Family Medicine Commons^™

Effective Hepatitis C Screening In High Risk Populations, Aekata Shah, Do, Jennifer Seymour, Do

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Purpose

The purpose of our study was to demonstrate how various quality improvement initiatives activated in selected Jefferson Northeast family medicine teaching offices have enabled effective HCV screening. Given the cost effectiveness of screening and early treatment versus treatment of the disease in the later stages of progression,8 we hope to encourage other primary care offices to implement quality initiatives to encourage appropriate HCV screening. This is especially important for the baby boomer generation, as well as for high risk individuals with a history for and/or current IV drug abuse or other high risk behaviors.

Implementation Of A Volunteer-Based Hospital Program For Older Adults, Elizabeth Collins, Md, Kristine Swartz, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Background

• A multi-faceted, volunteer-led, hospital-based program1has been shown to: •Reduce the incidence of delirium •Decrease hospital length of stay •Reduce hospital costs.
• Implementation of such a program requires upfront investment.
• A smaller, volunteer-based visitation program for older adults may provide support for the allocation of more hospital resources in delirium prevention and establishment of a formal Hospital Elder Life Program1in this institution.
• This research aims to investigate: •If the implementation of a visitation program is feasible at this hospital •Volunteer experience with the program.

The Effects Of Office-Based Interventions To Increase Patient Enrollment In An Online Electronic Medical Record Portal, Lionel Mcintosh, Md, Allison Rague, Md, Claire Thesing, Md, Amy Lachewitz, Md, Gillian Love, Md, Daniel Sizemore, Md, Zachary Klock, Md, Aimee Mcmullin, Md, Zeynep Uzumcu, Md, Patrick Mcmanus, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

We aimed to increase the number of JFMA patients signed up with MyChart by 50% over a 5 month time frame by educating providers and staff on ways to implement patient portal sign up into the office visit as well raising awareness of the portal for both providers and patients

Improving Follow-Up For Family Medicine Patients After Hospital Discharge, Erica Li, Md, Rebecca Simon, Md, Michael Weissberger, Md, Angela Silverman, Md, Mpg, Bryan Botti, Md, Laura Emerson, Md, Zoe Agoos, Md, Rachel Ehrman-Dupre, Md, Jennifer Moyer, Md, Andrew Rabovsky, Md, Geoffrey Mills, Md, Phd

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Aims

• Increase percentage of JFMA patients with follow-up appointment scheduled after discharge to 100% by March 2018
• Increase percentage of JFMA patients who show up to their follow up appointments after discharge to 80% by March 2018

Prevalence And Factors Associated With Female Sexual Dysfunction Amongst Women Using Hormonal And Non-Hormonal Contraception At The Aga Khan University Hospital Nairobi Clinics, Momin Butt

Master of Medicine in Family Medicine

Background: Female sexual function is a complex phenomenon. It integrates all the body systems and is influenced by a variety of factors. Contraceptives have been shown to have variable effects on female sexual function, but there have not been adequately powered studies on this in our setting. Justification: The prevalence of female sexual dysfunction (FSD) has been shown to vary among different population subsets globally. The associations of different factors with FSD have also shown variable conclusions that are not generalizable to our setting. In Kenya there is a high discontinuation rate of contraception and this is mainly attributed to …

A Comparison Of Caesarean Section Rates Before And After Introduction Of Free Maternity Services At Maragua Level Iv Hospital, Grace Rwamba

Master of Medicine in Family Medicine

Introduction: At population level, a caesarean section (CS) rate between 10 and 15 percent is considered optimal for maternal and infant health outcomes and a useful process indicator of quality of care. However, that there has been a worldwide increase of CS rates in the past three decades. Compared to vaginal birth, questions abide of appropriateness, balance of risk versus benefit and cost implications to the health care system. Introduction of free maternity services (FMS) in June 2013has been known to increase health facility deliveries. However it may affect the quality of care offered in these facilities due to a …

The Effect Of Diabetes Self-Management Education On Hba1c And Quality Of Life In African-Americans: A Systematic Review And Meta-Analysis., Amy T. Cunningham, Denine R. Crittendon, Neva White, Geoffrey D. Mills, Victor Diaz, Marianna Lanoue

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Type 2 diabetes presents a major morbidity and mortality burden in the United States. Diabetes self-management education (DSME) is an intervention associated with improved hemoglobin A1c(HbA1c) and quality of life(QOL), and is recommended for all individuals with type 2 diabetes. African-Americans have disproportionate type 2 diabetes morbidity and mortality, yet no prior meta-analyses have examined DSME outcomes exclusively in this population. This systematic review and meta-analysis examined the impact of DSME on HbA1c and QOL in African-Americans compared to usual care.

