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Triple aim goal

Sheri Kittelson, Read Pierce, Jeanie Youngwerth
BACKGROUND: In response to poor healthcare quality outcomes and rising costs, healthcare reform triple aim has increased requirements for providers to demonstrate value to payers, partners, and the public. OBJECTIVE: Electronically automating measurement of the meaningful impact of palliative care (PC) programs on clinical, operational, and financial systems over time is imperative to the success of the field and the goal of development of this automated PC scorecard...
January 12, 2017: Journal of Palliative Medicine
Karan Chopra, Arvind U Gowda, Colton H L McNichols, Emile N Brown, Sheri Slezak, Yvonne Rasko
BACKGROUND: Breast augmentation is one of the most commonly performed aesthetic surgery procedures worldwide. Bacterial contamination is of paramount concern due to its role in biofilm formation and capsular contracture. Plastic surgeons have adopted a variety of perioperative interventions in efforts to reduce implant contamination, however definitive evidence supporting these practices is lacking. OBJECTIVE: The goal of this study was to assess current practice patterns aimed at reducing implant-related infections in breast augmentation and comparing them to current evidence-based medicine recommendations...
December 5, 2016: Annals of Plastic Surgery
Neal D Shore, Dana Jacoby
Changes involving the health care economic landscape have affected physicians' workflow, productivity, compensation structures, and culture. Ongoing Federal legislation regarding regulatory documentation and imminent payment-changing methodologies have encouraged physician consolidation into larger practices, creating affiliations with hospitals, multidisciplinary medical specialties, and integrated delivery networks. As subspecialization and evolution of care models have accelerated, independent medical groups have broadened ancillary service lines by investing in enterprises that compete with hospital-based (academic and nonacademic) entities, as well as non-physician- owned multispecialty enterprises, for both outpatient and inpatient services...
2016: Reviews in Urology
Joel Zonszein, Per-Henrik Groop
INTRODUCTION: The duration of uncontrolled type 2 diabetes mellitus (T2DM) can adversely impact small and large vessels, eventually leading to microvascular and macrovascular complications. Failure of therapeutic lifestyle changes, monotherapy, and clinical inertia contribute to persistent hyperglycemia and disease progression. The aim was to review the complex pathophysiology of type 2 diabetes and how different oral agents can be used effectively as first-line therapy in combination with metformin, as well as in patients not achieving glycemic goals with metformin therapy...
December 2016: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Yves Bergevin, Bettina Habib, Keesa Elicksen-Jensen, Stephen Samis, Jean Rochon, Jean-Louis Denis, Denis Roy
A study on the impact of regionalization on the Triple Aim of Better Health, Better Care and Better Value across Canada in 2015 identified major findings including: (a) with regard to the Triple Aim, the Canadian situation is better than before but variable and partial, and Canada continues to underperform compared with other industrialized countries, especially in primary healthcare where it matters most; (b) provinces are converging toward a two-level health system (provincial/regional); (c) optimal size of regions is probably around 350,000-500,000 population; d) citizen and physician engagement remains weak...
2016: HealthcarePapers
Poonam Malhotra Kapoor, Rohan Magoon, Rajinder Rawat, Yatin Mehta
Goal-directed therapy (GDT) encompasses guidance of intravenous (IV) fluid and vasopressor/inotropic therapy by cardiac output or similar parameters to help in early recognition and management of high-risk cardiac surgical patients. With the aim of establishing the utility of perioperative GDT using robust clinical and biochemical outcomes, we conducted the present study. This multicenter randomized controlled study included 130 patients of either sex, with European system for cardiac operative risk evaluation ≥3 undergoing coronary artery bypass grafting on cardiopulmonary bypass...
October 2016: Annals of Cardiac Anaesthesia
Walter P Wodchis
This paper reviews approaches to performance measurement in health systems with particular attention to people with multimorbidity and complex health needs. Performance measurement should be informative and used by multiple stakeholders in order to align performance improvement efforts. System performance measures must allow for macro-system and meso-organization and provider-level reporting, and they should be relevant and important to stakeholders at each level, as well as to patients and all potential care recipients...
