"Practice Transformation"

Building on previous efforts to transform primary care, the Agency for Healthcare Research and Quality (AHRQ) launched EvidenceNOW: Advancing Heart Health in 2015. This 3-year initiative provided external quality improvement support to small and medium-size primary care practices to implement evidence-based cardiovascular care. Despite challenges, results from an independent national evaluation demonstrated that the EvidenceNOW model successfully boosted the capacity of primary care practices to improve quality of care, while helping to advance heart health...

PURPOSE: A pragmatic, cluster-randomized controlled trial of a comprehensive practice-level, multi-staged practice transformation intervention aimed to increase behavioral health integration in primary care practices and improve patient outcomes. We examined association between the completion of intervention stages and patient outcomes across a heterogenous national sample of primary care practices. METHODS: Forty-two primary care practices across the U.S. with co-located behavioral health and 2,426 patients with multiple chronic medical and behavioral health conditions completed surveys at baseline, midpoint and two year follow-up...

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This paper discusses green human resource management practices, employee engagement, and transformational leadership in green banking. Specifically, we explore how green human resource management practices influence employee engagement, and how the role of transformational leadership influences their relationships. We used a random sample of 363 green bank employees in Indonesia. Data was collected through online surveys and analyzed using regression modeling. The results show that in general, green human resource management practices are positively and significantly related to employee engagement, and transformational leadership is shown to moderate the relationship...

As organizations have recognized their cause/solution relationship with the environment, increasing attention is being given to the role of employees make in achieving green organizational objectives. Even though, business sustainability initiatives are often led by leaders; employee green behavior (EGB) plays a vital role in success of such initiatives. The current paper focuses on relatively less researched topic of EGB. It uses a narrative review approach to develop a multi-level conceptual framework that draws upon the connectivity of leadership influence at firm and team levels, and how this influences individual level EGB...

This article aimed to know the scientific evidence that underlies Culture Circle application as a device of Permanent Education in Health for professional practice transformation. This is an integrative literature review carried out in the PubMed, CINAHL, LILACS and Scopus databases, in October 2021, with the descriptors "health professionals", "professional practice", "continuing education", "health promotion" and the uncontrolled term "Culture Circle". Data were analyzed in a descriptive way. The results identified 217 articles and five were included to compose the final sample...

BACKGROUND: Data on financial hardship, an "adverse event" in individuals with cancer, are needed to inform policy and supportive care interventions and reduce adverse economic outcomes. METHODS: Lay navigator-led financial hardship screening was piloted among University of Alabama at Birmingham oncology patients initiating treatment in October 2020. Financial hardship screening, including reported financial distress and difficulty, was added to a standard-of-care treatment planning survey...

Numerous calls at national and international level are leading some countries to seek to redesign the provision of healthcare and services. Care pathways have the potential to improve outcomes by providing a mechanism to coordinate care and reduce fragmentation and ultimately costs. However, their implementation still shows variable results, resulting in them being considered as complex interventions in complex systems. By mobilizing an emerging approach combining action research and grounded theory methodology, we conducted a pilot project on care pathways...

Value-based primary care has reduced health care costs, improved the quality of rendered care, and enhanced the patient experience. Value-based care emphasizes prevention, outreach, follow-up, patient engagement, and comprehensive, whole-person health. Primary care Accountable Care Organizations have leveraged technology-enabled workflows, practice transformation, and cutting-edge data and analytics to achieve success. These efforts are increasingly aided by predictive modeling used in the context of patient identification and prioritization algorithms...

BACKGROUND: Many speech sound disorder (SSD) interventions with a long-term evidence base are 'new' to clinical practice, and the role of services in supporting or constraining capacity for practice change is underexplored. Innovations from implementation science may offer solutions to this research-practice gap but have not previously been applied to SSD. AIM: To explain variation in speech and language therapy service capacity to implement new SSD interventions...

Despite consumer concern for sustainability, avoiding plastic packaging, particularly in food shopping, is difficult due to its pervasiveness and usefulness. Yet achieving changes in consumer behaviour is an important part of environmental management approaches towards a circular economy and plastic reduction. This research explores how everyday food shopping practices might adapt and evolve to become more sustainable through consumers avoiding, reducing, or replacing plastic packaging in their grocery shopping...

