integrated health care delivery

Ana Licina, Andrew Silvers, Harry Laughlin, Jeremy Russell, Crispin Wan
BACKGROUND: The best evidence-enhanced recovery care pathway is yet to be defined for patients undergoing spinal surgery. Minimally invasive surgery, multimodal analgesia, early mobilization, and early postoperative nutrition have been considered as critical components of enhanced recovery in spinal surgery (ERSS). The objective of this study will be to synthesize the evidence underpinning individual components of a proposed multidisciplinary enhanced recovery pathway for patients undergoing spinal surgery...
February 21, 2020: Systematic Reviews
Naomi Lince-Deroche, Cheryl Hendrickson, Aneesa Moolla, Sharon Kgowedi, Masangu Mulongo
BACKGROUND: Healthcare providers' skills and attitudes are both barriers and facilitators of contraceptive uptake. In South Africa, migration of healthcare workers and the demands of the HIV epidemic have also contributed to inequitable access to sexual and reproductive health (SRH) care. Yet, the country has committed to achieving universal access to SRH services. We explored healthcare provider's opinions and attitudes on provision of contraceptive services in public facilities, their personal use of methods, and their thoughts on the recent integration of new contraceptive methods in their facilities...
February 21, 2020: BMC Health Services Research
Carmen D Samuel-Hodge, Ziya Gizlice, Sallie D Allgood, Audrina J Bunton, Amber Erskine, Jennifer Leeman, Samuel Cykert
BACKGROUND: Community Health Workers (CHW) are recommended for delivery of interventions to prevent cardiovascular disease, but there is insufficient evidence to guide implementation of CHW interventions in rural, medically underserved areas. METHODS: Using a hybrid implementation-effectiveness design, we evaluated the implementation and effectiveness of an adapted, evidence-based cardiovascular disease risk reduction intervention among rural high-risk adults. CHWs at a community health center and local health department recruited, enrolled and counseled participants during 4 monthly home visits and 3 brief phone contacts...
February 21, 2020: BMC Public Health
Stephanie L Smith, Molly F Franke, Christian Rusangwa, Hildegarde Mukasakindi, Beatha Nyirandagijimana, Robert Bienvenu, Eugenie Uwimana, Clemence Uwamaliya, Jean Sauveur Ndikubwimana, Sifa Dorcas, Tharcisse Mpunga, C Nancy Misago, Jean Damascene Iyamuremye, Jeanne d'Arc Dusabeyezu, Achour A Mohand, Sidney Atwood, Robyn A Osrow, Rajen Aldis, Shinichi Daimyo, Alexandra Rose, Sarah Coleman, Anatole Manzi, Yvonne Kayiteshonga, Giuseppe J Raviola
INTRODUCTION: To address the know-do gap in the integration of mental health care into primary care in resource-limited settings, a multi-faceted implementation program initially designed to integrate HIV/AIDS care into primary care was adapted for severe mental disorders and epilepsy in Burera District, Rwanda. The Mentoring and Enhanced Supervision at Health Centers (MESH MH) program supported primary care-delivered mental health service delivery scale-up from 6 to 19 government-run health centers over two years...
2020: PloS One
Ashley M Kranz, Rachel Ross, Mark Sorbero, Aaron Kofner, Bradley D Stein, Andrew W Dick
BACKGROUND: Integrating preventive oral health services (POHS) into medical offices may ease access to care for children with intellectual and developmental disabilities (IDD). The authors examined the impact of state policies allowing delivery of POHS in medical offices on receipt of POHS among Medicaid enrollees with IDD. METHODS: The authors used 2006 through 2014 Medicaid data for children with IDD aged 6 months through 5 years from 38 states. IDD were defined using 14 condition codes from Centers for Medicare & Medicaid Services Chronic Conditions Data Warehouse...
February 17, 2020: Journal of the American Dental Association
Nancy Howell Agee
Quality and safety are the top priorities of every hospital and health system. Patients put their trust in us as healthcare leaders, often in the most vulnerable moments of their lives, and we must respond with high-quality, highly reliable, and compassionate care.Patients have the right to expect the best return for their healthcare dollars. Recognizing that expectation, progressive hospitals and health systems are embracing the move to value-based care and are enhancing affordability. The goal is to provide greater value to patients by improving quality, lowering costs, and enhancing the patient experience...
