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https://www.readbyqxmd.com/read/28523477/the-impact-of-e-visits-on-patient-access-to-primary-care
#1
Xiang Zhong, Peter Hoonakker, Philip A Bain, Albert J Musa, Jingshan Li
To improve patient access to primary care, many healthcare organizations have introduced electronic visits (e-visits) to provide patient-physician communication through secure messages. However, it remains unclear how e-visit affects physicians' operations on a daily basis and whether it would increase physicians' panel size. In this study, we consider a primary care physician who has a steady patient panel and manages patients' office and e-visits, as well as other indirect care tasks. We use queueing-based performance outcomes to evaluate the performance of care delivery...
May 18, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28521750/data-for-improvement-and-clinical-excellence-a-report-of-an-interrupted-time-series-trial-of-feedback-in-home-care
#2
Kimberly D Fraser, Anne E Sales, Melba Andrea B Baylon, Corinne Schalm, John J Miklavcic
BACKGROUND: There is substantial evidence about the effectiveness of audit with feedback, but none that we know have been conducted in home care settings. The primary purpose of the Data for Improvement and Clinical Excellence - Home Care (DICE-HC) project was to evaluate the effects of an audit and feedback delivered to care providers on home care client outcomes. The objective of this paper is to report the effects of feedback on four specific quality indicators: pain, falls, delirium, and hospital visits...
May 18, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28511584/a-pilot-intervention-designed-to-address-behavioral-factors-that-place-overweight-obese-young-children-at-risk-for-later-life-obesity
#3
Leigh Small, Leroy Thacker, Heather Aldrich, Darya Bonds-McClain, Bernadette Melnyk
The purpose of this pilot randomized controlled trial (RCT) was to intervene with parents of overweight/obese 4- to 8-year-old children to improve child internalizing and externalizing behaviors. Parent-child dyads ( N = 60) were randomly assigned to treatment or comparison conditions. Parents attended four intervention sessions at their child's primary health care office over 3 months. Child behaviors were assessed at 0, 3, 6, and 12 months post intervention. Parental beliefs in their skills/abilities increased in the experimental group parents, but there was no statistical difference between groups at any time...
May 1, 2017: Western Journal of Nursing Research
https://www.readbyqxmd.com/read/28501231/complementary-and-integrative-interventions-for-chronic-neurologic-conditions-encountered-in-the-primary-care-office
#4
REVIEW
Danny Bega
Chronic neurologic conditions are frequently managed in the primary care setting, and patients with these conditions are increasingly seeking nonconventional treatment options. This article provides a review and summary of the evidence for some of the most commonly studied and most frequently used complementary and integrative interventions for 3 conditions managed every day in primary care offices - diabetic neuropathy, migraine, and dementia.
June 2017: Primary Care
https://www.readbyqxmd.com/read/28498199/incorporating-alternative-care-site-characteristics-into-estimates-of-substitutable-ed-visits
#5
Nathan Seth Trueger, Kao-Ping Chua, Aamir Hussain, Aisha T Liferidge, Stephen R Pitts, Jesse M Pines
BACKGROUND: Several recent efforts to improve health care value have focused on reducing emergency department (ED) visits that potentially could be treated in alternative care sites (ie, primary care offices, retail clinics, and urgent care centers). Estimates of the number of these visits may depend on assumptions regarding the operating hours and functional capabilities of alternative care sites. However, methods to account for the variability in these characteristics have not been developed...
May 11, 2017: Medical Care
https://www.readbyqxmd.com/read/28492811/permanent-education-in-primary-health-care-perception-of-local-health-managers
#6
Luiz Anildo Anacleto da Silva, Rafael Marcelo Soder, Letícia Petry, Isabel Cristine Oliveira
Objectives: To know the health education strategies advocated and developed for workers of primary care, in the view of managers. Method: The study is characterized as a qualitative, descriptive and exploratory research. A semistructured interview was used to collect data. The sample population was chosen intentionally, with an audience of 26 municipal health managers ascribed to a regional health coordination office, located in the north/northwest of the Rio Grande do Sul State...
