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Physician assistants and quality of care

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https://www.readbyqxmd.com/read/29141664/prevalence-and-prognosis-of-acutely-ill-patients-with-organ-failure-at-arrival-to-hospital-protocol-for-a-systematic-review
#1
Peter Bank Pedersen, Asbjorn Hrobjartsson, Daniel Lykke Nielsen, Daniel Pilsgaard Henriksen, Mikkel Brabrand, Annmarie Touborg Lassen
BACKGROUND: Acutely ill patients are a heterogeneous group, and some of these suffer from organ failure. As the prognosis of organ failure improves with early treatment, it is important to identify these patients as early as possible. Most studies on organ failure have been performed in intensive care settings, or on selected groups of patients, where a high prevalence and mortality have been reported. Before patients arrive to the intensive care unit, or the general ward, most of them have passed through the emergency department (ED), where diagnosis and treatment has been initiated...
November 15, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29138172/framework-for-building-primary-care-capacity-to-address-the-social-determinants-of-health
#2
Andrew D Pinto, Gary Bloch
PROBLEM ADDRESSED: Family physicians have long understood that social factors influence the health of individuals and communities; however, most primary care organizations have yet to develop the capacity to specifically address these social determinants of health (SDOH). OBJECTIVE OF PROGRAM: To support SDOH interventions and foster an organizational culture in which addressing SDOH is considered part of high-quality primary care. PROGRAM DESCRIPTION: An academic family health team in Toronto, Ont, established a committee comprising a diverse group of health professionals focused on the SDOH...
November 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29138153/deprescribing-antihyperglycemic-agents-in-older-persons-evidence-based-clinical-practice-guideline
#3
Barbara Farrell, Cody Black, Wade Thompson, Lisa McCarthy, Carlos Rojas-Fernandez, Heather Lochnan, Salima Shamji, Ross Upshur, Manon Bouchard, Vivian Welch
OBJECTIVE: To develop an evidence-based guideline to help clinicians make decisions about when and how to safely taper, stop, or switch antihyperglycemic agents in older adults. METHODS: We focused on the highest level of evidence available and sought input from primary care professionals in guideline development, review, and endorsement processes. Seven clinicians (2 family physicians, 3 pharmacists, 1 nurse practitioner, and 1 endocrinologist) and a methodologist comprised the overall team; members disclosed conflicts of interest...
November 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29137860/quality-of-anthropometric-measurements-in-spanish-intensive-care-units-the-camies-study
#4
M A García-Martínez, T Cherednichenko, Y Hidalgo Encinas, A I Catalá Espinosa, A Arrascaeta Llanes, J A Acosta Escribano
INTRODUCTION: Real body weight and height are essential data to be obtained in all critically ill patients (CIP), due to their influence in the designing of therapies and monitoring. Visual estimation is a very inaccurate practice. No precise descriptions of anthropometric measurements among CIP are available in the clinical practice guides. OBJECTIVE: To describe anthropometric quality in CIP, health professional perception of such quality, and its influencing factors...
November 11, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29137035/enteral-nutrition-tube-placement-assisted-by-ultrasonography-in-patients-with-severe-acute-pancreatitis-a-novel-method-for-quality-improvement
#5
Gang Li, Yiyuan Pan, Jing Zhou, Zhihui Tong, Lu Ke, Weiqin Li
To evaluate the effect of a novel procedure using real-time ultrasonography to assist nasojejunal tube placement at bedside in patients with severe acute pancreatitis (SAP).Single center, prospective descriptive study in a 15-bed surgery intensive care unit of a university hospital. Thirty SAP patients were enrolled. The whole procedure of placing nasojejunal tube was performed by a single physician, who places nasojejunal tube at the bedside and performs ultrasonography to guide the tube positioning. The final nasojejunal tube position was confirmed by abdominal radiograph...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29129345/defining-value-based-care-in-cardiac-and-vascular-anesthesiology-the-past-present-and-future-of-perioperative-cardiovascular-care
#6
REVIEW
Lavinia M Kolarczyk, Harendra Arora, Michael W Manning, David A Zvara, Robert S Isaak
Health care reimbursement models are transitioning from volume-based to value-based models. Value-based models focus on patient outcomes both during the hospital admission and postdischarge. These models place emphasis on cost, quality of care, and coordination of multidisciplinary services. Perioperative physicians are challenged to evaluate traditional practices to ensure coordinated, cost-effective, and evidence-based care. With the Centers for Medicare and Medicaid Services planned introduction of bundled payments for coronary artery bypass graft surgery, cardiovascular anesthesiologists are financially responsible for postdischarge outcomes...