2020: Frontiers of Health Services Management
Bayan Teisho Takizawa, Stephen Christopher Born, Salvatore Mascia
There is a tremendous opportunity to modernize the pharmaceutical manufacturing industry-relinquishing outdated machines that have been used for decades, and replacing them with state-of-the-art equipment that reflect more contemporary advanced technologies. This article describes how the implementation of continuous manufacturing, replacing outdated batch systems, can positively impact our health care sector. Important benefits will include the creation of advanced pharmaceutical manufacturing jobs in the United States, the establishment of capabilities and capacity to quickly produce drugs critical to U...
January 7, 2020: Military Medicine
Ilana Graetz, Jie Huang, Emilie R Muelly, Bruce Fireman, John Hsu, Mary E Reed
Importance: Online patient portals support self-management, and mobile devices expand portal access, but whether this translates to improvements in diabetes outcomes is unclear. Objective: To examine the association of adding mobile patient portal access with diabetes medication adherence and glycemic levels among adults with diabetes. Design, Setting, and Participants: This retrospective cohort study included patients with diabetes treated at Kaiser Permanente Northern California, a large, integrated health care delivery system, from April 1, 2015, to December 31, 2017...
February 5, 2020: JAMA Network Open
Maria R Shirey, Cynthia S Selleck, Connie White-Williams, Michele Talley, Doreen C Harper
The purpose of this paper is to describe the development, implementation, and lessons learned associated with an interprofessional collaborative practice (IPCP) care delivery model initiated at the University of Alabama at Birmingham (UAB). The model emphasizes transitional care coordination in chronic disease management for underserved and vulnerable populations. The model operates within a clinic environment with care providers from a variety of disciplines who integrate individual case management and actualize leadership taken by the appropriate discipline based on the needs of each patient...
February 19, 2020: Population Health Management
Alaia Harvie, Amie Steel, Jon Wardle
Introduction: Classical Chinese medicine (CCM) encompasses many simple lifestyle recommendations which can be adopted into daily routines in support of short and long-term health outcomes. The rise in non-communicable diseases (NCDs) globally in recent decades has led to a need for cost-effective and scalable health care interventions to address lifestyle risk for NCDs in the community. This analysis explores the experience of staff and practitioners delivering a CCM community health care program designed to improve health behaviors in the community in rural Scotland...
March 2020: Integrative Medicine Research
Aznida Firzah Abdul Aziz, Nor Azlin Mohd Nordin, Amrizal Muhd Nur, Saperi Sulong, Syed Mohamed Aljunid
BACKGROUND: The delivery of post stroke care is fragmented even in advanced public healthcare systems, globally. Primary care teams are entrusted to provide longer term care for stroke survivors in most developing countries. The integrated Care Pathway for Post Stroke patients (iCaPPS© ) was designed to guide primary care teams to incorporate further rehabilitation and regular screening for post stroke complications among patients residing at home in communities, using the shared-care approach, especially in areas with limited access to specialist stroke care services...
February 18, 2020: BMC Geriatrics
Lindsey A Herrel, Ziwei Zhu, Jennifer J Griggs, Deborah R Kaye, James M Dupree, Chandy S Ellimoottil, David C Miller
PURPOSE: To determine whether the type of delivery system is associated with intensity of care at the end of life for Medicare beneficiaries with cancer. PATIENTS AND METHODS: We used SEER registry data linked with Medicare claims to evaluate intensity of end-of-life care for patients who died of one of ten common cancers diagnosed from 2009 through 2014. Patients were categorized as receiving the majority of their care in an integrated delivery system, designated cancer center, health system that was both integrated and a certified cancer center, or health system that was neither...
February 18, 2020: JCO oncology practice
Sahar Elyahoodayan, Christopher Larson, Angelica M Cobo, Ellis Meng, Dong Song
BACKGROUND: Extraneural cuffs are among the least invasive peripheral nerve interfaces as they remain outside the nerve. However, compared with more invasive interfaces, these electrodes may suffer from lower selectivity and sensitivity since the targeted nerve fibers are more distanced from the electrodes. NEW METHOD: A lyse-and-attract cuff electrode (LACE) was enabled by microfabrication and developed to improve selectivity and sensitivity while maintaining a cuff format...
February 14, 2020: Journal of Neuroscience Methods
Carlos Iribarren, Malini Chandra, Sabee Molloi, Danny Sam, Gabriela Sanchez, Fatemeh Azamian Bidgoli, Hyo-Min Cho, Huanjun Ding, Joan C Lo
Context: The association between bone mineral density (BMD) and breast arterial calcification (BAC) remains poorly understood and controversial. Objective: The objective of this article is to examine the association between BMD and BAC in a large cohort of postmenopausal women undergoing routine mammography. Design: A cross-sectional analysis of baseline data from a multiethnic cohort was performed. Setting: The setting for this analysis is an integrated health care delivery system in Northern California in the United States...
