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Patient aligned care team

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https://www.readbyqxmd.com/read/29139336/home-health-aides-perceptions-of-quality-care-goals-challenges-and-implications-for-a-rapidly-changing-industry
#1
Emily Franzosa, Emma K Tsui, Sherry Baron
Home care payment models, quality measures, and care plans are based on physical tasks workers perform, ignoring relational care that supports clients' cognitive, emotional, and social well-being. As states seek to rein in costs and improve the efficiency and quality of care, they will need to consider how to measure and support relational care. In four focus groups ( n = 27) of unionized, agency-based New York City home health aides, workers reported aide-client relationships were a cornerstone of high-quality care, and building them required communication, respect, and going the extra mile...
January 1, 2017: New Solutions: a Journal of Environmental and Occupational Health Policy: NS
https://www.readbyqxmd.com/read/29132581/resuscitation-resequenced-a-rational-approach-to-patients-with-trauma-in-shock
#2
REVIEW
Andrew Petrosoniak, Christopher Hicks
Trauma resuscitation is a complex and dynamic process that requires a high-performing team to optimize patient outcomes. More than 30 years ago, Advanced Trauma Life Support was developed to formalize and standardize trauma care; however, the sequential nature of the algorithm that is used can lead to ineffective prioritization. An improved understanding of shock mandates an updated approach to trauma resuscitation. This article proposes a resequenced approach that (1) addresses immediate threats to life and (2) targets strategies for the diagnosis and management of shock causes...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29120010/innovative-transition-interventions-to-better-align-healthcare-needs-in-hospitalised-medical-patients
#3
Alexander Kutz, Fahim Ebrahimi, Tristan Struja, Jeffrey Greenwald, Philipp Schuetz, Beat Mueller
Understanding how best to manage the complex healthcare needs of hospitalised, mostly multimorbid medical patients is an international priority. Healthcare should be effective, safe and provide high quality at a reasonable cost. However, basic logistic and organisational issues of medical ward-based care have received less attention than the medical treatment of specific pathologies. Consequently, we still use old-fashioned care and transition procedures for medical inpatients. This contrasts with dynamic developments in other, non-healthcare industries, where process optimisation is a major part of innovation...
November 9, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29116979/translating-theory-into-practice-implementing-a-program-of-assessment
#4
Karen E Hauer, Patricia S O'Sullivan, Kristen Fitzhenry, Christy Boscardin
PROBLEM: A program of assessment addresses challenges in learner assessment using a centrally planned, coordinated approach that emphasizes assessment for learning. This report describes the steps taken to implement a program of assessment framework within a medical school. APPROACH: A literature review on best practices in assessment highlighted six principles that guided implementation of the program of assessment in 2016-2017: (1) a centrally coordinated plan for assessment aligns with and supports a curricular vision; (2) multiple assessment tools used longitudinally generate multiple data points; (3) learners require ready access to information-rich feedback to promote reflection and informed self-assessment; (4) mentoring is essential to facilitate effective data use for reflection and learning planning; (5) the program of assessment fosters self-regulated learning behaviors; and (6) expert groups make summative decisions about grades and readiness for advancement...
November 7, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29095704/medical-education-must-move-from-the-information-age-to-the-age-of-artificial-intelligence
#5
Steven A Wartman, C Donald Combs
Changes to the medical profession require medical education reforms that will enable physicians to more effectively enter contemporary practice. Proposals for such reforms abound. Common themes include renewed emphasis on communication, teamwork, risk-management, and patient safety. These reforms are important but insufficient. They do not adequately address the most fundamental change--the practice of medicine is rapidly transitioning from the information age to the age of artificial intelligence. Employers need physicians who: work at the top of their license, have knowledge spanning the health professions and care continuum, effectively leverage data platforms, focus on analyzing outcomes and improving performance, and communicate the meaning of the probabilities generated by massive amounts of data to patients given their unique human complexities...
November 1, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29091509/a-person-centered-registry-based-learning-health-system-for-palliative-care-a-path-to-coproducing-better-outcomes-experience-value-and-science
#6
Arif H Kamal, Kathryn B Kirkland, Diane E Meier, Tamara S Morgan, Eugene C Nelson, Steven Z Pantilat
BACKGROUND: Palliative care offers an approach to the care of people with serious illness that focuses on quality of life and aligning care with individual and family goals, and values in the context of what is medically achievable. OBJECTIVE: Measurement of the impact of palliative care is critical for determining what works for which patients in what settings, to learn, improve care, and ensure access to high value care for people with serious illness. METHODS: A learning health system that includes patients and families partnering with clinicians and care teams, is directly linked to a registry to support networks for improvement and research, and offers an ideal framework for measuring what matters to a range of stakeholders interested in improving care for this population...