September 28, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29128038/emergency-physicians-who-produce-higher-relative-value-units-per-hour-spend-similar-amounts-of-time-at-patient-bedsides-as-their-colleagues
#7
Michael Breyer, Heather Farley, Greg Neyman, Wendy Nichols, John Kendall
BACKGROUND: Emergency physicians (EPs) are expected to deliver quality care while maintaining high levels of efficiency and productivity as measured by the relative value unit (RVU). OBJECTIVES: We sought to determine whether academic EPs with higher RVUs spend less time at the bedside than their colleagues. METHODS: This was a prospective, observational, cohort study. A 13-item task list was generated, pilot-tested, and placed onto a computerized tablet...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29079031/neuropsychiatric-symptoms-in-people-with-korsakoff-syndrome-and-other-alcohol-related-cognitive-disorders-living-in-specialized-long-term-care-facilities-prevalence-severity-and-associated-caregiver-distress
#8
Ineke J Gerridzen, Cees M P M Hertogh, Marja F Depla, Ruth B Veenhuizen, Els M L Verschuur, Karlijn J Joling
OBJECTIVES: Caring for people with Korsakoff syndrome (KS) residing in specialized long-term care facilities (LTCFs) can be distressing because of challenging neuropsychiatric symptoms (NPS). However, good-quality studies on NPS in this under-researched population are lacking. This study examined the prevalence and severity of NPS in people with KS living in specialized LTCFs and the associated caregiver distress. DESIGN: Cross-sectional, observational study. Data were obtained using structured interviews with care staff, elderly care physicians, and residents...
October 24, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29066037/end-of-life-care-preferences-in-patients-with-severe-and-persistent-mental-illness-and-chronic-medical-conditions-a-comparative-cross-sectional-study
#9
Dominique Elie, Amanda Marino, Susana G Torres-Platas, Saeid Noohi, Trent Semeniuk, Marilyn Segal, Karl J Looper, Soham Rej
OBJECTIVES: Physicians rarely engage severe and persistent mental illness (SPMI) patients in end-of-life care discussion despite an increased risk of debilitating medical illnesses and mortality. Access to quality palliative care and medical assistance in dying (MAID) has become a priority in Canada and many jurisdictions. In this study, we compared SPMI and chronic medically ill (CMI) patients' end-of-life care preferences and comfort level with end-of-life care discussion, and identified potential predictors of interest in MAID...
September 25, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/29060440/modelling-and-analysis-of-four-telemedicine-italian-experiences
#10
Samanta Rosati, Maddalena Zema, Cristina Castagneri, Fulvio Marchetti, Gabriella Balestra
In the last 10 years the European population aged 65 years and over grew of 2.3%, with Italy having the highest share of elderly persons in the total population. OPLON (OPportunities for active and healthy LONgevity) is a project supported by the Italian Ministry of Education, Universities, and Research aiming to identify and prevent frailty and to improve the life quality of elderly subjects. The main goal of OPLON is to develop a "Care&Cure" model for the management of subjects with different morbidities and co-morbidities, adaptable to the subject's risk level and to the regional contexts...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29033999/reminding-the-health-team-about-what-companions-of-the-patients-undergoing-gynecological-surgery-should-know-a-qualitative-study
#11
Marzieh Hasanpour, Nasrin Galehdar, Ashraf Kazemi, Ahmadreza Zamani
BACKGROUND: Patients' family members often do not receive sufficient information, especially because the reproductive system of women is considered a taboo, providing information becomes problematic. The aim of the current study was to explore the informational-educational needs of companions of the patients who were undergoing gynecological surgery. MATERIALS AND METHODS: This study was conducted using inductive and conventional content analysis method. For data collection, 34 semi-structured in-depth interviews were performed at a gynecology and obstetrics center with purposeful sampling and maximum variation...
September 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/29031492/comprehensive-vs-assisted-management-of-mood-and-pain-symptoms-cammps-trial-study-design-and-sample-characteristics
#12
Kurt Kroenke, Erica Evans, Sharon Weitlauf, Stephanie McCalley, Brian Porter, Tabeel Williams, Fitsum Baye, Spencer G Lourens, Marianne S Matthias, Matthew J Bair
BACKGROUND: Pain is the most common presenting somatic symptom in medical outpatients, and depression and anxiety are the two most common mental disorders. They frequently co-occur, are under-treated, and result in substantial disability and reduced health-related quality of life. OBJECTIVES: The Comprehensive vs. Assisted Management of Mood and Pain Symptoms (CAMMPS) study is a randomized comparative effectiveness trial designed to test the relative effectiveness of a lower-resource vs...
October 12, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28986341/computerized-decision-aids-for-shared-decision-making-in-serious-illness-systematic-review
#13
Anna Staszewska, Pearl Zaki, Joon Lee
BACKGROUND: Shared decision making (SDM) is important in achieving patient-centered care. SDM tools such as decision aids are intended to inform the patient. When used to assist in decision making between treatments, decision aids have been shown to reduce decisional conflict, increase ease of decision making, and increase modification of previous decisions. OBJECTIVE: The purpose of this systematic review is to assess the impact of computerized decision aids on patient-centered outcomes related to SDM for seriously ill patients...
