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"Advanced Practice Provider"

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https://www.readbyqxmd.com/read/29325786/a-proactive-outreach-intervention-that-decreases-readmission-after-hepatectomy
#1
Nisha Narula, Bradford J Kim, Catherine H Davis, Whitney L Dewhurst, Leigh A Samp, Thomas A Aloia
BACKGROUND: After hepatectomy, 7%-19% of patients are readmitted within 30 days, accounting for substantial cost and poor patient experience. The purpose of this study was to analyze the impact of a proactive outreach intervention on readmissions. METHODS: Consecutive patients undergoing hepatectomy by a single surgeon 2012-2016 were identified in a prospectively maintained database. In August 2013 a postoperative intervention was implemented; an advanced practice provider called each patient within 72 hours of discharge...
January 9, 2018: Surgery
https://www.readbyqxmd.com/read/29289476/perspectives-on-research-participation-and-facilitation-among-dialysis-patients-clinic-personnel-and-medical-providers-a-focus-group-study
#2
Jennifer E Flythe, Julia H Narendra, Adeline Dorough, Jonathan Oberlander, Antoinette Ordish, Caroline Wilkie, Laura M Dember
BACKGROUND: Most prospective studies involving individuals receiving maintenance dialysis have been small, and many have had poor clinical translatability. Research relevance can be enhanced through stakeholder engagement. However, little is known about dialysis clinic stakeholders' perceptions of research participation and facilitation. The objective of this study was to characterize the perspectives of dialysis clinic stakeholders (patients, clinic personnel, and medical providers) on: (1) research participation by patients and (2) research facilitation by clinic personnel and medical providers...
December 19, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29282724/the-impact-of-enhanced-critical-care-training-and-24-7-tele-icu-support-on-medicare-spending-and-postdischarge-utilization-patterns
#3
Matthew J Trombley, Andrea Hassol, Jennifer T Lloyd, Timothy G Buchman, Allison F Marier, Alan White, Erin Colligan
OBJECTIVE: To estimate the effect of implementing a tele-ICU and a critical care residency training program for advanced practice providers on service utilization and total Medicare episode spending. DATA SOURCES/STUDY SETTINGS: Medicare claims data for fee-for-service beneficiaries at 12 large, inpatient hospitals in the Atlanta Hospital Referral Region. STUDY DESIGN: Difference-in-differences design where changes in spending and utilization for Medicare beneficiaries eligible for treatment in participating ICUs was compared to changes in a comparison group of clinically similar beneficiaries treated at similar hospitals' ICUs in the same hospital referral region...
December 27, 2017: Health Services Research
https://www.readbyqxmd.com/read/29233937/provider-perspectives-on-use-of-medical-marijuana-in-children-with-cancer
#4
Prasanna Ananth, Clement Ma, Hasan Al-Sayegh, Leah Kroon, Victoria Klein, Claire Wharton, Elise Hallez, Ilana Braun, Kelly Michelson, Abby R Rosenberg, Wendy London, Joanne Wolfe
BACKGROUND: Although medical marijuana (MM) may have utility in the supportive care of children with serious illness, it remains controversial. We investigated interdisciplinary provider perspectives on legal MM use in children with cancer. METHODS: We sent a 32-item, cross-sectional survey to 654 pediatric oncology providers in Illinois, Massachusetts, and Washington characterizing MM practices, knowledge, attitudes, and barriers. Forty-eight percent responded; 44% (n = 288) were included in analyses...
December 12, 2017: Pediatrics
https://www.readbyqxmd.com/read/29224796/residents-impressions-of-the-impact-of-advanced-practice-providers-on-surgical-training
#5
Ravinder Kang, Jesse A Columbo, Samuel T Kunkel, Ryland S Stucke, Matthew J Sabatino, Austin Tang, Philip P Goodney, Kari M Rosenkranz
BACKGROUND: To ensure that residents are appropriately trained in the era of the 80-hour work-week, training programs have restructured resident duties and hired advanced practice providers (APPs). However, the effect of APPs on surgical training remains unknown. STUDY DESIGN: We created a survey using a modified Delphi technique to examine the interaction between residents and APPs across practice settings (inpatient, outpatient, and operating room (OR)). We identified four domains: administrative tasks, clinical experience, operative experience, and overall impressions...
