Family Medicine Commons^™

Clinician Evaluators: Take Your Mark!, Jodi Polaha, William Lusenhop, Mckenzie Highsmith, Deepu George, Adrian Sandoval

ETSU Faculty Works

• Discuss two implementation outcomes (adoption and reach) and explain why they are important for clinicians to measure and report, with application to own work.
• Name sources of data that are accessible to clinicians in health care settings, with consideration of own setting.
• Describe a range of dissemination strategies used to create impact, including new ideas for dissemination of own work.

References

• Proctor, E. K., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G. A., Bunger, A., . . . Hensley, M. (2011). Outcomes for implementation research: Conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health and Mental …

Harmonizing Clinical, Research, And Teaching Aims: Team Care For Patients With Complex Needs, Alicia Williams, Millie Wykoff, Ryan Tewell, Jodi Polaha, Jim Holt

ETSU Faculty Works

At the conclusion of this session, the participants will be able to:
1. Describe a team-based approach to addressing complex patients’ needs.
2. Develop engaged and experiential methods for teaching interprofessional learners about team-care for complex patients.
3. Demonstrate familiarity with an evaluation strategy and preliminary outcomes data for a team approach for complex patients.

Program Evaluation Intensive: Practical Training In Selecting Measures And Data Collection Methods To Obtain Useful Outcome Data, Robyn Shepherdson, Jennifer Funderburk, Nadiya Sunderji, Nadiya Sunderji, Jodi Polaha

ETSU Faculty Works

Do you need help determining appropriate measures and feasible data collection methods for program evaluations within integrated primary care? In this 3-hour preconference workshop, leaders from CFHA’s Research & Evaluation Committee and Families, Systems, & Health journal will provide practical training in conducting rigorous program evaluations. This workshop will help you identify appropriate measures to answer your key questions as well as data collection methods that balance quality and feasibility. This workshop is designed for those who are planning, conducting, or revising a program evaluation, as attendees will apply the material to their own personal projects within interactive small groups.

Clinical Evaluators Take Your Mark, Jodi Polaha, Mckenzie Highsmith, William Lusenhop, Deepu George, Adrian Sandoval

ETSU Faculty Works

• Discuss two implementation outcomes (adoption and reach) and explain why they are important for clinicians to measure and report, with application to own work
• Name sources of data that are accessible to clinicians in health care settings, with consideration of own setting.
• Describe a range of dissemination strategies used to create impact, including new ideas for dissemination of own work.

Relationship Of Patient Self-Administered Copd Assessment Test To Physician Standard Assessment Of Chronic Obstructive Pulmonary Disease In A Family Medicine Residency Training Program, Jessica E. Burchette, Ivy A. Click, Leigh Johnson, Sandra Alicia Williams, Brett Tyler Morgan

ETSU Faculty Works

Assessing the global impact of chronic obstructive pulmonary disease (COPD) on a patient’s life can be difficult to perform in the clinical setting due to time constraints and workflow challenges. The primary objective of this study was to compare disease impact ratings between patient selfadministered COPD Assessment Test (CAT) and physician standard office assessment. This prospective study was conducted at a family medicine residency clinic in northeast Tennessee. The study included two study groups: 1) adult patients seen at the clinic during the 3-month study period with an active diagnosis of COPD, and 2) their physicians. Physicians’ assessment of the …

Family Medicine Clerkship Students’ Experiences With Team-Based Care, Ivy A. Click, Jodi Polaha, Jason B. Moore

ETSU Faculty Works

Interprofessional team-based care has the potential to improve patient outcomes, improve access to care, decrease costs, and improve team satisfaction. In recent years, efforts to implement team-based care have grown with the adoption of the Patient-Centered Medical Home (PCMH) and an increasing focus on value-based payment models. To better prepare our learners for this future, we introduced a formal team-based care curriculum in our three family medicine residency programs and one pediatric program. In addition to curricula for residents, we developed a team-based care didactic for family medicine clerkship students, presented by an interprofessional team of faculty. This session will …