November 1, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29049043/challenges-of-healthcare-administration-optimizing-quality-and-value-at-an-affordable-cost-in-pediatric-cardiology
#7
Mitchell I Cohen, Patricio A Frias
PURPOSE OF REVIEW: The purpose of this review is to explore the paradigm shift in healthcare delivery that will need to take place over the next few years away from an emphasis on supply-driven health care to better quality transparent-driven health care whose focus is on the consumer's best interest. RECENT FINDINGS: The current healthcare system is fragmented and costs continue to rise. The best way to contain costs is to improve quality to the consumer, the patient...
October 18, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29042844/designing-a-care-pathway-model-a-case-study-of-the-outpatient-total-hip-arthroplasty-care-pathway
#8
Robin I Oosterholt, Lianne Wl Simonse, Stella U Boess, Stephan Bw Vehmeijer
INTRODUCTION: Although the clinical attributes of total hip arthroplasty (THA) care pathways have been thoroughly researched, a detailed understanding of the equally important organisational attributes is still lacking. The aim of this article is to contribute with a model of the outpatient THA care pathway that depicts how the care team should be organised to enable patient discharge on the day of surgery. THEORY: The outpatient THA care pathway enables patients to be discharged on the day of surgery, shortening the length of stay and intensifying the provision and organisation of care...
March 9, 2017: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28991850/aligning-education-with-health-care-transformation-identifying-a-shared-mental-model-of-new-faculty-competencies-for-academic-faculty
#9
Jed D Gonzalo, Amarpreet Ahluwalia, Maria Hamilton, Heidi Wolf, Daniel R Wolpaw, Britta M Thompson
PURPOSE: To develop a potential competency framework for faculty development programs aligned with the needs of faculty in academic health centers (AHCs). METHOD: In 2014 and 2015, the authors interviewed 23 health system leaders and analyzed transcripts using constant comparative analysis and thematic analysis. They coded competencies and curricular concepts into subcategories. Lead investigators reviewed drafts of the categorization themes and subthemes related to gaps in faculty knowledge and skills, collapsed and combined competency domains, and resolved disagreements via discussion...
October 3, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28990992/comparing-patient-centered-medical-home-implementation-in-urban-and-rural-vha-clinics-results-from-the-patient-aligned-care-team-initiative
#10
Victoria Johnson, Edwin Wong, Michelle Lampman, Idamay Curtis, John Fortney, Peter Kaboli, Stephan Fihn, Karin Nelson
Rural Veterans Health Administration (VHA) primary care clinics are smaller, have fewer staff, and serve more rural patients compared with urban VHA primary care clinics. This may lead to different challenges to implementation of the Patient-Centered Medical Home (PCMH) model, the Patient Aligned Care Team, in the VHAs' large integrated health system. In this cross-sectional observational study of 905 VHA primary clinics in the United States and Puerto Rico, we found overall PCMH implementation was greater in rural compared to urban primary care clinics...
October 4, 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/28985692/comprehensive-blood-conservation-program-in-a-new-congenital-cardiac-surgical-program-allows-bloodless-surgery-for-the-jehovah-witness-and-a-reduction-for-all-patients
#11
Vincent Olshove, Nicole Berndsen, Veena Sivarajan, Pooja Nawathe, Alistair Phillips
BACKGROUND: Cardiac surgery on Jehovah's Witnesses (JW) can be challenging, given the desire to avoid blood products. Establishment of a blood conservation program involving the pre-, intra- and post-operative stages for all patients may lead to a minimized need for blood transfusion in all patients. METHODS: Pre-operatively, all JW patients were treated with high dose erythropoietin 500 IU/kg twice a week. JW patients were compared to matching non-JW patients from the congenital cardiac database, two per JW to serve as control...
October 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28982645/workarounds-emerging-from-electronic-health-record-system-usage-consequences-for-patient-safety-effectiveness-of-care-and-efficiency-of-care
#12
Vincent Blijleven, Kitty Koelemeijer, Marijntje Wetzels, Monique Jaspers
BACKGROUND: Health care providers resort to informal temporary practices known as workarounds for handling exceptions to normal workflow unintendedly imposed by electronic health record systems (EHRs). Although workarounds may seem favorable at first sight, they are generally suboptimal and may jeopardize patient safety, effectiveness of care, and efficiency of care. OBJECTIVE: Research into the scope and impact of EHR workarounds on patient care processes is scarce...
October 5, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/28959780/restructuring-hospitalist-work-schedules-to-improve-care-timeliness-and-efficiency
#13
Monika Wells, Evan Coates, Barbara Williams, Craig Blackmore
Background In 2014, we recognised that the pace of admissions frequently exceeded our ability to assign a hospitalist. Long patient wait times occurred at admission, especially for patients arriving in the late afternoon when hospitalist day shifts were ending. Our purpose was to redesign hospitalist schedules, duties and method of distributing admissions to match demand. Design We used administrative data to tabulate Hospital Medicine admission requests by time of day and identified mismatch between volume and capacity with the current staffing model...
