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Primary Care Transformation

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https://www.readbyqxmd.com/read/28099065/exploring-variation-in-transformation-of-primary-care-practices-to-patient-centered-medical-homes-a-mixed-methods-approach
#1
Robert D Lieberthal, Tom Karagiannis, Evan Bilheimer, Manisha Verma, Colleen Payton, Mona Sarfaty, George Valko
The objective was to quantify the activities required for patient-centered medical home (PCMH) transformation in a sample of small to medium-sized National Committee for Quality Assurance (NCQA) recognized practices, and explore barriers and facilitators to transformation. Eleven small to medium-sized PCMH practices in Southeastern Pennsylvania completed a survey, which was adapted from the 2011 NCQA standards. Semistructured follow-up interviews were conducted, descriptive statistics were computed for the quantitative analysis, and a process of thematic coding was deployed for the qualitative analysis...
January 18, 2017: Population Health Management
https://www.readbyqxmd.com/read/28068618/the-effectiveness-of-suicide-prevention-delivered-by-gps-a-systematic-review-and-meta-analysis
#2
REVIEW
Allison Milner, Katrina Witt, Jane Pirkis, Sarah Hetrick, Jo Robinson, Dianne Currier, Matthew J Spittal, Andrew Page, Gregory L Carter
BACKGROUND: The aim of this review was to assess whether suicide prevention provided in the primary health care setting and delivered by GPs results in fewer suicide deaths, episodes of self-harm, attempts and lower frequency of thoughts about suicide. METHODS: We conducted a systematic review and meta-analysis using PRIMSA guidelines. Eligible studies: 1) evaluated an intervention provided by GPs; 2) assessed suicide, self-harm, attempted suicide or suicide ideation as outcomes, and; 3) used a quasi-experimental observational or trial design...
December 24, 2016: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28068135/the-pediatric-patient-centered-medical-home-innovative-models-for-improving-behavioral-health
#3
Joan Rosenbaum Asarnow, David J Kolko, Jeanne Miranda, Anne E Kazak
This article examines the concept of the Patient-Centered Medical Home (PCMH) as it applies to children and adolescents, emphasizing care for behavioral health conditions, the role of psychology and psychological science, and next steps for developing evidence-informed models for the Pediatric-PCMH. The PCMH concept for pediatric populations offers unique opportunities for psychological science to inform and enhance the transformation of the United States health care system and improve health in our nation...
January 2017: American Psychologist
https://www.readbyqxmd.com/read/28062814/from-our-practices-to-yours-key-messages-for-the-journey-to-integrated-behavioral-health
#4
Stephanie B Gold, Larry A Green, C J Peek
BACKGROUND: The historic, cultural separation of primary care and behavioral health has caused the spread of integrated care to lag behind other practice transformation efforts. The Advancing Care Together study was a 3-year evaluation of how practices implemented integrated care in their local contexts; at its culmination, practice leaders ("innovators") identified lessons learned to pass on to others. METHODS: Individual feedback from innovators, key messages created by workgroups of innovators and the study team, and a synthesis of key messages from a facilitated discussion were analyzed for themes via immersion/crystallization...
January 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28062811/moving-upstream-health-extension-and-primary-care
#5
Lyle J Fagnan
Health extension programs represent an opportunity for practice-based research networks (PBRNs) and primary care practices to develop collaborations reaching beyond the clinic walls to address the upstream social determinants of health and engage in community-based research. The Health Extension Regional Officers (HEROs) program at the University of New Mexico described in this issue of the JABFM is an innovative model with a bidirectional approach to linking academic health centers to community-based practices and organizations...
January 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28034916/engaging-patients-in-primary-care-practice-transformation-theory-evidence-and-practice
#6
REVIEW
Anjana E Sharma, Kevin Grumbach
Patient engagement is a fundamental strategy for achieving patient centred care and is receiving increasing attention in primary care reform efforts such as the patient-centred medical home and related care models. Much of the prior published theory and evidence supporting patient engagement has focused on improving engagement in individual care. Much less is understood about engaging patients as partners in practice improvement at the primary care clinic or practice level. We review the historical and policy context for the growing interest in the USA and UK in patient engagement at the primary care practice level, highlight findings from systematic reviews of the research evidence on practice-level patient engagement and discuss practical considerations for implementing patient engagement...
December 29, 2016: Family Practice
https://www.readbyqxmd.com/read/28034342/an-evaluation-of-experiences-and-views-of-scottish-leadership-training-opportunities-amongst-primary-care-professionals
#7
Ailsa Power, Helen Allbutt, Lucy Munro, Marion MacLeod, Susan Kennedy, Donald Cameron, Ken Scoular, Graham Orr, John Gillies
AIM: To determine experiences of leadership training of six primary care professions in Scotland and consider future development. METHODS: A questionnaire on previous leadership course attendance and future intentions was distributed to community pharmacists, general dental practitioners, general practitioners, practice nurses, practice managers and optometrists. Analysis comprised descriptive statistics for closed questions and management of textual data. RESULTS: Formal leadership training participation was fairly low except for practice managers...
