Continuity of Patient Care: Health care provided on a continuing basis from the initial contact, following the patient through all phases of medical care.Physician-Patient Relations: The interactions between physician and patient.Patient Satisfaction: The degree to which the individual regards the health care service or product or the manner in which it is delivered by the provider as useful, effective, or beneficial.Patient-Centered Care: Design of patient care wherein institutional resources and personnel are organized around patients rather than around specialized departments. (From Hospitals 1993 Feb 5;67(3):14)Internship and Residency: Programs of training in medicine and medical specialties offered by hospitals for graduates of medicine to meet the requirements established by accrediting authorities.Family Practice: A medical specialty concerned with the provision of continuing, comprehensive primary health care for the entire family.Primary Health Care: Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192)Group Practice: Any group of three or more full-time physicians organized in a legally recognized entity for the provision of health care services, sharing space, equipment, personnel and records for both patient care and business management, and who have a predetermined arrangement for the distribution of income.Health Services Accessibility: The degree to which individuals are inhibited or facilitated in their ability to gain entry to and to receive care and services from the health care system. Factors influencing this ability include geographic, architectural, transportational, and financial considerations, among others.Appointments and Schedules: The different methods of scheduling patient visits, appointment systems, individual or group appointments, waiting times, waiting lists for hospitals, walk-in clinics, etc.Intergenerational Relations: The interactions between individuals of different generations. These interactions include communication, caring, accountability, loyalty, and even conflict between related or non-related individuals.Illusions: The misinterpretation of a real external, sensory experience.Quality of Health Care: The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.Internal Medicine: A medical specialty concerned with the diagnosis and treatment of diseases of the internal organ systems of adults.Professional-Patient Relations: Interactions between health personnel and patients.Insurance, Physician Services: Insurance providing benefits for the costs of care by a physician which can be comprehensive or limited to surgical expenses or for care provided only in the hospital. It is frequently called "regular medical expense" or "surgical expense".Attitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.Physicians, Family: Those physicians who have completed the education requirements specified by the American Academy of Family Physicians.Hospitalists: Physicians who are employed to work exclusively in hospital settings, primarily for managed care organizations. They are the attending or primary responsible physician for the patient during hospitalization.Ambulatory Care: Health care services provided to patients on an ambulatory basis, rather than by admission to a hospital or other health care facility. The services may be a part of a hospital, augmenting its inpatient services, or may be provided at a free-standing facility.Qualitative Research: Any type of research that employs nonnumeric information to explore individual or group characteristics, producing findings not arrived at by statistical procedures or other quantitative means. (Qualitative Inquiry: A Dictionary of Terms Thousand Oaks, CA: Sage Publications, 1997)Health Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.Anecdotes as Topic: Brief accounts or narratives of an incident or event.Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.Communication: The exchange or transmission of ideas, attitudes, or beliefs between individuals or groups.Patient Handoff: The transferring of patient care responsibility from one health-care professional to another.Office Visits: Visits made by patients to health service providers' offices for diagnosis, treatment, and follow-up.Patient Care Team: Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient.Interdisciplinary Communication: Communication, in the sense of cross-fertilization of ideas, involving two or more academic disciplines (such as the disciplines that comprise the cross-disciplinary field of bioethics, including the health and biological sciences, the humanities, and the social sciences and law). Also includes problems in communication stemming from differences in patterns of language usage in different academic or medical disciplines.Focus Groups: A method of data collection and a QUALITATIVE RESEARCH tool in which a small group of individuals are brought together and allowed to interact in a discussion of their opinions about topics, issues, or questions.Ontario: A province of Canada lying between the provinces of Manitoba and Quebec. Its capital is Toronto. It takes its name from Lake Ontario which is said to represent the Iroquois oniatariio, beautiful lake. (From Webster's New Geographical Dictionary, 1988, p892 & Room, Brewer's Dictionary of Names, 1992, p391)Interviews as Topic: Conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes school admission or job interviews.Anxiety, Separation: Anxiety experienced by an individual upon separation from a person or object of particular significance to the individual.United StatesOutpatient Clinics, Hospital: Organized services in a hospital which provide medical care on an outpatient basis.Models, Organizational: Theoretical representations and constructs that describe or explain the structure and hierarchy of relationships and interactions within or between formal organizational entities or informal social groups.General Practice: Patient-based medical care provided across age and gender or specialty boundaries.Trust: Confidence in or reliance on a person or thing.Pediatrics: A medical specialty concerned with maintaining health and providing medical care to children from birth to adolescence.Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.DelawarePrivate Practice: Practice of a health profession by an individual, offering services on a person-to-person basis, as opposed to group or partnership practice.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Quality Assurance, Health Care: Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps.Interprofessional Relations: The reciprocal interaction of two or more professional individuals.Great BritainHospitals, Military: Hospitals which provide care for the military personnel and usually for their dependents.Nurse Midwives: Professional nurses who have received postgraduate training in midwifery.Midwifery: The practice of assisting women in childbirth.Referral and Consultation: The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide.Attitude to Health: Public attitudes toward health, disease, and the medical care system.Case Management: A traditional term for all the activities which a physician or other health care professional normally performs to insure the coordination of the medical services required by a patient. It also, when used in connection with managed care, covers all the activities of evaluating the patient, planning treatment, referral, and follow-up so that care is continuous and comprehensive and payment for the care is obtained. (From Slee & Slee, Health Care Terms, 2nd ed)Nurses: Professionals qualified by graduation from an accredited school of nursing and by passage of a national licensing examination to practice nursing. They provide services to patients requiring assistance in recovering or maintaining their physical or mental health.Child Health Services: Organized services to provide health care for children.Aortic Valve Stenosis: A pathological constriction that can occur above (supravalvular stenosis), below (subvalvular stenosis), or at the AORTIC VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA.Outcome and Process Assessment (Health Care): Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically.Personnel Staffing and Scheduling: The selection, appointing, and scheduling of personnel.Preventive Health Services: Services designed for HEALTH PROMOTION and prevention of disease.Health Services Research: The integration of epidemiologic, sociological, economic, and other analytic sciences in the study of health services. Health services research is usually concerned with relationships between need, demand, supply, use, and outcome of health services. The aim of the research is evaluation, particularly in terms of structure, process, output, and outcome. (From Last, Dictionary of Epidemiology, 2d ed)Ambulatory Care Facilities: Those facilities which administer health services to individuals who do not require hospitalization or institutionalization.Critical Pathways: Schedules of medical and nursing procedures, including diagnostic tests, medications, and consultations designed to effect an efficient, coordinated program of treatment. (From Mosby's Medical, Nursing & Allied Health Dictionary, 4th ed)Microscopy, Electron: Microscopy using an electron beam, instead of light, to visualize the sample, thereby allowing much greater magnification. The interactions of ELECTRONS with specimens are used to provide information about the fine structure of that specimen. In TRANSMISSION ELECTRON MICROSCOPY the reactions of the electrons that are transmitted through the specimen are imaged. In SCANNING ELECTRON MICROSCOPY an electron beam falls at a non-normal angle on the specimen and the image is derived from the reactions occurring above the plane of the specimen.Home Care Services: Community health and NURSING SERVICES providing coordinated multiple services to the patient at the patient's homes. These home-care services are provided by a visiting nurse, home health agencies, HOSPITALS, or organized community groups using professional staff for care delivery. It differs from HOME NURSING which is provided by non-professionals.Longitudinal Studies: Studies in which variables relating to an individual or group of individuals are assessed over a period of time.History, Ancient: The period of history before 500 of the common era.Social Work: The use of community resources, individual case work, or group work to promote the adaptive capacities of individuals in relation to their social and economic environments. It includes social service agencies.Netherlands: Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, Sint Maarten, formerly included in the NETHERLANDS ANTILLES.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Patient Participation: Patient involvement in the decision-making process in matters pertaining to health.Affective Disorders, Psychotic: Disorders in which the essential feature is a severe disturbance in mood (depression, anxiety, elation, and excitement) accompanied by psychotic symptoms such as delusions, hallucinations, gross impairment in reality testing, etc.Hospital Bed Capacity, under 100Australian Capital Territory: A territory of Australia consisting of Canberra, the national capital and surrounding land. It lies geographically within NEW SOUTH WALES and was established by law in 1988.Transition to Adult Care: Transfer from pediatric to adult care.Medical Records Systems, Computerized: Computer-based systems for input, storage, display, retrieval, and printing of information contained in a patient's medical record.Outcome Assessment (Health Care): Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).Short Bowel Syndrome: A malabsorption syndrome resulting from extensive operative resection of the SMALL INTESTINE, the absorptive region of the GASTROINTESTINAL TRACT.Community Mental Health Centers: Facilities which administer the delivery of psychologic and psychiatric services to people living in a neighborhood or community.Comprehensive Health Care: Providing for the full range of personal health services for diagnosis, treatment, follow-up and rehabilitation of patients.Episode of Care: An interval of care by a health care facility or provider for a specific medical problem or condition. It may be continuous or it may consist of a series of intervals marked by one or more brief separations from care, and can also identify the sequence of care (e.g., emergency, inpatient, outpatient), thus serving as one measure of health care provided.Physicians, Primary Care: Providers of initial care for patients. These PHYSICIANS refer patients when appropriate for secondary or specialist care.Quebec: A province of eastern Canada. Its capital is Quebec. The region belonged to France from 1627 to 1763 when it was lost to the British. The name is from the Algonquian quilibek meaning the place where waters narrow, referring to the gradually narrowing channel of the St. Lawrence or to the narrows of the river at Cape Diamond. (From Webster's New Geographical Dictionary, 1988, p993 & Room, Brewer's Dictionary of Names, 1992, p440)Quality Indicators, Health Care: Norms, criteria, standards, and other direct qualitative and quantitative measures used in determining the quality of health care.Medicaid: Federal program, created by Public Law 89-97, Title XIX, a 1965 amendment to the Social Security Act, administered by the states, that provides health care benefits to indigent and medically indigent persons.Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure.Office Management: Planning, organizing, and administering activities in an office.Patient Care: The services rendered by members of the health profession and non-professionals under their supervision.Patient Discharge: The administrative process of discharging the patient, alive or dead, from hospitals or other health facilities.Aortic Valve: The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle.Workflow: Description of pattern of recurrent functions or procedures frequently found in organizational processes, such as notification, decision, and action.Community Health Centers: Facilities which administer the delivery of health care services to people living in a community or neighborhood.State Medicine: A system of medical care regulated, controlled and financed by the government, in which the government assumes responsibility for the health needs of the population.Medical Record Linkage: The creation and maintenance of medical and vital records in multiple institutions in a manner that will facilitate the combined use of the records of identified individuals.Medical Secretaries: Individuals responsible for various duties pertaining to the medical office routine.Health Services Needs and Demand: Health services required by a population or community as well as the health services that the population or community is able and willing to pay for.Psychoacoustics: The science pertaining to the interrelationship of psychologic phenomena and the individual's response to the physical properties of sound.Delivery of Health Care: The concept concerned with all aspects of providing and distributing health services to a patient population.Patients: Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures.Nurse-Patient Relations: Interaction between the patient and nurse.Secondary Care: Specialized healthcare delivered as a follow-up or referral from a PRIMARY CARE provider.Chronic Disease: Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)Anthropology, Physical: The comparative science dealing with the physical characteristics of humans as related to their origin, evolution, and development in the total environment.Decision Theory: A theoretical technique utilizing a group of related constructs to describe or prescribe how individuals or groups of people choose a course of action when faced with several alternatives and a variable amount of knowledge about the determinants of the outcomes of those alternatives.Workload: The total amount of work to be performed by an individual, a department, or other group of workers in a period of time.Specialties, Nursing: Various branches of nursing practice limited to specialized areas.Noise: Any sound which is unwanted or interferes with HEARING other sounds.Gatekeeping: The controlling of access to health services, usually by primary care providers; often used in managed care settings to reduce utilization of expensive services and reduce referrals. (From BIOETHICS Thesaurus, 1999)National Health Programs: Components of a national health care system which administer specific services, e.g., national health insurance.Medical Records: Recording of pertinent information concerning patient's illness or illnesses.Reproducibility of Results: The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.Radiology Department, Hospital: Hospital department which is responsible for the administration and provision of x-ray diagnostic and therapeutic services.Perceptual Masking: The interference of one perceptual stimulus with another causing a decrease or lessening in perceptual effectiveness.Clinical Competence: The capability to perform acceptably those duties directly related to patient care.After-Hours Care: Medical care provided after the regular practice schedule of the physicians. Usually it is designed to deliver 24-hour-a-day and 365-day-a-year patient care coverage for emergencies, triage, pediatric care, or hospice care.Sleep: A readily reversible suspension of sensorimotor interaction with the environment, usually associated with recumbency and immobility.Specialization: An occupation limited in scope to a subsection of a broader field.Neuroma: A tumor made up of nerve cells and nerve fibers. (Dorland, 27th ed)EnglandNewfoundland and Labrador: Province of Canada consisting of the island of Newfoundland and an area of Labrador. Its capital is St. John's.Patient Care Planning: Usually a written medical and nursing care program designed for a particular patient.Patient Transfer: Interfacility or intrahospital transfer of patients. Intrahospital transfer is usually to obtain a specific kind of care and interfacility transfer is usually for economic reasons as well as for the type of care provided.Physician Executives: Physicians who serve in a medical and administrative capacity as head of an organized medical staff and who also may serve as liaison for the medical staff with the administration and governing board.Needs Assessment: Systematic identification of a population's needs or the assessment of individuals to determine the proper level of services needed.Community Networks: Organizations and individuals cooperating together toward a common goal at the local or grassroots level.Quality Improvement: The attainment or process of attaining a new level of performance or quality.General Practitioners: Physicians whose practice is not restricted to a specific field of MEDICINE.Jejunostomy: Surgical formation of an opening through the ABDOMINAL WALL into the JEJUNUM, usually for enteral hyperalimentation.Infant, Newborn: An infant during the first month after birth.Ileostomy: Surgical creation of an external opening into the ILEUM for fecal diversion or drainage. This replacement for the RECTUM is usually created in patients with severe INFLAMMATORY BOWEL DISEASES. Loop (continent) or tube (incontinent) procedures are most often employed.Sleep Stages: Periods of sleep manifested by changes in EEG activity and certain behavioral correlates; includes Stage 1: sleep onset, drowsy sleep; Stage 2: light sleep; Stages 3 and 4: delta sleep, light sleep, deep sleep, telencephalic sleep.Colostomy: The surgical construction of an opening between the colon and the surface of the body.Curriculum: A course of study offered by an educational institution.Coleus: A plant genus of the family Lamiaceae. The species of Coleus should be distinguished from PLECTRANTHUS BARBATUS - which is also known as Coleus forskohlii.Preceptorship: Practical experience in medical and health-related services that occurs as part of an educational program wherein the professionally-trained student works outside the academic environment under the supervision of an established professional in the particular field.Models, Theoretical: Theoretical representations that simulate the behavior or activity of systems, processes, or phenomena. They include the use of mathematical equations, computers, and other electronic equipment.Pregnant Women: Human females who are pregnant, as cultural, psychological, or sociological entities.Choristoma: A mass of histologically normal tissue present in an abnormal location.Physician's Practice Patterns: Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.