A new National Academies of Sciences, Engineering, and Medicine report, "Achieving Whole Health: A New Approach for Veterans and the Nation," redefines what it means to be healthy and creates a roadmap for health systems, including the Veterans Health Administration and the nation, to scale and spread a whole health approach to care. The report identifies 5 foundational elements for whole health care and sets 6 national, state, and local policy goals for change. This article summarizes the report, emphasizes the importance of preventive medicine, and identifies concrete actions clinicians and practices can take now to deliver whole health care...

Family medicine is a champion of human-focused health care in the context of lasting relationships. What do humans need-those who seek care and those who offer it? Respect, understanding, and kindness. Without it, more money, more ancillary personnel, more time-saving technology cannot lift us from the profession's doldrums. The author believes that the deep desire to be of help to others can be rekindled in an office culture where the humanity in all of us is honored.

NAPCRG celebrated 50 years of leadership and service at its 2022 meeting. A varied team of primary care investigators, clinicians, learners, patients, and community members reflected on the organization's past, present, and future. Started in 1972 by a small group of general practice researchers in the United States, Canada, and the United Kingdom, NAPCRG has evolved into an international, interprofessional, interdisciplinary, and intergenerational group devoted to improving health and health care through primary care research...

BACKGROUND AND OBJECTIVES: Most research in residency training has focused on quality improvement within a single program. We explored resident involvement in curricular and clinical practice change, the learning environment, and resident satisfaction in 3-year family medicine residencies compared to matched 4-year residencies. METHODS: We used two surveys to capture data. One was for program directors, which assessed the level of resident involvement in curricular and practice transformation...

BACKGROUND: This study aims to explore the perceived impact of Project TEACH (Training and Education for the Advancement of Children's Health), a New York State Office of Mental Health funded Child Psychiatric Access Program (CPAP), on pediatric Primary Care Providers (PCPs) and their practice. Practice change over time was assessed in the context of rising mental health needs and in the context of COVID19 pandemic. METHODS: Focus groups utilizing a semi-structured format were conducted with pediatric PCPs who have been high utilizers of Project TEACH over the past 5-10 years and PCPs in similar regions who have been low or non-utilizers of the program...

Patient-reported outcome (PRO) measures offer a unique opportunity to systematically incorporate patient perspectives of their health and wellbeing into treatment, view progress over time, and develop opportunities related to clinical decision support, shared decision making, and outcomes-driven payment and practice transformation. As healthcare institutions increasingly look toward adopting PRO measures in their practices, more information is needed regarding the practicalities of implementing a successful PRO program outside of the research setting...

INTRODUCTION: The ACESO project, which was part of the Autonomy support in health national experimentation, brought together 21 partners from Ile-de-France. Among these partners, 14 had practices similar to autonomy support. Partners’ presupposition was that experimenting a cooperative approach would encourage the empowerment of participants, improve their autonomy support and put into place the conditions necessary for the empowerment of people who would be supported. To help participants to meet this goal, the project leader took on a role as third party whose function was to facilitate the cooperative approach by proposing a framework and a method...

Continuing Professional Development (CPD) has received increased attention within the pharmacy profession in the United States and is recognized as a potential pathway for ongoing professional development and practice transformation. Despite potential benefits of CPD, adoption in the United States has remained limited. A CPD program accreditation pathway, including principles, guidance, and a credit system for CPD programs, has recently been approved by the Accreditation Council for Pharmacy Education (ACPE) Board of Directors...

BACKGROUND AND PURPOSE: Flip the Pharmacy (FtP) helps community pharmacies "flip" from dispensing- to patient-centered care models with assistance from practice transformation coaches ("coaches"). Purdue University College of Pharmacy created a novel advanced pharmacy practice experience (APPE) positioning students to serve as FtP coaches with oversight from four faculty coaches. This communication describes the APPE's design, characterizes preliminary student coaching outcomes, and identifies the APPE's strengths and limitations...