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Patient aligned care team

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https://www.readbyqxmd.com/read/29330243/task-delegation-and-burnout-trade-offs-among-primary-care-providers-and-nurses-in-veterans-affairs-patient-aligned-care-teams-va-pacts
#1
Samuel T Edwards, Christian D Helfrich, David Grembowski, Elizabeth Hulen, Walter L Clinton, Gordon B Wood, Linda Kim, Danielle E Rose, Greg Stewart
PURPOSE: Appropriate delegation of clinical tasks from primary care providers (PCPs) to other team members may reduce employee burnout in primary care. However, (1) the extent to which delegation occurs within multidisciplinary teams, (2) factors associated with greater delegation, and (3) whether delegation is associated with burnout are all unknown. METHODS: We performed a national cross-sectional survey of Veterans Affairs (VA) PCP-nurse dyads in Department of VA primary care clinics, 4 years into the VA's patient-centered medical home initiative...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330237/-the-hand-on-the-doorknob-visit-agenda-setting-by-complex-patients-and-their-primary-care-physicians
#2
Christine P Kowalski, Deanna B McQuillan, Neetu Chawla, Courtney Lyles, Andrea Altschuler, Connie S Uratsu, Elizabeth A Bayliss, Michele Heisler, Richard W Grant
BACKGROUND: Choosing which issues to discuss in the limited time available during primary care visits is an important task for complex patients with chronic conditions. DESIGN, SETTING, AND PARTICIPANTS: We conducted sequential interviews with complex patients (n = 40) and their primary care physicians (n = 17) from 3 different health systems to investigate how patients and physicians prepare for visits, how visit agendas are determined, and how discussion priorities are established during time-limited visits...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29315375/improving-patient-safety-for-older-people-in-acute-admissions-implementation-of-the-frailsafe-checklist-in-12-hospitals-across-the-uk
#3
Chrysanthi Papoutsi, Alan Poots, Jake Clements, Zoe Wyrko, Natalie Offord, Julie E Reed
Background: checklists are increasingly proposed as a means to enhance safety and quality of care. However, their use has been met with variable levels of success. The Frailsafe project focused on introducing a checklist with the aim to increase completion of key clinical assessments and to facilitate communication for the care of older patients in acute admissions. Objectives: to examine the use of the Frailsafe checklist, including potential to contribute to improved safety, quality and reliability of care...
January 5, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29311170/integrating-community-health-workers-into-medical-homes
#4
Elizabeth A Rogers, Sarah Turcotte Manser, Joan Cleary, Anne M Joseph, Eileen M Harwood, Kathleen T Call
PURPOSE: Though evidence supports the value of community health workers (CHWs) in chronic disease self-management support, and authorities have called for expanding their roles within patient-centered medical homes (PCMHs), few PCMHs in Minnesota have incorporated these health workers into their care teams. We undertook a qualitative study to (1) identify facilitators and barriers to utilizing a CHW model among PCMHs in Minnesota, and (2) define roles played by this workforce within the PCMH team...
January 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29283617/treating-ptsd-in-primary-care-one-small-step-is-one-giant-leap
#5
Andrew S Pomerantz
Comments on an article by J. A. Cigrang et al. (see record 2017-56601-006). At first glance, the article by Cigrang et al. is another in a long line of randomized clinical trials of psychotherapy for a common condition. Under closer scrutiny, however, it is a groundbreaking study that challenges many commonly held beliefs about effective interventions for posttraumatic stress disorder (PTSD). Cigrang et al. have begun to change the status quo with this study within the DoD. The same protocol is now in the early stages of implementation as a pilot in the VA's Patient Aligned Care Team (VA equivalent of the Patient Centered Medical Home)...
December 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/29281980/who-is-on-the-primary-care-team-professionals-perceptions-of-the-conceptualization-of-teams-and-the-underlying-factors-a-mixed-methods-study
#6
Kirti D Doekhie, Martina Buljac-Samardzic, Mathilde M H Strating, Jaap Paauwe
BACKGROUND: Due to the growing prevalence of elderly patients with multi-morbidity living at home, there is an increasing need for primary care professionals from different disciplinary backgrounds to collaborate as primary care teams. However, it is unclear how primary care professionals conceptualize teams and what underlying factors influence their perception of being part of a team. Our research question is: What are primary care professionals' perceptions of teams and team membership among primary care disciplines and what factors influence their perceptions? METHODS: We conducted a mixed-methods study in the Dutch primary care setting...
December 28, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/29280778/perceptions-of-integration-of-the-clinical-pharmacist-into-the-pcmh-model-by-the-pcmh-team
#7
M Shawn McFarland, Kristen Lamb, Jonathan Hughes, Ashley Thomas, Justin Gatwood, Jacob Hathaway
INTRODUCTION: The patient-centered medical home (PCMH) model is a multidisciplinary, team-based approach to healthcare that focuses on actively involving the patient in clinical decision making. The Veterans Health Administration (VA), while desiring to be a national leader in the delivery of primary care services, used the principles of the PCMH model to design the patient-aligned care team (PACT). The purpose of this study, was to explore the perception of the PACT members after integration of a clinical pharmacist to the PACT...
