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https://www.readbyqxmd.com/read/28642372/the-highland-health-advocates-a-preliminary-evaluation-of-a-novel-programme-addressing-the-social-needs-of-emergency-department-patients
#1
Lia Ilona Losonczy, Dennis Hsieh, Michael Wang, Christopher Hahn, Tarak Trivedi, Marcela Rodriguez, Jahan Fahimi, Harrison Alter
OBJECTIVES: Patients commonly come to the emergency department (ED) with social needs. To address this, we created the Highland Health Advocates (HHA), an ED-based help desk and medical-legal partnership using undergraduate volunteers to help patients navigate public resources and provide onsite legal and social work referrals. We were able to provide these services in English and Spanish. We aimed to determine the social needs of the patients who presented to our ED and the potential impact of the programme in resolving those needs and connecting them to a 'medical home' (defined as a consistent, primary source of medical care such as a primary care doctor or clinic)...
June 22, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28636834/implementation-of-medical-homes-in-federally-qualified-health-centers
#2
Justin W Timbie, Claude M Setodji, Amii Kress, Tara A Lavelle, Mark W Friedberg, Peter J Mendel, Emily K Chen, Beverly A Weidmer, Christine Buttorff, Rosalie Malsberger, Mallika Kommareddi, Afshin Rastegar, Aaron Kofner, Lisa Hiatt, Ammarah Mahmud, Katherine Giuriceo, Katherine L Kahn
Background From 2011 through 2014, the Federally Qualified Health Center Advanced Primary Care Practice Demonstration provided care management fees and technical assistance to a nationwide sample of 503 federally qualified health centers to help them achieve the highest (level 3) medical-home recognition by the National Committee for Quality Assurance, a designation that requires the implementation of processes to improve access, continuity, and coordination. Methods We examined the achievement of medical-home recognition and used Medicare claims and beneficiary surveys to measure utilization of services, quality of care, patients' experiences, and Medicare expenditures in demonstration sites versus comparison sites...
June 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28629279/understanding-determinants-of-cardiovascular-health-in-a-mexican-american-community
#3
Karen A Larimer, Meg Gulanick, Sue Penckofer
Cardiovascular disease (CVD) is the leading cause of death in Hispanic Americans. Social and physical determinants of health unique to this community must be understood before interventions can be designed and implemented. This article describes a CVD risk assessment conducted in a primarily Mexican American community, using Healthy People 2020 as a model. Social (language, culture, awareness of CVD, and socio-economic status) and physical (presence and use of recreation areas, presence of grocery stores, public transportation, and environmental pollution) determinants of health as well as access to health services were assessed...
July 2017: Health Promotion Practice
https://www.readbyqxmd.com/read/28624253/constructing-an-inflammatory-bowel-disease-patient-centered-medical-home
#4
Miguel Regueiro, Benjamin Click, Diane Holder, William Shrank, Sandra McAnallen, Eva Szigethy
No abstract text is available yet for this article.
June 14, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28622983/the-effect-of-a-comprehensive-care-transition-model-on-cost-and-utilization-for-medically-complex-children-with-cerebral-palsy
#5
Steven W Howard, Zidong Zhang, Paula Buchanan, Eric Armbrecht, Christine Williams, Geneva Wilson, Janna Hutchinson, Lindsey Pearson, Samantha Ellsworth, Caitlin M Byler, Travis Loux, Jing Wang, Steph Bernell, Nicholas Holekamp
INTRODUCTION: Our aim was to evaluate cost and acute care utilization related to an organized approach to care coordination and transitional care after major acute care hospitalization for children with medical complexities, including cerebral palsy. METHODS: A retrospective cohort of 32 patients from Ranken Jordan Pediatric Bridge Hospital (RJPBH) who received the Care Beyond the Bedside model was compared with 151 patients receiving standard care elsewhere across Missouri...
June 13, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28620828/capsule-commentary-on-timbie-et-al-association-between-patient-centered-medical-home-capabilities-and-outcomes-for-medicare-beneficiaries-seeking-care-from-federally-qualified-health-centers
#6
https://www.readbyqxmd.com/read/28620725/understanding-adaptations-to-patient-centered-medical-home-activities-the-pcmh-adaptations-model
#7
Tristen L Hall, Jodi Summers Holtrop, L Miriam Dickinson, Russell E Glasgow
Primary care practices have increasingly adopted the patient-centered medical home (PCMH) model and often adapted quality improvement efforts to fit local context. This paper implemented a modified framework for understanding adaptations in the context of primary care PCMH transformation efforts. We combined an adaptations model by Stirman et al. that categorized adaptations to evidence-based interventions in research studies with dimensions from the RE-AIM framework, as well as items specific to PCMH. The resulting constructs were translated into a "plain English" adaptations interview...
