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https://www.readbyqxmd.com/read/28795264/decreasing-patient-length-of-stay-via-new-flexible-exam-room-allocation-policies-in-ambulatory-care-clinics
#1
Vahab Vahdat, Jacqueline Griffin, James E Stahl
To address prolonged lengths of stay (LOS) in ambulatory care clinics, we analyze the impact of implementing flexible and dynamic policies for assigning exam rooms to providers. In contrast to the traditional approaches of assigning specific rooms to each provider or pooling rooms among all practitioners, we characterize the impact of alternate compromise policies that have not been explored in previous studies. Since ambulatory care patients may encounter multiple different providers in a single visit, room allocation can be determined separately for each encounter accordingly...
August 9, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28791282/the-global-health-service-partnership-an-academic-clinical-partnership-to-build-nursing-and-medical-capacity-in-africa
#2
REVIEW
Eileen M Stuart-Shor, Elizabeth Cunningham, Laura Foradori, Elizabeth Hutchinson, Martha Makwero, Jill Smith, Jane Kasozi, Esther M Johnston, Aliasgar Khaki, Elisa Vandervort, Fabiola Moshi, Vanessa B Kerry
The World Health Organization estimates a global deficit of about 12.9 million skilled health professionals (midwives, nurses, and physicians) by 2035. These shortages limit the ability of countries, particularly resource-constrained countries, to deliver basic health care, to respond to emerging and more complex needs, and to teach, graduate, and retain their future health professionals-a vicious cycle that is perpetuated and has profound implications for health security. The Global Health Service Partnership (GHSP) is a unique collaboration between the Peace Corps, President's Emergency Plan for AIDS Relief, Seed and host-country institutions, which aims to strengthen the breadth and quality of medical and nursing education and care delivery in places with dire shortages of health professionals...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28734963/variability-in-elective-day-surgery-rates-between-belgian-hospitals-analyses-of-administrative-data-explained-by-surgical-experts
#3
Roos Leroy, Cécile Camberlin, Mélanie Lefèvre, Koen Van den Heede, Carine Van de Voorde, Claire Beguin
BACKGROUND: In the last decades, day surgery has steadily and significantly grown in many countries, yet the increase has been uneven. There are large variations in day-surgery activity between countries, but also within countries between hospitals and surgeons. This paper explores the variability in day-care activity for elective surgical procedures between Belgian hospitals. MATERIALS AND METHODS: The administrative hospital data of all patients formally admitted in a Belgian hospital for inpatient or day-care surgery between 2011 and 2013 were analysed and summarized in graphs...
July 19, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28734557/-conversational-advice-a-mixed-methods-analysis-of-medical-residents-experiences-co-managing-primary-care-patients-with-behavioral-health-providers
#4
Patrick Hemming, R B Levine, Joseph J Gallo
OBJECTIVE: When integrated behavioral health clinicians (IBHCs) and residents co-manage patients, residents may learn new approaches. We aimed to understand the effect of co-management on residents' behavioral health (BH) management learning. METHODS: Residents completed a web-based survey enquiring: whether co-management included a shared visit and/or face-to-face meeting with an IBHC, whether residents received feedback from the IBHC, and what they learned. Qualitative responses were coded thematically using a constant comparative method...
July 14, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28727619/an-innovative-transitional-care-program-improves-community-health
#5
Barbara M Richardson
In this month's Magnet® Perspectives column, Barbara Richardson, MSN, RN-BC, CCRN, clinical nurse specialist at the Southwestern Vermont Medical Center, examines the ways in which a robust transitional care program improves community health, reduces readmissions and emergency department visits, and provides valuable social support for even the most complex patients. Richardson shares critical factors that impacted the program's success, including a Magnet® environment of innovation, a visionary hospital leadership team, strong community alliances, and collaborative solutions to previously intractable problems...