Psychology, Medical Family Therapy, Social Work, Psychiatric Nursing, Counseling, And Others: Effective Collaborators, Or Sibling Disciplines At-War?, Tai Mendenhall, Angela Lamson, Jodi Polaha

ETSU Faculty Works

At the conclusion of this session, the participant will be able to: Articulate ways that we all – across a myriad of guildmemberships, license-types, and field/practice orientations – can do better work when we work together

Disseminating Your Ideas: A Conversation With The Editors Of Families, Systems, & Health, Jodi Polaha, Nadiya Sunderji, L. Mauksch, C. Fogarty

ETSU Faculty Works

No abstract provided.

Champion Teams As A Mechanism For Developing Team Care Capacity, Robert M. Tolliver, Gayatri Jaishankar, Jodi Polaha

ETSU Faculty Works

"Practice transformation" toward team care as a singular undertaking can be daunting. In this presentation, we describe the development of a mechanism for small, iterative and sustainable practice changes toward team care known as "Champion Teams." Champion Teams are based on the Institute of Medicine's "learning health care system" approach in which practitioners develop an internal mechanism for and culture around digesting and implementing new evidence based practices on an ongoing basis. In addition to presenting the Champion Team concept as a strategy for implementing new team care initiatives, interprofessional providers will present two case examples from each adult and …

How We Close The Gaps: Our Interprofessional Team Approach To Meeting Quality Measures, Peter Blockhurst, William Buselmeier, Mckenzie Calhoun, Paige Gilbert-Green, Jesse Gilbreath, Erin Harris, Amy Lawrence

ETSU Faculty Works

• Define the role/function of an interprofessional team in the management of complex outpatients.
• Identify the types of patients that would benefit most from a team-based approach.
• Implement elements of our team-based patient care model into individual practices.

Shark Tank: Clinician Innovators To Clinician Scientists, Jodi Polaha, Jennifer Funderburk, Tina Studts, Lesley Manson, J. D. Smith, Nadiya Sunderji, Mark Vosvick

ETSU Faculty Works

No abstract provided.

Toolkit For Pcbh In Pediatric Primary Care, Leslie Manson, Tawnya Meadows, Jodi Polaha, Sarah Trane, Robert M. Tolliver, Allison Dixson, Julie M. Austen, Hayley Quinn, Sonny Pickowitz

ETSU Faculty Works

No abstract provided.

Using Mock Interviews To Evaluate An Interprofessional Education (Ipe) Curriculum, Ivy A. Click, Jodi Polaha, Leonard Brian Cross, Richard A. Hess, Adam C. Welch, Jessica Epley Burchette

ETSU Faculty Works

The aim of this study was to evaluate the influence of targeted team care training in our institution’s interprofessional practice and education (IPE) program on medical and pharmacy students' expression of knowledge and attitudes about team care as measured in a mock interview. Medical and Pharmacy students were recruited to participate in a 20-minute mock interview for an advanced placement position.

Relationship Of Patient Self-Administered Copd Assessment Test (Cat) To Physician Standard Assessment Of Copd In A Family Medicine Residency Training Program, Leigh Johnson, Jessica Burchette, Ivy A. Click, Sandra Alicia Williams

ETSU Faculty Works

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality in the United States. COPD is of particular concern in certain sectors of the country, including Central Appalachia where our clinic is located. Assessing patients with COPD presents many challenges as symptoms range from those considered "typical" such as shortness of breath and sputum production to those less often identified like anxiety and social isolation. We conducted a pilot study comparing physician standard assessment of COPD to patient self-assessment using the COPD Assessment Test (CAT). The CAT is an eight-item questionnaire that measures the impact COPD has …

Champion Teams: An Implementation Strategy To Drive Practice Improvement, Jodi Polaha, Leigh Johnson, Millie Wykoff, J. Montgomery, S. Peace, D. Sloan, Reid Blackwelder

