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Community Health Worker Support For Disadvantaged Patients With Multiple Chronic Diseases: A Randomized Clinical Trial, Shreya Kangovi, Nandita Mitra, David Grande, Hairong Huo, Robyn A. Smith, Judith A. Long 2017 University of Pennsylvania

Community Health Worker Support For Disadvantaged Patients With Multiple Chronic Diseases: A Randomized Clinical Trial, Shreya Kangovi, Nandita Mitra, David Grande, Hairong Huo, Robyn A. Smith, Judith A. Long

Research Briefs

In a randomized trial, a community health worker intervention reduced hospitalization and improved outcomes in uninsured or publicly insured patients with multiple chronic conditions such as diabetes, obesity, and smoking. Community health workers can improve health and lower costs, and provide a scalable strategy to improve population health.


During The Wait: A Phenomenological Study On Denied Social Security Dissability Applicants Awaiting Appeal, Stefanie A. Ford 2017 University of Arkansas, Fayetteville

During The Wait: A Phenomenological Study On Denied Social Security Dissability Applicants Awaiting Appeal, Stefanie A. Ford

Theses and Dissertations

The purpose of the present study is to investigate the essence of the experience of individuals who were denied Social Security Disability benefits and who sought the appeals process. In the first round, five semi-structured face-to-face interviews allow the participants to share their thoughts, feelings, and actions taken and, if any, what life changes occurred during the appeals process. Data analysis using phenomenological methods create textural-structural descriptions from which, in a second interview, applicants choose to confirm, edit, or add to their analyzed interviews. The findings present as seven major themes that describes the phenomenon. They are: (a) procedural unfairness ...


Starting At The End: Measuring Learning Using Retrospective Pre-Post Evaluations, Debi Lang, Judith A. Savageau 2017 University of Massachusetts Medical School

Starting At The End: Measuring Learning Using Retrospective Pre-Post Evaluations, Debi Lang, Judith A. Savageau

Center for Health Policy and Research (CHPR) Publications

Blog post to AEA365, a blog sponsored by the American Evaluation Association (AEA) dedicated to highlighting Hot Tips, Cool Tricks, Rad Resources, and Lessons Learned for evaluators. The American Evaluation Association is an international professional association of evaluators devoted to the application and exploration of program evaluation, personnel evaluation, technology, and many other forms of evaluation. Evaluation involves assessing the strengths and weaknesses of programs, policies, personnel, products, and organizations to improve their effectiveness.


Call For Submissions. Special Issue – July 2018: Patient & Family Experience In Children’S Hospitals And Pediatric Care, Patient Experience Journal 2017 The Beryl Institute

Call For Submissions. Special Issue – July 2018: Patient & Family Experience In Children’S Hospitals And Pediatric Care, Patient Experience Journal

Patient Experience Journal

Patient Experience Journal (PXJ) is excited to announce a call for submission for its special issue scheduled for July 2018 on the topic of patient & family experience in children’s hospitals and pediatric care. This special issue is open to all authors conducting cutting-edge research, implementing innovative practices or with powerful experiences to share around efforts in either children’s hospitals or pediatric care. It is encouraged that articles submitted deal directly with efforts in those care settings. The issue will look for pieces that address evidence-based efforts at improvement, practices that have impact on outcomes or stories that reflect ...


Experience-Based Co-Design: A Method For Patient And Family Engagement In System-Level Quality Improvement, Bianca Fucile, Erica Bridge, Charlene Duliban, Madelyn P. Law Dr. 2017 Brock University

Experience-Based Co-Design: A Method For Patient And Family Engagement In System-Level Quality Improvement, Bianca Fucile, Erica Bridge, Charlene Duliban, Madelyn P. Law Dr.

Patient Experience Journal

Integrating patient and family member needs, wants and preferences in healthcare is of utmost importance. However, a standardized patient and family engagement model to understand these needs, wants and preferences in order to translate into high quality improvement activities is lacking. Experience based co-design (EBCD) is an approach that enables patients, family members and healthcare providers to co-design improvement initiatives together. In this study, EBCD was employed to: 1) assess the current state of information and educational resources at a local oncology center and 2) partner with patients, family members, and healthcare providers to create quality improvement initiatives targeting identified ...


