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Physician assistants and quality of care

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https://www.readbyqxmd.com/read/28441270/improving-quality-through-clinical-registries-in-urology
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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-aging-population-a-systematic-literature-review
#9
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 aging population (primary aim) and to describe what influences the implementation (secondary aim). BACKGROUND: Healthcare for the aging 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
https://www.readbyqxmd.com/read/28296974/joint-analyses-of-open-comments-and-quantitative-data-added-value-in-a-job-satisfaction-survey-of-hospital-professionals
#10
Ingrid Gilles, Mauro Mayer, Nelly Courvoisier, Isabelle Peytremann-Bridevaux
OBJECTIVE: To obtain a comprehensive understanding of the job opinions of hospital professionals by conducting qualitative analyses of the open comments included in a job satisfaction survey and combining these results with the quantitative results. DESIGN: A cross-sectional survey targeting all Lausanne University Hospital professionals was performed in the fall of 2013. MATERIAL AND METHODS: The survey considered ten job satisfaction dimensions (e...
2017: PloS One
https://www.readbyqxmd.com/read/28256999/characteristics-of-primary-care-physicians-in-patient-centered-medical-home-practices-united-states-2013
#11
Esther Hing, Ellen Kurtzman, Denys T Lau, Caroline Taplin, Andrew B Bindman
Objective-This report describes the characteristics of primary care physicians in patient-centered medical home (PCMH) practices and compares these characteristics with those of primary care physicians in non-PCMH practices. Methods-The data presented in this report were collected during the induction interview for the 2013 National Ambulatory Medical Care Survey, a national probability sample survey of nonfederal physicians who see patients in office settings in the United States. Analyses exclude anesthesiologists, radiologists, pathologists, and physicians in community health centers...
February 2017: National Health Statistics Reports
https://www.readbyqxmd.com/read/28242768/american-orthopaedic-foot-and-ankle-society-aofas-ankle-hindfoot-score-a-study-protocol-for-the-translation-and-validation-of-the-dutch-language-version
#12
Esther M M Van Lieshout, A Siebe De Boer, Duncan E Meuffels, P Ted Den Hoed, Cornelis H Van der Vlies, Wim E Tuinebreijer, Michael H J Verhofstad
INTRODUCTION: The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score is among the most commonly used instruments for measuring the outcome of treatment in patients who sustained a complex ankle or hindfoot injury. It combines a clinician-reported and a patient-reported part. A valid Dutch version of this instrument is currently not available. Such a translated and validated instrument would allow objective comparison across hospitals or between patient groups, and with shown validity and reliability it may become a quality of care indicator in future...
February 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28238229/suspecting-non-cystic-fibrosis-bronchiectasis-what-the-busy-primary-care-clinician-needs-to-know
#13
REVIEW
Diego J Maselli, Bravein Amalakuhan, Holly Keyt, Alejandro A Diaz
AIMS: Non-cystic fibrosis bronchiectasis (NCFB) is a chronic, progressive respiratory disorder characterised by irreversibly and abnormally dilated airways, persistent cough, excessive sputum production and recurrent pulmonary infections. In the last several decades, its prevalence has increased, making it likely to be encountered in the primary care setting. The aim was to review the clinical presentation and diagnosis of NCFB, with an emphasis on the role of computed tomography (CT)...