June 15, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28617244/continuity-of-care-in-infancy-and-early-childhood-health-outcomes
#8
Elizabeth Enlow, Molly Passarella, Scott A Lorch
BACKGROUND AND OBJECTIVES: Continuity of care is a key aspect of the patient-centered medical home and improves pediatric outcomes. Health care reform requires high-quality data to demonstrate its continued value. We hypothesized that increased provider continuity in infancy will reduce urgent health care use and increase receipt of preventive services in early childhood. METHODS: Continuity, using the Usual Provider of Care measure, was calculated across all primary care encounters during the first year of life in a prospectively-constructed cohort of 17 773 infants receiving primary care from birth through 3 years at 30 clinics...
June 15, 2017: Pediatrics
https://www.readbyqxmd.com/read/28617023/integrated-behavioral-health-practice-facilitation-in-patient-centered-medical-homes-a-promising-application
#9
Sarah S Roderick, Nelly Burdette, Debra Hurwitz, Pano Yeracaris
INTRODUCTION: The purpose of this study was to assess the degree of behavioral health (BH) integration change in patient-centered medical homes (PCMHs) when using a practice facilitator (PF) specially trained in implementing integrated care and how a quasi-experimental design assists in this process. METHOD: Twelve PCMHs, 8 Federally Qualified Health Centers and 4 private practices, with varying degrees of BH services participated in this study. The degree of BH integration was assessed with a quasi-experimental design using the Maine Health Access Foundation's Site Self Assessment (MeHAF SSA) at baseline and after implementing site-specific BH services...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28614167/the-role-of-organizational-context-in-the-implementation-of-a-statewide-initiative-to-integrate-mental-health-services-into-pediatric-primary-care
#10
Melissa A King, Lawrence S Wissow, Rebecca A Baum
BACKGROUND: Although there is evidence that mental health services can be delivered in pediatric primary care with good outcomes, few changes in service delivery have been seen over the past decade. Practices face a number of barriers, making interventions that address determinants of change at multiple levels a promising solution. However, these interventions may need appropriate organizational contexts in place to be successfully implemented. PURPOSE: The objective of this study was to test whether organizational context (culture, climate, structures/processes, and technologies) influenced uptake of a complex intervention to implement mental health services in pediatric primary care...
June 13, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28609248/using-statewide-data-on-health-care-quality-to-assess-the-effect-of-a-patient-centered-medical-home-initiative-on-quality-of-care
#11
Nathan D Shippee, Michael Finch, Douglas Wholey
Patient-centered medical homes comprise a large portion of modern health care redesign. However, most efforts have reflected rigid, limited models of transformation. In addition, evaluations of their impact on quality of care have relied on data designed for other purposes. Minnesota's Health Care Home (HCH) initiative is a statewide medical home model relying on state-run, adaptive certification and supportive data infrastructure. This longitudinal study leverages a unique statewide system of clinic-reported, patient-level quality data (2010-2013) to assess the effect of being in a HCH clinic on health care quality...
June 13, 2017: Population Health Management
https://www.readbyqxmd.com/read/28604260/developing-high-functioning-teams-factors-associated-with-operating-as-a-real-team-and-implications-for-patient-centered-medical-home-development
#12
Somava Stout, Leah Zallman, Lisa Arsenault, Assaad Sayah, Karen Hacker
Team-based care is a foundation of health care redesign models like the patient-centered medical home (PCMH). Yet few practices rigorously examine how the implementation of PCMH relates to teamwork. We identified factors associated with the perception of a practice operating as a real team. An online workforce survey was conducted with all staff of 12 primary care sites of Cambridge Health Alliance at different stages of PCMH transformation. Bivariate and multivariate analyses of factors associated with teamwork perceptions were conducted...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28596445/development-of-a-new-care-model-for-hospitalized-children-with-medical-complexity
#13
Christine M White, Joanna E Thomson, Angela M Statile, Katherine A Auger, Ndidi Unaka, Matthew Carroll, Karen Tucker, Derek Fletcher, David E Hall, Jeffrey M Simmons, Patrick W Brady
Children with medical complexity are a rapidly growing inpatient population with frequent, lengthy, and costly hospitalizations. During hospitalization, these patients require care coordination among multiple subspecialties and their outpatient medical homes. At a large freestanding children's hospital, a new inpatient model of care was developed in an effort to consistently provide coordinated, family-centered, and efficient care. In addition to expanding the multidisciplinary team to include a pharmacist, dietician, and social worker, the team redesign included: (1) medication reconciliation rounds, (2) care coordination rounds, and (3) multidisciplinary weekly handoff with outpatient providers...
June 8, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28586285/improving-the-health-of-rural-america-s-chronically-ill-a-case-study-of-a-patient-centered-medical-home-clinic-in-mississippi
#14
Wesley James, Karen Matthews, Peter Albrecht, Anna Church
No abstract text is available yet for this article.
