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Quality of physician care

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https://www.readbyqxmd.com/read/29334347/methods-to-describe-referral-patterns-in-a-canadian-primary-care-electronic-medical-record-database-modelling-multilevel-count-data
#1
Bridget L Ryan, Joshua Shadd, Heather Maddocks, Moira Stewart, Amardeep Thind, Amanda L Terry
  A referral from a family physician (FP) to a specialist is an inflection point in the patient journey, with potential implications for clinical outcomes and health policy. Primary care electronic medical record (EMR) databases offer opportunities to examine referral patterns. Until recently, software techniques were not available to model these kinds of multi-level count data. OBJECTIVE:  To establish methodology for determining referral rates from FPs to medical specialists using the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) EMR database...
November 17, 2017: Journal of Innovation in Health Informatics
https://www.readbyqxmd.com/read/29334301/navigating-social-distance-in-foundational-clinical-encounters-understanding-medical-students-early-experiences-with-diverse-patients
#2
Miesha Roberts-MacDonald, Saleem Razack
BACKGROUND: Social distance between patients and physicians has been shown to affect the quality of care that patients receive. Little is known about how social distance between students and patients is experienced by learners during early clinical exposures in medical school. OBJECTIVE: This study aims to explore students' stories of experiencing social distance with patients with concordant and discordant social characteristics as themselves, respectively, as well as students' needs from medical curricula regarding developing social competence...
January 15, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29334251/discussing-edaravone-with-the-als-patient-an-ethical-framework-from-a-u-s-perspective
#3
Crystal Jing Jing Yeo, Zachary Simmons
The recent approval of edaravone by the United States Food and Drug Administration has generated a mix of hope tempered by reality. The costs of the drug, both monetarily and with regard to intensity of treatment, are high. The benefits, while modest, will be viewed through a very different lens by individuals depending on their goals of care. By virtue of our training and experience, physicians are ideally suited to understand and explain new treatments to our patients. As healthcare providers with a fiduciary responsibility to our patients, we must make sure they are fully informed about both the costs and benefits of non-curative therapies such as edaravone, and be prepared to discuss these in the context of their goals of care and potential impact on quality of life...
January 15, 2018: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/29332776/compliance-with-a-national-standard-by-norwegian-helicopter-emergency-physicians
#4
Lars Petter Bjørnsen, Andrea Marie Solheim, Oddvar Uleberg, Eirik Skogvoll
OBJECTIVE: The "National Standard Requirements for Helicopter Emergency Medicine Services Physicians" gives recommendations on medical requirements for flight physicians. This study describes the level of formal competence, experience, and guideline compliance of Norwegian helicopter emergency medical service (HEMS) physicians. METHODS: In May 2013, all HEMS physicians with full-time engagement at Norwegian HEMS bases were invited to participate in a cross-sectional survey using a structured, Web-based questionnaire...
January 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29332213/survivorship-care-plan-outcomes-for-primary-care-physicians-cancer-survivors-and-systems-a-scoping-review
#5
REVIEW
Weston LaGrandeur, Julie Armin, Carol L Howe, Leila Ali-Akbarian
PURPOSE: With the focus on survivorship care-coordination between oncology and primary care providers (PCPs), there is a need to assess the research regarding the use of survivorship care plans (SCPs) and determine emerging research areas. We sought to find out how primary care physicians have been involved in the use of SCPs and determine SCP's effectiveness in improving care for cancer survivors. In this scoping review, we aimed to identify gaps in the current research and reveal opportunities for further research...
January 13, 2018: Journal of Cancer Survivorship: Research and Practice
https://www.readbyqxmd.com/read/29331474/clinical-databases-for-chest-physicians
#6
REVIEW
Andrew M Courtwright, Peter E Gabriel
A clinical database is a repository of patient medical and sociodemographic information focused on one or more specific health condition or exposure. Although clinical databases may be used for research purposes, their primary goal is to collect and track patient data for quality improvement, quality assurance, and/or actual clinical management. This article aims to provide an introduction and practical advice on the development of small-scale clinical databases for Chest physicians and practice groups. Through example projects we discuss the pros and cons of available technical platforms, including Microsoft Excel and Access, relational database management systems such as Oracle and PostgreSQL, and REDCap...
January 10, 2018: Chest
https://www.readbyqxmd.com/read/29331259/public-and-physician-s-expectations-and-ethical-concerns-about-electronic-health-record-benefits-outweigh-risks-except-for-information-security
#7
Eleni Entzeridou, Evgenia Markopoulou, Vasiliki Mollaki
INTRODUCTION: Electronic Health Record systems (EHRs) offer numerous benefits in health care but also pose certain risks. As we progress toward the implementation of EHRs, a more in-depth understanding of attitudes that influence overall levels of EHR support is required. OBJECTIVES: To record public and physicians' awareness, expectations for, and ethical concerns about the use of EHRs. METHODS: A convenience sample was surveyed for both the public and physicians...
