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https://www.readbyqxmd.com/read/29777334/patient-engagement-in-community-health-center-leadership-how-does-it-happen
#1
Anjana E Sharma, Beatrice Huang, Margae Knox, Rachel Willard-Grace, Michael B Potter
Patient engagement in primary care leadership is an important means to involve community voices at community health centers. Federally qualified health centers (FQHCs) are mandated to have patient representation within their governing boards, while practices seeking patient-centered medical home certification receive credit for implementing patient advisory councils (PACs). Our objective was to compare and contrast how community health centers engage patients in clinic management, decision-making and planning within governing boards versus PACs...
May 18, 2018: Journal of Community Health
https://www.readbyqxmd.com/read/29777306/respiratory-manifestations-in-lps-responsive-beige-like-anchor-lrba-protein-deficient-patients
#2
Oded Shamriz, Bella Shadur, Adeeb NaserEddin, Irina Zaidman, Natalia Simanovsky, Orly Elpeleg, Eitan Kerem, Joel Reiter, Polina Stepensky
Lipopolysaccharide (LPS)-responsive beige-like anchor (LRBA) protein deficiency is a rare syndrome of primary immune deficiency and immune dysregulation. In this study, we sought to summarize our experience with respiratory manifestations in LRBA-deficient patients. We conducted a retrospective analysis of the medical records of LRBA-deficient patients treated at Hadassah-Hebrew University Medical Center, Jerusalem, Israel. Data retrieved included pulmonary workup, disease course, treatment, and outcome. Ten patients were included...
May 18, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29776836/analysis-of-incidence-of-traumatic-brain-injury-in-blunt-trauma-patients-with-glasgow-coma-scale-of-12-or-less
#3
Alexander Becker, Kobi Peleg, Oded Olsha, Adi Givon, Boris Kessel
PURPOSE: Early diagnosis of traumatic brain injury (TBI) is important for improving survival and neurologic outcome in trauma victims. The purpose of this study was to assess whether Glasgow Coma Scale (GCS) of 12 or less can predict the presence of TBI and the severity of associated injuries in blunt trauma patients. METHODS: A retrospective cohort study including 303,435 blunt trauma patients who were transferred from the scene to hospital from 1998 to 2013. The data was obtained from the records of the National Trauma Registry maintained by Israel's National Center for Trauma and Emergency Medicine Research, in the Gertner Institute for Epidemiology and Health Policy Research...
April 16, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29775736/surgical-consent-practice-in-the-uk-following-the-montgomery-ruling-a-national-cross-sectional-questionnaire-study
#4
Chris McKinnon, Dafydd Loughran, Roísín Finn, Madeline Coxwell-Matthewman, Deva Sanjeeva Jeyaretna, Adam P Williams
BACKGROUND: The Supreme Court case of Montgomery vs Lanarkshire Health Board in 2015 was a landmark case for consent practice in the UK which shifted focus from a traditional paternalistic model of consent towards a more patient-centered approach. Widely recognised as the most significant legal judgment on informed consent in the last 30 years, the case was predicted to have a major impact on the everyday practice of surgeons working in the UK National Health Service (NHS). Two years after the legal definition of informed consent was redefined, we carried out an audit of surgical consent practice across the UK to establish the impact of the Montgomery ruling on clinical practice...
May 15, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29775072/exploring-the-patients-experiences-of-living-with-a-subcutaneous-implantable-cardioverter-defibrillator
#5
Jacqueline Forman, Jennifer Baumbusch, Heather Jackson, Jen Lindenberg, Alyssa Shook, Jamil Bashir
BACKGROUND: The implantable cardioverter defibrillator provides effective treatment for the prevention of sudden cardiac arrest but significant risks associated with transvenous implantation persist. The subcutaneous implantable cardioverter defibrillator has proven to be an alternative and innovative treatment option for select patients to mitigate these risks. Obtaining the patients' perspectives can provide clinicians with essential information to guide implant selection, procedural decision-making, and support patient management...
May 1, 2018: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29774227/identifying-what-matters-to-hysterectomy-patients-postsurgery-perceptions-beliefs-and-experiences
#6
Andrew S Bossick, Roopina Sangha, Heather Olden, Gwen L Alexander, Ganesa Wegienka
Purpose: Hysterectomy is the most common non-obstetrical surgery for women in the United States. Few investigations comparing hysterectomy surgical approaches include patient-centered outcomes. Methods: The study was performed at Henry Ford Health System in Detroit, Michigan between February 2015 and May 2015. The data were collected through structured focus groups with 24 post-hysterectomy women in order to identify PCOs to employ in a subsequent cohort study of hysterectomy surgical approaches...
2018: Journal of Patient-centered Research and Reviews
https://www.readbyqxmd.com/read/29773148/personalized-treatment-outcomes-in-patients-with-somatoform-disorder-a-concept-mapping-study
#7
Sonja Klemm, Saskia van Broeckhuysen-Kloth, Sanne van Vliet, Lummy Oosterhuis, Rinie Geenen
OBJECTIVE: From a patient-centered perspective, treatment outcome measures in somatoform disorder need to be (1) personalized to the patient, (2) fit core problems that are targeted in therapy, and (3) reflect one's ability to adapt and self-manage anticipated deterioration. The aim of this study was to identify an encompassing set of treatment outcome variables in patients with somatoform disorder. METHODS: In-depth interviews yielded a comprehensive overview of 60 treatment outcomes that were sorted in a card sorting task according to similarity of meaning by 30 patients...
