Health Policy Commons^™

Implementation Of The Drug Medi Cal Organized Delivery System In An Outpatient Sud Rehabilitation Agency, Casie Greene

Capstone Projects and Master's Theses

A new funding strategy called the Drug Medi-Cal Organized Delivery System (DMC-ODS) has been implemented in Santa Cruz County in efforts to combat the rising Substance Use Disorder (SUD) epidemic in the community. This system increases access to treatment services in hopes of decreasing the harmful effects of substance abuse in communities. The program aids in efforts to reduce barriers accessing care and show the people in the community the importance of and whole person care. This capstone project consisted of the implementation process of a system evaluation aligned with DMC-ODS at Sobriety Works, using data collection and analysis to …

Sweeping Exposures: Lead Poisonings And Black Working Poor Populations In The United States, Shirley Reid

Dissertations, Theses, and Capstone Projects

The focus of my thesis is to explore some of the realities that the impoverished urban black poor populations face in America today. The goal of my thesis is to illustrate how poverty is reproduced within impoverished neighborhoods through the idea and mechanism of lead exposure, by recognizing how specific exposure to the element lead and its by-products is both a symbol and a material cause of black urban poor illness and disability. There is no mistake that people living in the U.S. are aware of the social injustices against black populations in the form of racial injustice. However, …

The Patient-Physician Relationship: Overcoming Language And Cultural Barriers, Corrilynn Lynch

Senior Honors Theses

The patient-physician relationship governs the field of medicine, forming the basis for all relationships, interactions, and procedures in medicine. The degree to which a patient trusts his physician and thus is willing to be receptive to medical advice and adhere to assigned treatment is dependent on the quality of his relationship with his physician. The method of relationship chosen will dictate how the patient feels he is perceived and thus to what extend he will participate in his healthcare. A patient-centered approach to medicine will increase this confidence and lead to improved clinical results. Additionally, the rise of physician burnout …

Preventive Health Service Use Among Rural Women, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Nathan Paluso Mph, Jaclyn Janis Bsn, Rn

Access / Insurance

Preventive health services and screenings are an important component in the continuum of care provided to individuals across all ages. Yet, research has shown that rural residents generally use fewer preventive health services and screenings. This study used the National Health Interview Survey to examine receipt of preventive health services (cholesterol check, fasting blood sugar test, mammogram, pap smear, and receipt of the HPV vaccine) by rural and urban women over the age of 18. Findings indicate that rural women were less likely than their urban peers to receive preventive health services, and that some of the differences may be …

British Government Information Resources, Bert Chapman

Libraries Faculty and Staff Creative Materials

Provides an overview of British Government information resources. Contents include basic British economic and political background and information from British Government websites including the Department of Environment, Food, and Rural Affairs (DEFRA), Brexit related material produced by British government agencies such as the Department for Exiting the European Union,, the Ministry of Defence, the National Museum of the Royal Navy, the Home Office Visas and Immigration Section, the Office of National Statistics, Her Majesty's Treasury, the British Parliament including parliamentary committees and research agencies, the website of Member of Parliament (MP) Jacob Rees-Mogg (Conservative-North East Somerset), a webcast of House …

Nhs England Always Events® Program: Developing A National Model For Co-Production, Claire Marshall, Angela Zambeaux, Esther Ainley, David Mcnally, Jenny King Miss, Lorraine Wolfenden, Helen Lee

Patient Experience Journal

NHS England, the Institute for Healthcare Improvement, Picker and NHS Improvement started the work described in this article to strengthen how patients, carers and staff working together in co-design and co-production can make a real difference in improving experience of care. Always Events®, which is an improvement methodology for the co-design and consistent implementation of those aspects of patient experience that matter most to patients in a health care setting, was chosen. The approach has been to first test the methodology with three organizations then to spread to a substantial proportion of acute health care providers, with concurrent scale-up within …

Interprofessional Collaboration To Improve And Sustain Patient Experience Outcomes In An Ambulatory Setting, Natalie Sanchez, Kimberly Hermis

Patient Experience Journal

Patient experience is an important factor across diverse healthcare delivery settings. Despite enhanced attention to and advances in patient experience, many of the published initiatives focus on in-hospital care and opportunities have been identified to continue to strategically address patient experience in the ambulatory setting. This quality improvement initiative presents the development of an interprofessional approach to patient experience in a freestanding ambulatory oncology center. The objective of this initiative was to improve and sustain patient experience, as reflected in the Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores via Press Ganey. This approach consisted of redesigning a previously …

Twelve Principles To Support Caregiver Engagement In Health Care Systems And Health Research, Kerry Kuluski, Kristina M. Kokorelias, Allie Peckham, Jodeme Goldhar, John Petrie, Carole Anne Alloway

