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Health care redesign

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https://www.readbyqxmd.com/read/27870546/integrated-care-organizations-medicare-financing-for-care-at-home
#1
Karen Davis, Amber Willink, Cathy Schoen
OBJECTIVES: As the boomer population ages, there is a growing need for integrated care organizations (ICOs) that can integrate both medical care and long-term services and supports in the home. This paper presents a policy proposal to support the creation of ICOs, redesign care, and provide financing for home- and community-based services (HCBS), with the goal of enhancing financial protection for beneficiaries, coordinating care, and preventing costly hospital and nursing home use. METHODS: This study used the 2012 Medicare Current Beneficiary Survey (MCBS) Cost and Use File, inflated to 2016 figures, to describe the characteristics of Medicare beneficiaries and their healthcare utilization and spending...
November 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27821596/do-online-communities-change-power-processes-in-healthcare-using-case-studies-to-examine-the-use-of-online-health-communities-by-patients-with-parkinson-s-disease
#2
Laura M Visser, Inge L Bleijenbergh, Yvonne W M Benschop, Allard C R Van Riel, Bastiaan R Bloem
OBJECTIVE: Communication technologies, such as personal online health communities, are increasingly considered as a tool to realise patient empowerment. However, little is known about the actual use of online health communities. Here, we investigated if and how patients' use of online communities supports patient empowerment. SETTING: A network of primary and secondary care providers around individual patients with Parkinson's disease. PARTICIPANTS: We conducted case studies to examine our research question...
November 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27802560/outcomes-oriented-medical-training-a-critical-curricular-design-consideration-in-developing-21st-century-health-care-professionals
#3
Darrin D'Agostino, Frank J Papa
The core competencies of medical schools and residencies have initiated a change in curricular design but have been limited in their execution of systems-based practice. The introduction of milestones and entrustable professional activities has emerged to enhance the current educational paradigm. Linking public health systemic approaches with evidence-based practices focused on population-level health care will affect patients more than current non-systems-based approaches. Curricular redesign, including population health-based strategies, public health competency, health care policy, and education linking the "determinants of health" to patient care, will better prepare future physicians to practice in the emerging paradigm of health care of the future...
November 1, 2016: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/27784648/protocol-for-a-randomized-controlled-trial-of-proactive-web-based-versus-telephone-based-information-and-support-can-electronic-platforms-deliver-effective-care-for-lung-cancer-patients
#4
Christine L Paul, Allison W Boyes, Lorna O'Brien, Amanda L Baker, Frans A Henskens, Ian Roos, Tara Clinton-McHarg, Douglas Bellamy, Glenda Colburn, Shiho Rose, Martine E Cox, Elizabeth A Fradgley, Hannah Baird, Daniel Barker
BACKGROUND: Community-based services such as telephone support lines can provide valuable informational, emotional, and practical support for cancer patients via telephone- or Web-based (live chat or email) platforms. However, very little rigorous research has examined the efficacy of such services in improving patient outcomes. OBJECTIVE: This study will determine whether: proactive telephone or Web-delivered support produces outcomes superior to printed information; and Web-delivered support produces outcomes comparable to telephone support...
October 26, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27756368/the-effect-of-ncms-on-catastrophic-health-expenditure-and-impoverishment-from-tuberculosis-care-in-china
#5
Chengchao Zhou, Qian Long, Jiaying Chen, Li Xiang, Qiang Li, Shenglan Tang, Fei Huang, Qiang Sun, Henry Lucas, Shitong Huan
BACKGROUND: Health expenditure for tuberculosis (TB) care often pushes households into catastrophe and poverty. New Cooperative Medical Scheme (NCMS) aims to protect households from catastrophic health expenditure (CHE) and impoverishment in rural China. This article assesses the effect of NCMS on relieving CHE and impoverishment from TB care in rural China. METHODS: Three hundred fourty-seven TB cases are included in the analysis. We analyze the incidence and intensity of CHE and poverty, and assess the protective effect of NCMS by comparing the CHE and impoverishment before and after reimbursement...
October 18, 2016: International Journal for Equity in Health
https://www.readbyqxmd.com/read/27753670/integrating-geropsychiatric-nursing-and-interprofessional-collaborative-practice-competencies-into-adult-gerontology-clinical-nurse-specialist-education
#6
Ann M Mayo, Melodee Harris, Bill Buron
Specific changes to the national clinical nurse specialist (CNS) certification are necessitating a move away the psychiatric/mental health (P/MH) CNS population focus. However, a rapidly increasing older adult population with P/MH comorbidities such as depression and anxiety means that the adult-gerontology CNS (AGCNS) will likely be coordinating much of the complex care needs of this vulnerable population. Therefore, strategies are needed to ensure AGCNSs are competent in advanced practice P/MH nursing. In addition, at this critical time in the redesign of healthcare, the Institute of Medicine has made interprofessional practice center stage for healthcare professional education...
