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Physician assistants and quality of care

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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
#1
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
#2
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
https://www.readbyqxmd.com/read/28156436/effect-of-edmonton-symptom-assessment-scale-esas-on-symptom-data-collection-in-a-radiation-oncology-department
#3
Puja Venkat, Michael Yu
: 83 Background: ESAS has been used to examine quality of life and symptom burden of patients undergoing cancer treatment. The purpose of this study is to examine attitudes towards ESAS among patients in a Radiation Oncology clinic in conjunction with the perspective of cancer care professionals, to establish ideal implementation of this tool to improve patient care. METHODS: Routine use of ESAS in a single Radiation Oncology Department was initiated in July 2015...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152973/multidisciplinary-process-improvement-to-optimize-oral-chemotherapy-safety
#4
Kerin B Adelson, Monica Fradkin, Renee Havriliak, Michelle Renee Harrison, Osama Abdelghany, Stephanie Kregling, Jessica Wright, Bret Morrow, Roberta Sterling, Mandeep Smith, Frank Esposito, Martha Stutsky, LeeAnn Miller, Rogerio Lilenbaum, Catherine A Lyons, Anne C Chiang, Howard Cohen
: 134 Background: The rapid development of oral chemotherapy agents brings unique challenges. These drugs must be treated with the same vigilance as parenteral chemotherapy. The oral chemotherapy system is not optimized or integrated across our hospital. A quality assessment survey identified the need for a better means to monitor and improve oral chemotherapy patient outcomes. METHODS: Patient and staff satisfaction with the current process was measured. A chartered multidisciplinary task force reviewed existing practice and developed a program to identify patients, ensure drug access, standardize prescription and consent, ensure on-going clinical support including patient education, regimen specific adherence monitoring, toxicity assessment and address patient concerns...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152683/hiv-testing-in-a-cancer-center-emergency-department
#5
Kelly W Merriman, Zeena Shelal, Hadil Bazerbashi, Patricia A Brock, Carmen E Gonzalez, Harrys A Torres, Terry Rice
: 225 Background: HIV is a cancer-associated virus classically associated with KS, NHL, and cervical cancer, but more recently with anal cancer, lung, and head and neck cancers. HIV testing and treatment are important for cancer patients for three reasons: 1) HIV treatment is associated with reduced transmission of a cancer-associated virus. 2) HIV treatment is associated with improved outcomes of cancer therapy in many cancers. 3) HIV testing optimizes quality of care, since testing is recommended by the Centers for Disease Control and Prevention (CDC) and the US Preventive Services Task Force (USPSTF)(A level recommendation) for patients between the ages of 15 and 65 years of age...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28145766/an-official-american-thoracic-society-systematic-review-the-effect-of-nighttime-intensivist-staffing-on-mortality-and-length-of-stay-among-intensive-care-unit-patients
#6
Meeta Prasad Kerlin, Neill K J Adhikari, Louise Rose, M Elizabeth Wilcox, Cassandra J Bellamy, Deena Kelly Costa, Hayley B Gershengorn, Scott D Halpern, Jeremy M Kahn, Meghan B Lane-Fall, David J Wallace, Curtis H Weiss, Hannah Wunsch, Colin R Cooke
BACKGROUND: Studies of nighttime intensivist staffing have yielded mixed results. GOALS: To review the association of nighttime intensivist staffing with outcomes of intensive care unit (ICU) patients. METHODS: We searched five databases (2000-2016) for studies comparing in-hospital nighttime intensivist staffing with other nighttime staffing models in adult ICUs and reporting mortality or length of stay. We abstracted data on staffing models, outcomes, and study characteristics and assessed study quality, using standardized tools...
February 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28125369/payer-perspectives-on-patient-reported-outcomes-in-health-care-decision-making-oncology-examples
#7
Andrew P Brogan, Carla DeMuro, Amy M Barrett, Denise D'Alessio, Vasudha Bal, Susan L Hogue
BACKGROUND: Health authorities and payers increasingly recognize the importance of patient perspectives and patient-reported outcomes (PROs) in health care decision making. However, given the broad variety of PRO endpoints included in clinical programs and variations in the timing of PRO data collection and country-specific needs, the role of PRO data in reimbursement decisions requires characterization. OBJECTIVES: To (a) determine the effect of PRO data on market access and reimbursement decisions for oncology products in multiple markets and (b) assess the effect of PRO data collected after clinical progression on payer decision making...
