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Physician engagement

Kirsten Beck, Elaine Albert, Andrew Johnsen, Courtney Newhouse, John McGuire
Medical rounds in the Pediatric Intensive Care Unit (PICU) took about four hours each day to complete. The length of rounds was affecting the advancement of care of the patients, the engagement of sub-specialty providers who needed to be present on other rounds, and the engagement of the PICU faculty and staff due to overburdening waste created by the long duration of rounds. Specific interventions were identified aimed at reducing the duration of rounds each day, increasing engagement of the rounding team and satisfying the needs of the patients and families...
2016: BMJ Quality Improvement Reports
Amira Mustafa, Samar Mahgoub
Delays in the discharge of hospital patients cause a backlog for new admissions from the Emergency Departments (ED), outpatient clinics, and transfers from the Intensive Care Units (ICU). A variety of initiatives have been reported on previously which aim to tackle this problem with variable success. In this quality improvement project, we aimed to increase the proportion of discharged patients who leave the paediatric unit by 12:00 Noon from 7% to 30% by May 2015. A baseline discharge process map was studied to understand the possible causes of the delays...
2016: BMJ Quality Improvement Reports
Ellen A Lipstein, Daniel J Lovell, Lee A Denson, Sandra C Kim, Charles Spencer, Richard F Ittenbach, Maria T Britto
OBJECTIVES: To understand the association between parents' perceptions of the decision process and the decision outcomes in decisions about the use of biologics in pediatric chronic conditions. METHODS: We mailed surveys to parents of children with IBD (inflammatory bowel disease) or JIA (juvenile idiopathic arthritis) who had started treatment with biologics in the prior two years and were treated at either of 2 children's hospitals. The survey included measures of the decision process, including decision control and physician engagement, and decision outcomes, including conflict and regret...
September 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
Michael I Brener, Jeremy A Epstein, Jeremy Cho, Hsin-Chieh Yeh, Robert A Dudas, Leonard Feldman
BACKGROUND: Patients often cannot recognise the names and faces of providers involved in their hospital care. OBJECTIVE: The aim of this study was to determine whether photographs of a patient's providers (physicians and ancillary support staff) using the FACES (Faces of All Clinically Engaged Staff) instrument would increase recognition of the healthcare team, improve the perception of teamwork, and enhance patient satisfaction. METHODS: Cluster randomised controlled trial with patients admitted to four adult internal medicine services of an urban, tertiary care hospital...
October 14, 2016: International Journal of Clinical Practice
Tasha R Wyatt, Kelli Braun, Lance Evans, Alexis Rossi, Paul M Wallach, Lara M Stepleman
INTRODUCTION: In institutional assessments of faculty, scholarly activity is often cited as a deficiency. Faculty lack the training and resources needed to produce peer-reviewed, quality scholarship. Although a variety of formats have been suggested and used to fill this void, fellowships are a commonly used format to foster educational leaders within institutions. In 2010, the Educational Innovation Institute at the Medical College of Georgia created an educational research fellowship to address this need...
October 13, 2016: Perspectives on Medical Education
Kelly K Anderson, Paul Kurdyak
OBJECTIVE: Physician follow-up after a first diagnosis of psychotic disorder is crucial for improving treatment engagement. We examined the factors associated with physician follow-up within 30 days of a first diagnosis of schizophrenia. METHOD: We conducted a retrospective cohort study using linked health administrative data to identify incident cases of schizophrenia between 1999 and 2008 among people aged 14 to 35 years in Ontario. We estimated the proportion of patients who had physician follow-up within 30 days of the index diagnosis...
October 13, 2016: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
Maria Lalouni, Ola Olén, Marianne Bonnert, Erik Hedman, Eva Serlachius, Brjánn Ljótsson
BACKGROUND: Children with pain-related functional gastrointestinal disorders (P-FGIDs) have an increased risk for school absenteeism, depression, anxiety and low quality of life. Exposure-based cognitive behavior therapy (CBT) has shown large treatment effects in adults with irritable bowel syndrome, but has not been tested for children 8-12 years with P-FGIDs. AIM: The aim of this trial was to test the feasibility, acceptability and potential efficacy of a newly developed exposure-based CBT for children with P-FGIDs...
