scholarly journals Using the Teamlet Model to Improve Chronic Care in an Academic Primary Care Practice

2010 ◽  
Vol 25 (S4) ◽  
pp. 610-614 ◽  
Author(s):  
Ellen H. Chen ◽  
David H. Thom ◽  
Danielle M. Hessler ◽  
La Phengrasamy ◽  
Hali Hammer ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Care ◽  
Primary Care Practice ◽  
Care Practice ◽  
Academic Primary Care

scholarly journals Longitudinal, multidisciplinary, resident-driven intervention to increase immunisation rates for Medicaid, low-income and uninsured patients

2020 ◽  
Vol 9 (4) ◽  
pp. e000986
Author(s):  
Cynthia Cantu ◽  
Kristopher Koch ◽  
Ramon S Cancino
Keyword(s):  
Primary Care ◽  
Low Income ◽  
Primary Care Practice ◽  
Care Practice ◽  
Waiting Room ◽  
Improvement Project ◽  
Vaccination Rates ◽  
Initial Intervention ◽  
Risk Patients ◽  
Academic Primary Care

IntroductionMore payers are closely linking reimbursement to high-value care outcomes such as immunisation rates. Despite this, there remain high rates of pneumonia and influenza-related hospitalisations generating hospital expenditures as high as $11 000 per hospitalisation. Vaccinating the public is an integral part of preventing poor health and utilisation outcomes and is particularly relevant to high-risk patients. As part of a multidisciplinary effort between family and internal medicine residency programmes, our goal was to improve vaccination rates to an average of 76% of eligible Medicaid, low-income and uninsured (MLIU) patients at an academic primary care practice.MethodsThe quality improvement project was completed over 3 months by three primary care resident groups. The setting was a suburban academic primary care practice and eligible patients were 18 years of age or older. Our aim was to increase immunisation rates of pneumococcal, influenza, varicella, herpes zoster virus and tetanus and diphtheria vaccination. There were 1690 patients eligible for the vaccination composite metric. Data were derived from the electronic health record and administrative data.InterventionsCohort 1 developed an initial intervention that consisted of a vaccine questionnaire for patients to complete while in the waiting room. Cohort 2 modified questionnaire after reviewing results from initial intervention. Cohort 3 recommended elimination of questionnaire and implementation of a bundled intervention approach.ResultsThere were minimal improvements in patient immunisation rates after using a patient-directed paper questionnaire. After implementation of multiple interventions via an improvement bundle, there were improvements in immunisation rates which were sustained and the result of special cause variation.ConclusionA key to improving immunisation rates for MLIU patients in this clinic was developing relationships with faculty and staff stakeholders. We received feedback from all the medical staff and then applied it to the interventions and made an impact in the average of vaccinations.

Implementing the Chronic Care Model for Improvements in Diabetes Care and Education in a Rural Primary Care Practice

2005 ◽  
Vol 31 (2) ◽  
pp. 225-234 ◽  
Author(s):  
Linda M. Siminerio ◽  
Gretchen Piatt ◽  
Janice C. Zgibor
Keyword(s):  
Primary Care ◽  
Patient Outcomes ◽  
Chronic Care ◽  
Primary Care Practice ◽  
Self Management ◽  
Standards Of Care ◽  
Care Practice ◽  
Practice Setting ◽  
Care Model ◽  
Rural Primary Care

Purpose The purpose of this pilot study was to determine the impact of implementing elements of the chronic care model (CCM; decision support, self-management, and delivery system redesign) on providers' diabetes care practices and patient outcomes in a rural practice setting. Methods In this pilot study, 104 patients with type 2 diabetes and 6 providers in a rural primary care practice were involved in an intervention that included a certified diabetes educator (CDE) who educated and supported providers on diabetes management and adherence to the American Diabetes Association (ADA) Standards of Care over the year of the project. The CDE also provided diabetes self-management education (DSME) at the office site for 29 of the 104 patients who received their care in the practice. The following variables were evaluated: provider perceived barriers to care and adherence to ADA standards of care and patient A1C, blood pressure, cholesterol, knowledge, and empowerment levels. Results Provider adherence to ADA Standards of Care increased significantly across all process measures. Patients who received DSME at point of service in the primary care practice setting gained improvements in knowledge, empowerment, A1C, and high-density lipoprotein cholesterol levels. Conclusions Implementing systems to support decision support, selfmanagement education, and delivery system redesign has a positive influence on practices and patient outcomes in outlying rural communities.