February 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28112634/guideline-gov-a-database-of-clinical-specialty-guidelines
#8
Yamila M El-Khayat, Carrie S Forbes, Jeffrey G Coghill
The National Guidelines Clearinghouse (NGC), also known as Guideline.gov, is a database of resources to assist health care providers with a central depository of guidelines for clinical specialty areas in medicine. The database is provided free of charge and is sponsored by the U.S. Department of Health and Human Services and the Agency for Healthcare Research and Quality. The guidelines for treatment are updated regularly, with new guidelines replacing older guidelines every five years. There are hundreds of current guidelines with more added each week...
January 2017: Medical Reference Services Quarterly
https://www.readbyqxmd.com/read/28105542/hospice-in-heart-failure-why-when-and-what-then
#9
Jeffrey L Spiess
Hospice is a model of care for patients nearing the end of their lives that emphasizes symptom management, quality of life (QOL), and support of the patient and caregiving family through the death of the patient and the family's bereavement. It is associated with high patient and caregiver satisfaction and appears to not shorten lifespan for appropriately referred patients. Patients with advanced heart failure are being referred to hospice care more often than in the past, but the majority of deaths occur without this benefit...
January 20, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28096482/chronic-disease-management-interventions-for-people-with-chronic-kidney-disease-in-primary-care-a-systematic-review-and-meta-analysis
#10
Lauren Galbraith, Casey Jacobs, Brenda R Hemmelgarn, Maoliosa Donald, Braden Manns, Min Jun
BACKGROUND: Primary care providers manage the majority of patients with chronic kidney disease (CKD), although the most effective chronic disease management (CDM) strategies for these patients are unknown. We assessed the efficacy of CDM interventions used by primary care providers managing patients with CKD. METHODS: MEDLINE, EMBASE and CENTRAL were systematically searched (inception to November 2014) for randomized controlled trials (RCTs) assessing education-based and computer-assisted CDM interventions targeting primary care providers managing patients with CKD in the community...
January 16, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28048404/we-h-201-03-enthusiasm-and-generosity-of-spirit-necessitate-a-volunteering-structure-to-make-them-more-meaningful
#11
Y Pipman
: The desperate need for radiotherapy in low and mid-income countries (LMICs) has been well documented. Roughly 60 % of the worldwide incidence of cancer occurs in these resource-limited settings and the international community alongside governmental and non-profit agencies have begun publishing reports and seeking help from qualified volunteers. However, the focus of several reports has been on how dire the situation is and the magnitude of the problem, leaving most to feel overwhelmed and unsure as to how to help and why to get involved...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047760/we-h-201-04-models-for-developing-medical-physics-educators-and-education-programs-in-the-developing-countries-and-the-potential-role-of-us-universities-and-individual-medical-physicists
#12
P Sprawls
: The desperate need for radiotherapy in low and mid-income countries (LMICs) has been well documented. Roughly 60 % of the worldwide incidence of cancer occurs in these resource-limited settings and the international community alongside governmental and non-profit agencies have begun publishing reports and seeking help from qualified volunteers. However, the focus of several reports has been on how dire the situation is and the magnitude of the problem, leaving most to feel overwhelmed and unsure as to how to help and why to get involved...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047637/we-h-201-00-opportunities-for-physicists-to-support-low-and-mid-income-countries
#13
Julianne Pollard
: The desperate need for radiotherapy in low and mid-income countries (LMICs) has been well documented. Roughly 60 % of the worldwide incidence of cancer occurs in these resource-limited settings and the international community alongside governmental and non-profit agencies have begun publishing reports and seeking help from qualified volunteers. However, the focus of several reports has been on how dire the situation is and the magnitude of the problem, leaving most to feel overwhelmed and unsure as to how to help and why to get involved...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046986/we-h-201-01-the-opportunities-and-benefits-of-helping-lmics-how-helping-them-can-help-you
#14
J Pollard
: The desperate need for radiotherapy in low and mid-income countries (LMICs) has been well documented. Roughly 60 % of the worldwide incidence of cancer occurs in these resource-limited settings and the international community alongside governmental and non-profit agencies have begun publishing reports and seeking help from qualified volunteers. However, the focus of several reports has been on how dire the situation is and the magnitude of the problem, leaving most to feel overwhelmed and unsure as to how to help and why to get involved...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046328/we-h-201-02-emerging-models-and-opportunities-in-global-health-for-medical-physicists-powered-by-information-and-communication-technologies
#15
W Ngwa
: The desperate need for radiotherapy in low and mid-income countries (LMICs) has been well documented. Roughly 60 % of the worldwide incidence of cancer occurs in these resource-limited settings and the international community alongside governmental and non-profit agencies have begun publishing reports and seeking help from qualified volunteers. However, the focus of several reports has been on how dire the situation is and the magnitude of the problem, leaving most to feel overwhelmed and unsure as to how to help and why to get involved...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28041774/the-effects-of-expanded-nurse-practitioner-and-physician-assistant-scope-of-practice-on-the-cost-of-medicaid-patient-care
#16
Edward Joseph Timmons
The provision of health care to low-income Americans remains an ongoing policy challenge. In this paper, I examine how important changes to occupational licensing laws for nurse practitioners and physician assistants have affected cost and intensity of health care for Medicaid patients. The results suggest that allowing physician assistants to prescribe controlled substances is associated with a substantial (more than 11%) reduction in the dollar amount of outpatient claims per Medicaid recipient. I find little evidence that expanded scope of practice has affected proxies for care intensity such as total claims and total care days...
