scholarly journals Development of an Educational Program to Increase Patient Involvement in a Healthcare Patient Portal: A Quality Improvement Project (Preprint)

2018 ◽  
Author(s):  
Cheryl Stone ◽  
Becky Faett ◽  
Kathy Magdic
Keyword(s):  
Quality Improvement ◽  
Health Care Providers ◽  
Nurse Practitioner ◽  
The United States ◽  
Quality Improvement Project ◽  
Patient Portal ◽  
Care Providers ◽  
Patient Portals ◽  
Convenience Sample ◽  
Improvement Project

BACKGROUND Efforts in the United States to improve patient engagement and communication with health care providers have led to the creation of the meaningful use program. [1] The Centers for Medicare and Medicaid Services have created a three-stage process to encourage the adoption and use of electronic health records (EHR). Benefits of EHR use include the ability to provide accurate, up-to-date, legible, and complete information about patients at the point of care. One important component of EHR is the patient portal. Patient portals provide 24-hour access to portions of a patient medical record as well as a secure pathway to send messages to providers, ask for refills of medications, and schedule appointments. OBJECTIVE To assess if patients who have not used the patient portal will engage in using the portal after an in-office orientation on how to access and the benefits of using the patient portal. METHODS A quality improvement project was performed using a convenience sample of 60 participants who were scheduled for an appointment in an outpatient cardiology office and had not accessed the patient portal in the past 12 months. The participants were given a survey regarding their computer and internet access as well as their level of comfort using a computer. Each participant was assisted in creating a username and password as well as a security question and answer. The participant then accessed the portal and navigated through the portal with the guidance of the nurse practitioner. They also sent a message via the portal to the provider they were assigned to that day. Each participant was given a pamphlet and a printed power point to reinforce what they had learned. After two months, the nurse practitioner accessed the portal to determine if the enrolled participants had accessed the portal. The reasons for access and frequency were recorded. If there was no access, the participant was called by the nurse practitioner to determine the reason they had not accessed the portal. RESULTS Of the 60 participants, 54% were women, 46% men, 93% were Caucasian. Fifty-six point seven accessed the portal from home. Reasons for access included: 85% reviewed labs, 53% reviewed messages sent to them from the office and 23% sent messages to the office. Twenty-four participants did not access the portal. Of those participants, 33% stated that they had no clear reason to access the portal, 25% stated that they forgot their login information and 17% stated they no interest in the portal. CONCLUSIONS Patient portals are a useful tool for communication between patients and their providers. Providing an in-office orientation to the portal increased patient access to the portal.

scholarly journals Improving documentation of side-effects discussions by doctors for newly initiated psychotropic medications in outpatient clinics: A single-centre quality-improvement project

2020 ◽  
Vol 29 (3) ◽  
pp. 176-182
Author(s):  
Balasundaram Bharathi ◽  
Phua June ◽  
Tan Lay Ling ◽  
Peh Lai Huat ◽  
Selvaraj Ashvini ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Side Effects ◽  
Health Care Providers ◽  
Quality Improvement Project ◽  
Outpatient Clinics ◽  
Medical Council ◽  
Clinical Documentation ◽  
Care Providers ◽  
Ethical Guidelines ◽  
Improvement Project

Background: Robust clinical documentation of side-effects communication is an integral component of good patient care, endorsed by the Singapore Medical Council Ethical Code and Ethical Guidelines and further highlighted by the Modified Montgomery Test. In addition to ensuring quality of care, good clinical documentation can help mitigate potential medico-legal risks against doctors and health-care providers. Objectives: This audit-cum-quality-improvement project aimed to enhance clinical documentation of side-effects discussion of newly prescribed medication in psychiatry outpatient clinics to 100% in a 12-month period. Methods: A baseline measurement revealed that 40% of new cases seen in general and geriatric psychiatry outpatient clinics from March to June 2017 had evidenced clinical documentation of at least one or more side effects. PDSA methodology was employed to bring about improvements and test change interventions. Results: Through three audit cycles between January and December 2018 and a fourth round of data collection in April 2019, documentation rates showed marked improvement from a baseline of 40% to 91%. The IT document tool was the most effective intervention which was successfully adopted and implemented into the standard documentation template for new case assessments. Conclusions: The project was a success overall, with improvements in documentation rates rising to 91%. Through change interventions, systemic factors rooted in patient safety have been embodied in everyday clinical practice.