February 1, 2020: Journal of the Endocrine Society
Lynn Leppla, Juliane Mielke, Maria Kunze, Oliver Mauthner, Alexandra Teynor, Sabine Valenta, Jasper Vanhoof, Fabienne Dobbels, Lut Berben, Robert Zeiser, Monika Engelhardt, Sabina De Geest
PURPOSE: We report on our contextual analysis's methodology, as a first step of an implementation science project aiming to develop, implement, and test the effectiveness of an integrated model of care in SteM-cell transplantatIon faciLitated by eHealth (SMILe). METHODS: We applied an explanatory sequential mixed-methods design including clinicians and patients of the University Hospital Freiburg, Germany. Data were collected from 3/2017 to 1/2018 via surveys in 5 clinicians and 60 adult allogeneic stem-cell transplantation patients...
January 22, 2020: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
Maria Brenner, Miriam P O'Shea, Philip Larkin, Jay Berry
BACKGROUND: The number of children requiring long-term home ventilation has consistently increased over the last 25 years. Given the growing population of children with complex care needs (CCNs), this was an important area of focus within the Models of Child Health Appraised (MOCHA) project, funded by the European Union (EU) under the Horizon 2020 programme. We examined the structures and processes of care in place for children with CCNs and identified key constituents for effective integration of care for these children at the community and acute care interface across 30 EU/ European Economic Area (EEA) countries...
February 15, 2020: BMC Pediatrics
J Bauer, S Rohner-Rojas, M Holderried
Cross-enterprise electronic patient records are a key element in the design of interoperable medical care networks and process chains. However, the different requirements concerning type, performance and quality assurance of available communication services within the different healthcare sectors still require that the hospitals participate in various secure communication networks which have to be bridged for cross-sectoral communication. Cross-institutional pathways for telemedicine, however, can be mapped both within and across sectoral boundaries via automated process chains using the IHE (Integrating the Healthcare Enterprise) defined integration profile CrossEnterprise Document Sharing (XDS) and associated integration profiles...
February 14, 2020: Der Radiologe
Agnes Rupp, Michael C Freed, Denise Juliano-Bult
INTRODUCTION: The authors are health scientist administrators at the National Institute of Mental Health (NIMH). The mission of NIMH is "to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure." As part of its portfolio, NIMH supports research on mental health economics, and mental health services research. METHOD: In this perspective article, the authors comment on two papers presented at the NIMH-sponsored Mental Health Services Research Conference in 2018 and subsequently published in the September 2019 issue of the Journal of Mental Health Policy and Economics...
December 1, 2019: Journal of Mental Health Policy and Economics
Shalini Ahuja, Azaz Khan, Lucy Goulding, Rachel Kaur Bansal, Rahul Shidhaye, Graham Thornicroft, Mark Jordans
Background: Mental health information systems are, in general, inadequate and unreliable in India. We have developed key mental health indicators for measuring mental health service coverage in primary care. This study aims to evaluate the use of these new indicators in seven health care facilities in Sehore District of Madhya Pradesh in India. Methods: The study employed a mixed methods approach. We conducted: a qualitative study (n = 26) with health workers, Health Management Information Systems (HMIS) staff, project coordinators and supervisors; a review of case records (n = 61 at time 1 and n = 74 at time 2); and a structured questionnaire (n = 26) with health workers...
2020: International Journal of Mental Health Systems
Tone M Norekvål, Heather G Allore, Bjørn Bendz, Cathrine Bjorvatn, Britt Borregaard, Gunhild Brørs, Christi Deaton, Nina Fålun, Heather Hadjistavropoulos, Tina Birgitte Hansen, Stig Igland, Alf Inge Larsen, Pernille Palm, Trond Røed Pettersen, Trine Bernholdt Rasmussen, Jan Schjøtt, Rikke Søgaard, Irene Valaker, Ann Dorthe Zwisler, Svein Rotevatn
INTRODUCTION: Percutaneous coronary intervention (PCI) aims to provide instant relief of symptoms, and improve functional capacity and prognosis in patients with coronary artery disease. Although patients may experience a quick recovery, continuity of care from hospital to home can be challenging. Within a short time span, patients must adjust their lifestyle, incorporate medications and acquire new support. Thus, CONCARDPCI will identify bottlenecks in the patient journey from a patient perspective to lay the groundwork for integrated, coherent pathways with innovative modes of healthcare delivery...
February 12, 2020: BMJ Open
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