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https://www.readbyqxmd.com/read/28327094/finger-tapping-impairments-are-highly-sensitive-for-evaluating-upper-motor-neuron-lesions
#1
Afsaneh Shirani, Braeden D Newton, Darin T Okuda
BACKGROUND: Identifying highly sensitive and reliable neurological exam components are crucial in recognizing clinical deficiencies. This study aimed to investigate finger tapping performance differences between patients with CNS demyelinating lesions and healthy control subjects. METHODS: Twenty-three patients with multiple sclerosis or clinically isolated syndrome with infratentorial and/or cervical cord lesions on MRI, and 12 healthy controls were videotaped while tapping the tip of the index finger against the tip and distal crease of the thumb using both the dominant and non-dominant hand...
March 21, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28264744/a-qualitative-study-of-patient-and-provider-perspectives-on-using-web-based-pain-coping-skills-training-to-treat-persistent-cancer-pain
#2
Christine Rini, Maihan B Vu, Hannah Lerner, Catherine Bloom, Jessica Carda-Auten, William A Wood, Ethan M Basch, Peter M Voorhees, Katherine E Reeder-Hayes, Francis J Keefe
OBJECTIVE: Persistent pain is common and inadequately treated in cancer patients. Behavioral pain interventions are a recommended part of multimodal pain treatments, but they are underused in clinical care due to barriers such as a lack of the resources needed to deliver them in person and difficulties coordinating their use with clinical care. Pain coping skills training (PCST) is an evidence-based behavioral pain intervention traditionally delivered in person. Delivering this training via the web would increase access to it by addressing barriers that currently limit its use...
March 7, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28228099/impact-of-adding-additional-providers-to-resident-workload-and-the-resident-experience-on-a-medical-consultation-rotation
#3
Michele Fang, Eric Linson, Manish Suneja, Ethan F Kuperman
BACKGROUND: Excellence in Graduate Medical Education requires the right clinical environment with an appropriate workload where residents have enough patients to gain proficiency in medicine with optimal time for reflection. The Accreditation Council for Graduate Medical Education (ACGME) has focused more on work hours rather than workload; however, high resident workload has been associated with lower resident participation in education and fatigue-related errors. Recognizing the potential risks associated with high resident workload and being mindful of the costs of reducing resident workload, we sought to reduce residents' workload by adding an advanced practice provider (APP) to the surgical comanagement service (SCM) and study its effect on resident satisfaction and perceived educational value of the rotation...
February 22, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28160889/is-there-a-shortage-of-obstetrician-gynecologists
#4
REVIEW
Jody Stonehocker, Joyce Muruthi, William F Rayburn
Projections of supply and demand for obstetricians-gynecologists suggest a current minimal or modest shortage that will worsen in the future. The US adult female population is expected to increase by more than 20% by 2045 and represents a key driver for increased demand for health care services. The annual number of obstetrician-gynecologists (ob-gyn) residency graduates has increased negligibly, whereas the proportion accepted into fellowships increased steadily, reducing those in general practice. The gradual increase in proportion of ob-gyns who are women coincides with desires for more work-life balance and earlier retirement from clinical practice...
March 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/28156649/critical-conversations-in-gynecologic-oncology-pilot-study-of-communication-skills-training-for-fellows-and-advanced-practice-providers
#5
Kerri S Bevis, Elise Carey, Robert Arnold, Lisa Podgurski
29 Background: Good communication is crucial to good patient care. Gynecologic oncology providers often face challenging communication scenarios, including giving serious news and discussing goals of care. Communication skills training (CST) has been shown to improve skill acquisition among providers of multiple specialties, but it has not been described in providers from gynecologic oncology or any surgical oncology specialty. METHODS: We conducted a two-day CST workshop, based on the VitalTalk© model, with four faculty members (2 gynecologic oncologists and 2 palliative care physicians) and 10 gynecologic oncology provider participants (5 fellows and 5 advanced practice providers)...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152808/ambulatory-redesign-strategies-for-quality-improvement-in-patient-care
#6
Catherine A Lyons, Nancy Smith, Maureen McGlennon, Terri L Parker, Carolyn Truini, Maureen Major-Campos, Jill Lacy, Karen Michaels, Vanna Dest, Richard Lisitano, Kerin B Adelson, Rogerio Lilenbaum
85 Background: Growing outpatient volume poses patient flow challenges, making it difficult to accommodate the complexities of academic medical practice. Volume increases create operational inefficiencies like delays in lab turnaround time (TAT) and limited rooming capacity resulting in delays in patient access and reduced provider productivity. These bottlenecks negatively impact patient satisfaction. METHODS: Four multidisciplinary teams assessed barriers to patient flow in the lab, rooming and scheduling process...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152719/development-and-implementation-of-competency-based-orientation-program-for-advanced-practice-providers-at-an-academic-cancer-center