Integrating Person Directed Care Into The Client Experience, Tammy L. Marshall Ms., Joann P. Reinhardt, Orah Burack, Audrey S. Weiner 2017 The New Jewish Home

Integrating Person Directed Care Into The Client Experience, Tammy L. Marshall Ms., Joann P. Reinhardt, Orah Burack, Audrey S. Weiner

Patient Experience Journal

Culture Change leaders in long term care have identified creative ways to implement a model of Person Directed Care to improve the client experience by providing choice, instilling dignity, and fostering deep relationships among its community members. One organization created an environment of care called ”The Small House” and educated its’ workforce using the Green House® Project Legacy Alignment program to redesign the organizational structure, experience and environment. Interviews were conducted with elders, staff, and family members (N=20) about their experiences living, working or visiting a Small House as compared to experiences in their previous dwelling, a traditional nursing ...


Understanding The Role Of Patient And Public Involvement In Renal Dietetic Research, Andrew Morris Mr, Deborah Biggerstaff, Nithya Krishnan, Deborah Lycett 2017 University Hospital Coventry and Warwickshire NHS Trust

Understanding The Role Of Patient And Public Involvement In Renal Dietetic Research, Andrew Morris Mr, Deborah Biggerstaff, Nithya Krishnan, Deborah Lycett

Patient Experience Journal

The objective was to consult patients on a proposed recruitment strategy to a patient and public involvement exercise. We wanted to explore the reasoning and willingness of patients to become co-researchers within a grant application. Eighteen people using the renal health service informed the consultation by action research so that their experiences could be used to guide the overall methodology. Twelve people took part in semi-structured interviews. NVIVO 10 and Framework Analysis were used to interpret emerging themes from the data. The recruitment strategy, informed by research expertise, became an experience-based expert design. The design took into account the limitations ...


Lack Of Patient Involvement In Care Decisions And Not Receiving Written Discharge Instructions Are Associated With Unplanned Readmissions Up To One Year, Kyle A. Kemp, Hude Quan, Maria J. Santana 2017 University of Calgary

Lack Of Patient Involvement In Care Decisions And Not Receiving Written Discharge Instructions Are Associated With Unplanned Readmissions Up To One Year, Kyle A. Kemp, Hude Quan, Maria J. Santana

Patient Experience Journal

This retrospective, cross-sectional study examined the relationship between aspects of inpatient communication and discharge instructions and unplanned, all-cause readmissions using individual-level data up to one-year post-discharge. Patients completed the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) telephone survey within 6 weeks of hospital discharge in Alberta, Canada. Survey data were linked to corresponding inpatient records. Independent variables included selected demographic characteristics, clinical variables, and five survey questions: a) patient involvement in care decisions, b) receiving written information at discharge, c) understanding the purpose of taking medications, d) understanding responsibility for one’s health, and e) discussing help needed ...


A Trip To Healthcare, david e. matz 2017 UMass/Boston

A Trip To Healthcare, David E. Matz

Patient Experience Journal

This narrative shares how my experience with two colonoscopies and three surgeries in one year taught me that I am not so good at engaging in treatment decisions. I thought I was. This essay sets out where I made my mistakes, why I believe I made those mistakes, and how the hospitals, intentionally or not, made good decision-making harder. I offer two suggestions for enhancing the role of the patient in decision-making including 1) Every doctor in a diagnostic-decision-making interview should use the sentence “You have some choices here.” The doctor will have preferences, of course, but the patient needs ...


The Paradigm Of Patient Must Evolve: Why A False Sense Of Limited Capacity Can Subvert All Attempts At Patient Involvement, Dave deBronkart 2017 Chair Emeritus, Society for Participatory Medicine

The Paradigm Of Patient Must Evolve: Why A False Sense Of Limited Capacity Can Subvert All Attempts At Patient Involvement, Dave Debronkart

Patient Experience Journal

This essay reviews the role of paradigms in molding the thoughts of a scientific field and looks rigorously at what two key terms mean – empowered and engaged – and how their interaction points to a new way forward, requiring a re-examination of our “paradigm of patient.” Five years ago, the Institute of Medicine’s Best Care at Lower Cost declared that patient-clinician partnerships are a cornerstone of a learning health system, a declaration that’s foundational to the era of involvement. How can we engineer that era correctly if our conception of “patient” is out of date? And how can we ...