2016: PloS One
Ian Kodish
Functional neurological symptom disorder (FNSD) is characterized by motor or sensory impairments inconsistent with recognized neurologic conditions. Usually emerging in adolescence, somatic symptoms remain challenging for the physician to assess and treat. Also termed "conversion disorder," FNSD has been recently reconceptualized with greater diagnostic emphasis on positive neurologic findings while eliminating the requirement for a precipitating stressor. This has broadened the initial treatment emphasis from mandating psychotherapeutic engagement to a more collaborative model that requires open communication of neurologic findings and strives to align with families' perspectives...
October 1, 2016: Pediatric Annals
Yves Bergevin, Bettina Habib, Keesa Elicksen-Jensen, Stephen Samis, Jean Rochon, Jean-Louis Denis, Denis Roy
A study on the impact of regionalization on the Triple Aim of Better Health, Better Care and Better Value across Canada in 2015 identified major findings including: (a) with regard to the Triple Aim, the Canadian situation is better than before but variable and partial, and Canada continues to underperform compared with other industrialized countries, especially in primary healthcare where it matters most; (b) provinces are converging toward a two-level health system (provincial/regional); (c) optimal size of regions is probably around 350,000-500,000 population; d) citizen and physician engagement remains weak...
2016: HealthcarePapers
Jennifer Hulme, Catherine Moravac, Farah Ahmad, Shelley Cleverly, Aisha Lofters, Ophira Ginsburg, Sheila Dunn
BACKGROUND: Breast and cervical cancer screening rates remain low among immigrant women and those of low socioeconomic status. The Cancer Awareness: Ready for Education and Screening (CARES) project ran a peer-led multi-lingual educational program between 2012 and 2014 to reach under and never-screened women in Central Toronto, where breast and cervical cancer screening rates remain low. The objective of this qualitative study was to better understand how Chinese and South Asian immigrants - the largest and most under-screened immigrant groups according to national and provincial statistics - conceive of breast and cervical cancer screening...
October 13, 2016: BMC Public Health
Bradley D Holbrook, Stephen M Petterson, William F Rayburn
Objectives Retirement of "baby boomer" physicians is a matter of growing concern in light of the shortage of certain physician groups. The objectives of this investigation were to define what constitutes a customary retirement age range of maternal-fetal medicine (MFM) physicians and examine how that compares with other obstetrician-gynecologist (ob-gyn) specialists. Study Design This descriptive study was based on American Medical Association Masterfile survey data from 2010 to 2014. Data from the National Provider Identifier were used to correct for upward bias in reporting retirement ages...
October 12, 2016: American Journal of Perinatology
Suzette C Brémault-Phillips, Jasneet Parmar, Steven Friesen, Laura G Rogers, Ashley Pike, Bryan Sluggett
BACKGROUND: The Decision-Making Capacity Assessment (DMCA) Model includes a best-practice process and tools to assess DMCA, and implementation strategies at the organizational and assessor levels to support provision of DMCAs across the care continuum. A Developmental Evaluation of the DMCA Model was conducted. METHODS: A mixed methods approach was used. Survey (N = 126) and focus group (N = 49) data were collected from practitioners utilizing the Model. RESULTS: Strengths of the Model include its best-practice and implementation approach, applicability to independent practitioners and inter-professional teams, focus on training/mentoring to enhance knowledge/skills, and provision of tools/processes...
September 2016: Canadian Geriatrics Journal: CGJ
C Reese, F Petrak, O Mittag
Purpose: The goal of the project was to develop evidence- and consensus-based practice guidelines for psychological interventions in the rehabilitation of patients with type 2 diabetes. Method: The practice guidelines were developed in several steps including a literature search, surveys of clinicians (psychologists and head physicians from rehabilitation centres) and an expert workshop. National experts from scientific departments, rehabilitation centres and patients were engaged in the development of the practice guidelines...
