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Patient aligned care team

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https://www.readbyqxmd.com/read/29762272/differences-in-experiences-with-care-between-homeless-and-nonhomeless-patients-in-veterans-affairs-facilities-with-tailored-and-nontailored-primary-care-teams
#1
Audrey L Jones, Leslie R M Hausmann, Stefan Kertesz, Ying Suo, John P Cashy, Maria K Mor, James H Schaefer, Adi V Gundlapalli, Adam J Gordon
BACKGROUND: Homeless patients describe poor experiences with primary care. In 2012, the Veterans Health Administration (VHA) implemented homeless-tailored primary care teams (Homeless Patient Aligned Care Team, HPACTs) that could improve the primary care experience for homeless patients. OBJECTIVE: To assess differences in primary care experiences between homeless and nonhomeless Veterans receiving care in VHA facilities that had HPACTs available (HPACT facilities) and in VHA facilities lacking HPACTs (non-HPACT facilities)...
May 12, 2018: Medical Care
https://www.readbyqxmd.com/read/29760030/nurse-practitioner-physician-comanagement-a-theoretical-model-to-alleviate-primary-care-strain
#2
Allison A Norful, Krystyna de Jacq, Richard Carlino, Lusine Poghosyan
PURPOSE: Various models of care delivery have been investigated to meet the increasing demands in primary care. One proposed model is comanagement of patients by more than 1 primary care clinician. Comanagement has been investigated in acute care with surgical teams and in outpatient settings with primary care physicians and specialists. Because nurse practitioners are increasingly managing patient care as independent clinicians, our study objective was to propose a model of nurse practitioner-physician comanagement...
May 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29752289/interventions-to-reduce-over-utilized-tests-and-treatments-in-bronchiolitis
#3
Amy Tyler, Paige Krack, Leigh Anne Bakel, Kimberly O'Hara, Douglas Scudamore, Irina Topoz, Julia Freeman, Angela Moss, Renee Allen, Angela Swanson, Lalit Bajaj
OBJECTIVES: The American Academy of Pediatrics published bronchiolitis clinical practice guidelines in 2014 recommending against the routine use of bronchodilators, chest radiographs, or respiratory viral testing in children with a clinical diagnosis of bronchiolitis. Our aim in this project was to align care with the American Academy of Pediatrics clinical practice guidelines by decreasing the overuse of these interventions. METHODS: This study included patients who were admitted to a non-ICU setting with a primary or secondary diagnosis of bronchiolitis...
May 11, 2018: Pediatrics
https://www.readbyqxmd.com/read/29743228/implementation-of-the-geriatric-patient-aligned-care-team-model-in-the-veterans-health-administration-va
#4
Jennifer L Sullivan, Rina Eisenstein, Thomas Price, Samantha Solimeo, Kenneth Shay
BACKGROUND: Here, we describe the implementation of a specialty primary care medical home (PCMH) model called Geriatric Patient-Aligned Care Teams (GeriPACT) in the Veterans' Health Administration (VA) that is focused on serving older complex patients. In particular, our aims in this article are to describe how the GeriPACT model was developed and implemented in VA sites, provide a closer look at how GeriPACT functions by presenting a case study, and highlight data showing national variation in the implementation of GeriPACT staffing models and PCMH practices...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29742756/applying-user-centered-design-methods-to-the-development-of-an-mhealth-application-for-use-in-the-hospital-setting-by-patients-and-care-partners
#5
Brittany Couture, Elizabeth Lilley, Frank Chang, Ann DeBord Smith, Jessica Cleveland, Awatef Ergai, Zachary Katsulis, James Benneyan, Esteban Gershanik, David W Bates, Sarah A Collins
INTRODUCTION:  Developing an optimized and user-friendly mHealth application for patients and family members in the hospital environment presents unique challenges given the diverse patient population and patients' various states of well-being. OBJECTIVE:  This article describes user-centered design methods and results for developing the patient and family facing user interface and functionality of MySafeCare, a safety reporting tool for hospitalized patients and their family members...
