in a large integrated system. DESIGN: Retrospective cohort design. SETTING/PARTICIPANTS: Adult decedents from January 1, 2012, to December 31, 2014, who had at least one hospitalization at 11 Kaiser Permanente Southern California medical centers in the 12 months before death and not hospitalized for a trauma-related condition or receiving home-based PC or hospice were included in the cohort...
March 13, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29629923/organizational-processes-and-patient-experiences-in-the-patient-centered-medical-home
#4
Jaya Aysola, Marilyn M Schapira, Hairong Huo, Rachel M Werner
BACKGROUND: There is increasing emphasis on the use of patient-reported experience data to assess practice performance, particularly in the setting of patient-centered medical homes. Yet we lack understanding of what organizational processes relate to patient experiences. OBJECTIVE: Examine associations between organizational processes practices adopt to become PCMH and patient experiences with care. RESEARCH DESIGN: We analyzed visit data from patients (n=8356) at adult primary care practices (n=22) in a large health system...
April 6, 2018: Medical Care
https://www.readbyqxmd.com/read/29623236/does-use-of-oral-anticoagulants-at-the-time-of-admission-affect-outcomes-following-hip-fracture
#5
Ariana Lott, Jack Haglin, Rebekah Belayneh, Sanjit R Konda, Philipp Leucht, Kenneth A Egol
Purpose: The purpose of this study was to compare hospital quality outcomes in patients over the age of 60 undergoing fixation of hip fracture based on their anticoagulation status. Materials and Methods: Patients aged 60 and older with isolated hip fracture injuries treated operatively at 1 academic medical center between October 2014 and September 2016 were analyzed. Patients on the following medications were included in the anticoagulation cohort: warfarin, clopidogrel, aspirin 325 mg, rivaroxaban, apixaban, dabigatran, and dipyridamole/aspirin...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29621893/facilitating-home-hospice-transitions-of-care-in-oncology-evaluation-of-clinical-pharmacists-interventions-hospice-program-satisfaction-and-patient-representation-rates
#6
Alison P Duffy, Nina M Bemben, Jueli Li, James Trovato
BACKGROUND: The importance of medication reconciliation and the pharmacist's role within the interdisciplinary team at the point of transition to home hospice is understudied. A transitions of care pilot initiative was developed to streamline the transition for patients at end of life from inpatient cancer center care to home hospice. The initiative consisted of using a hospice discharge checklist, pharmacist-led discharge medication reconciliation in consultation with the primary team responsible for inpatient care, review of discharge prescriptions, and facilitation of bedside delivery of discharge medications...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29618922/in-depth-interviews-of-patients-with-primary-immunodeficiency-who-have-experienced-pump-and-rapid-push-subcutaneous-infusions-of-immunoglobulins-reveal-new-insights-on-their-preference-and-expectations
#7
Grégoire Jacques Noël Cozon, Pierre Clerson, Annaïk Dokhan, Yann Fardini, Taylor Pindi Sala, Jean-Charles Crave
Purpose: Patients with primary immunodeficiency (PID) often receive immunoglobulin replacement therapy (IgRT). Physicians and patients have the choice between various methods of administration. For subcutaneous immunoglobulin infusions, patients may use an automated pump (P) or push the plunger of a syringe (rapid push [RP]). P infusions are performed once a week and last around 1 hour. RP decreases the duration of administration, but requires more frequent infusions. Patients and methods: Eight out of 30 patients (coming from a single center) who had participated in the cross-over, randomized, open-label trial comparing P and RP participated in a focus group or underwent in-depth interviews...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29616653/accessibility-of-cesarean-deliveries-in-benin
#8
V Mongbo, J Saïzonou, G Sopoh, C Sossa-Jérôme, E M Ouendo, I Godin
To be used effectively, emergency obstetric and neonatal care must be available and accessible. This study sought to measure the accessibility of cesarean deliveries in Benin. Cross-sectional study of randomly selected women in each of the 12 obstetrics departments in Benin. Geographical accessibility was measured by estimating the distance between the parturientes residence and the hospital. Financial accessibility was the average direct cost of the cesarean delivery -the sum of medical and non-medical costs...
February 1, 2018: Médecine et Santé Tropicales
https://www.readbyqxmd.com/read/29611089/impact-of-patient-centered-medical-home-implementation-on-diabetes-control-in-the-veterans-health-administration
#9
LeChauncy D Woodard, Omolola E Adepoju, Amber B Amspoker, Salim S Virani, David J Ramsey, Laura A Petersen, Lindsey A Jones, Lea Kiefer, Praveen Mehta, Aanand D Naik
BACKGROUND: Given its widespread dissemination across primary care, the Veterans Health Administration (VA) is an ideal setting to examine the impact of the patient-centered medical home (PCMH) on diabetes outcomes. OBJECTIVE: To assess the impact of PCMH implementation on diabetes outcomes among patients receiving care in the Veterans Health Administration. DESIGN: Retrospective cohort analysis and multilevel logistic regression. PATIENTS: Twenty thousand eight hundred fifty-eight patients in one Midwest VA network who had a diabetes diagnosis in both 2009 and 2012 and who received primary care between October 1, 2008 and September 30, 2009...