November 2016: Clinical Nurse Specialist CNS
https://www.readbyqxmd.com/read/27749347/using-lean-six-sigma-methodology-to-improve-quality-of-the-anesthesia-supply-chain-in-a-pediatric-hospital
#7
Renée J Roberts, Ashley E Wilson, Zenaide Quezado
Six Sigma and Lean methodologies are effective quality improvement tools in many health care settings. We applied the DMAIC methodology (define, measure, analyze, improve, control) to address deficiencies in our pediatric anesthesia supply chain. We defined supply chain problems by mapping existing processes and soliciting comments from those involved. We used daily distance walked by anesthesia technicians and number of callouts for missing supplies as measurements that we analyzed before and after implementing improvements (anesthesia cart redesign)...
October 3, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27729027/what-is-the-impact-of-systems-of-care-for-heart-failure-on-patients-diagnosed-with-heart-failure-a-systematic-review
#8
Andrea Driscoll, Sharon Meagher, Rhoda Kennedy, Melanie Hay, Jayant Banerji, Donald Campbell, Nicholas Cox, Debra Gascard, David Hare, Karen Page, Voltaire Nadurata, Rhonda Sanders, Harry Patsamanis
BACKGROUND: Hospital admissions for heart failure are predicted to rise substantially over the next decade placing increasing pressure on the health care system. There is an urgent need to redesign systems of care for heart failure to improve evidence-based practice and create seamless transitions through the continuum of care. The aim of the review was to examine systems of care for heart failure that reduce hospital readmissions and/or mortality. METHOD: Electronic databases searched were: Ovid MEDLINE, EMBASE, CINAHL, grey literature, reviewed bibliographies and Cochrane Central Register of Controlled Trials for randomised controlled trials, non-randomised trials and cohort studies from 1(st) January 2008 to 4(th) August 2015...
October 11, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27720202/time-driven-activity-based-costing-of-low-dose-rate-and-high-dose-rate-brachytherapy-for-low-risk-prostate-cancer
#9
Annette M Ilg, Aaron A Laviana, Mitchell Kamrava, Darlene Veruttipong, Michael Steinberg, Sang-June Park, Michael A Burke, Douglas Niedzwiecki, Patrick A Kupelian, Christopher Saigal
PURPOSE: Cost estimates through traditional hospital accounting systems are often arbitrary and ambiguous. We used time-driven activity-based costing (TDABC) to determine the true cost of low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy for prostate cancer and demonstrate opportunities for cost containment at an academic referral center. METHODS AND MATERIALS: We implemented TDABC for patients treated with I-125, preplanned LDR and computed tomography based HDR brachytherapy with two implants from initial consultation through 12-month followup...
October 3, 2016: Brachytherapy
https://www.readbyqxmd.com/read/27713112/developing-a-health-information-technology-systems-matrix-a-qualitative-participatory-approach
#10
Jolie N Haun, Margeaux Chavez, Kim M Nazi, Nicole Antinori
BACKGROUND: The US Department of Veterans Affairs (VA) has developed various health information technology (HIT) resources to provide accessible veteran-centered health care. Currently, the VA is undergoing a major reorganization of VA HIT to develop a fully integrated system to meet consumer needs. Although extensive system documentation exists for various VA HIT systems, a more centralized and integrated perspective with clear documentation is needed in order to support effective analysis, strategy, planning, and use...
October 6, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27712605/creating-a-professional-ladder-for-interpreters-for-improvement-of-care
#11
Lori Marshall, Anna Fischer, Allison Noyes Soeller, Richard Cordova, Yvonne R Gutierrez, Luis Alford
BACKGROUND: Children's Hospital Los Angeles (CHLA), a metropolitan academic medical center, recognized limitations in how the professional interpreters from the Diversity Services Department were used to support effective patient-provider communication across the organization. Given the importance of mitigating language and communication barriers, CHLA sought to minimize clinical and structural barriers to health care for limited English proficiency populations through a comprehensive restructuring of the Diversity Services Department...
2016: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/27695822/alternative-strategies-to-inpatient-hospitalization-for-acute-medical-conditions-a-systematic-review
#12
Jared Conley, Colin W O'Brien, Bruce A Leff, Shari Bolen, Donna Zulman
Importance: Determining innovative approaches that better align health needs to the appropriate setting of care remains a key priority for the transformation of US health care; however, to our knowledge, no comprehensive assessment exists of alternative management strategies to hospital admission for acute medical conditions. Objective: To examine the effectiveness, safety, and cost of managing acute medical conditions in settings outside of a hospital inpatient unit...
October 3, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27695373/police-custody-health-care-a-review-of-health-morbidity-models-of-care-and-innovations-within-police-custody-in-the-uk-with-international-comparisons
#13
Iain G McKinnon, Stuart Dm Thomas, Heather L Noga, Jane Senior
This paper is a scoping review of the available evidence regarding health care issues in police custody. It describes the types and prevalence of health disorders encountered in custody and provides an overview of current practice and recent innovations in police custody health care. In contrast to the health of prisoners, the health of police custody detainees has, until recently, received little academic or clinical attention. Studies on health care in police custody identified for this review are limited to a few geographical jurisdictions, including the UK, continental Europe, North America, and Australia...
