Abstract NS3: A Comprehensive Post-Acute Stroke Services (COMPASS) Website for Public Use

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Sylvia Coleman ◽  
Meghan Radman ◽  
Mysha Sissine ◽  
Pamela Duncan ◽  
Cheryl Bushnell ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Human Services ◽  
Transitional Care ◽  
Care Plan ◽  
Evidence Based ◽  
Care Providers ◽  
Educational Materials ◽  
Health And Human Services ◽  
Stroke Services

Background: Stroke patients, caregivers, and health and human services are in need of organized, evidence-based resources to improve post-acute care and outcomes. Educational materials vetted by stakeholders are scarce and difficult to develop. The COMprehensive Post-Acute Stroke Services (COMPASS) Study developed online resources by discipline for clinical providers, patients, caregivers, and health and human services teams. Purpose: This presentation introduces the COMPASS website content available and ready for immediate use to support post-acute stroke care quality improvement. Methods: Materials were developed as a component of the PCORI-funded COMPASS Study designed to implement and evaluate comprehensive transitional care (TC) for stroke survivors. Patients discharged home from 41 NC hospitals after a stroke or TIA received COMPASS TC which incorporated Centers for Medicare and Medicaid (CMS) recommendations: a follow-up phone call within two days of discharge; a comprehensive follow-up clinic visit; and delivery of a patient care plan. An interdisciplinary team of health care providers, stakeholders, and researchers developed patient and caregiver educational materials tested for sixth grade literacy, a community resource directory, and training materials for implementation of COMPASS TC that are available on the COMPASS website at www.nccompass-study.org/. Results: Educational products, including a directory of resources, training manuals, recorded webinars, instructional handouts, animated videos, and patient/caregiver materials are on the COMPASS website. An electronic application called COMPASS-Care Plan (CP) also developed can be readily integrated into Epic and Cerner electronic health records. COMPASS-CP was developed to streamline the delivery of the TC model. Since the website was made public July 1, 2019, there have been 616 views from 15 countries with the majority reviewing patient/caregiver resources. Conclusions: The COMPASS website provides health and human services teams with organized, evidence-based resources to support delivery and management of post-acute transitional care for patients and caregivers.

Abstract 184: Patterns of Outpatient Follow-up after Acute Myocardial Infarction: Follow-up Frequency is Associated with Utilization of Evidence-based Therapies

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Rebecca Vigen ◽  
Yan Li ◽  
Thomas M Maddox ◽  
Stacie Daugherty ◽  
Steven M Bradley ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Primary Outcome ◽  
Beta Blockers ◽  
Primary Care Providers ◽  
Risk Scores ◽  
Evidence Based ◽  
Care Providers ◽  
Multivariable Analyses

Background: ACC/AHA guidelines recommend that patients with acute myocardial infarction (AMI) follow-up within several weeks of hospital discharge. Recommendations regarding intensity of following-up in the year following AMI are not provided. The relationship between frequency of follow-up and use of evidence-based therapies following AMI is unknown. Methods: 6,838 patients from 2 multicenter prospective AMI registries, PREMIER and TRIUMPH registries were studied. We divided the number of patient self-reported outpatient follow-up visits with cardiologists, primary care providers, or both into tertiles: low, medium, and high. The primary outcome was use of statins, beta blockers, aspirin, ACE/ARBs, and a composite of all four medications at 12 months among eligible patients. The association between tertiles of visits following AMI among patients who had at least one visit and primary outcome was evaluated using hierarchical multivariable modified Poisson models. Results: Mean number of follow-up visits in the year following AMI was 6 (IQR 3 - 8) and 189 (4%) of patients had no visits. In lowest tertile, patients had 1 to < 4 visits, in the medium tertile, 4 to < 7 visits, and in highest tertile, 7 to 59 visits. Patients in medium and high intensity tertiles were older, more likely to have insurance, and had higher GRACE 6-month mortality risk scores compared to the lowest tertile. In multivariable analyses, patients in the medium tertile were more likely to use statins and ASA than those in the lowest tertile (Figure). There were no differences in use of individual medications when comparing the highest and medium tertiles although individuals in the highest tertile were less likely to use all four medications. Conclusions: Significant variability exists in follow-up frequency following AMI and 4% of the cohort had no follow-up. Patients who had medium intensity visits were more likely to use some evidence-based medications than those with low intensity. Higher intensity visits was not associated with greater medication use. It is possible that the observed differences may be attributed to unmeasured differences among patients rather than the actual follow-up visits. Prospective studies are needed to assess key elements of outpatient visits that may lead to better utilization of evidence-based therapies.