EP.TU.653Improving surgical admission clerking by introducing a standardized clerking proforma: a quality improvement project

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Georgios Geropoulos ◽  
Clio Kennedy ◽  
Stanley Tang ◽  
Ahmed Elhamshary ◽  
Sara Rakhshani-Moghadam ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Health Care Providers ◽  
Quality Improvement Project ◽  
Surgical Patient ◽  
Care Providers ◽  
Allied Health Professionals ◽  
Improvement Project ◽  
Operative Care ◽  
Detailed Medical History ◽  
Before And After

Abstract Aims When clerking new admissions several critical actions must be performed in a timely and accurate way. These include reviewing referral letters, obtaining a detailed medical history and documenting the patient’s plan. This is of paramount importance, especially in high volume surgical hospitals. The aim of this quality improvement project is to evaluate a standardized electronic proforma for surgical patient clerking in an attempt to minimize missing information that can compromise peri-operative care. Methods A short questionnaire assessing the clerking process was handed out to doctors and allied health professionals. It was completed before and after the introduction of the clerking proforma. Proportion confidence intervals (95% CI) compared for each answer before and after the proforma releasing. Results Domains with a statistically significant improvement were the admission reason, management, treatment escalation and venous thromboprophylaxis plan in patients on long term anticoagulation. After introduction of the proforma, feedback still implied that the social history needed to be more extensive. Further edits to the proforma in a second cycle include prompts regarding baseline function and ADLs, as well as existing packages of care. Conclusions Overall, the introduction of the surgical patient clerking proforma lead to an improvement of the quality of the clerking as assessed by standardized questionnaires. It is noteworthy that a complete clerking is correlated with more effective handover between health care providers, less medical errors, less treatment delays and improved patient outcomes.

scholarly journals An Interprofessional, Multimodal, Family-Centered Quality Improvement Project for Sleep Safety of Hospitalized Infants

2021 ◽  
Vol 8 ◽  
pp. 237437352110083
Author(s):  
Mariah Erlick ◽  
Irene Dutko Fioravanti ◽  
Jeffrey Yaeger ◽  
Spencer Studwell ◽  
Jan Schriefer
Keyword(s):  
Quality Improvement ◽  
Health Care Providers ◽  
Quality Improvement Project ◽  
Care Providers ◽  
Safe Sleep ◽  
Sleep Behavior ◽  
Improvement Project ◽  
Audit System ◽  
Sleep Safety ◽  
Family Centered

The American Academy of Pediatrics published expanded guidelines for infant safe sleep in 2011, expanding the definition from “back to sleep” to “safe to sleep,” more fully describing risk factors and guidelines. In 2016, the guidelines were revised to promote “providers modeling safe sleep behavior” to the highest level of recommendation. Previous studies have addressed the difficulty in creating clear, consistent communication between health care providers and families during an infant’s inpatient stay. This institutional update describes an interprofessional and family-centered quality improvement project to improve sleep safety for hospitalized infants through a multimodal approach. Five family-centered interventions were designed: a designated safe sleep web page, a clear bedside guide to safe sleep, additional training for nursing staff in motivational interviewing, a Kamishibai card audit system, and electronic health record smart phrases. These coordinated interventions reflect advantages of an interprofessional and family-centered approach: building rapport and achieving improvements to infant sleep safety.