ETSU Faculty Works

Developing collaborative practice is an ongoing process requiring frequent upgrades as team members and processes are added. Recently, faculty in ETSU’s Department of Family Medicine have been experimenting with a mechanism for iterative upgrades to team care practice known as Champion Teams. Champion Teams are based on the Institute of Medicine’s "learning health care system" approach in which practitioners develop an internal strategy for implementing new evidence based practices on an ongoing basis. In this presentation, our interprofessional team will describe team-based education and practice at ETSU as it relates to the Champion Team concept including its origins, evidence-base, and …

Dermoscopy In Family Medicine, Alex Verdieck-Devlaeminck, Jim Holt, Richard Usatine

ETSU Faculty Works

Seminar objectives:
– Introduce dermoscopy as a method for dermatologic diagnosis
– Teach methods to identify melanoma using dermoscopy
– Introduce other methods to identify additional skin conditions
– Provide resources for learning dermoscopy

Navigating Long-Term Care, Jim Holt

ETSU Faculty Works

Americans over age 65 constitute a larger percentage of the population each year: from 14% in 2010 (40 million elderly) to possibly 20% in 2030 (70 million elderly). In 2015, an estimated 66 million people provided care to the ill, disabled, and elderly in the United States. In 2000, according to the Centers for Disease Control and Prevention (CDC), 15 million Americans used some form of long-term care: adult day care, home health, nursing home, or hospice. In all, 13% of people over 85 years old, compared with 1% of those ages 65 to 74, live in nursing homes in …

Using Implementation Science To Guide The Integration Of Evidence-Based Family Interventions Into Primary Care, Justin D. Smith, Jodi Polaha

ETSU Faculty Works

This article is a demonstration of how an implementation-science (IS) framework can be coupled with the measurement of implementation outcomes to effectively integrate evidence-based family interventions in primary care. The primary care environment presents a number of challenges for successfully integrating such interventions. However, IS methods can improve the prospect of successfully implementing a new intervention while simultaneously and rigorously evaluating the impact on salient outcomes. We used our experiences across 2 pilot trials in which the family check-up (Smith, Montaño, Mauricio, Berkel, & Dishion, 2016), an evidence-based family intervention, was integrated into primary care. In these pilot trials, the …

Predictors Of Marital Satisfaction In Couples With At Least One Physician Partner, Glenda F. Stockwell, Ivy A. Click, Jessee D. Gilreath, Erin Elizabeth Harris

ETSU Faculty Works

No abstract provided.

New Payment Models Within A Virtual Practice, Jim Holt

ETSU Faculty Works

No abstract provided.

Training A Workforce For Primary Care, K. Van Sickle, A. Beecham, Jodi Polaha

ETSU Faculty Works

No abstract provided.

Rural Parents’ Perceived Stigma Of Seeking Mental Health Services For Their Children: Development And Evaluation Of A New Instrument, Stacey L. William, Jodi Polaha

ETSU Faculty Works

The purpose of our research was to examine the validity of score interpretations of an instrument developed to measure parents’ perceptions of stigma about seeking mental health services for their children. The validity of the score interpretations of the instrument was tested in 2 studies. Study 1 employed confirmatory factor analysis (CFA), using a split half approach, and construct and criterion validity on data from the entire sample of parents in rural Appalachia whose children were experiencing psychosocial concerns (N = 347), while Study 2 employed CFA, construct and criterion validity, and predictive validity of the scores on data from …

Predictors Of Marital Satisfaction In Couples That Include A Physician Partner, Glenda F. Stockwell, Ivy A. Click, Jessee D. Gilreath, Erin Elizabeth Harris

ETSU Faculty Works

It is estimated that the divorce rate for marriages in which at least one party is a physician is 10-20% higher than the general population. Predicting the variables that contribute to marital satisfaction, identifying the skills associated with those behaviors and developing a residency curriculum to teach the skills to resident physicians is the focus of this study. Intimacy, conflict resolution and emotional expressiveness have all been identified as important aspects of marital satisfaction. We will determine how each of these variables contributes to marital satisfaction using multilevel logistic regression. The results will be used to develop a skills based …