2016: Healthcare Quarterly
Alexandre Rambaud, Pierre Samozino, Pascal Edouard
OBJECTIVE: After anterior cruciate ligament (ACL) tear, the ACL reconstruction (ACLR) is the standard treatment to return to pivots/contacts sports. The goal of rehabilitation programs is to guide the functional recovery and the safe return to sport without additional knee injury or other injuries. Functional tests, like Hop tests and their side to-side difference index [limb symmetry index (LSI)], are commonly used following ACLR to help return to sport decision making. However, the most commonly used criterion to return to sport is the postoperative time: return to light activities (RtlA) at 3 or 4 month mark and return to sport with contacts and side-cuttings (RtS) between 6 and 9 month mark...
September 2016: Annals of Physical and Rehabilitation Medicine
Michelle Vu, Annesha White, Virginia P Kelley, Jennifer Kuca Hopper, Cathy Liu
BACKGROUND: The Affordable Care Act (ACA) healthcare reforms, centered on achieving the Centers for Medicare & Medicaid Services (CMS) Triple Aim goals of improving patient care quality and satisfaction, improving population health, and reducing costs, have led to increasing partnerships between hospitals and insurance companies and the implementation of employee wellness programs. Hospitals and insurance companies have opted to partner to distribute the risk and resources and increase coordination of care...
July 2016: American Health & Drug Benefits
Kathryn W Hoffses, Lisa Y Ramirez, Louise Berdan, Rachel Tunick, Sarah Morsbach Honaker, Tawnya J Meadows, Laura Shaffer, Paul M Robins, Lynne Sturm, Terry Stancin
OBJECTIVES : In the midst of large-scale changes across our nation's health care system, including the Affordable Care Act and Patient-Centered Medical Home initiatives, integrated primary care models afford important opportunities for those in the field of pediatric psychology. Despite the extensive and growing attention, this subspecialty has received in recent years, a comprehensive set of core professional competencies has not been established. METHODS : A subset of an Integrated Primary Care Special Interest Group used two well-established sets of core competencies in integrated primary care and pediatric psychology as a basis to develop a set of integrated pediatric primary care-specific behavioral anchors...
November 2016: Journal of Pediatric Psychology
Sofie J M van Hoof, Marieke D Spreeuwenberg, Mariëlle E A L Kroese, Jessie Steevens, Ronald J Meerlo, Monique M H Hanraets, Dirk Ruwaard
BACKGROUND: Reinforcing the gatekeeping role of general practitioners (GPs) by embedding specialist knowledge into primary care is seen as a possibility for stimulating a more sustainable healthcare system and avoiding unnecessary referrals to outpatient care. An intervention called Primary Care Plus (PC+) was developed to achieve these goals. The objective of this study is to gain insight into: (1) the content and added value of PC+ consultations according to stakeholders, and (2) patient satisfaction with PC+ compared to outpatient care...
2016: BMC Family Practice
Arvind U Gowda, Karan Chopra, Emile N Brown, Sheri Slezak, Yvonne Rasko
BACKGROUND: Implant-based breast reconstruction is commonly performed by plastic surgeons worldwide. Bacterial contamination is of paramount concern because of its role in biofilm formation and capsular contracture. Plastic surgeons have adopted a variety of perioperative interventions in efforts to reduce implant contamination; however, definitive evidence supporting these practices is lacking. OBJECTIVE: The goal of this study was to assess current practice patterns aimed at reducing implant-related infections...
July 26, 2016: Annals of Plastic Surgery
William Jackson Epperson, Susan Fink Childs, Gordon Wilhoit
The Triple Aim has become the guiding light and benchmark by which healthcare organizations plan their future efforts. It has been adopted into healthcare policies with little regard for including the skill sets of compassion and emotional intelligence. The multiple increasing demands on providers of healthcare are unsustainable and will cripple the system, resulting in outcomes that are counter to the Triple Aim goals. Patient engagement with shared decision-making should become the primary focus of care delivery...
