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"Advanced Practice Provider"

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https://www.readbyqxmd.com/read/29147800/the-pediatric-heart-failure-workforce-an-international-multicenter-survey
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28932992/the-impact-of-a-primary-care-education-program-regarding-cancer-survivorship-care-plans-results-from-an-engineering-primary-care-and-oncology-collaborative-for-survivorship-health
#11
SarahMaria Donohue, James E Haine, Zhanhai Li, Elizabeth R Trowbridge, Sandra A Kamnetz, David A Feldstein, James M Sosman, Lee G Wilke, Mary E Sesto, Amye J Tevaarwerk
Survivorship care plans (SCPs) have been recommended as tools to improve care coordination and outcomes for cancer survivors. SCPs are increasingly being provided to survivors and their primary care providers. However, most primary care providers remain unaware of SCPs, limiting their potential benefit. Best practices for educating primary care providers regarding SCP existence and content are needed. We developed an education program to inform primary care providers of the existence, content, and potential uses for SCPs...
September 20, 2017: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/28904893/surgical-patient-selection-and-counseling
#12
REVIEW
Matt Ziegelmann, Tobias S Köhler, George C Bailey, Tanner Miest, Manaf Alom, Landon Trost
The objectives of patient selection and counseling are ultimately to enhance successful outcomes. However, the definition for success is often narrowly defined in published literature (ability to complete surgery, complications, satisfaction) and fails to account for patient desires and expectations, temporal changes, natural history of underlying diseases, or independent validation. Factors associated with satisfaction and dissatisfaction are often surgery-specific, although correlation with pre-operative expectations, revisions, and complications are common with most procedures...
August 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28885879/infusion-room-based-transition-to-practice-model-for-teaching-cancer-systemic-therapy-management
#13
Jennifer M Duff, Merry-Jennifer Markham, Thomas J George, Julia L Close
PURPOSE: Oncology training requirements mandate that fellows demonstrate competence in delivery of cancer therapeutics, understand clinical indications for treatment, and manage toxicities by completion of training. An academic training environment may hinder fellows' engagement in prescribing, monitoring, and adjusting cancer therapy; thus, trainees may complete their fellowship with limited experience in developing such critical skills. To provide hands-on experience in cancer systemic therapy management, we created a novel infusion room-based rotation in the final year of training; here we report the structure, logistics, and evaluation of this innovative program...
November 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28800760/perceptions-of-patients-and-providers-on-myocardial-perfusion-imaging-for-asymptomatic-patients-choosing-wisely-and-professional-liability
#14
Kristopher P Kline, Leslee Shaw, Rebecca J Beyth, Jared Plumb, Linda Nguyen, Tianyao Huo, David E Winchester
BACKGROUND: Despite efforts by professional societies to reduce low value care, many reports indicate that unnecessary tests, such as nuclear myocardial perfusion imaging (MPI), are commonly used in contemporary practice. The degree to which lack of awareness and professional liability concerns drive these behaviors warrants further study. We sought to investigate patient and provider perceptions about MPI in asymptomatic patients, the Choosing Wisely (CW) campaign, and professional liability concerns...
August 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28791786/emergency-department-provider-perspectives-on-benzodiazepine-opioid-co-prescribing-a-qualitative-study
#15
Howard S Kim, Danielle M McCarthy, Jason A Hoppe, D Mark Courtney, Bruce L Lambert
OBJECTIVE: Benzodiazepines and opioids are prescribed simultaneously (i.e. "co-prescribed") in many clinical settings, despite guidelines advising against this practice and mounting evidence that concomitant use of both medications increases overdose risk. This study sought to characterize the contexts in which benzodiazepine-opioid co-prescribing occurs and providers' reasons for co-prescribing. METHODS: We conducted focus groups with ED providers (resident and attending physicians, advanced practice providers, and pharmacists) from three hospitals using semi-structured interviews to elicit perspectives on benzodiazepine-opioid co-prescribing...
August 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28746071/toward-a-utopian-model-for-teaching-and-nonteaching-services-every-journey-begins-with-a-first-step
#16
Lisa M Bellini, Jack Ende
Nonteaching services are an imperfect step toward enabling inpatient teaching services to transition from an unregulated, natural state, driven solely by the exigencies of patient volume and throughput, to one that is more controlled and intends to achieve the proper balance between service and education. As career educators the authors prefer to view nonteaching services as critical components of an integrated system that enables the best possible patient care and learning, yet they acknowledge that, to meet the needs of patients and learners, teaching and nonteaching services alike must be truly complementary, collaborative, and integrated components of a single system...
July 25, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28738052/collaborative-care-in-melanoma-the-essential-role-of-the-nurse%C3%A2
#17
John M Kirkwood, Antoni Ribas
This article provides perspective from medical oncologists on the importance of this supplement from the Melanoma Nursing Initiative. The authors (a) delineate the challenges inherent in addressing adverse event (AE) management with newer melanoma therapies, particularly in the community setting; (b) illustrate how advanced practice providers with extensive clinical trial experience in melanoma are in a key position to set the agenda and educate colleagues on best practices in AE management; and
August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28738030/delivery-of-%C3%A2-clinical-services-mobilizing-advanced-practice-providers-to-enhance-patient-care
#18
Kimberly Tripp, LaKeisha Day, Alexandra Blake, Ivy Bertram
Advanced practice providers (APPs) are increasingly being used in a variety of healthcare settings to provide care, treatment, and services to patients with cancer. They are also being deployed to acute oncologic settings to enhance patient care delivery and address the ever-evolving needs of patients in academic medicine. In response, the University of Texas MD Anderson Cancer Center developed a series of innovative clinical programs staffed by acute care APPs. These provide an opportunity to rapidly adapt to the acute care needs of patients with cancer while fostering the professional development of APPs within the full scope of their oncologic clinical practice...
August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28716014/the-comprehensive-post-acute-stroke-services-compass-study-design-and-methods-for-a-cluster-randomized-pragmatic-trial
#19
Pamela W Duncan, Cheryl D Bushnell, Wayne D Rosamond, Sara B Jones Berkeley, Sabina B Gesell, Ralph B D'Agostino, Walter T Ambrosius, Blair Barton-Percival, Janet Prvu Bettger, Sylvia W Coleman, Doyle M Cummings, Janet K Freburger, Jacqueline Halladay, Anna M Johnson, Anna M Kucharska-Newton, Gladys Lundy-Lamm, Barbara J Lutz, Laurie H Mettam, Amy M Pastva, Mysha E Sissine, Betsy Vetter
BACKGROUND: Patients discharged home after stroke face significant challenges managing residual neurological deficits, secondary prevention, and pre-existing chronic conditions. Post-discharge care is often fragmented leading to increased healthcare costs, readmissions, and sub-optimal utilization of rehabilitation and community services. The COMprehensive Post-Acute Stroke Services (COMPASS) Study is an ongoing cluster-randomized pragmatic trial to assess the effectiveness of a comprehensive, evidence-based, post-acute care model on patient-centered outcomes...
July 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28699936/clinician-attitudes-regarding-icd-deactivation-in-dnr-dni-patients
#20
Andrew Bradley, Adam Marks
BACKGROUND: Implantable cardioverter-defibrillators (ICDs) offer lifesaving therapies but can become burdensome at the end of life. Many ICD patients choose to implement a do-not-resuscitate/do-not-intubate (DNR/DNI) order. When hospitalized, patients are seen by a range of clinicians whose beliefs about ICD management in DNR/DNI patients may vary. OBJECTIVE: To assess clinician opinions on managing ICDs in DNR/DNI patients and stratify it by specialty and training level...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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