December 30, 2016: Education for Primary Care
https://www.readbyqxmd.com/read/28033146/health-service-management-interns-serve-as-practice-facilitators-for-patient-centered-medical-home-recognition-east-carolina-university-appalachian-state-university-initiative
#8
Bonita Sasnett, R W Watkins, Marianne Ferlazzo
East Carolina University College of Allied Health Science's Department of Health Services Management program is partnering with Community Care of North Carolina and Access East to transform medical practices and educate students on the Patient-Centered Medical Home (PCMH) model of health care delivery. Why now? The Affordable Care Act (2010) and other health care reform changes brought to the forefront the need to focus on improving the quality of care while lowering the overall cost of care. This article describes the first year of implementation of a PCMH initiative where students in a health services management internship program act as facilitators to assist practices in the PCMH recognition process...
December 28, 2016: Health Care Manager
https://www.readbyqxmd.com/read/28030459/implementation-and-sequencing-of-practice-transformation-in-urban-practices-with-underserved-patients
#9
Denise D Quigley, Zachary S Predmore, Alex Y Chen, Ron D Hays
BACKGROUND: Patient-centered medical home (PCMH) has gained momentum as a model for primary-care health services reform. METHODS: We conducted interviews at 14 primary care practices undergoing PCMH transformation in a large urban federally qualified health center in California and used grounded theory to identify common themes and patterns. RESULTS: We found clinics pursued a common sequence of changes in PCMH transformation: Clinics began with National Committee for Quality Assurance (NCQA) level 3 recognition, adding care coordination staff, reorganizing data flow among teams, and integrating with a centralized quality improvement and accountability infrastructure...
January 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28024090/cost-effectiveness-of-the-4-pillars-practice-transformation-program-to-improve-vaccination-of-adults-aged-65-and-older
#10
Kenneth J Smith, Richard K Zimmerman, Mary Patricia Nowalk, Chyongchiou J Lin
OBJECTIVES: To estimate the cost-effectiveness of an intervention to increase pneumococcal, influenza, and pertussis-containing vaccine uptake in adults aged 65 and older in primary care practices. DESIGN: Markov decision analysis model, comparing the cost-effectiveness of the 4 Pillars Practice Transformation Program with no intervention. SETTING: Diverse primary care practices in two U.S. cities. PARTICIPANTS: Clinical trial participants aged 65 and older...
December 26, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28011411/call-to-action-a-new-path-for-improving-diabetes-care-for-indigenous-peoples-a-global-review
#11
REVIEW
Stewart B Harris, Jordan W Tompkins, Braden TeHiwi
Diabetes has reached epidemic proportions in Indigenous populations around the globe, and there is an urgent need to improve the health and health equity of Indigenous peoples with diabetes through timely and appropriate diabetes prevention and management strategies. This review describes the evolution of the diabetes epidemic in Indigenous populations and associated risk factors, highlighting gestational diabetes and intergenerational risk, lifestyle risk factors and social determinants as having particular importance and impact on Indigenous peoples...
December 5, 2016: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28007226/role-expansion-on-interprofessional-primary-care-teams-barriers-of-role-self-efficacy-among-clinical-associates
#12
Karleen F Giannitrapani, Lynn Soban, Alison B Hamilton, Hector Rodriguez, Alexis Huynh, Susan Stockdale, Elizabeth M Yano, Lisa V Rubenstein
BACKGROUND: Interprofessional team-based models of primary care that expand the role of clinical associates (CAs) are increasingly adopted in primary care practices. In this study we query team members of a newly implemented patient centered medical home (PCMH) to identify facilitators and barriers of occupational role self-efficacy, a belief of possessing the capacity to execute their new team based role effectively. METHODS: 79 key informants, members of primary care teams at six Veterans Health Administration (VA) clinics, were interviewed to assess their experiences with implementing expanded roles for CAs...
December 2016: Healthcare
https://www.readbyqxmd.com/read/28000925/a-concept-analysis-of-systems-thinking
#13
Ann M Stalter, Janet M Phillips, Jeanne S Ruggiero, Debra L Scardaville, Deborah Merriam, Mary A Dolansky, Karen A Goldschmidt, Carol M Wiggs, Sherri Winegardner
PURPOSE: This concept analysis, written by the National Quality and Safety Education for Nurses (QSEN) RN-BSN Task Force, defines systems thinking in relation to healthcare delivery. METHODS: A review of the literature was conducted using five databases with the keywords "systems thinking" as well as "nursing education," "nursing curriculum," "online," "capstone," "practicum," "RN-BSN/RN to BSN," "healthcare organizations," "hospitals," and "clinical agencies." Only articles that focused on systems thinking in health care were used...
December 21, 2016: Nursing Forum
https://www.readbyqxmd.com/read/27997643/partnering-with-nurses-to-transform-primary-care
#14
Diana J Mason
No abstract text is available yet for this article.
