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https://www.readbyqxmd.com/read/28501112/early-results-of-a-surgeon-led-perioperative-surgical-home
#1
Anathea C Powell, Marie S Thearle, Matthew Cusick, Dorothy Jensen Sanderson, Holly Van Lew, Candace Lee, Jennefer A Kieran
BACKGROUND: The Perioperative Surgical Home is a novel care model designed to provide patient-centered, high-quality surgical care. In 2013, we implemented POSH, a pilot Peri-Operative Surgical Home at Phoenix Indian Medical Center (PIMC), an Indian Health Service hospital, as a quality improvement project. After 2 y, we sought to quantify the impact of POSH on the quality of surgical care at PIMC. MATERIALS AND METHODS: We conducted a retrospective review of 33 surgical patients who underwent surgery at PIMC through the POSH process between 2013 and 2015 matched to 64 historical controls with similar operations...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28492914/antibiotic-prescribing-for-nonbacterial-acute-upper-respiratory-infections-in-elderly-persons
#2
Michael Silverman, Marcus Povitz, Jessica M Sontrop, Lihua Li, Lucie Richard, Sonny Cejic, Salimah Z Shariff
Background: Reducing inappropriate antibiotic prescribing for acute upper respiratory tract infections (AURIs) requires a better understanding of the factors associated with this practice. Objective: To determine the prevalence of antibiotic prescribing for nonbacterial AURIs and whether prescribing rates varied by physician characteristics. Design: Retrospective analysis of linked administrative health care data. Setting: Primary care physician practices in Ontario, Canada (January-December 2012)...
May 9, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28492816/enhanced-recovery-after-surgery-program-implementation-in-2-surgical-populations-in-an-integrated-health-care-delivery-system
#3
Vincent X Liu, Efren Rosas, Judith Hwang, Eric Cain, Anne Foss-Durant, Molly Clopp, Mengfei Huang, Derrick C Lee, Alex Mustille, Patricia Kipnis, Stephen Parodi
Importance: Novel approaches to perioperative surgical care focus on optimizing nutrition, mobility, and pain management to minimize adverse events after surgical procedures. Objective: To evaluate the outcomes of an enhanced recovery after surgery (ERAS) program among 2 target populations: patients undergoing elective colorectal resection and patients undergoing emergency hip fracture repair. Design, Setting, and Participants: A pre-post difference-in-differences study before and after ERAS implementation in the target populations compared with contemporaneous surgical comparator groups (patients undergoing elective gastrointestinal surgery and emergency orthopedic surgery)...
May 10, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28490882/connectivity-to-computers-and-the-internet-among-patients-with-schizophrenia-spectrum-disorders-a-cross-sectional-study
#4
Maritta Välimäki, Lauri Kuosmanen, Heli Hätönen, Marita Koivunen, Anneli Pitkänen, Christina Athanasopoulou, Minna Anttila
PURPOSE: Information and communication technologies have been developed for a variety of health care applications and user groups in the field of health care. This study examined the connectivity to computers and the Internet among patients with schizophrenia spectrum disorders (SSDs). PATIENTS AND METHODS: A cross-sectional survey design was used to study 311 adults with SSDs from the inpatient units of two psychiatric hospitals in Finland. The data collection lasted for 20 months and was done through patients' medical records and a self-reported, structured questionnaire...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28490560/nursing-home-team-care-deprescribing-study-a-stepped-wedge-randomised-controlled-trial-protocol
#5
Chong-Han Kua, Cindy Ying Ying Yeo, Cheryl Wai Teng Char, Cheryl Wei Yan Tan, Poh Ching Tan, Vivienne Sl Mak, Shaun Wen Huey Lee, Ian Yi-Onn Leong
INTRODUCTION: An ageing population has become an urgent concern for Asia in recent times. In nursing homes, polypharmacy has also become a compounding issue. Deprescribing practice is an evidence-based strategy to provide a better outcome in this group of patients; however, its implementation in nursing homes is often challenging, and prospective outcome data on deprescribing practice in the elderly is lacking. Our study assesses the implementation of team-care deprescribing to understand the benefits of this practice in geriatric setting and to explore the factors affecting deprescribing practice...
