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https://www.readbyqxmd.com/read/28427304/translating-u-500r-randomized-clinical-trial-evidence-to-the-practice-setting-a-diabetes-educator-expert-prescriber-team-approach
#1
Paula M Bergen, Davida F Kruger, April D Taylor, Wael E Eid, Arti Bhan, Jeffrey A Jackson
Purpose The purpose of this article is to provide recommendations to the diabetes educator/expert prescriber team for the use of human regular U-500 insulin (U-500R) in patients with severely insulin-resistant type 2 diabetes, including its initiation and titration, by utilizing dosing charts and teaching materials translated from a recent U-500R clinical trial. Conclusions Clinically relevant recommendations and teaching materials for the optimal use and management of U-500R in clinical practice are provided based on the efficacy and safety results of and lessons learned from the U-500R clinical trial by Hood et al, current standards of practice, and the authors' clinical expertise...
April 1, 2017: Diabetes Educator
https://www.readbyqxmd.com/read/28401571/tying-knots-an-activity-theory-analysis-of-student-learning-goals-in-clinical-education
#2
Douglas P Larsen, Austin Wesevich, Jana Lichtenfeld, Antony R Artino, Ryan Brydges, Lara Varpio
CONTEXT: Learning goal programmes are often created to help students develop self-regulated learning skills; however, these programmes do not necessarily consider the social contexts surrounding learning goals or how they fit into daily educational practice. OBJECTIVES: We investigated a high-frequency learning goal programme in which students generated and shared weekly learning goals with their clinical teams in core Year 3 clerkships. Our study explores: (i) how learning goals were incorporated into the clinical work, and (ii) the factors that influenced the use of students' learning goals in work-based learning...
April 12, 2017: Medical Education
https://www.readbyqxmd.com/read/28394156/the-readiness-for-integrated-care-questionnaire-ricq-an-instrument-to-assess-readiness-to-integrate-behavioral-health-and-primary-care
#3
Victoria C Scott, Tara Kenworthy, Erin Godly-Reynolds, Gilberte Bastien, Jonathan Scaccia, Courtney McMickens, Sharon Rachel, Sayon Cooper, Glenda Wrenn, Abraham Wandersman
Integration of behavioral health and primary care services is a promising approach for reducing health disparities. The growing national emphasis on care coordination has mobilized efforts to integrate behavioral health and primary care services across the United States. These efforts align with broader health care system goals of improving health care quality, health equity, utilization efficiency, and patient outcomes. Drawing from our work on a multiyear integrated care initiative (Integrated Care Leadership Program; ICLP) and an implementation science heuristic for organizational readiness (Readiness = Motivation x General Capacity and Innovation-Specific Capacity; R = MC2), this article describes the development and implementation of a tool to assess organizational readiness for integrated care, referred to as the Readiness for Integrated Care Questionnaire (RICQ)...
April 10, 2017: American Journal of Orthopsychiatry
https://www.readbyqxmd.com/read/28382678/recognising-and-responding-to-in-hospital-clinical-deterioration-an-integrative-review-of-interprofessional-practice-issues
#4
REVIEW
Emily Allen, Doug Elliott, Debra Jackson
AIMS AND OBJECTIVES: To identify, appraise and synthesise current evidence regarding organisation-wide interprofessional practice issues that facilitate or inhibit effective recognition and response to clinical deterioration, using a theoretical Rapid Response System (RRS) model. BACKGROUND: Recognition and response to clinical deterioration, in adult general medical-surgical ward patients, is embedded as a routine interprofessional practice in acute healthcare organisations worldwide...