February 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29330239/one-year-of-family-physicians-observations-on-working-with-medical-scribes
#8
Amelia Sattler, Tracy Rydel, Cathina Nguyen, Steven Lin
PURPOSE: The immense clerical burden felt by physicians is one of the leading causes of burnout. Scribes are increasingly being used to help alleviate this burden, yet few published studies investigate how scribes affect physicians' daily work, attitudes and behaviors, and relationships with patients and the workplace. METHODS: Using a longitudinal observational design, data were collected, over 1 year, from 4 physicians working with 2 scribes at a single academic family medicine practice...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29329135/clinician-perceptions-of-the-importance-of-the-components-of-hospital-discharge-care-for-children
#9
Kevin Blaine, Jayne Rogers, Margaret R OʼNeill, Sarah McBride, Jennifer Faerber, Chris Feudtner, Jay G Berry
BACKGROUND: Discharging hospitalized children involves several different components, but their relative value is unknown. We assessed which discharge components are perceived as most and least important by clinicians. METHODS: March and June of 2014, we conducted an online discrete choice experiment (DCE) among national societies representing 704 nursing, physician, case management, and social work professionals from 46 states. The DCE consisted of 14 discharge care components randomly presented two at a time for a total of 28 choice tasks...
April 11, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29328043/complementary-and-alternative-medicine-and-medical-education-in-georgia-state-of-the-art-and-further-perspectives
#10
I Nadareishvili, K Lunze, G Pkhakadze, N Japiashvili, N Tabagari
Aim - complementary and alternative medicine (CAM) is popular in Georgia, but providers' training not well understood or regulated. The aim of this mixed-methods study was to inform the process of implementing quality CAM curricula in Georgia and strategies for the inclusion of effective CAM curricula into medical education in Georgia. We analyzed existing medical curricula. We conducted a contextual analysis based of qualitative data collected from relevant medical education experts, qualified physicians, CAM practitioners and other stakeholders; and administered a quantitative MD students' survey to MD students...
December 2017: Georgian Medical News
https://www.readbyqxmd.com/read/29327527/role-and-relevance-of-blood-pressure-variability-in-hypertension-related-co-morbidities
#11
Ashok Kumar, B C Kalmath, Georgi Abraham, Johann Christopher, Pln Kaparthi, Louie Fischer, Neeta Deshpande, N K Mishra, Praveen Raj, Rajesh Javerani, Ramesh Goyal, Reefa Dsouza, Shashank R Joshi
Despite maintaining mean blood pressure at optimal levels, cardiovascular complications still occur in hypertensive patients. Blood pressure variability (BPV) has been implicated as a prominent factor responsible for incurring this additional risk. In this review we attempted to generate a consensus on the importance of BPV in the hypertension management and to evaluate different therapeutic options available to reduce BPV. Panel comprising of 11 leading experts from India in different areas of clinical practice (including nephrology, diabetes and endocrinology, cardiology, and critical care medicine) was convened...
December 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29325764/self-management-model-in-the-scheduling-of-successive-appointments-in-rheumatology
#12
David Castro Corredor, José Luis Cuadra Díaz, Javier José Mateos Rodríguez, Joaquín Anino Fernández, María Dolores Mínguez Sánchez, Isabel María de Lara Simón, María Ángeles Tébar, Encarnación Añó, María Dolores Sanz, María Nieves Ballester
INTRODUCTION: The rheumatology service of Ciudad Real Hospital, located in an autonomous community of that same name that is nearly in the center of Spain, implemented a self-management model of successive appointments more than 10 years ago. Since then, the physicians of the department schedule follow-up visits for their patients depending on the disease, its course and ancillary tests. The purpose of this study is to evaluate and compare the self-management model for successive appointments in the rheumatology service of Ciudad Real Hospital versus the model of external appointment management implemented in 8 of the hospital's 15 medical services...
January 8, 2018: Reumatología Clinica
https://www.readbyqxmd.com/read/29322372/examination-of-patient-reported-outcomes-in-association-with-tnf-inhibitor-treatment-response-results-from-a-us-observational-cohort-study
#13
Cynthia J Larmore, Natalie N Boytsov, Carol L Gaich, Xiang Zhang, Andre B Araujo, Sabrina Rebello, Bob A Salim, George W Reed, Leslie R Harrold
INTRODUCTION: Implementation of a treat-to-target strategy is challenging when the patient and physician prioritize different goals. This study aimed to "translate" improvements in Clinical Disease Activity Index (CDAI) to concepts that resonate with patients (such as pain, fatigue, morning stiffness) by examining the association between changes in disease activity and patient-reported outcomes (PROs) in a national cohort of patients with rheumatoid arthritis (RA) initiating their first biologic treatment...
