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"Practice Transformation"

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https://www.readbyqxmd.com/read/27909251/-in-principle-we-have-agreement-but-in-practice-it-is-a-bit-more-difficult-obtaining-organizational-buy-in-to-patient-centered-medical-home-transformation
#1
Janelle Applequist, Michelle Miller-Day, Peter F Cronholm, Robert A Gabbay, Deborah S Bowen
The patient-centered medical home (PCMH) is a model of care that emphasizes the coordination of patient treatment among health care providers. Practice transformation to this model, however, presents a number of challenges. One of these challenges is getting the buy-in of all personnel to commit to making organizational changes in the journey to becoming a nationally recognized medical home. This study investigated internal messages of buy-in as communicated by practices transitioning to this type of care. Grounding itself in stakeholder theory, this study analyzed interviews with staff, administration, and practitioners from 20 medical practices in a mid-Atlantic state...
November 30, 2016: Qualitative Health Research
https://www.readbyqxmd.com/read/27893519/effects-of-hospital-systems-on-medical-home-transformation-in-primary-care-residency-training-practices
#2
Kyle Knierim, Tristen Hall, Douglas Fernald, Thomas J Staff, Emilie Buscaj, Jessica Cornett Allen, Mary Onysko, W Perry Dickinson
Most primary care residency training practices have close financial and administrative relationships with teaching hospitals and health systems. Many residency practices have begun integrating the core principles of the patient-centered medical home (PCMH) into clinical workflows and educational experiences. Little is known about how the relationships with hospitals and health systems affect these transformation efforts. Data from the Colorado Residency PCMH Project were analyzed. Results show that teaching hospitals and health systems have significant opportunities to influence residency practices' transformation, particularly in the areas of supporting team-based care, value-based payment reforms, and health information technology...
November 23, 2016: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27876200/improving-adolescent-hpv-vaccination-in-a-randomized-controlled-cluster-trial-using-the-4-pillars%C3%A2-practice-transformation-program
#3
Richard K Zimmerman, Krissy K Moehling, Chyongchiou J Lin, Song Zhang, Jonathan M Raviotta, Evelyn C Reis, Sharon G Humiston, Mary Patricia Nowalk
OBJECTIVE: Uptake of meningococcal vaccine (MCV) and tetanus, diphtheria and pertussis (Tdap) vaccine among adolescents has approached Healthy People 2020 goals, but human papillomavirus (HPV) vaccination has not. This study evaluated an intervention using the 4 Pillars™ Practice Transformation Program to increase HPV, MCV and Tdap uptake among adolescents in primary care practices. METHODS: Practices with at least 50 patients 11-17years old with estimated vaccination rates less than national goals, were assigned to intervention (n=11) and control (n=11) groups in a randomized controlled cluster trial; 9 intervention and 11 control sites completed the study...
November 18, 2016: Vaccine
https://www.readbyqxmd.com/read/27875602/practice-facilitation-for-pcmh-implementation-in-residency-practices
#4
Emilie Buscaj, Tristen Hall, Linda Montgomery, Douglas H Fernald, Jaclyn King, Nicole Deaner, W Perry Dickinson
BACKGROUND AND OBJECTIVES: Primary care residency programs continue to adapt and change to become high-performing training sites for advanced primary care. Practice facilitation is a key method to assist practices in implementing organizational changes. This evaluation described the unique nature and essential roles and qualities of practice facilitation for residency program patient-centered medical home (PCMH) transformation. METHODS: Evaluation of the Colorado Residency PCMH Project from 2009 through 2014 included template and immersion-crystallization approaches to qualitative analysis of field notes, key informant interviews, and meeting documentation to identify themes related to external facilitation for practice transformation in 11 Colorado primary care residency practices...
