Patient-centered care in chronic disease management: A thematic analysis of the literature in family medicine

2012 ◽  
Vol 88 (2) ◽  
pp. 170-176 ◽  
Author(s):  
Catherine Hudon ◽  
Martin Fortin ◽  
Jeannie Haggerty ◽  
Christine Loignon ◽  
Mireille Lambert ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Family Medicine ◽  
Disease Management ◽  
Thematic Analysis ◽  
Chronic Disease Management ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Centered Care

scholarly journals Achieving Value-Based Care in Chronic Disease Management: Intervention Study (Preprint)

2018 ◽  
Author(s):  
Nilmini Wickramasinghe ◽  
Blooma John ◽  
Joey George ◽  
Doug Vogel
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Disease Management ◽  
Standard Care ◽  
Chronic Disease Management ◽  
Monitoring Device ◽  
Patient Centered ◽  
Centered Care ◽  
Diabetes Monitoring ◽  
Technology Solution

BACKGROUND The World Health Organization notes that diabetes, a chronic disease, is a silent epidemic, and by 2020 there will be a 54% rise in the total number of individuals diagnosed with this disease. These are alarming figures that have significant repercussions for the quality of life of individuals and their families as well as for the financial stress of health care systems globally. Early detection and proactive management of diabetes is essential. The Diamond solution provides diabetes self-management by enabling patients to send details about their blood sugar readings at specific times to their nominated care coordinator to receive recommendations for diet and exercise and insulin titration. OBJECTIVE The aim of the study was to assess the usability, acceptability, and fidelity of the Diamond diabetes monitoring device for patients with gestational diabetes mellitus (GDM). Specifically assessed were (1) patient compliance, (2) patient satisfaction, (3) level of glycemic control achieved, and (4) health professional satisfaction. METHODS Using a design science research perspective, the Diamond diabetes monitoring device solution was adapted to the Australian health care environment. Once the solution was deemed fit for purpose by the director of the OB/GYN clinical institute and on securing all relevant ethics approvals, a 2-period 2-arm nonblinded crossover clinical trial was conducted for 8 weeks total time with crossover at 4 weeks to establish proof of concept, usability, and fidelity. The patient perspective was assessed by using structured questionnaires at 4 specific stages of the project, while the clinician perspective was captured via semistructured interviews and unstructured questionnaires. RESULTS The 10 patients studied reported preferring standard care with the technology solution to standard care alone. Further, all clinicians involved concurred that the technology solution greatly assisted their ability to provide higher value patient-centered care. They also noted that it was extremely helpful for assisting in systematically monitoring glucose levels and any/all changes and trends. CONCLUSIONS Based on these initial findings, we offer a holistic pervasive approach to enable the achievement of value-based, patient-centered care in chronic disease management. Key lessons include the importance when designing such solutions to focus on the two primary user groups (patients and clinicians).

scholarly journals Guideline Implementation in Standardized Office Workflows and Exam Types

2019 ◽  
Vol 10 ◽  
pp. 215013271983689
Author(s):  
Amy Dawson ◽  
Brian Henriksen ◽  
Penny Cortvriend
Keyword(s):  
Chronic Disease ◽  
Chronic Illness ◽  
Family Medicine ◽  
Disease Management ◽  
Qualitative Study ◽  
Change Management ◽  
Chronic Disease Management ◽  
Medical Society ◽  
Successful Implementation ◽  
Card Sort

Background: Clinical practice guidelines (CPGs) in medicine are recommendations supported by systematic review of evidence to facilitate optimal patient outcomes. Primary care practices are expected to implement more than 200 CPGs, overwhelming many practices. This qualitative study elucidated the perspectives and priorities of family medicine physicians and office managers in grouping CPGs to facilitate implementation. Methods: A qualitative study was performed using individual, semistructured interviews. During the interviews the participants completed an open card-sort exercise grouping 20 CPGs. Purposive sampling was used to identify family medicine physicians and office managers practicing in medically underserved zip codes listed in the local medical society directory. Seven physicians and 6 office managers were interviewed. The interviews were transcribed and analyzed using thematic analysis and compared with the card-sort results. Results: Thematic content analysis identified priorities and perspectives of office managers and physicians when grouping multiple CPGs for implementation: delegation, personalization, triggers, and change management. The card sort exercise revealed grouping by standardized preventive care visit, standardized rooming and discharge processes, and chronic illness. Chronic illness-based groupings and personalization of guidelines were recognized as presenting barriers to delegation of CPGs to the care team. Development of standardized preventive exams, standard rooming and discharge processes and chronic disease management were identified as promoting CPG adherence through team-based care. Standardized workflows provided opportunities for task delegation through predicable roles. Medicalization of CPG implementation relied heavily on the physician alone to remember to adhere to CPGs and inhibited task sharing by not giving office staff clear disease-based protocols to follow. Conclusions: This study identified priorities and perspectives of office managers and physicians when grouping multiple CPGs for concomitant implementation: delegation, personalization, triggers, and change management. Successful implementation was perceived to be associated with standardized preventive exams, standard rooming and discharge processes, and chronic disease management.