October 2016: Die Rehabilitation
Laura E Walker, Annie T Sadosty, James E Colletti, Deepi G Goyal, Kharmene L Sunga, Sharonne N Hayes
Since 1995, women have comprised more than 40% of all medical school graduates. However, representation at leadership levels in medicine remains considerably lower. Gender representation among the American Board of Medical Specialties (ABMS) boards of directors (BODs) has not previously been evaluated. Our objective was to determine the relative representation of women on ABMS BODs and compare it with the in-training and in-practice gender composition of the respective specialties. The composition of the ABMS BODs was obtained from websites in March 2016 for all Member Boards...
October 7, 2016: Mayo Clinic Proceedings
Norio Sugawara, Manabu Saito, Kazuhiko Nakamura
Since December 1, 2015, the Japanese government has required employers to conduct the Stress Check Program. The Ministry of Health, Labour and Welfare announced that this program should focus on the primary prevention of mental health problems. Although employers are obliged to perform screening for mental health problems and a physician's interview, employees are not mandated to participate in this program. Classical occupational health studies have accumulated evidence indicating that quantitative or qualitative workload is associated with mental health problems...
September 30, 2016: Journal of Occupational Health
S Aybek, P Vuilleumier
Brain imaging techniques provide unprecedented opportunities to study the neural mechanisms underlying functional neurologic disorder (FND, or conversion disorder), which have long remained a mystery and clinical challenge for physicians, as they arise with no apparent underlying organic disease. One of the first questions addressed by imaging studies concerned whether motor conversion deficits (e.g., hysteric paralysis) represent a form of (perhaps unconscious) simulation, a mere absence of voluntary movement, or more specific disturbances in motor control (such as abnormal inhibition)...
2017: Handbook of Clinical Neurology
Kathrin M Cresswell, Lisa Lee, Hajar Mozaffar, Robin Williams, Aziz Sheikh
OBJECTIVE: To explore and understand approaches to user engagement through investigating the range of ways in which health care workers and organizations accommodated the introduction of computerized physician order entry (CPOE) and computerized decision support (CDS) for hospital prescribing. STUDY SETTING: Six hospitals in England, United Kingdom. STUDY DESIGN: Qualitative case study. DATA COLLECTION: We undertook qualitative semi-structured interviews, non-participant observations of meetings and system use, and collected organizational documents over three time periods from six hospitals...
October 7, 2016: Health Services Research
David A Cook, Morris J Blachman, Colin P West, Christopher M Wittich
OBJECTIVES: To determine physicians' perceptions of current maintenance of certification (MOC) activities and to explore how perceptions vary across specialties, practice characteristics, and physician characteristics, including burnout. PATIENTS AND METHODS: We conducted an Internet and paper survey among a national cross-specialty random sample of licensed US physicians from September 23, 2015, through April 18, 2016. The questionnaire included 13 MOC items, 2 burnout items, and demographic variables...
October 2016: Mayo Clinic Proceedings
C Maulsby, R O Valdiserri, J J Kim, N Mahon, A Flynn, E Eriksson, K M Jain, Blessing Enobun, D R Holtgrave
The National HIV AIDS Strategy (NHAS) calls for a more coordinated response to the HIV epidemic. The Global Engagement in Care Convening created a forum for domestic and international experts to identify best practices in HIV care. This manuscript summarizes the meeting discussions and recommendations from meeting notes and an audio recording of the meeting. Recommendations include: further standardization of performance goals and performance measures; additional research; a more robust system to support competing needs of clients receiving services; electronic information exchanges for HIV-related data; an expansion of the role of other health professionals to extend the capacity of physicians and other members of the care team; and revisions to current financing systems to increase reimbursement for and access to services that promote linkage to and retention in HIV care...
October 2016: AIDS Education and Prevention: Official Publication of the International Society for AIDS Education
Tim Blake, Andrew Whallett
Medical registrars have been described as the 'workhorses' of National Health Service hospitals, being at the interface of acute and chronic health services. They are expected to demonstrate effective leadership skills. There are concerns from the Royal College of Physicians that medical registrars are being overwhelmed and unsupported by organisations, and are struggling in their ability to provide safe, high-quality patient care. Junior colleagues are also being deterred by general medical specialties by the prospect of becoming the 'Med Reg'...
October 5, 2016: Postgraduate Medical Journal
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