scholarly journals Patient Self-Reported Health, Clinical Quality, and Patient Satisfaction in English Primary Care: Practice-Level Longitudinal Observational Study

2021 ◽  
Author(s):  
Yan Feng ◽  
Hugh Gravelle
2019 ◽  
Vol 7 (4) ◽  
pp. e000208
Author(s):  
Rebecca Vitale ◽  
Samantha Smith ◽  
Benjamin R Doolittle

ObjectiveThe objective of this study was to improve the telephone communication experience for patients in a primary care practice.DesignAn exploratory survey was conducted that revealed suboptimal patient satisfaction with clinic access due to the telephone triage system. Several interventions were designed: a monthly quality meeting was established among clinic staff, all phone interactions were recorded in the electronic medical record (EMR) and clinic appointments were made available several months in advance. A follow-up survey was conducted to evaluate these interventions.SettingThe study was conducted in a multispecialty, urban-based, resident-faculty practice from November 2016 to November 2017.ParticipantsSubjects were recruited in a convenience sample from the waiting room. 200 subjects participated in the initial survey and 215 in the second survey.ResultsAfter the interventions, patients felt that their questions were answered more frequently than before (p<0.01). They also felt that appointments were easier to make (p=0.03). A similar number of patients reported seeking emergency care because they were unable to reach a provider (33.8% vs 31.9%, p=0.68). The percentage of patients who received a call back within 24 hours increased, but it was not statistically significant (38.6% vs 44%, p=0.13).ConclusionImproving telephone triage through implementing a monthly quality improvement meeting, optimising use of the EMR and opening schedules several months in advance resulted in several improvements in the patient experience, but did not change use of emergency services. Further interventions, including increased resource allocation, are needed to optimise patient experience.


2021 ◽  
Author(s):  
Lenard I Lesser ◽  
Raj Behal

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.


2020 ◽  
Vol 8 (3) ◽  
pp. 288-297
Author(s):  
Tyanna C. Snider ◽  
Whitney J. Raglin Bignall ◽  
Cody A. Hostutler ◽  
Ariana C. Hoet ◽  
Bethany L. Walker ◽  
...  

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