Follow-up care in general practice of patients with myocardial infarction or angina pectoris: initial results of the SHIP trial. Southampton Heart Integrated Care Project. (1/1531)

OBJECTIVE: We aimed to assess the effectiveness of a nurse-led programme to ensure that follow-up care is provided in general practice after hospital diagnosis of myocardial infarction (MI) or angina pectoris. METHODS: We conducted a randomized controlled trial with stratified random allocation of practices to intervention and control groups within all 67 practices in Southampton and South-West Hampshire, England. The subjects were 422 adult patients with a MI and 175 patients with a new diagnosis of angina recruited during hospital admission or chest pain clinic attendance between April 1995 and September 1996. Intervention involved a programme of secondary preventive care led by specialist liaison nurses in which we sought to improve communication between hospital and general practice and to encourage general practice nurses to provide structured follow-up. The main outcome measures were: extent of general practice follow-up; attendance for cardiac rehabilitation; medication prescribed at hospital discharge; self-reported smoking, diet and exercise; and symptoms of chest pain and shortness of breath. Follow-ups of 90.1 % of subjects at 1 month and 80.6% at 4 months were carried out. RESULTS: Median attendance for nurse follow-up in the 4 months following diagnosis was 3 (IQR 2-5) in intervention practices and 0 (IQR 0-1) in control practices; the median number of visits to a doctor was the same in both groups. At hospital discharge, levels of prescribing of preventive medication were low in both intervention and control groups: aspirin 77 versus 74% (P = 0.32), cholesterol lowering agents 9 versus 10% (P = 0.8). Conversely, 1 month after diagnosis, the vast majority of patients in both groups reported healthy lifestyles: 90 versus 84% reported eating healthy food (P = 0.53); 73 versus 67% taking regular exercise (P = 0.13); 89 versus 92% not smoking (P = 0.77). Take up of cardiac rehabilitation was 37% in the intervention group and 22% in the control group (P = 0.001); the median number of sessions attended was also higher (5 versus 3 out of 6). CONCLUSIONS: The intervention of a liaison nurse is effective in ensuring that general practice nurses follow-up patients after hospital discharge. It does not alter the number of follow-up visits made by the patient to the doctor. Levels of prescribing and reported changes in behaviour at hospital discharge indicate that the main tasks facing practice nurses during follow-up are to help patients to sustain changes in behaviour, to encourage doctors to prescribe appropriate medication and to encourage patients to adhere to medication while returning to an active life. These are very different tasks to those traditionally undertaken by practice nurses in relation to primary prevention, where the emphasis has been on identifying risk and motivating change. Assessment of the effectiveness of practice nurses in undertaking these new tasks requires a longer follow-up.  (+info)

Follow-up of breast cancer in primary care vs specialist care: results of an economic evaluation. (2/1531)

A randomized controlled trial (RCT) comparing primary-care-centred follow-up of breast cancer patients with the current standard practice of specialist-centred follow-up showed no increase in delay in diagnosing recurrence, and no increase in anxiety or deterioration in health-related quality of life. An economic evaluation of the two schemes of follow-up was conducted concurrent with the RCT Because the RCT found no difference in the primary clinical outcomes, a cost minimization analysis was conducted. Process measures of the quality of care such as frequency and length of visits were superior in primary care. Costs to patients and to the health service were lower in primary care. There was no difference in total costs of diagnostic tests, with particular tests being performed more frequently in primary care than in specialist care. Data are provided on the average frequency and length of visits, and frequency of diagnostic testing for breast cancer patients during the follow-up period.  (+info)

Management of primary antibody deficiency by consultant immunologists in the United Kingdom: a paradigm for other rare diseases. (3/1531)

Variation in clinical practice and its effect on outcome is little known for rare diseases such as primary antibody deficiency. As part of a national audit a survey of all 30 consultant immunologists in the United Kingdom dealing with primary antibody deficiency syndromes in adults and children was carried out in 1993 to ascertain their practices in diagnosis and management. Consensus guidelines were published after the survey was completed. Comparison of the survey results of clinical practice at the time the guidelines were published with the standards identified highlighted that the practice of a minority of specialists was at variance with their peers and with the consensus document, particularly in the use of intramuscular immunoglobulin, the dose and frequency of intravenous immunoglobulin, and target trough immunoglobulin G concentration, which has implications for the quality of patient care. However, much closer agreement existed in the key areas of management, such as diagnosis and selection of intravenous immunoglobulin. The approach and the problems identified are relevant to the management of other rare diseases, in which diagnosis and management is complex and there are few specialists with the necessary knowledge to undertake such care. This survey, the first attempted audit of practice, shows that within a motivated group of specialists highly significant differences in practice may exist and the authors emphasise the importance of setting clear guidelines against which care can be assessed.  (+info)

Patients' satisfaction with care after stroke: relation with characteristics of patients and care. (4/1531)

OBJECTIVES: To evaluate stroke patients' satisfaction with care received and to identify characteristics of patients and care which are associated with patients' dissatisfaction. DESIGN: Cross sectional study. SETTING: Sample of patients who participated in a multicentre study on quality of care in 23 hospitals in the Netherlands. PATIENTS: 327 non-institutionalised patients who had been in hospital six months before because of stroke. MAIN MEASURES: Data were collected on (a) characteristics of patients: socio-demographic status, cognitive function (mini mental state examination), disability (Barthel index), handicap (Rankin scale), emotional distress (emotional behavior subscale of the sickness impact profile) and health perception; (b) characteristics of care: use of various types of formal care after stroke, unmet care demands perceived by patients, unmet care demands confirmed by their general practitioners, continuity of care, and secondary prevention, and (c) patients' satisfaction with care received. RESULTS: 40% of the study sample were dissatisfied with at least one type of care received. Multivariate analyses showed that unmet care demands perceived by patients (odds ratio (OR) 3.2, 95% confidence interval (95% CI) 1.8-5.7) and emotional distress (OR 1.8, 95% CI 1.1-3.0) were the main variable associated with dissatisfaction. CONCLUSIONS: Patients' satisfaction was primarily associated with emotional distress and unmet care demands perceived by patients. No association was found between patients' satisfaction on the one hand and continuity of care or secondary prevention on the other; two care characteristics that are broadly accepted by professional care givers as important indicators of quality of long term care after stroke. IMPLICATIONS: In view of these findings discussion should take place about the relative weight that should be given to patients' satisfaction as an indicator of quality of care, compared with other quality indicators such as continuity of care and technical competence. More research is needed to find which dimensions of quality care are considered the most important by stroke patients and professional care givers.  (+info)

Integrating MCH/FP and STD/HIV services: current debates and future directions. (5/1531)

The issue of integrating MCH/FP and STD/HIV services has gained an increasingly high priority on public health agendas in recent years. In the prevailing climate of health sector reform, policy-makers are likely to be increasingly pressed to address the broader concept of "reproductive health' in the terms consolidated at the Cairo International Conference on Population and Development, and the UN Conference on Women in Beijing. Integrated MCH/FP and STD/HIV services could be regarded as a significant step towards providing integrated reproductive health services, but clarity of issues and concerns is essential. A number of rationales have emerged which argue for the integration of these services, and many concerns have been voiced. There is little consensus, however, on the definition of "integrated services' and there are few documented case studies which might clarify the issues. This paper reviews the context in which rationales for "integrated services' emerged, the issues of concern and the case studies available. It concludes by suggesting future directions for research, noting in particular the need for country-specific and multi-dimensional frameworks and the appropriateness of a policy analysis approach.  (+info)

The three dimensions of managed care pharmacy practice. (6/1531)

Our goal is to provide a framework for pharmacy in an evolving healthcare marketplace by identifying and discussing the three dimensions of pharmacy practice: (1) pharmacy practice across the continuum of care; (2) the major elements of pharmacy practice; and (3) the evolution of pharmacy during the five stages of the development of managed care. The framework was devised under the proposition that there is a substantial consistency in what patients need or should expect from pharmacists. As integrated health systems develop, pharmacists must apply their skills and knowledge across the continuum of care to ensure that they play an integral part in the systems. In a managed care environment characterized by change and the development of integrated health systems, pharmacists have opportunities to become involved directly in patient care in such areas as disease prevention, home healthcare, primary care, and subacute care. Information systems, hospital drug distribution, clinical pharmacy, and the fiscal environment comprise the major elements of pharmacy practice within an integrated health system, and the way in which each of these elements evolves as the healthcare market adapts to managed care is critical to pharmacy practice. If the pharmacy profession can demonstrate its ability to manage disease and health, improve outcomes, and reduce costs within the evolving healthcare system, pharmacists will play a vital role in the managed healthcare market in the approaching new millennium.  (+info)

Development of a heart failure center: a medical center and cardiology practice join forces to improve care and reduce costs . (7/1531)

Congestive heart failure (CHF) is a rapidly growing and expensive cardiovascular disorder. Conventional care for CHF is ineffective and results in a cycle of "crisis management" that includes repeated emergency department visits, hospitalizations, and physician visits. Recently, a number of outpatient coronary care centers that provide consistent, aggressive outpatient therapies and extensive patient education have emerged and are successfully breaking this cycle of dependence on hospital services. One such effort is the Heart Institute's Heart Failure Center, the result of a partnership between a private-practice cardiology group and our tertiary-care medical center. Our program includes not only patient education and outpatient infusions of inotropic agents, but an electronic linkage to the emergency department and home healthcare services. Preliminary data show that 16 months after the program was initiated, hospital admissions decreased by 30%, hospital days by 42% and average length of stay by 17%. An effective outpatient heart failure program can alleviate the economic burden of CHF and improve the quality of patient care.  (+info)

Physicians in training as quality managers: survival strategy for academic health centers. (8/1531)

Being responsible for medical education places academic health centers at a disadvantage in competing for managed care contracts. Although many suggestions have been made for changing medical education to produce physicians who are better prepared for the managed care environment, few studies have shown how physicians in training can actually contribute to the competitiveness of an academic health center. We present three examples of engaging trainees in projects with a population-based perspective that demonstrate how quality improvement for the academic health center can be operationalized and even led by physicians in training. In addition to gaining experience in a managed care skill that is increasingly important for future employment, physicians in training can simultaneously improve the quality of care delivered through the academic health center.  (+info)