October 6, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28982205/-how-to-become-a-respiratory-therapist-in-germany-status-quo-and-development-prospects
#14
O Karg
The profession respiratory therapist is well established in Germany 10 years after the introduction. 600 participants have successfully graduated from the training facilities.Our goals are high quality interprofessional teamwork and medical assistance inclusive delegation of formerly physician activities. The duties are comparable to the work pattern of Technical Assistants in surgery. For this profession different ways of qualification are possible: primary training, advanced training and academic studies Physician Assistance...
October 5, 2017: Pneumologie
https://www.readbyqxmd.com/read/28980729/barriers-and-facilitators-for-implementation-of-family-medicine-oriented-model-of-primary-care-in-bosnia-and-herzegovina-a-qualitative-study
#15
Maja Racic, Tanja Pekez-Pavlisko, Sandra Jokovic
INTRODUCTION: A health care system reform and the development of a new primary health care model, oriented toward family medicine, have been implemented to improve the quality of health services in Bosnia and Herzegovina. The primary objective of this article was to identify factors that hinder or facilitate implementation of family medicine in the country. METHODS: The qualitative study was performed by focus groups sessions, involving 54 family physicians, selected from 15 geographical regions in Bosnia and Herzegovina...
October 5, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28978488/icu-team-composition-and-its-association-with-abcde-implementation-in-a-quality-collaborative
#16
Deena Kelly Costa, Thomas S Valley, Melissa A Miller, Milisa Manojlovich, Sam R Watson, Phyllis McLellan, Corine Pope, Robert C Hyzy, Theodore J Iwashyna
PURPOSE: Awakening, Breathing Coordination, Delirium, and Early Mobility bundle (ABCDE) should involve an interprofessional team, yet no studies describe what team composition supports implementation. MATERIALS & METHODS: We administered a survey at MHA Keystone Center ICU 2015 workshop. We measured team composition by the frequency of nurse, respiratory therapist, physician, physical therapist, nurse practitioner/physician assistant or nursing assistant involvement in 1) spontaneous awakening trials (SATs), 2) spontaneous breathing trials, 3) delirium and 4) early mobility...
September 28, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28962568/facilitators-of-high-quality-teaching-in-medical-school-findings-from-a-nation-wide-survey-among-clinical-teachers
#17
S Schiekirka-Schwake, S Anders, N von Steinbüchel, J C Becker, T Raupach
BACKGROUND: Clinical teachers in medical schools are faced with the challenging task of delivering high-quality patient care, producing high-impact research and contributing to undergraduate medical education all at the same time. Little is known on the gap between an 'ideal' environment supporting clinical teachers to provide high quality teaching for their students and the reality of clinical teaching during worktime in the clinical environment. Most quantitative research published so far was done in a wide range of medical educators and did not consider individual academic qualifications...
September 29, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28961623/physician-assistant-education-association-past-present-and-future
#18
David P Asprey, Timi Agar Barwick
The Physician Assistant Education Association (PAEA), known as the Association of Physician Assistant Programs (APAP) until 2006, is the professional organization that represents physician assistant (PA) programs in the United States. Its mission is to "pursue excellence, foster faculty development, advance the body of knowledge that defines quality education and patient-centered care, and promote diversity in all aspects of PA education." PAEA has played an important role in promoting and shaping the educational mission of the PA profession...
October 2017: Journal of Physician Assistant Education
https://www.readbyqxmd.com/read/28958803/evaluation-of-an-automated-knowledge-based-textual-summarization-system-for-longitudinal-clinical-data-in-the-intensive-care-domain
#19
Ayelet Goldstein, Yuval Shahar, Efrat Orenbuch, Matan J Cohen
OBJECTIVES: To examine the feasibility of the automated creation of meaningful free-text summaries of longitudinal clinical records, using a new general methodology that we had recently developed; and to assess the potential benefits to the clinical decision-making process of using such a method to generate draft letters that can be further manually enhanced by clinicians. METHODS: We had previously developed a system, CliniText (CTXT), for automated summarization in free text of longitudinal medical records, using a clinical knowledge base...
October 2017: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/28926751/collaboration-of-midwives-in-primary-care-midwifery-practices-with-other-maternity-care-providers
#20
J Catja Warmelink, Therese A Wiegers, T Paul de Cock, Trudy Klomp, Eileen K Hutton
BACKGROUND: Inter-professional collaboration is considered essential in effective maternity care. National projects are being undertaken to enhance inter-professional relationships and improve communication between all maternity care providers in order to improve the quality of maternity care in the Netherlands. However, little is known about primary care midwives' satisfaction with collaboration with other maternity care providers, such as general practitioners, maternity care assistance organisations (MCAO), maternity care assistants (MCA), obstetricians, clinical midwives and paediatricians...
September 6, 2017: Midwifery
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