December 20, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27984555/implementation-of-antiretroviral-therapy-for-life-in-pregnant-breastfeeding-hiv-women-option-b-alongside-rollout-and-changing-guidelines-for-art-initiation-in-rural-zimbabwe-the-lablite-project-experience
#15
Deborah Ford, Margaret Muzambi, Misheck J Nkhata, George Abongomera, Sarah Joseph, Makosonke Ndlovu, Travor Mabugu, Caroline Grundy, Adrienne K Chan, Fabian Cataldo, Cissy Kityo, Janet Seeley, Elly Katabira, Charles F Gilks, Andrew Reid, James Hakim, Diana M Gibb
BACKGROUND: Life-long ART for pregnant and breastfeeding women (Option B+) was rolled-out in Zimbabwe from 2014 with simultaneous raising of the CD4 treatment-threshold in non-pregnant/breastfeeding adults and children >5 years to 500 cells/mm. METHODS: Lablite is an implementation project in Zimbabwe, Malawi and Uganda evaluating ART rollout. Routine patient-level data were collected for 6 months prior to and 12 months after Option B+ rollout at a district hospital and three primary care facilities in Zimbabwe (two with outreach ART; one with no ART provision prior to Option B+)...
December 7, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/27927280/barriers-to-accessing-primary-health-care-comparing-australian-experiences-internationally
#16
Lisa Corscadden, Jean-Frederic Levesque, Virginia Lewis, Mylaine Breton, Kim Sutherland, Jan-Willem Weenink, Jeannie Haggerty, Grant Russell
Most highly developed economies have embarked on a process of primary health care (PHC) transformation. To provide evidence on how nations vary in terms of accessing PHC, the aim of this study is to describe the extent to which barriers to access were experienced by adults in Australia compared with other countries. Communities participating in an international research project on PHC access interventions were engaged to prioritise questions from the 2013 Commonwealth Fund International Health Policy Survey within a framework that conceptualises access across dimensions of approachability, acceptability, availability, affordability and appropriateness...
December 8, 2016: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/27926614/clinical-coordination-in-accountable-care-organizations-a-qualitative-study
#17
Valerie A Lewis, Karen Schoenherr, Taressa Fraze, Aleen Cunningham
BACKGROUND: Accountable care organizations (ACOs) are becoming a common payment and delivery model. Despite widespread interest, little empirical research has examined what efforts or strategies ACOs are using to change care and reduce costs. Knowledge of ACOs' clinical efforts can provide important context for understanding ACO performance, particularly to distinguish arenas where ACOs have and have not attempted care transformation. PURPOSE: The aim of the study was to understand ACOs' efforts to change clinical care during the first 18 months of ACO contracts...
December 6, 2016: Health Care Management Review
https://www.readbyqxmd.com/read/27922462/fostering-evidence-based-quality-improvement-for-patient-centered-medical-homes-initiating-local-quality-councils-to-transform-primary-care
#18
Susan E Stockdale, Jessica Zuchowski, Lisa V Rubenstein, Negar Sapir, Elizabeth M Yano, Lisa Altman, Jacqueline J Fickel, Skye McDougall, Timothy Dresselhaus, Alison B Hamilton
BACKGROUND: Although the patient-centered medical home endorses quality improvement principles, methods for supporting ongoing, systematic primary care quality improvement have not been evaluated. We introduced primary care quality councils at six Veterans Health Administration sites as an organizational intervention with three key design elements: (a) fostering interdisciplinary quality improvement leadership, (b) establishing a structured quality improvement process, and (c) facilitating organizationally aligned frontline quality improvement innovation...
December 3, 2016: Health Care Management Review
https://www.readbyqxmd.com/read/27913657/cost-benefit-analysis-of-telehealth-in-pre-hospital-care
#19
James R Langabeer, Tiffany Champagne-Langabeer, Diaa Alqusairi, Junghyun Kim, Adria Jackson, David Persse, Michael Gonzalez
OBJECTIVE: There has been very little use of telehealth in pre-hospital emergency medical services (EMS), yet the potential exists for this technology to transform the current delivery model. In this study, we explore the costs and benefits of one large telehealth EMS initiative. METHODS: Using a case-control study design and both micro- and gross-costing data from the Houston Fire Department EMS electronic patient care record system, we conducted a cost-benefit analysis (CBA) comparing costs with potential savings associated with patients treated through a telehealth-enabled intervention...
December 2, 2016: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/27913318/walsh-hadamard-based-3d-steganography-for-protecting-sensitive-information-in-point-of-care
#20
Alsharif Abuadbba, Ibrahim Khalil
Remote points-of-care has recently had a lot of attention for their advantages such as saving lives and cost reduction. The transmitted streams usually contain (1) normal biomedical signals (e.g. ECG) and (2) highly private information (e.g. patient identity). Despite the obvious advantages, the primary concerns are privacy and authenticity of the transferred data. Therefore, this paper introduces a novel steganographic mechanism that ensures (1) strong privacy preservation of private information by random concealing inside the transferred signals employing a key, and (2) evidence of originality for the biomedical signals...
November 29, 2016: IEEE Transactions on Bio-medical Engineering
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