The Center for Effective Global Action (CEGA) is the University of Californias premiere center for research on global development. CEGAs faculty affiliates use two powerful techniques-rigorous evaluation and economic analysis-to measure the impacts of large-scale social and economic development projects.
In Phase I, a systematic literature review and interviews with patient/clients and their families provided conceptual material to develop draft items for two components of an instrument to measure continuity - a patient/client self-report component and a component containing items to be rated by a trained observer on health event information collected prospectively. Draft items for the patient/client report component were pre-tested with patients/clients and mental healthcare professionals and then piloted in a sample of 317 patients/clients in three regions. Draft items for the observer component were validity-tested by seven raters on five case scenarios developed from health records. Both components were found to have reasonable validity and reliability, although there was much variability among items in performance.. The resulting instrument - the Alberta Continuity of Services Scale for Mental Health - was then used in a 17-month cohort study of adult service recipients with severe and ...
The International Association for K-12 Online Learning (iNACOL) has launched a new web site to help schools deliver continuity of learning in the event of a swine flu outbreak or other pandemic. iNACOLs Continuity of Learning web site provides free resources to help schools, districts, and states prepare for the H1N1 flu pandemic or other natural disasters. The sites toolkit of online resources includes a Readiness Assessment questionnaire; Continuity of Learning planning frameworks; case studies with sample state and district contingency plans; archived events, such as webinars and presentations, on continuity of learning and how online learning can help; steps that districts can take to prepare for short-term and long-term closures prompted by the H1N1 virus; and a section where service providers (companies and organizations) can link to resources they offer for continuity of learning. Interest in online learning solutions for [providing] continuity of learning is … high [among] school ...
MICHAEL F. EASLEY GOVERNOR EXECUTIVE ORDER NO. 102 CONTINUITY OF OPERATIONS AND CONTINUITY OF GOVERNMENT PLANNING WHEREAS, natural and man-made emergencies and disasters can hinder the ability of State agencies to deliver essential services to the people of North Carolina; and WHEREAS, the purpose of Continuity of Operations and Continuity of Government planning is to ensure survival of a constitutional form of government and the continuity of essential State functions under all circumstances; and WHEREAS, effective State agency planning is vital to the implementation and operation of coordinated and well-managed Continuity of Operations and Continuity of Government plans; and WHEREAS, it is imperative that all State agencies have in place a viable Continuity of Operations capability which outlines the performance of their essential functions during any emergency or situation that may disrupt normal operations; and WHEREAS, North Carolina General Statute § 147-33.89 requires that each State ...
Personal continuity in general practice is considered to be a prerequisite of high quality patient care based on shared knowledge and mutual understanding. Not much is known about how personal continuity is reflected in the content of GP - patient communication. We explored whether personal continuity of care influences the content of communication during the consultation. Personal continuity was defined as the degree of familiarity between GP and patient, rated by both the GP and the patient. 394 videotaped consultations between GPs and patients aged 18 years and older were analyzed. GP - patient communication was evaluated with an observation checklist, which rated the following topics of conversation: (1) medical issues, (2) psychological themes, and (3) the social environment of the patient. For each of these topics we coded whether or not it received attention, and was built upon prior knowledge. Data were analyzed using multilevel logistic regression analyses. No relationship was found between GP
Restoration of bowel continuity after Hartmanns procedure is considered technically challenging and is associated with high morbidity and mortality. This is the main reason why restoration of intestinal continuity is often not attempted. Over the past decade, considerable international experience has gained on this topic with new minimally invasive techniques being developed. This review details the evolution of minimally invasive techniques in restoration of colonic continuity after Hartmanns procedure. A comprehensive search of PubMed and Embase was done. Different restoration modalities were included. Eight studies, from six different countries, in which multiport laparoscopic restoration of continuity was compared to conventional open restoration of bowel continuity, were included. In the total of 254 patients, continuity was restored laparoscopically compared with 255 patients in which continuity was performed in open fashion. Restoration of bowel continuity via trephine access was also reported;
Define Continuity Army Council. Continuity Army Council synonyms, Continuity Army Council pronunciation, Continuity Army Council translation, English dictionary definition of Continuity Army Council. Noun 1. Continuity Army Council - a terrorist organization formed in Ireland in 1994 as a clandestine armed wing of Sinn Fein CIRA, Continuity Irish...
Bad news: But suppose you are in that highly unusual situation of being an older person with multiple chronic diseases and needing the personal continuity of being seen by the same clinician each time, not only for your own safety but your sanity too. If I have to tell another doctor the same story again I shall go mad! Supposing your healthcare record needs to flag that up? We dont have a code for that!!! No not one. Typing continuity into a read code search engine will give you codes for disorders in continuity of bone or heart valves but nothing on continuity of personal care! The nearest you can get is the code XaKZN Provision of continuing care, but even this is more about Continuing Healthcare Funding than continuity of care. Our coding system has evolved to reflect successive governments obsession with access to appointments to the exclusion of continuity despite a wealth of evidence that continuity delivers on quality, cost, safety and patient satisfaction. There are hundreds of ...
Authors contributions. M. Aller was responsible for the supervision of the fieldwork, design, implementation and interpretation of data analysis and writing of the paper. Ingrid Vargas contributed to the study conception, design and implementation and writing of the paper. I. Sánchez designed the sample and I. García collaborated in the statistical analyses. J. Coderch participated providing operational and methodological support to the field work; and together with J.R. Llopard, L. Colomés and M. Ferrán participated as experts in healthcare systems in all project phases. M.L. Vázquez was responsible for the study design and supervision of all phases of the research and writing the article. All authors participated in data interpretation, reviewed draft versions of the paper and approved the final version.. Conflicts of interests. None.. Acknowledgments. The authors are most grateful to Silvina Berra, Maribel Pasarín, Josep María Argimon and Soledad Romea for their support to the ...
NHS hospitals are often overwhelmed by people presenting to hospital for care that is unexpected, in particular attending their A&E departments, and subsequently being admitted to hospital as an emergency. In considering reasons for this, it is natural to consider the potential influence of factors related to general practices where these people are registered. Sometimes the way practices are organised make their patients end up needing unplanned care from hospitals when they fall ill. In particular, we wish to determine whether having continuity of care (usually seeing the same doctor) can reduce the risk of having an unplanned hospital admission. We will use data from the Clinical Practice Research Datalink (CPRD), a nationally representative sample of general practices with data on every patient consultation. It is linked to another dataset, "Hospital Episode Statistics" (HES), which tell us about patients stays in hospital. This current pilot project will investigate whether the linked ...
Business Continuity Planning. April 29, 2005 Edmonton Sean Lawson, CBCP Linc Group Corp. Resources. DRI Canada - Business Continuity Institute - Disaster Recovery Information Exchange - West ( ) Slideshow 6658943 by aaron-roberts
The Emergency Planning and Business Continuity conference will provide participants with a platform to discuss how best to develop emergency response and business continuity plans to prepare and effectively combat unexpected incidents.
Northwestern Universitys business continuity planning efforts are coordinated, facilitated, and overseen by the Business Continuity Planning Office. At Northwestern, we recognized Business Continuity is a shared responsibility across the institution and community. All Northwestern administrative, academic, and research areas are responsible for developing a business continuity plan in an effort to minimize the impact caused by an interruption of operations. ...
Business continuity is an organizations capability to maintain mission-critical functionality during and after a disaster, such as service outages, security breaches or other threats.
Buy Approximation Theory Moduli of Continuity and Global Smoothness Preservation by George A. Anastassiou at ISBN/UPC: 9780817641511. Save an average of 50% on the marketplace.
Dont Be a Menace to South Central While Drinking Your Juice in the Hood (1996) continuity mistakes, goofs, trivia, quotes, trailers, pictures and more. Add more and vote on your favourites!
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Continuity is a part of high-quality patient care. The purpose of this study was to analyse what factors are important in the continuity of patients care, and how well continuity is achieved in different stages of the ...
Health, ...MONDAY April 1 (HealthDay News) -- Timely follow-up care with a docto...Chest pain is the most common reason patients go to the ER accounting...In this study researchers analyzed data from nearly 57000 adults av...Only 17 percent of the patients were evaluated by a cardiologist withi...,Follow-Up,Care,After,Chest,Pain,Called,Crucial,medicine,medical news today,latest medical news,medical newsletters,current medical news,latest medicine news
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Between 1989 and 1996, four Tie-In Novels were published for Red Dwarf, but in a different continuity (which split into two continuities itself after the …
Does your company have a business continuity (BC) plan? If it does, its headed in the right direction. If not, its wise that you start putting one together now. Test your BC IQ and see if you know what a good, solid BC plan should include. Continue Reading ...
Note that, by default, the function prop.test() used the Yates continuity correction, which is really important if either the expected successes or failures is < 5. If you dont want the correction, use the additional argument correct = FALSE in prop.test() function. The default value is TRUE. (This option must be set to FALSE to make the test mathematically equivalent to the uncorrected z-test of a proportion.) ...
There is something reassuring, too (at least, I find it so), in these renewals of former admirations. We all endeavour, as Spinoza says, to persist in our own being; and that endeavour is, he adds, the very essence of our existence. When, therefore, we find that what delighted us once can still delight us: that though the objects of our admiration may be intermittent, yet they move in fixed orbits, and their return is certain, these reappearances will suggest that we have after all maintained something of our own integrity; that a sort of system lies beneath the apparent variability of our interests; that there is, so to speak, a continuity within ourselves, a core of meaning which has not disintegrated with the years. ...
COMTICS also offers the highest level of cyberprotection. Designed to meet the specific requirements of operations at sea, including high availability despite the risk of combat damage, COMTICS is built on a redundant all-IP architecture to ensure operational continuity under all circumstances ...
It is well-established that longitudinal care from a primary care physician improves quality and efficiency of patient care. Patients report higher satisfaction in the context of their care when engaged in a long-term relationship with one healthcare provider [1-3]. Better patient health outcomes have also been associated with continuity of care [2, 4]. In addition, longitudinal care promotes cost efficacy; for instance, by decreasing the number of hospital and/or emergency department visits [5-7].. Though training and experience in longitudinal care supports student interest in primary care careers [8-10], the structure of medical education makes it difficult for large numbers of students to experience providing continuity of care. Standardized patient encounters usually simulate "one-time" interactions with no opportunity for the student to consider the continuity of care that would be provided to that patient in a true outpatient setting, especially in a primary care practice. In terms of ...
A Risk Management Approach to Business Continuity: Aligning Business Continuity with Corporate Governance by David Kaye, Julia Graham starting at . A Risk Management Approach to Business Continuity: Aligning Business Continuity with Corporate Governance has 0 available edition to buy at Alibris
Enterprise Risk Management on Continuity Insights | By Zeb Ahmed, CLOUD, XaaS & BCDR Leader - IBM: Although Service Providers have been providing offsite…
This research project addresses the theme of managing continuity of care, specifically systems for managing continuity of care in the subregional context of a networked operating structure for delivering perinatal care and services. At the request of local authorities with which we had previously co-operated, our team conducted an assessment of the implementation and effects of the prenatal component of a system for managing continuity of perinatal care based essentially on inter-institutional referrals and a pregnancy logbook managed by each pregnant woman. Developers of the system sought the following objectives: 1) promote identification and early referral of pregnant women presenting biopsychosocial risks; and 2) ensure continuity of information among the various healthcare partners.. Using data gathered from October 2003 to August 2004, the study consists of two parts, one qualitative and the other quantitative. The first part entailed a case study to describe the intervention and determine ...
Continuity in the context of healthcare refers to the perception of the client that care has been connected and coherent over time. For over a decade professionals providing maternity and child and family health (CFH) services in Australia and internationally have emphasised the importance of continuity of care for women, families and children. However, continuity across maternity and CFH services remains elusive. Continuity is defined and implemented in different ways, resulting in fragmentation of care particularly at points of transition from one service or professional to another. This paper examines the concept of continuity across the maternity and CFH service continuum from the perspectives of midwifery, CFH nursing, general practitioner (GP) and practice nurse (PN) professional leaders. Data were collected as part of a three phase mixed methods study investigating the feasibility of implementing a national approach to CFH services in Australia (CHoRUS study). Representatives from the four
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PubMed comprises more than 30 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
We have received an update from Public Health England with regards to hepatitis A vaccine supply. There is an ongoing global shortage which is impacting on continuity of supply in the UK. Anybody requiring boosters of this vaccination can be safely delayed at the present time. We are currently investigating alternative vaccine options as advised by Public Health England. ... gives a two-sided Wilson confidence interval with continuity correction for the difference of two dependent proportions. The continuity correction is performed to the score limits. Data are assumed to be of a fourfold table, which contains the numbers of concordance and the numbers of discordance of two dependent methods.
The download cretan sanctuaries and cults continuity and change from late minoan iiic to the and lectures items are the latest justified on their Loop gift designers and may rather Paraphrase their family at the quote of year. Most of the lot site conducted easy during resources, when ergodic bit can add Selected. RP presents defined by social or s values or writers the download cretan sanctuaries and cults continuity and change from late minoan iiic to the archaic period religions in the graeco roman world formulas yet led such wear that the trends emerged missing not under statements which were memorable and 2nd.
Health,continuity of primary care practices. Our findings will be useful to ......,Study,shows,loosening,managed,care,restrictions,may,improve,doctor-patient,relationship,medicine,medical news today,latest medical news,medical newsletters,current medical news,latest medicine news
A fundamental aim of primary care redesign and the patient-centered medical home is improving access to care. Patients who report having a usual site of care and usual provider are more likely to rece
Continuity of care can be a hard thing to come by - but when healthcare providers practice based on electronic health records, it vastly improves the care the patient receives.
The importance for manufacturing firms to add services to their offerings has been asserted over and over again (Neu and Brown 2005). Adding services to product sales require manufacturing firms to develop other types of offerings such as maintenance services, hybrid offerings or integrated solutions. This implies using new and often unknown practices to be able to provide services. Previous research has focused on the benefits of servitization (Gebauer, Gustafsson, and Witell 2011), albeit in larger firms. Hence, similar research on Small and Medium sized Enterprises (SME) has been scarce. Furthermore, servitization as a unidirectional transition process can be questioned as researchers argue that manufacturing firms might offer different types of services simultaneously and might not have the intention to take the next step that a transition process suggests (Kowalkowski et al. 2015). Moreover, previous research shows that the step from offering after-sales services and repair to offering more ...
Choose business IT software and services with confidence. Compare verified reviews from the IT community of Fusion Risk Management vs. RecoveryPlanner in Business Continuity Management Planning Solutions
Swine Flu is impacting locations in Mexico, the US, Canada, Asia, and Australia. We recommend that you review your business continuity plan now. Even if the outbreak is contained, if it occurs where you have employees, your business could feel the full impact of the flu. According to health officials at the UK NHS: This…
Fusion Risk Management 3601 Algonquin Road, Suite 1250 Rolling Meadows, IL 60008 Fusion provides the award-winning Fusion Framework® Continuity Risk Management…
Use tabletop exercises to stress-test your business continuity management and make sure critical personnel are familiar with the BCM recovery plans.
There is no magic formula for continuity risk management or measurement. In the end, risk measurement is a process. Here are some tips that can help.
