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https://www.readbyqxmd.com/read/29776478/perceptions-of-health-care-professionals-on-the-effects-of-residential-summer-camp-in-their-patients
#1
P Galen DiDomizio, Ann Gillard
PURPOSE: A growing body of literature exists regarding medical specialty camps for children. However, very little of the research focuses on the perspectives of healthcare providers. This study explored perceptions of pediatric healthcare providers on a medical specialty camp for children. DESIGN AND METHODS: Interviews with five volunteer physicians and five nurses were conducted and analyzed using inductive content analysis. RESULTS: Results showed that healthcare providers perceived camp to be a positive influence on campers' normalization and healthcare ownership, and to strengthen patient-provider relationships...
May 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29743228/implementation-of-the-geriatric-patient-aligned-care-team-model-in-the-veterans-health-administration-va
#2
Jennifer L Sullivan, Rina Eisenstein, Thomas Price, Samantha Solimeo, Kenneth Shay
BACKGROUND: Here, we describe the implementation of a specialty primary care medical home (PCMH) model called Geriatric Patient-Aligned Care Teams (GeriPACT) in the Veterans' Health Administration (VA) that is focused on serving older complex patients. In particular, our aims in this article are to describe how the GeriPACT model was developed and implemented in VA sites, provide a closer look at how GeriPACT functions by presenting a case study, and highlight data showing national variation in the implementation of GeriPACT staffing models and PCMH practices...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29685465/concurrent-spontaneous-pneumomediastinum-and-pneumorrhachis
#3
Alexander J Heckman, Michael Mohseni, Armando Villanueva, Jennifer B Cowart, Charles G Graham
BACKGROUND: Spontaneous pneumomediastinum with concurrent pneumorrhachis (air in the spinal canal) and subcutaneous emphysema can be an alarming presentation, both clinically and radiographically. These clinical entities often require only conservative measures after ruling out any worrisome underlying causes. Management often involves appropriate imaging, hospital admission, and sub-specialty consultation as needed to help determine any potential causes for the presentation that may require anything more than a period of medical observation...
April 20, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29620961/building-a-medicaid-ambulatory-complex-care-program-within-an-urban-medical-home
#4
Laura D Sander, Michael Albert, Nkem Okeke, Steven Kravet, Katherine Rediger, Sarah Johnson Conway, Maura J McGuire
Five percent of Medicaid patients account for 50% of total costs. Preventable costs are often incurred by patients with complex medical, behavioral, and social needs who disproportionately utilize acute care services. Evidence for design, implementation, and evaluation of complex care programs in the urban Medicaid population is lacking. The article provides a description of a complex care program (CCP), challenges, and early outcomes based on a pre-post evaluation. The CCP was located within an existing urban medical home...
April 5, 2018: Population Health Management
https://www.readbyqxmd.com/read/29578853/michigan-pharmacists-transforming-care-and-quality-developing-a-statewide-collaborative-of-physician-organizations-and-pharmacists-to-improve-quality-of-care-and-reduce-costs
#5
Hae Mi Choe, Alexandra Tungol Lin, Kathleen Kobernik, Marc Cohen, Laurie Wesolowicz, Nabeel Qureshi, Tom Leyden, David A Share, Rozanne Darland, David A Spahlinger
BACKGROUND: Inappropriate drug use, increasing complexity of drug regimens, continued pressure to control costs, and focus on shared accountability for clinical measures drive the need to leverage the medication expertise of pharmacists in direct patient care. A statewide strategy based on the collaboration of pharmacists and physicians regarding patient care was developed to improve disease state management and medication-related outcomes. PROGRAM DESCRIPTION: Blue Cross Blue Shield of Michigan (BCBSM) partnered with Michigan Medicine to develop and implement a statewide provider-payer program called Michigan Pharmacists Transforming Care and Quality (MPTCQ), which integrates pharmacists within physician practices throughout the state of Michigan...
April 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29538782/primary-care-preparation-for-children-with-medical-complexity-for-emergency-encounters-in-the-community
#6
Amber Hoffman, Ingrid A Larson
It can be difficult to assist children with medical complexities (CMC) in maintaining wellness outside of hospital and emergency department settings. This growing population, with high use of medical technology and specialty care, has created a challenge for community providers who may infrequently care for children with these rare disorders and needs. CMCs have increased hospitalization rates and emergency care use. It is not realistic to believe that emergency health providers will know how to manage every type of CMC when they present for emergency care...
March 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29408298/from-hypothermia-to-cephalosomatic-anastomoses-the-legacy-of-robert-white-1926-2010-at-case-western-reserve-university-of-cleveland
#7
REVIEW
Sunil Manjila, Vilakshan Alambyan, Gagandeep Singh, Priyanka Satish, Robert T Geertman
Dr. Robert J. White (1926-2010) was an eminent neurosurgeon and bioethicist, renowned for his classic work in hypothermia and pioneering mammalian head transplant experiments. He founded the Division of Neurosurgery at the Cleveland Metropolitan General Hospital (currently MetroHealth Medical Center, a level 1 trauma county hospital) and became the youngest full professor at the Case Western Reserve University in Cleveland, Ohio. With over 500 research articles to his credit, he founded the Brain Research Laboratory at what was then the Cleveland Metropolitan General Hospital, which was also home to future leaders in neurosurgery, neurosciences, and allied specialties...