Does Structured Quality Improvement Training For Residents Increase Qi In Practice?, Ivy A. Click, Jeri Ann Basden, Fred Tudiver

ETSU Faculty Works

East Tennessee State University implemented quality improvement (QI) training for second-year family medicine residents in 2009. Results in 2011 indicated training increased scores in QI skill assessments as well as self-efficacy in QI. With residents who completed the training now in practice, does the increase in knowledge and skill translate to increased QI in practice? A survey of graduates compares frequency of QI cycles and self-assessment of QI skills among graduating classes, those receiving QI training and those graduating before training began. Residents that completed the QI curriculum rated their training higher; however residents that did not receive training were …

Focused Anticoagulation Service In Family Medicine Residencies, Ivy A. Click, Emily Flores, Leonard Brian Cross, Douglas Rose

ETSU Faculty Works

A report on the creation of a new program to improve family medicine residents' understanding, and quality of care, of anticoagulation patients. Patients requiring anticoagulation therapy pose unique issues requiring a systematic approach to their care, balancing the potential benefit from therapy with possible adverse events. Here, we describe a model that helps to standardize both the care received by patients on anticoagulation therapy as well as the training of family medicine residents caring for those patients. A team-based model of care (family medicine residents, clinical pharmacists, and nurses) is used to achieve the goals of improved care and education. …

Predictors Of Treatments Acceptable To Patients For Late-Life Depression, Gerald J. Jogerst, Shimin Zheng, Erik Vanderlip

ETSU Faculty Works

Objectives. Describe older patients’ perceptions about depression and characteristics associated with acceptance of treatments. Design. Cross-sectional study. Setting. Three primary care clinics in Iowa. Participants. Consecutive sample of 529 primary care patients. Measurements. Depression screening tool (a 9-item patient health questionnaire [PHQ-9]) and questionnaire including sociodemographic data, patient attitudes about depression, and acceptability of different treatments. Results. Mean age was 71.9 years (range 60–93 years), 314 (59%) female. Among the 529 participants, 93 (17.5%) had history of depression and 60 (11.3%) had PHQ-9 scores of 10 or greater. Participants believed depression is a disease for which they would use medication …

Continuing Education Training Focused On The Development Of Behavioral Telehealth Competencies In Behavioral Healthcare Providers, Valerie Gifford, Britton Niles, Inna Rivkin, Catherine Koverola, Jodi Polaha

ETSU Faculty Works

Introduction: Telehealth allows behavioral health care and specialty services to be extended to rural residents. Telehealth is an important resource for the Alaskan healthcare system, which is tasked with providing services to culturally diverse populations living in remote areas. Training competent providers to deliver telehealth services is vital for the implementation of successful telehealth programs. Yet, the literature is lacking in the area of provider behavioral telehealth competency training.

Methods: This study assessed the impact of a Behavioral Telehealth Ethical Competencies Training program on 16 behavioral health providers' development of behavioral telehealth competency. A total of 14 competencies were developed, …

A New Model For Assessing Teaching Quality Improvement To Family Medicine Residents: Does It Work?, Ivy A. Click, Fred Tudiver, Jeri Ann Basden

ETSU Faculty Works

Objective: To develop and implement a formal didactics and experiential curriculum to train Family Medicine (FM) residents in Quality Improvement (QI) knowledge and skills. Method: 1) All FM faculty participated in seven workshops on QI theory and design. 2) All second year residents received a day-long workshop on knowledge and skills of QI and conducted QI projects for up to two years. Results: Knowledge and confidence scores significantly improved following training, p

Implementing A New R1 Orientation, Jim Holt, Allan Garrett, Fereshteh Gerayli

ETSU Faculty Works

No abstract provided.

Rapid Resident Skills Evaluation Using The Integrated Osce, Mark Brummel, Reid B. Blackwelder, J. Moore, Glenda Stockwell, Beth Anne Fox

ETSU Faculty Works

No abstract provided.