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"Advanced Practice Provider"

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https://www.readbyqxmd.com/read/28514976/working-despite-having-influenza-like-illness-results-of-an-anonymous-survey-of-healthcare-providers-who-care-for-transplant-recipients
#1
Sherif B Mossad, Abhishek Deshpande, Sarah Schramm, Xiaobo Liu, Michael B Rothberg
OBJECTIVE To compare the rates of and reasons for presenteeism associated with influenza-like illness (ILI) among healthcare professionals (HCPs) caring for hospitalized inpatient transplant recipients and internal medicine patients. DESIGN We designed a 10-question anonymous survey in which ILI was defined as fever (>37.8°C) and cough and/or sore throat and ILI B was defined as fever (>37.8°C) or cough or sore throat; both definitions were considered in the absence of another known cause. SETTING Tertiary-care center...
May 18, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28499759/trends-in-operating-room-assistance-for-major-urologic-surgical-procedures-an-increasing-role-for-advanced-practice-providers
#2
Amanda R Swanton, Ahmad N Alzubaidi, Yu Han, Kenneth G Nepple, Bradley A Erickson
OBJECTIVE: To characterize changes in surgical assistance patterns over time for commonly performed urologic operations. METHODS: This study used the Medicare Physician/Supplier Procedure Summary Master File to identify cases performed by urologists from 2003-2014. CPT modifiers were used to identify operations assisted by second surgeons and advanced practice providers (APPs). Rates were reported annually for six common urologic operations and average annual rates of change were determined using least squares regression and tested using t-tests (α=0...
May 9, 2017: Urology
https://www.readbyqxmd.com/read/28479409/-i-just-felt-like-i-was-stuck-in-the-middle-physician-assistants-experiences-communicating-with-terminally-ill-patients-and-their-families-in-the-acute-care-setting
#3
Elizabeth Chuang, Richard Lamkin, Aluko A Hope, Gina Kim, Jean Burg, Michelle Ng Gong
CONTEXT: Terminally ill hospitalized patients and their families consistently rank effective communication and shared decision-making among their top priorities. Advance Practice Providers such as Physician Assistants (PAs) are increasingly providing care in the hospital setting and are often called to communicate with patients and families. A first step to improving PA communication is to better understand PAs' current experiences in their daily practices. OBJECTIVES: This study aimed to explore: 1) roles PAs serve in communicating with terminally ill patients/families; 2) PAs' attitudes and opinions about communication roles and 3) perceived barriers and facilitators of communication with patients/families in the hospital setting...
May 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28478875/assessment-of-volume-status-using-ultrasonography
#4
REVIEW
Brooke A Bailey, Sarah Davis, Briana Witherspoon
Ultrasonography is a first-line diagnostic tool when evaluating volume status in the critical care patient population. Ultrasonography leads to a prompt diagnosis and more appropriate management plan, while decreasing health care costs, time to diagnosis, hospital length of stay, time to definitive operation, and mortality. It is recommended that critical care providers treating critically ill patients be skilled and competent in critical care ultrasonography. As the critical care population and the shortage of critical care physicians increases, advanced practice providers are becoming more prevalent in critical care areas and should be competent in this skill as well...
June 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28472533/a-systematic-review-of-the-impact-of-physician-implicit-racial-bias-on-clinical-decision-making
#5
Erin Dehon, Nicole Weiss, Jonathan Jones, Whitney Faulconer, Elizabeth Hinton, Sarah Sterling
OBJECTIVES: Disparities in diagnosis and treatment of racial minorities exist in the emergency department (ED). A better understanding of how physician implicit (unconscious) bias contributes to these disparities may help identify ways to eliminate such racial disparities. The objective of this systematic review was to examine and summarize the evidence on the association between physician implicit racial bias and clinical decision making. METHODS: Based on PRISMA guidelines, a structured electronic literature search of PubMed, CINAHL, Scopus, and PsycINFO databases was conducted...
May 4, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28471818/spectrum-of-diagnosis-and-disposition-of-patients-referred-to-a-pediatric-orthopaedic-center-for-a-diagnosis-of-intoeing
#6
Shawne Faulks, Kaitlyn Brown, John G Birch
BACKGROUND: Orthopaedic surgeons frequently evaluate otherwise healthy children for concern of intoed gait. Intoeing in otherwise healthy young children due to metatarsus adductus, internal tibial torsion, and increased femoral anteversion do not typically require orthopaedic treatment. This study reviewed the actual diagnosis, management, and disposition of patients referred to a pediatric orthopaedic specialty hospital for a diagnosis of intoeing; the efficacy of an Advanced Practice Provider (APP) assessment program to screen and triage patients with a primary complaint of intoeing; and parental satisfaction with that program...
May 3, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28456338/urgent-care-medicine-and-the-role-of-the-app-within-this-specialty
#7
Jessica Memmel, Marcy Spalsbury
The field of urgent care medicine offers an additional medical pathway for patients who have immediate, but non-life-threatening, medical concerns. Urgent care medicine offers a more varied set of resources and services than a physician office setting, with more flexible hours. This gives patients an opportunity to not have to go to the emergency department for non-emergent care. As a newer specialty within the medical field, certain roles of healthcare providers other than physicians are becoming established, including the advanced practice provider (APP)...
