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https://www.readbyqxmd.com/read/28535316/residents-confidence-providing-primary-care-with-behavioral-health-integration
#1
Patrick Hemming, Amber Hewitt, Joseph J Gallo, Rodger Kessler, R B Levine
BACKGROUND AND OBJECTIVES: Behavioral health integration (BHI) entails integrated behavioral health clinicians (IBHCs) providing care-generally for mental health and substance abuse disorders and behavioral comorbidity- within the operational functioning of primary care. Because limited data exist regarding BHI in residency, we studied its impact on resident education by examining whether increased behavioral health (BH) co-management improved residents' perceived ability to treat BH conditions...
May 2017: Family Medicine
https://www.readbyqxmd.com/read/28532856/implementation-of-a-referral-to-discharge-glycemic-control-initiative-for-reduction-of-surgical-site-infections-in-gynecologic-oncology-patients
#2
Laura Hopkins, Jennifer Brown-Broderick, James Hearn, Janine Malcolm, James Chan, Wendy Hicks-Boucher, Filomena De Sousa, Mark C Walker, Sylvain Gagné
OBJECTIVE(S): To evaluate the frequency of surgical site infections before and after implementation of a comprehensive, multidisciplinary perioperative glycemic control initiative. STUDY METHODS: As part of a CUSP (Comprehensive Unit-based Safety Program) initiative, between January 5 and December 18, 2015, we implemented comprehensive, multidisciplinary glycemic control initiative to reduce SSI rates in patients undergoing major pelvic surgery for a gynecologic malignancy ('Group II')...
May 20, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28532628/milestones-barriers-and-beacons-shared-decision-making-in-canada-inches-ahead
#3
France Légaré, Dawn Stacey, Pierre-Gerlier Forest, Marie-France Coutu, Patrick Archambault, Laura Boland, Holly O Witteman, Annie LeBlanc, Krystina B Lewis, Anik M C Giguere
Canada's approach to shared decision making (SDM) remains as disparate as its healthcare system; a conglomerate of 14 public plans - ten provincial, three territorial and one federal. The healthcare research funding environment has been largely positive for SDM because there was funding for knowledge translation research which also encompassed SDM. The funding climate currently places new emphasis on patient involvement in research and on patient empowerment in healthcare. SDM fields have expanded from primary care to elder care, paediatrics, emergency and critical care medicine, cardiology, nutrition, occupational therapy and workplace rehabilitation...
May 19, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28531787/clinical-nutrition-in-primary-care-an-evaluation-of-resident-physicians-attitudes-and-self-perceived-proficiency
#4
Sarah L Han, Reto Auer, Jacques Cornuz, Pedro Marques-Vidal
BACKGROUND & AIMS: There is little information regarding the impact of clinical nutrition training among medical residents. We aimed to evaluate the attitudes, self-perceived proficiency and knowledge of Swiss residents regarding clinical nutrition. METHODS: Cross-sectional study conducted between June and September 2014 in two medical education facilities located in Lausanne, Switzerland. Attitudes, self-perceived proficiency and knowledge regarding clinical nutrition were assessed by questionnaire...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28507284/melanoma-masquerading-as-a-zosteriform-rash
#5
Saif Ibrahim, Bashar Al-Turk, Ciel Harris, Farrah Al-Saffar, Sayf Said, Maheera Farsi, Jeffrey Winder, Christian Landa
BACKGROUND Primary care physicians and internal medicine specialists frequently encounter a variety of rashes. Many of these cases look and feel typical of common entities, resulting in the potential for misdiagnosis. CASE REPORT This is a case of a zosteriform rash where the surprising true diagnosis of metastatic melanoma was confirmed with bedside skin punch biopsy. Possible mechanisms involve direct cutaneous injury, neuronal, and dorsal root ganglia involvement in metastases. CONCLUSIONS Skin biopsy is indispensable especially when there is a lack of clinical response or deterioration in the clinical condition...
May 16, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28503220/medication-reconciliation-errors-in-a-tertiary-care-hospital-in-saudi-arabia-admission-discrepancies-and-risk-factors
#6
Faizan Mazhar, Shahzad Akram, Yousif A Al-Osaimi, Nafis Haider
BACKGROUND: Medication reconciliation is a major component of safe patient care. One of the main problems in the implementation of a medication reconciliation process is the lack of human resources. With limited resources, it is better to target medication reconciliation resources to patients who will derive the most benefit from it. OBJECTIVE: The primary objective of this study was to determine the frequency and types of medication reconciliation errors identified by pharmacists performing medication reconciliation at admission...
January 2017: Pharmacy Practice
https://www.readbyqxmd.com/read/28502910/balancing-volume-and-duration-of-information-consumption-by-physicians-the-case-of-health-information-exchange-in-critical-care
#7
Liran Politi, Shlomi Codish, Iftach Sagy, Lior Fink
BACKGROUND: The realization of the potential benefits of health information exchange systems (HIEs) for emergency departments (EDs) depends on the way these systems are actually used. The attributes of volume of information and duration of information processing are important for the study of HIE use patterns in the ED, as cognitive load and time constraints may result in a trade-off between these attributes. Experts and non-experts often use different problem-solving strategies, which may be consequential for their system use patterns...
