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Physician assistants and quality of care

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https://www.readbyqxmd.com/read/28534164/an-evaluation-of-patient-experience-during-percutaneous-breast-biopsy
#1
Jean M Seely, Fraser Hill, Susan Peddle, Jackie Lau
OBJECTIVE: Percutaneous breast biopsy in a tertiary referral high volume breast centre: can we improve the patient experience? PURPOSE: The study was performed to evaluate patient experience during ultrasound-guided (UGB) and vacuum-assisted stereotactic breast biopsy (SBB) and determine what factors could improve the patient experience. METHODS: Consecutive patients who underwent image guided breast biopsy from 01- 05/30, 2015 were approached in a structured telephone interview to evaluate pain and bruising from the procedure...
May 22, 2017: European Radiology
https://www.readbyqxmd.com/read/28508806/telemonitoring-and-medical-care-of-heart-failure-patients-supported-by-left-ventricular-assist-devices-the-medolution-project
#2
Nils Reiss, Thomas Schmidt, Frerk Müller-von Aschwege, Wolfgang Thronicke, Jan-Dirk Hoffmann, Jenny Inge Röbesaat, Ezin Deniz, Andreas Hein, Heiko Krumm, Franz-Josef Stewing, Detlev Willemsen, Jan Dieter Schmitto, Christina Feldmann
Long-term survival after left ventricular assist device (LVAD) implantation in heart failure patients is mainly determined by a sophisticated after-care. Ambulatory visits only take place every 12 weeks. In case of life-threatening complications (pump thrombosis, driveline infection) this might lead to delayed diagnosis and delayed intervention. It is the intention of the international project Medolution (Medical care evolution) to develop new approaches in order to create best structures for telemonitoring of LVAD patients...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28503041/pediatric-end-of-life-care-barriers-and-facilitators-perception-of-nursing-professionals-in-jordan
#3
Omar Mohammad Khraisat, Nemeh Ahmad Alakour, Teresa M O'Neill
INTRODUCTION: End-of-life care is a critical issue for pediatric population with terminal illness to ensure the best possible quality of care for them and their families. A survey was conducted to identify the barriers and facilitators to provide pediatric end-of-life care. METHODS: A descriptive cross-sectional study was conducted at three tertiary centers providing end-of-life care in Jordan. Two hundred critical care nurses were surveyed (response rate 93%). RESULTS: Nurses reported moderate level of experience in all areas of delivering pediatric end-of-life care...
April 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28495351/electronic-health-record-in-the-internal-medicine-clinic-of-a-brazilian-university-hospital-expectations-and-satisfaction-of-physicians-and-patients
#4
Jurandir Godoy Duarte, Raymundo Soares Azevedo
PURPOSE: To evaluate the satisfaction and expectations of patients and physicians before and after the implementation of an electronic health record (EHR) in the outpatient clinic of a university hospital. METHODS: We conducted 389 interviews with patients and 151 with physicians before and after the implementation of a commercial EHR at the internal medicine clinic of Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (HC-FMUSP), Brazil...
June 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28484212/quality-of-analgesia-in-physician-operated-telemedical-prehospital-emergency-care-is-comparable-to-physician-based-prehospital-care-a-retrospective-longitudinal-study
#5
Niklas Lenssen, Andreas Krockauer, Stefan K Beckers, Rolf Rossaint, Frederik Hirsch, Jörg C Brokmann, Sebastian Bergrath
Acute pain is a common reason for summoning emergency medical services (EMS). Yet in several countries the law restricts opioid-based analgesia administration to physicians. Telemedical support of paramedics is a novel approach to enable timely treatment under the guidance of a physician. In this retrospective observational study, conducted in the EMS of Aachen, Germany, the analgesic quality and occurrence of adverse events were compared between telemedically-supported paramedics (July-December, 2014) and a historical control group (conventional on-scene EMS physicians; January-March, 2014)...
May 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28483137/expanded-roles-of-registered-nurses-in-primary-care-delivery-of-the-future
#6
Laurie Bauer, Thomas Bodenheimer
BACKGROUND: Primary care in the United States is changing: practice size is increasing, there is a growing shortage of primary care practitioners, and there is a heightened prevalence of chronic disease. Given these trends, it is likely that registered nurses will become important members of the primary care team. PURPOSE: This paper explores the challenges and opportunities in primary care delivery in the 21st century and examines the likelihood of expanded roles for RNs to improve quality and add capacity to the primary care workforce...
