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Patient aligned care team

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
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
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
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
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
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
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
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
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
Emily M Mader, Chester H Fox, John W Epling, Gary J Noronha, Carlos M Swanger, Angela M Wisniewski, Karen Vitale, Amanda L Norton, Christopher P Morley
BACKGROUND: Despite the current evidence of preventive screening effectiveness, rates of breast, cervical, and colorectal cancer in the United States fall below national targets. We evaluated the efficacy and feasibility of combining practice facilitation and academic detailing quality improvement (QI) strategies to help primary care practices increase breast, cervical, and colorectal cancer screening among patients. METHODS: Practices received a 1-hour academic detailing session addressing current cancer screening guidelines and best practices, followed by 6 months of practice facilitation to implement evidence-based interventions aimed at increasing patient screening...
September 2016: Journal of the American Board of Family Medicine: JABFM
Barbara Wadsworth, Fiona Felton, Rita Linus
In 2013, a new system chief nursing officer engaged the nursing leaders and staff in an Appreciative Inquiry process utilizing strengths, opportunities, aspirations, and results (SOAR), and a Journey of Excellence to assess and understand the current environment. The ultimate goal was to engage all nurses in strategic planning and goal setting to connect their patient care to the system strategic initiatives. This work led to the creation of a nursing vision, a revised professional practice model and greater council alignment, resulting in significant positive change and ongoing advancement throughout the system...
October 2016: Nursing Administration Quarterly
Paraag Trivedi, Nicola Rosaasen, Holly Mansell
CONTEXT: Adequate patient education is essential for preparing potential recipients for kidney transplantation. Health-care providers play a vital role in education and can identify gaps in patient understanding. OBJECTIVE: To identify deficits in patient knowledge from the perspective of a transplant multidisciplinary care team and determine whether their perceptions align with patients who have previously undergone a transplant. DESIGN: An open call was advertised for health-care providers to attend a focus group discussion regarding the educational needs of pretransplant patients in 1 Canadian center...
August 22, 2016: Progress in Transplantation
Lydia F J van Overveld, Jozé Braspenning, Rosella P M G Hermens
OBJECTIVES: Oncological care is very complex, and delivery of integrated care with optimal alignment and collaboration of several disciplines is crucial. To monitor and effectively improve high-quality integrated oncological care, a dashboard of valid and reliable quality indicators (QIs) is indispensable. The aim was to develop multidisciplinary QIs to measure quality of integrated oncological care, specifically for head and neck cancer (HNC) patients. DESIGN: The RAND-modified Delphi method was used to decide on the outcome, process, and structure QIs form three different perspectives...
August 18, 2016: Clinical Otolaryngology
Takashi Higashiguchi, Junichi Ikegaki, Kazuya Sobue, Yoichiro Tamura, Nobuhisa Nakajima, Akihiko Futamura, Mitsunori Miyashita, Naoharu Mori, Akio Inui, Keiichiro Ohta, Toyoshi Hosokawa
BACKGROUND: Japan's first guidelines for parenteral fluid management for terminal cancer patients were issued in 2006. These guidelines focused on the fluid levels to administer to patients with a remaining life expectancy of 1-2 months. However, recent refinement of the concept of cachexia is prompting caregivers worldwide to rethink parenteral fluid management for terminal cancer patients. OBJECTIVE: Our objective was to develop guidelines for parenteral fluid management for terminal cancer patients with a remaining life expectancy of 1 month, a point when cachexia generally begins to severely adversely affect the body...
August 12, 2016: Japanese Journal of Clinical Oncology
Emma Haynes, Harry Hohnen, Judith M Katzenellenbogen, Benjamin D Scalley, Sandra C Thompson
OBJECTIVE: Translation of evidence into practice by health systems can be slow and incomplete and may disproportionately impact disadvantaged populations. Coronary heart disease is the leading cause of death among Aboriginal Australians. Timely access to effective medical care for acute coronary syndrome substantially improves survival. A quality-of-care audit conducted at a regional Western Australian hospital in 2011-2012 compared the Emergency Department management of Aboriginal and non-Aboriginal acute coronary syndrome patients...
2016: SAGE Open Medicine
Kristin D Negley, Mary E Cordes, Laura K Evenson, Shauna P Schad
PURPOSE/OBJECTIVES: This article describes how a large healthcare organization expanded the practice of clinical nurse specialists from the hospital to the ambulatory setting. BACKGROUND: Clinical nurse specialist practice traditionally focused on actualizing the 3 spheres of influence (patient, nurse, and organization) in the hospital setting. RATIONALE: Changes in the healthcare system shifting patient care to the ambulatory setting created opportunities for clinical nurse specialists to improve patient outcomes in this setting...
September 2016: Clinical Nurse Specialist CNS
Amanda Locke, Norifumi Kamo
Access to mental health providers has become an increasingly common challenge for many patients with depression and anxiety disorders. Primary care providers often manage this gap in care and currently provide solo care without the assistance of other team members. In order to provide quality care that aligns with best practice, we developed a depression and anxiety disorder treatment pathway utilizing a multidisciplinary team based on each members' individual skill set, or skill-task alignment. The main change to treatment implemented by the pathway was the addition of a clinical pharmacist in the management of patient care...
2016: BMJ Quality Improvement Reports
Steven A Farmer, Joel Shalowitz, Meaghan George, Frank McStay, Kavita Patel, James Perrin, Ali Moghtaderi, Mark McClellan
BACKGROUND AND OBJECTIVES: Payers are implementing alternative payment models that attempt to align payment with high-value care. This study calculates the breakeven capitated payment rate for a midsize pediatric practice and explores how several different staffing scenarios affect the rate. METHODS: We supplemented a literature review and data from >200 practices with interviews of practice administrators, physicians, and payers to construct an income statement for a hypothetical, independent, midsize pediatric practice in fee-for-service...
August 2016: Pediatrics
Sheila A Haas, Frances Vlasses, Julia Havey
There are multiple demands and challenges inherent in establishing staffing models in ambulatory heath care settings today. If health care administrators establish a supportive physical and interpersonal health care environment, and develop high-performing interprofessional teams and staffing models and electronic documentation systems that track performance, patients will have more opportunities to receive safe, high-quality evidence-based care that encourages patient participation in decision making, as well as provision of their care...
May 2016: Nursing Economic$
Elizabeth M Yano, Jill E Darling, Alison B Hamilton, Ismelda Canelo, Emmeline Chuang, Lisa S Meredith, Lisa V Rubenstein
BACKGROUND: The Veterans Health Administration (VA) has undertaken a major initiative to transform care through implementation of Patient Aligned Care Teams (PACTs). Based on the patient-centered medical home (PCMH) concept, PACT aims to improve access, continuity, coordination, and comprehensiveness using team-based care that is patient-driven and patient-centered. However, how VA should adapt PACT to meet the needs of special populations, such as women Veterans (WVs), was not considered in initial implementation guidance...
2016: Implementation Science: IS
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