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https://www.readbyqxmd.com/read/28219383/the-alice-springs-hospital-readmission-prevention-project-ashrapp-a-randomised-control-trial
#1
Gabrielle Diplock, James Ward, Simon Stewart, Paul Scuffham, Penny Stewart, Carole Reeve, Lea Davidson, Graeme Maguire
BACKGROUND: Hospitals are frequently faced with high levels of emergency department presentations and demand for inpatient care. An important contributing factor is the subset of patients with complex chronic diseases who have frequent and preventable exacerbations of their chronic diseases. Evidence suggests that some of these hospital readmissions can be prevented with appropriate transitional care. Whilst there is a growing body of evidence for transitional care processes in urban, non-indigenous settings, there is a paucity of information regarding rural and remote settings and, specifically, the indigenous context...
February 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28216856/feasibility-and-acceptability-of-implementing-the-integrated-care-plan-for-the-dying-in-the-indian-setting-survey-of-perspectives-of-indian-palliative-care-providers
#2
Naveen Salins, Jeremy Johnson, Stanley Macaden
INTRODUCTION: Capacity to provide end-of-life care in India is scored as 0.6/100, and very few people in India have access to palliative and end-of-life care. Lack of end-of-life care provision in India has led to a significant number of people receiving inappropriate medical treatment at the end of life, with no access to pain and symptom control and high treatment costs. The International Collaborative for the Best Care for the Dying Person is an initiative that offers the opportunity to apply international evidence on the key factors required to provide best care for the dying in the Indian context...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28203324/lived-experience-of-caregivers-of-family-centered-care-in-the-neonatal-intensive-care-unit-evocation-of-being-at-home
#3
Zahra Hadian Shirazi, Farkhondeh Sharif, Mahnaz Rakhshan, Narjes Pishva, Faezeh Jahanpour
BACKGROUND: In recent decades, family-centered care (FCC) has come to be known, accepted, and reported as the best care strategy for admitted children and their families. However, in spite of the increasing application of this approach, the experiences of the caregivers have not yet been studied. OBJECTIVES: The present study aimed at the description and interpretation of the FCC experience in two neonatal intensive care units (NICU) at Shiraz University of Medical Sciences...
October 2016: Iranian Journal of Pediatrics
https://www.readbyqxmd.com/read/28199265/a-decision-support-approach-for-provider-scheduling-in-a-patient-centered-medical-home
#4
Renata Konrad, Sarah Ficarra, Catherine Danko, Rachel Wallace, Cliona Archambeault
The patient-centered medical home (PCMH) has been proposed as a viable and medically effective model of primary care delivery. The fundamental principles of a PCMH address increased access and offer new ways to organize a practice. Creating provider schedules able to satisfy the operational and organizational constraints imposed by this type of delivery model is a challenging, complex, and time-consuming task.This article presents a two-step approach for scheduling providers and prospectively assessing the consequences of various schedules on patient throughput without experimenting on the real-world system...
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28196524/financial-barriers-and-adverse-clinical-outcomes-among-patients-with-cardiovascular-related-chronic-diseases-a-cohort-study
#5
David J T Campbell, Braden J Manns, Robert G Weaver, Brenda R Hemmelgarn, Kathryn M King-Shier, Claudia Sanmartin
BACKGROUND: Some patients with cardiovascular-related chronic diseases such as diabetes and heart disease report financial barriers to achieving optimal health. Previous surveys report that the perception of having a financial barrier is associated with self-reported adverse clinical outcomes. We sought to confirm these findings using linked survey and administrative data to determine, among patients with cardiovascular-related chronic diseases, if there is an association between perceived financial barriers and the outcomes of: (1) disease-related hospitalizations, (2) all-cause mortality and (3) inpatient healthcare costs...