Patient Experience Journal

Family and friend caregivers (i.e., unpaid carers) play a critical role in meeting the needs of people across various ages and illness circumstances. Caregiver experiences and expertise, which are currently overlooked, should be considered in practice (such as designing and evaluating services) and when designing and conducting research. In order to improve the quality of health care we need to understand how best to meaningfully engage caregivers in research, policy and program development to fill this important gap. Our study aimed to determine principles to support caregiver engagement in practice and research. A pan Canadian meeting brought together 48 stakeholders …

A Case Study Of The Patient Wait Experience In An Emergency Department With Therapy Dogs, Colleen A. Dell, James Stempien, Lindsey Broberg, Alicia Husband, Lacey Jurke, Betty Rohr, Jane Smith, Joseph Rubin, Susan Tupper, Donna Goodridge, Cathie Fornssler, Logan Fele-Slaferek

Patient Experience Journal

The quality of patient healthcare is a growing concern in Canada’s hospital emergency departments (ED) due to increasing wait times and associated adverse outcomes. A developing body of literature indicates that therapy dogs can positively impact the patient experience. In 2016, members of our team partnered with the Royal University Hospital (RUH) in Saskatchewan to become the first ED in Canada to integrate a visiting therapy dog to positively impact the patient wait experience. The aim of this preliminary case study was to examine if and how this unique initiative impacted patients’ feelings during their ED wait. A brief questionnaire …

Comparing Psychiatric Care Experiences Shared Online With Validated Questionnaires; Do They Include The Same Content?, Rebecca Baines, John Donovan, Samantha Regan De Bere, Julian Archer, Ray Jones

Patient Experience Journal

Patient feedback is considered integral to patient safety and quality of care. However, limited research has compared the content of validated questionnaires with subjective patient experiences shared online. The aim of this study was to therefore identify and compare the content of psychiatric care experiences shared online with validated questionnaires. All research was conducted in co-production with a volunteer mental-health-patient-research-partner. We analysed all reviews published on the United Kingdom’s leading health and social care feedback platform Care Opinion, between 2005-2017 that discussed adult psychiatric care and compared findings with two validated questionnaires (ACP360 and General Medical Council patient feedback questionnaire). …

“Can I Still Get A Tattoo?” Patients’ Experiences Across The Clinical Trajectory For Metastatic Melanoma: A Dynamic Narrative Model Of Patient Journey, Klay Lamprell, Melvin Chin, Jeffrey Braithwaite

Patient Experience Journal

Advanced and metastatic cancer has a complex diagnostic and management profile that places a heavy long-term burden on patients and healthcare systems. Little attention has been given to patients’ experiences across their entire clinical journey. Using a qualitative, longitudinal methodology over a ten-month period, we examined the symptom-to-outcome trajectories of seven people attending a medical oncology clinic at a large, public tertiary referral center in Sydney, Australia. Rather than care being experienced as a largely linear progression through diagnosis, treatment and onto surveillance in which life may return to ‘normal’, participants are embedded in a cyclical clinical pathway. Recurrence or …

Patient Perception Of Telephone Follow-Up After Resection For Colorectal Cancer: Is It Time For An Alternative To The Out-Patient Clinic?, Marcus Gilmartin, Nicholas Leaver, George Hall, Helena Fawdry, Seung Lee, James Nicholson, Ramya Kalaiselvan, Raj Rajaganeshan

Patient Experience Journal

The economic reality of modern healthcare provides a timely reminder to clinicians of their duty to provide outstanding and cost-effective care. Although multiple guidelines outline investigation, management and surveillance of colorectal cancer, none advocate a particular delivery method. Nurse-led telephone follow-up in multiple specialties has demonstrated equivalent clinical outcomes and patient satisfaction when compared to traditional outpatient department follow-up. This paper aims to compare nurse-led telephone and outpatient follow-up, following surgical resection of colorectal cancer (CRC), focusing on patient perceptions. This cross-sectional study distributed adapted patient satisfaction questionnaire (PS-Q 18) to patients undergoing surveillance following CRC resection via either nurse-led …

How Have Patients' Experiences Of Cancer Care Been Linked To Survival? A Systematic Review, Saleh A. Alessy, Margreet Lüchtenborg Dr, Elizabeth A. Davies Dr.

Patient Experience Journal

Patient experience of care remains an important indicator of health care quality. Although studies show care experiences are associated with health outcomes for some conditions, the situation for cancer is unclear. New datasets on cancer patients in the US, Canada, and UK linking information on experiences and survival may enable an exploration of any association. This review aimed to identify studies linking any aspect of cancer patients’ experiences to their survival, to inform future analyses. We performed a systematic review using Medline database from January 1998 until March 2018.