February 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28230456/off-label-prescribing-for-children-with-migraines-in-u-s-ambulatory-care-settings
#14
L Leanne Lai, Leroy Koh, Jane Ai-Chen Ho, Alexander Ting, Augustine Obi
BACKGROUND: Migraines, Which Affect About 10% Of School-Age Children In The United States, Can Significantly Impair Quality Of Life. Despite Potential Disability, Many Children Do Not Receive Treatment Or Prophylaxis, Since Medications Specifically Approved For Children Are Significantly Less Than For Adults. There Is Also Controversy Surrounding The Apparent Widespread Practice Of Prescribing Off-Label Medications For Children With Migraines. However, Little Research Has Been Done To Identify Physician-Prescribing Patterns Of Migraine Medication For Children...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28223153/evaluations-of-implementation-at-early-adopting-lung-cancer-screening-programs-lessons-learned
#15
Yaron B Gesthalter, Elisa Koppelman, Rendelle Bolton, Christopher G Slatore, Sue H Yoon, Hilary C Cain, Nichole T Tanner, David H Au, Jack A Clark, Renda Soylemez Wiener
BACKGROUND: Guidelines recommend lung cancer screening and it is currently being adopted nationwide. The American College of Chest Physicians advises inclusion of specific programmatic components to ensure high-quality screening. However, little is known about how lung cancer screening has been implemented in practice. We sought to evaluate the experience of early-adopting programs, characterize barriers faced, and identify strategies to achieve successful implementation. METHODS: We performed qualitative evaluations of lung cancer screening implementation at three Veterans Health Administration facilities, conducting semi-structured interviews with key staff (n=29)...
February 18, 2017: Chest
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#16
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28222471/telemedizin-potenziale-in-der-notfallmedizin
#17
REVIEW
Jörg C Brokmann, Marc Felzen, Stefan K Beckers, Michael Czaplik, Frederik Hirsch, Sebastian Bergrath, Rolf Rossaint
The telemedical support and networking between health personnel and medical specialists increases the quality of supply also in the prehospital emergency care. Till now only for some tracer diagnosis specifically designed telemedical services were used. However, now a unique holistic telemedicine system, which can be used for the whole emergency spectrum as a supplementary feature has been developed. It can be used for the whole prehospital emergency care. The needfulness and meaningfulness of telemedicine as well as the important structural characteristics in prehospital emergency care are pictured...
February 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28216856/feasibility-and-acceptability-of-implementing-the-integrated-care-plan-for-the-dying-in-the-indian-setting-survey-of-perspectives-of-indian-palliative-care-providers
#18
Naveen Salins, Jeremy Johnson, Stanley Macaden
INTRODUCTION: Capacity to provide end-of-life care in India is scored as 0.6/100, and very few people in India have access to palliative and end-of-life care. Lack of end-of-life care provision in India has led to a significant number of people receiving inappropriate medical treatment at the end of life, with no access to pain and symptom control and high treatment costs. The International Collaborative for the Best Care for the Dying Person is an initiative that offers the opportunity to apply international evidence on the key factors required to provide best care for the dying in the Indian context...
January 2017: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/28173766/factors-influencing-decision-of-general-practitioners-and-managers-to-train-and-employ-a-nurse-practitioner-or-physician-assistant-in-primary-care-a-qualitative-study
#19
Mieke van der Biezen, Emmy Derckx, Michel Wensing, Miranda Laurant
BACKGROUND: Due to the increasing demand on primary care, it is not only debated whether there are enough general practitioners (GPs) to comply with these demands but also whether specific tasks can be performed by other care providers. Although changing the workforce skill mix care by employing Physician Assistants (PAs) and Nurse Practitioners (NPs) has proven to be both effective and safe, the implementation of those professionals differs widely between and within countries. To support policy making regarding PAs/NPs in primary care, the aim of this study is to provide insight into factors influencing the decision of GPs and managers to train and employ a PA/NP within their organisation...
February 7, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28156525/feasibility-of-a-physician-extender-approach-to-increase-advance-care-planning-uptake
#20
Cynthia Fanning
8 Background: Advanced care planning (ACP) for people with life-limiting cancer has been associated with improved patient quality of life and care more consistent with patient wishes. Nevertheless, even though approximately 70% of patients with a life-limiting illness will require the substituted judgment of a proxy, fewer than 25% of patients have documented goals of care. This poor uptake has been attributed to limits in physician time and ACP training. The current study evaluated the feasibility of utilizing a physician-extender trained in ACP best practices to overcome these barriers and improve ACP uptake...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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