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integrated health care delivery

Megan Quinn, Sheila Gephart
BACKGROUND: Palliative care is a holistic framework that is designed to improve quality of life by identifying and treating distressing symptoms of life-threatening or complex conditions. Neonatal palliative care (NPC) has potential benefits for parents, staff, and patients, yet evidence suggests that implementation and utilization of organized NPC services are low. PURPOSE: The purpose of this study is to answer the clinical question: In neonatal intensive care, what evidence can be used to guide implementation of palliative care protocols? SEARCH STRATEGY: A literature search was conducted using CINAHL (Cumulative Index of Nursing and Allied Health Literature), PubMed, and the Cochrane Library databases...
October 22, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Claudia Chaufan, Andrew J Karter, Howard H Moffet, Judy Quan, Melissa M Parker, Jenna Kruger, Dean Schillinger, Alicia Fernandez
OBJECTIVES: Language barriers negatively impact health care access and quality for US immigrants. Latinos are the second largest immigrant group and the largest, fastest growing minority. Health care systems need simple, low cost and accurate tools that they can use to identify physicians with Spanish language competence. We sought to address this need by validating a simple and low-cost tool already in use in a major health plan. DESIGN SETTING PARTICIPANTS: A web-based survey conducted in 2012 among physicians caring for patients in a large, integrated health care delivery system...
October 20, 2016: Ethnicity & Disease
Prem N Ramkumar, Ton La, Evan Fisch, Peter D Fabricant, Alexander E White, Kristofer J Jones, Samuel A Taylor
PURPOSE: The purpose of this observational study of social media in sports medicine was to investigate and analyze the presence and shared content of anterior cruciate ligament (ACL) patients, sports surgeons, and top orthopaedic hospitals on popular social media streams. METHODS: A search of 2 public domains (Instagram and Twitter) was performed over a 6-month period. ACL surgery ("#aclsurgery") was selected for the Instagram-based patient analysis after exclusion of veterinary ACL operations...
October 19, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Magdalena M Sakowska, Megan V Thomas, Saxon Connor, Ross Roberts
BACKGROUND: In measuring quality of health-care delivery, digital infrastructure is essential. The aim at this tertiary centre was to create a hospital-wide workflow system that collected data prospectively as part of daily practice. METHODS: In moving towards an electronic health record, a hospital-wide integrated workflow system was introduced in 2013, which electronically managed the perioperative patient journey while simultaneously facilitating surgical audit...
October 21, 2016: ANZ Journal of Surgery
Caitlin McConnico, Suzanne L Jed, Eva Marumo, Sipho Mazibuko, Gladys Makati Mema, Julia DeKadt, King K Holmes, Pamela K Kohler
Sexually transmitted infection (STI) service delivery in the context of integrated care and the South African HIV epidemic is complex. We aimed to document STI care and HIV testing processes in public health clinics in South Africa, revealing bottlenecks to patient flow and identifying opportunities for improvement. Clinic mapping, with semi-structured interviews and clinic observation, was conducted with facility representatives at three clinical sentinel surveillance sites. Facility surveys assessed patient volume and staffing...
September 17, 2016: Journal of the Association of Nurses in AIDS Care: JANAC
Rena Zendedel, Barbara C Schouten, Julia C M van Weert, Bas van den Putte
OBJECTIVE: To explore the perspective of Turkish-Dutch general practitioner (GP) patients on informal interpreting from an integrated theory base, focusing on interpreters' roles, trust and power. DESIGN: Semi-structured in depth interviews were conducted with 21 first-generation Turkish-Dutch migrant patients who made use of informal interpreters to communicate with their GPs. An interview guide was designed based on the theoretical framework of interpreter's roles, trust and power, covering questions about interpreters' role, trust in informal/professional interpreters and power division in the medical consultation...
October 21, 2016: Ethnicity & Health
Martin Kuete, HongFang Yuan, Aude Laure Tchoua Kemayou, Emmanuel Ancel Songo, Fan Yang, XiuLan Ma, ChengLiang Xiong, HuiPing Zhang
BACKGROUND: Integration of family planning services (FPS) into human immunodeficiency virus (HIV) care for HIV-infected women is an important aspect of the global prevention of mother-to-child transmission (PMTCT) strategy. We assessed the integration of FPS into routine care of HIV-infected mothers by evaluating the uptake and barriers of contraception and PMTCT services. METHODS: We conducted an interventional study using the interrupted time series approach in the health care facilities located in Yaounde, Cameroon...