April 5, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28376839/a-hybrid-iii-stepped-wedge-cluster-randomized-trial-testing-an-implementation-strategy-to-facilitate-the-use-of-an-evidence-based-practice-in-va-homeless-primary-care-treatment-programs
#5
Molly M Simmons, Sonya Gabrielian, Thomas Byrne, Megan B McCullough, Jeffery L Smith, Thom J Taylor, Tom P O'Toole, Vincent Kane, Vera Yakovchenko, D Keith McInnes, David A Smelson
BACKGROUND: Homeless veterans often have multiple health care and psychosocial needs, including assistance with access to housing and health care, as well as support for ongoing treatment engagement. The Department of Veterans Affairs (VA) developed specialized Homeless Patient Alignment Care Teams (HPACT) with the goal of offering an integrated, "one-stop program" to address housing and health care needs of homeless veterans. However, while 70% of HPACT's veteran enrollees have co-occurring mental health and substance use disorders, HPACT does not have a uniform, embedded treatment protocol for this subpopulation...
April 4, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28358972/nurse-patient-and-care-partner-perceptions-of-a-personalized-safety-plan-screensaver
#6
Megan Duckworth, Emily Leung, Theresa Fuller, Jenzel Espares, Brittany Couture, Frank Chang, Alexandra C Businger, Sarah Collins, Anuj Dalal, Anne Fladger, Jeffrey L Schnipper, Kumiko O Schnock, David W Bates, Patricia C Dykes
A patient safety plan dashboard was developed that captures disparate data from the electronic health record that is then displayed as a personalized bedside screensaver. The dashboard aligns all care team members, including patients and families, in the safety plan. The screensaver content includes icons that pertain to common geriatric syndromes. In two phases, interviews were conducted with nurses, nursing assistants, patients, and informal caregivers in a large, tertiary care center. End user perceptions of the content and interface of the personalized safety plan screensavers were identified and strategies to overcome the barriers to use for future iterations were defined...
April 1, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28350314/integrating-quality-improvement-and-continuing-professional-development-at-an-academic-medical-center-a-partnership-between-practice-plan-hospital-and-medical-school
#7
Barbara Gold, Dawn England, William Riley, Ginny Jacobs-Halsey, Corinne Webb, Bobbi Daniels
INTRODUCTION: While quality improvement (QI) initiatives can be a highly effective means for improving health care delivery in academic medical centers (AMCs), many health care professionals are not formally trained in basic QI methodology, engaging clinicians in QI activities can be challenging, and there is often a lack of integration and coordination among QI functions (eg, Departments of Quality and Safety, Continuing Professional Development). In our AMC, we undertook a collaborative approach to achieve better vertical and horizontal integration of our QI education efforts...
October 2016: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/28334910/evaluating-pharmacist-input-into-the-pharmaceutical-care-of-patients-in-dispensing-medical-practices-in-remote-and-rural-areas-of-scotland
#8
Derek Stewart, Breda Anthony, Clare Morrison, Yvonne MacRae, Lucy Dixon, Emer Friel, Evelyn Yoong, Scott Cunningham, Katie MacLure
Background.: The Highlands and the Western Isles are the two most remote and rural areas of Scotland, with many medical practices in areas where pharmacies would not be viable. Recent regulations state that that dispensing medical practices in these areas must receive pharmacist support for patients who would benefit. Objective.: This study aimed to evaluate pilot services, which centred on the provision of patient centred pharmaceutical care. Methods...
March 8, 2017: Family Practice
https://www.readbyqxmd.com/read/28318522/prognostic-stratification-and-healthcare-approach-in-patients-with-multiple-pathologies
#9
M Bernabeu-Wittel, B Barón-Franco, D Nieto-Martín, L Moreno-Gaviño, N Ramírez-Duque, M Ollero-Baturone
Polypathological patients constitute a prevalent, fairly homogeneous population, which is characterised by high clinical complexity, substantial vulnerability and significant resource consumption, in addition to high mortality and the need for comprehensive, coordinated care. It is particularly important to establish a reliable prognosis in these patients. It is also extremely useful for professionals involved in the decision-making process for patients and their families in vital planning and their preferences, for strategic health planning in management fields, and for clinical research, by facilitating their incorporation into clinical trials and other intervention studies...