2017: BMJ Open Qual
https://www.readbyqxmd.com/read/28953731/impact-of-a-cleft-and-craniofacial-center-on-an-academic-health-system
#14
Navid Pourtaheri, Aaron Kearney, Derrick C Wan, Gregory Lakin
BACKGROUND: The contributions of all physician specialties and ancillary services involved in cleft and craniofacial center care must be evaluated to fairly assess the financial impact of a cleft and craniofacial center. The authors hypothesized that the cleft and craniofacial center generates profitable downstream productivity for the academic health system. METHODS: This was a retrospective cohort study of all patients who presented to a cleft and craniofacial center in the first quarter of 2011...
October 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28951532/interprofessional-collaboration-among-care-professionals-in-obstetrical-care-are-perceptions-aligned
#15
Anita Romijn, Pim W Teunissen, Martine C de Bruijne, Cordula Wagner, Christianne J M de Groot
BACKGROUND: In an obstetrical team, obstetricians, midwives and nurses work together in a dynamic and complex care setting. Different professional cultures can be a barrier for effective interprofessional collaboration. Although the different professional cultures in obstetrical care are well known, little is understood about discrepancies in mutual perceptions of collaboration. Similar perceptions of collaboration are important to ensure patient safety. We aimed to understand how different care professionals in an obstetrical team assess interprofessional collaboration in order to gain insight into the extent to which their perceptions are aligned...
September 26, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28939446/next-generation-terminology-infrastructure-to-support-interprofessional-care-planning
#16
Sarah Collins, Stephanie Klinkenberg-Ramirez, Kira Tsivkin, Perry L Mar, Dina Iskhakova, Hari Nandigam, Lipika Samal, Roberto A Rocha
OBJECTIVE: Develop a prototype of an interprofessional terminology and information model infrastructure that can enable care planning applications to facilitate patient-centered care, learn care plan linkages and associations, provide decision support, and enable automated, prospective analytics. DESIGN: The study steps included a 3 step approach: 1) Process model and clinical scenario development, and 2) Requirements analysis, and 3) Development and validation of information and terminology models...
September 19, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28903723/domains-associated-with-successful-quality-improvement-in-healthcare-a-nationwide-case-study
#17
Aleidis Skard Brandrud, Bjørnar Nyen, Per Hjortdahl, Leiv Sandvik, Gro Sævil Helljesen Haldorsen, Maria Bergli, Eugene C Nelson, Michael Bretthauer
BACKGROUND: There is a distinct difference between what we know and what we do in healthcare: a gap that is impairing the quality of the care and increasing the costs. Quality improvement efforts have been made worldwide by learning collaboratives, based on recognized continual improvement theory with limited scientific evidence. The present study of 132 quality improvement projects in Norway explores the conditions for improvement from the perspectives of the frontline healthcare professionals, and evaluates the effectiveness of the continual improvement method...
September 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28830867/creation-of-a-certification-requirement-for-pharmacists-in-direct-patient-care-roles
#18
David R Hager, Katherine J Hartkopf, Sara M Koth, Steven S Rough
PURPOSE: Steps taken by a large health system to require certification for all pharmacists in direct patient care roles are detailed. SUMMARY: Major supply chain changes and rising payer expectations are reshaping pharmacy practice, resulting in expanded responsibilities for pharmacists and a heightened need for certification in specialized practice areas. In response, the pharmacy leadership team at UW Health, the integrated health system of the University of Wisconsin-Madison, used an iterative process and a "rolling" FAQ format to develop and implement a certification requirement...
October 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28806373/patient-aligned-care-team-engagement-to-connect-veterans-experiencing-homelessness-with-appropriate-health-care
#19
Adi V Gundlapalli, Andrew Redd, Daniel Bolton, Megan E Vanneman, Marjorie E Carter, Erin Johnson, Matthew H Samore, Jamison D Fargo, Thomas P O'Toole
BACKGROUND: Veterans experiencing homelessness frequently use emergency and urgent care (ED). OBJECTIVE: To examine the effect of a Patient-aligned Care Team (PACT) model tailored to the unique needs of Veterans experiencing homelessness (H-PACT) on frequency and type of ED visits in Veterans Health Administration (VHA) medical facilities. RESEARCH DESIGN: During a 12-month period, ED visits for 3981 homeless Veterans enrolled in (1) H-PACT at 20 VHA medical centers (enrolled) were compared with those of (2) 24,363 homeless Veterans not enrolled in H-PACT at the same sites (nonenrolled), and (3) 23,542 homeless Veterans at 12 non-H-PACT sites (usual care) using a difference-in-differences approach...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28775217/end-of-life-services-for-older-people-in-residential-care-homes-in-hong-kong
#20
REVIEW
J K Luk
Good end-of-life care is needed for older people living in residential care homes with advanced irreversible chronic medical illnesses and cancers. At present, the usual practice of residential care homes is to send older residents to acute hospitals when they are unwell, and some residents will die in hospital. Dying in hospital without choice for older people may not be in alignment with the principle of 'good death'. There are many barriers for older people to die in the place of their choice, particularly in a residential care home...
August 4, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
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