December 7, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29196079/burnout-moral-distress-work-life-balance-and-career-satisfaction-among-hematopoietic-cell-transplantation-professionals
#6
Joyce L Neumann, Lih-Wen Mau, Sanya Virani, Ellen M Denzen, Deborah A Boyle, Nancy J Boyle, Jane Dabney, Alexandra De KeselLofthus, Marion Kalbacker, Tippu Khan, Navneet S Majhail, Elizabeth A Murphy, Pamela Paplham, Leslie Parran, Miguel-Angel Perales, Todd H Rockwood, Kim Schmit-Pokorny, Tait D Shanafelt, Elaine Stenstrup, William A Wood, Linda J Burns
BACKGROUND: A projected shortage of hematopoietic cell transplantation (HCT) health professionals was identified as a major issue during the National Marrow Donor Program (NMDP)/Be The Match System Capacity Initiative. Work-related distress and work-life balance were noted to be potential barriers to recruitment/retention. This study examined these barriers and their association with career satisfaction across HCT disciplines. METHODS: A cross-sectional, 90-item, web-based survey was administered to advanced practice providers (APP), nurses, physicians, pharmacists, and social workers in 2015...
November 28, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29194282/frequency-and-characterization-of-tracheal-intubation-adverse-events-in-pediatric-sepsis
#7
Sarah K Schmidt, Lina Brou, Sara J Deakyne, Rakesh D Mistry, Halden F Scott
OBJECTIVES: Intubation in critically ill pediatric patients is associated with approximately 20% rate of adverse events, but rates in the high-risk condition of sepsis are unknown. Our objectives were to describe the frequency and characteristics of tracheal intubation adverse events in pediatric sepsis. DESIGN: Retrospective cohort study of a sepsis registry. SETTING: Two tertiary care academic emergency departments and four affiliated urgent cares within a single children's hospital health system...
November 30, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29189649/physician-assistant-student-training-for-the-inpatient-setting-a-needs-assessment
#8
Poonam Sharma, Megan Brooks, Pahresah Roomiany, Lalit Verma, Lisa Criscione-Schreiber
PURPOSE: The number of physician assistants (PAs) practicing hospital medicine is rapidly expanding. Little research has been done to determine which inpatient medicine rotation experiences are most helpful to prepare PA students for a career in inpatient medicine. We aimed to determine those skills that practicing hospitalists believe are most critical for PA students to master and to describe hospitalists' current understanding of PA training. We also sought to evaluate the current performance of our own inpatient medicine rotation for PA students...
December 2017: Journal of Physician Assistant Education
https://www.readbyqxmd.com/read/29187102/education-and-training-in-pediatric-cardiac-critical-care
#9
Mary E McBride, Dorothy M Beke, James D Fortenberry, Annette Imprescia, Louise Callow, Lindsey Justice, Ronald A Bronicki
Pediatric cardiac critical care is a new and emerging field. There is no standardization to the current education provided, and high-quality patient outcomes require such standardization. For physicians, this includes fellowship training, specific competencies, and a certification process. For advanced practice providers, a standardized curriculum as well as a certification process is needed. There is evidence that supports a finding that critical care nursing experience may have a positive impact on outcomes from pediatric cardiac surgery...
November 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29166352/more-learners-finite-resources-and-the-changing-landscape-of-procedural-training-at-the-bedside
#10
Michael A Gisondi, Linda Regan, Jeremy Branzetti, Laura R Hopson
There is growing competition for non-operative, procedural training in teaching hospitals, due to an increased number of individuals seeking to learn procedures from a finite number of appropriate teaching cases. Procedural training is required by students, post-graduate learners, and practicing providers who must maintain their skills. These learner groups are growing in size as the number of medical schools increase and advance practice providers expand their skills to include complex procedures. These various learner needs occur against a background of advancing therapeutic techniques that improve patient care, but also act to reduce the overall numbers of procedures available to learners...