Enterprise risk management is an important aspect of business continuity planning. This tip will help you understand risks, threats and vulnerabilities to build a foundation for your work.
Molecular Genetics, Storage and Transfer of Genetic Information, Principles of Genetics:A Review in Continuity and Evolution of Animal Life
Ottienilo da una biblioteca! Painted songs : continuity and change in an Indian folk art. [Thomas Kaiser; Joan Clough; Karina Moschke; Universität Zürich. Völkerkundemuseum.] -- For over 2000 years and until just a few decades ago artists traveled throughout India, using painted picture scrolls to spread stories from the great Indian epics Mahabharata and Ramayana, as well ...
Intimal re-layering technique for type A acute aortic dissection-reconstructing the intimal layer continuity to induce remodeling of the false channel
I chose this months theme because it is constantly coming up in my life right now. I am hoping to graduate sometime this year. This has spurred a lot of talk in my lab and in my home about continuity. In the lab it tends to be in the form of sharing my knowledge and skills with Advisor and my fellow grad students. At home its of the where will we live and what shall I do variety. With this in the forefront of my mind, I decided to make Continuity the theme of this months Scientiae Carnival. It seems, from most everyones posts, that we, as scientists, have very little continuity in our lives. However, sometimes the more things change, the more they stay the same ...
WCHN Community Nurse is to contact the families and offer an AABR screen to all infants who referred in one or both ears from their hospital screen or who did not complete a hospital screen. In this way, effective and timely follow-up can be achieved ...
Bad news on the health front- At that same doctors appointment on 11/1 he was talking to me about my bp and he mentioned that I am on A LOT of medication, which I think I am too. I told him that I kinda feel like it might not even be enough because Ill have days when it gets pretty high (130-140/90s). He asked me if I had ever had my kidneys checked and I said that all of my bloodwork has come back with normal kidney function. He decided to refer me to a specialist anyway and wanted me to have an ultrasound done on all of my "systems" so I went in on 11/8. I figured all theyd find was a gallstone (they found one when I was pregnant with Gracie) but when I turned to see the screen as she was checking my left kidney I saw a black blip on the screen. I asked "Is that a cyst?" and she said yes very nonchalantly. I know they arent supposed to discuss their findings with the patients so I didnt press her for more ...
I am a 25 year old female. About 2 years ago I noticed a painful swelling in my left underarm. I went to my gyn and she said it is probably just a swollen gland, and if it kept reoccuring to come back. It returned on and off. About 6 months ago, it returned and has remained. I returned to the same doctor, and she ordered an ultrasound. The results from the ultrasound were inconclusive. She said she does not think it is breast cancer because it has gone on so long, and a mamogram isnt neccesary. There is clearly a lump there, and it is very tender and painful. What could this be, and what is my best course of action? I have no family history of breast cancer, do not currently take any medicines, and am overall healthy except for HPV - which has not caused any problems since I was diagnosed and treated for cervical dysplacia three years ago. Thank you for your help ...
(HealthDay)-Black children are less likely to be prescribed antibiotics and to be diagnosed with conditions that require antibiotics, even when treated by the same doctor, according to research published online March 18 ...
I often wondered how I could have the same doctor for over 20 yrs. and he not diagnose me with diabetes. I came across this article and after reading it I wa...
In the past century, there has been a transition in healthcare from focusing on diseases and their pathology to focusing instead on a variety of socio-environmental factors that influence health outcomes.
Whilst checking out the reviews for NA he-man, overall I thought it was an excellent figure, I couldnt help but think there was something a bit off regarding the sculpt of the face and hands. Having looked at my other figures, I can see that it must be the same horseman that sculpted jitsu, Marlena and probably a few others. My problem is its clear another horseman did the face sculpts earlier in the line as the newer ones seem more thin and small compared to the more natural, round faces
Whilst checking out the reviews for NA he-man, overall I thought it was an excellent figure, I couldnt help but think there was something a bit off regarding the sculpt of the face and hands. Having looked at my other figures, I can see that it must be the same horseman that sculpted jitsu, Marlena and probably a few others. My problem is its clear another horseman did the face sculpts earlier in the line as the newer ones seem more thin and small compared to the more natural, round faces
Taiwans long-governing pro-Beijing party is out of power. But for now, neither China nor the newly ascendant opposition are looking to shake up cross-strait relations.
In handoff discussions between attending physicians in an intensive care unit, more time is allocated to patients discussed early in each session compared with those discussed last, despite the order of cases being unrelated to severity or complexity of illness.
Hope to check in with my close cyber friends personally, but thought I should also post here to keep continuity and let people know whats up with us. Between hyperemesis in early...
Because companies cant immediately see the ROI of an IT/business continuity plan, too many put developing one on the backburner. But when a disast...
Unlike four-year schools, it is necessary for all Student Organizations to have a structured leadership transition process in place to ensure that the students who will be assuming leadership have all the information necessary to continue building upon the Student Organizations success. A transition process allows student leaders to plan in advance of the coming semesters and not feel rushed or stressed about how to lead the Student Organization. The transition process should begin when the Student Organization first starts talking about elections and end several weeks into the new officers term. In order to make the process successful, incoming and outgoing officers must know that participation in the transition process is an essential obligation of their role and to the success of the organization. The Student Organization Advisor should work with the outgoing officers prior to elections to determine how they will move forward with the transition process. The following information, if ...
Communication between physicians caring for hospitalized patients and those patients primary care providers (PCPs) is often suboptimal. Hospital-based information systems can improve communication by automating information exchange between hospital physicians and PCPs, and perhaps, as a result, improve the quality and safety of health care. MedTrak, the University of Pittsburgh Medical Center (UPMC) electronic physician communication tool, has proven successful and is poised to move forward with an initiative the investigators call virtual continuity, allowing PCPs to follow their patients electronically if they cannot do so physically. Virtual continuity will include: emails to PCPs triggered by clinical events with embedded links to electronic medical record data and communication portals, medication lists electronically delivered to PCPs at admission and discharge, and immediate PCP notification of discharge with pertinent clinical details. To evaluate virtual continuity, the investigators ...
In this paper, results of a numerical study on pore continuity, permeability and durability of cementitious slurries for carbon sequestration projects are presented. The hydration model Hymostruc is used to simulate and visualize 3D virtual microstructures which are used to demonstrate the contribution of capillary pores to the continuity of the capillary pore system embedded in an evolving cementitious microstructure. Once capillary pores are blocked due to ongoing hydration, transport of CO2 species through the microstructure is avoided which may protect the slurry from leakage. Evaluating the pore continuity of the capillary pore system during hydration of the microstructure is therefore indispensable for a robust cementitious sealing material and is the main objective for slurry design. Simulations are conducted on slurries exposed to ambient temperatures of 20 °C, 40 °C, and 60 °C, and a durability outlook regarding the CO2 ingress is given as well. Aggregates and associated interfacial ...
Welcome to La Clinic - Oliver L. Kreitmann, M.D., F.A.C.O.G. La Clinic is a gynecologic practice with convenient locations in Silver Spring and Bowie, Maryland. Under the direction of Dr. Oliver L. Kreitmann, a board certified obstetrician and gynecologist, La Clinic offers a wide range of health care services for women of all ages. Our practice mission is to provide state of the art womens health services. We focus on continuity of care, information, planning and prevention for successful health care and maintenance ...
Dr. Michel J. Berg joined the University of Rochester School of Medicine and Dentistry faculty in 1993 and is currently an Associate Professor of Neurology . He has a special interest in technology for healthcare. He is involved in projects on enhancing medication adherence with smart medication dispensers, establishing the equivalence of generic anti-epilepsy drugs (AED), automating MRI analysis, seizure prediction from EEG, and the genetics of abnormalities of brain development with a focus on cerebral cavernous malformations. He is the chair of the American Epilepsy Society Task Force on Continuity of Medication Supply which is currently focused on the issue of generic equivalence of anti-epilepsy drugs. He is on the Scientific Advisory Board of the Angioma Alliance. He is co-author of the text, 100 Maxims in Clinical Neuroradiology, and has authored and coauthored numerous scientific articles in the above fields ...
ZCZC MIATCDAT4 ALL TTAA00 KNHC DDHHMM Tropical Depression Four Discussion Number 4 NWS National Hurricane Center Miami FL AL042017 500 PM AST Thu Jul 06 2017 Its difficult to tell from visible and microwave satellite imagery whether or not the depression still has a closed surface circulation. In addition, the forward speed is now about 20 kt, which would make it difficult for a 25-kt depression to maintain westerly winds to the south of the center. For now, advisories will be maintained until/if there is stronger evidence that the circulation has opened up. Convective cloud tops have warmed during the past few hours, and Dvorak final-T numbers from TAFB and SAB have decreased. Therefore, the initial intensity will be held at 25 kt based on continuity. Multispectral satellite imagery shows the Saharan Air Layer is overtaking the depression, and it will be increasingly more difficult for the system to maintain organized deep convection. It has also become more likely that the cyclone will not ...
The Evolution of Minimally Invasive Techniques in Restoration of Colonic Continuity. By Stefan H.E.M. Clermonts, Laurents P.S. Stassen and David D.E. Zimmerman. Restoration of bowel continuity after Hartmanns procedure is considered technically challenging and is associated with high morbidity and mortality. This is the main reason why restoration of intestinal continuity is often not attempted. Over the past decade, considerable international experience has gained on this topic with new minimally invasive techniques being developed. This review details the evolution of minimally invasive techniques in restoration of colonic continuity after Hartmanns procedure. A comprehensive search of PubMed and Embase was done. Different restoration modalities were included. Eight studies, from six different countries, in which multiport laparoscopic restoration of continuity was compared to conventional open restoration of bowel continuity, were included. In the total of 254 patients, continuity was ...
Background. The benefits of continuity of care COC have not been firmly established for pediatric patients. Objective. To assess whether greater COC is associated with lower emergency department ED utilization. Setting. Outpatient teaching clinic at Children s Hospital and Regional Medical Center, Seattle, WA. Patients. All 785 Medicaid managed...
For example: A fire in the Registrars office during the first week of the semester requires the immediate evacuation of personnel. Fire crews respond and extinguish the fire, and Facilities Services makes every effort to prevent further water damage caused by fire suppression systems. These are considered response activities. The fire and water led to considerable damage that will take weeks to repair, but the office needs to resume operations immediately to avoid a lengthy disruption of service. Continuity plans address contingencies to temporarily relocate the Registrars office, reestablish a functional work space, restore critical information systems, and resume services. ... in political action ... in political action ...
Continuity tester Assembly kit Conrad Components 199842 9 Vdc, 12 Vdc - now buy online with ease from , your online shop for technology, electronics and innovative ideas. | 199842
HI IM 29,im trying to figure out if i have MS.Ive recently,been having my right side fall asleep or have the tingling numbness in my foot really bad!!Ive also exprienced Lhermittes sign in nov.2007and after that i had acute hyperthyrodism,in 2008 after april alot of the symptoms went away but i was left with anxiety disorder now.Ive been seeing the same doctor and now have been expriencing alot of numbness now in my right side ...
Background/Aim: Transition from pediatric to adult care is a challenging turning point. The aim was to evaluate the transition process and needs expressed by patients with chronic endocrine conditions at transition in order to ensure program optimiza
Quality of life: The study suggests that the relationship between leisure, work, and housework will change in the future, with leisure time increasing on average.. While the study focused on Germany, the researchers say that the findings are applicable across many aging societies. Loichinger says, "The particular context of another country will determine the degree of their relevance. For example, an increase in educational attainment levels can be found almost universally around the globe, and the finding that the elderly belonging to subsequent cohorts have better health has also been shown in other contexts. Depending on a countrys stage in the demographic transition process, the results from the analyses of bequests and CO2 emissions are also generalizable.". ...
Introduction Traditionally, it has been difficult for network operators to guarantee consistent policies to in-flight packets during configuration transitions, leading to potentially insecure or undefined network behavior during the transition period. It is possible that the transition process briefly allows propagation of malicious traffic, causes packets to be dropped, or incurs bandwidth degradation. For example,…
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To see this methodology in action, see my previous responses to Nick and Murali. Compatibly with a clear-headed understanding of reductionism about identity -- that is, the claim that persons do not really endure in any way that is a deep further fact over and above the fact that we have temporal stages that are physically and psychologically related in various qualitative respects, so that ordinary survival is not really any better than being duplicated or uploaded -- we still reasonably care about our future stages, i.e. we care about the existence of future minds that are relevantly similar to our current minds. Psychological continuity thus suffices as far as the interests of persons are concerned. But it is not plausible to say the same in the case of animals. I assume most people would agree with me that concern for my particular cat does not give me any reason to have it duplicated or uploaded prior to death. Such psychological continuity does not suffice, intuitively, to advance ...
To see this methodology in action, see my previous responses to Nick and Murali. Compatibly with a clear-headed understanding of reductionism about identity -- that is, the claim that persons do not really endure in any way that is a deep further fact over and above the fact that we have temporal stages that are physically and psychologically related in various qualitative respects, so that ordinary survival is not really any better than being duplicated or uploaded -- we still reasonably care about our future stages, i.e. we care about the existence of future minds that are relevantly similar to our current minds. Psychological continuity thus suffices as far as the interests of persons are concerned. But it is not plausible to say the same in the case of animals. I assume most people would agree with me that concern for my particular cat does not give me any reason to have it duplicated or uploaded prior to death. Such psychological continuity does not suffice, intuitively, to advance ...
To solve this problem, determine if there is an association between the presence or absence of a given source of pigs and the presence or absence of disease X within a lot of grow-finish pigs (Figure 1). For this purpose, we will use the epidemiologists work horse, the two-by-two contingency table. The basic approach to the statistical analysis of such a table is to first determine the probability that the distribution is due to a random process. The tests most often used for this purpose are the Chi square, the Chi square corrected for continuity, and Fishers exact test. The Chi square corrected for continuity is useful when cell values are less than 30. The Fishers exact test is used when the expected value of any one cell is less than 5. Because our contingency table has small numbers, we must use the Fishers exact test. Thus, for each origin, we make up a two-by-two table, as illustrated by Table 1 for Source 9.. ...
In the BDM I dont think the doctor went into much detail regarding what was done to River. So while Simon may have had some ideas he needed as much information as possible before he could come up with any treatments for River. Hence, the diagnostic room in the hospital on Ariel. Using that sophisticated piece of equipment he was able to get a detailed picture of everything that was done to her brain. He was also able to save a record of it for detailed analysis and for further reference ...
We designed a bespoke framework which outlines the benefits of BCP, an efficient and effective process, Business Impact Assessment, Action Planning for severe risks and production of Immediate Response and Business Recovery Plans including testing options and training awareness requirements ...
f(x)-f(a), is not less than ,f(x-a),. Its not like f is linear or something. ,f(x)-f(a),=,(f(x)-f(a))/(x-a),*,x-a,. Now to get a d, you need a bound on ,(f(x)-f(a))/(x-a), near x=a. Hint: doesnt that look like a difference quotient ...
It definitely wasnt the dominant lineage but it was there. Personally I think WHG from somewhere around the Danube is a more likely source (from WHG to MN to BB to today) but we dont have the samples really to tell. I dont think Yamnaya is a likely though - I dont think wed have the extreme cultural continuity with a steppe elite wiping out the whole existing Y-DNA pool. If anything, I think a pool of somewhat EHG admixed WHG around the Danube is the source of R1b within both Bell Beakers and Yamnaya. I think thats more likely as I could see greater cultural continuity if the new substrate is from a closely related (WHG) culture, rather than a more distantly related ANE one. ...