June 2018: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/29771817/high-value-cost-conscious-communication-skills-in-undergraduate-medical-education-validity-evidence-for-scores-derived-from-two-standardized-patient-scenarios
#8
Neena Natt, Stephanie R Starr, Darcy A Reed, Yoon Soo Park, Liselotte N Dyrbye, Andrea N Leep Hunderfund
INTRODUCTION: Training in high-value, cost-conscious care (HVCCC) is increasingly being incorporated into medical school curricula, but students may have limited opportunities to engage patients in HVCCC conversations. The aim of this study was to develop two standardized patient scenarios with associated checklists, hypothesizing that resulting scores would allow for valid formative assessments of HVCCC communication skills. METHODS: Scenarios were designed to generate a less-is-more conversation (in response to a patient requesting an unnecessary test) and a shared decision-making conversation (in response to a patient choosing between multiple effective treatment options)...
May 15, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29768053/quality-of-life-and-patients-expectations-in-soft-tissue-sarcoma
#9
Robin L Jones, Axel Le Cesne
Assessment of health-related quality of life (HRQoL) is essential for holistic care. Greater efforts are required to incorporate HRQoL measures into clinical trials and daily practice. Considerable HRQoL data are available for localized soft tissue sarcomas (STS), particularly in the orthopedic setting. In future, HRQoL is expected to become increasingly important in the evaluation of palliative therapy in advanced STS. A patient-centric approach is advocated for STS management. Greater awareness of STS by nonspecialist clinicians, and timely referral to specialized sarcoma reference centers, is crucial for patient welfare...
May 2018: Future Oncology
https://www.readbyqxmd.com/read/29763388/how-should-trauma-patients-informed-consent-or-refusal-be-regarded-in-a-trauma-bay-or-other-emergency-settings
#10
Ashley Suah, Peter Angelos
The precipitous and unexpected nature of trauma requires training health care practitioners to think and act quickly, according to the best medical interest of the patient. The urgency of treatment for trauma patients, who frequently have temporary alterations in their abilities to make autonomous and competent decisions, often results in presumed consent for medically necessary treatment. Academic trauma centers use protocol-based management of injuries to facilitate their simultaneous evaluation by multiple clinicians and to avoid delays in treatment, ensuring that trauma patients receive the best possible care...
May 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29762273/patient-engagement-in-aco-practices-and-patient-reported-outcomes-among-adults-with-co-occurring-chronic-disease-and-mental-health-conditions
#11
Susan L Ivey, Stephen M Shortell, Hector P Rodriguez, Yue Emily Wang
BACKGROUND: Accountable care organizations (ACOs) have increased their use of patient activation and engagement strategies, but it is unknown whether they achieve better outcomes for patients with comorbid chronic physical and mental health conditions. OBJECTIVES: To assess the extent to which practices with patient-centered cultures, greater shared decision-making strategies, and better coordination among team members have better patient-reported outcomes (PROs) for patients with diabetes and/or cardiovascular and comorbid mental health diagnoses...
May 12, 2018: Medical Care
https://www.readbyqxmd.com/read/29759070/identifying-frailty-in-primary-care-a-qualitative-description-of-family-physicians-gestalt-impressions-of-their-older-adult-patients
#12
Clara Korenvain, Ida-Maisie Famiyeh, Sheila Dunn, Cynthia R Whitehead, Paula A Rochon, Lisa M McCarthy
BACKGROUND: Many tools exist to guide family physicians' impressions about frailty status of older adults, but no single tool, instrument, or set of criteria has emerged as most useful. The role of physicians' subjective impressions in frailty decisions has not been studied. This study explores how family physicians conceptualize frailty, and the factors that they consider when making subjective decisions about patients' frailty statuses. METHODS: Descriptive qualitative study of family physicians who practice in a large urban academic family medicine center as they participated in one-on-one "think-aloud" interviews about the frailty status of their patients aged 80 years and over...
May 14, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29757073/breast-cancer-screening-in-primary-care-a-call-for-development-and-validation-of-patient-oriented-shared-decision-making-tools
#13
Sarina Schrager, Elizabeth Burnside
The latest recommendations on breast cancer screening in women from 40 to 49 years charge primary care providers (PCPs) with completing shared decision-making with women about screening mammography. However, there is a lack of supportive materials accompanying this directive. No easy-to-use risk assessment tool is available for PCPs to stratify women's risk. Neither is an evidence-based patient-centered way to assess values surrounding mammography available. To provide the highest quality care for women of 40-49 years, further research should clarify ways to apply risk assessment and values clarification to individual women...