November 21, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29147800/the-pediatric-heart-failure-workforce-an-international-multicenter-survey
#11
Scott R Auerbach, Melanie D Everitt, Ryan J Butts, David N Rosenthal, Yuk M Law
Our objective was to understand the scope of pediatric heart failure (HF) and the current staffing environment of HF programs. An online survey was distributed to members of the Pediatric Heart Transplant Study and the Pediatric Council of the International Society for Heart and Lung Transplantation. All participants received the primary 23-question survey. Additionally, HF program directors received a 32-question supplemental survey. Of 235 invitations sent, there were 69 (29%) primary surveys and 34 program director surveys completed (24 U...
November 17, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29137503/global-lessons-in-frugal-innovation-to-improve-health-care-delivery-in-the-united-states
#12
Yasser Bhatti, Andrea Taylor, Matthew Harris, Hester Wadge, Erin Escobar, Matt Prime, Hannah Patel, Alexander W Carter, Greg Parston, Ara W Darzi, Krishna Udayakumar
In a 2015 global study of low-cost or frugal innovations, we identified five leading innovations that scaled successfully in their original contexts and that may provide insights for scaling such innovations in the United States. We describe common themes among these diverse innovations, critical factors for their translation to the United States to improve the efficiency and quality of health care, and lessons for the implementation and scaling of other innovations. We highlight promising trends in the United States that support adapting these innovations, including growing interest in moving care out of health care facilities and into community and home settings; the growth of alternative payment models and incentives to experiment with new approaches to population health and care delivery; and the increasing use of diverse health professionals, such as community health workers and advanced practice providers...
November 2017: Health Affairs
https://www.readbyqxmd.com/read/29129263/variation-in-post-discharge-opioid-prescriptions-among-members-of-a-surgical-team
#13
Eddie Blay, Michael J Nooromid, Karl Y Bilimoria, Jane L Holl, Bruce Lambert, Julie K Johnson, Jonah J Stulberg
BACKGROUND: Surgeons play a pivotal role in the opioid epidemic but it is unknown how different members of a surgical team vary in the way they prescribe opioids after surgical episodes. STUDY DESIGN: We conducted a retrospective cohort study of all inpatient discharges for 5 common surgeries. Total number of tablets and total milligram equivalents (MME) prescribed were calculated and differences in prescription patterns were determined for attending surgeons, surgical residents and advanced practice providers...
November 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29098650/cancer-survivorship-care-plan-utilization-and-impact-on-clinical-decision-making-at-point-of-care-visits-with-primary-care-results-from-an-engineering-primary-care-and-oncology-collaborative-for-survivorship-health
#14
SarahMaria Donohue, James E Haine, Zhanhai Li, David A Feldstein, Mark Micek, Elizabeth R Trowbridge, Sandra A Kamnetz, James M Sosman, Lee G Wilke, Mary E Sesto, Amye J Tevaarwerk
Every cancer survivor and his/her primary care provider should receive an individualized survivorship care plan (SCP) following curative treatment. Little is known regarding point-of-care utilization at primary care visits. We assessed SCP utilization in the clinical context of primary care visits. Primary care physicians and advanced practice providers (APPs) who had seen survivors following provision of an SCP were identified. Eligible primary care physicians and APPs were sent an online survey, evaluating SCP utilization and influence on decision-making at the point-of-care, accompanied by copies of the survivor's SCP and the clinic note...
November 2, 2017: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/29068851/perinatal-nurses-reported-to-boards-of-nursing-understanding-the-facts
#15
Rebecca L Cypher, Kara Kosycarz
Today's healthcare system is in a state of transformation, as changes in technology, diagnostic approaches, treatments, and levels of professional practice occur on a regular basis. Nurses continue to be the most trusted profession. What has not changed in clinical practice is the amount of responsibility and level of accountability. Therefore, nurses are morally, legally, and ethically responsible for nursing judgment and clinical-based actions covered under each state's Nurse Practice Act, the American Nurses Association's core principles, and position statements as well as standard setting documents from professional organizations...