February 15, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28193716/preventing-falls-in-a-high-risk-vision-impaired-population-through-specialist-orientation-and-mobility-services-protocol-for-the-platform-randomised-trial
#6
Lisa Keay, Lisa Dillon, Lindy Clemson, Anne Tiedemann, Catherine Sherrington, Peter McCluskey, Pradeep Ramulu, Stephen Jan, Kris Rogers, Jodi Martin, Frances Tinsley, Kirsten Bonrud Jakobsen, Rebecca Q Ivers
BACKGROUND: Older people with vision impairment have significant ongoing morbidity, including risk of falls, but are neglected in fall prevention programmes. PlaTFORM is a pragmatic evaluation of the Lifestyle-integrated Functional Exercise fall prevention programme for older people with vision impairment or blindness (v-LiFE). Implementation and scalability issues will also be investigated. METHODS: PlaTFORM is a single-blinded, randomised trial designed to evaluate the v-LiFE programme compared with usual care...
February 13, 2017: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
https://www.readbyqxmd.com/read/28186016/collaborators-and-communication-channels-in-eight-patient-centered-medical-homes
#7
Dian A Chase, David A Dorr, Deborah J Cohen, Joan S Ash
BACKGROUND: The patient-centered medical home (PCMH) concept requires collaboration among clinicians both within the medical home clinic, and outside the clinic. As we redesign health information technology (HIT) to support transformation to the PCMH, we need to better understand these collaboration patterns. This study provides quantitative data describing these collaborations in order to facilitate the design of systems to allow for more efficient collaboration. APPROACH: Eighty-four clinicians in eight clinics identified their two most recent significant collaborators - one each within the clinic and in the medical neighborhood...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28183346/study-protocol-improving-the-transition-of-care-from-a-non-network-hospital-back-to-the-patient-s-medical-home
#8
Roman A Ayele, Emily Lawrence, Marina McCreight, Kelty Fehling, Jamie Peterson, Russell E Glasgow, Borsika A Rabin, Robert Burke, Catherine Battaglia
BACKGROUND: The process of transitioning Veterans to primary care following a non-Veterans Affairs (VA) hospitalization can be challenging. Poor transitions result in medical complications and increased hospital readmissions. The goal of this transition of care quality improvement (QI) project is to identify gaps in the current transition process and implement an intervention that bridges the gap and improves the current transition of care process within the Eastern Colorado Health Care System (ECHCS)...
February 10, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28169976/the-impact-of-alternative-payment-in-chronically-ill-and-older-patients-in-the-patient-centered-medical-home
#9
Claudia A Salzberg, Asaf Bitton, Stuart R Lipsitz, Cal Franz, Shimon Shaykevich, Lisa P Newmark, Japneet Kwatra, David W Bates
BACKGROUND: Patient-centered medical home (PCMH) has gained prominence as a promising model to encourage improved primary care delivery. There is a paucity of studies that evaluate the impact of payment models in the PCMH. OBJECTIVES: We sought to examine whether coupling coordinated, team-based care transformation plan with a novel reimbursement model affects outcomes related to expenditures and utilization. RESEARCH DESIGN: Interrupted time-series model with a difference-in-differences approach to assess differences between intervention and control groups, across time periods attributable to PCMH transformation and/or payment change...
