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Collaborative Care

Marina Weißenborn, Martin Schulz, Manuel Kraft, Walter E Haefeli, Hanna M Seidling
AIM OF THE STUDY: Collaboration between general practitioners and community pharmacists is essential to ensure safe and effective patient care. However, collaboration in primary care is not standardized and varies greatly. This review aims to highlight projects about professional collaboration in ambulatory care in Germany and identifies promising approaches and successful benchmarks that should be considered for future projects. METHODS: A systematic literature search was performed based on the PRISMA guidelines to identify articles focusing on professional collaboration between general practitioners and pharmacists...
June 21, 2018: Das Gesundheitswesen
Geraldine Jacobson, Linus Chuang, Maximilian Pankow
The purpose of this report is to describe the interventions implemented between 2012 and 2017 at the National Cancer Institute Paraguay (NCI Paraguay) to improve treatment quality and efficiency for patients with cervical cancer, with an emphasis on radiation quality and access. The NCI Paraguay requested collaboration with Health Volunteers Overseas (HVO), an international volunteer organization, to improve the care of patients with cervical cancer. This report is based on site visits to NCI Paraguay by HVO volunteers in 2012, 2013, and 2016, with a follow-up report from the site in 2017...
August 2018: Gynecologic Oncology Reports
Frank W J M Smeenk, Laurien A Schrijver, Hennie C J van Bavel, Eric F J van de Laar
In 2014, a group of physicians of the Catharina Hospital in Eindhoven (The Netherlands) started a project called "Talking about end-of-life care in a timely manner". Just like others in the country, the Eindhoven group noticed that regularly, very frail elderly people were admitted to hospital in acute situations without there ever having been conversations about their wishes concerning treatment options at the end of life. The project aimed to prevent unnecessary admissions and treatments for these frail patients by stimulating physicians, patients and informal caregivers to start conversations about end-of-life care together at an earlier stage...
December 2017: Breathe
Linda Lee, W Wayne Weston, Loretta Hillier, Douglas Archibald, Joseph Lee
Family physicians often find themselves inadequately prepared to manage dementia. This article describes the curriculum for a resident training intervention in Primary Care Collaborative Memory Clinics (PCCMC), outlines its underlying educational principles, and examines its impact on residents' ability to provide dementia care. PCCMCs are family physician-led interprofessional clinic teams that provide evidence-informed comprehensive assessment and management of memory concerns. Within PCCMCs residents learn to apply a structured approach to assessment, diagnosis, and management; training consists of a tutorial covering various topics related to dementia followed by work-based learning within the clinic...
June 21, 2018: Gerontology & Geriatrics Education
Iestyn M Shapey, Angela M Summers, Iain J Simkin, Titus Augustine, David van Dellen
Brexit may lead to major political, societal, and financial changes-this has significant implications for a tax revenue funded healthcare system such as the United Kingdom's (UK) National Health Service. The complex relationship between European Union (EU) legislation and clinical practice of organ donation and transplantation is poorly understood. However, it is unclear what impact Brexit may have on organ donation and transplantation in the UK and EU. This work aims to describe the current legislative interactions affecting organ donation and transplantation regulation and governance within the UK and EU...
June 21, 2018: Clinical Transplantation
Martin Härter, Birgit Watzke, Anne Daubmann, Karl Wegscheider, Hans-Helmut König, Christian Brettschneider, Sarah Liebherz, Daniela Heddaeus, Maya Steinmann
Guidelines recommend stepped and collaborative care models (SCM) for depression. We aimed to evaluate the effectiveness of a complex guideline-based SCM for depressed patients. German primary care units were cluster-randomised into intervention (IG) or control group (CG) (3:1 ratio). Adult routine care patients with PHQ-9 ≥ 5 points could participate and received SCM in IG and treatment as usual (TAU) in CG. Primary outcome was change in PHQ-9 from baseline to 12 months (hypothesis: greater reduction in IG)...