April 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29718079/the-integrated-care-team-approach-of-the-department-of-veterans-affairs-va-geriatric-primary-care
#6
Donna Rasin-Waters, Valerie Abel, Lisa K Kearney, Antonette Zeiss
Historically, integrated mental and behavioral healthcare in the Department of Veterans Affairs (VA) commenced with initiatives in geriatrics. Innovation and system-wide expansion has occurred over decades and culminated in a unified vision for training and practice in the VA medical home model: Patient Aligned Care Team or PACT approach. In one VA hospital, the integration of neuropsychological services in geriatric primary care is pivotal and increases access for patients, as well as contributing to timely and effective care on an interprofessional team...
May 1, 2018: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/29708287/nurse-practitioner-integration-qualitative-experiences-of-the-change-management-process
#7
Grainne Lowe, Virginia Plummer, Leanne Boyd
AIM: The aim of this qualitative research was to explore perceptions of organisational change related to the integration of nurse practitioners from key nursing stakeholders. BACKGROUND: The ongoing delivery of effective and efficient patient services is reliant upon the development and sustainability of nurse practitioner roles. Examination of the factors contributing to the underutilization of nurse practitioner roles is crucial to inform future management policies...
April 30, 2018: Journal of Nursing Management
https://www.readbyqxmd.com/read/29698772/an-operations-partnered-evaluation-of-care-redesign-for-high-risk-patients-in-the-veterans-health-administration-vha-study-protocol-for-the-pact-intensive-management-pim-randomized-quality-improvement-evaluation
#8
Evelyn T Chang, Donna M Zulman, Steven M Asch, Susan E Stockdale, Jean Yoon, Michael K Ong, Martin Lee, Alissa Simon, David Atkins, Gordon Schectman, Susan R Kirsh, Lisa V Rubenstein
BACKGROUND: Patient-centered medical homes have made great strides providing comprehensive care for patients with chronic conditions, but may not provide sufficient support for patients at highest risk for acute care use. To address this, the Veterans Health Administration (VHA) initiated a five-site demonstration project to evaluate the effectiveness of augmenting the VA's Patient Aligned Care Team (PACT) medical home with PACT Intensive Management (PIM) teams for Veterans at highest risk for hospitalization...
April 23, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29697473/we-do-not-know-what-we-do-not-know-innovative-approaches-to-value-measurement
#9
Aaron A Laviana, Matthew J Resnick
PURPOSE OF REVIEW: Over the past several years, there has been an increasing focus on improving the 'value' of healthcare delivered, defined as the ratio of clinical outcomes to the costs incurred to achieve them. The former U.S. Secretary of Health and Human Services Sylvia Burwell announced in 2015 that the majority of healthcare payments in the Medicare and Medicaid programmes will align with value by 2018. Although this has yet to fully mature, numerous health systems have restructured with a goal of improving the value of care delivered to their populations...
April 24, 2018: Current Opinion in Urology
https://www.readbyqxmd.com/read/29691206/designing-for-clinical-change-creating-an-intervention-to-implement-new-statin-guidelines-in-a-primary-care-clinic
#10
Melissa DeJonckheere, Claire H Robinson, Lindsey Evans, Julie Lowery, Bradley Youles, Adam Tremblay, Caitlin Kelley, Jeremy B Sussman
BACKGROUND: Recent clinical practice guidelines from major national organizations, including a joint United States Department of Veterans Affairs (VA) and Department of Defense (DoD) committee, have substantially changed recommendations for the use of the cholesterol-lowering statin medications after years of relative stability. Because statin medications are among the most commonly prescribed treatments in the United States, any change in their use may have significant implications for patients and providers alike...