May 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28486553/pilot-study-of-a-multi-pronged-intervention-using-social-norms-and-priming-to-improve-adherence-to-antiretroviral-therapy-and-retention-in-care-among-adults-living-with-hiv-in-tanzania
#6
Sandra I McCoy, Carolyn Fahey, Aarthi Rao, Ntuli Kapologwe, Prosper F Njau, Sergio Bautista-Arredondo
BACKGROUND: Interventions incorporating constructs from behavioral economics and psychology have the potential to enhance HIV 'treatment as prevention' (TasP) strategies. To test this hypothesis, we evaluated an intervention to improve antiretroviral therapy (ART) adherence based on the concepts of social norms and priming. METHODS: We used tools from marketing research and patient-centered design to develop a combination intervention that included visual feedback about clinic-level retention in care, a self-relevant prime, and useful take-home items with the priming image...
2017: PloS One
https://www.readbyqxmd.com/read/28486076/medical-providers-knowledge-and-concerns-about-opioid-overdose-education-and-take-home-naloxone-rescue-kits-within-veterans-affairs-health-care-medical-treatment-settings
#7
Rachel P Winograd, Corey S Davis, Maria Niculete, Elizabeth Oliva, Richard P Martielli
BACKGROUND: Overdose from opioids is a serious public health and clinical concern. Veterans are at increased risk for opioid overdose compared with the civilian population, suggesting the need for enhanced efforts to address overdose prevention in Department of Veterans Affairs (VA) health care settings, such as primary care clinics. METHODS: Prescribing providers (N = 45) completed surveys on baseline knowledge and concerns about the VA Overdose Education and Naloxone Distribution (OEND) initiative prior to attending an OEND educational training...
April 2017: Substance Abuse
https://www.readbyqxmd.com/read/28483892/a-hepatitis-c-treatment-program-based-in-a-safety-net-hospital-patient-centered-medical-home
#8
Karen E Lasser, Alexandra Heinz, Leandra Battisti, Alexandria Akoumianakis, Ve Truong, Judith Tsui, Glorimar Ruiz, Jeffrey H Samet
Hepatitis C virus (HCV) infection is a major public health problem. Urban safety-net hospitals are a prime location for HCV treatment delivery. Showing that physicians in primary care settings can deliver HCV infection care is important to expand treatment; models doing so in the era of newer oral HCV medications are needed. This article describes an innovative and successful HCV primary care treatment program in a patient-centered medical home based at an urban, safety-net hospital. The program is public health oriented in that a central team member is a public health social worker who performs population management and addresses underlying social determinants of health to facilitate engagement in HCV treatment...
May 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28483888/alignment-of-canadian-primary-care-with-the-patient-medical-home-model-a-qualico-pc-study
#9
Alan Katz, Nicole Herpai, Glenys Smith, Kris Aubrey-Bassler, Mylaine Breton, Antoine Boivin, William Hogg, Baukje Miedema, Jocelyn Pang, Walter P Wodchis, Sabrina T Wong
PURPOSE: The patient medical home (PMH) model aims to improve patient satisfaction and health outcomes in Canada, but since its introduction in 2009, there has been no evaluation of the extent to which primary care conforms with PMH attributes. Our objective was to compare current primary care across Canada with the 10 goals of the PMH model. METHODS: A cross-sectional survey of primary care organization and delivery was conducted in Canadian provinces to evaluate the PMH-based attributes of primary care practices...
May 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28482877/electronic-patient-self-reporting-of-adverse-events-patient-information-and-advice-erapid-a-randomised-controlled-trial-in-systemic-cancer-treatment
#10
Kate Absolom, Patricia Holch, Lorraine Warrington, Faye Samy, Claire Hulme, Jenny Hewison, Carolyn Morris, Leon Bamforth, Mark Conner, Julia Brown, Galina Velikova
BACKGROUND: eRAPID (electronic patient self-Reporting of Adverse-events: Patient Information and aDvice) is an internet based system for patients to self-report symptoms and side effects (adverse events or AE) of cancer treatments. eRAPID allows AE reporting from home and patient reported data is accessible via Electronic Patient Records (EPR) for use in routine care. The system can generate alerts to clinical teams for severe AE and provides patient advice on managing mild AEs. The overall aims of eRAPID are to improve the safe delivery of cancer treatments, enhance patient care and standardise AE documentation...
