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Primary Care Transformation

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https://www.readbyqxmd.com/read/29243823/pathways-to-medical-home-recognition-a-qualitative-comparative-analysis-of-the-pcmh-transformation-process
#1
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/29238580/endometrioid-adenocarcinoma-arising-from-colon-endometriosis
#2
Viktoria-Varvara Palla, Georgios Karaolanis, Theodora Bliona, Ioannis Katafigiotis, Ioannis Anastasiou, Demetrios Hassiakos
Endometriosis-associated intestinal tumors represent the malignant transformation of gastrointestinal endometriosis. Approximately 50 cases have been reported in the literature. They are most commonly found among women aged 30-60 years, whereas exogenous hormone therapy and obesity are primary risk factors for the malignant transformation of endometriotic lesions. Clinical features simulate a primary colonic carcinoma. A high index of suspicion in conjunction with careful histological and immunohistochemical examination (CK7, CK20, CDX2, CD10, ER, and PR) is important for establishing a correct diagnosis...
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29234927/toward-a-unified-integration-approach-uniting-diverse-primary-care-strategies-under-the-primary-care-behavioral-health-pcbh-model
#3
Brian E Sandoval, Jennifer Bell, Parinda Khatri, Patricia J Robinson
Primary care continues to be at the center of health care transformation. The Primary Care Behavioral Health (PCBH) model of service delivery includes patient-centered care delivery strategies that can improve clinical outcomes, cost, and patient and primary care provider satisfaction with services. This article reviews the link between the PCBH model of service delivery and health care services quality improvement, and provides guidance for initiating PCBH model clinical pathways for patients facing depression, chronic pain, alcohol misuse, obesity, insomnia, and social barriers to health...
December 12, 2017: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29234358/hearing-loss-screening-tool-cobra-score-for-newborns-in-primary-care-setting
#4
Watcharapol Poonual, Niramon Navacharoen, Jaran Kangsanarak, Sirianong Namwongprom, Surasak Saokaew
Purpose: To develop and evaluate a simple screening tool to assess hearing loss in newborns. A derived score was compared with the standard clinical practice tool. Methods: This cohort study was designed to screen the hearing of newborns using transiently evoked otoacoustic emission and auditory brain stem response, and to determine the risk factors associated with hearing loss of newborns in 3 tertiary hospitals in Northern Thailand. Data were prospectively collected from November 1, 2010 to May 31, 2012...
November 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/29224702/early-intervention-to-restore-function-and-maintain-healthy-trajectory
#5
REVIEW
Juan Jover, Lydia Abasolo
The health of the global population has undergone rapid transformation. Life expectancy and chronic conditions are increasing, and persons aged 65 years or older have become the fastest growing segment of population. The worldwide picture of disease burden is increasingly defined by disability instead of premature mortality. Population growth, ageing and sedentary lifestyles, particularly in developing countries, will result in a crisis for the population health that requires a multi-system response. The growing awareness of the diseases burden increases the need for accurate measurement and assessment of the burden and measurement of the impact of any public health action...
April 2017: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/29216974/position-statement-full-practice-authority-for-advanced-practice-registered-nurses-is-necessary-to-transform-primary-care
#6
Jordon Bosse, Katherine Simmonds, Charlene Hanson, Joyce Pulcini, Lynne Dunphy, Patricia Vanhook, Lusine Poghosyan
No abstract text is available yet for this article.
November 2017: Nursing Outlook
https://www.readbyqxmd.com/read/29207983/protocol-for-project-impact-improving-millions-hearts-for-provider-and-community-transformation-a-quasi-experimental-evaluation-of-an-integrated-electronic-health-record-and-community-health-worker-intervention-study-to-improve-hypertension-management-among
#7
Priscilla M Lopez, Jennifer Zanowiak, Keith Goldfeld, Katarzyna Wyka, Ahmad Masoud, Susan Beane, Rashi Kumar, Phoebe Laughlin, Chau Trinh-Shevrin, Lorna Thorpe, Nadia Islam
BACKGROUND: The Million Hearts® initiative aims to prevent heart disease and stroke in the United States by mobilizing public and private sectors around a core set of objectives, with particular attention on improving blood pressure control. South Asians in particular have disproportionately high rates of hypertension and face numerous cultural, linguistic, and social barriers to accessing healthcare. Interventions utilizing Health information technology (HIT) and community health worker (CHW)-led patient coaching have each been demonstrated to be effective at advancing Million Hearts® goals, yet few studies have investigated the potential impact of integrating these strategies into a clinical-community linkage initiative...