Nurse Practitioner Challenges to the Orthodox Structure of Health Care Delivery: Regulation and Restraints on Trade

1985 ◽  
Vol 11 (2) ◽  
pp. 195-225
Author(s):  
Karla Kelly
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Allied Health ◽  
Care Delivery ◽  
The United States ◽  
Care Providers ◽  
Allied Health Care

AbstractUntil recently, physicians have been the primary health care providers in the United States. In response to the rising health care costs and public demand of the past decade, allied health care providers have challenged this orthodox structure of health care delivery. Among these allied health care providers are nurse practitioners, who have attempted to expand traditional roles of the registered nurse.This article focuses on the legal issues raised by several major obstacles to the expansion of nurse practitioner services: licensing restrictions, third party reimbursement policies, and denial of access to medical facilities and physician back-up services. The successful judicial challenges to discriminatory practices against other allied health care providers will be explored as a solution to the nurse practitioners’ dilemma.

scholarly journals Patient Portal, Patient-Generated Images, and Medical Decision-Making in a Pediatric Ambulatory Setting

2020 ◽  
Vol 11 (05) ◽  
pp. 764-768
Author(s):  
Karolin Ginting ◽  
Adrienne Stolfi ◽  
Jordan Wright ◽  
Abiodun Omoloja
Keyword(s):  
Decision Making ◽  
Health Care Providers ◽  
Medical Decision Making ◽  
Pediatric Population ◽  
Private Insurance ◽  
Medical Decision ◽  
Ambulatory Setting ◽  
Patient Portal ◽  
Care Providers ◽  
Patient Portals

Abstract Background Electronic health record (EHR) patient portals are a secure electronic method of communicating with health care providers. In addition to sending secure messages, images, and videos generated by families can be sent to providers securely. With the widespread use of smart phones, there has been an increase in patient-generated images (PGI) sent to providers via patient portals. There are few studies that have evaluated the role of PGI in medical decision-making. Objectives The study aimed to characterize PGI sent to providers via a patient portal, determine how often PGI-affected medical decision-making, and determine the rate of social PGI sent via patient portal. Methods A retrospective chart review of PGI uploaded to a children's hospital's ambulatory patient portal from January 2011 to December 2017 was conducted. Data collected included patient demographics, number and type of images sent, person sending images (patient or parent/guardian), and whether an image-affected medical decision-making. Images were classified as medical related (e.g., blood glucose readings and skin rashes), nonmedical or administrative related (e.g., medical clearance or insurance forms), and social (e.g., self-portraits and camp pictures). Results One hundred forty-three individuals used the portal a total of 358 times, sending 507 images over the study period. Mean (standard deviation) patient age was 9.5 (5.9) years, 50% were females, 89% were White, and 64% had private insurance. About 9% of images were sent directly by patients and the rest by parents/guardians. A total of 387 (76%) images were sent for medical related reasons, 20% for nonmedical, and 4% were deemed social images. Of the 387 medical related images, 314 (81%) affected medical decision-making. Conclusion PGI-affected medical decision-making in most cases. Additional studies are needed to characterize use of PGI in the pediatric population.

Transgender Intimate Partner Violence and Help-Seeking Patterns

2019 ◽  
pp. 088626051988017 ◽  
Author(s):  
Victoria Kurdyla ◽  
Adam M. Messinger ◽  
Milka Ramirez
Keyword(s):  
Intimate Partner Violence ◽  
Health Care Providers ◽  
Sexual Minority ◽  
Partner Violence ◽  
Help Seeking ◽  
The United States ◽  
Intimate Partner ◽  
Self Report ◽  
Care Providers ◽  
Convenience Sample