June 6, 2017: Population Health Management
https://www.readbyqxmd.com/read/28585163/engaging-multilevel-stakeholders-in-an-implementation-trial-of-evidence-based-quality-improvement-in-va-women-s-health-primary-care
#15
Alison B Hamilton, Julian Brunner, Cindy Cain, Emmeline Chuang, Tana M Luger, Ismelda Canelo, Lisa Rubenstein, Elizabeth M Yano
The Veterans Health Administration (VHA) has undertaken primary care transformation based on patient-centered medical home (PCMH) tenets. VHA PCMH models are designed for the predominantly male Veteran population, and require tailoring to meet women Veterans' needs. We used evidence-based quality improvement (EBQI), a stakeholder-driven implementation strategy, in a cluster randomized controlled trial across 12 sites (eight EBQI, four control) that are members of a Practice-Based Research Network. EBQI involves engaging multilevel, inter-professional leaders and staff as stakeholders in reviewing evidence and setting QI priorities...
June 5, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28583968/racial-and-ethnic-disparities-persist-at-veterans-health-administration-patient-centered-medical-homes
#16
Donna L Washington, W Neil Steers, Alexis K Huynh, Susan M Frayne, Uchenna S Uchendu, Deborah Riopelle, Elizabeth M Yano, Fay S Saechao, Katherine J Hoggatt
Patient-centered medical homes are widely promoted as a primary care delivery model that achieves better patient outcomes. It is unknown if their benefits extend equally to all racial/ethnic groups. In 2010 the Veterans Health Administration, part of the Department of Veterans Affairs (VA), began implementing patient-centered medical homes nationwide. In 2009 significant disparities in hypertension or diabetes control were present for most racial/ethnic groups, compared with whites. In 2014 hypertension disparities were similar for blacks, had become smaller but remained significant for Hispanics, and were no longer significant for multiracial veterans, whereas disparities had become significant for American Indians/Alaska Natives and Native Hawaiians/other Pacific Islanders...
June 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28576956/the-integral-role-of-the-clinical-pharmacist-practitioner-in-primary-care
#17
Mollie Ashe Scott, Jeffrey E Heck, Courtenay Gilmore Wilson
Clinical pharmacist practitioners serve as integral team members in primary care clinics. They extend the care provided for patients with chronic illnesses, improve health and wellness, and positively impact quality metrics in patient-centered medical homes and accountable care organizations.
May 2017: North Carolina Medical Journal
https://www.readbyqxmd.com/read/28561691/improving-quality-and-value-of-cancer-care-for-older-adults
#18
Erika E Ramsdale, Valerie Csik, Andrew E Chapman, Arash Naeim, Beverly Canin
The concepts of quality and value have become ubiquitous in discussions about health care, including cancer care. Despite their prominence, these concepts remain difficult to encapsulate, with multiple definitions and frameworks emerging over the past few decades. Defining quality and value for the care of older adults with cancer can be particularly challenging. Older adults are heterogeneous and often excluded from clinical trials, severely limiting generalizable data for this population. Moreover, many frameworks for quality and value focus on traditional outcomes of survival and toxicity and neglect goals that may be more meaningful for older adults, such as quality of life and functional independence...
2017: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/28560783/end-of-life-care-planning-in-accountable-care-organizations-associations-with-organizational-characteristics-and-capabilities
#19
Sangeeta C Ahluwalia, Benjamin J Harris, Valerie A Lewis, Carrie H Colla
OBJECTIVE: To measure the extent to which accountable care organizations (ACOs) have adopted end-of-life (EOL) care planning processes and characterize those ACOs that have established processes related to EOL. DATA SOURCES: This study uses data from three waves (2012-2015) of the National Survey of ACOs. Respondents were 397 ACOs participating in Medicare, Medicaid, and commercial ACO contracts. STUDY DESIGN: This is a cross-sectional survey study using multivariate ordered logit regression models...
May 30, 2017: Health Services Research
https://www.readbyqxmd.com/read/28560769/patient-experience-of-chronic-illness-care-and-medical-home-transformation-in-safety-net-clinics
#20
Elizabeth L Tung, Yue Gao, Monica E Peek, Robert S Nocon, Kathryn E Gunter, Sang Mee Lee, Marshall H Chin
OBJECTIVE: To examine the relationship between medical home transformation and patient experience of chronic illness care. STUDY SETTING: Thirteen safety net clinics located in five states enrolled in the Safety Net Medical Home Initiative. STUDY DESIGN: Repeated cross-sectional surveys of randomly selected adult patients were completed at baseline (n = 303) and postintervention (n = 271). DATA COLLECTION METHODS: Questions from the Patient Assessment of Chronic Illness Care (PACIC) (100-point scale) were used to capture patient experience of chronic illness care...
May 30, 2017: Health Services Research
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