scholarly journals Effectiveness of Village Health Worker–Delivered Smoking Cessation Counseling in Vietnam

2018 ◽  
Vol 21 (11) ◽  
pp. 1524-1530 ◽  
Author(s):  
Nan Jiang ◽  
Nina Siman ◽  
Charles M Cleland ◽  
Nancy Van Devanter ◽  
Trang Nguyen ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Controlled Trial ◽  
Evidence Based ◽  
Care Providers ◽  
Water Pipe ◽  
Randomized Controlled ◽  
Provider Advice ◽  
Village Health

Abstract Introduction Smoking prevalence is high in Vietnam, yet tobacco dependence treatment (TDT) is not widely available. Methods We conducted a quasiexperimental study that compared the effectiveness of health care provider advice and assistance (ARM 1) versus ARM 1 plus village health worker (VHW) counseling (ARM 2) on abstinence at 6-month follow-up. This study was embedded in a larger two-arm cluster randomized controlled trial conducted in 26 community health centers (CHCs) in Vietnam. Subjects (N = 1318) were adult patients who visited any participating CHC during the parent randomized controlled trial intervention period and were self-identified as current tobacco users (cigarettes and/or water pipe). Results At 6-month follow-up, abstinences rates in ARM 2 were significantly higher than those in ARM 1 (25.7% vs. 10.5%; p &lt; .001). In multivariate analyses, smokers in ARM 2 were almost three times more likely to quit compared with those in ARM 1 (adjusted odds ratio [AOR] = 2.96, 95% confidence interval [CI] = 1.78% to 4.92%). Compared to cigarette-only smokers, water pipe–only smokers (AOR = 0.4, 95% CI = 0.26% to 0.62%) and dual users (AOR = 0.62, 95% CI = 0.45% to 0.86%) were less likely to achieve abstinence; however, the addition of VHW counseling (ARM 2) was associated with higher quit rates compared with ARM 1 alone for all smoker types. Conclusion A team approach in TDT programs that offer a referral system for health care providers to refer smokers to VHW-led cessation counseling is a promising and potentially scalable model for increasing access to evidence-based TDT and increasing quit rates in low middle-income countries (LMICs). TDT programs may need to adapt interventions to improve outcomes for water pipe users. Implications The study fills literature gaps on effective models for TDT in LMICs. The addition of VHW-led cessation counseling, available through a referral from primary care providers in CHCs in Vietnam, to health care provider’s brief cessation advice, increased 6-month biochemically validated abstinence rates compared to provider advice alone. The study also demonstrated the potential effectiveness of VHW counseling on reducing water pipe use. For LMICs, TDT programs in primary care settings with a referral system to VHW-led cessation counseling might be a promising and potentially scalable model for increasing access to evidence-based treatment.