July 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28725785/pathology-course-director-perspectives-of-a-recent-lcme-experience-preparation-in-an-integrated-curriculum-with-the-revised-standards
#6
Barbara E C Knollmann-Ritschel, Eric Suarez, William Gilliland, Richard Conran, Arnyce Pock
Preparation for a Liaison Committee of Medical Education (LCME) accreditation site visit is a daunting task for any medical school, particularly for medical schools that have adopted integrated curricula. The LCME accreditation is the standard that all US and Canadian allopathic medical schools must meet in order for the school to award the degree of medical doctor. The Uniformed Services University of the Health Sciences (USU) recently underwent a full-scale LCME accreditation visit that was conducted under the newly revised LCME standards and elements...
January 2017: Acad Pathol
https://www.readbyqxmd.com/read/28723302/why-use-group-visits-for-opioid-use-disorder-treatment-in-primary-care-a-patient-centered-qualitative-study
#7
Randi Sokol, Chiara Albanese, Deviney Chaponis, Jessica Early, George Maxted, Diana Morrill, Grace Poirier, Fran Puopolo, Zev Schuman-Olivier
BACKGROUND: Primary care providers are well positioned to respond to the opioid crisis by providing buprenorphine/naloxone (B/N) through shared medical appointments (SMA). While quantitative research has been previously conducted on SMAs with B/N, we conducted a qualitative assessment from the patients' point of view, considering whether and how group visits provide value for patients. METHODS: Twenty-five participants with opioid use disorder (OUD) who were enrolled in a weekly B/N group visit at a family medicine clinic participated in either of two one-hour-long focus groups, which were conducted as actual group visits...
July 19, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28721436/age-at-natural-menopause-and-risk-of-type-2-diabetes-a-prospective-cohort-study
#8
Taulant Muka, Eralda Asllanaj, Naim Avazverdi, Loes Jaspers, Najada Stringa, Jelena Milic, Symen Ligthart, M Arfan Ikram, Joop S E Laven, Maryam Kavousi, Abbas Dehghan, Oscar H Franco
AIMS/HYPOTHESIS: In this study, we aimed to examine the association between age at natural menopause and risk of type 2 diabetes, and to assess whether this association is independent of potential mediators. METHODS: We included 3639 postmenopausal women from the prospective, population-based Rotterdam Study. Age at natural menopause was self-reported retrospectively and was treated as a continuous variable and in categories (premature, <40 years; early, 40-44 years; normal, 45-55 years; and late menopause, >55 years [reference])...
July 18, 2017: Diabetologia
https://www.readbyqxmd.com/read/28708781/fracture-site-mobility-at-six-weeks-following-humeral-shaft-fracture-predicts-nonunion-without-surgery
#9
Adam S Driesman, Nina Fisher, Raj Karia, Sanjit Konda, Kenneth A Egol
OBJECTIVES: To assess the presence of fracture site gross motion on physical examination to predict humeral shaft fracture progression to nonunion in patients managed non-operatively. DESIGN: Retrospective cohort study SETTING:: Single trauma level 1 institutional center PATIENTS:: Eighty-four consecutive patients undergoing non-operative treatment of a diaphyseal humeral shaft fracture were identified. The average age of the population was 48.3 years and 50% of the cohort was male...
July 8, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28701156/the-current-level-of-shared-decision-making-in-anesthesiology-an-exploratory-study
#10
F E Stubenrouch, E M K Mus, J W Lut, E M Hesselink, D T Ubbink
BACKGROUND: Shared decision-making (SDM) seeks to involve both patients and clinicians in decision-making about possible health management strategies, using patients' preferences and best available evidence. SDM seems readily applicable in anesthesiology. We aimed to determine the current level of SDM among preoperative patients and anesthesiology clinicians. METHODS: We invited 115 consecutive preoperative patients, visiting the pre-assessment outpatient clinic of the department of Anesthesiology at the Academic Medical Center of Amsterdam...