December 22, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29261816/improving-quality-of-care-for-seriously-ill-patients-opportunities-for-hospitalists
#8
Robin E Fail, Diane E Meier
As the shift to value-based payment accelerates, hospitals are under increasing pressure to deliver high-quality, efficient services. Palliative care approaches improve quality of life and family well-being, and in doing so, reduce resource utilization and costs. Hospitalists frequently provide palliative care interventions to their patients, including pain and symptom management and engaging in conversations with patients and families about the realities of their illness and treatment plans that align with their priorities...
December 20, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29205778/the-graduating-european-dentist-domain-ii-safe-and-effective-clinical-practice
#9
J C Field, E DeLap, M C Manzanares Cespedes
This position paper outlines the areas of competence and learning outcomes of "The Graduating European Dentist" that specifically relate to Safe and Effective Clinical Practice. Dentists are required to ensure that they are capable of providing appropriate care for their patients, whilst also effectively managing and leading the wider clinical team. The care that is provided should align to a contemporaneous evidence base wherever possible, and the quality of care and the management systems that underpin it should be regularly audited and improved...
December 2017: European Journal of Dental Education: Official Journal of the Association for Dental Education in Europe
https://www.readbyqxmd.com/read/29198094/-from-pastoral-care-to-spiritual-care-transforming-the-conception-of-the-role-of-the-spiritual-care-provider
#10
REVIEW
Michael Schultz, Netta Bentur, Ziv Rei Koren, Gil Bar Sela
Spirituality is a difficult concept to define, one that is often understood differently by different cultures and religious communities. Illness constitutes a dramatic change in the ongoing flow and norms of a person's life, raising questions of the value or meaning of life, questions of self-worth, and questions of forgiveness, to ourselves and others. The profession of spiritual care comes to provide support in these areas. Originally focused on religious care, the profession has shifted to providing care for general spiritual well-being, where professionals care for all patients regardless of religion...
November 2017: Harefuah
https://www.readbyqxmd.com/read/29197382/beyond-quality-improvement-exploring-why-primary-care-teams-engage-in-a-voluntary-audit-and-feedback-program
#11
Daniel J Wagner, Janet Durbin, Jan Barnsley, Noah M Ivers
BACKGROUND: Despite its popularity, the effectiveness of audit and feedback in support quality improvement efforts is mixed. While audit and feedback-related research efforts have investigated issues relating to feedback design and delivery, little attention has been directed towards factors which motivate interest and engagement with feedback interventions. This study explored the motivating factors that drove primary care teams to participate in a voluntary audit and feedback initiative...
December 2, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29189491/project-echo-a-telementoring-network-model-for-continuing-professional-development
#12
Sanjeev Arora, Summers G Kalishman, Karla A Thornton, Miriam S Komaromy, Joanna G Katzman, Bruce B Struminger, William F Rayburn
INTRODUCTION: A major challenge with current systems of CME is the inability to translate the explosive growth in health care knowledge into daily practice. Project ECHO (Extension for Community Healthcare Outcomes) is a telementoring network designed for continuing professional development (CPD) and improving patient outcomes. The purpose of this article was to describe how the model has complied with recommendations from several authoritative reports about redesigning and enhancing CPD...
November 15, 2017: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/29176339/patient-and-nurse-experiences-in-a-rural-chronic-disease-management-program-a-qualitative-evaluation
#13
Erica A Davisson, Elizabeth A Swanson
PURPOSE: Rural status confounds chronic disease self-management. The purpose of this qualitative, descriptive study was to evaluate the nurse-led "Living Well" chronic disease management program reporting patient recruitment and retention issues since program initiation in 2013. The Chronic Care Model (CCM) was the guiding framework used to reinforce that interdisciplinary teams must have productive patient interactions for their program(s) to be sustainable. PRIMARY PRACTICE SETTING: A rural, Midwest county clinic's chronic disease management program...
January 2018: Professional Case Management
https://www.readbyqxmd.com/read/29154464/patient-centered-medical-home-implementation-and-improved-chronic-disease-quality-a-longitudinal-observational-study
#14
Ann-Marie Rosland, Edwin Wong, Matthew Maciejewski, Donna Zulman, Rebecca Piegari, Stephan Fihn, Karin Nelson
OBJECTIVE: To examine associations between clinics' extent of patient-centered medical home (PCMH) implementation and improvements in chronic illness care quality. DATA SOURCE: Data from 808 Veterans Health Administration (VHA) primary care clinics nationwide implementing the Patient Aligned Care Teams (PACT) PCMH initiative, begun in 2010. DESIGN: Clinic-level longitudinal observational study of clinics that received training and resources to implement PACT...
November 20, 2017: Health Services Research
https://www.readbyqxmd.com/read/29139336/home-health-aides-perceptions-of-quality-care-goals-challenges-and-implications-for-a-rapidly-changing-industry
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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