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"Practice Transformation"

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https://www.readbyqxmd.com/read/29314462/palladium-ii-mediated-c-h-tritiation-of-complex-pharmaceuticals
#1
Haifeng Yang, Peter G Dormer, Nelo R Rivera, Andrew J Hoover
Tritium-labeled molecules are critical tools for elucidating the binding and metabolic properties of bioactive compounds, particularly during pharmaceutical discovery. Direct tritiation of inert C-H bonds with T2 gas is an ideal approach for tritium labeling, but significant gaps remain for direct tritiation of structurally complex molecules with diverse functional groups. Here we report the first application of palladium(II) C-H activation chemistry for tritiation with T2 gas. This practical transformation exhibits novel substrate scope and greater functional group tolerance compared to previous state of the art tritiation methods, and has been applied to directly tritiate 9 complex pharmaceuticals and an unprotected dipeptide...
January 3, 2018: Angewandte Chemie
https://www.readbyqxmd.com/read/29243823/pathways-to-medical-home-recognition-a-qualitative-comparative-analysis-of-the-pcmh-transformation-process
#2
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/29189650/application-of-adult-learning-theory-to-physician-assistant-education
#3
Sarah K Lewis, Patricia Thompson
Just as we depend on medical science and research to treat patients, we should connect our teaching methods to educational theory and research. In particular, the foundations of adult education philosophy and adult learning theories can be deliberately applied to further strengthen the clinical learning experience of physician assistants (PAs). We propose that PA educators should be aware of how their personal philosophy of education affects their teaching practice. In addition, educators should apply learning theories to both classroom process and content...
December 2017: Journal of Physician Assistant Education
https://www.readbyqxmd.com/read/29182350/using-the-4-pillars-to-increase-vaccination-among-high-risk-adults-who-benefits
#4
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/29181795/comparison-of-3d-echocardiogram-derived-3d-printed-valve-models-to-molded-models-for-simulated-repair-of-pediatric-atrioventricular-valves
#5
Adam B Scanlan, Alex V Nguyen, Anna Ilina, Andras Lasso, Linnea Cripe, Anusha Jegatheeswaran, Elizabeth Silvestro, Francis X McGowan, Christopher E Mascio, Stephanie Fuller, Thomas L Spray, Meryl S Cohen, Gabor Fichtinger, Matthew A Jolley
Mastering the technical skills required to perform pediatric cardiac valve surgery is challenging in part due to limited opportunity for practice. Transformation of 3D echocardiographic (echo) images of congenitally abnormal heart valves to realistic physical models could allow patient-specific simulation of surgical valve repair. We compared materials, processes, and costs for 3D printing and molding of patient-specific models for visualization and surgical simulation of congenitally abnormal heart valves...
November 27, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29034825/a-tale-of-four-practices
#6
Michelle Miller-Day, Janelle Applequist, Keri Zabokrtsky, Alexandra Dalton, Katherine Kellom, Robert Gabbay, Peter F Cronholm
Purpose The Patient-Centered Medical Home (PCMH) has become a dominant model of primary care re-design. This transformation presents a challenge to many care delivery organizations. The purpose of this paper is to describe attributes shaping successful and unsuccessful practice transformation within four medical practice groups. Design/methodology/approach As part of a larger study of 25 practices transitioning into a PCMH, the current study focused on diabetes care and identified high- and low-improvement medical practices in terms of quantitative patient measures of glycosylated hemoglobin and qualitative assessments of practice performance...
September 18, 2017: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/28947346/using-the-4-pillars%C3%A2-practice-transformation-program-to-increase-adolescent-human-papillomavirus-meningococcal-tetanus-diphtheria-pertussis-and-influenza-vaccination
#7
Richard K Zimmerman, Jonathan M Raviotta, Mary Patricia Nowalk, Krissy K Moehling, Evelyn Cohen Reis, Sharon G Humiston, Chyongchiou Jeng Lin
OBJECTIVES: To report the results of an intervention using the 4 Pillars™ Practice Transformation Program (4 Pillars™ Program) to increase adolescent vaccinations including human papillomavirus vaccine (HPV) and influenza vaccines, which remain underutilized in this population. STUDY DESIGN: Eleven pediatric and family medicine practices, previously control sites from a randomized controlled cluster trial, with ≥50 adolescent patients participated. The 4 Pillars™ Program was the foundation of the intervention...