METHODS: Randomized controlled trials, cluster-randomized trials, and quasi-experimental interventions were included. 352 citations were retrieved; 279 abstracts were …

Healthcare Provider Attitudes Toward Personalized Care Plan Development, Kafi Rudolph, Adarsh Gupta

Rowan-Virtua Research Day

Background: Prevention care plans are created by healthcare workers to direct patient care and are guidelines to optimize patient health. The care plans include actions patients can take to prevent worsening of chronic conditions and potentially decrease hospitalizations. The current research project was conducted to assess satisfaction of using automated personalized care plans among healthcare providers, which can increase office visit efficiency.

Tracking The Trajectory Of Resident Learning Through The Lens Of Self-Determination Theory., Susan E. Hansen Ma, Nicole L. Defenbaugh Phd, Susan S. Mathieu Md, Linda Garufi Md, Med, Julie Dostal Md

Department of Family Medicine

No abstract provided.

Increasing Interest In Family Medicine Through Innovative Student Curriculum And Promotion Of Shared Work Among All Levels Of Medical Learners, Katerina C. Valavanis Md, Veronica Brohm Do, Yasir Abunamous Md

Department of Family Medicine

No abstract provided.

Post-Traumatic Stress Disorder: Review Of Dsm Criteria And Functional Neuroanatomy, Cornelius W. Thomas

Marshall Journal of Medicine

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for post-traumatic stress disorder (PTSD) consist of over twenty possible symptoms that can be divided into six broad categories. These categories correlate with specific brain networks that regulate emotions, behaviors, and autonomic function. Normal functioning of these networks depends on two key regions; the prefrontal cortex and the amygdala. The prefrontal cortex provides top-down executive control over amygdala, whereas the amygdala is critical for threat detection and activation of the ‘fight or flight’ response. Events that trigger extreme and/or prolonged fear can cause persisting dysregulation within the prefrontal-amygdala circuit; resulting …

Ot In Pediatric Primary Care, Anne H. Zachry, J. Flick

Faculty Presentations

This session described a program where licensed occupational therapists and master’s level OT students provide free developmental screenings to infants and young children in local pediatric medical practice. Strategies for strategies for developing relationships and bridging communication between occupational therapists, primary practice physicians, and families were reviewed.

Transabdominal Versus Transvaginal, Kyla Camille Gray

Grace Peterson Nursing Research Colloquium

Background: In the United States, there has been a 21% increase in the occurrence of premature births within the last two decades. These children are also more likely to require lifelong therapies, assistive technologies, mobility devices, and more supportive services throughout their time in school. Globally, preterm births, and their preventions, have become a topic of interest. One method that has had significant success rates is placing a cerclage to prevent cervical dilation; while simultaneously treating prophylactically for early delivery.

Objectives: The purpose of this integrative literature review was to focus on which placement of cerclages, transabdominal or transvaginal, …

Influence Of Supportive Care On Chemotherapy Patients' Self-Care Behaviour And Satisfaction: A Pilot Study Conducted In Karachi, Pakistan, Salima Shams, Adnan Jabbar, Kashmira Nanji, Rafat Jan, Ambreen Tharani

School of Nursing & Midwifery

Background and aim: Cancer is a daunting illness affecting a vast number of people globally. During the illness trajectory, cancer patients suffer from physical and/or psychosocial issues. These physical and psychosocial issues demand conscious actions by patients to maintain their well-being. Hence, the objective of the pilot study was to evaluate the level of self-care behaviors and satisfaction in women suffering from cancer after exposure to supportive care (education and mind diversion activities) delivered via a patient help group program.
Methods: The study was conducted at the chemotherapy day care unit of one of the tertiary care hospitals …

Intra-Articular Tranexamic Acid During Total Knee Arthroplasty, Ahmed F. Khan

Clinical Research in Practice: The Journal of Team Hippocrates

An informed consent conversation regarding bleeding risk prior to total knee arthroplasty in an elderly patient with chronic kidney disease.