April 7, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28479410/impact-of-undertreatment-of-cancer-pain-with-analgesic-drugs-on-patient-outcomes-a-nationwide-survey-of-outpatient-cancer-patient-care-in-taiwan
#7
Wen-Chi Shen, Jen-Shi Chen, Yu-Yun Shao, Kuan-Der Lee, Tzeon-Jye Chiou, Yung-Chuan Sung, Kun-Ming Rau, Chia-Jui Yen, Yu-Min Liao, Ta-Chih Liu, Ming-Fang Wu, Ming-Yang Lee, Ming-Sun Yu, Wen-Li Hwang, Pang-Yu Lai, Cheng-Shyong Chang, Wen-Chi Chou, Ruey-Kuen Hsieh
CONTEXT: Undertreatment of cancer pain among outpatient cancer patients needs to be addressed to enhance care and improve patients' quality of life. OBJECTIVES: This prospective, cross-sectional, patient-focused study aimed to explore the prevalence of pain and undertreatment of cancer pain in outpatients in Taiwan. METHODS: A total of 2,652 non-selected outpatients with cancer and aged 20 or older from 16 medical centers across Taiwan were included in this survey...
May 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28477307/quality-indicators-in-headache-care-an-implementation-study-in-six-italian-specialist-care-centres
#8
L Pellesi, S Benemei, V Favoni, C Lupi, E Mampreso, A Negro, M Paolucci, T J Steiner, M Ulivi, S Cevoli, S Guerzoni
BACKGROUND: Headache disorders are highly prevalent, and have a substantial and negative impact on health worldwide. They are largely treatable, but differences in structure, objectives, organization and delivery affect the quality of headache care. In order to recognize and remedy deficiencies in care, the Global Campaign against Headache, in collaboration with the European Headache Federation, recently developed a set of quality indicators for headache services. These require further assessment to demonstrate fitness for purpose...
December 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/28469903/transitional-care-management-in-the-outpatient-setting
#9
Analiza Baldonado, Ofelia Hawk, Thomas Ormiston, Danielle Nelson
Patients who are high risk high cost (HRHC), those with severe or multiple medical issues, and the chronically ill elderly are major drivers of rising health care costs.1 The HRHC patients with complex health conditions and functional limitations may likely go to emergency rooms and hospitals, need more supportive services, and use long-term care facilities.2 As a result, these patient populations are vulnerable to fragmented care and "falling through the cracks".2 A large county health and hospital system in California, USA introduced evidence-based interventions in accordance with the Triple AIM3 focused on patient-centered health care, prevention, health maintenance, and safe transitions across the care continuum...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28458524/treatment-approaches-and-adherence-to-urate-lowering-therapy-for-patients-with-gout
#10
REVIEW
Thanda Aung, Gihyun Myung, John D FitzGerald
Gout is the most common inflammatory arthritis characterized by painful disabling acute attacks. It is caused by hyperuricemia and deposition of urate crystals in and around the joints. Long-standing untreated hyperuricemia can lead to chronic arthritis with joint damage, tophi formation and urate nephropathy. Gout is associated with significant morbidity and health care associated cost. The goal of long-term therapy is to lower the serum urate level to promote dissolution of urate crystals, reduce recurrent acute gout flares, resolve tophi and prevent joint damage...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28451013/the-effect-of-group-exercise-frequency-on-health-related-quality-of-life-in-institutionalized-elderly
#11
Nivash Rugbeer, Serela Ramklass, Andrew Mckune, Johan van Heerden
INTRODUCTION: The study aimed to determine the effect of group exercise frequency on health related quality of life in institutionalized elderly. METHODS: One hundred participants were recruited for voluntary participation from five aged care facilities, with inclusion being based on the outcome of a medical assessment by a sports physician. A quasi-experimental design was used to compare the effect of a 12 week group exercise programme on two groups of participants using pre-test and post-test procedures...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28441270/improving-quality-through-clinical-registries-in-urology
#12
Mark D Tyson, Daniel A Barocas
PURPOSE OF REVIEW: In this review, we highlight the use of clinical registries for quality improvement and research purposes in urology. We focus on national and regional clinical database registries, such as the National Surgical Quality Improvement Programme, the Cancer of the Prostate Strategic Urologic Research Endeavor, the Michigan Urological Surgery Improvement collaborative and the American Urological Association Quality Registry programme. RECENT FINDINGS: It is widely known that claims-based and institutional databases are limited in their capacity to provide granular, real-time data for quality improvement purposes...
April 22, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28441226/patient-satisfaction-with-pas-in-the-netherlands
#13
Koos Meijer, Luppo Kuilman
Physician assistants (PAs) were introduced in the Netherlands in 2002 and are now widely deployed. However, little is known about patient satisfaction with Dutch PAs. A comparative study of patient satisfaction was undertaken in the primary care setting. Patients seen by general practitioners (GPs) and PAs were surveyed using the Consumer Quality Index, a European quality survey instrument. Quality of performance indicators included patient satisfaction, effectiveness of treatment, and safety of treatment. The results found that few differences emerged, and Dutch patients appear to be as satisfied with the care received by PAs as with GPs...
