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"High value care"

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https://www.readbyqxmd.com/read/29159414/hepatitis-b-vaccination-screening-and-linkage-to-care-best-practice-advice-from-the-american-college-of-physicians-and-the-centers-for-disease-control-and-prevention
#1
Winston E Abara, Amir Qaseem, Sarah Schillie, Brian J McMahon, Aaron M Harris
Background: Vaccination, screening, and linkage to care can reduce the burden of chronic hepatitis B virus (HBV) infection. However, recommendations vary among organizations, and their implementation has been suboptimal. The American College of Physicians' High Value Care Task Force and the Centers for Disease Control and Prevention developed this article to present best practice statements for hepatitis B vaccination, screening, and linkage to care. Methods: A narrative literature review of clinical guidelines, systematic reviews, randomized trials, and intervention studies on hepatitis B vaccination, screening, and linkage to care published between January 2005 and June 2017 was conducted...
November 21, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29159367/promoting-high-value-practice-by-reducing-unnecessary-transfusions-with-a-patient-blood-management-program
#2
Divyajot Sadana, Ariella Pratzer, Lauren J Scher, Harry S Saag, Nicole Adler, Frank M Volpicelli, Moises Auron, Steven M Frank
Although blood transfusion is a lifesaving therapy for some patients, transfusion has been named 1 of the top 5 overused procedures in US hospitals. As unnecessary transfusions only increase risk and cost without providing benefit, improving transfusion practice is an effective way of promoting high-value care. Most high-quality clinical trials supporting a restrictive transfusion strategy have been published in the past 5 to 10 years, so the value of a successful patient blood management program has only recently been recognized...
November 20, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29155338/financial-toxicity-in-bladder-cancer-patients-reasons-for-delay-in-care-and-effect-on-quality-of-life
#3
Marianne M Casilla-Lennon, Seul Ki Choi, Allison M Deal, Jeannette T Bensen, Gopal Narang, Pauline Filippou, Benjamin McCormick, Raj Pruthi, Eric Wallen, Hung-Jui Tan, Michael Woods, Matthew Nielsen, Angela Smith
PURPOSE: Costly surveillance and treatment of bladder cancer can lead to financial toxicity (FT), a treatment-related financial burden. Our objective was to define the prevalence of FT among bladder cancer patients and identify delays in care and its effect on health-related quality of life (HRQOL). METHODS: We identified bladder cancer patients in the UNC Health Registry/Cancer Survivorship Cohort. FT was defined as agreement with having "to pay more for medical care than you can afford...
November 16, 2017: Journal of Urology
https://www.readbyqxmd.com/read/29151009/risk-stratification-triage-and-implementation-of-an-expedited-hip-fracture-treatment-protocol-is-it-safe-and-effective
#4
William Zelenty, Richard Yoon, Lorraine Hutzler, Nirmal Tejwani, Joseph Bosco
INTRODUCTION: The population of patients in the USA over the age of 65 is expected to significantly increase over the next 40 years. These patients are at increased risk for hip fractures and will pose a burden to providers in the near future. In order to provide high value care, providers will need to maintain positive outcomes, mitigate complications, and reduce overall cost burdens. This study was designed to investigate the safety and efficacy of a patient transfer protocol between a large academic medical center and a single specialty orthopaedic institution...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29145981/total-hip-arthroplasty-in-the-outpatient-setting-what-you-need-to-know-part-2
#5
REVIEW
Zain Sayeed, Leila Abaab, Mouhanad El-Othmani, Vinay Pallekonda, William Mihalko, Khaled J Saleh
The intra- and postoperative phases of outpatient total hip arthroplasty (THA) vary by institution and surgeon. An understanding of an evidence-based approach to enhancing the intra- and postoperative phases of the care continuum is warranted to offer high-value care to outpatient candidates. This article will discuss methods for implementing successful outpatient THA protocols. Specifically it reviews information regarding anesthesia and analgesia modalities, intraoperative considerations, and postoperative rehabilitation amenable to outpatient THA...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145584/critical-lessons-from-high-value-oncology-practices
#6
Douglas W Blayney, Melora K Simon, Beatrice Podtschaske, Scott Ramsey, Margaret Shyu, Craig Lindquist, Arnold Milstein
Importance: Cancer care is expensive. Cancer care provided by practice organizations varies in total spending incurred by patients and payers during treatment episodes and in quality of care, and this unnecessary variation contributes to the high cost. Objective: To use the variation in total spending and quality of care to assess oncology practice attributes distinguishing "high value" that may be tested and adopted by others to produce similar results. Design, Setting, and Participants: "Positive deviance" was used in this exploratory mixed-methods (quantitative and qualitative) analysis of interview results...