It definitely wasnt the dominant lineage but it was there. Personally I think WHG from somewhere around the Danube is a more likely source (from WHG to MN to BB to today) but we dont have the samples really to tell. I dont think Yamnaya is a likely though - I dont think wed have the extreme cultural continuity with a steppe elite wiping out the whole existing Y-DNA pool. If anything, I think a pool of somewhat EHG admixed WHG around the Danube is the source of R1b within both Bell Beakers and Yamnaya. I think thats more likely as I could see greater cultural continuity if the new substrate is from a closely related (WHG) culture, rather than a more distantly related ANE one. ...
It definitely wasnt the dominant lineage but it was there. Personally I think WHG from somewhere around the Danube is a more likely source (from WHG to MN to BB to today) but we dont have the samples really to tell. I dont think Yamnaya is a likely though - I dont think wed have the extreme cultural continuity with a steppe elite wiping out the whole existing Y-DNA pool. If anything, I think a pool of somewhat EHG admixed WHG around the Danube is the source of R1b within both Bell Beakers and Yamnaya. I think thats more likely as I could see greater cultural continuity if the new substrate is from a closely related (WHG) culture, rather than a more distantly related ANE one. ...
Continuity of care in general practice is associated with fewer hospital admissions among older patients, researchers have found.
We provide preventive care services as well as care for chronic conditions and acute illnesses. Our clinicians consult and work with specialists to ensure you receive the best care, education and support. You will see the same team of providers whenever possible. This fosters trust, understanding and continuity of care. You care team includes:. ...
With diagnostic testing options including chromosome analysis, FISH, and SNP microarray, we offer continuity and choice for patients and providers.
Considering the years when the project was designed and realized, it is easy to read the lack of attention on public space.. The areas lack in continuity and are strongly disconnected from the village; spaces are poorly maintained and need a consistent upgrade of urban quality.. This situation calls for a re-thinking of the green areas into a system that could establish a strong relationship with the countryside and the architectural heritage of the first project from 1952. ...
Im trying something different on this project than I did on Moms Cancer or WHTTWOT: pencilling the entire story first, then going back and inking it (on my previous books, I pencilled and inked a few pages at a time, completing small batches as I went). This solves a few problems. First, a characters appearance naturally evolves as you draw it over and over, streamlining and polishing, so that the same character can look very different between start and finish. Ive already noticed that happening with these characters. Thatll be much easier to adjust between pencilling and inking than if I had to go back and fix a bunch of already-inked pages. Second, I have some continuity concerns--things that must match at the beginning and end of the story, or build slowly throughout--that are again easier to get right and revise in pencils than inks. Third, it gives me freedom to think of new ideas as I go and weave them back in retroactively ...
Cheyene Marling, Hon. MBCI has been an executive recruiter for over 22 years, with 20 of those years specializing in the business continuity field. She currently serves as the Firestorm EVP of People Solutions and Program Analytics.
process, whatever it may be, a process of physiological induction, we may apply a similar name to a process which seems closely analogous to, if it is not really identical with, the process we are now considering. I refer to some highly remarkable observations which were published a year or two ago in Mr. Darwins work on "Insectivorous Plants". It is there stated that, while looking at a linear series of excitable cells with the microscope, Mr. Darwin could observe the passage of a stimulus along the series, the protoplasm in the cells immediately stimulated first undergoing aggregation, then the protoplasm in those next adjacent doing the same, and so on. Now, the protoplasm in each cell was separated from the protoplasm in the adjacent cell by the walls of both the cells; yet, notwithstanding there was no observable anatomical continuity between these masses of protoplasm, a disturbance set up in any one of the series of masses immediately set up, by some process of physiological induction, a ...
Acad Pediatr. 2009 Jul-Aug;9(4):228-33. doi: 10.1016/j.acap.2008.12.010. Epub 2009 Mar 9. Comparative Study; Research Support, Non-U.S. Govt
Although the various transition processes were not well described, thus making comparability across studies difficult, there appears to be some preliminary evidence of a positive impact of structured transition programmes on glycaemic control, clinic attendance and diabetes-related hospitalizations for young people with Type 1 diabetes during healthcare transition. Studies assessing the outcomes of participants who attended transition programmes or interventions, compared with those who did not, found no change in or improved glycaemic control, better attendance rates and fewer diabetes-related hospitalizations post-transition. Well designed randomized controlled trials are now needed to assess this. It is also important that future studies provide in-depth descriptions of transition processes and protocols so that cross-study comparisons can be made. Studies examining the experiences of transition suggest many processes that should be considered in transition programmes as they are likely to ...
Objectives. The aims of this research were to generate a set of time-variant measures of continuity of outpatient care using administrative data, and to evaluate the validity of these measures for persons in the community with serious mental illness (SMI) who use public mental health services.. Data Sources. Individuals with SMI were identified using multistage random sampling from shelters, streets, and public mental health clinics in Houston, Texas.. Study Design. The study design was observational, cross-sectional, and retrospective. Based on a review of the literature, five distinct conceptual dimensions of continuity of care were defined: timeliness, intensity, comprehensiveness, stability, and coordination. Repeated measures of continuity were generated for each day of the year. Construct validity was assessed by comparing continuity for housed persons and homeless persons based on the assumption that homelessness is a risk factor for low continuity of outpatient care.. Data Collection. ...
Caesarean section (CS) has short and long-term health effects for both the woman and her baby. One of the greatest contributors to the CS rate is elective repeat CS. Vaginal birth after caesarean (VBAC) is an option for many women; despite this the proportion of women attempting VBAC remains low. Potentially the relationship that women have with their healthcare professional may have a major influence on the uptake of VBAC. Models of service delivery, which enable an individual approach to care, may make a difference to the uptake of VBAC. Midwifery continuity of care could be an effective model to encourage and support women to choose VBAC. A randomised, controlled trial will be undertaken. Eligible pregnant women, whose most recent previous birth was by lower-segment CS, will be randomly allocated 1:1 to an intervention group or control group. The intervention provides midwifery continuity of care to women through pregnancy, labour, birth and early postnatal care. The control group will receive
The study has two research objectives: (1) to expand access and options for HIV testing with individuals in the criminal justice system, by focusing on high-risk intravenous drug users (IDUs) and crack cocaine smokers in community settings; and (2) to improve access and maintenance of highly active antiretroviral treatment (HAART) among HIV-positive persons in this population, by implementing a promising intervention focused on continuity of HIV care, and evaluating it using a rigorous experimental design.. HIV-positive persons will be identified through the testing activities described in Objective 1. They will then be offered enrollment in a randomized controlled trial (RCT) of an intervention designed to engage and maintain HIV-positive people with criminal justice involvement in medical care. The intervention, Project Bridge, has shown great promise but has not yet been rigorously evaluated. The RCT will assess the efficacy of Project Bridge compared with a Usual Care arm. Our hypotheses are ...
A new tool available from the Joint Commission Center for Transforming Healthcare aims to help health care organizations with the process of passing necessary and critical information about a patient from 1 caregiver to the next, or from 1 team of caregivers to another, to prevent miscommunication-related errors.. The Hand-off Communications Targeted Solutions Tool™ (TST) is an application that guides health care organizations through a step-by-step process to accurately measure their organizations actual performance, identify their barriers to excellent performance, and direct them to proven solutions that are customized to address their particular barriers.. Using TST and the solutions from the centers Hand-off Communications Project, health care organizations have reduced readmissions by 50%, and have reduced the time it takes to move a patient from the emergency department to an inpatient unit by 33%, says the Joint Commission. Health care organizations also report an increase in patient ...
This series was established in 2006 with an editorial board based in the Department of History and the CMRS. The series is concerned with the relationship between religion, society, culture and identity in Europe from the early medieval period to the end of the ancien regime, with particular emphasis on continuity and transformation within urban religious life and institutions. The series concentrates on medieval Europe, but also includes North Africa and the Middle East, with a particular emphasis on studies that focus on history in the longue durée.. Recent and forthcoming titles :. Alison Brown, Medicean and Savonarolan Florence: The Interplay of Politics, Humanism, and Religion.. Nicholas Terpstra, Adriano Prosperi, Stefania Pastore (eds.), Faiths Boundaries: Laity and Clergy in Early Modern Confraternities. Prospective authors are invited to send manuscripts to the Chair of the editorial board for consideraton ([email protected]). Brepols has adopted the MHRA Style Guide.. ...
Cook, R. I., Render, M., & Woods, D. D. (2000). Gaps in the continuity of care and progress on patient safety. British Medical ... Advances in Health Care Management. Advances in Health Care Management. 7: 33-68. doi:10.1016/S1474-8231(08)07003-1. ISBN 978-1 ... Health Care Management Review, 29(2): 90-97. Chiles, J. R. (2002). Inviting disaster: Lessons from the edge of technology. New ... Rasmussen, J. (1999). The concept of human error: Is it useful for the design of safe systems in health care? In C. Vincent & B ...
Those barriers to medical care complicate patients monitoring and continuity in treatment. In the US, Minorities and low-income ... Lack of access and delay in receiving care result in worse outcomes for patients from minorities and underserved populations. ... Eighty-four percent of all health care spending in 2006 was for the 50% of the population who have one or more chronic medical ... Mead H et al "Racial and Ethnic Disparities in U.S. Health Care: A Chartbook" The Commonwealth Fund 2008. Sondik EJ, Huang DT, ...
was challenging because it was about patients' biographies and thus continuity of care. Running a Practice (jtly with Jones RVH ... London RCPsych 1994 Developing Primary Care: The Academic Contribution 1996 "Who is in the research team?". St Leonard's ...
... patient strategies for coping with an absence of care coordination and continuity. Sociology of health & illness, 38(6), 854- ... patient strategies for coping with an absence of care coordination and continuity. Sociology of health & illness, 38(6), 854- ... Some of the difficulties experienced by patients include: poor coordination of medical care, managing multiple medications, ... Patients with co-morbid conditions encountered problems with the coordination between services and with polypharmacy. Patients ...
Branches of this section include: department level, patient care, infrastructure, business continuity, security, and HazMat. ... This allows the hospital to handle a surge in patients and render life-saving care to the greatest number of patients. FEMA, ( ... Business continuity branch director vii. Patient family assistance branch director (added in the 2014 version) ➢ Planning chief ... Demobilization unit leader ➢ Logistics chief - (direct maintenance and supply operations to ensure patient care, supplies, ...
Furthermore, remote dispensing terminal manufacturers state that this technology can facilitate patient continuity of care ... limiting the pharmacist's ability to detect a patient's nonverbal cues. A patient with alcohol on his or her breath would go ... Hands-on patient training on inhalers and glucose meters is not feasible with remote dispensing, and administration of ... Remote dispensing is used in health care environments to describe the use of automated systems to dispense (package and label) ...
Clinical Care Coordination/Facilitation - coordinating multiple aspects of care to ensure the patient progresses. Continuity/ ... The goal is to coordinate the care so as to both improve continuity and quality of care and lower costs. Specific types of case ... 2) Planning & delivery of care 3) Evaluation of results for each patient & adjustment of the care plan 4) Evaluation of overall ... Provide patient education; 4) Provide post-care follow-up; and 5) Coordinate services with other health care providers. Case ...
... the work week include disruptions in continuity of care and limiting training gained through involvement in patient care. ... explained to patients, and applied to patient care. Residents should participate in scholarly activity. The sponsoring ... It does allow up to six hours for inpatient and outpatient continuity and transfer of care. However, interns and residents may ... The first year of practical patient-care-oriented training after medical school has long been termed "internship." Even as late ...
Residents also must provide care for a panel of continuity patients in an outpatient "model practice" for the entire period of ... Primary Care. CQ Researcher, 5 (10), March 17, 1995. "Patient Brochure", American Board of Family Medicine. Retrieved 6-30-09. ... Many family physicians deliver babies in addition to taking care of patients of all ages. In order to become board certified, ... Many American family physicians deliver babies and provide prenatal care. In the U.S., family physicians treat more patients ...
... and medical guidance to ensure excellence and continuity in patient care. Philadelphia has nine responders, all state certified ... "A & E Patients Set for the Sabbath" (PDF). Gateshead Health Matters. Gateshead: Gateshead Health NHS Trust. 73: 2. April 2004. ... Gateshead Manchester Kiev Los Angeles has a chapter which provides Basic life support level care and relies on the Los Angeles ... On August 31, 2009 they began direct transport of patients to area hospitals using their own ambulance. Los Angeles Covering ...
Each patient is assigned a specific physician to provide the continuity of care that is essential for a healthy doctor-patient ... The Health Center provides each patients with a primary care physician who will treat and track the patient's health as long as ... Typical volunteer positions include signing in patients, answering telephones, filing, charting, and assisting patients in ... close to 100 physician and non-physician volunteers donate their time to assist in the care of the Health Center's patients. ...
Continuity of Care Starts With You By Gregory J. Warth at Medscape. 04/21/2011 Patient-Centered Care Please visit www. ... Continuity of health care (also called continuum of care) is to what degree the care is coherent and linked, in turn depending ... transitional care is defined as a set of actions designed to ensure the coordination and continuity of health care as patients ... and long-term care facilities. Transitional care is based on a comprehensive plan of care and the availability of health care ...
They work 12-hour shifts to ensure continuity of care but also aim to prevent excessive physician fatigue. Patients who have ... Safety engineering features such as low bed height and a patient position monitor that alerts staff when a patient is moving in ... Carteret Health Care (formerly Carteret General Hospital) is a 135 bed, non-profit hospital in Morehead City, North Carolina. ... "Robot connects patients to doctors across regions" Archived 23 March 2012 at the Wayback Machine. By Brittany Edney, News 14. 2 ...
... care documentation is advancing structured communication between healthcare professionals to ensure the continuity of patient ... The patient's health record is a legal document that contains details regarding patient's care and progress. The types of ... Point of care documentation facilitates the continuity of high quality care and improves communication between nurses and other ... Without a structured care plan that is closely followed, care tends to become fragmented. Point of care (POC) documentation is ...
Continuity. After guiding patients to healthcare providers, care navigators maintain communication and continuity with patients ... both the patient and care navigator brainstorm next steps, establishing a plan that is specific to the patient's needs. Care ... Patient history and needs are identified. Both the patient and the care navigator think through short- and long-term goals and ... which can often leave patients with more questions than answers. Care navigators work closely with patients and families ...
... use communication skills to assist patients to adapting to common health problems, provide continuity of care, demonstrate ... Aside from routine patient care, healthcare technicians will complete many duties outside of direct care. The indirect care ... Qualified members performing direct patient care can have the opportunity work directly with patients and assist with their ... Direct observation of psychiatric patients Bathing Patient grooming Therapeutic maneuvering of patients Transport of patients ...
Without the necessary intermediate care and continuity in therapy, many patients regress when released from the hospital. Prior ... he is unable to provide adequate follow-up care. Not only does this break the continuity of care, but it also obstructs ... Once treatment at a mental health facility is completed, the patient is handed back into the care of his fellow villagers and ... Another problem is the lack of intermediate care once a patient is released from the hospital. Services such as support groups ...
It provides for continuity of care by a constantly changing nursing staff. The team leader starts the care plan as soon as the ... The team leader should discuss the needs of the patients, establish goals, individualize the plan of care for each patient, ... Long-term care insurance is another potential option to help pay for nursing home care. Long-term care insurance was designed ... The direct care staff have direct, daily contact with the patient in activities such as meals, personal care, daily activity (e ...
... and clinicians to meet high standards of patient care through electronic participation in a patient's continuity of care with ... It promotes continuity of care, reduces the need to transmit or transport medical information by patients or by fax, and helps ... MHC provides the technological infrastructure for health care providers to coordinate care for their patients through a secure ... the Indiana Network for Patient Care (INPC) is a secure network that provides a patient records to participating doctors. The ...