February 6, 2017: Medical Care
https://www.readbyqxmd.com/read/28168041/developing-and-testing-an-electronic-medication-administration-monitoring-device-for-community-dwelling-seniors-a-feasibility-study
#10
Henry Yu-Hin Siu, Dee Mangin, Michelle Howard, David Price, David Chan
BACKGROUND: Medication non-adherence, polypharmacy, and adverse drug events are major healthcare issues leading to significant morbidity, mortality, and healthcare expenditures. Currently, there are no methods to systematically track medication usage in community-dwelling seniors. The eDosette prototype was created to make medication use patterns visible via the Internet. This study aims to demonstrate feasibility, usability, and acceptability of the eDosette in community-dwelling seniors in primary care...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28166784/randomized-controlled-trial-of-a-coordinated-care-intervention-to-improve-risk-factor-control-after-stroke-or-transient-ischemic-attack-in-the-safety-net-secondary-stroke-prevention-by-uniting-community-and-chronic-care-model-teams-early-to-end-disparities
#11
Amytis Towfighi, Eric M Cheng, Monica Ayala-Rivera, Heather McCreath, Nerses Sanossian, Tara Dutta, Bijal Mehta, Robert Bryg, Neal Rao, Shlee Song, Ali Razmara, Magaly Ramirez, Theresa Sivers-Teixeira, Jamie Tran, Elizabeth Mojarro-Huang, Ana Montoya, Marilyn Corrales, Beatrice Martinez, Phyllis Willis, Mireya Macias, Nancy Ibrahim, Shinyi Wu, Jeremy Wacksman, Hilary Haber, Adam Richards, Frances Barry, Valerie Hill, Brian Mittman, William Cunningham, Honghu Liu, David A Ganz, Diane Factor, Barbara G Vickrey
BACKGROUND: Recurrent strokes are preventable through awareness and control of risk factors such as hypertension, and through lifestyle changes such as healthier diets, greater physical activity, and smoking cessation. However, vascular risk factor control is frequently poor among stroke survivors, particularly among socio-economically disadvantaged blacks, Latinos and other people of color. The Chronic Care Model (CCM) is an effective framework for multi-component interventions aimed at improving care processes and outcomes for individuals with chronic disease...
February 6, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28166580/outcomes-of-embedded-care-management-in-a-family-medicine-residency-patient-centered-medical-home
#12
Robert J Newman, Richard Bikowski, Kristy Nakayama, Tina Cunningham, Pam Acker, Dana Bradshaw
BACKGROUND AND OBJECTIVES: Much attention is devoted nationally to preventing hospital readmissions and emergency department (ED) use, given the high cost of this care. There is a growing body of evidence from the Patient Centered Primary Care Collaborative that a patient-centered medical home (PCMH) model successfully lowers these costs. Our study evaluates a specific intervention in a family medicine residency PCMH to decrease readmissions and ED utilization using an embedded care manager...
January 2017: Family Medicine
https://www.readbyqxmd.com/read/28166266/medication-related-factors-associated-with-health-related-quality-of-life-in-patients-older-than-65-years-with-polypharmacy
#13
Alonso Montiel-Luque, Antonio Jesús Núñez-Montenegro, Esther Martín-Aurioles, Jose Carlos Canca-Sánchez, Maria Carmen Toro-Toro, José Antonio González-Correa
METHODS AND DESIGN: Objective: To describe the relationship between medication-related factors and the health-related quality of life in patients older than 65 years who use multiple medications (polypharmacy). Design: Cross-sectional descriptive study. Setting: Primary care. Participants: Patients older than 65 years who use multiple medications (n = 375). Measurements: The main outcome measure was health-related quality of life according to the EuroQol-5D instrument. Sociodemographic, clinical and medication-related variables were recorded during home interviews...
2017: PloS One
https://www.readbyqxmd.com/read/28165617/physicians-responsibilities-for-deaths-occurring-at-home
#14
Mia Yang, Matthew K McNabney
Deaths occurring at home are increasing in the United States. Primary care physicians and trainees may not be explicitly taught about management of deaths in the home. Physician responsibilities for expected and unexpected deaths at home are summarized. The medical examiner should be contacted if death was due to natural disease processes but occurred suddenly or when a physician was not treating the decedent. Police and emergency personnel are often called after terminally ill individuals have died at home, which may cause significant family distress and is typically not necessary if the death was expected...