Community Health, Advocacy, And Managing Populations (Champ) Longitudinal Residency Education And Evaluation, Kjersti E. Knox, Will Lehmann, Joseph Vogelgesang, Deborah Simpson

Journal of Patient-Centered Research and Reviews

Purpose: Longitudinal education initiatives designed to prepare residents to address health disparities and social determinants of health (SDH) are needed. This report addresses this gap by describing a family medicine residency’s Community Health, Advocacy, and Managing Populations (CHAMP) curriculum and its evaluation by learners, faculty, and community partners. The CHAMP longitudinal curriculum is explicitly designed to prepare residents to address health disparities and SDH. We report early outcomes, including community partner feedback, of this innovative curriculum.

Methods: Data were obtained through standardized rotation evaluations, thematic analysis of structured group and individual interviews, and aggregated competency milestone data. Kirkpatrick’s four-level model …

Challenges Of Refugee Health Care: Perspectives Of Medical Interpreters, Case Managers, And Pharmacists, Fabiana Kotovicz, Anne Getzin, Thy Vo

Journal of Patient-Centered Research and Reviews

Purpose: Our objective was to identify perceived challenges in the provision of health care for refugees from the perspective of medical interpreters, case managers, and pharmacists working with refugee patients in Milwaukee, Wisconsin.

Methods: Two 60-minute focus groups were performed exploring challenges in refugee health care using a literature-based semi-structured protocol. Focus groups were transcribed and de-identified prior to independent analysis by two of the investigators. Using a memoing-process qualitative approach, major concepts, cross-cutting themes, and subthemes were established and ultimately developed a narrative. The project protocol was approved as not human subject research by the local institutional review board. …

Imagine A World …, David A. Nelson

Journal of Patient-Centered Research and Reviews

The author and issue editor introduces the second half of Journal of Patient-Centered Research and Reviews’ two-part series on health disparities and inequities in the United States. The chasm between an ideal health care system and the current reality may appear vast, and closing it insurmountable at times, but acknowledging and working to address the many health conditions that disproportionately affect specific patient populations is one step health providers and researchers can take toward closing the gap.

Effect Of A Brief Patient Communication Teaching On Both Attendee And Non-Attendee Family Medicine Residents., Dilip Nair, Adrienne Mays, Mohit Harsh

Marshall Journal of Medicine

Physician-patient communication skills are important for physicians to acquire. Teaching skills is thought to require attendance by learners but this is difficult in graduate medical education settings. We asked if an educational intervention on physician-patient communication was associated with a "spill-over" effect to non-attendees in the same family medicine residency program.

We surveyed residents regarding communicating instructions to patients before the intervention and one month later, regardless of their attendance. Residents’ assessment of their patients’ understanding increased significantly post-intervention only if non-attendees were included.

This pilot study suggests a beneficial “spill-over” effect to non-attendee residents that warrants further study.

Frequency And Factors Associated With Adult Immunization In Patients Visiting Family Medicine Clinics At A Tertiary Care Hospital, Karachi, Samar Zaki, Asma Usman, Swaleha Tariq, Sameena Shah, Iqbal Azam Syed, Waris Qidwai, Kashmira Nanji

Department of Family Medicine

Objective: The goal of this study was to determine the frequency and factors associated with adult immunization in patients visiting family medicine clinics at a tertiary care hospital in Karachi.
Methods: A cross-sectional study was conducted from March 2014 to March 2015 in a tertiary care hospital in Karachi, Pakistan. Participants more than 18 years were invited to participate in the study. A pretested questionnaire was used to collect information. Data were entered and analyzed using IBM SPSS Statistics for Windows, version 19.0 (Armonk, NY: IBM Corp).
Results: A total of 340 patients were surveyed. The majority of patients …