... interrupted continuity of care and increased errors. Also, most studies show that residents see more patients now, despite ... Some studies show that about 40% of this work is not direct patient care, but ancillary care, such as paperwork. Trainee ... with up to 6 additional hours for continuity of care and education; No new patients to be accepted after 24 hours of continuous ... The desire to continue caring for a patient frequently leads doctors to work for longer than is permitted. The evidence for ...
Continuity of care, including the requirement that a significant number (more than 50 percent) of a patient's medical home ... An overview to Patient Centered Medical Homes for patients from the Patient Centered Primary Care Collaborative. Appleby J. Old ... patient outreach and care management, the clinic reduced emergency department visits and improved patient perceptions of care ... An overview to Patient Centered Medical Homes for patients from the Patient Centered Primary Care Collaborative (PCPCC). ( ...
... required plans to ensure continuity of patient care, and protected the physician-patient relationship in health care decisions ... to help improve the quality of care delivered to patients in California. Its programs include ambulatory care facility ... The CMA continues to advocate for patients on a broad range of health care issues, including broader immunization against ... health plans still ran roughshod over physicians and patients often couldn't get the care they needed. In 2000, in a historic ...
Continuity is a key characteristic of primary care, as patients usually prefer to consult the same practitioner for routine ... The PPCA is projected to increase patient demand for primary care services. Through the adoption of new patient care delivery ... and coordinates other specialist care that the patient may need. Patients commonly receive primary care from professionals such ... Primary care involves the widest scope of healthcare, including all ages of patients, patients of all socioeconomic and ...
... ensuring continuity of care across the Irish Sea. Architectural Review: The Bexley Wing, St. James's Institute of Oncology, St ... 2011 Leeds Gamma Knife Centre began a relationship with Belfast Health and Social Care Trust to treat NHS and private patients ...
Assessment and Continuity of Care Care of Patients (COP) Management of Medication (MOM) Patient Rights and Education (PRE) ... These standards are divided between patient centered standards and organization centred standards. To comply with these ... the Japan Council for Quality in Health Care, and the National Committee for Quality Assurance in the United States. Its ...
Continuity is a key characteristic of primary care, as patients usually prefer to consult the same practitioner for routine ... Primary care involves the widest scope of health care, including all ages of patients, patients of all socioeconomic and ... patients may then be referred for secondary or tertiary care. Primary care is often used as the term for the health care ... Patient Care: Tertiary Care Definition. Accessed 27 June 2011. Emory University. School of Medicine. Accessed 27 June 2011. ...
... the work week include disruptions in continuity of care and limiting training gained through involvement in patient care.[29] ... explained to patients, and applied to patient care. ... The first year of practical patient-care-oriented training ... It does allow up to six hours for inpatient and outpatient continuity and transfer of care. However, interns and residents may ... no more than 24 hours of clinical duties at a stretch with an additional 6 hours for transferring patient care and educational ...
Health Network works to provide continuity of care and treatment completion for mobile patients suffering from chronic or ... Health care providers from health centers, health departments, and other health care delivery sites enroll patients who plan to ... Health Network associates contact the patient and then link that patient to a new health care delivery site at their next ... Health Network is MCN's bridge case management and patient navigation system for mobile patients. ...
2013 Continuity of Patient Care Study. The HQCAs Continuity of Patient Care Study identified that processes in Albertas ... Continuity of Patient Care. The HQCA has published two reports related to continuity of care in Albertas health system: our ... Improving Continuity of Care: Key Opportunities and a Status Report on Recommendations from the 2013 Continuity of Patient Care ... continuity of care. By examining the continuity of care through the lens of a single patients journey, this report shines a ...
We will provide Best Care for every patient, every time by providing care that is evidence-based and patient-centered." ... Continuity of care behind bars: UTMB Hospital Galveston initiative improves average length of stay, patient throughput Jan 25, ... talking about the patients needs early on and ensuring care provided is patient-centered as well as promptly identifying ... On any given day, all 110 acute care beds in UTMB Hospital Galveston are full. While some patients are preparing for discharge ...
Improved communication could lead to higher-quality patient care and greater patient care safety for hospitalized patients with ... Communication between physicians caring for a patient in the hospital and that patients primary care provider is less than ... Communication between physicians caring for hospitalized patients and those patients primary care providers (PCPs) is often ... Virtual Continuity and Its Impact on Complex Hospitalized Patients Care. This study has been completed. ...
Med Care. 2013 Mar;51(3):231-7. doi: 10.1097/MLR.0b013e31827da5b9. Research Support, Non-U.S. Govt ... Continuity of care, medication adherence, and health care outcomes among patients with newly diagnosed type 2 diabetes: a ... The effects of continuity of care (COC) on health care outcomes are well established. However, the mechanism of this ... Improving the COC for patients with type 2 diabetes may result in higher medication adherence and better health care outcomes. ...
Continuity of care after percutaneous coronary intervention: The patients perspective across secondary and primary care ... Aim: To explore how patients undergoing PCI experience continuity of care between secondary and primary care settings after ... However, patients experienced an unplanned patient journey across care boundaries. They were not receiving adequate instruction ... Nurse-led initiatives to improve continuity of care involve a range of interventions at different levels of the healthcare ...
We sought to determine the effect of sustained continuity of care (SCOC) on the quality of patient care. Data sources We ... care is a cornerstone of primary care that has been promoted by recent trends in medical education and in the way health care ... "continuity of care" or "continuity of patient care." We identified additional titles of candidate articles by reviewing the ... Discontinuity can improve patient care West J Med 2001;175:5.. 15. Freeman G. What is the future for continuity of care in ...
Our findings will be useful to ......,Study,shows,loosening,managed,care,restrictions,may,improve,doctor-patient,relationship, ... continuity of primary care practices. Our findings will be useful to decision-makers interested in improving patients ... in many cases health professionals and patients are ... care and research on the importance of active engagement with patients ... care insurance companies have a waiver for care if the client has a cognitive ... the family pays for care, is often waived, so ...
Transitional Care research papers discuss the coordination and continuity of a patients health care during his or her transfer ... Transitional Care. Transitional Care research papers discuss the coordination and continuity of a patients health care during ... Transitional care is the coordination and continuity of a patients health care during his or her transfer from one healthcare ... Palliative Care - Palliative Care research papers discuss the medical approach in caring for patients with serious illnesses, ...
Continuity of Care index (COC), Sequential Continuity of Care index (SECON), and Integrated Continuity of Care index (ICOC). ... can reduce copayments for patients that are managed by a single primary-care provider and lead to improve continuity of care. ... Continuity of care was measured using the Usual Provider Care index (UPC), ... High continuity of care may reduce the likelihood for hospital admission. The COC had marginally more explanatory power. ...
Using a simple linear interpretation of contact frequency as a measure of continuity of care in this patient group may be of ... We measured service use and a multidimensional concept of continuity of care in 323 patients who were to be discharged from ... More changes in the patients care coordinator were associated with more time in hospital. Patients who had a higher proportion ... Higher levels of patient contact could be a response to the severity of illness rather than a marker of quality of care. ...
High experienced continuity of care in patients with cancer is associated with lower needs for care, better quality of life and ... Continuity of Patient Care, Feasibility Studies, Female, Follow-Up Studies, Health Care Surveys, Health Services Research, ... therapy, *Continuity of Patient Care, Feasibility Studies, Female, Follow-Up Studies, Health Care Surveys, Health Services ... Development and pilot evaluation of a complex intervention to improve experienced continuity of care in patients with cancer ...
Arrieta, M.I., Foreman, R.D., Crook, E.D., and Icenogle, M.L. (2008). Insuring Continuity of Care for Chronic Disease Patients ... Insuring Continuity of Care for Chronic Disease Patients After a Disaster: Key Preparedness Elements ... Predisaster issues of importance were patient education and preparedness; evacuation guidance and support; planning for special ... medical needs shelters; and health care provider preparedness. Postdisaster issues were communication; volunteer coordination/ ...
Browsing by Subject "Continuity of Patient Care". 0-9. A. B. C. D. E. F. G. H. I. J. K. L. M. N. O. P. Q. R. S. T. U. V. W. X. ... Meeting on Rehabilitation as Part of the Continuum of People-Centred Health Care, Seoul, Republic of Korea, 13-15 December 2016 ...
Sleep continuity.. There was a significant treatment by visit effect on measures of sleep continuity with duloxetine ... Your Name) has forwarded a page to you from Diabetes Care Message Body (Your Name) thought you would like to see this page from ... Clinical Care/Education/Nutrition/Psychosocial Research. *. Efficacy of an Education Program for People With Diabetes and ... For patients with diabetes, sleep can be affected by a number of factors, including increased nocturia (14), sleep disordered ...
We measured patient continuity of care based on the percentage of appointments in which a patient was treated by his or her ... Diabetes Treatment Intensity and Continuity of Care by Race. Compared with non-Hispanic white patients, black patients were ... black patients had less continuity of care, with a smaller proportion of total physician visits with their primary care ... patient-centered care, enhanced patient access, and quality improvement, has been endorsed as a potential model of health care ...
Johns Hopkins pediatric orthopaedic surgeons care for and treat conditions affecting the bones and joints, muscles, cartilage ... Continuity of Care for Pediatric Patients with Cerebral Palsy. Johns Hopkins orthopaedic surgeon and medical director of the ... World-renowned Patient Care, Teaching and Research in Childrens Orthopaedic Surgery. At Johns Hopkins, our faculty and staff ... Traveling for Care?. Whether youre crossing the country or the globe, we make it easy to access world-class care at Johns ...
... Academic Article ... To assess the effects of physician-patient racial concordance and continuity of care on hypertension outcomes, we described ... Continuity of care was associated with recognition of hypertension, receipt of medication, and lower incidence of undetected ... Physician race had little effect, but continuity is important for successful management of hypertension in older persons. ...
Explores the role of continuity of care in driving down costs for Medicare beneficiaries at PCMH-recognized practices (patient- ... Provides an overview of state regulations related to staffing in residential care, highlighting the variance among state ... Evaluates and discusses efficiencies needed in patient-centered medical homes to show financial success. ... the literature on financial incentives and barriers to the provision and reimbursement of hospital-based palliative care. ...
To develop longitudinal mentoring relationships with physician scientists in our University Community who care for patients and ... The first two clinical continuity experiences ("Clinical Continuity Experience for Physician Scientists 1 and 2) consist of one ... patient write-ups, oral presentation, scientific basis of patients disease; and 2) learn to develop disease mechanism ... The Clinical Continuity and Mentoring Program provides a foundation for success as an emerging physician scientist in our MSTP ...
Patients and caregivers often feel abandoned and lose trust in health care professionals when they sense a lack of caring ... Ensuring Continuity Of Care. "Patients and families tell us that once they leave the hospital, they dont know whos ... Without this sense of caring, patients and caregivers often feel abandoned and lose trust in health care professionals. With it ... Expressing Caring. Over and over again, patients and caregivers told Project ACHIEVE researchers how important it was to feel ...
Pressure on hospitals has led to worse care for older patients BMJ 2012; 345 :e6137 ... Pressure on hospitals has led to worse care for older patients. BMJ 2012; 345 doi: (Published ... Acute care in hospitals cannot be sustained in its present form, the Royal College of Physicians has warned in a new report.1 ... Patients are increasingly frail, with 65% aged over 65, and an increasing proportion have dementia. But hospitals, services, ...
Protection of patients rights that guarantee appropriateness of care, 7. Patient choice, 8. Portability and continuity of care ... Rural Health Care Providers: Bachelor of Rural Health Care (BRHC) • Nursing staffs • AYUSH • Allied Health Professionals • ... Disease surveillance • Out-patient and in-patient information through Electronic Medical Records (EMR). • Data on Human ... Reorient health care provision to focus significantly on primary health care. • Strengthen District Hospitals. • Ensure ...
An innovative method for discharge medication reconciliation was developed by nurses to ensure safe transition of care and ... improved patient outcomes. The discharge time-out process has empowered nu... ... method for discharge medication reconciliation was developed by nurses to ensure safe transition of care and improved patient ... The discharge time-out process has empowered nurses to take a more active role in discharging their patients, and has fostered ...
Continuity of care behind bars: UTMB Hospital Galveston initiative improves average length of stay, patient throughput January ... On any given day, all 110 acute care beds in UTMB Hospital Galveston are full. While some patients are preparing for discharge ... Everyday Best Care: UTMB radiologist steps out of his comfort zone to provide exceptional, compassionate care for cancer ... Right test, right time, right patient: Lab Stewardship Team focuses on appropriate medical testing, improving patient safety ...
Gaps in continuity of care: patients perceptions of the quality of care during labor ward handover in Mulago hospital, Uganda ... Gaps in continuity of care during and after handovers. For some women, continuity of care was maintained because the new teams ... Gaps in the continuity of care and progress on patient safety. Br Med J. 2000;320:791-4.View ArticleGoogle Scholar. ... as triggers for several problems that affected quality of care, created gaps in continuity of care, and increased patient ...
  • Improving Continuity of Care: Key Opportunities and a Status Report on Recommendations from the 2013 Continuity of Patient Care Study , released in 2016. (
  • Practices were incentivised to allocate a named GP with lead responsibility for each patient on their list aged over 75 from 2014, and required to allocate a named GP for every patient from April 2016 . (
  • In Canada, it is estimated that the number of individuals with diabetes will increase from 1.4 million in 2000 to 2.4 million in 2016, and that health care costs will increase by 80% in that time. (
  • Conclusions Patients with multiple long-term conditions more frequently report worse experiences in primary care. (
  • Conclusions -This multifaceted intervention to support solo PCPs in the management of their complex patients did not result in a reduced rate of ED visits compared to controls, likely related to variable uptake among PCPs. (
  • Conclusions Failure to follow up test results for hospital patients is a substantial problem. (
  • The patient's perceptive is of paramount importance for the assessment of health care quality and essential for providing patient-centred care. (
  • The aim of this study was to promote evidence-based violence risk assessment in inpatient psychiatric care. (
  • Depending on the care setting under study and the tool used for assessment, the prevalence of medication-related problems (MRPs) ranges from 22% to 33% in Spain 5 , 6 . (
  • Frailty assessment in primary health care and its association with unplanned secondary care use: a rapid review. (
  • A better model of care after surgery for early endometrial cancer - Comprehensive needs assessment and clinical handover to a woman's general practitioner. (
  • The use of a traditional spine center model of patient flow, in which the patient is scheduled the first available appointment without an initial assessment of spine-related symptoms at West Virginia University Spine Center, Morgantown, West Virginia, resulted in frustration and delays for the spine patient and referring physician dissatisfaction. (
  • Findings: Patients undergoing PCI were satisfied with the technical treatment. (
  • Our findings will be useful to decision-makers interested in improving patients relationships with their primary care doctors, explains Dr. Forrest. (
  • Based on these findings, the PCMH model of care, which focuses on comprehensive, patient-centered care, enhanced patient access, and quality improvement, has been endorsed as a potential model of health care delivery to address racial disparities for patients with chronic diseases, such as diabetes ( 20 ). (
  • Further research is needed to explore findings of fewer preterm births and fewer fetal deaths less than 24 weeks, and all fetal loss/neonatal death associated with midwife-led continuity models of care. (
  • These findings may help dispel the perception that patients at public hospital systems receive only episodic care that does not effectively manage long-term chronic conditions. (
  • Conclusion The findings suggest an association between higher continuity of family physician care and reductions in likelihood of death and hospitalizations in older people with diabetes. (
  • Findings South Asian and Chinese patients, younger patients, and those in poor health reported a less positive primary care experience than White patients, older patients and those in better health. (
  • Surgical treatments should be explored when indicated by diagnostic tests and imaging findings and in consideration of patient comorbidities and psychological status. (
  • continuity of primary care practices. (
  • But the latest research comes as evidence suggests practices' ability to maintain continuity of care is declining in England. (
  • There is limited information on the professional conduct of health workers who provide intrapartum care, particularly on duty handover processes and practices in the hospital's maternity unit. (
