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Patient aligned care team

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https://www.readbyqxmd.com/read/28065197/aligning-guidelines-and-medical-practice-literature-review-on-pediatric-palliative-care-guidelines
#1
Eva De Clercq, Michael Rost, Nadia Pacurari, Bernice S Elger, Tenzin Wangmo
OBJECTIVE: Palliative care for children is becoming an important subspecialty of healthcare. Although concurrent administration of curative and palliative care is recommended, timely referral to pediatric palliative care (PPC) services remains problematic. This literature review aims to identify barriers and recommendations for proper implementation of palliative care for children through the looking glass of PPC guidelines. METHOD: To identify studies on PPC guidelines, five databases were searched systematically between 1960 and 2015: Scopus, PubMed, PsycINFO, the Web of Science, and CINAHL...
January 9, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28063848/challenges-with-implementing-a-patient-centered-medical-home-model-for-women-veterans
#2
Emmeline Chuang, Julian Brunner, Selene Mak, Alison B Hamilton, Ismelda Canelo, Jill Darling, Lisa V Rubenstein, Elizabeth M Yano
BACKGROUND: The Veterans Health Administration (VA) Patient Aligned Care Team (PACT) initiative aims to ensure that all patients receive care consistent with medical home principles. Women veterans' unique care needs and minority status within the VA pose challenges to delivery of equitable, comprehensive primary care for this population. Currently, little is known about whether and/or how PACT should be tailored to better meet women veteran needs. METHODS: In 2014, we conducted semistructured interviews with 73 primary care providers and staff to examine facilitators and barriers encountered in providing PACT-principled care to women veterans...
January 4, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28062816/primary-care-clinic-re-design-for-prescription-opioid-management
#3
Michael L Parchman, Michael Von Korff, Laura-Mae Baldwin, Mark Stephens, Brooke Ike, DeAnn Cromp, Clarissa Hsu, Ed H Wagner
BACKGROUND: The challenge of responding to prescription opioid overuse within the United States has fallen disproportionately on the primary care clinic setting. Here we describe a framework comprised of 6 Building Blocks to guide efforts within this setting to address the use of opioids for chronic pain. METHODS: Investigators conducted site visits to thirty primary care clinics across the United States selected for their use of team-based workforce innovations...
January 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28030459/implementation-and-sequencing-of-practice-transformation-in-urban-practices-with-underserved-patients
#4
Denise D Quigley, Zachary S Predmore, Alex Y Chen, Ron D Hays
BACKGROUND: Patient-centered medical home (PCMH) has gained momentum as a model for primary-care health services reform. METHODS: We conducted interviews at 14 primary care practices undergoing PCMH transformation in a large urban federally qualified health center in California and used grounded theory to identify common themes and patterns. RESULTS: We found clinics pursued a common sequence of changes in PCMH transformation: Clinics began with National Committee for Quality Assurance (NCQA) level 3 recognition, adding care coordination staff, reorganizing data flow among teams, and integrating with a centralized quality improvement and accountability infrastructure...
January 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28027338/effect-of-an-intensive-outpatient-program-to-augment-primary-care-for-high-need-veterans-affairs-patients-a-randomized-clinical-trial
#5
Donna M Zulman, Christine Pal Chee, Stephen C Ezeji-Okoye, Jonathan G Shaw, Tyson H Holmes, James S Kahn, Steven M Asch
Importance: Many organizations are adopting intensive outpatient care programs for high-need patients, yet little is known about their effectiveness in integrated systems with established patient-centered medical homes. Objective: To evaluate how augmenting the Veterans Affairs (VA) medical home (Patient Aligned Care Teams [PACT]) with an Intensive Management program (ImPACT) influences high-need patients' costs, health care utilization, and experience. Design, Setting, and Participants: Randomized clinical trial at a single VA facility...
