scholarly journals Diversity, Equity and Inclusion in an Age-Friendly Health System

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 942-943
Author(s):  
Elizabeth Eckstrom ◽  
Emily Morgan ◽  
Bryanna de Lima ◽  
Anna Pleet
Keyword(s):  
Health Systems ◽  
Demographic Data ◽  
Cognitive Screening ◽  
Patient Centered ◽  
Centered Care ◽  
Core Elements ◽  
English Speaking ◽  
Internal Medicine Clinic ◽  
Equity And Inclusion ◽  
What Matters

Abstract The Age-Friendly Health Systems (AFHS) initiative uses a 4Ms framework to encourage patient-centered care for older adults. Many health systems have implemented the core elements of AFHS – What Matters, Mentation (Cognition and Depression), Medications, and Mobility – with the goal to uniformly apply these elements to all patients 65 years and older. However, equity in AFHS delivery has not yet been examined. Five diversity, equity, and inclusion (DEI) factors, including gender, race, ethnicity, preferred language and MyChart activation, were cross-sectionally analyzed against the 4Ms framework for patients seen (in person or virtual visit) in an academic internal medicine clinic between April 2020 and April 2021 (N= 3370) using two-way contingency tables. Preferred language, gender, and MyChart activation yielded significant pairings with the 4M metrics. For the AFHS What Matters metric, females were 1.10 times more likely than males and English-speaking patients were 1.67 times more likely than non-English speaking patients to receive advance care planning (p <0.01). Females and patients with MyChart activation were about 2.0 times more likely to have a high-risk medication on their medication list compared to males and patients without MyChart activation (p <0.01). MyChart activation was also significantly associated with cognitive screening. Patients with MyChart activation were 1.09 times more likely than patients without MyChart activation to get cognitive screening (p <0.001). This study, the first to incorporate demographic data, into AFHS quality measures, suggest a need to develop best practices for equitable Age-Friendly care at the clinical team and the institutional policy level.

scholarly journals Su salud a la mano (your health at hand): patient perceptions about a bilingual patient portal in the Los Angeles safety net

2019 ◽  
Vol 26 (12) ◽  
pp. 1525-1535 ◽  
Author(s):  
Alejandra Casillas ◽  
Giselle Perez-Aguilar ◽  
Anshu Abhat ◽  
Griselda Gutierrez ◽  
Tanya T Olmos-Ochoa ◽  
...  
Keyword(s):  
Los Angeles ◽  
Technology Acceptance ◽  
Health Systems ◽  
Safety Net ◽  
Patient Portal ◽  
Annual Household Income ◽  
Patient Centered ◽  
Spanish Speaking ◽  
English Speaking ◽  
Education Support

Abstract Objectives Driven by beneficial patient-centered outcomes associated with patient portal use and the Affordable Care Act, portal implementation has expanded into safety nets—health systems that offer access to care to a large share of uninsured, Medicaid, and other vulnerable populations. However, little attention has been paid to the factors that affect portal accessibility by the vulnerable patients served by these health systems—including those who are limited English proficient (LEP). Materials and Methods The Los Angeles County Department of Health Services (LAC DHS), the second-largest safety net system in the nation, launched its first patient portal, and one of the few bilingual English-Spanish interfaces in existence, in March of 2015. To explore portal awareness and perceptions, we conducted focus groups with LAC DHS patients, in English and Spanish (LEP). The Technology Acceptance Model was used to guide thematic analysis of focus group data. Results Of the 46 participants, 37 were patients and 9 were caretakers; 23 were English-speaking and 23 Spanish-speaking LEP. All patients had diabetes or hypertension. Over half had an annual household income <$10 000, yet 78% of English-speaking and 65% of Spanish-speaking LEP participants reported at-home Internet access. Participants’ discussion centered around 3 major thematic narratives: (1) participants’ awareness or attitudes about the LAC DHS portal; (2) role of culture, language, or community with regard to portal accessibility and utility; and (3) perceived needs for successful portal implementation. Conclusions Safety net participants identified concrete benefits to the portal and emphasized the need for portal engagement that offered accessible education, support, and resources in clinical and community settings. The portal offers an additional opportunity to engage the patient and family with trusted and validated health information, and should be further developed in this capacity. This study provides a better understanding of preferred improvements of patient portal engagement that guide broader health technology efforts to address electronic health disparities.