October 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/29068565/the-american-society-of-pediatric-hematology-oncology-workforce-assessment-part-2-implications-for-fellowship-training
#16
P J Leavey, J M Hilden, D Matthews, C Dandoy, S M Badawy, M Shah, A S Wayne, J Hord
The American Society of Pediatric Hematology/Oncology (ASPHO) solicited information from division directors and fellowship training program directors to capture pediatric hematology/oncology (PHO) specific workforce data of 6 years (2010-2015), in response to an increase in graduating fellows during that time. Observations included a stable number of physicians and advanced practice providers (APPs) in clinical PHO, an increased proportion of APPs hired compared to physicians, and an increase in training-level first career positions...
October 25, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29066616/precommitting-to-choose-wisely-about-low-value-services-a-stepped-wedge-cluster-randomised-trial
#17
Jeffrey Todd Kullgren, Erin Krupka, Abigail Schachter, Ariel Linden, Jacquelyn Miller, Yubraj Acharya, James Alford, Richard Duffy, Julia Adler-Milstein
BACKGROUND: Little is known about how to discourage clinicians from ordering low-value services. Our objective was to test whether clinicians committing their future selves (ie, precommitting) to follow Choosing Wisely recommendations with decision supports could decrease potentially low-value orders. METHODS: We conducted a 12-month stepped wedge cluster randomised trial among 45 primary care physicians and advanced practice providers in six adult primary care clinics of a US community group practice...
October 24, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28994631/health-care-resource-utilization-for-outpatient-cardiovascular-disease-and-diabetes-care-delivery-among-advanced-practice-providers-and-physician-providers-in-primary-care
#18
Salim S Virani, Julia M Akeroyd, David J Ramsey, Anita Deswal, Khurram Nasir, Suja S Rajan, Christie M Ballantyne, Laura A Petersen
Although effectiveness of diabetes or cardiovascular disease (CVD) care delivery between physicians and advanced practice providers (APPs) has been shown to be comparable, health care resource utilization between these 2 provider types in primary care is unknown. This study compared health care resource utilization between patients with diabetes or CVD receiving care from APPs or physicians. Diabetes (n = 1,022,588) or CVD (n = 1,187,035) patients with a primary care visit between October 2013 and September 2014 in 130 Veterans Affairs facilities were identified...
October 10, 2017: Population Health Management
https://www.readbyqxmd.com/read/28971927/joy-in-medical-practice-clinician-satisfaction-in-the-healthy-work-place-trial
#19
Mark Linzer, Christine A Sinsky, Sara Poplau, Roger Brown, Eric Williams
To better understand how clinicians' job satisfaction relates to work conditions and outcomes for clinicians and patients, we examined data from the Healthy Work Place trial. Data were collected from physicians and advanced practice providers at baseline and approximately one year later. At baseline, 74 percent of respondents indicated job satisfaction. Satisfaction was associated with less chaos, more cohesion, better communication, and closer values alignment at work, but not with higher-quality care or fewer medical errors...
October 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28970179/creation-and-efficacy-of-a-cadaver-based-prosection-anatomical-course-for-critical-care-advanced-practice-providers
#20
Melissa K Stewart, Stephen Gondek, Roslyn Green, Jason Young, Raeanna C Adams, Timothy Nunez
OBJECTIVE: Intensive care units (ICUs) increasingly rely on advanced practice providers (APPs) to care for critically ill patients. Our institutional APPs perceived functional anatomical knowledge deficits. To meet this need, a cadaver-based prosection course was developed. The purpose of our study was to describe and evaluate the learner-perceived course efficacy. DESIGN: A precourse survey collected participant demographics. Precourse and postcourse surveys assessed perceived confidence in 13 anatomical areas...
September 29, 2017: Journal of Surgical Education
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