February 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28156525/feasibility-of-a-physician-extender-approach-to-increase-advance-care-planning-uptake
#15
Cynthia Fanning
: 8 Background: Advanced care planning (ACP) for people with life-limiting cancer has been associated with improved patient quality of life and care more consistent with patient wishes. Nevertheless, even though approximately 70% of patients with a life-limiting illness will require the substituted judgment of a proxy, fewer than 25% of patients have documented goals of care. This poor uptake has been attributed to limits in physician time and ACP training. The current study evaluated the feasibility of utilizing a physician-extender trained in ACP best practices to overcome these barriers and improve ACP uptake...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156492/food-as-medicine-a-randomized-controlled-trial-rct-of-home-delivered-medically-tailored-meals-hdmtm-on-quality-of-life-qol-in-metastatic-lung-and-non-colorectal-gi-cancer-patients
#16
Raymond Mailhot Vega, Lisa Zullig, Alissa Wassung, Dorella Walters, Noah Berland, Kevin Lee Du, Jiyoung Ahn, Cynthia G Leichman, Deirdre Jill Cohen, Ping Gu, Abraham Chachoua, Lawrence P Leichman, Karen Pearl, Peter B Schiff
: 155 Background: Malnutrition incidence in cancer approaches 85%, disproportionately burdening those with lung, GI, and advanced stage cancers. Malnourished patients have impaired chemotherapy response, shorter survival, longer hospital stays, and decreased QoL. Home delivered meals are nutritional interventions that improve patient well-being, nutrition, and lower healthcare costs in the elderly but have not been studied as an intervention in cancer patients. HDMTM are nutritionist prescribed home delivered meals tailored to patient's symptoms, co-morbidities, and health needs...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28153704/pharmacy-accessibility-and-cost-related-underuse-of-prescription-medications-in-low-income-black-and-hispanic-urban-communities
#17
Dima Mazen Qato, Jocelyn Wilder, Shannon Zenk, Andrew Davis, Jennifer Makelarski, Stacy Tessler Lindau
OBJECTIVES: Policy efforts to reduce the cost of prescription medications in the US have failed to reduce disparities in cost-related underuse. Little is known about the relationships between pharmacy accessibility, utilization, and cost-related underuse of prescription medications among residents of low-income minority communities. The aim of this work was to examine the association between pharmacy accessibility, utilization, and cost-related underuse of prescription medications among residents of predominantly low-income Black and Hispanic urban communities...
January 30, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28152793/transitions-in-care-and-reduction-in-discharge-errors
#18
Tara Szyamnski, Megan Begnoche, Carol Chase, Michelle Moreau, Jessica Barnett
: 77 Background: Patients are often overwhelmed at the time of hospital discharge and focus on home rather than the discharge process. Fragmented communication and lack of planning between the hospital team, patient, family and primary oncologist can lead to frustration and delays in implementation of palliative or curative therapies and potential hospital readmission when the plan of care is not followed in a timely manner. Our goal is to avoid medication errors, delays in implementation of a care plan and reemergence of symptoms or new symptoms as a result of a suboptimal discharge transition...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28148227/effective-team-based-primary-care-observations-from-innovative-practices
#19
Edward H Wagner, Margaret Flinter, Clarissa Hsu, DeAnn Cromp, Brian T Austin, Rebecca Etz, Benjamin F Crabtree, MaryJoan D Ladden
BACKGROUND: Team-based care is now recognized as an essential feature of high quality primary care, but there is limited empiric evidence to guide practice transformation. The purpose of this paper is to describe advances in the configuration and deployment of practice teams based on in-depth study of 30 primary care practices viewed as innovators in team-based care. METHODS: As part of LEAP, a national program of the Robert Wood Johnson Foundation, primary care experts nominated 227 innovative primary care practices...
February 2, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28143494/evaluation-of-a-new-transmural-trauma-care-model-ttcm-for-the-rehabilitation-of-trauma-patients-a-study-protocol
#20
Suzanne H Wiertsema, Johanna M van Dongen, Edwin Geleijn, Maaike Schothorst, Frank W Bloemers, Vincent de Groot, Raymond W J G Ostelo
BACKGROUND: Improved organization of trauma care in the acute phase has reduced mortality of trauma patients. However, there has been limited attention for the optimal organization of post-clinical rehabilitation of trauma patients. Therefore we developed a Transmural Trauma Care Model (TTCM). This TTCM consists of four equally important components: 1) intake and follow up consultations by a multidisciplinary team consisting of trauma surgeon and hospital based trauma physical therapist, 2) coordination and individual goal setting for each patient by this team, 3) primary care physical therapy by specialized physical therapists organized in a network and 4) E-health support for transmural communication and treatment according to protocols...
January 31, 2017: BMC Health Services Research
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