November 16, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/29122544/population-health-management-for-inflammatory-bowel-disease
#7
REVIEW
Parambir S Dulai, Siddharth Singh, Lucilla Ohno-Machado, William J Sandborn
Inflammatory bowel diseases (IBDs) are chronic and impose significant, multidimensional burdens on patients and health care systems. The increasing prevalence of IBD will only worsen this problem globally-population health management (PHM) strategies are needed to increase quality of care and population health outcomes while reducing health care costs. We discuss the key components of PHM in IBD. Effective implementation of PHM strategies requires accurate identification of at-risk patients and key areas of variability in care...
November 7, 2017: Gastroenterology
https://www.readbyqxmd.com/read/29095705/transitioning-to-a-high-value-health-care-model-academic-accountability
#8
Pamela T Johnson, Matthew D Alvin, Roy C Ziegelstein
Health care spending in the United States has increased to unprecedented levels, and these costs have broken medical providers' promise to do no harm. Medical debt is the leading contributor to U.S. personal bankruptcy, more than 50% of household foreclosures are secondary to medical debt and illness, and patients are choosing to avoid necessary care because of its cost. Evidence that the health care delivery model is contributing to patient hardship is a call for action to the profession to transition to a high value model, one that delivers the highest health care quality and safety at the lowest personal and financial cost to patients...
November 1, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29091509/a-person-centered-registry-based-learning-health-system-for-palliative-care-a-path-to-coproducing-better-outcomes-experience-value-and-science
#9
Arif H Kamal, Kathryn B Kirkland, Diane E Meier, Tamara S Morgan, Eugene C Nelson, Steven Z Pantilat
BACKGROUND: Palliative care offers an approach to the care of people with serious illness that focuses on quality of life and aligning care with individual and family goals, and values in the context of what is medically achievable. OBJECTIVE: Measurement of the impact of palliative care is critical for determining what works for which patients in what settings, to learn, improve care, and ensure access to high value care for people with serious illness. METHODS: A learning health system that includes patients and families partnering with clinicians and care teams, is directly linked to a registry to support networks for improvement and research, and offers an ideal framework for measuring what matters to a range of stakeholders interested in improving care for this population...
November 1, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29075388/delivery-and-measurement-of-high-value-care-in-standardized-patient-encounters
#10
Jennifer DeLuca Baldwin, Jaclyn Cox, Zhao Helen Wu, Anne Kenny, Steven Angus
BACKGROUND : Residencies have incorporated high-value care (HVC) training to contain health care expenditures. Assessment methods of HVC curricula are limited. OBJECTIVE : In our clinical skills laboratory, we evaluated the effectiveness of HVC curricula using standardized patients (SPs) to determine if there is a correlation with performance in counseling, history and physical, HVC knowledge, and demographics. METHODS : Through ambulatory cases, SPs evaluated postgraduate year 2 (PGY-2) residents using checklists to determine if they obtained the chief complaint, medical and social history, focused physical examination, and conveyed information regarding patient management...
October 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/29075387/high-value-consults-a-curriculum-to-promote-point-of-care-evidence-based-recommendations
#11
Deepa Rani Nandiwada, Amar Kohli, Megan McNamara, Kenneth J Smith, Shanta Zimmer, Melissa McNeil, Carla Spagnoletti, Doris Rubio, Kathryn Berlacher
BACKGROUND : In an era when value-based care is paramount, teaching trainees to explicitly communicate the evidence behind recommendations fosters high-value care (HVC) in the consultation process. OBJECTIVE : To implement an HVC consult curriculum highlighting the need for clear consult questions, evidence-based recommendations to improve consult teaching, clinical decision-making, and the educational value of consults. METHODS : A pilot curriculum was implemented for residents on cardiology consult electives utilizing faculty and fellows as evidence-based medicine (EBM) coaches...
October 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/29068816/concerns-and-responses-for-integrating-health-systems-science-into-medical-education
#12
Jed D Gonzalo, Kelly J Caverzagie, Richard E Hawkins, Luan Lawson, Daniel R Wolpaw, Anna Chang
With the aim of improving the health of individuals and populations, medical schools are transforming curricula to ensure physician competence encompasses health systems science (HSS), which includes population health, health policy, high-value care, interprofessional teamwork, leadership, quality improvement, and patient safety. Large-scale, meaningful integration remains limited, however, and a major challenge in HSS curricular transformation efforts relates to the receptivity and engagement of students, educators, clinicians, scientists, and health system leaders...
October 24, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28987504/aga-institute-high-value-care-statement-is-high-resolution-manometry-always-needed-for-the-diagnosis-of-achalasia
#13
Dustin A Carlson, C Prakash Gyawali
No abstract text is available yet for this article.