June 20, 2018: Scientific Reports
Jennifer G Andrews, Kristin Conway, Christina Westfield, Christina Trout, F John Meaney, Katherine Mathews, Emma Ciafaloni, Christopher Cunniff, Deborah J Fox, Dennis Matthews, Shree Pandya
BACKGROUND: Duchenne muscular dystrophy (DMD) is an X-linked disorder characterized by progressive muscle weakness and multisystem involvement. Recent advances in management of individuals with DMD have prolonged survival. Lack of standardized care spurred an international collaboration to develop consensus-based care considerations for diagnosis and management. In this study, we evaluate adherence to considerations at selected sites. METHODS: We collaborated with the Muscular Dystrophy Surveillance, Tracking, and Research Network...
June 20, 2018: Pediatrics
William Liu, Thomas Walsh
BACKGROUND: A goal of effective electronic health record provider documentation platforms is to provide an efficient, concise, and comprehensive notation system that will effectively reflect the clinical course, including the diagnoses, treatments, and interventions. OBJECTIVE: The aim is to fully redesign and standardize the provider documentation process, seeking improvement in documentation based on ongoing All Patient Refined Diagnosis Related Group-based coding records, while maintaining noninferiority comparing provider satisfaction to our existing documentation process...
June 20, 2018: JMIR Medical Informatics
Katherine E Bates, Sunkyung Yu, Ray Lowery, Sara K Pasquali, David W Brown, Peter B Manning, Karen Uzark
BACKGROUND: Although interstage mortality for infants with hypoplastic left heart syndrome has declined within the National Pediatric Cardiology Quality Improvement Collaborative, variation across centres persists. It remains unclear whether centres with lower interstage mortality have lower-risk patients or whether differences in care may explain this variation. We examined previously established risk factors across National Pediatric Cardiology Quality Improvement Collaborative centres with lower and higher interstage mortality rates...
June 21, 2018: Cardiology in the Young
Kristy C Yiu, Anke Rohwer, Taryn Young
BACKGROUND: With the rise in pre-mature mortality rate from non-communicable disease (NCD), there is a need for evidence-based interventions. We evaluated existing systematic reviews on effectiveness of integration of healthcare services, in particular with focus on delivery of care designed to improve health and process outcomes in people with multi-morbidity, where at least one of the conditions was diabetes or hypertension. METHODS: We searched MEDLINE, EMBASE, Cochrane Library, and Health Evidence to November 8, 2016 and consulted experts...
June 20, 2018: BMC Health Services Research
Margaret Broom, Zsuzsoka Kecskes, Sue Kildea, Anne Gardner
In 2012, a tertiary neonatal intensive care unit (NICU) transitioned from an open plan (OP) to a dual occupancy (DO) NICU. The DO design aimed to provide a developmental appropriate, family-centered environment for neonates and their families. During planning, staff questioned the impact DO would have on staff workflow and activity. To explore the impact of changing from an OP to a DO NICU, a prospective longitudinal study was undertaken from 2011 to 2014, using observational, time and motion, and surveys methods...
January 1, 2018: HERD
Adeera Levin
BACKGROUND: Chronic Kidney Disease (CKD) is a major public health problem and is increasingly being recognized as an important driver of costs in all health care systems. The diversity of outcomes for people living with CKD is in part due to variability in biology, access to care, environmental factors, and health care system differences. The International Society of Nephrology (ISN), working in collaboration with its partners, has evolved into a philanthropic organization, from a traditional medical society, committed to a vision that sees "a future where all people have access to sustainable kidney health"...
2018: Annals of Nutrition & Metabolism
Bram Tilburgs, Myrra Vernooij-Dassen, Raymond Koopmans, Hans van Gennip, Yvonne Engels, Marieke Perry
BACKGROUND: Due to the disease's progressive nature, advance care planning (ACP) is recommended for people with early stage dementia. General practitioners (GPs) should initiate ACP because of their longstanding relationships with their patients and their early involvement with the disease, however ACP is seldom applied. AIM: To determine the barriers and facilitators faced by GPs related to ACP with people with dementia. DATA SOURCES: We systematically searched the relevant databases for papers published between January 1995 and December 2016, using the terms: primary healthcare, GP, dementia, and ACP...