April 24, 2018: JMIR Human Factors
https://www.readbyqxmd.com/read/29686733/towards-a-strategic-alignment-of-public-health-and-primary-care-practices-at-local-levels-the-case-of-severe-and-enduring-mental-illness
#11
Ricky Banarsee, Cornelius Kelly, Austen El-Osta, Paul Thomas, Chris Brophy
The rapidly increasing number of people who have long-term conditions requires a system of coordinated support for self-care throughout the NHS. A system to support self-care needs to be aligned to systems that support shared-care and community development, making it easier for the multidisciplinary teams who provide care to also help patients and populations to help themselves. Public health practitioners need to work closely with clinicians to achieve this. The best place to coordinate this partnership is a community-based coordinating hub, or local health community - a geographic area of about 50,000 population where different contributions to self-care can be aligned...
March 2018: London Journal of Primary Care
https://www.readbyqxmd.com/read/29678987/protocol-for-a-phase-iii-non-inferiority-randomised-comparison-of-a-new-fibrinogen-concentrate-versus-cryoprecipitate-for-treating-acquired-hypofibrinogenaemia-in-bleeding-cardiac-surgical-patients-the-fibres-trial
#12
Keyvan Karkouti, Jeannie Callum, Vivek Rao, Nancy Heddle, Michael E Farkouh, Mark A Crowther, Damon C Scales
INTRODUCTION: Coagulopathic bleeding is a serious complication of cardiac surgery to which an important contributor is acquired hypofibrinogenaemia (plasma fibrinogen <1.5-2.0 g/L). The standard intervention for acquired hypofibrinogenaemia is cryoprecipitate, but purified fibrinogen concentrates are also available. There is little comparative data between the two therapies and randomised trials are needed. METHODS AND ANALYSIS: FIBrinogen REplenishment in Surgery (FIBRES) is a multicentre, randomised (1:1), active-control, single-blinded, phase III trial in adult cardiac surgical patients experiencing clinically significant bleeding related to acquired hypofibrinogenaemia...
April 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29668717/using-the-normalization-process-theory-to-qualitatively-explore-sense-making-in-implementation-of-the-enhanced-recovery-after-surgery-programme-it-s-not-rocket-science
#13
Eileen Sutton, Georgia Herbert, Sorrel Burden, Stephen Lewis, Steve Thomas, Andy Ness, Charlotte Atkinson
INTRODUCTION: The Enhanced Recovery After Surgery programme (ERAS) is an approach to the perioperative care of patients encompassing multiple interventions and involving a wide range of different actors. It can thus be defined as a complex intervention. Despite the strength of the evidence-base in its support, the implementation of ERAS has been slow. This paper specifically explores the utility of Normalization Process Theory (NPT) as a methodological framework to aid exploration of ERAS implementation, with a focus on the core NPT construct coherence...
2018: PloS One
https://www.readbyqxmd.com/read/29659009/state-of-the-science-interprofessional-approaches-to-aging-dementia-and-mental-health
#14
Timothy W Farrell, Marilyn K Luptak, Katherine P Supiano, James T Pacala, Rosalind De Lisser
Interprofessional education (IPE) is essential to develop the healthcare workforce of the future. Geriatrics healthcare professionals have long championed innovations in IPE and patient care, but there is increased urgency to address challenges in aging, dementia, and geriatric mental health in America. In 2010, the Partnership for Health in Aging multidisciplinary competencies and a related position statement in the Journal of the American Geriatrics Society addressed interdisciplinary team (IDT) training in geriatrics...
April 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29588637/indicators-and-measurement-tools-for-health-systems-integration-a-knowledge-synthesis
#15
Esther Suter, Nelly D Oelke, Maria Alice Dias da Silva Lima, Michelle Stiphout, Robert Janke, Regina Rigatto Witt, Cheryl Van Vliet-Brown, Kaela Schill, Mahnoush Rostami, Shelanne Hepp, Arden Birney, Fatima Al-Roubaiai, Giselda Quintana Marques
Background: Despite far reaching support for integrated care, conceptualizing and measuring integrated care remains challenging. This knowledge synthesis aimed to identify indicator domains and tools to measure progress towards integrated care. Methods: We used an established framework and a Delphi survey with integration experts to identify relevant measurement domains. For each domain, we searched and reviewed the literature for relevant tools. Findings: From 7,133 abstracts, we retrieved 114 unique tools...