Pushing The Boundaries Of Patient Experience, Jason A. Wolf PhD 2017 The Beryl Institute / Patient Experience Journal

Pushing The Boundaries Of Patient Experience, Jason A. Wolf Phd

Patient Experience Journal

This special issue is designed to push the boundaries of patient experience a little farther. Beyond just examples of applying the critical principles of patient and family centered care or even practices of patient engagement, we have been pushed to move further down the perspective of partnership, to the era of “doing with” in which healthcare now finds itself. The idea of involvement as the descriptor selected to frame this issue, was due to its broad and representative nature. It reflects all the words on involving patients mentioned above, but gets further along to participation and ownership (or activation as ...


A Cross-Sectional Analysis Of Pharmaceutical Industry-Funded Events For Health Professionals In Australia, Alice Fabbri, Quinn Grundy, Barbara Mintzes, Swestika Swandari, Ray Moynihan, Emily Walkom, Lisa A Bero 2017 University of Sydney

A Cross-Sectional Analysis Of Pharmaceutical Industry-Funded Events For Health Professionals In Australia, Alice Fabbri, Quinn Grundy, Barbara Mintzes, Swestika Swandari, Ray Moynihan, Emily Walkom, Lisa A Bero

Ray Moynihan

OBJECTIVES:

To analyse patterns and characteristics of pharmaceutical industry sponsorship of events for Australian health professionals and to understand the implications of recent changes in transparency provisions that no longer require reporting of payments for food and beverages.

DESIGN:

Cross-sectional analysis.

PARTICIPANTS AND SETTING:

301 publicly available company transparency reports downloaded from the website of Medicines Australia, the pharmaceutical industry trade association, covering the period from October 2011 to September 2015.

RESULTS:

Forty-two companies sponsored 116 845 events for health professionals, on average 608 per week with 30 attendees per event. Events typically included a broad range of health professionals ...


Words Do Matter: A Systematic Review On How Different Terminology For The Same Condition Influences Management Preferences, Brooke Nickel, Alexandra Barratt, Tessa Copp, Ray Moynihan, Kirsten McCaffery 2017 University of Sydney

Words Do Matter: A Systematic Review On How Different Terminology For The Same Condition Influences Management Preferences, Brooke Nickel, Alexandra Barratt, Tessa Copp, Ray Moynihan, Kirsten Mccaffery

Ray Moynihan

OBJECTIVES: Changing terminology for low-risk, screen-detected conditions has now been recommended by several expert groups in order to prevent overdiagnosis and reduce the associated harms of overtreatment. However, the effect of terminology on patients' preferences for management is not well understood. This review aims to synthesise existing studies on terminology and its impact on management decision making. DESIGN: Systematic review. METHODS: Studies were included that compared two or more terminologies to describe the same condition and measured the effect on treatment or management preferences and/or choices. Studies were identified via database searches from inception to April 2017, and from ...


Using Timelines To Visualize Service Use Pathways To Alcohol Treatment, Lynda Berends, Michael Savic 2017 University of New South Wales

Using Timelines To Visualize Service Use Pathways To Alcohol Treatment, Lynda Berends, Michael Savic

The Qualitative Report

Many people in alcohol and other drug treatment are clients of other services, however there is limited consideration of the combinations and sequences of services and systems that they use. We used data visualization to analyze and re-present findings from a large research project on clients’ service use and referral sources in the year preceding alcohol treatment entry. Data were from 16 “high-end” service users with alcohol problems and analysis involved constructing individual text and timeline summaries and a visual encoding system to show service type and referral source. Three distinct service use pathways were identified and a visual model ...


Using Assessment Data To Perform Outcome-Based Quality Measurement, Marybeth McCaffrey 2017 University of Massachusetts Medical School

Using Assessment Data To Perform Outcome-Based Quality Measurement, Marybeth Mccaffrey

Commonwealth Medicine Publications

The MDS-HC, or the Minimum Data Set Home Care, is a tool to help identify the needs of and services for older adults and people with disabilities who live in the community. Twenty-four states perform assessments using the MDS-HC.

In addition to determining eligibility and creating service plans, this assessment data can be used to measure outcomes of home and community-based services (HCBS). These quality indicators are validated, relatively fast and easy to implement, place no additional burden on staff and providers, and enable analysis of population results.

Outcome-based measures are an essential but often missing puzzle piece in assuring ...


