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

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Major Depressive Disorder, Somatic Pain, and Health Care Costs in an Urban Primary Care Practice

The Journal of Clinical Psychiatry ◽

10.4088/jcp.v67n0809 ◽

2006 ◽

Vol 67 (08) ◽

pp. 1232-1239 ◽

Cited By ~ 50

Author(s):

Marc J. Gameroff ◽

Mark Olfson

Keyword(s):

Primary Care ◽

Health Care ◽

Major Depressive Disorder ◽

Depressive Disorder ◽

Health Care Costs ◽

Primary Care Practice ◽

Care Practice ◽

Major Depressive ◽

Somatic Pain ◽

Care Costs

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The Experience of Working With a Faith Community Nurse Liaison of Care in a Primary Care Practice Among Older Adult Clients and Their Informal Caregiver

Journal of Holistic Nursing ◽

10.1177/0898010120977327 ◽

2020 ◽

pp. 089801012097732

Author(s):

Loralee Sessanna ◽

Sherry H. Pomeroy ◽

Yvonne Askew ◽

Kathleen McDonald-Shanahan ◽

Maureen Couche

Keyword(s):

Primary Care ◽

Health Care ◽

Older Adult ◽

Primary Care Practice ◽

Informal Caregiver ◽

Informal Caregivers ◽

Essential Element ◽

Faith Community ◽

Care Practice ◽

Community Nurse

Informal caregivers of older adults aging in place are at risk for adverse health and financial consequences. This descriptive qualitative study explored the experience of working with a faith community nurse (FCN) liaison of care in a Catholic health care system affiliated primary care practice among older adult clients and their informal caregiver. Semistructured face-to-face interviews were conducted with nine older adult client–informal caregiver dyads, three clients, and one caregiver ( n = 22). Interviews were audio recorded, transcribed, and analyzed using Braun and Clarke’s reflexive thematic analysis method. The analysis generated one overarching theme, I’m Sorry the Study and FCN Visits Are Coming to an End, and two key themes, The FCN Was Always There to Help Us (older adult clients) and The FCN Took the Pressure Off of Caregiving for Awhile (informal caregivers). Participants viewed the FCN as an instrumental member of their health care team and considered prayer and spiritual support offered by the FCN an essential element of care.

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

BMJ Open Quality ◽

10.1136/bmjoq-2020-000986 ◽

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.

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