April 2, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29610828/interactions-between-physicians-and-skilled-home-health-care-agencies-in-the-certification-of-medicare-beneficiaries-plans-of-care-results-of-a-nationally-representative-survey
#10
Cynthia M Boyd, Bruce Leff, Julia Bellantoni, Navpreet Rana, Jennifer L Wolff, David L Roth, Kim Carl, Orla C Sheehan
Background: Physicians are required to certify a plan of care for patients who receive Medicare skilled home health care (SHHC) services. The Centers for Medicare & Medicaid Services form 485 (CMS-485) is typically used for certification of SHHC plans of care and for interactions between SHHC agencies and physicians. Little is known about how physicians use the CMS-485 or their perceptions of its usefulness with respect to coordinating care with SHHC agencies. Objective: To determine how physicians interact with SHHC agencies and use the CMS-485 in care coordination for patients receiving SHHC services...
April 3, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29609716/analyses-of-the-complexity-of-patients-undergoing-attended-polysomnography-in-the-era-of-home-sleep-apnea-tests
#11
Brendon Colaco, Daniel Herold, Matthew Johnson, Daniel Roellinger, James M Naessens, Timothy I Morgenthaler
STUDY OBJECTIVES: Health care complexity includes dimensions of patient comorbidity and the level of services needed to meet patient demands. Home sleep apnea tests (HSAT) are increasingly used to test medically uncomplicated patients suspected of having moderate to severe obstructive sleep apnea (OSA). Patients with significant comorbidities or other sleep disorders are not candidates for HSAT and require attended in-center polysomnography. We hypothesized that this trend would result in increasingly complex patients being studied in sleep centers...
March 30, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29606357/who-where-and-why-are-patients-lost-to-follow-up-a-20-year-study-of-bladder-exstrophy-patients-at-a-single-institution
#12
Emily Haddad, Ahmet Ali Sancaktutar, Blake W Palmer, Christopher Aston, Bradley P Kropp
INTRODUCTION: Individuals with bladder and cloacal exstrophy are at increased risk for kidney disease, renal failure, and bladder complications. Given the social implications and sensitive nature of the disease, these patients are also at risk for psychosocial problems. Lack of regular medical follow-up visits may pose serious risks to their long-term health status. The aim of this study is determine what factors place an affected individual at risk for limited long term follow up. MATERIALS AND METHODS: We identified all patients with bladder or cloacal exstrophy seen by the pediatric urology department at the Oklahoma University Health Sciences Center (OUHSC) between January 1996 and August 2016...
March 19, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29601425/predicting-risk-factors-for-30-day-readmissions-following-discharge-from-post-acute-care
#13
Nina M Flanagan, Victoria M Rizzo, Gary D James, Adele Spegman, Najla A Barnawi
PURPOSE OF STUDY: The specific aims of this descriptive study were to (1) examine the relationships between individual-level determinants of health using standard care admission assessments of residents admitted to a skilled nursing facility (SNF) and those residents readmitted to the hospital within 30 days from discharge from the same SNF; (2) identify and describe the risk factors of the residents readmitted to the hospital within 30 days; and (3) use the findings to inform and refine current practice to target the mutable risk factors correlated with 30-day hospital readmission...
May 2018: Professional Case Management
https://www.readbyqxmd.com/read/29600254/anesthesiology-residency-curriculum-and-implementation-of-a-perioperative-surgical-home-curriculum-a-survey-study
#14
Joseph Rinehart, Jenny Seong, Navid Alem, Roberta Andreatta, Jason Derhovanesian, Christina Smith, Zeev Kain
Background: The perioperative surgical home (PSH) is a physician-led, interdisciplinary, and patient-centered model of perioperative care that focuses on patient outcomes and comprehensive care management. Many studies to date have looked at the clinical implementation of varied PSH models with promising results discussed. There are no studies directly examining concrete plans for the various Accreditation Council for Graduate Medical Education (ACGME) anesthesiology residency programs to implement augmented PSH training into curricula...
July 2017: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/29594463/traumatic-brain-injury-in-indian-children
#15
REVIEW
Krishna Chaitanya, Archana Addanki, Rajendra Karambelkar, Rakesh Ranjan
INTRODUCTION: Traumatic brain injury (TBI) in children and adolescents is a community-based medical and educational challenge world-over due to increasing urbanization and motorization. In India, children between 1 to 15 years constitute significant proportion of the total population, who are vulnerable for TBI. In developed countries, pediatric trauma mortality still represents more than half of all childhood fatalities, which is 18 times more common than brain tumors. In this study, we attempted to analyze epidemiological factors, management, and outcome of TBI in children at a tertiary care center in Pune, Maharashtra...