Home Care Quality Effects Of Remote Monitoring, Cynthia Williams 2017 University of Central Florida

Home Care Quality Effects Of Remote Monitoring, Cynthia Williams

Cynthia A. Williams

Despite concerted efforts to decrease costs and increase public health, the embattled U.S. health care system continues to struggle to alleviate these widespread issues. Because the problem of hospital utilizations among patients with heart failure is posited to increase as the population ages, innovative methodologies need to be explored to mitigate adverse events. Remote monitoring harnesses the strength of advanced information and communication technology to affect positive changes in health care quality and cost. By reaching across geographical boundaries, remote monitoring may support increased access to less costly services and improve the quality of home health care. The purpose ...


“That Pain Is Genuine To Them”: Provider Perspectives On Chronic Pain In University Student Populations, Alexandra C.H. Nowakowski, Kaitlyn E. Barningham, Charlyn D. Buford, Martin Laguerre, J. E. Sumerau 2017 Florida State University

“That Pain Is Genuine To Them”: Provider Perspectives On Chronic Pain In University Student Populations, Alexandra C.H. Nowakowski, Kaitlyn E. Barningham, Charlyn D. Buford, Martin Laguerre, J. E. Sumerau

The Qualitative Report

We explored provider attitudes about and experiences in chronic pain management for university student populations. Our central question was: “What do providers at a large university campus health care center experience in the process of offering pain management services?” We explored instrumental, behavioral, emotional, and attitudinal dimensions of our participants’ experiences using a qualitative case study approach. Data were gathered through semi-structured interviews with 10 health care providers at the student health center for a large research university in Florida. Interviews captured providers’ background and experiences in providing pain management to student patients with diverse needs. We used grounded theory ...


Virtual Patient Technology: Engaging Primary Care In Quality Improvement Innovations, Amanda C. Blok, Christine N. May, Rajani S. Sadasivam, Thomas K. Houston 2017 University of Massachusetts Medical School

Virtual Patient Technology: Engaging Primary Care In Quality Improvement Innovations, Amanda C. Blok, Christine N. May, Rajani S. Sadasivam, Thomas K. Houston

Rajani S. Sadasivam

BACKGROUND: Engaging health care staff in new quality improvement programs is challenging.

OBJECTIVE: We developed 2 virtual patient (VP) avatars in the context of a clinic-level quality improvement program. We sought to determine differences in preferences for VPs and the perceived influence of interacting with the VP on clinical staff engagement with the quality improvement program.

METHODS: Using a participatory design approach, we developed an older male smoker VP and a younger female smoker VP. The older male smoker was described as a patient with cardiovascular disease and was ethnically ambiguous. The female patient was younger and was worried about ...


Direct-To-Patient Pro Collection To Support Quality Improvement In Tjr, Hua Zheng, Celeste A. Lemay, Wenyun Yang, Patricia D. Franklin 2017 University of Massachusetts Medical School

Direct-To-Patient Pro Collection To Support Quality Improvement In Tjr, Hua Zheng, Celeste A. Lemay, Wenyun Yang, Patricia D. Franklin

Celeste A. Lemay

Introduction: Patient-reported outcomes (PROs) are widely used in orthopedic clinical research to evaluate quality of care. However, it is difficult to capture complete post-operative PRO data through surgeon office visits. The UK and Sweden collect post-TJR PRO measures directly from patients in their homes. We compared two US post-operative PRO collection processes- PROs in clinic at scheduled office visits and direct-to-patient collection, to evaluate timing and completeness of both approaches.

Methods: At a large TJR center that has collected PROs at office visits routinely for years, post-TJR patients complete a PRO survey on a computer at follow-up clinic visits. In ...


Direct-To-Patient Pro Collection To Support Quality Improvement In Tjr, Hua Zheng, Celeste A. Lemay, Wenyun Yang, Patricia D. Franklin 2017 University of Massachusetts Medical School

Direct-To-Patient Pro Collection To Support Quality Improvement In Tjr, Hua Zheng, Celeste A. Lemay, Wenyun Yang, Patricia D. Franklin

Patricia D. Franklin

Introduction: Patient-reported outcomes (PROs) are widely used in orthopedic clinical research to evaluate quality of care. However, it is difficult to capture complete post-operative PRO data through surgeon office visits. The UK and Sweden collect post-TJR PRO measures directly from patients in their homes. We compared two US post-operative PRO collection processes- PROs in clinic at scheduled office visits and direct-to-patient collection, to evaluate timing and completeness of both approaches.

Methods: At a large TJR center that has collected PROs at office visits routinely for years, post-TJR patients complete a PRO survey on a computer at follow-up clinic visits. In ...


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