November 13, 2017: International Journal of Integrated Care
https://www.readbyqxmd.com/read/29582520/pediatric-endocrine-society-survey-of-diabetes-practices-in-the-united-states-what-is-the-current-state
#16
Ines Guttmann-Bauman, Paul Thornton, Soumya Adhikari, Kent Reifschneider, Michael A Wood, Tyler Hamby, Karen Rubin
The Practice Management Committee (PMC) of the Pediatric Endocrine Society (PES) conducted a survey of its membership in February/March 2016 to assess the current state of pediatric diabetes care delivery across multiple practice types in the United States. RESEARCH DESIGN AND METHODS: The PES distributed an anonymous electronic survey (Survey Monkey) via email to its membership and requested that only one survey be completed for each practice. RESULTS: Ninety-three unique entries from the US were entered into analysis...
March 26, 2018: Pediatric Diabetes
https://www.readbyqxmd.com/read/29579443/how-patient-partners-influence-quality-improvement-efforts
#17
Jessica Greene, Diane Farley, Christine Amy, Kathy Hutcheson
BACKGROUND: There is growing acknowledgement that patients are key stakeholders in improving quality of medical care, yet a key barrier to integrating patients into quality improvement teams (QITs) as patient partners is the lack of evidence of their impact. This mixed-method study was conducted to identify the ways patient partners influence QITs and to document the extent of patient partners' impact. METHODS: Focus groups and in-depth interviews were conducted with 17 patient partners and 11 staff at WellSpan Health and Aligning Forces for Quality-South Central Pennsylvania to identify the specific mechanisms through which patients influenced QIT efforts...
April 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29547577/pharmacists-as-interprofessional-collaborators-and-leaders-through-clinical-pathways
#18
Sherine Ismail, Mohamed Osman, Rayf Abulezz, Hani Alhamdan, K H Mujtaba Quadri
Pharmacists possess pivotal competencies and expertise in developing clinical pathways (CPs). We present a tertiary care facility experience of pharmacists vis-a-vis interprofessional collaboration for designing and implementing CPs. We participated in the development of CPs as leading members of a collaborative team of healthcare professionals. We reviewed literature, aligning it with hospital formulary and institutional standards, and participated in weekly team meetings for six months. Several tools and services were adapted to guide prescribing and standardization of care through time-bound order sets...
March 16, 2018: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29540119/primary-care-mental-health-integration-in-the-veterans-affairs-health-system-program-characteristics-and-performance
#19
Brittany L Cornwell, Laurie M Brockmann, Elaine C Lasky, Jennifer Mach, John F McCarthy
OBJECTIVES: The Veterans Health Administration (VHA) has achieved substantial national implementation of primary care-mental health integration (PC-MHI) services. However, little is known regarding program characteristics, variation in characteristics across settings, or associations between program fidelity and performance. This study identified core elements of PC-MHI services and evaluated their associations with program characteristics and performance. METHODS: A principal-components analysis (PCA) of reports from 349 sites identified factors associated with PC-MHI fidelity...
March 15, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29521123/adherence-of-physical-therapy-with-clinical-practice-guidelines-for-the-rehabilitation-of-stroke-in-an-active-inpatient-setting
#20
Ajimsha M S, Smithesh Kooven, Noora Al-Mudahka
BACKGROUND: Clinical guidelines are systematically developed statements designed to help practitioners and patients to make decisions about appropriate health care. Clinical practice guideline adherence analysis is the best way to fine tune the best practices in a health care industry with international benchmarks. OBJECTIVE: To assess the physical therapist's adherence to structured stroke clinical practice guidelines in an active inpatient rehabilitation center in Qatar...
March 9, 2018: Disability and Rehabilitation
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