May 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28441218/research-on-the-pa-profession-the-medical-model-shifts
#14
Richard W Dehn, Christine M Everett, Roderick S Hooker
Physician assistant (PA)-focused research arose in response to the idea that an assistant to the busy physician could improve healthcare delivery. The process of answering questions about the profession has involved multiple approaches and various scholarly disciplines. In the course of this undertaking, what emerged were three stages of examination of PA behavior. The bibliographic span from this period contains about 2,400 studies that advance some notion of PA benefit to society. On the 50th anniversary of the PA profession, a question arises as to what research has shown...
May 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28440589/prime-movers-advanced-practice-professionals-in-the-role-of-stroke-coordinator
#15
Nicholas A Rattray, Teresa M Damush, Cherie Luckhurst, Catherine J Bauer-Martinez, Barbara J Homoya, Edward J Miech
BACKGROUND AND PURPOSE: Following a stroke quality improvement clustered randomized trial and a national acute ischemic stroke (AIS) directive in the Veterans Health Administration in 2011, this comparative case study examined the role of advanced practice professionals (APPs) in quality improvement activities among stroke teams. METHODS: Semistructured interviews were conducted at 11 Veterans Affairs medical centers annually over a 3-year period. A multidisciplinary team analyzed interviews from clinical providers through a mixed-methods, data matrix approach linking APPs (nurse practitioners and physician assistants) with Consolidated Framework for Implementation Research constructs and a group organization measure...
April 25, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28411323/practice-patterns-for-the-prophylaxis-and-treatment-of-acute-radiation-dermatitis-in-the-united-states
#16
Patricia Lucey, Christos Zouzias, Loren Franco, Sravana K Chennupati, Shalom Kalnicki, Beth N McLellan
PURPOSE: Due to the inconclusive evidence for available treatment options, management of radiation dermatitis (RD) varies among practitioners. This study defines and reviews the current treatment patterns for RD in the USA, providing guidance for practicing physicians as well as directions for future research. METHODS: An online survey of 21 questions was emailed to all 5626 members of the 2013 American Society for Radiation Oncology (ASTRO) directory, which included radiation oncologists, residents, fellows, physician assistants, nurse practitioners, registered nurses and other care providers...
April 14, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28411013/physician-reported-factors-that-encourage-collaboration-with-community-pharmacists
#17
Nicole C Pezzino, Macary Weck Marciniak, Megan G Smith, Stefanie P Ferreri
OBJECTIVE: To determine factors that encourage physicians to establish collaborative practice agreements with community pharmacists. METHODS: A 20-item cross-sectional survey was mailed to a random sample of 1000 family medicine physicians practicing in North Carolina. Two weeks after the initial mailing, a reminder was sent to physicians. Physicians were entered into a drawing to receive a gift card as an incentive for survey completion. The questionnaire collected demographic information, factors important to physicians for collaboration with a community pharmacist, and physician perceptions of pharmacist qualifications...
April 12, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28376461/increased-health-information-technology-adoption-and-use-among-small-primary-care-physician-practices-over-time-a-national-cohort-study
#18
Diane R Rittenhouse, Patricia P Ramsay, Lawrence P Casalino, Sean McClellan, Zosha K Kandel, Stephen M Shortell
PURPOSE: Implementation and meaningful use of health information technology (HIT) has been shown to facilitate delivery system transformation, yet implementation is far from universal. This study examined correlates of greater HIT implementation over time among a national cohort of small primary care practices in the United States. METHODS: We used data from a 40-minute telephone panel survey of 566 small primary care practices having 8 or fewer physicians to investigate adoption and use of HIT in 2007-2010 and 2012-2013...
January 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28327274/physician-extenders-on-surgical-services-a%C3%A2-systematic-review
#19
Jagdeep Johal, Andrew Dodd
BACKGROUND: With the introduction of resident duty hour restrictions and the resulting in-house trainee shortages, a long-term solution to ensure safe and efficient patient care is needed. One solution is the integration of nurse practitioners (NPs) and physician assistants (PAs) in a variety of health care settings. We sought to examine the use of NPs and PAs on surgical/trauma services and their effect on patient outcomes and resident workload. METHODS: We performed a systematic review of EMBASE, Medline, CINAHL, and the Cochrane Central Register of Controlled Trials...
April 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28299815/effects-of-substituting-nurse-practitioners-physician-assistants-or-nurses-for-physicians-concerning-healthcare-for-the-ageing-population-a-systematic-literature-review
#20
REVIEW
Marleen H Lovink, Anke Persoon, Raymond T C M Koopmans, Anneke J A H Van Vught, Lisette Schoonhoven, Miranda G H Laurant
AIMS: To evaluate the effects of substituting nurse practitioners, physician assistants or nurses for physicians in long-term care facilities and primary healthcare for the ageing population (primary aim) and to describe what influences the implementation (secondary aim). BACKGROUND: Healthcare for the ageing population is undergoing major changes and physicians face heavy workloads. A solution to guarantee quality and contain costs might be to substitute nurse practitioners, physician assistants or nurses for physicians...
March 16, 2017: Journal of Advanced Nursing
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