Identifying measurement-based care practices of VHA co-located collaborative care providers.

2017 ◽  
Vol 48 (4) ◽  
pp. 236-242 ◽  
Author(s):  
Paul R. King ◽  
Gregory P. Beehler ◽  
Christina L. Vair ◽  
Julie Gass ◽  
Jennifer S. Funderburk ◽  
...  
Keyword(s):  
Collaborative Care ◽  
Care Providers ◽  
Measurement Based Care ◽  
Care Practices

scholarly journals VitalSign6: A Primary Care First (PCP-First) Model for Universal Screening and Measurement-Based Care for Depression

2019 ◽  
Vol 12 (2) ◽  
pp. 71 ◽  
Author(s):  
Madhukar Trivedi ◽  
Manish Jha ◽  
Farra Kahalnik ◽  
Ronny Pipes ◽  
Sara Levinson ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Universal Screening ◽  
Primary Care Providers ◽  
The United States ◽  
Care Providers ◽  
Similar Treatment ◽  
Measurement Based Care

Major depressive disorder affects one in five adults in the United States. While practice guidelines recommend universal screening for depression in primary care settings, clinical outcomes suffer in the absence of optimal models to manage those who screen positive for depression. The current practice of employing additional mental health professionals perpetuates the assumption that primary care providers (PCP) cannot effectively manage depression, which is not feasible, due to the added costs and shortage of mental health professionals. We have extended our previous work, which demonstrated similar treatment outcomes for depression in primary care and psychiatric settings, using measurement-based care (MBC) by developing a model, called Primary Care First (PCP-First), that empowers PCPs to effectively manage depression in their patients. This model incorporates health information technology tools, through an electronic health records (EHR) integrated web-application and facilitates the following five components: (1) Screening (2) diagnosis (3) treatment selection (4) treatment implementation and (5) treatment revision. We have implemented this model as part of a quality improvement project, called VitalSign6, and will measure its success using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework. In this report, we provide the background and rationale of the PCP-First model and the operationalization of VitalSign6 project.

scholarly journals Diabetes Self-Care Practice, and Associated Factors Among Type 2 Diabetic Patients in Public Hospitals of Tigray Region, Ethiopia

2020 ◽  
Author(s):  
Medina Abdulkadir Wehabrebi ◽  
Goitom Molalign Takele ◽  
Hiyab Teklemichael Kidane ◽  
Kahsu Gebrekirstos Gebrekidan ◽  
Birhan Gebresillassie Gebregiorgis
Keyword(s):  
Type 2 Diabetes ◽  
Self Care ◽  
Public Hospitals ◽  
Care Practice ◽  
Diabetic Patients ◽  
Care Providers ◽  
Factors Associated ◽  
Tigray Region ◽  
Care Practices

Abstract Background: The prevalence of Type 2 diabetes is increasing steadily at an alarming rate and Ethiopia is placed fourth among the top five countries of the Africa region according to the International diabetes federation. Regardless of its burden, the self-care behaviors are still unknown. This study is aimed to determine the level of diabetes self-care practice and factors associated with among Type 2 diabetes mellitus patients in public hospitals of Tigray region.Methods: Institution-based, cross-sectional study was conducted in six selected hospitals of Tigray region from January to February, 2020. Data was collected by trained nurses with a face to face interview method using Summary Diabetes Self-Care Activities (SDSCA). Bivariate and multivariate logistic regression was used to identify factors associated with self-care practices. Statistical significance was declared at P-value < 0.05.Results: A total of 570 patients with type 2 diabetes were included in this study. The mean age of the participant was 46 ± 14.6 years. Less than half (46.7%) of the participants has good diabetes self-care practices. Urban residency (AOR=2.79, 95% CI 1.858-4.205), age group above 64 years (AOR=2.384, 95% CI 1.258-4.518), not having formal education (AOR=2.616, 95% CI 1.337-4.518), having family or social support (AOR=1.878, 95% CI 1.243-2.837), duration DM above 10 years (AOR=2.325, 95% CI 1.224-4.418), having personal glucometer at home (AOR=5.9, 95% CI 2.790-12.764) were determinant factors of good diabetes self-care practice. Conclusion: the diabetes self-care practices in the region was found to be low. Health care providers might have to consider actions to act on the identified factors and improve self-care practices of the patients. Especially, focusing on caring and giving follow up services to younger adults and DM patients coming from a rural areas.