February 2017: Health Policy
https://www.readbyqxmd.com/read/28024923/management-and-follow-up-of-the-male-with-lower-urinary-tract-symptoms-secondary-to-benign-prostate-hyperplasia
#17
J Castiñeiras, J M Cózar, B Miñana, F J Brenes, F Brotons, A Fernández-Pro, J A Martín, Mª L Martínez-Berganza, J M Molero
Benign prostate hyperplasia (BPH) is a high-incidence pathology. Its diagnosis and treatment is shared between urologists and Primary Care physicians. Its management consumes a huge amount of resources. The the Spanish Association of Urology [AEU], Spanish Society of Primary Care Physicians [SEMERGEN], the Spanish Society of General Practitioners and Family Doctors [SEMG] and the Spanish Society of Family and Community Medicine [semFYC] have prepared a document on management and monitoring of BPH, in which the aim is to incorporate the latest evidence to so as to update the previously published guidelines and which are presented here in condensed form...
December 23, 2016: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28002309/committee-opinion-no-683-behavior-that-undermines-a-culture-of-safety
#18
(no author information available yet)
A key element of an organizational safety culture is maintaining an environment of professionalism that encourages communication and promotes high-quality care. Behavior that undermines a culture of safety, including disruptive or intimidating behavior, has a negative effect on the quality and safety of patient care. Intimidating behavior and disruptive behavior are unprofessional and should not be tolerated. Confronting disruptive individuals is difficult. Co-workers often are reluctant to report disruptive behavior because of fear of retaliation and the stigma associated with "blowing the whistle" on a colleague...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28002304/committee-opinion-no-683-summary-behavior-that-undermines-a-culture-of-safety
#19
(no author information available yet)
A key element of an organizational safety culture is maintaining an environment of professionalism that encourages communication and promotes high-quality care. Behavior that undermines a culture of safety, including disruptive or intimidating behavior, has a negative effect on the quality and safety of patient care. Intimidating behavior and disruptive behavior are unprofessional and should not be tolerated. Confronting disruptive individuals is difficult. Co-workers often are reluctant to report disruptive behavior because of fear of retaliation and the stigma associated with "blowing the whistle" on a colleague...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27926687/an-initiative-to-standardize-the-identification-of-and-acute-response-to-postoperative-lower-extremity-neurological-deficits-effects-on-provider-knowledge-confidence-and-communication-skills
#20
Peter B Derman, Sravisht Iyer, Matthew Garner, Steven Orr, Karla J Felix, Allison Goldberg, Titilayo Ologhobo, Minlun Wu, Laura Robbins, Charles Cornell
BACKGROUND: Although relatively uncommon, neurological deficits following hip and knee arthroplasty can have permanent and debilitating consequences. This study was conducted to quantify the effectiveness of an educational curriculum aimed at standardizing the identification of and acute response to postoperative neurological deficits in the inpatient setting, specifically with respect to improvements in clinician knowledge, confidence levels, and communication skills. METHODS: A multidisciplinary committee at a single, high-volume academic institution created an algorithm delineating the appropriate clinical actions and escalation procedures in the setting of a postoperative neurological deficit for each clinical practitioner involved in care for patients who undergo arthroplasty...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
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