2018: PloS One
Marie E Robert, Sheila E Crowe, Lawrence Burgart, Rhonda K Yantiss, Benjamin Lebwohl, Joel K Greenson, Stefano Guandalini, Joseph A Murray
Small intestinal biopsy interpretation has been the cornerstone for the diagnosis of celiac disease for over 50 years. Despite the existence of sensitive and specific serological tests, duodenal mucosal biopsies continue to be obtained in the vast majority of patients in whom a diagnosis of celiac disease is being considered. The accurate evaluation of these biopsies requires coordination and information sharing between the gastroenterologist, laboratory, and pathologist in order to optimize tissue sampling, preparation and interpretation...
June 19, 2018: American Journal of Surgical Pathology
Alaina R Miller, Kimberly Fenstermacher, Barbara L Buchko
BACKGROUND AND PURPOSE: Donor human milk (DHM) is used when a mother's own milk is not available. Donor human milk is available as a frozen pasteurized or commercially sterilized product. An abrupt change in practice in use of donor milk products raised concerns among nurses caring for infants in the neonatal intensive care unit (NICU). The change in practice occurred without the input of nurses and without the sharing of supportive evidence with them. The purpose of this study was to explore NICU nurses' perceptions of the practice change from using frozen pasteurized DHM to using sterilized DHM in this context...
June 19, 2018: MCN. the American Journal of Maternal Child Nursing
M G Loutet, C Sinclair, N Whitehead, C Cosgrove, M K Lalor, H L Thomas
Improving access to tuberculosis (TB) care and ensuring early diagnosis are two major aims of the WHO End TB strategy and the Collaborative TB Strategy for England. This study describes risk factors associated with diagnostic delay among TB cases in England. We conducted a retrospective cohort study of TB cases notified to the Enhanced TB Surveillance System in England between 2012 and 2015. Diagnostic delay was defined as more than 4 months between symptom onset and treatment start date. Multivariable logistic regression was used to identify demographic and clinical factors associated with diagnostic delay...
June 20, 2018: Epidemiology and Infection
Lotte Ramerman, Pieter J Hoekstra, Gerda de Kuijper
BACKGROUND: It is unknown why professionals' adherence to guideline recommendations on antipsychotic drug prescription in the intellectual disabilities care is insufficient. This study aimed to explore barriers and facilitators in the implementation and use of these recommendations. METHODS: In-depth interviews with four intellectual disability physicians, two psychiatrists and five behavioural scientists were used to explore the implementation and use of guideline recommendations...
June 20, 2018: Journal of Applied Research in Intellectual Disabilities: JARID
Debra B Gordon, Judy Watt-Watson, Beth B Hogans
No abstract text is available yet for this article.
May 2018: Pain Reports (Baltimore, Md.)
Giulio Pioli, Chiara Bendini, Paolo Pignedoli, Andrea Giusti, David Marsh
A high proportion of patients with fragility fracture, mainly hip fracture, have a variable degree of comorbidity and show some degree of dependence in basic or more complex activities of daily living. Evaluating these patents following the geriatric concept of frailty, about one third of hip fracture patients may be categorised as frail with high risk of poor outcomes and prolonged length of stay, one third as not frail, and about one third with an intermediate condition. Due to the high vulnerability, combined with the hip fracture event and surgical repair procedures, a multidisciplinary approach that includes geriatric competencies becomes essential to improve short and long-term outcomes after hip fracture...
April 20, 2018: Injury
Julie E Reed, Cathy Howe, Cathal Doyle, Derek Bell
BACKGROUND: Ensuring patients benefit from the latest medical and technical advances remains a major challenge, with rational-linear and reductionist approaches to translating evidence into practice proving inefficient and ineffective. Complexity thinking, which emphasises interconnectedness and unpredictability, offers insights to inform evidence translation theories and strategies. Drawing on detailed insights into complex micro-systems, this research aimed to advance empirical and theoretical understanding of the reality of making and sustaining improvements in complex healthcare systems...
June 20, 2018: BMC Medicine
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