March 29, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29588293/associations-between-changes-in-depressive-symptoms-and-social-support-and-diabetes-management-among-low-income-predominantly-hispanic-patients-in-patient-centered-care
#16
Hyunsung Oh, Kathleen Ell
OBJECTIVE: This study examined whether changes in depressive symptoms and social support prospectively predicted diabetes management among Hispanic patients with probable depression in patient-centered medical homes at safety-net clinics in East Los Angeles, CA. RESEARCH DESIGN AND METHODS: Data were collected from 251 patients enrolled in a randomized clinical trial testing the effectiveness of a promotora-assisted self-management intervention. Cross-lagged analyses examined associations between changes in depression symptoms and social support between baseline and 6-month follow-up and self-efficacy and adherence to diabetes management at the 6- and 12-month follow-ups...
March 27, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29580074/early-palliative-care-for-patients-with-brain-metastases-decreases-inpatient-admissions-and-need-for-imaging-studies
#17
Akram Habibi, S Peter Wu, Daniel Gorovets, Alexandra Sansosti, Marc Kryger, Cameron Beaudreault, Wei-Yi Chung, Gary Shelton, Joshua Silverman, Joseph Lowy, Douglas Kondziolka
BACKGROUND: Early encounters with palliative care (PC) can influence health-care utilization, clinical outcome, and cost. AIM: To study the effect of timing of PC encounters on brain metastasis patients at an academic medical center. SETTING/PARTICIPANTS: All patients diagnosed with brain metastases from January 2013 to August 2015 at a single institution with inpatient and/or outpatient PC records available for review (N = 145). DESIGN: Early PC was defined as having a PC encounter within 8 weeks of diagnosis with brain metastases; late PC was defined as having PC after 8 weeks of diagnosis...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29578853/michigan-pharmacists-transforming-care-and-quality-developing-a-statewide-collaborative-of-physician-organizations-and-pharmacists-to-improve-quality-of-care-and-reduce-costs
#18
Hae Mi Choe, Alexandra Tungol Lin, Kathleen Kobernik, Marc Cohen, Laurie Wesolowicz, Nabeel Qureshi, Tom Leyden, David A Share, Rozanne Darland, David A Spahlinger
BACKGROUND: Inappropriate drug use, increasing complexity of drug regimens, continued pressure to control costs, and focus on shared accountability for clinical measures drive the need to leverage the medication expertise of pharmacists in direct patient care. A statewide strategy based on the collaboration of pharmacists and physicians regarding patient care was developed to improve disease state management and medication-related outcomes. PROGRAM DESCRIPTION: Blue Cross Blue Shield of Michigan (BCBSM) partnered with Michigan Medicine to develop and implement a statewide provider-payer program called Michigan Pharmacists Transforming Care and Quality (MPTCQ), which integrates pharmacists within physician practices throughout the state of Michigan...
April 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29573481/safety-profile-during-initiation-of-propranolol-for-treatment-of-infantile-hemangiomas-in-an-ambulatory-day-care-hospitalization-setting
#19
Itay Fogel, Ayelet Ollech, Alex Zvulunov, Yulia Valdman-Greenshpon, Vered Atar-Sagie, Rivka Friedland, Moshe Lapidoth, Dan Ben-Amitai
BACKGROUND: Propranolol is the mainstay of treatment for infantile hemangioma. Despite its good safety profile, it is not risk-free. Guidelines for propranolol initiation and monitoring have been suggested, but protocols vary among practitioners. OBJECTIVE: This study sought to assess the prevalence of adverse events and clinically significant fluctuations in hemodynamic parameters in children with infantile hemangioma during initiation of treatment with propranolol in a day-hospitalization setting...
March 24, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/29555515/home-use-of-binocular-dichoptic-video-content-device-for-treatment-of-amblyopia-a-pilot-study
#20
Daphna Mezad-Koursh, Amir Rosenblatt, Hadas Newman, Chaim Stolovitch
PURPOSE: To evaluate the efficacy of the BinoVision home system as measured by improvement of visual acuity in the patient's amblyopic eye. METHODS: An open-label prospective pilot-trial of the system was conducted with amblyopic children aged 4-8 years at the pediatric ophthalmology unit, Tel-Aviv Medical Center, January 2014 to October 2015. Participants were assigned to the study or sham group for treatment with BinoVision for 8 or 12 weeks. Patients were instructed to watch animated television shows and videos at home using the BinoVision device for 60 minutes, 6 days a week...
March 16, 2018: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
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