#7
Julie Ann Berkhof, Cheryl Hokula, Julie Kozlowski, Jennifer Galdys, Nicole Zimmer
119 Background: Increased utilization of Advanced Practice Providers (APPs) has been identified as a means to increase oncology visit capacity and improve productivity. Many APPs have little experience in oncology or are new to the APP role. As a result, there is a need for a comprehensive, competency-based orientation and mentorship program to aid in this transition and ensure effective integration of APPs into the complex oncology environment. METHODS: We developed and implemented a comprehensive, competency-based orientation and mentorship program for APPs hired into the Wilmot Cancer Institute...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152676/evaluation-of-resource-utilization-using-time-derived-activity-based-costing-tdabc-to-result-in-more-effective-processes-and-cost-reduction
#8
Elizabeth A Garcia, Kai E Lang, Valerie Villanueva, Shannon Neville Westin, Nicole D Fleming, Thomas W Feeley, Karen H Lu, Larissa Meyer
22 Background: Current changes in health care economics have led to a focus on value-based health care. TDABC is a systematic method to assess personnel utilization and the associated cost in the delivery of medical care. Based on baseline process maps and cost estimates in our outpatient center, cancer surveillance visits (CSV) were identified as inefficient, lengthy and high cost. The purpose of this study was to determine if reallocation of personnel was feasible, resulted in decrease cost and better value care...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28090368/applying-metrics-to-outpatient-oncology-advanced-practice-providers
#9
REVIEW
Elizabeth Gilbert, Victoria Sherry
No abstract text is available yet for this article.
March 2016: Journal of the Advanced Practitioner in Oncology
https://www.readbyqxmd.com/read/28063867/-it-is-like-heart-failure-it-is-chronic-%C3%A2-and-it-will-kill-you-a-qualitative-analysis-of-burnout-among-hospice-and-palliative-care-clinicians
#10
Dio Kavalieratos, Daniel E Siconolfi, Karen E Steinhauser, Janet Bull, Robert M Arnold, Keith M Swetz, Arif H Kamal
CONTEXT: Although prior surveys have identified rates of self-reported burnout among palliative care clinicians as high as 62%, limited data exist to elucidate the causes, ameliorators, and effects of this phenomenon. OBJECTIVES: We explored burnout among palliative care clinicians, specifically their experiences with burnout, their perceived sources of burnout, and potential individual, interpersonal, organizational, and policy-level solutions to address burnout...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28057065/-they-re-younger%C3%A2-it-s-harder-primary-providers-perspectives-on-hypertension-management-in-young-adults-a-multicenter-qualitative-study
#11
MULTICENTER STUDY
Heather M Johnson, Ryan C Warner, Christie M Bartels, Jamie N LaMantia
BACKGROUND: Young adults (18-39 year-olds) have the lowest hypertension control rates among adults with hypertension in the United States. Unique barriers to hypertension management in young adults with primary care access compared to older adults have not been evaluated. Understanding these differences will inform the development of hypertension interventions tailored to young adults. The goals of this multicenter study were to explore primary care providers' perspectives on barriers to diagnosing, treating, and controlling hypertension among young adults with regular primary care...
January 3, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28007061/the-evolution-of-an-adult-congenital-heart-surgery-program-the-emory-system
#12
REVIEW
Brian Kogon, Joshua Rosenblum, Bahaaldin Alsoufi, Subhadra Shashidharan, Wendy Book
The Emory Adult Congenital Heart (Emory University, Atlanta, GA) program was founded in 2001. In 2004, the surgical component transitioned from a pediatric facility to an adult facility. The aim of this article is characterize the program as a whole, outline changes in the program, and discuss the challenges of the transition process. Between 2001 and 2015, changes in program structure and personnel were evaluated. There has been significant growth of the program between 2001 and 2015. There are currently 19 half-day clinics per week, with 2,700 clinic visits per year...
January 2017: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/28002115/pilot-testing-a-web-based-system-for-the-assessment-and-management-of-chemotherapy-induced-peripheral-neuropathy
#13
Robert Knoerl, William N Dudley, Gloria Smith, Celia Bridges, Grace Kanzawa-Lee, Ellen M Lavoie Smith
Because numerous barriers hinder the assessment and management of chemotherapy-induced peripheral neuropathy in clinical practice, the Carevive Care Planning System, a novel Web-based platform, was developed to address these barriers. It provides patients an opportunity to report their symptoms before their clinic visit and generates customizable care plans composed of evidence-based management strategies. The purpose of this study was to evaluate patient and provider perspectives of feasibility, usability, acceptability, and satisfaction with the Carevive platform...