November 2016: Family Medicine
https://www.readbyqxmd.com/read/27849352/medical-home-transformation-and-breast-cancer-screening
#5
Amy W Baughman, Phyllis Brawarsky, Tracy Onega, Tor D Tosteson, Qianfei Wang, Anna N A Tosteson, Jennifer S Haas
OBJECTIVES: The patient-centered medical home (PCMH) continues to gain momentum as a primary care delivery system. We evaluated whether medical home transformation of primary care practices is associated with the use of breast cancer screening, a broadly endorsed preventive service. STUDY DESIGN: Retrospective cohort study evaluating 12 Brigham and Women's Hospital (BWH)-affiliated primary care clinics in greater Boston, Massachusetts. METHODS: Practice transformation was measured quarterly using a continuous PCMH transformation score (range = 0-100) modeled after National Committee for Quality Assurance recognition requirements...
November 1, 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27809793/using-the-4-pillars%C3%A2-practice-transformation-program-to-increase-adult-influenza-vaccination-and-reduce-missed-opportunities-in-a-randomized-cluster-trial
#6
Chyongchiou J Lin, Mary Patricia Nowalk, Valory N Pavlik, Anthony E Brown, Song Zhang, Jonathan M Raviotta, Krissy K Moehling, Mary Hawk, Edmund M Ricci, Donald B Middleton, Suchita Patel, Jeannette E South-Paul, Richard K Zimmerman
BACKGROUND: An evidence-based, step-by-step guide, the 4 Pillars™ Practice Transformation Program, was the foundation of an intervention to increase adult immunizations in primary care and was tested in a randomized controlled cluster trial. The purpose of this study is to report changes in influenza immunization rates and on factors related to receipt of influenza vaccine. METHODS: Twenty five primary care practices were recruited in 2013, stratified by city (Houston, Pittsburgh), location (rural, urban, suburban) and type (family medicine, internal medicine), and randomized to the intervention (n = 13) or control (n = 12) in Year 1 (2013-14)...
November 3, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27755655/using-the-4-pillars-practice-transformation-program-to-increase-pneumococcal-immunizations-for-older-adults-a-cluster-randomized-trial
#7
Richard K Zimmerman, Anthony E Brown, Valory N Pavlik, Krissy K Moehling, Jonathan M Raviotta, Chyongchiou J Lin, Song Zhang, Mary Hawk, Shakala Kyle, Suchita Patel, Faruque Ahmed, Mary Patricia Nowalk
OBJECTIVES: To test the effectiveness of a step-by step, evidence-based guide, the 4 Pillars Practice Transformation Program, to increase adult pneumococcal vaccination. DESIGN: Randomized controlled cluster trial (RCCT) in Year 1 (June 1, 2013 to May 31, 2014) and pre-post study in Year 2 (June 1, 2014 to January 31, 2015) with data analyzed in 2016. Baseline year was June 1, 2012, to May 31, 2013. Demographic and vaccination data were derived from deidentified electronic medical record extractions...
October 18, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27706282/community-health-teams-a-healthcare-provider-s-system-transformation-opportunity
#8
James C Rajotte, Deborah Garneau, Nancy Sutton, Ailis Clyne
"The goal of community health teams is to develop and implement care models that integrate clinical and community health promotion and preventive services for patients." -Association of State and Territorial Health Officials (ASTHO)1 Eleven community health teams (CHTs) operate in various geographies within Rhode Island. Physicians and payers refer their highest-risk patients to CHTs that serve as community extenders. Community health workers and others work to link referred individuals to primary care and work to address the other determinants affecting their health, such as safe housing...
October 4, 2016: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/27666095/using-a-change-model-to-reduce-the-risk-of-surgical-site-infection
#9
Mel Burden
A surgical site infection (SSI) surveillance module completed in 2014 highlighted that infection rates for breast surgery inpatients and readmissions at an acute trust had increased to 2.2%, from 0.5% in 2012. The national benchmark for 2014 established by Public Health England (PHE) was 1.0%. This demonstrated a greater than fourfold absolute increase in SSI for breast surgery during these periods. The infection rate could have been due to chance, but warranted investigation. The results were presented to the breast team and used to drive practice transformation through audit and observation, identifying areas of change to improve patient safety...