Barriers to Patient-Centered Care: A Thematic Analysis Study

2013 ◽  
Vol 25 (1) ◽  
pp. 2-8 ◽  
Author(s):  
Maryam Esmaeili ◽  
Mohammad Ali Cheraghi ◽  
Mahvash Salsali
Keyword(s):  
Thematic Analysis ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Analysis Study ◽  
Centered Care

scholarly journals Measuring Patients' Perceptions of Patient-Centered Care: A Systematic Review of Tools for Family Medicine

2011 ◽  
Vol 9 (2) ◽  
pp. 155-164 ◽  
Author(s):  
C. Hudon ◽  
M. Fortin ◽  
J. L. Haggerty ◽  
M. Lambert ◽  
M.-E. Poitras
Keyword(s):  
Systematic Review ◽  
Family Medicine ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Centered Care

scholarly journals Complexity and Health Coaching: Synergies in Nursing

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Gail J. Mitchell ◽  
Nadine Cross ◽  
Michelle Wilson ◽  
Shauna Biernacki ◽  
Winnie Wong ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Disease Management ◽  
Health Care Professionals ◽  
Chronic Disease Management ◽  
Mutual Influence ◽  
Health Coach ◽  
Person Centered Care ◽  
Care And Support ◽  
Centered Care

Health care professionals are increasingly aware that persons are complex and live in relation with other complex human communities and broader systems. Complex beings and systems are living and evolving in nonlinear ways through a process of mutual influence. Traditional standardized approaches in chronic disease management do not address these non-linear linkages and the meaning and changes that impact day-to-day life and caring for self and family. The RN health coach role described in this paper addresses the complexities and ambiguities for persons living with chronic illness in order to provide person-centered care and support that are unique and responsive to the context of persons’ lives. Informed by complexity thinking and relational inquiry, the RN health coach is an emergent innovation of creative action with community and groups that support persons as they shape their health and patterns of living.

scholarly journals A survey of the working status of family medicine physicians in clinics and hospitals in Korea

2020 ◽  
Author(s):  
Hyun-Young Shin
Keyword(s):  
Chronic Disease ◽  
Family Medicine ◽  
Disease Management ◽  
South Korea ◽  
Working Conditions ◽  
Online Survey ◽  
Chronic Disease Management ◽  
Treatment Pattern ◽  
National Insurance ◽  
Working Status

Abstract Background In the approximately 35 years since family medicine was established in South Korea, family medicine physicians have sought to expand their expertise to cover clinical fields beyond primary medicine. This study examines their working status and compares the working conditions of family medicine physicians in clinics and hospitals in Korea.Methods We conducted an online survey with 4,057 family medicine physicians in Korea in 2016. The results were analyzed using descriptive statistics.Results Of the respondents, 572 doctors were working in clinics and 441 in hospitals. In the analysis of treatment pattern by doctors, the rate of chronic disease management was 84.7% in clinics and 93.4% in hospitals ( p < 0.001), and the rate of diseases covered by national insurance was 74.8% in clinics and 76.9% in hospitals ( p = 0.005). Among physicians younger than 40 years, the rate of chronic disease management and diseases covered by national insurance were 64.6% and 68.0% in clinics and 93.6% and 78.5% in hospitals, retrospectively.Conclusions Family medicine physicians working in hospitals have higher rates of chronic disease management and diseases covered by national insurance. This discrepancy of treatment pattern became larger for doctors younger than 40 years. More in-depth studies of the treatment pattern and its tendencies between family medicine physicians in clinics and hospitals are needed in the future.

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