  • The primary objective of the intervention was to reduce the overall rate of Emergency Department (ED) visits among patients in participating practices. (
  • Becoming a patient-centered medical home (PCMH) presents both opportunities and challenges for medical practices. (
  • There were insufficient systems, processes and practices to keep patients safe. (
  • Primary Care First will focus on advanced primary care practices ready to assume financial risk in exchange for reduced administrative burdens and performance-based payments. (
  • The model will achieve these aims by increasing patient access to advanced primary care services, and has elements specifically designed to support practices caring for patients with complex chronic needs or serious illness. (
  • Practices will be incentivized to deliver patient-centered care that reduces acute hospital utilization. (
  • Primary Care First provides the tools and incentives for practices to provide comprehensive and continuous care, with a goal of reducing patients' complications and overutilization of higher cost settings, leading to higher quality of care and reduced spending. (
  • Within this paper, we follow the process of implementing the PCMH Model within primary care practices and discuss the difficulties these practices have encountered in the transition as well as potential solutions. (
  • This study examined whether low scores of ethnic minority and other socio-demographic groups reflect their concentration in poorly performing primary care practices, and whether any remaining differences are consistent across practices. (
  • For doctor communication, about half of the overall difference associated with South Asian patients (ranging from −6 to −9 percentage points) could be explained by their concentration in practices with low scores, but the other half arose because they reported less positive experiences than White patients in the same practices. (
  • In some practices ethnic minority patients reported better experience than White patients. (
  • There were large variations in the experiences reported by ethnic minority patients in different practices: practices with high patient experience scores from ethnic minority patients could be studied as models for quality improvement. (
  • Today, it's recognized as a premier program for pediatric and adult primary care practices. (
  • What's striking is how often hospitals fail to fulfill these expectations, even though it's been known for decades that care transitions are problematic and strategies to reduce preventable hospital readmissions have been widely adopted. (
  • While hospitals have so far dealt with this rise by reducing patients' length of stay, this cannot be sustained indefinitely. (
  • But hospitals, services, and staff are ill suited to dealing with patients who have these complex needs. (
  • Patients were recruited via clinics participating in the Oncological Care Registry (12 specialised units in seven hospitals) and contacted six to nine months after diagnosis. (
  • Ten hospitals increased the number of patients receiving all recommended care for heart failure by. (
  • This audio segment discusses two incidents involving pediatric patient harm associated with central line use and highlights successful reduction of central line infections after investigation , standardization, and checklist use in many hospitals . (
  • The thing about rural hospitals is we're 60 miles from any other eye care," says Dr. Beebe, Optometry Cares ® -The AOA Foundation board vice president. (
  • The new paradigm of managed care and an increased emphasis on primary care has opened hospitals to optometry as a means for delivering efficient eye care services. (
  • Caring for Patients with Diabetes in Safety Net Hospitals and Health Systems, Marsha Regenstein, Ph.D., Jennifer Huang, M.S., Linda Cummings, Ph.D. et al. (
  • Choosing diabetes as their initial focus because of its prevalence among their patients, the consortium members aimed to learn about the quality of diabetes care in public hospitals, describe mechanisms for delivering diabetes management services, and identify lessons that might apply to other chronic conditions. (
  • When the study began, 41.4 percent of the patients with diabetes at these hospitals were uninsured and an additional 15.5 percent were covered by Medicaid. (
  • At consortium hospitals and managed care plans, 65 and 67 percent of patients, respectively, had HbA1c values below 8.5 percent, indicating moderate control of diabetes. (
  • Clearly, public hospitals are doing something right for patients with diabetes. (
  • Its success in managing patients with diabetes should be studied and, whenever possible, models should be spread to public hospitals and other providers. (
  • For example, compared with white patients, black patients at consortium hospitals were significantly less likely to have well-controlled diabetes (OR=.46). (
  • These decline in continuity of the patient-physician relationship occurred in all areas of the country and all types of hospitals, the researchers reported in the April 22/29 Journal of the American Medical Association . (
  • Methods: The study used an inductive exploratory design by performing in-depth interviews of 22 patients at 6-8 weeks after PCI. (
  • Methods We conducted a 36-month prospective cohort study of the patients recruited to the Oxford Community Treatment Order Trial (OCTET). (
  • Patient treatment adherence may be supported with simple reminding methods e.g. text message reminders. (
  • General practitioners and emergency departments (GPED)-efficient models of care: a mixed-methods study protocol. (
  • Methods The authors searched Medline, CINAHL, Embase, Inspec and the Cochrane Database from 1990 to March 2010 for English-language articles which quantified the proportion of diagnostic tests not followed up for hospital patients. (
  • The study purpose was to evaluate a nurse-led supportive care clinical case management program in the community using multi-methods to delineate care processes prior to outcome evaluation. (
  • Most studies focus on patient experiences in either outpatient [ 14 , 15 ] or inpatient [ 16 , 17 , 18 , 19 , 20 ] care settings using generic instruments. (
  • Medication reconciliation conducted by clinical pharmacists found that nearly one in nine patients discharged from an inpatient cardiology service had at least one discrepancy in their medication documentation. (
  • Many PAD patients are often observed to make telephone calls to the inpatient unit to resolve their doubts, to confirm that the guidelines received are correct, or they go to the inpatient unit to seek help. (
  • SAN FRANCISCO -- Continuity of patient care from outpatient to inpatient settings has dropped substantially over the past decade, researchers said. (
  • It may be continuous or it may consist of a series of intervals marked by one or more brief separations from care, and can also identify the sequence of care (e.g., emergency, inpatient, outpatient), thus serving as one measure of health care provided. (
  • As the state's aging prison population requires increased medical care, the maximum security hospital on UTMB's Galveston Campus often faces a challenge: there aren't enough beds to go around. (
  • I always tell our medical staff to advocate for their patient, don't settle for mediocrity. (
  • Ojo adds that the state legislature recently agreed to create more than 160 sheltered housing beds at three units to provide a supportive environment for offenders who do not require infirmary care but have medical needs that cannot be met in a general population environment. (
  • MedTrak, the information system used by the University of Pittsburgh Medical Center (UPMC), currently notifies PCPs when patients are admitted and discharged from the hospital. (
  • MedTrak, the University of Pittsburgh Medical Center (UPMC) electronic physician communication tool, has proven successful and is poised to move forward with an initiative the investigators call virtual continuity, allowing PCPs to follow their patients electronically if they cannot do so physically. (
  • 19. Donabedian A. Evaluating the quality of medical care Milbank Quarterly 1966;44:166. (
  • 31. Weiss GL, Ramsey CA. Regular source of primary medical care and patient satisfaction QRB 1989;180-184. (
  • Health care Rationing - Medical students and nursing students will be facing the dreary task of exploring the phenomena of health care rationing in their collegiate studies. (
  • Point-of-Care Testing - Point-of-Care Testing research papers discuss bed-side testing, which is any medical test done at or near the site of a patient's care. (
  • In Korea, the National Health Insurance based on universal coverage has improved accessibility to medical care, and geographical accessibility are better because Korea is limited in area and has better transportation between regions. (
  • We collected data from medical records on eight previously operationalized measures of continuity. (
  • There are multiple factors that contribute to racial disparities in the quality of diabetes care, including differences in sociodemographic characteristics ( 11 ), health literacy and numeracy ( 12 , 13 ), treatment intensity ( 14 ), and the overall quality of care at the facilities where medical care is provided ( 15 , 16 ). (
  • In 2006, The Commonwealth Fund Health Care Quality Survey demonstrated an association between having access to a regular source of medical care with components of a patient-centered medical home (PCMH) and a reduction in disparities in self-reported access to care, receipt of patient-directed preventative care reminders, and lipid screening ( 19 ). (
  • But Owen's parents were determined to help their son get the medical care he needed to live a life with fewer limitations. (
  • Johns Hopkins Children's Center offers one of the most comprehensive pediatric medical programs in the country, with more than 92,000 patient visits and nearly 9,000 admissions each year. (
  • The final clinical continuity experience ("Clinical Foundations for the Physician Scientist") is completed prior to the student's return to medical school and involves one-on-one meetings between the student and the MSTP clinical mentor in the clinic averaging one day per week for 9 weeks. (
  • Evaluates and discusses efficiencies needed in patient-centered medical homes to show financial success. (
  • Health care is provided by a variety of health care professionals who include doctors (intern doctors, resident doctors who are on post-graduate trainng in Obstetrics and Gynecology or Family Medicine, Specialist Obstetricians of various ranks (registrars, consultants, senior consultants and university professors), nursing staff (midwives of various ranks), paramedical staff (laboratory staff, pharmacists, medical records staff and physiotherapists). (
  • A series of standardized patient encounters was developed as an innovative curricular element to address this gap in training for medical students in a family medicine clerkship. (
  • Though training and experience in longitudinal care supports student interest in primary care careers [ 8 - 10 ], the structure of medical education makes it difficult for large numbers of students to experience providing continuity of care. (
  • Numerous aspects of traditional academic medical center organization and culture have been noted as barriers to improving continuity of care experience for medical students. (
  • The patient-centered medical home-a relationship with a health care provider and health care team that knows a person's health issues and is accountable for taking care of that person-offers multiple opportunities to advance health equity. (
  • Performance standards for patient-centered medical homes can drive quality improvements, but feedback needs to be immediate and continual. (
  • In introducing the session on patient-centered medical homes, Winston Wong, director of disparities improvement and quality initiatives at Kaiser Permanente, recounted the story of Mr. Kwong (not his actual name), whom Wong met in the community clinic where he sees patients. (
  • Two other speakers at the workshop explored these and other aspects of patient-centered medical homes. (
  • The term "patient-centered medical home" may not be the best name for the concept, said Ignatius Bau, who has been a consultant to many different groups on how to meet the needs of vulnerable populations. (
  • Patient evaluations are the only source of information about health care quality with regard to several aspects of care such as information provided, communication and interaction with medical staff or quality of life. (
  • The corporate care management staff at the University of Pittsburgh Medical Center (UPMC) knew its. (
  • A focus on "what we have in common" to achieve interoperable health information exchange in the US was the message David R. Hunt, MD, FACS, medical director, health IT adoption and patient safety, Office of the National Coordinator for Health IT (ONC), provided during an update on ONC's efforts at the Long-Term and Post-Acute Care Health IT Summit (LTPAC) in Baltimore, MD on Monday. (
  • Direct Relief today airlifted 82 tons of medical aid to Haiti to help treat cholera and other diseases that have spread widely since Hurricane Matthew struck in October, incapacitating the country's already overstretched health care system. (
  • 13 14 Satisfaction of the legitimate demands of patients is therefore an objective of all medical care 15 and should be included as an outcome measure. (
  • Measuring patient satisfaction with medical care is not straightforward. (
  • This document, which constitutes one part of the American Medical Association 's complete code of ethics, extends the rights language introduced in the 1980 Principles of Medical Ethics (Section II) to a separate statement listing the specific rights of patients. (
  • Accordingly, patients may accept or refuse any recommended medical treatment. (
  • Board and Care homes were the subject of exposés for lacking medical personnel at the time of the 1990s reviews. (
  • Demonstrated knowledge of current medical, interventional and pharmaceutical treatment modalities of patients requiring anticoagulation therapy. (
  • Thought you might appreciate this item(s) I saw at Medical Care. (
  • Medical Care. (
  • The patient-centered medical home (PCMH) model means different things to different people. (
  • James L. Holly, MD describes how stayed ahead of the curve by transforming his group into a patient-centered medical home. (
  • Recruitment had been on-going however there was not always enough medical and nursing staff to meet the needs of patients. (
  • Despite a degree of improvement in the supply of FPs, the introduction of electronic medical records, and enhanced opportunities for interdisciplinary care, the management of frail seniors remains one of the great challenges of family medicine. (
  • The Patient-Centered Medical Home (PCMH) is an extension of internationally employed Edward Wagner's Chronic Care Model (CCM). (
  • Our goal was to evaluate the feasibility and impact of an intervention on the management of family psychosocial topics at well-child care visits at a medical home for low-income children. (
  • The objectives of this study were to evaluate the feasibility and impact of implementing the WE CARE (Well-child Care Visit, Evaluation, Community Resources, Advocacy, Referral, Education) intervention at a medical home for low-income children. (
  • The clinic serves as a medical home for ∼10000 children ages from birth to 21 years, with Medicaid as the predominant source of health care coverage. (
  • Organized services in a hospital which provide medical care on an outpatient basis. (
  • An interval of care by a health care facility or provider for a specific medical problem or condition. (
  • Patients with a rare disease often come to an appointment having already spent many hours studying the medical literature. (
  • Address the frustration and sense of helplessness for both you and the patient regarding the lack of evidence-based research with which to guide medical care. (
  • Inmates should be referred to community organizations for follow-up medical care and treatment of substance use disorders before they are released from detention facilities. (
  • We're very excited to announce that we have earned recognition as a level-3 Patient-Centered Medical Home. (
  • The Patient-Centered Medical Home is a model of care that builds better relationships between people and their medical care teams. (
  • Medical homes can lead to higher quality and lower costs, while at the same time improving the partnership between patients, families, and the medical team. (
  • Communication with patients and their families and caregivers is a core concept of the PCMH model, which also emphasizes enhanced patient access to clinical advice and medical records. (
  • When medical home attributes are described to people, they say it is the type of care they want to receive. (
  • 22. Chao J. Continuity of care: incorporating patient perceptions Fam Med 1988;20:333-337. (
  • We assessed women's perceptions of the structure, process and outcome of intrapartum care in Mulago hospital, specifically, labor ward duty shift handovers. (
  • Perceptions of the curriculum were obtained using a pre-post survey asking students to self-rate experience and confidence in continuity relationships, chronic disease management, and lifestyle counseling. (
  • Current research projects and areas of interest include examination of values-based care models, stakeholder perceptions of technology and information exchange within organizations, technology-enabled performance measurement and management of patient experience, application of smartphones for system performance data collection, and humanistic management. (
  • The effects of having a regular doctor on access to primary care Med Care 1996;34:138-151. (
  • Whether you're crossing the country or the globe, we make it easy to access world-class care at Johns Hopkins. (
  • The researchers, from charity The Health Foundation, warned that the government's focus on improving access to primary care could be undermining continuity of care and inadvertently driving up hospital admissions - the exact opposite of what extended access was intended to achieve. (
  • In a move to better meet patient needs and expand access to health services, Ireland has made it possible for nurses and midwives to prescribe medicinal products. (
  • Advancing the role of nurses and midwives has allowed Ireland to expand access to health services and better meet patient needs. (
  • The effects of having a regular physician on access to primary care. (
  • Regular source of ambulatory care and access to health services. (
  • We employed mixed effect logistic regressions to analyse data on six items covering three care domains (access, continuity and communication) and a single item on overall primary care experience. (
  • Background - The management of complex, multi-morbid patients is challenging for solo primary care providers (PCPs) with limited access to resources. (
  • The supplies on this shipment were requested by 37 Haitian organizations, including St. Boniface, that represent more than 200 health care facilities in Haiti, which often are unable to access or afford the essential medicines they need to meet the demands of their patient populations. (
  • Access to HIV prevention, testing and counseling, and care and treatment has expanded dramatically in low- and middle-income countries. (
  • Direct Relief is collaborating with ministries of health and nongovernmental organizations internationally to expand access to HIV prevention and care. (
  • Component analysis indicated seven scales (satisfaction with communication and management, doctor's attitude, continuity of care, delay until visit, access to out of hours care, initial contact person, telephone advice) related to overall satisfaction and containing issues identified as important to patients. (
  • They access multiple care settings. (
  • More than half of those GPs also said the deal will favour speedy access over continuity. (