scholarly journals Preventive Health Care Among Older Women in an Academic Primary Care Practice

2008 ◽  
Vol 18 (4) ◽  
pp. 249-256 ◽  
Author(s):  
Mara A. Schonberg ◽  
Meghan York ◽  
Nisha Basu ◽  
Daniele Ölveczky ◽  
Edward R. Marcantonio
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Older Women ◽  
Primary Care Practice ◽  
Preventive Health Care ◽  
Preventive Health ◽  
Care Practice ◽  
Academic Primary Care

Improving the Implementation of Lung Cancer Screening Guidelines at an Academic Primary Care Practice

2017 ◽  
pp. 1 ◽  
Author(s):  
Alison T. Brenner ◽  
Laura Cubillos ◽  
Katherine Birchard ◽  
Caleb Doyle-Burr ◽  
John Eick ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Primary Care ◽  
Cancer Screening ◽  
Primary Care Practice ◽  
Lung Cancer Screening ◽  
Care Practice ◽  
Screening Guidelines ◽  
Academic Primary Care

scholarly journals Evaluating a Model to Predict Primary Care Physician-Defined Complexity in a Large Academic Primary Care Practice-Based Research Network

2015 ◽  
Vol 30 (12) ◽  
pp. 1741-1747 ◽  
Author(s):  
Clemens S. Hong ◽  
Steven J. Atlas ◽  
Jeffrey M. Ashburner ◽  
Yuchiao Chang ◽  
Wei He ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physician ◽  
Primary Care Practice ◽  
Care Physician ◽  
Research Network ◽  
Care Practice ◽  
Practice Based Research ◽  
Academic Primary Care

scholarly journals Change in glycemic control for patients enrolled in a membership-based primary care program: longitudinal observational study (Preprint)

2021 ◽  
Author(s):  
Lenard I Lesser ◽  
Raj Behal
Keyword(s):  
Primary Care ◽  
Observational Study ◽  
Chronic Care Model ◽  
Chronic Care ◽  
Primary Care Practice ◽  
Care Service ◽  
Care Practice ◽  
Care Model ◽  
Diabetes Registry ◽  
Uncontrolled Diabetes

BACKGROUND Both primary care practices based on the Chronic Care Model (CCM) and digital therapeutics have been shown to improve the care of patients with diabetes. OBJECTIVE This observational study examines the change in diabetes control for patients enrolled in a membership-based primary care service that is based on the CCM. METHODS Using a diabetes registry, we analyzed change in HbA1c for patients with uncontrolled diabetes mellitus (initial HbA1c >=9%). All patients had access to a technology-enhanced primary care practice built on the chronic care model. RESULTS The registry included 621 patients diagnosed with uncontrolled diabetes. All patients had at least two HbA1c measurements, with the average time between the first and last measurement of 1.2 years (SD=0.4). The average starting value of HbA1c was 10.7, which decreased to 8.7, corresponding to a -2.03 (p<0.001) reduction. Secondary analyses showed statistically significant reductions in total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides. CONCLUSIONS Patients with initially uncontrolled diabetes who undergo care in a technology-enhanced primary care practice based on the CCM have long-term clinically meaningful reductions in HbA1c.

scholarly journals Hepatitis B Screening in a US Academic Primary Care Practice

2012 ◽  
Vol 172 (19) ◽  
pp. 1517
Author(s):  
Nicole M. Loo ◽  
W. Ray Kim ◽  
Joseph J. Larson ◽  
Mark L. Wieland ◽  
Rajeev Chaudhry
Keyword(s):  
Primary Care ◽  
Hepatitis B ◽  
Primary Care Practice ◽  
Care Practice ◽  
Academic Primary Care ◽  
Hepatitis B Screening

scholarly journals Utilizing Lean Leadership Principles to Build an Academic Primary Care Practice of the Future

2020 ◽  
Vol 35 (12) ◽  
pp. 3650-3655
Author(s):  
Sasha Morduchowicz ◽  
Jonathan S. Lee ◽  
Lei Choi ◽  
Coleen Kivlahan ◽  
Dan Null ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Practice ◽  
Care Practice ◽  
The Future ◽  
Academic Primary Care
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