December 27, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28007226/role-expansion-on-interprofessional-primary-care-teams-barriers-of-role-self-efficacy-among-clinical-associates
#6
Karleen F Giannitrapani, Lynn Soban, Alison B Hamilton, Hector Rodriguez, Alexis Huynh, Susan Stockdale, Elizabeth M Yano, Lisa V Rubenstein
BACKGROUND: Interprofessional team-based models of primary care that expand the role of clinical associates (CAs) are increasingly adopted in primary care practices. In this study we query team members of a newly implemented patient centered medical home (PCMH) to identify facilitators and barriers of occupational role self-efficacy, a belief of possessing the capacity to execute their new team based role effectively. METHODS: 79 key informants, members of primary care teams at six Veterans Health Administration (VA) clinics, were interviewed to assess their experiences with implementing expanded roles for CAs...
December 2016: Healthcare
https://www.readbyqxmd.com/read/27982485/urinary-incontinence-and-its-management-in-patients-aged-65-and-older-in-orthopaedic-care-what-nursing-and-rehabilitation-staff-know-and-do
#7
Maria Hälleberg Nyman, Henrietta Forsman, Joan Ostaszkiewicz, Ami Hommel, Ann Catrine Eldh
AIMS AND OBJECTIVES: To describe what nursing and rehabilitation staff know and do with regards to urinary incontinence and risk of urinary incontinence in patients 65 years or older undergoing hip surgery. BACKGROUND: Urinary incontinence is a common but often neglected issue for older people. Despite the existence of evidence-based guidelines on how to assess, manage and prevent UI, there are indications that these guidelines are not applied in hospital care. DESIGN: A qualitative study with descriptive design was conducted in two orthopaedic units...
December 16, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27939318/successful-geriatric-rehabilitation-effects-on-patients-outcome-of-a-national-program-to-improve-quality-of-care-the-singer-study
#8
Marije S Holstege, Monique A A Caljouw, Ineke G Zekveld, Romke van Balen, Aafke J de Groot, Jolanda C M van Haastregt, Jos M G A Schols, Cees M P M Hertogh, Jacobijn Gussekloo, Wilco P Achterberg
OBJECTIVE: To determine whether the implementation of a national program to improve quality of care in geriatric rehabilitation (GR) in the Netherlands improves successful GR in terms of independence in activities of daily living (ADL), discharge destination, and length of stay. DESIGN: Prospective longitudinal study, comparing 2 consecutive cohorts: at the start of implementation (n = 386) and at 1 year after implementation (n = 357) of this program. SETTING/PARTICIPANTS: Included were 16 skilled nursing facilities, 743 patients (median age 80 years, interquartile range 72-85; 64...
December 6, 2016: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/27919877/pharmacist-driven-respiratory-syncytial-virus-prophylaxis-stewardship-service-in-a-neonatal-intensive-care-unit
#9
Sara E Rostas, Christopher McPherson
PURPOSE: The development and implementation of a pharmacist-driven respiratory syncytial virus (RSV) prophylaxis stewardship program in a neonatal intensive care unit (NICU) are described. SUMMARY: An RSV prophylaxis stewardship service was created in the NICU at Brigham and Women's Hospital to align with the newly updated 2014 American Academy of Pediatrics (AAP) recommendations for palivizumab. The service comprised two NICU clinical pharmacists with oversight from the NICU medical director and the chair of the NICU infection control committee...
December 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27902947/what-factors-affect-implementation-of-early-rehabilitation-into-intensive-care-unit-practice-a-qualitative-study-with-clinicians
#10
Selina M Parry, Louisa Remedios, Linda Denehy, Laura D Knight, Lisa Beach, Thomas C Rollinson, Sue Berney, Zudin A Puthucheary, Peter Morris, Catherine L Granger
PURPOSE: To identify the barriers and enablers that influence clinicians' implementation of early rehabilitation in critical care. MATERIALS AND METHODS: Qualitative study involving 26 multidisciplinary participants who were recruited using purposive sampling. Four focus groups were conducted using semistructured questions to explore attitudes, beliefs, and experiences. Data were transcribed verbatim and thematic analysis was performed. RESULTS: Six themes emerged, as follows: (1) the clinicians' expectations and knowledge (including rationale for rehabilitation, perceived benefits, and experience), (2) the evidence for and application of rehabilitation (including beliefs regarding when to intervene), (3) patient factors (including prognosis, sedation, delirium, cooperation, motivation, goals, and family), (4) safety considerations (including physiological stability and presence of devices or lines), (5) environmental influences (staffing, resources, equipment, time, and competing priorities), and (6) culture and teamwork...