2016: Patient Preference and Adherence
Michael Popovich, Brandy Altstadter, Lara Hargraves Popovich, B S Biology
The Health Information Technology for Economic and Clinical Health (HITECH) Act encourages health information exchange between clinical care and public health through Meaningful Use measures. Meaningful Use specifically identifies objectives to support a number of public health programs including immunizations, cancer registries, syndromic surveillance, and disease case reports. The objective is to improve public and population health. Stage 2 of Meaningful Use focused on compliance to sending of information to public health...
2016: Online Journal of Public Health Informatics
Tiffany Y Peng, Samantha F Ehrlich, Yvonne Crites, John L Kitzmiller, Michael W Kuzniewicz, Monique H Hedderson, Assiamira Ferrara
BACKGROUND: Despite concern for adverse perinatal outcomes in women with diabetes prior to pregnancy, recent data on the prevalence of pregestational type 1 and type 2 diabetes in the U.S. are lacking. OBJECTIVE: To estimate changes in the prevalence of overall pregestational diabetes (all types) and pregestational type 1 and type 2 diabetes, and whether changes varied by race-ethnicity between 1996 and 2014. STUDY DESIGN: Cohort study conducted among 655,428 pregnancies at a Northern California integrated health delivery system in 1996-2014...
October 14, 2016: American Journal of Obstetrics and Gynecology
Christian Young, Allison Tong, Hasantha Gunasekera, Simone Sherriff, Deanna Kalucy, Peter Fernando, Jonathan C Craig
AIM: To describe the perspectives of health professionals and communities on an innovative health service delivery project, Hearing EAr health and Language Services (HEALS). HEALS was a government funded initiative to improve access to specialist ear, nose and throat and speech pathology services for Aboriginal families living in metropolitan areas. METHODS: Semi-structured interviews were conducted with 21 health-care professionals (clinicians, health service managers and Aboriginal health workers) and 16 care givers of children who participated in HEALS...
October 17, 2016: Journal of Paediatrics and Child Health
Chun Chao, Michael J Silverberg, Tracy A Becerra, Douglas A Corley, Christopher D Jensen, Qiaoling Chen, Virginia P Quinn
BACKGROUND: Human papillomavirus vaccination may result in lowered intention to be screened for cervical cancer, potentially leading to gaps in screening coverage and avoidable cervical cancer diagnoses. OBJECTIVE: To examine the association between human papillomavirus vaccination and subsequent cervical cancer screening initiation and adherence to recommended screening intervals to detect gaps in screening coverage and inform future prevention efforts. STUDY DESIGN: A retrospective cohort study was conducted in two distinct cohorts of female members of Kaiser Permanente Southern California, a large integrated healthcare delivery system...
October 13, 2016: American Journal of Obstetrics and Gynecology
Doyanne Darnell, Stephen O'Connor, Amy Wagner, Joan Russo, Jin Wang, Leah Ingraham, Kirsten Sandgren, Douglas Zatzick
OBJECTIVE: Injured patients presenting to acute care medical settings have high rates of posttraumatic stress disorder (PTSD) and comorbidities, such as depression and substance use disorders. Integrating behavioral interventions that target symptoms of PTSD and comorbidities into the acute care setting can overcome common barriers to obtaining mental health care. This study examined the feasibility and acceptability of embedding elements of cognitive-behavioral therapy (CBT) in the delivery of routine postinjury care management...
October 17, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Shaun K Morris, Lisa G Pell, Mohammed Ziaur Rahman, Michelle C Dimitris, Abdullah Mahmud, M Munirul Islam, Tahmeed Ahmed, Eleanor Pullenayegum, Tahmid Kashem, Shaila S Shanta, Jonathan Gubbay, Eszter Papp, Michelle Science, Stanley Zlotkin, Daniel E Roth
BACKGROUND: Early infancy is a high-risk period for severe acute respiratory infection (ARI), particularly in low-income countries with resource-limited health systems. Lower respiratory tract infection (LRTI) is commonly preceded by upper respiratory infection (URTI), and often caused by respiratory syncytial virus (RSV), influenza and other common community-acquired viral pathogens. Vitamin D status is a candidate modifiable early-life determinant of the host antiviral immune response and thus may influence the risk of ARI-associated morbidity in high-risk populations...