2016: Risk Management and Healthcare Policy
https://www.readbyqxmd.com/read/27684616/interoperability-of-information-systems-managed-and-used-by-the-local-health-departments
#14
Gulzar H Shah, Jonathon P Leider, Huabin Luo, Ravneet Kaur
BACKGROUND: In the post-Affordable Care Act era marked by interorganizational collaborations and availability of large amounts of electronic data from other community partners, it is imperative to assess the interoperability of information systems used by the local health departments (LHDs). OBJECTIVES: To describe the level of interoperability of LHD information systems and identify factors associated with lack of interoperability. DATA AND METHODS: This mixed-methods research uses data from the 2015 Informatics Capacity and Needs Assessment Survey, with a target population of all LHDs in the United States...
November 2016: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/27679723/renew-a-renal-redesign-project-in-predialysis-patient-care
#15
Josephine Sau Fan Chow, Kim Jobburn, Margaret Chapman, Michael Suranyi
BACKGROUND: An ageing population and geographical growth, along with an increase in the number of people that reside in specific location, are increasing the demand for renal replacement therapies. Hospital-based haemodialysis units are struggling to cope with the associated physical, staffing and cost demands. Home-based dialysis therapies are known to be more cost effective with superior social, physical health and survival outcomes. METHODS: 'RENEW, a renal redesign project, examined the pre-dialysis health care experience of renal patients to find opportunities to improve patient care outcomes and increase the uptake of home-based dialysis therapies...
October 2016: Clinical Kidney Journal
https://www.readbyqxmd.com/read/27670208/fast-track-systems-improve-timely-carotid-endarterectomy-in-stroke-prevention-outpatients
#16
Sophia Gocan, Aline Bourgoin, Dylan Blacquiere, Rany Shamloul, Dar Dowlatshahi, Grant Stotts
BACKGROUND: For optimal stroke prevention, best practices guidelines recommend carotid endarterectomy (CEA) for symptomatic patients within two weeks; however, 2013 Ontario data indicated that only 9% of eligible patients from outpatient Stroke Prevention Clinics (SPCs) achieved this target. The goal of our study was to identify modifiable system factors that could enhance the quality and timeliness of care among patients needing urgent CEA. METHODS: We conducted a retrospective chart review of transient ischemic attack/stroke patients assessed in Champlain Local Health Integrated Network SPCs between 2011 and 2014 who subsequently underwent CEA...
September 2016: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/27663517/utilizing-health-analytics-in-improving-the-performance-of-healthcare-services-a-case-study-on-a-tertiary-care-hospital
#17
Mohamed Khalifa, Ibrahim Zabani
Among the most common and chronic problems in the healthcare system worldwide is the crowding of emergency rooms (ER); leading to many serious complications. King Faisal Specialist Hospital and Research Center utilized health analytics methods to identify areas of deficiency and suggest potential improvements to ER performance. The project implemented solutions and monitored two indicators; ER length of stay (LOS), reflecting efficiency, and percentage of patients leaving without treatment, reflecting effectiveness of the ER...
November 2016: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/27637827/across-the-divide-primary-care-departments-working-together-to-redesign-care-to-achieve-the-triple-aim
#18
Steven Koslov, Elizabeth Trowbridge, Sandra Kamnetz, Sally Kraft, Jeffrey Grossman, Nancy Pandhi
BACKGROUND: Primary care is considered the foundation of an effective health care system. However, primary care departments at academic health centers have numerous challenges to overcome when trying to achieve the Triple Aim. METHODS: As part of an organizational initiative to redesign primary care at a large academic health center, departments of internal medicine, general pediatrics and adolescent medicine, and family medicine worked together to comprehensively redesign primary care...
September 2016: Healthcare
https://www.readbyqxmd.com/read/27613796/practice-based-research-networks-pbrns-bridging-the-gaps-between-communities-funders-and-policymakers
#19
Anne H Gaglioti, James J Werner, George Rust, Lyle J Fagnan, Anne Victoria Neale
In this commentary, we propose that practice-based research networks (PBRNs) engage with funders and policymakers by applying the same engagement strategies they have successfully used to build relationships with community stakeholders. A community engagement approach to achieve new funding streams for PBRNs should include a strategy to engage key stakeholders from the communities of funders, thought leaders, and policymakers using collaborative principles and methods. PBRNs that implement this strategy would build a robust network of engaged partners at the community level, across networks, and would reach state and federal policymakers, academic family medicine departments, funding bodies, and national thought leaders in the redesign of health care delivery...
September 2016: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/27608524/implementation-of-an-emergency-department-sepsis-bundle-and-system-redesign-a-process-improvement-initiative
#20
Tamara McColl, Mathieu Gatien, Lisa Calder, Krishan Yadav, Ryan Tam, Melody Ong, Monica Taljaard, Ian Stiell
BACKGROUND: In 2008-2009, the Canadian Institute for Health Information reported over 30,000 cases of sepsis hospitalizations in Canada, an increase of almost 4,000 from 2005. Mortality rates from severe sepsis and septic shock continue to remain greater than 30% in Canada and are significantly higher than other critical conditions treated in the emergency department (ED). Our group formed a multidisciplinary sepsis committee, conducted an ED process of care analysis, and developed a quality improvement protocol...
September 9, 2016: CJEM
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