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https://www.readbyqxmd.com/read/28319992/organizational-and-community-factors-associated-with-magnet-status-of-u-s-hospitals
#1
Teresa Wai Chi Tai, Sherry I Bame
The Magnet Recognition Program for healthcare organizations promotes excellence in nursing services and professional practices. However, organizational and community characteristics that contribute to the adoption of Magnet status remain unexplained. Investigating organizational and community factors will help determine systematic structural and contextual dimensions of Magnet hospitals previously shown to be more cost-effective in comparison with non-Magnet hospitals. Using the baseline 2005 database of all Magnet hospitals in the United States, the authors selected a matched sample to determine key organizational and community characteristics associated with Magnet adoption while controlling for regional and local factors...
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28318837/innovations-in-first-episode-psychosis-interventions-the-case-for-a-raise-plus-approach
#2
Emily Kline, Matcheri Keshavan
Several papers in the current issue of Schizophrenia Research show evidence supporting interventions that are not yet grouped with standard care practices in FEP. Taken together, these studies make the case for a more inclusive approach for early psychosis care than what is embodied in RAISE. Although providing all interventions to all patients, however, will be impractical and expensive, a personalized approach to such interventions, whereby the appropriate interventions are implemented in a phase specific and individually tailored manner after a careful assessment of each person's core deficits within a coordinated specialty care model, is likely to improve lives and be cost-effective...
March 17, 2017: Schizophrenia Research
https://www.readbyqxmd.com/read/28317290/the-effect-of-engagement-in-an-hiv-aids-integrated-health-programme-on-plasma-hiv-1-rna-suppression-among-hiv-positive-people-who-use-illicit-drugs-a-marginal-structural-modelling-analysis
#3
L Ti, H Dong, T Kerr, R B Turje, S Parashar, J E Min, J Montaner, E Wood, M-J Milloy
OBJECTIVES: HIV treatment-as-prevention campaigns emphasize early diagnosis and immediate access to care and antiretroviral therapy for HIV-positive individuals in order to increase levels of plasma HIV RNA viral load (VL) suppression. However, the possible role of harm reduction-based programmes in this objective has not yet been well evaluated. The objective of the study was to examine the relationship between being a client of the Dr. Peter Centre (DPC; an HIV/AIDS-focused adult integrated health programme) and VL suppression among highly active antiretroviral therapy (HAART)-exposed HIV-positive people who use illicit drugs (PWUD) in Vancouver, Canada...
March 19, 2017: HIV Medicine
https://www.readbyqxmd.com/read/28314501/legal-and-regulatory-barriers-to-reverse-innovation
#4
Virginia Rowthorn, Alexander J Plum, John Zervos
BACKGROUND: Reverse innovation, or the importation of new, affordable, and efficacious models to high-income countries from the developing world, has emerged as a way to improve the health care system in the United States. Reverse innovation has been identified as a key emerging trend in global health systems in part because low-resourced settings are particularly good laboratories for low-cost/high-impact innovations that are developed out of necessity. A difficult question receiving scant attention is that of legal and regulatory barriers...
November 2016: Annals of Global Health
https://www.readbyqxmd.com/read/28302915/sex-differences-in-ischaemic-stroke-potential-cellular-mechanisms
#5
REVIEW
Anjali Chauhan, Hope Moser, Louise D McCullough
Stroke remains a leading cause of mortality and disability worldwide. More women than men have strokes each year, in part because women live longer. Women have poorer functional outcomes, are more likely to need nursing home care and have higher rates of recurrent stroke compared with men. Despite continued advancements in primary prevention, innovative acute therapies and ongoing developments in neurorehabilitation, stroke incidence and mortality continue to increase due to the aging of the U.S. POPULATION: Sex chromosomes (XX compared with XY), sex hormones (oestrogen and androgen), epigenetic regulation and environmental factors all contribute to sex differences...
April 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28302101/preventing-diabetes-in-obese-latino-youth-with-prediabetes-a-study-protocol-for-a-randomized-controlled-trial
#6
Erica G Soltero, Yolanda P Konopken, Micah L Olson, Colleen S Keller, Felipe G Castro, Allison N Williams, Donald L Patrick, Stephanie Ayers, Houchun H Hu, Matthew Sandoval, Janiel Pimentel, William C Knowler, Kevin D Frick, Gabriel Q Shaibi
BACKGROUND: Obese Latino adolescents are disproportionately impacted by insulin resistance and type 2 diabetes. Prediabetes is an intermediate stage in the pathogenesis of type 2 diabetes and represents a critical opportunity for intervention. However, to date, no diabetes prevention studies have been conducted in obese Latino youth with prediabetes, a highly vulnerable and underserved group. Therefore, we propose a randomized-controlled trial to test the short-term (6-month) and long-term (12-month) efficacy of a culturally-grounded, lifestyle intervention, as compared to usual care, for improving glucose tolerance and reducing diabetes risk in 120 obese Latino adolescents with prediabetes...