May 2016: Journal of Medical Practice Management: MPM
E Bartolomé-Benito, J Jiménez-Carramiñana, L Sánchez-Perruca, M S Bartolomé-Casado, A B Dominguez-Mandueño, M Marti-Argandoña, M Hernández-Pascual, A Miquel-Gómez
OBJECTIVES: To describe the design, implementation, and monitoring of eSOAP (Primary Health Care Balanced Scorecard) and its role in the deployment of strategic objectives and clinical management, as well as to show the lessons learned during six years of follow-up. METHOD: Descriptive study areas: methodology (conceptual framework, strategic matrix, strategic map, and processes map), technology and standardisation. RESULTS: As of December 2014, 9,046 (78%) professionals are registered in eSOAP...
January 2017: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
Raffaella Palumbo, Federico Sottotetti, Antonio Bernardo
The therapeutic goals in metastatic breast cancer (MBC) remain palliative in nature, aimed at controlling symptoms, improving or maintaining quality of life and prolonging survival. The advent of new drugs and new formulations of standard agents has led to better outcomes in patients with advanced or metastatic disease. These developments have also allowed a tailored therapeutic approach, in which the molecular biology of the tumour, the treatment history, and patient attitudes are taken into account in the decision-making process...
May 2016: Therapeutic Advances in Medical Oncology
Arthur M Boudreaux, Thomas R Vetter
The movement toward value-based payment models, driven by governmental policies, federal statutes, and market forces, is propelling the importance of effectively managing the health of populations to the forefront in the United States and other developed countries. However, for many anesthesiologists, population health management is a new or even foreign concept. A primer on population health management and its potential perioperative application is thus presented here. Although it certainly continues to evolve, population health management can be broadly defined as the specific policies, programs, and interventions directed at optimizing population health...
July 2016: Anesthesia and Analgesia
Todd D Sorensen, Deborah L Pestka, Amanda R Brummel, Daniel J Rehrauer, Molly J Ekstrand
UNLABELLED: Medication adherence is a problem that has received widespread attention in the medical literature and health policy circles. With the increased emphasis on recognizing and rewarding quality in the U.S. health care system, medication adherence measures are increasingly being adopted to assess quality of medication use. However, when adherence is discussed in the literature or evaluated via quality measures, there is rarely any dialogue surrounding adherence in the context of patient-centered issues such as clinical status, individualized medication needs, or personal expectations and social situation...
May 2016: Journal of Managed Care & Specialty Pharmacy
Martina Zemp, Anne Milek, Patrick T Davies, Guy Bodenmann
Although a large body of literature indicates that interparental discord is a primary risk factor for child maladjustment, less research has examined children's behavior as a predictor of the parents' relationship quality. The goal of this randomized trial intervention study was to examine the effects of improved problem behavior in children on the parents' relationship quality 1 year later in a community sample. One hundred couples were randomly assigned to (a) a parenting training (Triple P) or (b) an untreated control group...
December 2016: Journal of Family Psychology: JFP
David A Dorr, Tracy Anastas, Katrina Ramsey, Jesse Wagner, Bhavaya Sachdeva, LeAnn Michaels, Lyle J Fagnan
BACKGROUND: Health reform programs like the patient-centered medical home are intended to improve the triple aim. Previous studies on patient-centered medical homes have shown mixed effects, but high value elements (HVEs) are expected to improve the triple aim. OBJECTIVE: The aim of this study is to understand whether focusing on HVEs would improve patient experience with care. METHODS: Eight clinics were cluster-randomized in a year-long trial...
August 2016: Medical Care
Caryn Bredenkamp, Leander R Buisman
The objective of this article is to assess the progress of the Philippines health sector in providing financial protection to the population, as measured by estimates of health insurance coverage, out-of-pocket spending, catastrophic payments and impoverishing health expenditures. Data are drawn from eight household surveys between 2000 and 2013, including two Demographic and Health Surveys, one Family Health Survey and five Family Income and Expenditure Surveys. We find that out-of-pocket spending increased by 150% (real) from 2000 to 2012, with the sharpest increases occurring in recent years...
September 2016: Health Policy and Planning
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