Lamotrigine and lithium in primary care psychiatric consultation: adoption and adverse effects

2020 ◽  
Author(s):  
James R Phelps ◽  
Olivia R Pipitone ◽  
Kenneth Squires ◽  
Jonathan D Bale
Keyword(s):  
Primary Care ◽  
Weight Gain ◽  
Adverse Effects ◽  
Collaborative Care ◽  
Bipolar Depression ◽  
Care Program ◽  
Primary Care Providers ◽  
Thyroid Stimulating Hormone ◽  
Care Providers ◽  
Psychiatric Consultation

Abstract Background The Collaborative Care Model of psychiatric consultation in primary care has improved outcomes for unipolar depression, but bipolar depressions are challenging for providers and consultants. Although lamotrigine and lithium are both first line medications for bipolar depression, their use in primary care has been declining over the last decade. Objective Our project aimed to quantify the frequency of and adoption of recommendations for lamotrigine and lithium, and their adverse effects, in a Collaborative Care program. Methods Chart review. Results For 620 depressed adult patients (Public Health Questionnaire, 9-item ≥10), lamotrigine and lithium were recommended by psychiatric consultant for 35% and 26% of patients, respectively; and when recommended, were prescribed by primary care providers 50% and 32% of the time, respectively. Eighty-four percent of lithium dosages were 600 mg or less; average serum level 0.32 mEq/l. In follow-up up to 6 months, lithium was associated with no more weight gain than lamotrigine; but 12% of patients receiving lithium had thyroid stimulating hormone increases exceeding the upper limit of normal, occurring in an average of 32 days after the initial prescription. Conclusions (i) In a Collaborative Care program of psychiatric consultation, recommendations for lamotrigine and lithium were very frequent. (ii) Adoption of these recommendations is variable, warranting further investigation. (iii) Like higher doses, low doses of lithium induced hypothyroidism (rapidly)—but not weight gain.

scholarly journals Experiences of Young Children With Cancer and Their Parents With Nurses’ Caring Practices During the Cancer Trajectory

2019 ◽  
Vol 37 (1) ◽  
pp. 21-34 ◽  
Author(s):  
Karin Enskär ◽  
Laura Darcy ◽  
Maria Björk ◽  
Susanne Knutsson ◽  
Karina Huus
Keyword(s):  
Young Children ◽  
Health Care Providers ◽  
Care Plan ◽  
Care Providers ◽  
Children With Cancer ◽  
Nurse Care ◽  
Care Processes ◽  
Care Practices ◽  
Oncology Unit

Children with cancer require repeated hospitalizations and the family’s everyday life and routines undergo change. Concrete descriptions of how nurses act when caring for children with cancer throughout the various phases of care and treatment are sparsely highlighted in the literature. The aim of this study was to describe young children with cancer and their parents’ experiences of nurses’ caring practices over a 3-year period, from diagnosis to follow-up. This study is based on semistructured interviews with 25 children newly diagnosed with cancer, aged 1 to 6 years, and their parents, connected to a pediatric oncology unit in Sweden. Child and parent data were analyzed with a deductive content analysis using Swanson’s theory of caring. The result shows that nurse care practices directed toward young children with cancer and their parents are to some extent similar across a 3-year period from diagnosis to follow-up but also differ in some ways. Nurses’ caring practices aim to support children and parents in the transition to a “new normal.” Child- and family-friendly care processes include the following: creating hope and a trustful relationship, asking rather than assuming, providing knowledge and information, performing tasks skillfully, displaying an interest in the child’s and parents’ life outside the hospital, and helping the family to trust in the future and other health care providers. Based on these results, we recommend the development of a standardized and structured nursing care plan or clinical guideline with detailed information on how to carry out clinical nurse care practices in the different phases.

A novel continuum-based framework for translating behavioral health integration to primary care settings

2020 ◽  
Vol 10 (3) ◽  
pp. 580-589 ◽  
Author(s):  
Matthew L Goldman ◽  
Ekaterina Smali ◽  
Talia Richkin ◽  
Harold A Pincus ◽  
Henry Chung
Keyword(s):  
Primary Care ◽  
Behavioral Health ◽  
Technical Assistance ◽  
New York State ◽  
Behavioral Health Care ◽  
Primary Care Providers ◽  
Care Providers ◽  
Behavioral Health Integration ◽  
Care Practices ◽  
Primary Care Practices

Abstract Although evidence-based behavioral health integration models have been demonstrated to work well when implemented properly, primary care practices need practical guidance on the steps they can take to build behavioral health integration capacities. This is especially true for practice settings with fewer resources. This study is a pilot field test of a framework continuum composed of core components of behavioral health integration that can be used to translate the implementation of behavioral health into diverse clinical settings guided by a practice's priorities and available resources. This framework, in combination with technical assistance by the study team, was piloted in 11 small primary care sites (defined as ≤5 primary care providers) throughout New York State. Surveys were collected at baseline, 6 months, and 12 months. Informal check-in calls and site visits using qualitative semistructured individual and group interviews were conducted with 10 of the 11 sites. A mixed-methods approach was used to incorporate the survey data and qualitative thematic analysis. All practices advanced at least one level of behavioral health integration along various components of the framework. These advances included implementing depression screening, standardizing workflows for positive screens, integrating patient tracking tools for follow-up behavioral health visits, incorporating warm hand-offs to on-site or off-site behavioral health providers, and formalized external referrals using collaborative agreements. Practices reported they had overall positive experiences using the framework and offered feedback for how to improve future iterations. The framework continuum, in combination with technical assistance, was shown to be useful for primary care practices to advance integrated behavioral health care based on their priorities and resource availability. The results combined with feedback from the practices have yielded a revised “Framework 2.0” that includes a new organization as well as the addition of a “Sustainability” domain.