May 4, 2017: Revista Gaúcha de Enfermagem
https://www.readbyqxmd.com/read/28491236/self-referral-patterns-among-federal-civil-servants-in-oyo-state-south-western-nigeria
#7
Henry Okoli, Taiwo Obembe, Kayode Osungbade, Folashayo Adeniji, David Adewole
INTRODUCTION: Primary health care is widely accepted as the first point of care; yet, individuals requiring healthcare engage in self-referrals to higher levels of care thereby by-passing primary care. Little is known of the extent to which self-referrals are carried out when care is needed. This study thus sought to determine the prevalence of self-referral, its patterns and factors influencing self-referrals amongst federal civil servants in Southwestern Nigeria. METHODS: A cross-sectional study was carried out among 300 federal civil servants who were interviewed using validated and pre-tested interviewer-administered semi structured questionnaires...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28486672/-meet-and-greet-intake-appointments-in-primary-care-a-new-pattern-of-patient-intakes
#8
Emily Gard Marshall, Imhokhai Ogah, Beverley Lawson, Richard J Gibson, Frederick Burge
Background.: Family physicians (FPs) are expected to take on new patients fairly and equitably and to not discriminate based on medical or social history. 'Meet and greet' appointments are initial meetings between physicians and prospective patients to establish fit between patient needs and provider scope of practice. The public often views these appointments as discriminatory; however, there is no empirical evidence regarding their prevalence or outcomes. Objectives...
May 9, 2017: Family Practice
https://www.readbyqxmd.com/read/28483890/premature-death-among-primary-care-patients-with-a-history-of-self-harm
#9
Matthew J Carr, Darren M Ashcroft, Evangelos Kontopantelis, David While, Yvonne Awenat, Jayne Cooper, Carolyn Chew-Graham, Nav Kapur, Roger T Webb
PURPOSE: Self-harm is a public health problem that requires a better understanding of mortality risk. We undertook a study to examine premature mortality in a nationally representative cohort of primary care patients who had harmed themselves. METHODS: During 2001-2013, a total of 385 general practices in England contributed data to the Clinical Practice Research Datalink with linkage to Office for National Statistics mortality records. We identified 30,017 persons aged 15 to 64 years with a recorded episode of self-harm...
May 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28483887/patient-perceptions-of-telehealth-primary-care-video-visits
#10
Rhea E Powell, Jeffrey M Henstenburg, Grace Cooper, Judd E Hollander, Kristin L Rising
PURPOSE: Telehealth is a care delivery model that promises to increase the flexibility and reach of health services. Our objective is to describe patient experiences with video visits performed with their established primary care clinicians. METHODS: We constructed semistructured, in-depth qualitative interviews with adult patients following video visits with their primary care clinicians at a single academic medical center. Data were analyzed with a content analysis approach...
May 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28483228/clinical-manifestations-of-neuroblastoma-with-head-and-neck-involvement-in-children
#11
Sameer Alvi, Omar Karadaghy, Michelle Manalang, Robert Weatherly
OBJECTIVE: The purpose of our study is to review our 15-year experience with pediatric patients who have been diagnosed with neuroblastoma, and to determine their most frequent head and neck manifestations and symptoms. STUDY DESIGN: Retrospective chart review of electronic medical record. SETTING: An academic, tertiary care pediatric hospital. SUBJECTS AND METHODS: IRB approval from the Office of Research Integrity at Children's Mercy Hospital was obtained...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28470836/physicians-report-sleep-apnea-infrequently-in-older-and-older-vulnerable-adults
#12
Andrew M Namen, Daniel J Forest, Karen E Huang, Steven R Feldman, William R Hazzard, Stephen P Peters, Edward F Haponik
OBJECTIVES: To determine how often outpatient physician visits detect sleep apnea (SA) in older persons in the United States. DESIGN: Retrospective Analysis. SETTING: US non hospital and hospital based clinics. PARTICIPANTS: US physicians. MEASUREMENTS: National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey data from 1993 to 2011 were used to assess the frequency of physicians' coding diagnoses of SA in persons aged 65 and older...
May 4, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28464935/provision-of-peer-specialist-services-in-va-patient-aligned-care-teams-protocol-for-testing-a-cluster-randomized-implementation-trial
#13
Matthew Chinman, Karin Daniels, Jeff Smith, Sharon McCarthy, Deborah Medoff, Amanda Peeples, Richard Goldberg
BACKGROUND: Over 1100 Veterans work in the Veterans Health Administration (VHA) as peer specialists (PSs). PSs are Veterans with formal training who provide support to other Veterans with similar diagnoses, primarily in mental health settings. A White House Executive Action mandated the pilot reassignment of VHA PSs from mental health to 25 primary care Patient Aligned Care Teams (PACT) in order to broaden the provision of wellness services that can address many chronic illnesses. An evaluation of this initiative was undertaken to assess the impact of outside assistance on the deployment of PS in PACT, as implementation support is often needed to prevent challenges commonly experienced when first deploying PSs in VHA settings...