May 11, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28499300/-recent-surgical-options-for-vestibular-vertigo
#8
Stefan Volkenstein, Stefan Dazert
Vertigo is not a well defined symptom but a heterogenous entity diagnosed and treated mainly by otolaryngologists, neurologists, internal medicine and primary care physicians. Most vertigo syndroms have a good prognosis and management is predominantly conservative, whereas the need for surgical therapy is rare, but for a subset of patients often the only remaining option. In this paper, we describe the development of surgical therapy for hydropic inner ear diseases, Menière disease, dehiscence syndroms, perilymphatic fistulas, and benign paroxysmal vertigo...
April 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28495815/understanding-the-implementation-and-adoption-of-an-information-technology-intervention-to-support-medicine-optimisation-in-primary-care-qualitative-study-using-strong-structuration-theory
#9
Mark Jeffries, Denham Phipps, Rachel L Howard, Anthony Avery, Sarah Rodgers, Darren Ashcroft
OBJECTIVES: Using strong structuration theory, we aimed to understand the adoption and implementation of an electronic clinical audit and feedback tool to support medicine optimisation for patients in primary care. DESIGN: This is a qualitative study informed by strong structuration theory. The analysis was thematic, using a template approach. An a priori set of thematic codes, based on strong structuration theory, was developed from the literature and applied to the transcripts...
May 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28491306/association-of-provider-opioid-prescribing-practices-and-the-centers-for-medicare-and-medicaid-services-hierarchical-condition-category-score-a-retrospective-examination-of-correlation-between-the-volume-of-provider-prescribed-opioid-medications-and-provider
#10
Frederick North, Sidna M Tulledge-Scheitel, Sarah J Crane
OBJECTIVE: Opioids are being prescribed at increasing rates in primary care practices, and among individual providers there is significant variability in opioid prescribing. Primary care practices also vary significantly in complexity of their patients, ranging from healthy patients to those with multiple comorbidities. Our objective was to examine individual primary care providers for an association between their opioid prescribing and the complexity/risk of their panel of patients (a panel of patients is a group of patients whose medical care is the responsibility of a specific healthcare provider or care team)...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28491135/highlights-from-the-15th-st-gallen-international-breast-cancer-conference-15-18-march-2017-vienna-tailored-treatments-for-patients-with-early-breast-cancer
#11
Consuelo Morigi
The 15th St Gallen International Breast Cancer Conference was held in Vienna for the second time, from 15th-18th March 2017. 4000 people from 105 countries all over the world were invited to take part in the event. The real highlight of the conference was the last day with the International Consensus Session which was chaired by around 50 experts on breast cancer worldwide. With reference to data from scientific research, the consensus panel tried to offer guidelines for the management of breast cancer with the aim of providing patients with optimal treatment...
2017: Ecancermedicalscience
https://www.readbyqxmd.com/read/28481570/integrated-behavioral-health-training-for-primary-care-clinicians-five-lessons-learned-from-a-negative-study
#12
Matthew P Martin
INTRODUCTION: There are very few studies examining the effectiveness of integrated behavioral health training for primary care clinicians. The purpose of this article is to review the findings of a negative study examining the effectiveness of medical resident training in integrated behavioral health and offer specific ideas for future research in workforce development. METHODS: Twenty-three family medicine residents from a community-based residency program in the mid-Atlantic region completed a required rotation in which they consulted with behavioral health in primary care, observed psychotherapy, read behavioral medicine books, and received individual instruction...
May 8, 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28480471/measuring-quality-of-healthcare-outcomes-in-type-2-diabetes-from-routine-data-a-seven-nation-survey-conducted-by-the-imia-primary-health-care-working-group-primary-health-care-informatics-working-group-contribution-to-the-year-book-of-medical-informatics-2017
#13
W Hinton, H Liyanage, A McGovern, S-T Liaw, C Kuziemsky, N Munro, S de Lusignan
BACKGROUND: The Institute of Medicine framework defines six dimensions of quality for healthcare systems: (1) safety, (2) effectiveness, (3) patient centeredness, (4) timeliness of care, (5) efficiency, and (6) equity. Large health datasets provide an opportunity to assess quality in these areas. OBJECTIVE: To perform an international comparison of the measurability of the delivery of these aims, in people with type 2 diabetes mellitus (T2DM) from large datasets...