March 16, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28301335/interdisciplinary-collaboration-in-maternal-mental-health
#7
Nancy Selix, Erin Henshaw, Alinne Barrera, Luba Botcheva, Erin Huie, Gabrielle Kaufman
One out of every five to seven births is affected by postpartum depression, making it the most common maternal health problem in the first year after childbirth. Early identification and treatment are essential, though screening and treatment rates are low. Factors that inhibit effective screening and treatment include lack of uniform screening policies in all maternal health settings, poor coordination of care between primary care and mental health services, coordination of community education efforts and resources, social stigma surrounding mental health treatment, and ineffective application of research and technology in the clinical setting...
March 15, 2017: MCN. the American Journal of Maternal Child Nursing
https://www.readbyqxmd.com/read/28300980/primary-health-care-reform-in-portugal-portuguese-modern-and-innovative
#8
André Rosa Biscaia, Liliana Correia Valente Heleno
The 2005 Portuguese primary health care (CSP) reform was one of the most successful reforms of the country's public services. The most relevant event was the establishment of Family Health Units (USF): voluntary and self-organized multidisciplinary teams that provide customized medical and nursing care to a group of people. Then, the remaining realms of CSP were reorganized with the establishment of Health Center Clusters (ACeS). Clinical governance was implemented aiming at achieving health gains by improving quality and participation and accountability of all...
March 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28293127/care-pathways-in-thrombosis-management-the-innovate-peer-to-peer-educational-initiative
#9
REVIEW
Raj K Patel
CONTEXT: Anticoagulant options for the management of venous thromboembolism (VTE) now include the non-vitamin K antagonist oral anticoagulants (NOACs). The safe and effective integration of these agents into routine clinical practice within different health care settings presents common challenges. Bayer AG created the INternational Network fOr Venous and Arterial Thrombosis Excellence in practice (INNOVATE) program as a professional education network to foster best practice in thrombosis management in the NOAC era...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28291598/identifying-radiology-s-place-in-the-expanding-landscape-of-episode-payment%C3%A2-models
#10
Andrew B Rosenkrantz, Joshua A Hirsch, Bibb Allen, H Benjamin Harvey, Gregory N Nicola
The current fee-for-service system for health care reimbursement in the United Stated is argued to encourage fragmented care delivery and a lack of accountability that predisposes to insufficient focus on quality as well as unnecessary or duplicative resource utilization. Episode payment models (EPMs) seek to improve coordination by linking payments for all services related to a patient's condition or procedure, thereby improving quality and efficiency of care. The CMS Innovation Center has implemented a broadening array of EPMs...
March 10, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28280744/glycemic-excursions-in-type-1-diabetes-in-pregnancy-a-semiparametric-statistical-approach-to-identify-sensitive-time-points-during-gestation
#11
Resmi Gupta, Jane Khoury, Mekibib Altaye, Lawrence Dolan, Rhonda D Szczesniak
Aim. To examine the gestational glycemic profile and identify specific times during pregnancy that variability in glucose levels, measured by change in velocity and acceleration/deceleration of blood glucose fluctuations, is associated with delivery of a large-for-gestational-age (LGA) baby, in women with type 1 diabetes. Methods. Retrospective analysis of capillary blood glucose levels measured multiple times daily throughout gestation in women with type 1 diabetes was performed using semiparametric mixed models...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28277261/building-a-palliative-radiation-oncology-program-from-bedside-to-b-e-d
#12
Mark J Stavas, Jonathan D Pagan, Sumeeta Varma, Benjamin Li, Lisa A Kachnic
A growing body of evidence supports the integration of palliative care with standard cancer treatments. In these situations, patients often experience a better quality of life, better quality of care, decreased cost, and, in some cases, improved survival with the addition of palliative care services to traditional treatment pathways. In this manuscript, we explore the integration of radiation oncology at palliative care. First, we discuss the impetus for change at Vanderbilt University and the inception of Vanderbilt's inpatient Palliative Radiation Oncology Service at Vanderbilt...
September 13, 2016: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28271017/improved-delivery-of-cardiovascular-care-idocc-findings-from-narrative-reports-by-practice-facilitators
#13
Clare Liddy, Margo Rowan, Sophie-Claire Valiquette-Tessier, Paul Drosinis, Lois Crowe, William Hogg
Practice facilitation can help family physicians adopt evidence-based guidelines. However, many practices struggle to effectively implement practice changes that result in meaningful improvement. Building on our previous research, we examined the barriers to and enablers of implementation perceived by practice facilitators (PF) in helping practices to adopt the Improved Delivery of Cardiovascular Care (IDOCC) program, which took place at 84 primary care practices in Ottawa, Canada between April 2008 and March 2012...