The settings included outpatient oncology clinics, primary care, hospitals, and cancer …

Exploring Interventions To Increase Primary Care Providers’ Use Of Self-Management Goals, Nanci Reiland, Kathleen Fitzgerald, Mary E. Maragos

Patient Experience Journal

Accreditors, such as the Joint Commission, consider evidence of patient engagement strategies for awarding Primary Care/Patient-Centered Medical Home (PCMH) accreditation. This project explored the use of brief Motivational Interviewing (MI) training at a local county health center and evaluated the impact on the documented use of self-management goals (SMGs) for patients with diabetes and hypertension. Methods included a professional development program, including an online module, presentation, and educational materials. The goal was to increase providers’ MI knowledge and skills to better construct and document SMGs. The program impact was evaluated by chart review to determine the use of SMGs by …

One Patient's Experiences And Expectations In The Healthcare System: Complicated And Critical Illness With Rare Diagnosis Described By His Advocate, Jennifer Cademartori

Patient Experience Journal

The health care business serves as a profession in the art of human illness. But unlike other businesses there is the human side, the patient experience. These patients are the “customers” receiving the care, but they, unlike customers at a retail store, are vulnerable and scared and must trust their lives in the hands of people they don’t know. The paradigm must change to reflect how the health care business is handled from the eyes of the person receiving the care from the first office visit, through the inpatient stay, to follow up visits. Patient focused training on all levels …

Reframing The Conversation On Patient Experience: Three Considerations, Jason A. Wolf Phd, Cpxp

Patient Experience Journal

In experience, every voice matters, and each of those individual voices are contributing to an ocean of ripples that are positively impacting countless lives. In experience, no one organization owns, nor should claim to own all the answers, but many contribute to the possibilities found in elevating the human experience in healthcare. In experience, when we ensure this is a true strategic focus at the heart of healthcare we will find our way to achieving all the outcomes we aspire to achieve and know are possible in healthcare. This issue helps frame that reality through contributions from around the world …

From Beshear To Bevin: The Rise And Fall Of The Aca In Kentucky, Ellen Baker

Annual Undergraduate Conference on Health and Society

No abstract provided.

Fostering University Collaboration And Building Capacity To Respond To Coastal Resilience Challenges In Virginia: Findings From The Rotating Resilience Roundtables Workshop Spring 2019, Wie Yusuf, Michelle Covi, Anamaria Bukvic, Tom Allen, Taiwo Oguntuyo

Presentations, Lectures, Posters, Reports

[from Background and Overview]

Communities in coastal Virginia, particularly in the urban region of Hampton Roads and the rural Eastern Shore peninsula, are experiencing the impacts of climate change as part of everyday life. Among the most apparent impacts are sea level rise and associated flooding, but increasingly residents of the region are observing changing ecosystems, health impacts and complex social challenges are made more difficult. The region is experiencing the fastest rate of relative sea level rise on the U.S. east coast due to interactions between ocean currents, global sea level rise, high-water tables and ground subsidence (Adapt Virginia …

Restricted Access And Delays To Hcv Treatment Among Medicaid Patients In Louisiana, Morris M. Kim, Keanan M. Mcgonigle

Journal of Health Disparities Research and Practice

Background: Many people living with chronic Hepatitis C Virus (HCV) have seen delays in accessing treatment or been denied entirely due to Medicaid restrictions requiring patients to meet certain criteria prior to receiving approval for medication pre-authorization.

Methods: This study identified a cohort of Medicaid-insured patients with chronic HCV infection within New Orleans, LA. Patient medical records were reviewed and information regarding HCV care was gathered. This study sought to determine the degree to which HCV care was delayed for this population and describe common reasons for prior-authorization denials for direct-acting antiviral (DAA) medications.

Results: For this population of Medicaid-insured …

Regulatory Disclosure Policies And Potential Induced Changes In Behavior: An Outcome Evaluation Of Santa Clara County’S Enhanced Food Safety Program Elements, Christian Cruz

Master's Projects

Despite countless advances in food microbiology and public health regulations, foodborne illness continues to be a major strain on public health outcomes and a costly economic burden. In the United States, many agencies are responsible for ensuring the quality of food, both domestically produced and imported. States and localities are delegated the responsibility of identifying and ensuring sound practices in the latter stages of the food production process, namely the retail distribution of food products to consumers.

Regulatory policies across the nation have only recently incorporated the evidenced-based principles of hazard risk management (Law, 2003). Still, food-related acute gastrointestinal illnesses …