Patient-Centered Empowerment Through Evidence-Based Engagement in Sensitive Clinical Settings

2020 ◽  
pp. 155-175
Author(s):  
Iris Reychav ◽  
Roger W. McHaney ◽  
Lin Zhu ◽  
Rami Moshonov
Keyword(s):  
Pap Test ◽  
Well Being ◽  
Clinical Settings ◽  
Evidence Based ◽  
Coding System ◽  
Educational Materials ◽  
Patient Centered ◽  
Shared Information ◽  
The Relationship

Patient-centered empowerment is enhanced through evidence-based engagement in stressful medical situations. The current study provided expert-vetted educational materials in dynamic text and video formats using the 5S approach. The materials are relevant, reliable, and readable for patients with abnormal Pap test results. Findings indicated patients that understood the information better were more engaged. Engagement was measured using a coding system that kept track of explicitly shared information, requested recommendations, and tacit knowledge during patient-physician interaction. Other outcomes were that dynamic text had a greater impact on engagement in both initial and follow-up meetings. Important findings included that those who found the dynamic text relevant had their social well-being, self-esteem, optimism, and acceptance improved in initial meetings. Those who found the dynamic text reliable were more confident in the relationship with their physician in follow-up meetings and felt their social well-being was improved in both initial and follow-up meetings.

scholarly journals Lessons Learned from Pompe Disease Newborn Screening and Follow-up

2020 ◽  
Vol 6 (1) ◽  
pp. 11
Author(s):  
Tracy L. Klug ◽  
Lori B. Swartz ◽  
Jon Washburn ◽  
Candice Brannen ◽  
Jami L. Kiesling
Keyword(s):  
Newborn Screening ◽  
Pompe Disease ◽  
Human Services ◽  
Lessons Learned ◽  
Lysosomal Storage ◽  
Health And Human Services ◽  
Disease Phenotypes ◽  
Department Of Health ◽  
The World

In 2015, Pompe disease became the first lysosomal storage disorder to be recommended for universal newborn screening by the Secretary of the U.S. Department of Health and Human Services. Newborn screening for Pompe has been implemented in 20 states and several countries across the world. The rates of later-onset disease phenotypes for Pompe and pseudodeficiency alleles are higher than initially anticipated, and these factors must be considered during Pompe disease newborn screening. This report presents an overview of six years of data from the Missouri State Public Health Laboratory for Pompe disease newborn screening and follow-up.

scholarly journals Experiences of Young Children With Cancer and Their Parents With Nurses’ Caring Practices During the Cancer Trajectory

2019 ◽  
Vol 37 (1) ◽  
pp. 21-34 ◽  
Author(s):  
Karin Enskär ◽  
Laura Darcy ◽  
Maria Björk ◽  
Susanne Knutsson ◽  
Karina Huus
Keyword(s):  
Young Children ◽  
Health Care Providers ◽  
Care Plan ◽  
Care Providers ◽  
Children With Cancer ◽  
Nurse Care ◽  
Care Processes ◽  
Care Practices ◽  
Oncology Unit

Children with cancer require repeated hospitalizations and the family’s everyday life and routines undergo change. Concrete descriptions of how nurses act when caring for children with cancer throughout the various phases of care and treatment are sparsely highlighted in the literature. The aim of this study was to describe young children with cancer and their parents’ experiences of nurses’ caring practices over a 3-year period, from diagnosis to follow-up. This study is based on semistructured interviews with 25 children newly diagnosed with cancer, aged 1 to 6 years, and their parents, connected to a pediatric oncology unit in Sweden. Child and parent data were analyzed with a deductive content analysis using Swanson’s theory of caring. The result shows that nurse care practices directed toward young children with cancer and their parents are to some extent similar across a 3-year period from diagnosis to follow-up but also differ in some ways. Nurses’ caring practices aim to support children and parents in the transition to a “new normal.” Child- and family-friendly care processes include the following: creating hope and a trustful relationship, asking rather than assuming, providing knowledge and information, performing tasks skillfully, displaying an interest in the child’s and parents’ life outside the hospital, and helping the family to trust in the future and other health care providers. Based on these results, we recommend the development of a standardized and structured nursing care plan or clinical guideline with detailed information on how to carry out clinical nurse care practices in the different phases.

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