May 14, 2018: Journal of Women's Health
https://www.readbyqxmd.com/read/29755917/sharing-is-caring-minimizing-the-disruption-with-palliative-care
#14
EDITORIAL
Abd Moain Abu Dabrh, Robert P Shannon, Richard J Presutti
There is an upward trend incidence of multiple chronic life-limiting conditions with a well-documented associated impact on patients and their caregivers. When patients approach the end of life, they are often faced with a challenging multidimensional burden while navigating a complex health care system. Patients and families/caregivers are faced with daily decisions, often with little or no frame of reference or medical knowledge. The "what, how, when, and where" puzzle during this challenging time can be overwhelming for patients and their families, and when clinicians do not contemplate this associated workload's impact on patients and caregivers' capacity for self-care, patients and caregivers scramble to find compensatory solutions, often putting their health care at lower priority...
March 13, 2018: Curēus
https://www.readbyqxmd.com/read/29755403/has-the-time-come-to-stratify-and-score-sudep-risk-to-inform-people-with-epilepsy-of-their-changes-in-safety
#15
Rohit Shankar, Craig Newman, Alistair Gales, Brendan N McLean, Jane Hanna, Samantha Ashby, Matthew C Walker, Josemir W Sander
Recent publication of the American Academy of Neurology SUDEP guidance highlighted the importance to American clinicians of making people with epilepsy aware of SUDEP risk. It is the first guideline to do this in the United States. It follows precedent set out in the UK by National Institute of Clinical Excellence in 2004. While a significant achievement, the lack of clarity of how to deliver this guidance in an enduring and person-centered manner, raises concerns on how its long-term effectiveness in risk mitigation...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29754755/patients-should-define-value-in-health-care-a-conceptual-framework
#16
REVIEW
Robin N Kamal, Sarah E Lindsay, Sara L Eppler
The main tenet of value-based health care is delivering high-quality care that is centered on the patient, improving health, and minimizing cost. Collaborative decision-making frameworks have been developed to help facilitate delivering care based on patient preferences (patient-centered care). The current value-based health care model, however, focuses on improving population health and overlooks the individuality of patients and their preferences for care. We highlight the importance of eliciting patient preferences in collaborative decision making and describe a conceptual framework that incorporates individual patients' preferences when defining value...
May 10, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29754124/predictors-of-postoperative-rehabilitation-therapy-following-congenital-heart-surgery
#17
Ana Ubeda Tikkanen, Meena Nathan, Lynn A Sleeper, Marisa Flavin, Ana Lewis, Donna Nimec, John E Mayer, Pedro Del Nido
BACKGROUND: Patients with congenital heart disease are at risk of motor, cognitive, speech, and feeding difficulties after cardiac surgery. Rehabilitation therapy could improve functional outcomes in this population if applied in the acute postcardiac surgical in-hospital stay. However, information on the types of acute postcardiac surgery therapy needs in children is scarce. Our goal was to describe rehabilitation therapy following congenital heart surgery and pre/intraoperative factors associated with need for therapy...
May 12, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29753925/restless-legs-syndrome-patient-odyssey-survey-of-disease-burden-on-patient-and-spouses-partners
#18
William Ondo
BACKGROUND: Restless Legs Syndrome has been shown to impact quality of life using standardized scales, typically from tertiary referral centers. Little data exist that have evaluated specific life adaptation required by patients with RLS, and no survey has ever looked at the impact of RLS on family members. METHODS: The "Patient Odyssey" survey was commissioned by the Restless Legs Syndrome Foundation and designed to assess the day-to-day impact of RLS on patients and their spouses/partners...
December 20, 2017: Sleep Medicine
https://www.readbyqxmd.com/read/29753581/preoperative-risk-score-for-the-prediction-of-mortality-after-repair-of-ruptured-abdominal-aortic-aneurysms
#19
Brandon T Garland, Patrick J Danaher, Sarasi Desikan, Nam T Tran, Elina Quiroga, Niten Singh, Benjamin W Starnes
OBJECTIVE: Even in the ruptured endovascular aneurysm repair first era, there are still patients who will not survive their ruptured abdominal aortic aneurysm (rAAA). All previously published mortality risk scores include intraoperative variables and are not helpful with the decision to operate or in providing preoperative patient and family counseling. The purpose of this study was to develop a practical preoperative risk score to predict mortality after repair of rAAA. METHODS: Data of all patients with rAAA presenting between January 1, 2002, and October 31, 2013, were collected...
May 9, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29753079/curative-transvenous-embolization-for-ruptured-brain-arteriovenous-malformations-a-single-center-experience-from-china
#20
Yingkun He, Weixing Bai, Tianxiao Li, Ferdinand K Hui, Yanyan He, Bin Xu
OBJECTIVE: To evaluate the feasibility and safety of transvenous embolization treatment for brain arteriovenous malformations (bAVM). METHODS: Between November 2016 and August 2017, a transvenous endovascular embolization protocol was implemented at the Henan Provincial People's Hospital for consecutive patients with ruptured bAVM. Therapeutic decision making was based on Spetzler-Martin grades, bAVM location, pattern of venous drainage, and angioarchitecture. And the transvenous embolization procedure was combined with transarterial support...
May 9, 2018: World Neurosurgery
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