March 2017: Preventive Medicine Reports
https://www.readbyqxmd.com/read/28270122/implementation-of-integrated-geriatric-care-at-a-german-hospital-a-case-study-to-understand-when-and-why-beneficial-outcomes-can-be-achieved
#14
Loraine Busetto, Jörn Kiselev, Katrien Ger Luijkx, Elisabeth Steinhagen-Thiessen, Hubertus Johannes Maria Vrijhoef
BACKGROUND: Many health systems have implemented integrated care as an alternative approach to health care delivery that is more appropriate for patients with complex, long-term needs. The objective of this article was to analyse the implementation of integrated care at a German geriatric hospital and explore whether the use of a "context-mechanisms-outcomes"-based model provides insights into when and why beneficial outcomes can be achieved. METHODS: We conducted 15 semi-structured interviews with health professionals employed at the hospital...
March 7, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28264956/primary-health-care-that-works-the-costa-rican-experience
#15
Madeline Pesec, Hannah L Ratcliffe, Ami Karlage, Lisa R Hirschhorn, Atul Gawande, Asaf Bitton
Long considered a paragon among low- and middle-income countries in its provision of primary health care, Costa Rica reformed its primary health care system in 1994 using a model that, despite its success, has been generally understudied: basic integrated health care teams. This case study provides a detailed description of Costa Rica's innovative implementation of four critical service delivery reforms and explains how those reforms supported the provision of the four essential functions of primary health care: first-contact access, coordination, continuity, and comprehensiveness...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28264953/impact-of-health-care-delivery-system-innovations-on-total-cost-of-care
#16
Kevin W Smith, Anupa Bir, Nikki L B Freeman, Benjamin C Koethe, Julia Cohen, Timothy J Day
Using delivery system innovations to advance health care reform continues to be of widespread interest. However, it is difficult to generalize about the success of specific types of innovations, since they have been examined in only a few studies. To gain a broader perspective, we analyzed the results of forty-three ambulatory care programs funded by the first round of the Center for Medicare and Medicaid Innovation's Health Care Innovations Awards. The innovations' impacts on total cost of care were estimated by independent evaluators using multivariable difference-in-differences models...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28264944/innovative-oncology-care-models-improve-end-of-life-quality-reduce-utilization-and-spending
#17
Erin Murphy Colligan, Erin Ewald, Sarah Ruiz, Michelle Spafford, Caitlin Cross-Barnet, Shriram Parashuram
Three models that received Health Care Innovation Awards from the Centers for Medicare and Medicaid Services (CMS) aimed to reduce the cost and use of health care services and improve the quality of care for Medicare beneficiaries with cancer. Each emphasized a different principle: the oncology medical home, patient navigation, or palliative care. Comparing participants in each model who died during the study period to matched comparators, we found that the oncology medical home and patient navigation models were associated with decreased costs in the last ninety days of life ($3,346 and $5,824 per person, respectively) and fewer hospitalizations in the last thirty days of life (fifty-seven and forty per 1,000 people, respectively)...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28264943/innovative-home-visit-models-associated-with-reductions-in-costs-hospitalizations-and-emergency-department-use
#18
Sarah Ruiz, Lynne Page Snyder, Christina Rotondo, Caitlin Cross-Barnet, Erin Murphy Colligan, Katherine Giuriceo
While studies of home-based care delivered by teams led by primary care providers have shown cost savings, little is known about outcomes when practice-extender teams-that is, teams led by registered nurses or lay health workers-provide home visits with similar components (for example, care coordination and education). We evaluated findings from five models funded by Health Care Innovation Awards of the Centers for Medicare and Medicaid Services. Each model used a mix of different components to strengthen connections to primary care among fee-for-service Medicare beneficiaries with multiple chronic conditions; these connections included practice-extender home visits...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28264942/impact-of-the-ymca-of-the-usa-diabetes-prevention-program-on-medicare-spending-and-utilization
#19
Maria L Alva, Thomas J Hoerger, Ravikumar Jeyaraman, Peter Amico, Lucia Rojas-Smith
The YMCA of the USA received a Health Care Innovation Award from the Centers for Medicare and Medicaid Services to provide a diabetes prevention program to Medicare beneficiaries with prediabetes in seventeen regional networks of participating YMCAs nationwide. The goal of the program is to help participants lose weight and increase physical activity. We tested whether the program reduced medical spending and utilization in the Medicare population. Using claims data to compute total medical costs for fee-for-service Medicare participants and a matched comparison group of nonparticipants, we found that the overall weighted average savings per member per quarter during the first three years of the intervention period was $278...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28264941/strategies-for-assessing-delivery-system-innovations
#20
Elizabeth A McGlynn, Mark McClellan
Driven by evidence of continuing gaps in health care quality and efficiency and inspired by the emergence of new value-based payment models, both large and small health care organizations are developing and deploying a wide range of care delivery innovations. But how can decision makers in these organizations determine if the innovations really improve service delivery, patient experience, clinical outcomes, or costs? Organization leaders need appropriate, timely evidence to inform their decision making. In this article we describe a range of approaches to evaluating innovations and pose key questions about the validity of the results...
March 1, 2017: Health Affairs
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