October 27, 2017: Vaccine
https://www.readbyqxmd.com/read/28923809/a-randomized-trial-of-high-value-change-using-practice-facilitation
#8
LeAnn Michaels, Tracy Anastas, Elizabeth Needham Waddell, Lyle Fagnan, David A Dorr
PURPOSE: To understand how focused versus general practice facilitation can impact goal setting, action planning, and team performance in primary care transformation. BACKGROUND: Practice transformation in primary care is a crucial part of health reform, but can fatigue teams, leading to variable results. Practice facilitation may reduce primary care fatigue to help teams reach challenging transformation goals, but may require a more focused approach than previous studies suggest...
September 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28895218/strengthening-multipayer-collaboration-lessons-from-the-comprehensive-primary-care-initiative
#9
Grace Anglin, H A Tu, Kristie Liao, Laura Sessums, Erin Fries Taylor
Policy Points: Collaboration across payers to align financial incentives, quality measurement, and data feedback to support practice transformation is critical, but challenging due to competitive market dynamics and competing institutional priorities. The Centers for Medicare & Medicaid Services or other entities convening multipayer initiatives can build trust with other participants by clearly outlining each participant's role and the parameters of collaboration at the outset of the initiative. Multipayer collaboration can be improved if participating payers employ neutral, proactive meeting facilitators; develop formal decision-making processes; seek input on decisions from practice representatives; and champion the initiative within their organizations...
September 2017: Milbank Quarterly
https://www.readbyqxmd.com/read/28893826/2017-pbrn-conference-highlights-taking-practice-transformation-to-scale-with-quality-improvement
#10
Donald E Nease, Denise Campbell-Scherer, Jill Haught
No abstract text is available yet for this article.
September 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28868889/recruiting-practices-for-change-initiatives-is-hard-findings-from-evidencenow
#11
Shannon M Sweeney, Jennifer D Hall, Sarah S Ono, Leah Gordon, David Cameron, Jennifer Hemler, Leif I Solberg, Benjamin F Crabtree, Deborah J Cohen
Engaging primary care practices in initiatives designed to enhance quality, reduce costs, and promote safety is challenging as practices are already participating in numerous projects and mandated programs designed to improve care delivery and quality. Recruiters must expand their recruitment tools to engage today's practices in quality improvement. Using grant proposals, online diaries, observational site visits, and interviews with key stakeholders, the authors identify successful practice recruitment strategies in the EvidenceNOW initiative, which aimed to recruit approximately 1500 small- to medium-sized primary care practices...
September 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28829719/cost-effectiveness-of-a-practice-based-intervention-to-improve-vaccination-rates-in-adults-less-than-65-years-old
#12
Kenneth J Smith, Mary Patricia Nowalk, Chyongchiou J Lin, Richard K Zimmerman
The cost-effectiveness of the 4 Pillars™ Practice Transformation Program to improve vaccination rates in adults <65-years-old is unknown. Two vaccines, influenza and Tdap (tetanus, diphtheria, acellular pertussis), were targeted for this age group. Cost-effectiveness of the intervention compared with control, with a primary outcome of cost per quality adjusted life year (QALY) gained, was estimated from societal and third party payer perspectives over a 10-year time horizon using a decision analysis model...
October 3, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28818191/macra-is-a-law-practice-transformation-is-the-goal
#13
EDITORIAL
Mary Norine Walsh
No abstract text is available yet for this article.
August 22, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28812476/developing-nurses-transformational-leadership-skills
#14
Shelly Ann Fischer
Healthcare is a complex area with significant potential for service improvement despite the effects of increasing economic and social pressures on the quality and safety of patient care. As the largest group of healthcare professionals in direct contact with patients, nurses are well positioned to contribute to improvements in healthcare services and to the development of new policies. To influence healthcare improvements and policies effectively, nurses require leadership skills. Historically, it was thought that only nurses in management roles required leadership skills; however, the ability to influence change is a requirement at all levels of clinical practice...