November 12, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27852357/a-multifaceted-approach-to-reduction-of-catheter-associated-urinary-tract-infections-in-the-intensive-care-unit-with-an-emphasis-on-stewardship-of-culturing
#11
Katherine M Mullin, Christopher S Kovacs, Cynthia Fatica, Colette Einloth, Elizabeth A Neuner, Jorge A Guzman, Eric Kaiser, Venu Menon, Leticia Castillo, Marc J Popovich, Edward M Manno, Steven M Gordon, Thomas G Fraser
BACKGROUND Catheter-associated urinary tract infections (CAUTIs) are among the most common hospital-acquired infections (HAIs). Reducing CAUTI rates has become a major focus of attention due to increasing public health concerns and reimbursement implications. OBJECTIVE To implement and describe a multifaceted intervention to decrease CAUTIs in our ICUs with an emphasis on indications for obtaining a urine culture. METHODS A project team composed of all critical care disciplines was assembled to address an institutional goal of decreasing CAUTIs...
February 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27756716/strengthening-interprofessional-requirements-engineering-through-action-sheets-a-pilot-study
#12
Aline Kunz, Sabrina Pohlmann, Oliver Heinze, Antje Brandner, Christina Reiß, Martina Kamradt, Joachim Szecsenyi, Dominik Ose
BACKGROUND: The importance of information and communication technology for healthcare is steadily growing. Newly developed tools are addressing different user groups: physicians, other health care professionals, social workers, patients, and family members. Since often many different actors with different expertise and perspectives are involved in the development process it can be a challenge to integrate the user-reported requirements of those heterogeneous user groups. Nevertheless, the understanding and consideration of user requirements is the prerequisite of building a feasible technical solution...
October 18, 2016: JMIR Human Factors
https://www.readbyqxmd.com/read/27745569/developing-research-priorities-in-australian-primary-health-care-a-focus-on-nutrition-and-physical-activity
#13
Lauren Ball, Katelyn Barnes, Michael Leveritt, Lana Mitchell, Lauren T Williams, Dianne Ball, Elizabeth Patterson
Research priority setting is an important component of research planning, particularly when research options exceed available resources. This study identified the research priorities for supporting healthy lifestyle behaviours in the Australian primary healthcare setting. A five-step stakeholder engagement process was undertaken. Ten stakeholder organisations participated in the process, including patient representatives, health professional associations, health educators, researchers, government advisors and policymakers...
October 17, 2016: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/27734541/evidence-practice-gaps-in-lung-cancer-a-scoping-review
#14
N M Rankin, D McGregor, E Stone, P N Butow, J M Young, K White, T Shaw
Lung cancer is a significant international health problem. Aligning clinical practice with evidence-based guideline recommendations has the potential to improve patient outcomes. This scoping review describes evidence-practice gaps across the diagnostic and management care pathway for lung cancer. We conducted searches of online databases Medline, PsychInfo, Cinahl and the Cochrane Library to identify studies published between 2008 and 2012. Of 614 articles screened, 65 met inclusion criteria. We identified seven evidence-practice gaps: (1) delays in timely diagnosis and referral; (2) curative and (3) palliative treatments are under-utilised; (4) older age and co-morbidities influence the use of treatments; (5) the benefits of multidisciplinary team review are not available to all lung cancer patients; (6) psychosocial needs are unmet; and (7) early referral to palliative care services is under-utilised...
October 13, 2016: European Journal of Cancer Care
https://www.readbyqxmd.com/read/27712615/integration-of-nurse-practitioners-using-a-change-management-framework-the-way-forward
#15
Grainne Lowe, Virginia Plummer, Leanne Boyd
Objective The aim of the present study was to investigate and describe the application of a change management theoretical framework in relation to nurse practitioner (NP) role integration.Methods A survey formed Phase 1 of a broader mixed-methods study to explore perceptions of the change process involved with integrating NPs into Australian health care settings. The stakeholder participants were NPs, nurse managers and nurse policy advisers.Results Key themes were identified adding information about how NPs, nurse managers and nurse policy advisers perceive the integration of NPs into Australian healthcare...