March 16, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28317473/the-columbia-bronx-va-amalgamative-clerkship-an-effective-12-week-integrated-longitudinal-clinical-experience
#10
Jillian Diuguid-Gerber, Samuel Porter, Samuel C Quiah, Katherine Nickerson, Deborah Jones, Zeena Audi, Boyd F Richards
BACKGROUND: Many medical schools have adopted the longitudinal integrated clerkship (LIC) model in response to calls for increased continuity in clinical learning environments. However, because of implementation challenges, such programs are not feasible at some institutions or are limited to a small number of students. OBJECTIVE: In January 2014, Columbia University College of Physicians and Surgeons (P&S) recognized the need to explore different LIC formats and began offering four, 12-week amalgamative clerkships (AC)...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28287025/assessing-interprofessional-education-in-a-student-faculty-collaborative-practice-network
#11
Grace J Young, Marya J Cohen, Bonnie B Blanchfield, Meissa M Jones, Patricia A Reidy, Amy R Weinstein
Although interprofessional relationships are ubiquitous in clinical practice, undergraduate medical students have limited opportunities to develop these relationships in the clinical setting. A few student-faculty collaborative practice networks (SFCPNs) have been working to address this issue, but limited data exist examining the nature and extent of these practices. A systematic survey at a Harvard-affiliated SFCPN is utilised to evaluate the quantity and quality of interprofessional interactions, isolate improvements, and identify challenges in undergraduate interprofessional education (IPE)...
March 12, 2017: Education for Primary Care
https://www.readbyqxmd.com/read/28282333/using-a-comanagement-model-to-develop-a-hip-fracture-integrated-care-pathway
#12
Gonzalo Barinaga, Zain Sayeed, Afshin Anoushiravani, Steven Scaife, Mouhanad El-Othmani, Khaled Jamal Saleh
Hip fracture care represents a service line that profoundly affects patients' quality of life. As hospitals and physicians are motivated to improve quality, reduce costs, and maximize efficiency of care, several alignment models have been proposed under new healthcare legislation. Evaluation of such models as they pertain to hip fracture care warrants further investigation. In this article, we identify the current model of operations present in large healthcare organizations, examine the reasoning behind hospital-physician alignment, and describe specific comanagement principles that are common in healthcare settings...
March 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28276840/staff-perceptions-implementing-interprofessional-team-based-behavioural-healthcare
#13
Bo Kim, Christopher J Miller, A Rani Elwy, Sally K Holmes, Craig M Coldwell, Mark S Bauer
The US Veterans Health Administration (VHA) in 2013 mandated a nationwide implementation of interprofessional team-based care in the general mental health setting and officially endorsed the collaborative care model in 2015 to guide the coordinated and anticipatory care to be delivered by these teams. Front-line clinic staff are major stakeholders whose practices are most directly affected by this implementation and may or may not view teams as useful or feasible for their practice. Our objective was to examine their perspectives on delivering team-to-patient care in order to understand what system-level efforts can best support the transition to such care from the more conventional provider-to-patient care...
May 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28259309/clinician-attitudes-skills-motivations-and-experience-following-the-implementation-of-clinical-decision-support-tools-in-a-large-dental-practice
#14
Elizabeth Mertz, Cynthia Wides, Joel White
OBJECTIVE: This study assesses dental clinicians' pre- and post-implementation attitudes, skills, and experiences with three clinical decision support (CDS) tools built into the electronic health record (EHR) of a multi-specialty group dental practice. METHODS: Electronic surveys designed to examine factors for acceptance of EHR-based CDS tools including caries management by risk assessment (CAMBRA), periodontal disease management by risk assessment (PEMBRA) and a risk assessment-based Proactive Dental Care Plan (PDCP) were distributed to all Willamette Dental Group employees at 2 time points; 3 months pre-implementation (Fall 2013) and 15 months after implementation (winter 2015)...