January 10, 2018: Rheumatology and Therapy
https://www.readbyqxmd.com/read/29322243/humanistic-burden-of-disease-for-patients-with-advanced-melanoma-in-canada
#14
Winson Y Cheung, Martha S Bayliss, Michelle K White, Angela Stroupe, Andrew Lovley, Bellinda L King-Kallimanis, Kathryn Lasch
BACKGROUND: Metastatic melanoma is a highly aggressive cancer, often striking in the prime of life. This study provides new information directly from advanced melanoma (stage III and IV) patients on how their disease impacts their health-related quality of life (HRQL). METHODS: Twenty-nine in-depth, qualitative interviews were conducted with adult patients with advanced melanoma in Canada. A semi-structured interview guide was used. Interviews were transcribed verbatim and key concepts were identified using a grounded theory analytic approach...
January 10, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29320901/if-we-keep-doing-what-we-re-doing-we-ll-keep-getting-what-we-re-getting-a-need-to-rethink-academic-medicine
#15
Michael Wilkes, Christine Cassel, Marc Klau
PURPOSE: For generations there have been warnings of the need to reform medical education at all levels. Today the voices pushing reform are louder, the need is greater, and there is an urgency not seen before. Approaches that have worked in the past to train physicians are no longer as relevant today as demographics, disease patterns, human resources, practice behaviors, technology, and attention to costs demand new collaborative approaches to clinical practice. To prepare for this practice tomorrow's doctors will need a different type of educational model, a different type of learning, in different environments, often taught by different faculty...
January 10, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29320409/evaluating-the-impact-of-a-clinician-improvement-program-for-treating-patients-with-intellectual-and-developmental-disabilities-the-challenging-case-of-mississippi
#16
John P Bartkowski, Janelle Kohler, Craig L Escude, Xiaohe Xu, Stephen Bartkowski
In recent years, people with intellectual and developmental disabilities (IDD) have moved from institutionalized settings to local community residences. While deinstitutionalization has yielded quality of life improvements for people with IDD, this transition presents significant health-related challenges. Community clinicians have typically not been trained to provide sound medical care to people with IDD, a subpopulation that exhibits unique medical needs and significant health disparities. This study reports the results of a comprehensive evaluation of an IDD-focused clinician improvement program implemented throughout Mississippi...
January 10, 2018: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29319539/patterns-of-disrespectful-physician-behavior-at-an-academic-medical-center-implications-for-training-prevention-and-remediation
#17
Joseph Hopkins, Haley Hedlin, Ann Weinacker, Manisha Desai
PURPOSE: Physician disrespectful behavior affects quality of care, patient safety, and collaborative clinical team function. Evidence defining the demographics, ethnography, and epidemiology of disrespectful behavior is lacking. METHOD: The authors conducted a retrospective analysis of reports of disrespectful physician behavior at Stanford Hospital and Clinics from March 2011 through February 2015. Events were stratified by role, gender, specialty, and location in the hospital or clinics where the event occurred...
January 9, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29319389/top-10-tips-palliative-care-clinicians-should-know-when-caring-for-patients-with-ovarian-cancer
#18
Brittany A Davidson, Haley A Moss, Arif H Kamal
The vast majority of women diagnosed with ovarian cancer present with advanced-stage disease with a five-year survival rate less than 50%. Studies have shown that in the past, gynecologic oncologists were not routinely collaborating with palliative care physicians resulting in goals of care planning often not occurring until the last 30 days before death. In recent years, professional societies have been increasingly more vocal about the importance of incorporating palliative care early in a patient's disease course...
January 10, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29317920/indonesian-pharmacists-and-pharmacy-students-attitudes-towards-collaboration-with-physicians
#19
Adji P Setiadi, Yosi Wibowo, Sylvi Irawati, Eko Setiawan, Bobby Presley, Sajni Gudka, Ari S Wardhani
Background: Recent implementation of national health coverage and the increasing health burden in Indonesia require health professionals, including pharmacists, to work more collaboratively to improve access and quality of health care. Nevertheless, relatively little is known about Indonesian pharmacists' attitude towards collaboration. Objective: To assess and compare the attitude of Indonesian pharmacy students and pharmacists towards collaboration with physicians...
October 2017: Pharmacy Practice
https://www.readbyqxmd.com/read/29317919/impact-on-process-results-of-clinical-decision-support-systems-cdsss-applied-to-medication-use-overview-of-systematic-reviews
#20
Wálleri C Reis, Aline F Bonetti, Wallace E Bottacin, Alcindo S Reis, Thaís T Souza, Roberto Pontarolo, Cassyano J Correr, Fernando Fernandez-Llimos
Objective: The purpose of this overview (systematic review of systematic reviews) is to evaluate the impact of clinical decision support systems (CDSS) applied to medication use in the care process. Methods: A search for systematic reviews that address CDSS was performed on Medline following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Cochrane recommendations. Terms related to CDSS and systematic reviews were used in combination with Boolean operators and search field tags to build the electronic search strategy...
October 2017: Pharmacy Practice
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