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https://www.readbyqxmd.com/read/28334584/delayed-workup-of-rectal-bleeding-in-adult-primary-care-examining-process-of-care-failures
#1
Saul N Weingart, Elena M Stoffel, Daniel C Chung, Thomas D Sequist, Ruth I Lederman, Stephen R Pelletier, Helen M Shields
BACKGROUND: Although delayed colorectal cancer diagnoses figure prominently in medical malpractice claims, little is known about the quality of primary care clinicians' workup of rectal bleeding. METHODS: In this study, 438 patients were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for rectal bleeding, hemorrhoids, and blood in the stool at 10 Boston adult primary care practices. Following nurse chart abstraction, physician reviewers assessed the overall quality of care and key care processes...
January 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28333605/can-all-doctors-be-like-this-seven-stories-of-communication-transformation-told-by-physicians-rated-highest-by-patients
#2
Tom Janisse, Karen Tallman
INTRODUCTION: The top predictors of patient satisfaction with clinical visits are the quality of the physician-patient relationship and the communications contributing to their relationship. How do physicians improve their communication, and what effect does it have on them? This article presents the verbatim stories of seven high-performing physicians describing their transformative change in the areas of communication, connection, and well-being. METHODS: Data for this study are based on interviews from a previous study in which a 6-question set was posed, in semistructured 60-minute interviews, to 77 of the highest-performing Permanente Medical Group physicians in 4 Regions on the "Art of Medicine" patient survey...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28326827/factors-influencing-patients-receptiveness-to-evidence-based-recommendations-during-the-clinical-encounter
#3
Cara Stepanczuk, Nyna Williams, Katie Morrison, Charlene Kemmerer
AIM: To identify the factors that promote or interfere with evidence-based clinical decisions from the patient perspective. MATERIALS & METHODS: We developed four hypothetical scenarios with clinical decisions, such as whether to pursue testing for a chronic condition. We conducted eight focus groups to better understand the influences on individuals' decisions in the context of the scenarios. RESULTS: A patient's relationship with a physician emerged as the strongest influence on whether participants would accept or reject a physician's recommendation...
February 28, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/28326194/nurses-and-physicians-attitudes-toward-nurse-physician-collaboration-a-survey-from-gaza-strip-palestine
#4
Aymen Elsous, Mahmoud Radwan, Samah Mohsen
Interprofessional collaboration and teamwork between nurses and physicians is essential for improving patient outcomes and quality of health services. This study examined the attitudes of nurses and physicians toward nurse-physician collaboration. A cross-sectional study was conducted among nurses and physicians (n = 414) in two main referral public hospitals in the Gaza Strip using the Arabic Jefferson Scale of Attitude toward Physician-Nurse Collaboration. Descriptive statistics and difference of means, proportions, and correlations were examined using Student's t-test, one-way ANOVA, and Pearson correlation and p < 0...
2017: Nursing Research and Practice
https://www.readbyqxmd.com/read/28325745/aid-in-dying-laws-and-the-physician-s-duty-to-inform
#5
Mara Buchbinder
On 19 July 2016, three medical organisations filed a federal lawsuit against representatives from several Vermont agencies over the Patient Choice and Control at End of Life Act. The law is similar to aid-in-dying (AID) laws in four other US states, but the lawsuit hinges on a distinctive aspect of Vermont's law pertaining to patients' rights to information. The lawsuit raises questions about whether, and under what circumstances, there is an ethical obligation to inform terminally ill patients about AID as an end-of-life option...
March 21, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28322070/enhancing-clinical-communication-in-dermatologists-a-personalized-educational-intervention
#6
Zoi Tsimtsiou, Charitini Stavropoulou, Noni Papastefanou, Christos Lionis
OBJECTIVES: Effective communication is a vital component of patient-centered consultations with favourable treatment outcomes. This study aimed in testing the effectiveness of a personalized, communication training program for dermatologists in their practices. METHODS: Fifteen dermatologists were offered the educational intervention NO.TE.S. (Non Technical Skills). Depending on the dermatologists' needs, seven to nine sessions with a 60-minute duration were performed, focusing on: patient-centered care, principles of Neurolinguistic Programming, a guide to the medical interview, principles of motivational interviewing and self-care...
March 21, 2017: Journal of Dermatological Treatment
https://www.readbyqxmd.com/read/28321550/ethical-implications-of-the-electronic-health-record-in-the-service-of-the-patient
#7
Lois Snyder Sulmasy, Ana María López, Carrie A Horwitch
Electronic health records (EHRs) provide benefits for patients, physicians, and clinical teams, but also raise ethical questions. Navigating how to provide care in the digital age requires an assessment of the impact of the EHR on patient care and the patient-physician relationship. EHRs should facilitate patient care and, as an essential component of that care, support the patient-physician relationship. Billing, regulatory, research, documentation, and administrative functions determined by the operational requirements of health care systems, payers, and others have resulted in EHRs that are better able to satisfy such external functions than to ensure that patient care needs are met...