October 13, 2016: BMC Pregnancy and Childbirth
Sheila Cyril, Julie Green, Jan M Nicholson, Kingsley Agho, Andre M N Renzaho
BACKGROUND: Childhood obesity rates have been increasing disproportionately among disadvantaged communities including culturally and linguistically diverse (CALD) migrant groups in Australia due to their poor participation in the available obesity prevention initiatives. We sought to explore service providers' perceptions of the key factors influencing the participation of CALD communities in the existing obesity prevention services and the service requirements needed to improve CALD communities' participation in these services...
2016: PloS One
Heidi Williamson, Nichola Rumsey
An altered appearance can impact on the psychosocial well-being of adolescent cancer patients, yet patient reports imply a dearth of appearance-related support. Using a two-phase qualitatively driven mixed methods design, 62 health professionals from a range of UK oncology care settings, provided data relating to their views of the impact of appearance changes on adolescent patients (aged 12-18 years), of delivering appearance-related care, and their training needs. Integrated findings were divided into two main outcomes...
October 13, 2016: Journal of Psychosocial Oncology
C R Macchi, Rodger Kessler, Andrea Auxier, Juvena R Hitt, Daniel Mullin, Constance van Eeghen, Benjamin Littenberg
Insufficient knowledge exists regarding how to measure the presence and degree of integrated care. Prior estimates of integration levels are neither grounded in theory nor psychometrically validated. They provide scant guidance to inform improvement activities, compare integration efforts, discriminate among practices by degree of integration, measure the effect of integration on quadruple aim outcomes, or address the needs of clinicians, regulators, and policymakers seeking new models of health care delivery and funding...
October 13, 2016: Families, Systems & Health: the Journal of Collaborative Family Healthcare
Wendy Shulver, Maggie Killington, Maria Crotty
BACKGROUND: Telehealth technologies, which enable delivery of healthcare services at distance, offer promise for responding to the challenges created by an ageing population. However, successful implementation of telehealth into mainstream healthcare systems has been slow and fraught with failure. Understanding of frontline providers' experiences and attitudes regarding telehealth is a crucial aspect of successful implementation. This study aims to examine healthcare worker views on telehealth, and their implications for implementation to mainstream healthcare services for older people...
October 12, 2016: BMC Medical Informatics and Decision Making
Xin Wang, Stephen Birch, Weiming Zhu, Huifen Ma, Mark Embrett, Qingyue Meng
BACKGROUND: Increases in health care utilization and costs, resulting from the rising prevalence of chronic conditions related to the aging population, is exacerbated by a high level of fragmentation that characterizes health care systems in China. There have been several pilot studies in China, aimed at system-level care coordination and its impact on the full integration of health care system, but little is known about their practical effects. Huangzhong County is one of the pilot study sites that introduced organizational integration (a dimension of integrated care) among health care institutions as a means to improve system-level care coordination...
October 12, 2016: BMC Health Services Research
(no author information available yet)
This final rule will revise the requirements that Long-Term Care facilities must meet to participate in the Medicare and Medicaid programs. These changes are necessary to reflect the substantial advances that have been made over the past several years in the theory and practice of service delivery and safety. These revisions are also an integral part of our efforts to achieve broad-based improvements both in the quality of health care furnished through federal programs, and in patient safety, while at the same time reducing procedural burdens on providers...
October 4, 2016: Federal Register
William H Gruber, Adam C Powell, John B Torous
Historically, the process of scientific discovery and the process of clinical delivery have been poorly integrated. As a result of the Decade of Health Information Technology (2004-2014), many of the former barriers to capturing, processing, and retrieving medical information at the point of care have been surmounted. This change has the potential to both transform how new medical discoveries are made and how evidence-based medicine is put into practice. To illustrate the impact of this ongoing change, several examples are provided of institutions which have innovatively used information at the point of care...
October 6, 2016: Healthcare
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