May 2, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28457746/comparing-the-palliative-care-needs-of-those-with-cancer-to-those-with-common-non-cancer-serious-illness
#14
Doran Bostwick, Steven Wolf, Greg Samsa, Janet Bull, Donald H Taylor, Kimberly S Johnson, Arif Kamal
BACKGROUND: Historically, palliative care has been focused on those with cancer. While these ties persist, palliative care is rapidly integrating into the care of patients with common, non-cancer serious illnesses. Despite this, the bulk of literature informing palliative care practices stems from the care of cancer patients. OBJECTIVES: We compared functionality, advanced care planning, hospital admissions, prognosis, quality of life, pain, dyspnea, fatigue, and depression between patients with cancer and three non-cancer diagnoses--end stage renal disease (ESRD), heart failure (HF), and chronic obstructive pulmonary disease (COPD)...
April 27, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28449943/hearing-loss-education-for-older-adults-in-primary-care-clinics-benefits-of-a-concise-educational-brochure
#15
Margaret I Wallhagen, William J Strawbridge
Hearing loss, common in older adults, is associated with negative health outcomes but screening rates in primary care clinics are low and individuals screened or referred often do not follow-through. To address these problems, we worked with 2 primary care clinics to design a simple screening and education protocol for integration into a standard office visit. To assess the effectiveness on the education brochure that was developed, we assessed its impact on individuals age 60 or older who screened positive for possible hearing loss...
April 24, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/28448777/effect-of-an-advanced-pharmacy-practice-experience-on-medication-therapy-management-services-in-a-centralized-retail-pharmacy-program
#16
Joseph P Vande Griend, Melissa Rodgers, Wesley Nuffer
BACKGROUND: Medication therapy management (MTM) delivery is increasingly important in managed care. Successful delivery positively affects patient health and improves Centers for Medicare & Medicaid Services star ratings, a measure of health plan quality. As MTM services continue to grow, there is an increased need for efficient and effective care models. The primary objectives of this project were to describe the delivery of MTM services by fourth-year Advanced Pharmacy Practice Experience (APPE) students in a centralized retail pharmacy system and to evaluate and quantify the clinical and financial contributions of the students...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28443338/child-passenger-safety-technician-consultation-in-the-pediatric-primary-care-setting
#17
Dina Burstein, Mark R Zonfrillo, Janette Baird, Michael J Mello
Correct use of a child safety seat (CSS) can reduce the risk of fatal motor vehicle crash-related injury by up to 71%; however, misuse rates for CSS are as high as 70%. We recruited 189 caregivers at 2 large suburban pediatric office practices; 94 in the intervention group and 95 in the control group. All participants completed a baseline survey and received a CSS safety brochure. Intervention participants had their CSS installation checked at enrollment by a certified child passenger safety (CPS) technician...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28435420/qualitative-evaluation-of-the-implementation-of-an-integrated-care-delivery-model-for-chronic-patients-with-multi-morbidity-in-the-basque-country
#18
María Luz Jauregui, Carmen Silvestre, Pedro Valdes, Idoia Gaminde
INTRODUCTION: The objective of this study was to assess a model for improving healthcare integration for patients with multiple chronic diseases in an integrated healthcare organisation in the Basque Country and to propose areas for improvement. METHODS: We organised four nominal groups composed of representatives from different categories of clinicians involved in the development of an integrated healthcare organisation and in the integrated care of patients with multiple diseases, namely, internists, general practitioners, and primary care and hospital nurses...
August 19, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28434754/-patient-safety-culture-in-family-practice-residents-of-galicia
#19
Manuel Portela Romero, Rosendo Bugarín González, María Sol Rodríguez Calvo
OBJECTIVE: To determine the views held by Family practice (FP) residents on the different dimensions of patient safety, in order to identify potential areas for improvement. DESIGN: A cross-sectional study. LOCATION: Seven FP of Galicia teaching units. PARTICIPANTS: 182 FP residents who completed the Medical Office Survey on Patient Safety Culture questionnaire. MEASUREMENTS: The Medical Office Survey on Patient Safety Culture questionnaire was chosen because it is translated, validated, and adapted to the Spanish model of Primary Care...
April 20, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28434466/cost-effectiveness-of-acupuncture-in-an-employee-population-a-retrospective-analysis
#20
Bijan J Borah, James M Naessens, Amy E Glasgow, Brent A Bauer, Tony Y Chon
OBJECTIVES: To determine whether acupuncture is a cost-effective adjunct to usual care for Mayo Clinic employees and their dependents experiencing pain symptoms. DESIGN: Retrospective review of the medical and billing records of 466 employee-patients and their dependents who had received acupuncture as part of their care and 466 propensity score-matched control patients. INTERVENTIONS: Usual care in combination with acupuncture compared with usual care alone...
April 2017: Complementary Therapies in Medicine
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