scholarly journals Primary care providers' bereavement care practices: recommendations for research directions

2014 ◽  
Vol 29 (12) ◽  
pp. 1221-1229 ◽  
Author(s):  
Angela R. Ghesquiere ◽  
Sapana R. Patel ◽  
Daniel B. Kaplan ◽  
Martha L. Bruce
Keyword(s):  
Primary Care ◽  
Primary Care Providers ◽  
Care Providers ◽  
Research Directions ◽  
Care Practices ◽  
Bereavement Care

scholarly journals Self-Care Practices and Related Factors in Patients with Multiple Sclerosis (MS) Based on the Health Belief Model

2021 ◽  
Vol 10 (2) ◽  
pp. 77-83
Author(s):  
Hajar Habibi ◽  
Behnaz Sedighi ◽  
Yunes Jahani ◽  
Marzieh Hasani ◽  
Abedin Iranpour
Keyword(s):  
Multiple Sclerosis ◽  
Health Belief Model ◽  
Self Care ◽  
Health Belief ◽  
Perceived Benefits ◽  
Care Providers ◽  
Care Practices ◽  
Cues To Action ◽  
Belief Model ◽  
The Health Belief Model

Abstract Introduction: Self-care programs can raise health in patients with Multiple Sclerosis (MS). This study aimed to identify the self-care behaviors and determinants in patients with MS according to the Health Belief Model (HBM). Methods: In this cross-sectional study, we included 280 MS patients through convenience sampling method. The collection tool was a self-administered questionnaire based on HBM. The participants were the members of MS society in Kerman, Iran. The data were analyzed using descriptive statistics, path analysis, and multivariable linear regression in SPSS software Version 22. Results: The mean (SD) score for self-care practices was 2.86 (0.64), and medication adherence was the most conducted practice. The perceived benefits and cues to action exerted positive influence on self-care practices. The most frequent symptoms experienced by the participants were fatigue (82.5%), visual impairment (76.4%), headaches (72.1%), and muscle weakness (71.4%). The most important cues to action for self-care behavior were the physician (77%), media (52%), and other MS patients (32%). Conclusion: The quality of life (QOL) of MS patients is heavily influenced by self-care behaviors. In this study, only about half of the patients accomplished self-care behaviors, which seems to be insufficient. Since the perceived benefits and cues to action are the main predictors of self-care practices, intervention based on these two constructs can be utilized to promote self-care programs and QOL in MS patients. Health-care providers should pay more attention to these factors for promoting self-care behaviors.

scholarly journals Beyond BMI: a feasibility study implementing NutriSTEP in primary care practices using electronic medical records (EMRs)

2020 ◽  
Vol 40 (1) ◽  
pp. 1-10
Author(s):  
Lesley Andrade ◽  
Kathy Moran ◽  
Susan J. Snelling ◽  
Darshaka Malaviarachchi ◽  
Joanne Beyers ◽  
...  
Keyword(s):  
Primary Care ◽  
Eating Habits ◽  
Qualitative Interviews ◽  
Primary Care Providers ◽  
Early Years ◽  
Successful Implementation ◽  
Care Providers ◽  
Nutrition Risk ◽  
Care Practices ◽  
Primary Care Practices

Introduction Primary care providers have a role to play in supporting the development of healthy eating habits, particularly in a child’s early years. This study examined the feasibility of implementing the NutriSTEP® screen—a 17-item nutrition risk screening tool validated for use with both toddler and preschooler populations—integrated with an electronic medical record (EMR) in primary care practices in Ontario, Canada, to inform primary care decision-making and public health surveillance. Methods Five primary care practices implemented the NutriSTEP screen as a standardized form into their EMRs. To understand practitioners’ experiences with delivery and assess factors associated with successful implementation, we conducted semi-structured qualitative interviews with primary care providers who were most knowledgeable about NutriSTEP implementation at their site. We assessed the quality of the extracted patient EMR data by determining the number of fully completed NutriSTEP screens and documented growth measurements of children. Results Primary care practices implemented the NutriSTEP screen as part of a variety of routine clinical contacts; specific data collection processes varied by site. Valid NutriSTEP screen data were captured in the EMRs of 80% of primary care practices. Approximately 90% of records had valid NutriSTEP screen completions and 70% of records had both valid NutriSTEP screen completions and valid growth measurements. Conclusion Integration of NutriSTEP as a standardized EMR form is feasible in primary care practices, although implementation varied in our study. The application of EMR-integrated NutriSTEP screening as part of a comprehensive childhood healthy weights surveillance system warrants further exploration.

Sign in / Sign up

Export Citation Format

Share Document