May 8, 2017: Yearbook of Medical Informatics
https://www.readbyqxmd.com/read/28464179/physician-order-entry-clerical-support-improves-physician-satisfaction-and-productivity
#14
Erin Contratto, Katherine Romp, Carlos A Estrada, April Agne, Lisa L Willett
OBJECTIVES: To examine the impact of clerical support personnel for physician order entry on physician satisfaction, productivity, timeliness with electronic health record (EHR) documentation, and physician attitudes. METHODS: All seven part-time physicians at an academic general internal medicine practice were included in this quasi-experimental (single group, pre- and postintervention) mixed-methods study. One full-time clerical support staff member was trained and hired to enter physician orders in the EHR and conduct previsit planning...
May 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28464172/initial-experience-of-a-primary-urgent-care-clinic-curriculum-and-subspecialty-lectureship-series-implementation-in-a-los-angeles-county-hospital
#15
Harsh Agrawal, Anna Martinez, Elizabeth R Volkmann, Oleg Melamed, Soma Wali
OBJECTIVES: Urgent care clinics are extremely busy in the University of California-Los Angeles (UCLA) County hospital system. We determined that residents and medical students in the internal medicine residency program who are rotating through these clinics did not receive enough teaching during their rotation. We decided to create and implement an urgent care curriculum and lectures to help achieve structure for the rotation. The goal of this series was to educate and assist residents in the primary care setting to comfortably manage subspecialty conditions, help reduce the already-overwhelmed county subspecialty referral system, and promote learning...
May 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28459378/the-lesbian-gay-bisexual-and-transgender-development-of-clinical-skills-scale-lgbt-docss-establishing-a-new-interdisciplinary-self-assessment-for-health-providers
#16
Markus P Bidell
These three studies provide initial evidence for the development, factor structure, reliability, and validity of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale (LGBT-DOCSS), a new interdisciplinary LGBT clinical self-assessment for health and mental health providers. Research participants were voluntarily recruited in the United States and United Kingdom and included trainees, clinicians, and educators from applied psychology, counseling, psychotherapy, and primary care medicine...
May 1, 2017: Journal of Homosexuality
https://www.readbyqxmd.com/read/28456509/effect-of-early-tranexamic-acid-administration-on-mortality-hysterectomy-and-other-morbidities-in-women-with-post-partum-haemorrhage-woman-an-international-randomised-double-blind-placebo-controlled-trial
#17
(no author information available yet)
BACKGROUND: Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. METHODS: In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries...
April 26, 2017: Lancet
https://www.readbyqxmd.com/read/28449612/residents-responsibilities-adopting-a-wider-view
#18
Ami Schattner
Current ACGME regulations have limited residents' weekly hours and continuous working hours, a marked change, despite its uncertain effects on physician well-being and quality of care. Although residency programs in internal medicine and family medicine have adapted schedules to conform to these regulations, increasing evidence is accumulating to suggest that these training experiences are not adequately preparing the next generation of practicing primary care and hospital-based physicians. Data from an array of sources continue to demonstrate significant deficiencies in six areas of residents' responsibilities towards their patients: diminished patient "face time" and direct patient care; focus on patients' "reason for hospitalization" or "reason for visit" at the expense of possible neglect of patients' "secondary" medical problems; limited attention to patients' emotional or contextual problems and limited empathy; deficient implementation of the essential constituents of patient-centered care; neglect of habitual "reflective practice"; and excessive distinction between inpatient and outpatient responsibilities, leading to missed opportunities for inpatient residents to be aware of and attend to patients' post-discharge course although new information and readmissions related to the index hospitalization are prevalent...
April 27, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28445474/cost-effectiveness-of-a-transitional-pharmaceutical-care-program-for-patients-discharged-from-the-hospital
#19
Fatma Karapinar-Çarkıt, Ronald van der Knaap, Fatiha Bouhannouch, Sander D Borgsteede, Marjo J A Janssen, Carl E H Siegert, Toine C G Egberts, Patricia M L A van den Bemt, Marieke F van Wier, Judith E Bosmans
BACKGROUND: To improve continuity of care at hospital admission and discharge and to decrease medication errors pharmaceutical care programs are developed. This study aims to determine the cost-effectiveness of the COACH program in comparison with usual care from a societal perspective. METHODS: A controlled clinical trial was performed at the Internal Medicine department of a general teaching hospital. All admitted patients using at least one prescription drug were included...
2017: PloS One
https://www.readbyqxmd.com/read/28441678/the-addiction-recovery-clinic-a-novel-primary-care-based-approach-to-teaching-addiction-medicine
#20
Stephen R Holt, Nora Segar, Dana A Cavallo, Jeanette M Tetrault
PROBLEM: Substance use is highly prevalent in the United States, but little time in the curriculum is devoted to training internal medicine residents in addiction medicine. APPROACH: In 2014, the authors developed and launched the Addiction Recovery Clinic (ARC) to address this educational gap while also providing outpatient clinical services to patients with substance use disorders. The ARC is embedded within the residency primary care practice and is staffed by three to four internal medicine residents, two board-certified addiction medicine specialists, one chief resident, and one psychologist...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
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