September 22, 2016: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/27637827/across-the-divide-primary-care-departments-working-together-to-redesign-care-to-achieve-the-triple-aim
#10
Steven Koslov, Elizabeth Trowbridge, Sandra Kamnetz, Sally Kraft, Jeffrey Grossman, Nancy Pandhi
BACKGROUND: Primary care is considered the foundation of an effective health care system. However, primary care departments at academic health centers have numerous challenges to overcome when trying to achieve the Triple Aim. METHODS: As part of an organizational initiative to redesign primary care at a large academic health center, departments of internal medicine, general pediatrics and adolescent medicine, and family medicine worked together to comprehensively redesign primary care...
September 2016: Healthcare
https://www.readbyqxmd.com/read/27576073/using-the-4-pillars%C3%A2-practice-transformation-program-to-increase-adult-tdap-immunization-in-a-randomized-controlled-cluster-trial
#11
Mary Patricia Nowalk, Chyongchiou J Lin, Valory N Pavlik, Anthony E Brown, Song Zhang, Krissy K Moehling, Jonathan M Raviotta, Jeannette E South-Paul, Mary Hawk, Edmund M Ricci, Donald B Middleton, Suchita A Patel, Faruque Ahmed, Richard K Zimmerman
INTRODUCTION: National adult Tdap vaccination rates are low, reinforcing the need to increase vaccination efforts in primary care offices. The 4 Pillars™ Practice Transformation Program is an evidence-based, step-by-step guide to improving primary care adult vaccination with an online implementation tracking dashboard. This study tested the effectiveness of an intervention to increase adult Tdap vaccination that included the 4 Pillars™ Program, provider education, and one-on-one coaching of practice-based immunization champions...
September 22, 2016: Vaccine
https://www.readbyqxmd.com/read/27441739/enhancing-the-value-of-integrated-primary-care-the-role-of-occupational-therapy
#12
Sue Dahl-Popolizio, Lesley Manson, Sherry Muir, Oaklee Rogers
Primary care practice transformation is a priority in our rapidly evolving and complex health care system. Medical practices must maximize the use of staff to develop effective and efficient interprofessional care teams to optimize patient care delivery and improve outcomes and access with less cost. Occupational therapists have training and expertise that can provide valuable contributions to integrated primary care teams. In this article, we review the educational background and core competencies of this group of professionals and compare them to the core competencies of integrated behavioral health in primary care...
September 2016: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/27369855/consensus-based-recommendations-for-an-emergency-medicine-pain-management-curriculum
#13
Sabrina J Poon, Lewis S Nelson, Jason A Hoppe, Jeanmarie Perrone, Margaret K Sande, Donald M Yealy, Michael S Beeson, Knox H Todd, Sergey M Motov, Scott G Weiner
BACKGROUND: Increased prescribing of opioid pain medications has paralleled the subsequent rise of prescription medication-related overdoses and deaths. We sought to define key aspects of a pain management curriculum for emergency medicine (EM) residents that achieve the balance between adequate pain control, limiting side effects, and not contributing to the current public health opioid crisis. METHODS: We convened a symposium to discuss pain management education in EM and define the needs and objectives of an EM-specific pain management curriculum...
August 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27358078/a-national-evaluation-of-a-dissemination-and-implementation-initiative-to-enhance-primary-care-practice-capacity-and-improve-cardiovascular-disease-care-the-escalates-study-protocol
#14
Deborah J Cohen, Bijal A Balasubramanian, Leah Gordon, Miguel Marino, Sarah Ono, Leif I Solberg, Benjamin F Crabtree, Kurt C Stange, Melinda Davis, William L Miller, Laura J Damschroder, K John McConnell, John Creswell
BACKGROUND: The Agency for Healthcare Research and Quality (AHRQ) launched the EvidenceNOW Initiative to rapidly disseminate and implement evidence-based cardiovascular disease (CVD) preventive care in smaller primary care practices. AHRQ funded eight grantees (seven regional Cooperatives and one independent national evaluation) to participate in EvidenceNOW. The national evaluation examines quality improvement efforts and outcomes for more than 1500 small primary care practices (restricted to those with fewer than ten physicians per clinic)...