October 7, 2016: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/27700977/a-simple-evidence-based-intervention-to-improve-care-transitions-for-frail-patients-with-complex-health-conditions-why%C3%A2-didn-t-it-work-as-expected
#16
David McNeil, Roger Strasser, Nancy Lightfoot, Raymond Pong
The transition from hospital to home is a vulnerable period for patients with complex conditions, who are often frail, at risk for adverse events and unable to navigate a system of poorly coordinated care in the post-discharge period. Care transition interventions are seen as effective care coordinating mechanisms for reducing avoidable adverse events associated with the transition of the patient from the hospital to the home. A study was undertaken to evaluate the effectiveness of a care transition intervention involving a hand-off between a hospital-based care transitions nurse and a community-based rapid response nurse...
2016: Healthcare Quarterly
https://www.readbyqxmd.com/read/27688884/use-of-a-fictitious-community-based-virtual-teaching-platform-to-aid-in-the-teaching-of-pharmacy-practice-skills-student-perspectives-after-initial-implementation
#17
Louise E Curley, Maureen McDonald, Trudi Aspden
BACKGROUND: Providing patient-centred care requires pharmacy students to learn how to interact effectively and understand individual differences that can influence patients' health. The School of Pharmacy at The University of Auckland, New Zealand (NZ), developed a virtual teaching platform, called NZ Pharmville, which consisted of twenty-one community-based patients who are members of six families; each family had a video vignette associated with it. Bachelor of Pharmacy (BPharm) students, enrolled in the third year pharmacy practice course, were able to view these recorded vignettes as part of their weekly pre-laboratory work for the course...
2016: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/27650840/supporting-patients-with-incurable-cancer-backup-behavior-in-multidisciplinary-cross-functional-teams
#18
Fleur Huang, Amy Driga, Bronwen E LeGuerrier, Renée Schmitz, Debra M Hall-Lavoie, Xanthoula Kostaras, Karen P Chu, Edith Pituskin, Sharon M Watanabe, Alysa Fairchild
Caring for patients with incurable cancer presents unique challenges. Managing symptoms that evolve with changing clinical status and, at the same time, ensuring alignment with patient goals demands specific attention from clinicians. With care needs that often transcend traditional service provision boundaries, patients who seek palliation commonly interface with a team of providers that represents multiple disciplines across multiple settings. In this case study, we explore some of the dynamics of a cross-disciplinary approach to symptom management in an integrated outpatient radiotherapy service model...
September 20, 2016: Journal of Oncology Practice
https://www.readbyqxmd.com/read/27637827/across-the-divide-primary-care-departments-working-together-to-redesign-care-to-achieve-the-triple-aim
#19
Steven Koslov, Elizabeth Trowbridge, Sandra Kamnetz, Sally Kraft, Jeffrey Grossman, Nancy Pandhi
BACKGROUND: Primary care is considered the foundation of an effective health care system. However, primary care departments at academic health centers have numerous challenges to overcome when trying to achieve the Triple Aim. METHODS: As part of an organizational initiative to redesign primary care at a large academic health center, departments of internal medicine, general pediatrics and adolescent medicine, and family medicine worked together to comprehensively redesign primary care...
September 2016: Healthcare
https://www.readbyqxmd.com/read/27624949/shared-goal-setting-in-team-based-geriatric-oncology
#20
Allison Magnuson, James Wallace, Beverly Canin, Selina Chow, William Dale, Supriya G Mohile, Lauren M Hamel
We present the case of a 92-year-old man, MH, who was given a diagnosis of colorectal cancer. His primary care physician, surgeon, geriatric oncologist, and family members all played important roles in his care. MH's case is an example of a lack of explicit shared goal setting by the health care providers with the patient and family members and how that impeded care planning and health. This case demonstrates the importance of explicitly discussing and establishing shared goals in team-based cancer care delivery early on and throughout the care process, especially for older adults...
September 13, 2016: Journal of Oncology Practice
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