May 8, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28481843/vha-patient-centered-medical-home-associated-with-lower-rate-of-hospitalizations-and-specialty-care-among-veterans-with-posttraumatic-stress-disorder
#11
Ian Randall, David C Mohr, Charles Maynard
OBJECTIVE: The Veterans Health Administration (VHA) implemented a patient-centered medical home (PCMH) model, termed Patient Aligned Care Teams (PACT), in 2010. We assessed the association between PACT and the use of health services among U.S. veterans with posttraumatic stress disorder (PTSD). METHODS: VHA clinical and administrative data were obtained for the pre-PACT period of April 1, 2009 to March 31, 2010 and post-PACT period of June 1, 2011 to May 31, 2012...
May 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28481602/a-national-evaluation-of-homeless-and-nonhomeless-veterans-experiences-with-primary-care
#12
Audrey L Jones, Leslie R M Hausmann, Gretchen L Haas, Maria K Mor, John P Cashy, James H Schaefer, Adam J Gordon
Persons who are homeless, particularly those with mental health and/or substance use disorders (MHSUDs), often do not access or receive continuous primary care services. In addition, negative experiences with primary care might contribute to homeless persons' avoidance and early termination of MHSUD treatment. The patient-centered medical home (PCMH) model aims to address care fragmentation and improve patient experiences. How homeless persons with MHSUDs experience care within PCMHs is unknown. This study compared the primary care experiences of homeless and nonhomeless veterans with MHSUDs receiving care in the Veterans Health Administration's medical home environment, called Patient Aligned Care Teams...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28481600/-they-re-homeless-in-a-home-retaining-homeless-experienced-consumers-in-supported-housing
#13
Sonya Gabrielian, Alison B Hamilton, Adrian Alexandrino, Gerhard Hellemann, Alexander S Young
Permanent, community-based housing with supportive services ("supported housing") has numerous favorable outcomes for homeless-experienced consumers. Little is known, however, about consumers who attain but subsequently lose their supported housing. Using mixed methods, we compared persons who retained their supported housing for at least 1 year ("stayers") with those who lost their supported housing within 1 year of move-in ("exiters"). Among persons housed through the VA Supported Housing (VASH) program at the VA Greater Los Angeles between 2011 and 2012, we queried VA homeless registry data to identify stayers (n = 1,558) and exiters (n = 85)...
May 2017: Psychological Services
https://www.readbyqxmd.com/read/28475282/risk-of-intracranial-hemorrhage-in-ground-level-fall-with-antiplatelet-or-anticoagulant-agents
#14
Michael Ganetsky, Gregory Lopez, Tara Coreanu, Victor Novack, Steven Horng, Nathan I Shapiro, Kenneth A Bauer
OBJECTIVES: Anticoagulant and antiplatelet medications are known to increase the risk and severity of traumatic intracranial hemorrhage (tICH), even with minor head trauma. Most studies on bleeding propensity with head trauma are retrospective, based on trauma registries, or include heterogeneous mechanisms of injury. The goal of this study was to determine the rate of tICH from only a common low-acuity mechanism of injury, that of a ground level fall, in patients taking one or more of the following antiplatelet or anticoagulant medications: aspirin, warfarin, prasugrel, ticagrelor, dabigatran, rivaroxaban, apixaban or enoxaparin...
May 5, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28471436/a-novel-approach-in-pediatric-telegenetic-services-geneticist-pediatrician-and-genetic-counselor-team
#15
Shobana Kubendran, Siddharthan Sivamurthy, Gerald Bradley Schaefer
PurposeOur aim was to improve access to genetic services in an underserved region by developing a collaborative telegenetic service delivery model with a pediatrician, medical geneticist, and genetics counselor (GC).MethodsProtocols for the evaluation of common genetic indications were developed. Patients referred with indications suggestive of a syndromic etiology were scheduled to see the geneticist directly via telegenetics. Other patients were scheduled to see the pediatrician and GC in person before follow-up with the geneticist if indicated...