August 16, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28808852/patient-experience-with-the-patient-centered-medical-home-in-michigan-s-statewide-multi-payer-demonstration-a-cross-sectional-study
#15
Issidoros Sarinopoulos, Diane L Bechel-Marriott, Jean M Malouin, Shaohui Zhai, Jason C Forney, Clare L Tanner
BACKGROUND: The literature on patient-centered medical homes (PCMHs) and patient experience is somewhat mixed. Government and private payers are promoting multi-payer PCMH initiatives to align requirements and resources and to enhance practice transformation outcomes. To this end, the multipayer Michigan Primary Care Transformation (MiPCT) demonstration project was carried out. OBJECTIVE: To examine whether the PCMH is associated with a better patient experience, and whether a mature, multi-payer PCMH demonstration is associated with even further improvement in the patient experience...
November 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28720628/the-patient-centered-medical-home-pcmh-framing-typology-for-understanding-the-structure-function-and-outcomes-of-pcmhs
#16
Autumn M Kieber-Emmons, William L Miller
INTRODUCTION: Patient-centered medical homes (PCHMs) aspire to transform today's challenged primary care services. However, it is unclear which PCMH characteristics produce specific outcomes of interest for care delivery. This study tested a novel typology of PCMH practice transformation, the PCMH framing typology, and evaluated measurable outcomes by each type. METHODS: Using the Patient-Centered Primary Care Collaborative 2012 to 2013 Annual Review, this secondary analysis of the published PCMH literature extracted data from publications of 59 PCMHs...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28708933/colorectal-cancer-screening-at-us-community-health-centers-examination-of-sociodemographic-disparities-and-association-with-patient-provider-communication
#17
Sue C Lin, Duane McKinley, Alek Sripipatana, Laura Makaroff
BACKGROUND: Colorectal cancer (CRC) screening rates are low among underserved populations. High-quality patient-physician communication potentially influences patients' willingness to undergo CRC screening. Community health centers (HCs) provide comprehensive primary health care to underserved populations. This study's objectives were to ascertain national CRC screening rates and to explore the relations between sociodemographic characteristics and patient-provider communication on the receipt of CRC screening among HC patients...
November 1, 2017: Cancer
https://www.readbyqxmd.com/read/28686129/centres-for-leadership-a-strategy-for-academic-integration
#18
Gillian King, Kathryn Parker, Sean Peacocke, C J Curran, Amy C McPherson, Tom Chau, Elaine Widgett, Darcy Fehlings, Golda Milo-Manson
Purpose The purpose of this paper is to describe how an Academic Health Science Centre, providing pediatric rehabilitation services, research, and education, developed a Centres for Leadership (CfL) initiative to integrate its academic functions and embrace the goal of being a learning organization. Design/methodology/approach Historical documents, tracked output information, and staff members' insights were used to describe the ten-year evolution of the initiative, its benefits, and transformational learnings for the organization...
May 15, 2017: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/28665905/implementation-of-practice-transformation-patient-experience-according-to-practice-leaders
#19
Denise D Quigley, Alina I Palimaru, Alex Y Chen, Ron D Hays
OBJECTIVE: Examine practice leaders' perceptions and experiences of how patient-centered medical home (PCMH) transformation improves patient experience. SUBJECTS: Thirty-six interviews with lead physicians (n = 13), site clinic administrators (n = 13), and nurse supervisors (n = 10). METHODS: Semi-structured interviews at 14 primary care practices within a large urban Federally Qualified Health Center (FQHC) delivery system to identify critical patient experience domains and mechanisms of change...
July 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28617013/the-role-of-policy-in-supporting-clinician-led-research-on-behavioral-health-integration
#20
Nathaniel Z Counts
In Best Care at Lower Cost, the Institute of Medicine laid out a vision for continuously learning health systems (Institute of Medicine of the National Academies, 2016). This issue of Families, Systems, & Health represents a substantial step toward this vision, with on-the-ground clinicians and administrators testing empirically informed hypotheses about practice transformation and population health management, and using those results to produce shared learning within and across systems. While the studies in this issue demonstrate that producing generalizable knowledge from clinician-led initiatives is feasible, they also demonstrate that the current system does not adequately support clinicians in doing so...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
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