scholarly journals “What Matters to You?”: A pilot project for implementing patient-centered care

2016 ◽  
Vol 3 (2) ◽  
pp. 130-137
Author(s):  
Anthony M DiGIoia ◽  
Sarah B Clayton ◽  
Michelle B Giarrusso
Keyword(s):  
Pilot Project ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Centered Care ◽  
What Matters

Antecedent Context and Structure of Communication During a Caring Moment: Scoping Review and Analysis

2015 ◽  
Vol 19 (2) ◽  
pp. 7-21
Author(s):  
Zane Robinson Wolf ◽  
Beth M. King ◽  
Nancey E. M. France
Keyword(s):  
Thematic Analysis ◽  
Scoping Review ◽  
Nursing Faculty ◽  
Communication Process ◽  
Patient Centered ◽  
Data Synthesis ◽  
Search Terms ◽  
Care Relationship ◽  
Centered Care ◽  
Core Elements

This scoping review and analysis of related literature induced the structure of the nurse-patient communication process during a caring moment. Data sources consisted of literature from databases, using the search terms of caring encounter, caring moment, nurse, nursing, patient, patient-centered care, relationship, and communication, and related theories and personal collections of investigators. Using thematic analysis, investigators reviewed citations for units of text with similar meanings indicating structures of a caring moment. Data synthesis produced the structure of the caring moment presented as a narrative. Results provide nursing faculty an opportunity to examine core elements of the caring moment with students.

The Role of Shared Decision-Making in Audiologic Rehabilitation

2014 ◽  
Vol 21 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Helen Pryce ◽  
Amanda Hall
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Behavior Changes ◽  
Shared Decision ◽  
Patient Centered ◽  
Treatment Information ◽  
Centered Care ◽  
Potential Risks ◽  
Audiologic Rehabilitation

Shared decision-making (SDM), a component of patient-centered care, is the process in which the clinician and patient both participate in decision-making about treatment; information is shared between the parties and both agree with the decision. Shared decision-making is appropriate for health care conditions in which there is more than one evidence-based treatment or management option that have different benefits and risks. The patient's involvement ensures that the decisions regarding treatment are sensitive to the patient's values and preferences. Audiologic rehabilitation requires substantial behavior changes on the part of patients and includes benefits to their communication as well as compromises and potential risks. This article identifies the importance of shared decision-making in audiologic rehabilitation and the changes required to implement it effectively.

Principles of Solution Focused Therapy and Their Application to Audiology

2014 ◽  
Vol 15 (1) ◽  
pp. 27-33
Author(s):  
James C. Blair
Keyword(s):  
Basic Assumption ◽  
Current Practice ◽  
Helping Professions ◽  
Patient Centered ◽  
Therapy Approach ◽  
Agents Of Change ◽  
Centered Care ◽  
Client Centered Therapy ◽  
Solution Focused ◽  
Solution Focused Therapy

The concept of client-centered therapy (Rogers, 1951) has influenced many professions to refocus their treatment of clients from assessment outcomes to the person who uses the information from this assessment. The term adopted for use in the professions of Communication Sciences and Disorders and encouraged by The American Speech-Language-Hearing Association (ASHA) is patient-centered care, with the goal of helping professions, like audiology, focus more centrally on the patient. The purpose of this paper is to examine some of the principles used in a patient-centered therapy approach first described by de Shazer (1985) named Solution-Focused Therapy and how these principles might apply to the practice of audiology. The basic assumption behind this model is that people are the agents of change and the professional is there to help guide and enable clients to make the change the client wants to make. This model then is focused on solutions, not on the problems. It is postulated that by using the assumptions in this model audiologists will be more effective in a shorter time than current practice may allow.

Sign in / Sign up

Export Citation Format

Share Document