July 12, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28700529/rheumatologists-modestly-more-likely-to-counsel-smokers-in-visits-without-rheumatoid-arthritis-control-an-observational-study
#11
Andrew P Vreede, Heather M Johnson, Megan Piper, Daniel J Panyard, Joanna C Wong, Christie M Bartels
BACKGROUND: Among patients with rheumatoid arthritis (RA), smoking increases risk of severe RA and pulmonary and cardiovascular disease. Despite this, little is known about smoking cessation counseling by rheumatologists. OBJECTIVES: We examined predictors of tobacco counseling in RA patients who smoke including the effect of perceived RA control. We hypothesized that patients with controlled RA would receive more counseling according to the competing demands model, which explains that preventive care gaps occur as a result of competing provider, patient, and clinic factors...
August 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28694240/feasibility-of-establishing-hiv-case-based-surveillance-to-measure-progress-along-the-health-sector-cascade-situational-assessments-in-tanzania-south-africa-and-kenya
#12
Richelle Harklerode, Sandra Schwarcz, James Hargreaves, Andrew Boulle, Jim Todd, Serge Xueref, Brian Rice
BACKGROUND: To track the HIV epidemic and responses to it, the World Health Organization recommends 10 global indicators to collect information along the HIV care cascade. Patient diagnosis and medical record data, harnessed through case-based surveillance (CBS), can be used to measure 8 of these. While many high burden countries have well-established systems for monitoring patients on HIV treatment, few have formally adopted CBS. OBJECTIVE: In response to the need for improved strategic HIV information and to facilitate the development of CBS in resource-limited countries, we aimed to conduct situational assessments of existing data collection systems in Tanzania, South Africa, and Kenya...
July 10, 2017: JMIR Public Health and Surveillance
https://www.readbyqxmd.com/read/28692384/advancing-the-use-of-emergency-department-syndromic-surveillance-data-new-york-city-2012-2016
#13
Ramona Lall, Jasmine Abdelnabi, Stephanie Ngai, Hilary B Parton, Kelly Saunders, Jessica Sell, Amanda Wahnich, Don Weiss, Robert W Mathes
INTRODUCTION: The use of syndromic surveillance has expanded from its initial purpose of bioterrorism detection. We present 6 use cases from New York City that demonstrate the value of syndromic surveillance for public health response and decision making across a broad range of health outcomes: synthetic cannabinoid drug use, heat-related illness, suspected meningococcal disease, medical needs after severe weather, asthma exacerbation after a building collapse, and Ebola-like illness in travelers returning from West Africa...
July 2017: Public Health Reports
https://www.readbyqxmd.com/read/28690000/-i-m-not-gonna-pull-the-rug-out-from-under-you-patient-provider-communication-about-opioid-tapering
#14
Marianne S Matthias, Nicole L Johnson, Cleveland G Shields, Matthew J Bair, Palmer MacKie, Monica Huffman, Stewart C Alexander
In response to increases in harms associated with prescription opioids, opioid prescribing has come under greater scrutiny, leading many healthcare organizations and providers to consider or mandate opioid dose reductions (tapering) for patients with chronic pain. Communicating about tapering can be difficult, particularly for patients on long-term opioids who perceive benefits and are using their medications as prescribed. Given the importance of effective patient-provider communication for pain management and recent health system-level initiatives and provider practices to taper opioids, this study used qualitative methods to understand communication processes related to opioid tapering, to identify best practices and opportunities for improvement...