December 6, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29199920/consumers-understanding-and-expectations-of-a-community-based-recovery-oriented-mental-health-rehabilitation-unit-a-pragmatic-grounded-theory-analysis
#8
Stephen Parker, Frances Dark, Ellie Newman, Dominic Hanley, William McKinlay, Carla Meurk
AIMS: Incorporating consumer perspectives into mental health services design is important in working to deliver recovery-oriented care. One of the challenges faced in mental health rehabilitation services is limited consumer engagement with the available support. Listening to consumers' expectations of mental health services, and what they hope to achieve, provides an opportunity to examine the alignment between existing services and the priorities and preferences of the people who use them...
December 4, 2017: Epidemiology and Psychiatric Sciences
https://www.readbyqxmd.com/read/29191111/the-doing-and-undoing-of-male-household-decision-making-and-economic-authority-in-rwanda-and-its-implications-for-gender-transformative-programming
#9
Erin Stern, Lori Heise, Lyndsay McLean
This paper explores two key norms that underpin intimate partner violence in Rwanda: men's roles as economic providers and decision-making authorities in the household. It describes the political, legal and socio-economic factors affecting these norms and how they create opportunities and barriers to 'undoing' restrictive gender norms. Findings are drawn from an evaluation of Inadshyikirwa, an intimate partner violence prevention programme operating in Rwanda. Across three intervention sectors, 24 focus groups were conducted with unmarried and married men and women residing in intervention communities...
December 1, 2017: Culture, Health & Sexuality
https://www.readbyqxmd.com/read/29189491/project-echo-a-telementoring-network-model-for-continuing-professional-development
#10
Sanjeev Arora, Summers G Kalishman, Karla A Thornton, Miriam S Komaromy, Joanna G Katzman, Bruce B Struminger, William F Rayburn
INTRODUCTION: A major challenge with current systems of CME is the inability to translate the explosive growth in health care knowledge into daily practice. Project ECHO (Extension for Community Healthcare Outcomes) is a telementoring network designed for continuing professional development (CPD) and improving patient outcomes. The purpose of this article was to describe how the model has complied with recommendations from several authoritative reports about redesigning and enhancing CPD...
November 15, 2017: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/29187189/operational-integration-in-primary-health-care-patient-encounters-and-workflows
#11
Dimitra Sifaki-Pistolla, Vasiliki-Eirini Chatzea, Adelais Markaki, Kyriakos Kritikos, Elena Petelos, Christos Lionis
BACKGROUND: Despite several countrywide attempts to strengthen and standardise the primary healthcare (PHC) system, Greece is still lacking a sustainable, policy-based model of integrated services. The aim of our study was to identify operational integration levels through existing patient care pathways and to recommend an alternative PHC model for optimum integration. METHODS: The study was part of a large state-funded project, which included 22 randomly selected PHC units located across two health regions of Greece...
November 29, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29183689/participation-and-retention-can-be-high-in-randomized-controlled-trials-targeting-underserved-populations-a-systematic-review-and-meta-analysis
#12
Rohit P Ojha, Bradford E Jackson, Yan Lu, Mandy Burton, Somer E Blair, Brooke MacDonald, Tzu-Chun Chu, Kari Teigen, Melissa Acosta
OBJECTIVE: We aimed to systematically review published literature to assess study-level sources of heterogeneity in participation and retention for randomized controlled trials (RCTs) conducted exclusively at safety-net institutions, which are primary sources of care for underserved populations. STUDY DESIGN AND SETTING: We searched PubMed/Medline and the Cochrane Central Register of Controlled Trials to identify phase III RCTs of any topic conducted exclusively at safety-net institutions in the United States through October 15, 2016...
November 25, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/29182350/using-the-4-pillars-to-increase-vaccination-among-high-risk-adults-who-benefits
#13
Mary Patricia Nowalk, Krissy K Moehling, Song Zhang, Jonathan M Raviotta, Richard K Zimmerman, Chyongchiou J Lin
OBJECTIVES: To compare changes in vaccination rates (pneumococcal polysaccharide vaccine [PPSV]; tetanus, diphtheria, and pertussis [Tdap] vaccine; and influenza vaccine) among high-risk adults following an intervention (June 1, 2013, to January 31, 2015) that used the 4 Pillars Practice Transformation Program (4 Pillars Program). STUDY DESIGN: Post hoc analysis of data from a randomized controlled cluster trial. METHODS: Eighteen primary care practices received staff education, guidance for using the 4 Pillars Program, and support for a practice immunization champion...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29171828/analysis-of-postdischarge-costs-following-emergent-general-surgery-in-elderly-patients
#14
Gilgamesh J Eamer, Fiona Clement, Jenelle L Pederson, Thomas A Churchill, Rachel G Khadaroo
BACKGROUND: As populations age, more elderly patients will undergo surgery. Frailty and complications are considered to increase in-hospital cost in older adults, but little is known on costs following discharge, particularly those borne by the patient. We examined risk factors for increased cost and the type of costs accrued following discharge in elderly surgical patients. METHODS: Acute abdominal surgery patients aged 65 years and older were prospectively enrolled...
