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Full-Text Articles in Internal Medicine

Optimizing Secure Patient Messaging Workflow In A Vermont Primary Care Clinic, Kimberly S. Oleary Jan 2022

Optimizing Secure Patient Messaging Workflow In A Vermont Primary Care Clinic, Kimberly S. Oleary

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Optimizing Secure Patient Messaging Workflow in a Vermont Primary Care Clinic

Kim O’Leary, DNPc, RN

DNP Advisor: Margaret Aitken, DNP, AGNP, ANP-BC

Site Mentor: James Williamson, MHA, Site Supervisor, Adult Primary Care

Background: Secure patient messaging is a popular tool designed for non-urgent questions, yet patients sometimes use it to relay urgent concerns. As office workflows tend to prioritize responses to other methods of communication, this presents a potentially unsafe situation in which clinical staff may not respond to these urgent messages in a timely manner.

Purpose: To develop a methodology to improve the timeliness, effectiveness, and safety of secure …


Optimizing Drug Prior Authorization Procedures For Primary Care, Lydia S. Vorsteveld Jan 2020

Optimizing Drug Prior Authorization Procedures For Primary Care, Lydia S. Vorsteveld

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Title and Abstract

  1. 1. Title

Optimizing Drug Prior Authorization Procedures for Primary Care

  1. 2. Abstract

Background:

Medication prior authorization (MPA) is a cost containment strategy utilized by health plans. The payer, or health plan requires providers to obtain prior approval for plan coverage of a drug prescription. The list of drugs requiring MPA varies among health plans and is subject to frequent change. From 2007 to 2013 Medicare Part D increased MPA requirements by 38 percent (Hoadley, Summer, Hargrave, & Cubanski, 2014).

Methods:

Pre and post interventional surveys of primary care staff were used to gather descriptions of current MPA …


Implementation Of A Chronic Pain Functional Assessment Tool In Primary Care Practice, Jude Emerson Stevens Jan 2019

Implementation Of A Chronic Pain Functional Assessment Tool In Primary Care Practice, Jude Emerson Stevens

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background

An estimated 20% of patients with non-cancer pain symptoms or pain-related diagnoses receive an opioid prescription. Current guidelines advocate use of a functional assessment as a strategy to improve the efficacy and safety of chronic pain management using opioids. This project aimed to integrate functional assessments into patient care visits for chronic pain and optimize safe and effective prescribing.

Methods

This quality improvement project was conducted at a primary care clinic in Burlington, VT. Baseline data on current functional assessment utilization and barriers amongst providers were collected. The validated Pain, Enjoyment, and General Activity (PEG) scale was administered from …