May 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29406371/pediatric-specialty-care-model-for-management-of-chronic-respiratory-failure-cost-and-savings-implications-and-misalignment-with-payment-models
#8
Robert J Graham, Michael L McManus, Angie Mae Rodday, Ruth Ann Weidner, Susan K Parsons
OBJECTIVE: To describe program design, costs, and savings implications of a critical care-based care coordination model for medically complex children with chronic respiratory failure. DESIGN: All program activities and resultant clinical outcomes were tracked over 4 years using an adapted version of the Care Coordination Measurement Tool. Patient characteristics, program activity, and acute care resource utilization were prospectively documented in the adapted version of the Care Coordination Measurement Tool and retrospectively cross-validated with hospital billing data...
February 3, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29401022/a-payer-guided-approach-to-widespread-diffusion-of-behavioral-health-homes-in-real-world-settings
#9
James Schuster, Cara Nikolajski, Jane Kogan, Chaeryon Kang, Patricia Schake, Tracy Carney, Sally C Morton, Charles F Reynolds
People with serious mental illness experience decreased life expectancy related to co-occurring medical conditions. A nonprofit behavioral health managed care organization implemented an innovative behavioral health home, in partnership with community mental health providers, to build a culture of wellness among all staff members, with a focus on prevention and holistic (that is, behavioral, social, and physical) health. The behavioral health home added one of two distinct care approaches, one patient driven and the other provider driven...
February 2018: Health Affairs
https://www.readbyqxmd.com/read/29332504/changes-in-distress-measured-by-the-distress-thermometer-as-reported-by-patients-in-home-palliative-care-in-germany
#10
Stefanie Ohnhäuser, Johannes Wüller, Ann Christina Foldenauer, Tania Pastrana
AIM: To identify changes in distress as reported by patients in a home palliative care program over a 2-week period. METHODS: Prospective study in West Germany with consecutive patients cared for at home by a palliative care specialty team. Exclusion criteria were patients under 18 years of age, mentally or physically not able to complete the assessment questionnaires, or unable to comprehend German language. Distress was measured using the distress thermometer (DT); sociodemographic and medical data were collected from the patients' records...
January 2018: Journal of Palliative Care
https://www.readbyqxmd.com/read/29330238/changing-patterns-of-mental-health-care-use-the-role-of-integrated-mental-health-services-in-veteran-affairs-primary-care
#11
Lucinda B Leung, Jean Yoon, Lisa V Rubenstein, Edward P Post, Maureen E Metzger, Kenneth B Wells, Catherine A Sugar, José J Escarce
OBJECTIVE: Aiming to foster timely, high-quality mental health care for Veterans, VA's Primary Care-Mental Health Integration (PC-MHI) embeds mental health specialists in primary care and promotes care management for depression. PC-MHI and patient-centered medical home providers work together to provide the bulk of mental health care for primary care patients with low-to-moderate-complexity mental health conditions. This study examines whether increasing primary care clinic engagement in PC-MHI services is associated with changes in patient health care utilization and costs...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29238810/correlation-between-24-hour-predischarge-opioid-use-and-amount-of-opioids-prescribed-at-hospital-discharge
#12
Eric Y Chen, Andrew Marcantonio, Paul Tornetta
Importance: The United States is experiencing an opioid abuse epidemic. Opioid overprescription by physicians may contribute to this epidemic. Objectives: To determine if there was a correlation between a postoperative patient's 24-hour predischarge opioid use and the amount of opioids prescribed at hospital discharge and to determine the number of patients who used no opioids prior to discharge but were still prescribed opioids after hospital discharge. Design, Setting, and Participants: This cross-sectional study performed a retrospective record review of 18 343 postoperative patients at Boston Medical Center and Lahey Hospital and Medical Center-Burlington Campus who were discharged home after a postoperative inpatient admission of at least 24 hours...
February 21, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29226050/determinants-of-computed-tomography-head-scan-ordering-for-patients-with-low-risk-headache-in-the-emergency-department
#13
Meaghan J Mackenzie, Rashi Hiranandani, Dongmei Wang, Tak Fung, Eddy Lang
Background Many specialty societies have found that neuroimaging in headache is a low-value intervention for benign presentations. This study describes factors that influence Emergency Room (ER) physicians' adherence to Choosing Wisely (CW) recommendations for low-risk headache patients presenting to Calgary's Emergency Departments (EDs). Emergency medicine has yet to address imaging in headache as a CW topic; however, this study may inform that decision. Methods Data were retrospectively collected for all patients presenting to Calgary EDs with headaches from April 1, 2014 to March 31, 2016...