June 29, 2016: Implementation Science: IS
https://www.readbyqxmd.com/read/27251058/inadequate-systems-to-support-breast-and-cervical-cancer-screening-in-primary-care-practice
#15
Marilyn M Schapira, Brian L Sprague, Carrie N Klabunde, Anna N A Tosteson, Asaf Bitton, Jane S Chen, Elisabeth F Beaber, Tracy Onega, Charles D MacLean, Kimberly Harris, Kathleen Howe, Loretta Pearson, Sarah Feldman, Phyllis Brawarsky, Jennifer S Haas
BACKGROUND: Despite substantial resources devoted to cancer screening nationally, the availability of clinical practice-based systems to support screening guidelines is not known. OBJECTIVE: To characterize the prevalence and correlates of practice-based systems to support breast and cervical cancer screening, with a focus on the patient-centered medical home (PCMH). DESIGN: Web and mail survey of primary care providers conducted in 2014. The survey assessed provider (gender, training) and facility (size, specialty training, physician report of National Committee for Quality Assurance (NCQA) PCMH recognition, and practice affiliation) characteristics...
October 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27213488/refining-reporting-mechanisms-in-oregon-s-patient-centered-primary-care-home-program-to-improve-performance
#16
Sherril Gelmon, Billie Sandberg, Nicole Merrithew, Rebekah Bally
INTRODUCTION: As part of its strategy to achieve the Triple Aim, the Oregon Health Authority implemented the Patient-Centered Primary Care Home (PCPCH) Program in 2009. In 2014, the program recognized more than 500 primary care practices and had become an essential component of Oregon's strategy for transforming health services delivery. To assist the Oregon Health Authority with evaluating practices' achievement of the PCPCH model along its 6 core attributes (access, accountability, comprehensive care, continuity, coordination, and person-centered care), the research team developed an innovative scoring method...
May 20, 2016: Permanente Journal
https://www.readbyqxmd.com/read/27178475/an-ontological-model-of-the-practice-transformation-process
#17
Arun Sen, Atish P Sinha
Patient-centered medical home is defined as an approach for providing comprehensive primary care that facilitates partnerships between individual patients and their personal providers. The current state of the practice transformation process is ad hoc and no methodological basis exists for transforming a practice into a patient-centered medical home. Practices and hospitals somehow accomplish the transformation and send the transformation information to a certification agency, such as the National Committee for Quality Assurance, completely ignoring the development and maintenance of the processes that keep the medical home concept alive...
June 2016: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/27151971/a-bereavement-common-assessment-framework-in-palliative-care-informing-practice-transforming-care
#18
Pippa Blackburn, Kris Dwyer
This article describes the development of a bereavement assessment framework for the Western Australia Country Health Service Palliative Care Services bereavement program. The framework is grounded in a clearly articulated evidence base, integrating research from the bereavement field that has informed the development of a standardized assessment framework referred to as the bereavement common assessment framework (B-CAF). The B-CAF identifies the many facets of experiences of the bereaved, creating a holistic and contextual assessment and providing professionals with a tool to enhance assessment and intervention practices...
May 5, 2016: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/27119798/practicing-transformational-leadership
#19
Kristene Diggins
No abstract text is available yet for this article.
April 2016: Journal of Christian Nursing: a Quarterly Publication of Nurses Christian Fellowship
https://www.readbyqxmd.com/read/27118546/impact-of-the-pharmacy-practice-model-initiative-on-clinical-pharmacy-specialist-practice
#20
Judith Jacobi, Shaunta' Ray, Ilya Danelich, Elizabeth Dodds Ashley, Stephen Eckel, Roy Guharoy, Michael Militello, Paul O'Donnell, Teena Sam, Stephanie M Crist, Danielle Smidt
This paper describes the goals of the American Society of Health-System Pharmacists' Pharmacy Practice Model Initiative (PPMI) and its recommendations for health-system pharmacy practice transformation to meet future patient care needs and elevate the role of pharmacists as patient care providers. PPMI envisions a future in which pharmacists have greater responsibility for medication-related outcomes and technicians assume greater responsibility for product-related activities. Although the PPMI recommendations have elevated the level of practice in many settings, they also potentially affect existing clinical pharmacists, in general, and clinical pharmacy specialists, in particular...
May 2016: Pharmacotherapy
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