December 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29167886/payment-reform-to-enhance-collaboration-of-primary-care-and-cardiology-a-review
#15
Steven A Farmer, Paul N Casale, Linda D Gillam, John S Rumsfeld, Shari Erickson, Neil M Kirschner, Kevin de Regnier, Bruce R Williams, R Shawn Martin, Mark B McClellan
Importance: The US health care system faces an unsustainable trajectory of high costs and inconsistent outcomes. The fee-for-service payment model has contributed to inefficiency, and new payment methods are a promising approach to improving value. Health reforms are needed to increase patient access, reduce costs, and improve health care quality, and the landmark Medicare Access and CHIP Reauthorization Act presents a roadmap for reform. The product of a collaboration between primary care and cardiology clinicians, this review describes a conceptual approach to delivery and payment reforms that aim to better support primary care-cardiology comanagement of chronic cardiovascular disease (CVD)...
November 22, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29167142/creating-a-new-rural-pharmacy-workforce-development-and-implementation-of-the-rural-pharmacy-health-initiative
#16
Mollie Ashe Scott, Stephanie Kiser, Irene Park, Rebecca Grandy, Pamela U Joyner
PURPOSE: An innovative certificate program aimed at expanding the rural pharmacy workforce, increasing the number of pharmacists with expertise in rural practice, and improving healthcare outcomes in rural North Carolina is described. SUMMARY: Predicted shortages of primary care physicians and closures of critical access hospitals are expected to worsen existing health disparities. Experiential education in schools and colleges of pharmacy primarily takes place in academic medical centers and, unlike experiential education in medical schools, rarely emphasizes the provision of patient care in rural U...
December 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29161375/health-system-factors-affecting-implementation-of-integrated-management-of-childhood-illness-imci-qualitative-insights-from-a-south-african-province
#17
Himani Pandya, Wiedaad Slemming, Haroon Saloojee
The Integrated Management of Childhood Illness (IMCI) strategy has been adopted by 102 countries including South Africa, as the preferred primary health care (PHC) delivery strategy for sick children under 5 years. Despite substantial investment to support IMCI in South Africa, its delivery remains sub-optimal, with varied implementation in different settings. There is scarce research globally, and in the local context, examining the effects of health system characteristics on IMCI implementation. This study explored key determinants of IMCI delivery in a South African province, with a specific focus on health system building blocks using a health system dynamics framework...
November 17, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29155963/generating-modelling-data-from-repeat-dose-toxicity-reports
#18
Oriol López-Massaguer, Kevin Pinto-Gil, Ferran Sanz, Alexander Amberg, Lennart T Anger, Manuela Stolte, Carlo Ravagli, Philippe Marc, Manuel Pastor
Over the past decades, pharmaceutical companies have conducted a large number of high quality in vivo repeat-dose toxicity (RDT) studies for regulatory purposes. As part of the eTOX project, a high number of these studies have been compiled and integrated into a database. This valuable resource can be queried directly, but it can be further exploited to build predictive models. As the studies were originally conducted to investigate the properties of individual compounds, the experimental conditions across the studies are highly heterogeneous...
November 16, 2017: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/29144156/upmc-prescription-for-wellness-a-quality-improvement-case-study-for-supporting-patient-engagement-and-health-behavior-change
#19
Rebecca J Maners, Eric Bakow, Michael D Parkinson, Gary S Fischer, Geoffrey R Camp
Addressing patient health and care behaviors that underlie much of chronic disease continues to challenge providers, medical practices, health systems, and insurers. Improving health and care as described by the Quadruple Aim requires innovation at the front lines of clinical care: the doctor-patient interaction and office practice. This article describes the use of Lean Six Sigma in a quality improvement (QI) effort to design an effective and scalable method for physicians to prescribe health coaching for healthy behaviors in a primary care medical home within a large integrated delivery and financing system...
November 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29141738/dynamic-clinical-algorithms-digital-technology-can-transform-health-care-decision-making
#20
David Bell, Noni Gachuhi, Nassim Assefi
Most health care in low-income countries is delivered at a primary care level by health workers who lack quality training and supervision, often distant from more experienced support. Lack of knowledge and poor communication result in a poor quality of care and inefficient delivery of health services. Although bringing great benefits in sectors such as finance and telecommunication in recent years, the Digital Revolution has lightly and inconsistently affected the health sector. These advances offer an opportunity to dramatically transform health care by increasing the availability and timeliness of information to augment clinical decision-making, based on improved access to patient histories, current information on disease epidemiology, and improved incorporation of data from point-of-care and centralized diagnostic testing...
November 6, 2017: American Journal of Tropical Medicine and Hygiene
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