July 6, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28679915/medications-related-emergency-admissions-causes-and-recommendations
#15
Namareq Aldardeer, Nabila Benslimane, Mohamed Khalifa
Adverse drug events could require a patient to visit the emergency department, many of these visits lead to hospital admissions. A retrospective study, October 2015 to March 2016, examined the severity and factors contributing to medications related emergency visits leading to admissions at King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia. Out of 698 reviewed patients, 92 were medications related admissions. Adverse drug reactions were the primary cause (46.7%), drug prescribing (30...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28658020/socially-accountable-medical-education-an-innovative-approach-at-florida-international-university-herbert-wertheim-college-of-medicine
#16
Pedro J Greer, David R Brown, Luther G Brewster, Onelia G Lage, Karin F Esposito, Ebony B Whisenant, Frederick W Anderson, Natalie K Castellanos, Troy A Stefano, John A Rock
PROBLEM: Despite medical advances, health disparities persist, resulting in medicine's renewed emphasis on the social determinants of health and calls for reform in medical education. APPROACH: The Green Family Foundation Neighborhood Health Education Learning Program (NeighborhoodHELP) at Herbert Wertheim College of Medicine provides a platform for the school's community-focused mission. NeighborhoodHELP emphasizes social accountability and interprofessional education while providing evidence-based, patient- and household-centered care...
June 27, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28657819/cares-a-community-wide-collaboration-identifies-super-utilizers-and-reduces-their-9-1-1-call-emergency-department-and-hospital-visit-rates
#17
E Stein Bronsky, Constance McGraw, Robin Johnson, Kristin Giordano, Alessandro Orlando, David Bar-Or
BACKGROUND: A subset of individuals who inefficiently and frequently use emergency department (ED) services are called "super-utilizers." Our healthcare system is fragmented and complex, making it difficult for providers to identify super-utilizers and address their wide range of health issues. OBJECTIVE: The objective of our study was to evaluate a novel community-wide collaboration program called CARES (Community Assistance Referral and Education Services) designed to identify super-utilizers through local partnering organizations...
June 28, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28648218/innovative-information-technology-powered-population-health-care-management-improves-outcomes-and-reduces-hospital-readmissions-and-emergency-department-visits
#18
Sharon Anderson, Michele Campbell, Donna Mahoney, Ann Kathryn Muther, Janice Nevin, Patricia Resnik, Tabassum Salam, Terri Steinberg
BACKGROUND: Patients with chronic conditions are often the most frequent users of health care. Moreover, adapting to developments in one's illness, understanding how to self-manage a chronic illness, and sharing information between primary care and specialty providers, can be a full-time job for someone with a chronic illness. In response to these challenges, Christiana Care Health System (Wilmington, Delaware) developed Care Link, an information technology (IT)-enhanced care management support to enable populations of patients to achieve better clinical outcomes at lower cost...
July 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28592736/a-cloud-based-home-health-care-information-sharing-system-to-connect-patients-with-home-healthcare-staff-a-case-report-of-a-study-in-a-mountainous-region
#19
Shinichi Nomoto, Momoe Utsumi, Satoshi Sasayama, Hiroshi Dekigai
We have developed a cloud system, the e-Renraku Notebook (e-RN) for sharing of home care information based on the concept of "patient-centricity". In order to assess the likelihood that our system will enhance the communication and sharing of information between home healthcare staff members and home-care patients, we selected patients who were residing in mountainous regions for inclusion in our study. We herein report the findings.Eighteen staff members from 7 medical facilities and 9 patients participated in the present study...
2017: Nihon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
https://www.readbyqxmd.com/read/28585242/addressing-unmet-needs-of-patients-with-chronic-diseases-impact-of-the-visit-website-during-consultations
#20
Yew Kong Lee, Chirk Jenn Ng, Wah Yun Low
RATIONALE, AIMS, AND OBJECTIVES: Patient concerns are often neglected in consultations, especially for chronic diseases where patients and providers fall into the routine of chronic disease management in consultations. One strategy to elicit patient concerns has been to ask patients to complete agenda lists before the consultation. This study aimed to explore the impact of a preconsultation agenda website in addressing patients' unmet needs during chronic disease consultations. METHODS: Patients entered their concerns into a website (Values In Shared Interactions Tool (VISIT))...
June 6, 2017: Journal of Evaluation in Clinical Practice
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