October 5, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28983441/high-value-care-in-the-evaluation-of-stroke
#14
Prakrity Urja, Eric H Nippoldt, Virginia Barak, Carrie Valenta
Value-based care emphasizes achieving the greatest overall health benefit for every dollar spent. We present an interesting case of stroke, which made us consider how frequently health care providers are utilizing value-based care. A 73-year-old Caucasian, who was initially admitted for a hypertensive emergency, was transferred to our facility for worsening slurring of speech and left-sided weakness. The patient had an extensive chronic cerebrovascular disease, including multiple embolic type strokes, mainly in the distribution of the right temporal-occipital cerebral artery and transient ischemic attacks (TIAs)...
August 1, 2017: Curēus
https://www.readbyqxmd.com/read/28971621/medical-students-perceptions-of-low-value-care
#15
Christopher Steele, Justin Berk, Bimal Ashar, Amit Pahwa, Danelle Cayea
BACKGROUND: Medical schools are creating high-value care (HVC) curricula in undergraduate medical education; however, there are few studies identifying what are the most pressing low-value care (LVC) practices, as observed by students. This study is a multicentre, targeted needs assessment comparing medical student perceptions of LVC at four institutions, after completion of their internal medicine clerkship, to identify areas of focus for future HVC curriculum development. METHODS: A total of 307 medical students at four institutions participated in a voluntary survey and identified instances of LVC during the internal medicine clerkship...
October 3, 2017: Clinical Teacher
https://www.readbyqxmd.com/read/28958470/co-located-specialty-care-within-primary-care-practice-settings-a-systematic-review-and-meta-analysis
#16
REVIEW
Muhamad Y Elrashidi, Khaled Mohammed, Pavithra R Bora, Qusay Haydour, Wigdan Farah, Ramona DeJesus, Mohammad Hassan Murad, Jon O Ebbert
BACKGROUND: Co-location of specialists in primary care has been suggested as an approach to reduce care fragmentation, inefficiency, and cost. We conducted a systematic review and meta-analysis evaluating the impact of co-located specialty care models in primary care settings. METHODS: Ovid Medline In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus was conducted through February 2015...
September 23, 2017: Healthcare
https://www.readbyqxmd.com/read/28930760/medical-education-and-health-care-delivery-a-call-to-better-align-goals-and-purposes
#17
David P Sklar, Paul A Hemmer, Steven J Durning
The transformation of the U.S. health care system is under way, driven by the needs of an aging population, rising health care spending, and the availability of health information. However, the speed and effectiveness of the transformation of health care delivery will depend, in large part, upon engagement of the health professions community and changes in clinicians' practice behaviors. Current efforts to influence practice behaviors emphasize changes in the health payment system with incentives to move from fee-for-service to alternative payment models...
September 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28857962/women-s-awareness-of-and-responses-to-messages-about-breast-cancer-overdiagnosis-and-overtreatment-results-from-a-2016-national-survey
#18
Rebekah H Nagler, Erika Franklin Fowler, Sarah E Gollust
BACKGROUND: Scientists, clinicians, and other experts aim to maximize the benefits of cancer screening while minimizing its harms. Chief among these harms are overdiagnosis and overtreatment. Although available data suggest that patient awareness of these harms is low, we know little about how patients respond to information about these phenomena. OBJECTIVES: Using the case of breast cancer screening, this study assesses women's awareness of and reactions to statements about overdiagnosis and overtreatment...
October 2017: Medical Care
https://www.readbyqxmd.com/read/28857791/the-high-value-care-rounding-tool-development-and-validity-evidence
#19
Corrie E McDaniel, Andrew A White, Miranda C Bradford, Carolyn D Sy, Tiffany Chen, Doug Brock, Jeffrey Foti, Jimmy B Beck
Little is known about current practices in high-value care (HVC) bedside teaching. A lack of instruments for measuring bedside HVC behaviors confounds efforts to assess the impact of curricular interventions. The authors aimed to define observable HVC concepts by developing an instrument to measure the content and frequency of HVC discussions.The authors developed the HVC Rounding Tool in four iterative phases, using Messick's validity framework. Phases 1 and 2 were designed to collect evidence of content validity, Phases 3 and 4 to collect evidence of response process and internal structure...
August 29, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28841874/science-of-health-care-delivery-milestones-for-undergraduate-medical-education
#20
Rachel D Havyer, Suzanne M Norby, Andrea N Leep Hunderfund, Stephanie R Starr, Tara R Lang, Alexandra P Wolanskyj, Darcy A Reed
BACKGROUND: The changing healthcare landscape requires physicians to develop new knowledge and skills such as high-value care, systems improvement, population health, and team-based care, which together may be referred to as the Science of Health Care Delivery (SHCD). To engender public trust and confidence, educators must be able to meaningfully assess physicians' abilities in SHCD. We aimed to develop a novel set of SHCD milestones based on published Accreditation Council for Graduate Medical Education (ACGME) milestones that can be used by medical schools to assess medical students' competence in SHCD...
August 25, 2017: BMC Medical Education
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