March 20, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28319979/patient-experience-a-critical-indicator-of-healthcare-performance
#8
Pamela H Guler
Patient experience has become a critical differentiator for healthcare organizations, and it will only grow in importance as transparency and consumerism dominate the healthcare landscape. Creating and sustaining a consistently exceptional experience that promotes patient engagement and the best outcomes is far more than just "satisfying" patients, going well beyond amenities that may be provided.Perception of care experience is often shaped by methods we use to address the biopsychosocial needs of patients...
April 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28316793/development-and-validation-of-an-instrument-to-measure-collaborative-goal-setting-in-the-care-of-patients-with-diabetes
#9
Heather L Morris, Levent Dumenci, Jennifer E Lafata
OBJECTIVE: Despite known benefits of patient-perceived collaborative goal setting, we have a limited ability to monitor this process in practice. We developed the Patient Measure of Collaborative Goal Setting (PM-CGS) to evaluate the use of collaborative goal setting from the patient's perspective. RESEARCH DESIGN AND METHODS: A random sample of 400 patients aged 40 years or older, receiving diabetes care from the Virginia Commonwealth University Health System between 8/2012 and 8/2013, were mailed a survey containing potential PM-CGS items (n=44) as well as measures of patient demographics, perceived self-management competence, trust in their physician, and self-management behaviors...
2017: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/28315635/behaviors-of-consumers-physicians-and-pharmacists-in-response-to-adverse-events-associated-with-dietary-supplement-use
#10
Tsuyoshi Chiba, Yoko Sato, Etsuko Kobayashi, Kazuki Ide, Hiroshi Yamada, Keizo Umegaki
BACKGROUND: The prevalence of dietary supplements has increased in Japan, and, as a consequence, the adverse events associated with dietary supplement use have become more prominent. Severe adverse events must be reported to the Japanese government via public health centers. However, the number of cases reported to the Japanese government is limited. To clarify this discrepancy, we conducted an internet questionnaire, and surveyed how consumers, physicians and pharmacists acted when they or their patients developed adverse events due to dietary supplement use...
March 18, 2017: Nutrition Journal
https://www.readbyqxmd.com/read/28306169/economic-burden-of-relapsed-or-refractory-multiple-myeloma-results-from-an-international-trial
#11
Don Robinson, Robert Z Orlowski, Michael Stokes, Jianming He, Samuel Huse, Abhishek Chitnis, Britte Kranenburg, Annette Lam
OBJECTIVE: The direct cost of relapsed or refractory multiple myeloma (RRMM) is documented; indirect costs are being explored. Healthcare payers seek cost offsets from therapies that improve clinical outcomes but challenge budgets; employers seek lower absenteeism and better productivity. Study goals were to: 1) Identify direct and indirect economic factors of RRMM and, 2) Explore longitudinal relationships between clinical, economic, and health-related quality of life (HRQoL) assessments...
March 17, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28302116/portals-design-of-an-innovative-approach-to-anticoagulation-management-through-ehealth
#12
E P W A Talboom-Kamp, N A Verdijk, I J S H Talboom, L M Harmans, M E Numans, N H Chavannes
BACKGROUND: For the monitoring of International Normalized Ratio (INR) values, venous thromboembolism (VTE) and atrial fibrillation (AF) patients can visit anticoagulation clinics, laboratories, or physicians for venous puncture. Point-of-care testing (POCT) made it possible for patients to monitor INR themselves (self-monitoring) and even self-adjust their medication dosage (self-dosage). Both skills are accepted as forms of self-management. eHealth applications can improve this self-management, resulting in better clinical outcomes...
March 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28301962/overcoming-obesity
#13
Elaine Seaton Banerjee, Sharon J Herring, Katelyn E Hurley, Katherine Puskarz, Kyle Yebernetsky, Marianna LaNoue
PURPOSE: Low-income, African American women are disproportionately impacted by obesity. Little is known about the interactions between low-income, African American women who successfully lost weight and their primary care physicians (PCPs). DESIGN: Mixed methods, positive deviance study. SETTING: Urban university-based family medicine practice. PARTICIPANTS: The positive deviance group comprised low-income, African American women who were obese, lost 10% body weight, and maintained this loss for 6 months...
January 1, 2017: American Journal of Health Promotion: AJHP
https://www.readbyqxmd.com/read/28298834/diabetes-and-periodontitis-how-well-are-the-patients-aware-about-an-established-relation
#14
Teja Ummadisetty, Vijay Kumar Chava, Venkata Ramesh Reddy Bhumanapalli
AIM: The study aimed to assess the levels of awareness about the mutual relationship between diabetes and periodontitis among high-risk age group of the general population and to assess the attitude of general physicians in suggesting diabetic patients to visit a dentist. MATERIALS AND METHODS: A structured, closed-ended questionnaire either in English or in local language (Telugu) was distributed and collected from 203 patients who were willing to participate in the study attending the Department of Periodontics, Narayana Dental College & Hospital, Nellore, AP...