March 2017: Journal of Evidence-based Dental Practice
https://www.readbyqxmd.com/read/28248696/the-leadership-case-for-investing-in-continuing-professional-development
#15
Graham T McMahon
Continuing medical education (CME) has the power and capacity to address many challenges in the health care environment, from clinician well-being to national imperatives for better health, better care, and lower cost. Health care leaders who recognize the strategic value of education and engage their people in education can expect a meaningful return on their investment-not only in terms of the quality and safety of their clinicians' work but also in the spirit and cohesiveness of the clinicians who work at their institution...
February 28, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28243873/closing-the-false-divide-sustainable-approaches-to-integrating-mental-health-services-into-primary-care
#16
Kurt Kroenke, Jurgen Unutzer
Mental disorders account for 25% of all health-related disability worldwide. More patients receive treatment for mental disorders in the primary care sector than in the mental health specialty setting. However, brief visits, inadequate reimbursement, deficits in primary care provider (PCP) training, and competing demands often limit the capacity of the PCP to produce optimal outcomes in patients with common mental disorders. More than 80 randomized trials have shown the benefits of collaborative care (CC) models for improving outcomes of patients with depression and anxiety...
April 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28240078/using-the-gold-standards-framework-to-deliver-good-end-of-life-care
#17
Barry Quinn, Keri Thomas
The aims of excellent end of life care (EOLC) and nursing are at the heart of healthcare. Chelsea and Westminster Hospital NHS Foundation Trust, a multi-site London teaching care provider, recognises and values the importance of good EOLC, and the quality of EOLC is used as one of the key metrics in assessing the quality of patient and family care across the trust. The principles of EOLC, including those enshrined in the Gold Standards Framework (GSF), are closely aligned with the trust's core values. Each member of staff is encouraged and supported, through the GSF process, to recognise and respond as befits their role in implementing the principles of EOLC, agreed by staff, and by patients and their relatives...
February 27, 2017: Nursing Management (Harrow)
https://www.readbyqxmd.com/read/28193125/preparation-for-practice-a-novel-role-for-general-practice-in-pre-foundation-assistantships
#18
Peter S J Ryan, Gerard J Gormley, Nigel D Hart
BACKGROUND: Hospital-based undergraduate assistantships are now widely established in medical school curricula. They are considered to improve graduates' preparedness for practice in their role as a foundation doctor. Foundation doctors play a key team role in ensuring patient safety during complex transitions across the hospital/primary care interface, and their self-reported preparedness for practice still varies considerably. AIMS: We sought to explore what spending one week of the pre-foundation assistantship in General Practice might add...
February 13, 2017: Education for Primary Care
https://www.readbyqxmd.com/read/28193105/a-qualitative-analysis-of-information-sharing-in-hospice-interdisciplinary-group-meetings
#19
Karla T Washington, George Demiris, Debra Parker Oliver, Jeffrey A Swarz, Alexandria M Lewis, Uba Backonja
BACKGROUND: In the United States, hospice agencies are required to convene interdisciplinary group (IDG) meetings no less frequently than every 15 days to review patients' care plans. Challenges associated with information sharing during these meetings can impede efficiency and frustrate attendees. OBJECTIVES: We sought to examine information sharing in the context of hospice IDG meetings as a first step toward developing an informatics tool to support interdisciplinary collaboration in this setting...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28187730/adherence-to-treatment-guidelines-the-association-between-stroke-risk-stratified-comparing-chads2-and-cha2ds2-vasc-score-levels-and-warfarin-prescription-for-adult-patients-with-atrial-fibrillation
#20
Scott A Chapman, Catherine A St Hill, Meg M Little, Michael T Swanoski, Shellina R Scheiner, Kenric B Ware, M Nawal Lutfiyya
BACKGROUND: Ischemic stroke is a risk associated with atrial fibrillation (AF) and is estimated to occur five times more often in afflicted patients than in those without AF. Anti-thrombotic therapy is recommended for the prevention of ischemic stroke. Risk stratification tools, such as the CHADS2, and more recently the CHA2DS2-VASc, for predicting stroke in patients with AF have been developed to determine the level of stroke risk and assist clinicians in the selection of antithrombotic therapy...
February 11, 2017: BMC Health Services Research
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