Intimate partner violence (IPV) against transgender individuals is highly prevalent and impactful, and thus research is needed to examine the extent to which survivors are able to reach needed assistance and safety. To our knowledge, no U.S.-based quantitative studies have explored transgender utilization patterns and perceptions regarding a broad range of help-giving resources (HGRs). The present article fills this gap in the literature by exploring help-seeking attitudes and behaviors of a convenience sample of 92 transgender adults and 325 cisgender sexual minority adults in the United States. Results from an online questionnaire indicate that, among the subsample experiencing IPV ( n = 187), help-seeking rates were significantly higher among transgender survivors (84.1%) than cisgender sexual minority survivors (67.1%). In addition, transgender survivors most commonly sought help from friends (76.7%), followed by mental health care providers (39.5%) and family (30.2%), whereas formal HGRs such as police, IPV telephone hotlines, and survivor shelters had low utilization rates. Among all transgender participants, IPV survivors were significantly less likely than nonsurvivors to perceive family, medical doctors, and survivor hotlines as helpful HGRs for other survivors in general. Finally, transgender survivors were significantly less likely than nonsurvivors to self-report a willingness to disclose any future IPV to family. Although replication with larger, probability samples is needed, these findings suggest that friends often represent the primary line of defense for transgender survivors seeking help, and thus bystander intervention trainings and education should be adapted to address not just cisgender but also transgender IPV. Furthermore, because most formal HGR types appear to be underutilized and perceived more negatively by transgender survivors, renewed efforts are needed to tailor services, service advertising, and provider trainings to the needs of transgender communities. Directions for future research are reviewed.

scholarly journals Viewpoint: Health literacy and patient portals

2015 ◽  
Vol 7 (2) ◽  
pp. 172 ◽  
Author(s):  
Yulong Gu ◽  
Martin Orr ◽  
Jim Warren
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Health Information ◽  
Health Care Providers ◽  
Easy Access ◽  
Patient Portal ◽  
Care Providers ◽  
Patient Portals ◽  
Health Consumer ◽  
Improve Patient

Health literacy has been described as the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Improving health literacy may serve to promote concordance with therapy, engage patients in their own health care, and improve health outcomes. Patient portal technology aims at enabling patients and families to have easy access to key information in their own medical records and to communicate with their health care providers electronically. However, there is a gap in our understanding of how portals will improve patient outcome. The authors believe patient portal technology presents an opportunity to improve patient concordance with prescribed therapy, if adequate support is provided to equip patients (and family/carers) with the knowledge needed to utilise the health information available via the portals. Research is needed to understand what a health consumer will use patient portals for and how to support a user to realise the technology?s potential.

scholarly journals Improving heart failure transitional care after hospital discharge: A quality improvement project

2020 ◽  
Vol 10 (11) ◽  
pp. 62
Author(s):  
Janelle N. Akomah ◽  
Lynn Richards-McDonald ◽  
Diana-Lyn Baptiste
Keyword(s):  
Heart Failure ◽  
Quality Improvement ◽  
Education Program ◽  
Hospital Readmission ◽  
Transitional Care ◽  
Health Care Expenditures ◽  
The United States ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Care Clinic

Background and objective: The burden of heart failure is growing, affecting more than 6 million Americans and an estimated of 26 million worldwide. Heart failure is the most common cause of hospital readmission in the United States and is identified as a marker of poor health outcomes. Thirty day readmission contribute to more than $30 billion dollars in health care expenditures, underscoring a need for the development and implementation of programs that reduce readmission and improve outcomes for individuals with heart failure. The purpose of this quality improvement project was to implement a heart failure education program to increase attendance to a transitional care clinic and reduce 30-day readmissions.Methods: We included 22 individuals who received heart failure education, focused on symptom management and transitional care. Descriptive and statistical analyses were performed to examine attendance to the transitional care clinic and 30-day readmission.Results: There was a statistical significance between individuals attending follow-up at the designated transitional care clinic and 30-day hospital readmission (p ≤ .05). Of the (N = 22) participants, 64% were not readmitted into the hospital 30 days after discharge.Conclusions: The findings of this project demonstrate that a nurse-led evidence-based heart failure education program can improve attendance to transitional care programs and reduce 30-day readmissions. A well-designed plan for transitional care remains a critical component of patient care necessary to address complications and optimize continuity of care after discharge.

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