December 20, 2016: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/27850794/1157-nurses-perception-of-resident-and-advanced-practice-provider-critical-care-teams
#14
James Lunn, Peter Sandor, Zachary Lavender, Cathy Roy, Prashant Grover
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850047/407-implementation-of-a-critical-care-ultrasonography-workshop-for-advanced-practice-providers
#15
Brooke Bailey, Courtney Cook, April Kapu
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27828887/comprehensive-geriatric-assessment-for-trauma-operationalizing-the-trauma-quality-improvement-program-directive
#16
Stephanie Devore, Sara E Parli, Douglas R Oyler, Andrew Bernard
Elderly patients are the fastest growing trauma demographic and present some of the most complicated clinical challenges. This feasibility study employed observational data from a geriatric cohort. Comprehensive geriatric assessments (CGAs) were performed biweekly on eligible patients, 65 years or older, who met screening criteria. Mobility, activities of daily living impairment, frailty, and depression were screened and documented, and along with summative recommendations, were entered into the medical record, communicated to the patient's primary care provider, and discussed with family...
November 2016: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/27823696/comparative-effectiveness-of-outpatient-cardiovascular-disease-and-diabetes-care-delivery-between-advanced-practice-providers-and-physician-providers-in-primary-care-implications-for-care-under-the-affordable-care-act
#17
Salim S Virani, Julia M Akeroyd, David J Ramsey, Winston J Chan, Lorraine Frazier, Khurram Nasir, Suja S Rajan, Christie M Ballantyne, Laura A Petersen
BACKGROUND: The objective was to compare quality of diabetes and cardiovascular disease (CVD) care between advanced practice providers (APPs) and physicians in a primary care setting. METHODS: We identified diabetes (n=1,022,588) and CVD (n=1,187,035) patients receiving primary care between October 2013 and September 2014 in 130 Veterans Affairs facilities. We compared glycemic control (hemoglobin A1c <7%) in diabetic patients, blood pressure (BP) <140/90 mmHg in diabetic or CVD patients, cholesterol control (low-density lipoprotein cholesterol<100 mg/dL, receiving a statin) in diabetic or CVD patients, and those receiving a β-blocker (with history of myocardial infarction in the last 2 years) among patients receiving care from physicians and APPs...
November 2016: American Heart Journal
https://www.readbyqxmd.com/read/27777663/factors-associated-with-resident-continuity-in-ambulatory-training-practices
#18
Robert J Fortuna, Lynn Garfunkel, Michael D Mendoza, Megan Ditty, Julia West, Karen Nead, Brett W Robbins
BACKGROUND : Continuity of care is a critical element of residents' educational experience in primary care programs. OBJECTIVE : We examined how continuity in resident practices compares to nonteaching practices, identified factors associated with increased continuity, and explored the association between continuity and quality measures. METHODS : We analyzed 117 235 patient visits to 4 resident practices (26 resident teams in internal medicine, pediatrics, family medicine, and medicine-pediatrics) and 270 242 visits to nonteaching community practices between July 2013 and May 2014...
October 2016: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/27708827/surgical-readmissions-results-of-integrating-pre-peri-and-postsurgical-care
#19
Katia Noyes, Janet Baack-Kukreja, Edward M Messing, Luke Schoeniger, Eva Galka, Wei Pan, Cai Xueya, Fergal J Fleming, John Rt Monson, Supriya G Mohile, Todd Francone
AIMS: To explore the feasibility of recruiting surgical oncology patients and implementing a surgical integrated discharge (SID) programme led by advanced practice providers (APP). BACKGROUND: Burden of illness and complexity of treatment regimen makes it challenging for surgical oncology patients to participate in research. Surgical oncology nurses may have the necessary expertise to overcome this problem. DESIGN: Controlled longitudinal prospective observational study...
July 2016: Nursing Open
https://www.readbyqxmd.com/read/27697316/time-driven-activity-based-costing-to-identify-opportunities-for-cost-reduction-in-pediatric-appendectomy
#20
Yangyang R Yu, Paulette I Abbas, Carolyn M Smith, Kathleen E Carberry, Hui Ren, Binita Patel, Jed G Nuchtern, Monica E Lopez
PURPOSE: As reimbursement programs shift to value-based payment models emphasizing quality and efficient healthcare delivery, there exists a need to better understand process management to unearth true costs of patient care. We sought to identify cost-reduction opportunities in simple appendicitis management by applying a time-driven activity-based costing (TDABC) methodology to this high-volume surgical condition. METHODS: Process maps were created using medical record time stamps...
December 2016: Journal of Pediatric Surgery
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