May 4, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28468524/accountable-care-in-transitions-action-a-team-based-approach-to-reducing-hospital-utilization-in-a-patient-centered-medical-home
#16
Emily M Hawes, Jennifer N Smith, Nicole R Pinelli, Rayhaan Adams, Gretchen Tong, Sam Weir, Mark Gwynne
BACKGROUND: There is limited data describing the role of the patient-centered medical home (PCMH) in successful transitions programs and more information is needed to determine the transition points where pharmacist involvement is most impactful. METHODS: A family medicine center developed a multidisciplinary outpatient-based transitions program focused on reducing emergency department (ED) and hospital use in medically complex patients. Key team members were a medical provider, clinical pharmacist practitioner (CPP), and care manager...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28467266/patient-centered-medical-home-recognition-and-diabetes-control-among-health-centers-exploring-the-role-of-enabling-services
#17
Jessica M Dobbins, Nicholas Peiper, Emily Jones, Richard Clayton, Lars E Peterson, Robert L Phillips
The patient-centered medical home (PCMH) model has been considered a promising approach to improve chronic care delivery, particularly among patients with diabetes. There is theoretical support to suggest that certain nonmedical services, such as enabling services (eg, case management, social work, transportation), embedded within PCMH could be contributing to successful model implementation. It remains unclear whether PCMH recognition or enabling services are related to diabetes control. Federally Qualified Health Centers (FQHCs) are an important setting in which to study this relationship given the considerable effort required to implement the PCMH model and the ubiquity of enabling services in these safety net settings...
May 3, 2017: Population Health Management
https://www.readbyqxmd.com/read/28462622/trends-in-hiv-continuum-of-care-outcomes-over-10-years-of-follow-up-at-a-large-hiv-primary-medical-home-in-the-southeastern-united-states
#18
Michael K Ghiam, Peter Rebeiro, Megan Turner, William B Rogers, Sally Bebawy, Stephen P Raffanti, Anna Kristine Person, April C Pettit
BACKGROUND: Longitudinal studies of retention in care (RIC) and viral suppression (VS) in the southeastern United States (US), a region disproportionately affected by HIV-infection, are lacking. METHODS: HIV-infected adults with ≥1 medical visit at the Vanderbilt Comprehensive Care Clinic (Nashville, Tennessee) from 2004-2013 were included. RIC was ≥2 (a) laboratory dates [CD4+ counts or HIV-1 viral loads (VL)] or (b) provider encounters and/or laboratory dates in the year of interest, ≥90 days apart...
May 2, 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/28461356/medical-group-structural-integration-may-not-ensure-that-care-is-integrated-from-the-patient-s-perspective
#19
Michaela J Kerrissey, Jonathan R Clark, Mark W Friedberg, Wei Jiang, Ashley K Fryer, Molly Frean, Stephen M Shortell, Patricia P Ramsay, Lawrence P Casalino, Sara J Singer
Structural integration is increasing among medical groups, but whether these changes yield care that is more integrated remains unclear. We explored the relationships between structural integration characteristics of 144 medical groups and perceptions of integrated care among their patients. Patients' perceptions were measured by a validated national survey of 3,067 Medicare beneficiaries with multiple chronic conditions across six domains that reflect knowledge and support of, and communication with, the patient...
May 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28459925/effect-of-a-community-health-worker-intervention-among-latinos-with-poorly-controlled-type-2-diabetes-the-miami-healthy-heart-initiative-randomized-clinical-trial
#20
Olveen Carrasquillo, Cynthia Lebron, Yisel Alonzo, Hua Li, Aileen Chang, Sonjia Kenya
Importance: Community health worker (CHW) intervention is a promising approach to address type 2 diabetes among Latinos. However, evidence from randomized clinical studies is limited. Objective: To compare a CHW intervention with enhanced usual care. Design, Setting, and Participants: This 52-week, single-blind, randomized clinical trial included 300 Latino adults aged 18 to 65 years who were treated in 2 public hospital outpatient clinics in Miami-Dade County, Florida, from July 1, 2010, through October 31, 2013...
May 1, 2017: JAMA Internal Medicine
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