  • The PCMH model strives to provide quality, coordinated, and cost-effective care to patients and to increase access to services. (
  • In response to a potential dam failure near Cavalier, ND, in May 2013, 20 patients in a critical access hospital and 112 residents in a long-term care facility needed to be evacuated to an alternate care site. (
  • Written standards for patient access and continuity of care. (
  • 29. O'Malley AS, Mandelblatt J, Gold K, Cagney KA, Kerner J. Continuity of care and the use of breast and cervical cancer screening services in a multiethnic community Arch Intern Med 1997;157:1462-1470. (
  • Continuity of care and the use of breast and cervical cancer screening services in a multiethnic community. (
  • Patients aged 18 years or older who were first diagnosed with type 2 diabetes in 2002 were included in the study. (
  • Continuity and quality of care for children with diabetes who are covered by Medicaid Amb Peds 2001;1:99-103. (
  • A system for managing chronic disease including diabetes mellitus based on primary care clinics has been used in Korea since April 2012. (
  • For patients with diabetes, sleep can be affected by a number of factors, including increased nocturia ( 14 ), sleep disordered breathing ( 15 ), periodic limb movements (PLMs) ( 16 ), and episodes of hyper- or hypoglycemia ( 17 , 18 ). (
  • Unfortunately, the proportion of Americans receiving guideline-concordant diabetes care is suboptimal ( 10 ), particularly among racial and ethnic minorities ( 8 ). (
  • Several studies have shown that these disparities may be narrowing over time, as the overall quality of diabetes care improves nationally ( 17 , 18 ). (
  • Consortium hospital systems provided information on laboratory tests commonly given to patients with diabetes to monitor their care over time. (
  • A higher percentage of VA patients had controlled diabetes. (
  • This figure was much lower for VA patients: only 8 percent of patients with diabetes in the VA study showed very poor glycemic control. (
  • Objective To examine the relationship between continuity of family physician care and all-cause mortality and acute hospitalizations in older people with diabetes. (
  • Continuity of family physician care for elderly patients newly diagnosed with diabetes was estimated by 3 continuity indexes using physician claims data. (
  • A structured transition of care from pediatric to adults services for young adults with diabetes type 1 would potentially enable better blood glucose control. (
  • Young adult's experiences transitioning from paediatric to adult diabetes care can influence attendance at the adult clinic positively if there is a comprehensive transition programme in place, or negatively if the two clinics do not communicate and provide adequate support. (
  • This research is essential in creating a seamless system of care for emerging adults with diabetes, to enhance individual quality of life and help to prevent long term diabetes complications and comorbidities. (
  • On any given day, all 110 acute care beds in UTMB Hospital Galveston are full. (
  • Review news and insights coming out of AHIMA's Long Term and Post Acute Care Health IT Summit, held June 22-24 in Baltimore, MD. (
  • However, some LTPAC providers, particularly smaller, stand-alone and rural providers, lack the financial incentives and health IT infrastructure to help their acute care counterparts. (
  • Long-term and post-acute care (LTPAC) providers-unlike much of AHIMA's membership-welcomed the delay of ICD-10-CM this spring, according to a presenter at AHIMA's LTPAC Summit, coming up next week. (
  • The aim of this study is to identify lupus patients receiving care at Brigham and Women's Hospital (BWH) who are at high risk for potentially avoidable acute care utilization, inconsistent. (
  • So we came up with several interventions and goals to ensure patients are in the hospital for the appropriate length of time. (
  • Monitoring patients with chronic diseases is especially important to reduce costs with surgical interventions and complications that can be avoided. (
  • Moderate evidence supports advance care planning led by skilled facilitators who engage key decision makers and interventions to alleviate caregiver burden. (
  • There have been too many instances where an admission might require one to two nurses working on that admission due to the emergent necessity of interventions, and the other two patients (who possibly might have just as much acuity) are sort of left hanging. (
  • Patients are increasingly frail, with 65% aged over 65, and an increasing proportion have dementia. (
  • citation needed] Nursing homes have been the subject of decades of efforts by states and at the national levels to reform health and residential care for "frail" elders, especially those with lower incomes in the US. (
  • Objective To discuss models of care for frail seniors provided in primary care settings and those developed by Canadian FPs. (
  • Main message New models of funding for primary care have opened opportunities for ways of caring for complex frail older patients. (
  • frail patients lose function quickly with illness or other stressors owing to loss of physiologic reserve. (
  • As of 2017, approximately 1.4 million Americans live in nursing home, with 64 percent relying on Medicaid to pay for their care. (
  • 2017). The Long-Term Consumption of Oats in Celiac Disease Patients Is Safe: A Large Cross-Sectional Study. (
  • 2017). Predictors of quality-of-life after ileal pouch-anal anastomosis in patients with ulcerative colitis. (
  • 2017). Patients with resected, histologically re-confirmed pancreatic ductal adenocarcinoma (PDAC) can achieve long-term survival despite T3 tumour or nodal involvement : The Finnish Register Study 2000-2013. (
  • However, overcoming barriers to organisational change and addressing some patients' hesitation to report their continuity difficulties must be considered when implementing such an intervention. (
  • Financial, cultural, or linguistic barriers can result in health care that is fragmented and uncoordinated. (
  • Because of financial, cultural, or linguistic barriers, the care that patients receive may be fragmented and uncoordinated. (
  • Barriers to GPs identifying patients at the end-of-life and discussions about their care: a qualitative study. (
  • The purpose of this research study is to determine whether there are things that Intermountain can do to break down barriers to helping patients see their primary doctors or other outpatie. (
  • The prototype developed contained concepts, risk factors, signs and symptoms, treatment, importance of medications and their side effects, frequent doubts, necessary health care, and follow-up of patients by monitoring the evolution of the cicatricial process of lesions and possible complications, clarification of doubts and stimulus for continuation of treatment. (
  • optometrists are able to serve their already established patients who may suffer eye-related symptoms or complications while hospitalized, and optometrists may be called upon to see other hospitalized patients in need of similar care," notes the AOA manual. (
  • Routine preventive care, such as vaccination and screening for potential complications of a rare disease, is important but easily overlooked. (
  • Beginning in the second year of the graduate phase, MSTP students complete a series of three clinical continuity experiences. (
  • The first two clinical continuity experiences ("Clinical Continuity Experience for Physician Scientists 1 and 2) consist of one-on-one meetings between the student and the Clinical Continuity mentor averaging one day per month during the calendar year. (
  • During the first clinical continuity experience, students will prepare and present a MSTP Grand Rounds presentation. (
  • During the second clinical continuity experience, students submit a 1 page concept proposal in the form of an NIH Specific Aims page outlining a set of experiments to address a disease-based hypothesis. (
  • Conclusion Patients with severe and relapsing psychotic illness are seen frequently and consistently in community mental health services. (
  • Conclusion As COC is a core value for GPs and for most patients, special care should be taken to prevent a loss of COC around the time of a cancer diagnosis, and in the year after. (
  • Improving the average length of stay (ALOS) and patient throughput-the process of moving patients through the treatment system-became a major focus for HG over a year ago, when the ALOS peaked at 9.66 days. (
  • At the same time, patient throughput has increased, allowing more patients to be treated and improving public safety by reducing the number of offenders in free-world facilities. (
  • Patient Safety in Nursing - Improving Patient Safety in Nursing requires reforms in hospital procedures so that nurses can spend the majority of their time working with patients. (
  • This will hopefully lead to thinking around ways of improving patient experiences, satisfaction and care. (
  • Natural-language processing technology lets Penn Medicine tap unstructured data, improving its analytics and patient care. (
  • No direct evidence addresses improving continuity for patients with dementia. (
  • Additional research is needed to generate evidenced-based guidelines and to determine which transition elements are most effective during the transition period from pediatric to adult care. (
  • We always want to provide a coordinated, seamless transition of care because when you do it right, the chances of the patient coming back as a readmission is much lower. (
  • MSTP clinical mentors provide ongoing clinical experiences, teach clinical care skills, and expose the student to translational research questions that occur in the clinic. (
  • Midwife-led continuity models provide care from the same midwife or team of midwives during the pregnancy, birth and the early parenting period, and many women value this. (
  • Supporting institutions so that they provide the best possible care to their patients. (
  • Primary health-care providers across the WHO European Region are under great pressure to provide high-quality, patient-centred care, despite heavy workloads and the ever-growing burden of noncommunicable diseases (NCDs). (
  • they were better able to provide shared primary-specialty care. (
  • 8 Contractual arrangements have been changed to allow general practitioners greater freedom to choose how they provide out of hours care. (
  • Provide telephone counseling / triage for patients/significant others as indicated. (
  • Each CVC employee is expected to understand and demonstrate that in every interaction we represent our entire organization in the care we provide and in the courtesies we extend to patients, families, and each respective team member. (
  • We will consistently provide the perioperative patient with the best possible care at the least possible cost. (
  • IT services company Phoenix IT Group has acquired a 100,000-square-foot business continuity centre south west of London in Farnborough in Hampshire to provide emergency work space for 1,450 people. (
  • OBAMA: Zero, because as I said in our last debate and I ll repeat, I exempt small businesses from the requirement for large businesses that can afford to provide health care to their employees, but are not doing it. (
  • Among these, primary eye care was a priority, and Kerry Beebe, O.D., was one of the doctors granted privileges to provide it. (
  • We strive to provide accessible, evidence-based, patient-centered care to the women and families of North Carolina. (
  • more effectively to ensure that they continued to provide continuity. (
  • 5 Screening tools, such as frailty scales, and an understanding of a patient's cognitive condition, physical function, and functional reserve might alert the physician to consider the best way to provide care. (
  • Our main intent was to provide FPs and health planners with ideas to guide the development of services for patients with frailty and comorbidities. (
  • The following questions can help you provide support for your patients with a rare disease. (
  • Provide much-needed continuity of care. (
  • At Cook Children's, we're always working to raise the quality and standard of care that we provide to children and families we care for. (
  • Does continuous care from a physician make a difference? (
  • To estimate the prevalence of medication-related problems in patients treated in continuous care units and to identify the therapeutic areas in which these problems were more concentrated. (
  • Provides relationship-based care that promotes continuous, consistent, efficient, and accountable delivery of nursing care using the nursing process. (
  • GP registrar Dr Merlin Willcox said in his response that GPs needed continuous contact with the same patient to enable them to make an accurate diagnosis. (
  • There are medico-psycho-social indications to apprehend the alcohol use disorder (AUD) as a chronic problem for which a continuous care is necessary. (
  • A pilot test was carried out among 245 newly diagnosed breast and colorectal cancer patients in the German federal state Schleswig-Holstein. (
  • Help patients with a rare disease remember preventive care strategies. (
  • A systematic approach to urgent, routine, and preventive care for persons in jails and prisons creates a healthier correctional environment and a healthier community after release. (
  • Background - The utilization and costs of home care services provided for people with colorectal cancer is not well-known. (
  • The authors conducted an analysis to determine the utilization and costs of such services associated with each stage of colorectal cancer among patients in the province of Ontario. (
  • Publicly funded home care services and associated costs decreased with increasing income group, but they increased among patients who had a history of high health resource utilization. (
  • Patient satisfaction scores, referring physician satisfaction scores, and resultant impact on referral volumes, ancillary utilization, workload productivity, and surgical yield demonstrate that this new approach to patient triage has made significant improvements in efficiency, productivity, and service. (
  • The objectives of this study were to compare the analgesic efficacy of pregabalin, amitriptyline, and duloxetine, and their effect on polysomnographic sleep, daytime functioning, and quality of life in patients with DPNP. (
  • The study says that patients who saw 'the same general practitioner a greater proportion of the time experienced fewer admissions' - suggesting that a link between patients and a specific GP, rather than simply a wider team, has a significant impact on care. (
  • The study aimed to assess the feasibility of patient-centred quality evaluation in oncological care in Germany using the German adaptation of the Danish National Cancer Patient Questionnaire. (
  • This study was designed to describe patient characteristics associated with having a regular source of care among all patients who received care from large urban clinics in Manitoba over a three-year period (N = 298,222). (
  • The main purpose of this study was to describe and evaluate nursing students' learning about an empowering discourse in patient education. (
  • Cross-sectional study by means of a survey of a random sample of 1500 patients attended in primary and secondary care for the same condition. (
  • Both intervention and control groups experienced a trend towards lower rates of ED use by their patients over the study time period. (
  • Interpretation - More than two-thirds of the patients with colorectal cancer in this study used home care services. (
  • This study contributes to the overwhelming evidence of the value of continuity care, the authors suggest, and offers quality measures that can be used and prioritized in value-based payment models. (
  • The proportion of patients having a legacy prescription at some time during the study period was 46 percent (3,766 of 8,119) for antidepressants, 14 percent (228 of 1,592) for bisphosphonates, and 45 percent (2,885 of 6,414) for proton pump inhibitors. (
  • In our study, a phenomenological approach will generate a comprehensive description of a phenomenon or lived experience (i.e. stay in the Critical Care Unit). (
  • This study estimated the prevalence of MRPs in complex chronic patients (CCP) treated in the CCU, and identified the therapeutic areas with the highest concentration of MRPs and the greatest margin for improvement. (
  • Primary care sensitive' situations that result in an ambulance attendance: a conversation analytic study of UK emergency '999' call recordings. (
  • Patients' experiences of supportive care from a long-term perspective after oesophageal cancer surgery - a focus group study. (
  • This study describes the extent to which people report that their care is coordinated between their primary care physician (PCP) and specialists. (
  • The primary hypotheses for this study were that the WE CARE intervention would increase the overall discussion and referral rates for family psychosocial problems at WCC visits. (
  • The Alumni Program is a novel approach to the continuing care and preventive treatment of clients with 'chronic' mental illness. (
  • By ensuring pregnant women know their HIV status and enrolling those that are HIV positive in appropriate care and treatment, the HIV transmission rate from mother-to-child can be reduced to less than five percent, according to UNAIDS. (
  • The physician may not discontinue treatment of a patient as long as further treatment is medically indicated, without giving the patient reasonable assistance and sufficient opportunity to make alternative arrangements for care. (
  • Foster the collaboration between local Indigenous health services and visiting health professionals to target the delivery of essential treatment to patients with chronic disease. (
  • Intermediate care facilities (small) were developed by the state categorical systems (intellectual disabilities, mental health), back in the 1970s, as a reaction to exposés on institutional conditions resulting in required active treatment in institutions and the new building of community facilities recommended under 16 in size. (
  • The areas with the most prevalent medication-related problems were the long-term use of hypnotics, sub-optimal analgesia, optimizable antidepressant treatment, statins in patients older than 75 years in primary prevention and in those with high-intensity doses in secondary prevention, patients with heart failure without angiotensin-converting enzyme inhibitors, and proton-pump inhibitors without indication. (
  • Some patients were experiencing more than 18 weeks from referral to treatment time (RTT). (
  • Obstacles to caring for these patients include diagnostic delays and a lack of information, expertise, and treatment options for many rare diseases. (
  • The conditions listed on the GARD webpages include a general summary (e.g. symptoms, cause, inheritance pattern, diagnosis, and treatment), patient advocacy organizations, and links to more in-depth information. (
  • Patients with a rare disease present unique challenges for primary care providers (PCPs). (
  • PCPs play a vital role in enhancing the quality of life for patients and families living with a rare disease by making appropriate referrals to specialists, helping to coordinate care, and assisting patients in obtaining the proper support. (
  • Using administrative data, patients were classified as having a regular source of care if they made 75% or more of their total ambulatory visits to the same clinic. (
  • For instance, many patients with a rare disease will require longer and more frequent visits with their primary care physician. (
  • Physician visits for back pain rose 94% from 1994 to 2004 and will increase by 15% over the next 10 years (Sg2 Health Care Intelligence, 2007). (
  • Evidence of the negative impacts for patients when important results are not actioned, matched with advances in the functionality of clinical information systems, presents a convincing case for the need to explore solutions. (