October 9, 2017: Curēus
https://www.readbyqxmd.com/read/29196486/multiple-and-multidimensional-transitions-from-trainee-to-trained-doctor-a-qualitative-longitudinal-study-in-the-uk
#14
Lisi Gordon, Divya Jindal-Snape, Jill Morrison, Janine Muldoon, Gillian Needham, Sabina Siebert, Charlotte Rees
OBJECTIVES: To explore trainee doctors' experiences of the transition to trained doctor, we answer three questions: (1) What multiple and multidimensional transitions (MMTs) are experienced as participants move from trainee to trained doctor? (2) What facilitates and hinders doctors' successful transition experiences? (3) What is the impact of MMTs on trained doctors? DESIGN: A qualitative longitudinal study underpinned by MMT theory. SETTING: Four training areas (health boards) in the UK...
December 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/29153853/community-pharmacist-collaboration-with-a-patient-centered-medical-home-establishment-of-a-patient-centered-medical-neighborhood-and-payment-model
#15
Heidi R Luder, Pam Shannon, James Kirby, Stacey M Frede
OBJECTIVES: To determine the feasibility of a partnership between a community pharmacy and a patient-centered medical home (PCMH) by measuring the impact on office- and patient-level clinical outcomes. SETTING: Kroger Pharmacy and a PCMH practice in Cincinnati, OH. PRACTICE DESCRIPTION: The Kroger Co. is a large grocery store chain that operates 102 pharmacies in the Cincinnati-Dayton marketing area. The PCMH practice is an accredited PCMH office serving more than 9000 patients in the Cincinnati area...
January 2018: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29151009/risk-stratification-triage-and-implementation-of-an-expedited-hip-fracture-treatment-protocol-is-it-safe-and-effective
#16
William Zelenty, Richard Yoon, Lorraine Hutzler, Nirmal Tejwani, Joseph Bosco
INTRODUCTION: The population of patients in the USA over the age of 65 is expected to significantly increase over the next 40 years. These patients are at increased risk for hip fractures and will pose a burden to providers in the near future. In order to provide high value care, providers will need to maintain positive outcomes, mitigate complications, and reduce overall cost burdens. This study was designed to investigate the safety and efficacy of a patient transfer protocol between a large academic medical center and a single specialty orthopaedic institution...
December 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/29144719/real-world-health-plan-claims-analysis-of-differences-in-healthcare-utilization-and-total-cost-in-patients-suffering-from-cluster-headaches-and-those-without-headache-related-conditions
#17
Michael Polson, Todd C Lord, Themmi M Evangelatos, Maria Lopes, Briana L Santaniello
BACKGROUND: According to the World Health Organization, headache disorders are underappreciated by many health systems. These disorders have a substantial impact on quality of life, yet the true correlation between headache conditions and increased total healthcare utilization is not well understood. This study further explores the impact of headache conditions on healthcare utilization. OBJECTIVES: To assess differences in healthcare utilization and total cost in patients suffering from cluster headaches (CH) compared with patients without headache-related conditions...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29137878/integration-of-medicare-and-medicaid-for-dually-eligible-beneficiaries-a-focus-group-study-examining-beneficiaries-early-experiences-in-california-s-dual-financial-alignment-demonstration
#18
Carrie L Graham, Holly C Stewart, Elaine Kurtovich, Pi-Ju Liu
BACKGROUND: In 2014 California implemented a federal dual alignment demonstration used a capitated managed healthcare model called Cal MediConnect (CMC) to integrate medical care and long term services and supports (LTSS) for beneficiaries with both Medicare and Medicaid. These beneficiaries often have complex care needs, including multiple chronic conditions and disabilities. By 2016, 120,000 eligible beneficiaries were enrolled in the program. OBJECTIVES: Focus groups with enrolled beneficiaries were conducted to gather rich data about their early experiences with quality of care, access to care, and coordination of care in CMC plans and to identify recommendations for program improvement...
January 2018: Disability and Health Journal
https://www.readbyqxmd.com/read/29137666/utilization-of-the-behavior-change-wheel-framework-to-develop-a-model-to-improve-cardiometabolic-screening-for-people-with-severe-mental-illness
#19
Christina Mangurian, Grace C Niu, Dean Schillinger, John W Newcomer, James Dilley, Margaret A Handley
BACKGROUND: Individuals with severe mental illness (e.g., schizophrenia, bipolar disorder) die 10-25 years earlier than the general population, primarily from premature cardiovascular disease (CVD). Contributing factors are complex, but include systemic-related factors of poorly integrated primary care and mental health services. Although evidence-based models exist for integrating mental health care into primary care settings, the evidence base for integrating medical care into specialty mental health settings is limited...
November 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29080435/specialty-training-for-the-retention-of-malawian-doctors-a-cost-effectiveness-analysis
#20
Kate L Mandeville, Kara Hanson, Adamson S Muula, Titha Dzowela, Godwin Ulaya, Mylène Lagarde
Few medical schools and sustained emigration have led to low numbers of doctors in many sub-Saharan African countries. The opportunity to undertake specialty training has been shown to be particularly important in retaining doctors. Yet limited training capacity means that doctors are often sent to other countries to specialise, increasing the risk that they may not return. Expanding domestic training, however, may be constrained by the reluctance of doctors to accept training in their home country. We modelled different policy options in an example country, Malawi, to examine the cost-effectiveness of expanding specialty training to retain doctors in sub-Saharan Africa...
December 2017: Social Science & Medicine
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