July 2016: Journal of Indian Society of Periodontology
https://www.readbyqxmd.com/read/28295783/physician-cooperation-in-outpatient-cancer-care-an-amplified-secondary-analysis-of-qualitative-interview-data
#15
J Engler, C Güthlin, A Dahlhaus, E Kojima, J Müller-Nordhorn, L Weißbach, C Holmberg
The importance of outpatient cancer care services is increasing due to the growing number of patients having or having had cancer. However, little is known about cooperation among physicians in outpatient settings. To understand what inter- and multidisciplinary care means in community settings, we conducted an amplified secondary analysis that combined qualitative interview data with 42 general practitioners (GPs), 21 oncologists and 21 urologists that mainly worked in medical practices in Germany. We compared their perspectives on cooperation relationships in cancer care...
March 14, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28292289/at-first-glance-informal-payments-experience-on-track-why-accept-or-refuse-patients-perceive-in-cardiac-surgery-department-of-public-hospitals-northeast-of-iran-2013
#16
Ali Vafaei Najar, Hossein Ebrahimipour, Arefeh Pourtaleb, Habibollah Esmaily, Mehdi Jafari, Zohre Nejatzadegan, Yasamin Molavi Taleghani
BACKGROUND: Patient's Informal payments is among the main source of health care financing in some countries. This paper aimed at determining the patient informal payments and relative factors in Cardiac Surgery Departments (CSD) in hospitals affiliated to Mashhad University of Medical Sciences (MUMS) in 2013. METHODS: In this cross-sectional study, 316 discharged patients were selected using multi-stage sampling. Data gathering tool was a questionnaire which was filled by structured telephone interviews...
March 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28289468/the-effect-of-an-educational-intervention-in-family-phisicians-on-self-rated-quality-of-life-in-patients-with-medically-unexplained-symptoms
#17
Vojislav Ivetić, Klemen Pašić, Polona Selič
INTRODUCTION: Medically unexplained symptoms (MUS) are very common in family medicine, despite being a poorly-defined clinical entity. This study aimed to evaluate the effect of an educational intervention (EI) on self-rated quality of life, treatment satisfaction, and the family physician-patient relationship in patients with MUS. METHODS: In a multi-centre longitudinal intervention study, which was performed between 2012 and 2014, patients were asked to rate their quality of life, assess their depression, anxiety, stress and somatisation, complete the Hypochondriasis Index, the Medical Interview Satisfaction Scale and the Patient Enablement Instrument for assessing the physician-patient relationship, before and after the EI...
June 1, 2017: Zdravstveno Varstvo
https://www.readbyqxmd.com/read/28289113/the-effects-of-training-institution-practice-costs-quality-and-other-characteristics-on-future-practice
#18
Robert L Phillips, Stephen M Petterson, Andrew W Bazemore, Peter Wingrove, James C Puffer
PURPOSE: Medicare beneficiary spending patterns reflect those of the 306 Hospital Referral Regions where physicians train, but whether this holds true for smaller areas or for quality is uncertain. This study assesses whether cost and quality imprinting can be detected within the 3,436 Hospital Service Areas (HSAs), 82.4 percent of which have only 1 teaching hospital, and whether sponsoring institution characteristics are associated. METHODS: We conducted a secondary, multi-level, multivariable analysis of 2011 Medicare claims and American Medical Association Masterfile data for a random, nationally representative sample of family physicians and general internists who completed residency between 1992 and 2010 and had more than 40 Medicare patients (3,075 physicians providing care to 503,109 beneficiaries)...
March 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28289109/minding-the-gap-factors-associated-with-primary-care-coordination-of-adults-in-11-countries
#19
Jonathan Penm, Neil J MacKinnon, Stephen M Strakowski, Jun Ying, Michelle M Doty
PURPOSE: Care coordination has been identified as a key strategy in improving the effectiveness, safety, and efficiency of the US health care system. Our objective was to determine whether population or health care system issues are associated with primary care coordination gaps in the United States and other high-income countries. METHODS: We analyzed data from the 2013 Commonwealth Fund International Health Policy (IHP) survey with multivariate logistic regression analysis...
March 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28288953/impact-of-social-processes-in-online-health-communities-on-patient-empowerment-in-relationship-with-the-physician-emergence-of-functional-and-dysfunctional-empowerment
#20
Gregor Petrič, Sara Atanasova, Tanja Kamin
BACKGROUND: Substantial research demonstrates the importance of online health communities (OHCs) for patient empowerment, although the impact on the patient-physician relationship is understudied. Patient empowerment also occurs in relationship with the physician, but studies of OHCs mostly disregard this. The question also remains about the nature and consequences of this empowerment, as it might be based on the limited validity of some information in OHCs. OBJECTIVE: The main purpose of this study was to examine the impact of social processes in OHCs (information exchange with users and health professional moderators, social support, finding meaning, and self-expressing) on functional and dysfunctional patient empowerment in relationship with the physician (PERP)...
March 13, 2017: Journal of Medical Internet Research
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