April 26, 2017: Disease-a-month: DM
https://www.readbyqxmd.com/read/28452256/secondary-traumatic-stress-in-emergency-medicine-clinicians
#8
Jacob W Roden-Foreman, Monica M Bennett, Evan E Rainey, John S Garrett, Mark B Powers, Ann Marie Warren
Previously called Secondary Traumatic Stress (STS), secondary exposure to trauma is now considered a valid DSM-5 Criterion A stressor for posttraumatic stress disorder (PTSD). Previous studies have found high rates of STS in clinicians who treat traumatically injured patients. However, little research has examined STS among Emergency Medicine (EM) physicians and advanced practice providers (APPs). The current study enrolled EM providers (N = 118) working in one of 10 hospitals to examine risk factors, protective factors, and the prevalence of STS in this understudied population...
April 28, 2017: Cognitive Behaviour Therapy
https://www.readbyqxmd.com/read/28435035/the-expanding-role-of-advanced-practice-providers-in-urologic-procedural-care
#9
Joshua P Langston, Richard Duszak, Venetia L Orcutt, Heather Schultz, Brad Hornberger, Lawrence C Jenkins, Jennifer Hemingway, Danny R Hughes, Raj S Pruthi, Matthew E Nielsen
OBJECTIVE: To understand the role of Advanced Practice Providers (APPs) in urologic procedural care, and its change over time. As the population ages and the urologic workforce struggles to meet patient access demands, the role of APPs in the provision of all aspects of urologic care is increasing. However, little is currently known about their role in procedural care. MATERIALS AND METHODS: Commonly performed urologic procedures were linked to Current Procedural Terminology (CPT) codes from 1994 to 2012...
April 20, 2017: Urology
https://www.readbyqxmd.com/read/28430728/the-impact-of-a-dedicated-robotic-team-on-robotic-assisted-sacrocolpopexy-outcomes
#10
Charelle M Carter-Brooks, Angela L Du, Michael J Bonidie, Jonathan P Shepherd
BACKGROUND: Robotic-assisted sacrocolpopexy has been criticized for high cost. A strategy to increase operating room efficiency and decrease cost is implementation of a dedicated robotic team. Our objective was to determine if a dedicated robotic team decreases operative time. STUDY DESIGN: This institutional review board-approved retrospective cohort study included all robotic-assisted sacrocolpopexy performed from June 2010 to August 2015 by a single surgeon at 2 institutions in 1 health system...
April 20, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28413928/the-oncology-specialist-s-role-in-polst-form-completion
#11
Austin J Lammers, Dana M Zive, Susan W Tolle, Erik K Fromme
INTRODUCTION: Patients with cancer and oncology professional societies believe that advance care planning is important, but we know little of who actually has this conversation. Physician Orders for Life-Sustaining Treatment (POLST) forms can help to document these important conversations to ensure patients receive the level of treatment they want. We therefore sought to determine the specialty of those signing POLST forms for patients who died of cancer to better understand who is having this discussion with patients...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28391969/urgent-care-medicine-and-the-role-of-the-advanced-practice-providers-within-this-specialty
#12
EDITORIAL
Jerrold B Leikin
No abstract text is available yet for this article.
April 6, 2017: Disease-a-month: DM
https://www.readbyqxmd.com/read/28375495/quality-programs-in-neurosurgery-the-memorial-hermann-university-of-texas-experience
#13
Dong H Kim, Miriam Morales, Rahil Tai, Georgene Hergenroeder, Chirag Shah, Joanna O'Leary, Nicole Harrison, Gabrielle Edquilang, Emily Paisley, Enedra Allen-McBride, Allison Murphy, Justin Smith, William Gormley, Amanda Spielman
The importance of outcome measures is steadily increasing due to the rise of "pay for performance" and the advent of population health. In 2007, a quality initiative was started due to poor performance on rankings such as the University Health Consortium (UHC) report card. Inherent to all such efforts are common challenges: how to engage the providers; how to gather and ensure the accuracy of the data; how to attribute results to individuals; how to ensure permanent improvements. After analysis, a strategy was developed that included an initial focus on 3 metrics (mortality, infection rates, and complications), leadership from practicing neurosurgeons, protocol development and adherence, and subspecialization...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28363470/time-driven-activity-based-costing-a-dynamic-value-assessment-model-in-pediatric-appendicitis
#14
Yangyang R Yu, Paulette I Abbas, Carolyn M Smith, Kathleen E Carberry, Hui Ren, Binita Patel, Jed G Nuchtern, Monica E Lopez
OBJECTIVES: Healthcare reform policies are emphasizing value-based healthcare delivery. We hypothesize that time-driven activity-based costing (TDABC) can be used to appraise healthcare interventions in pediatric appendicitis. METHODS: Triage-based standing delegation orders, surgical advanced practice providers, and a same-day discharge protocol were implemented to target deficiencies identified in our initial TDABC model. Post-intervention process maps for a hospital episode were created using electronic time stamp data for simple appendicitis cases during February to March 2016...
March 18, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28327094/finger-tapping-impairments-are-highly-sensitive-for-evaluating-upper-motor-neuron-lesions
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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