The Primary Care Obesity Network: Translating Expert Committee Guidelines on Childhood Obesity Into Practice

2017 ◽  
Vol 57 (9) ◽  
pp. 1069-1079
Author(s):  
Ihuoma U. Eneli ◽  
Candace Howell ◽  
Megan E. Rose ◽  
Keeley Pratt ◽  
Ericca L. Lovegrove ◽  
...  
Keyword(s):  
Primary Care ◽  
Childhood Obesity ◽  
Tertiary Care ◽  
Overweight And Obesity ◽  
Expert Committee ◽  
Accountable Care ◽  
Adolescent Overweight ◽  
Care Practices ◽  
Implementation Resources ◽  
Primary Care Practices

Childhood obesity remains a serious public health threat. There is an urgent need for innovative, effective, and sustainable interventions for childhood obesity that are multisector, integrated, and pragmatic. Using the 2007 Expert Committee on the Assessment, Prevention, and Treatment of Child and Adolescent Overweight and Obesity as a guide, a tertiary care obesity program at a children’s hospital established the Primary Care Obesity Network (PCON). This article describes the structure, implementation, resources, and outcome measures of the PCON, a network of primary care practices and a tertiary care obesity center established to prevent and treat childhood obesity in Central Ohio. This program offers an opportunity to assess how and whether the expert committee guidelines can be translated into practice. As Accountable Care Organizations strive to provide services through the lens of improving population health, the PCON can serve as an example for addressing childhood obesity.

scholarly journals Implementation of cancer screening in rural primary care practices after joining an accountable care organisation: a multiple case study

2021 ◽  
Vol 9 (4) ◽  
pp. e001326
Author(s):  
Heather Nelson-Brantley ◽  
Edward F Ellerbeck ◽  
Stacy McCrea-Robertson ◽  
Jennifer Brull ◽  
Jennifer Bacani McKenney ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Screening ◽  
Multiple Case Study ◽  
Accountable Care ◽  
Rural Primary Care ◽  
Care Organisation ◽  
Multiple Case ◽  
Care Practices ◽  
Primary Care Practices

ObjectiveTo describe common strategies and practice-specific barriers, adaptations and determinants of cancer screening implementation in eight rural primary care practices in the Midwestern United States after joining an accountable care organisation (ACO).DesignThis study used a multiple case study design. Purposive sampling was used to identify a diverse group of practices within the ACO. Data were collected from focus group interviews and workflow mapping. The Consolidated Framework for Implementation Research (CFIR) was used to guide data collection and analysis. Data were cross-analysed by clinic and CFIR domains to identify common themes and practice-specific determinants of cancer screening implementation.SettingThe study included eight rural primary care practices, defined as Rural-Urban Continuum Codes 5–9, in one ACO in the Midwestern United States.ParticipantsProviders, staff and administrators who worked in the primary care practices participated in focus groups. 28 individuals participated including 10 physicians; one doctor of osteopathic medicine; three advanced practice registered nurses; eight registered nurses, quality assurance and licensed practical nurses; one medical assistant; one care coordination manager; and four administrators.ResultsWith integration into the ACO, practices adopted four new strategies to support cancer screening: care gap lists, huddle sheets, screening via annual wellness visits and information spread. Cross-case analysis revealed that all practices used both visit-based and population-based cancer screening strategies, although workflows varied widely across practices. Each of the four strategies was adapted for fit to the local context of the practice. Participants shared that joining the ACO provided a strong external incentive for increasing cancer screening rates. Two predominant determinants of cancer screening success at the clinic level were use of the electronic health record (EHR) and fully engaging nurses in the screening process.ConclusionsJoining an ACO can be a positive driver for increasing cancer screening practices in rural primary care practices. Characteristics of the practice can impact the success of ACO-related cancer screening efforts; engaging nurses to the fullest extent of their education and training and integrating cancer screening into the EHR can optimise the cancer screening workflow.

Enhancing the Safe and Effective Management of Chronic Pain in Accountable Care Organization Primary Care Practices in Kentucky

2016 ◽  
Vol 32 (2) ◽  
pp. 178-185 ◽  
Author(s):  
Selam Wubu ◽  
Laura Lee Hall ◽  
Paula Straub ◽  
Matthew J. Bair ◽  
Jill A. Marsteller ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Primary Care Physicians ◽  
The United States ◽  
Care Organization ◽  
Chronic Pain Management ◽  
Accountable Care ◽  
Care Practices ◽  
Primary Care Practices

Chronic pain is a prevalent chronic condition with significant burden and economic impact in the United States. Chronic pain is particularly abundant in primary care, with an estimated 52% of chronic pain patients obtaining care from primary care physicians (PCPs). However, PCPs often lack adequate training and have limited time and resources to effectively manage chronic pain. Chronic pain management is complex in nature because of high co-occurrence of psychiatric disorders and other medical comorbidities in patients. This article describes a quality improvement initiative conducted by the American College of Physicians (ACP), in collaboration with the Kentucky ACP Chapter, and the Center for Health Services and Outcomes Research at the Johns Hopkins Bloomberg School of Public Health, to enhance chronic pain management in 8 primary care practices participating in Accountable Care Organizations in Kentucky, with a goal of enhancing the screening, diagnosis, and treatment of patients with chronic pain.

scholarly journals Integrating childhood obesity resources into the patient-centered medical home: Provider perspectives in the United States

2018 ◽  
Vol 23 (1) ◽  
pp. 63-78 ◽  
Author(s):  
Samareh G Hill ◽  
Thao-Ly T Phan ◽  
George A Datto ◽  
Jobayer Hossain ◽  
Lloyd N Werk ◽  
...  
Keyword(s):  
Primary Care ◽  
Childhood Obesity ◽  
Primary Care Providers ◽  
System Level ◽  
Pediatric Primary Care ◽  
Care Providers ◽  
Obesity Management ◽  
Ancillary Staff ◽  
Care Practices ◽  
Primary Care Practices

Pediatric primary care providers play a critical role in managing obesity yet often lack the resources and support systems to provide effective care to children with obesity. The objective of this study was to identify system-level barriers to managing obesity and resources desired to better managing obesity from the perspective of pediatric primary care providers. A 64-item survey was electronically administered to 159 primary care providers from 26 practices within a large pediatric primary care network. Bivariate analyses were performed to compare survey responses based on provider and practice characteristics. Also factor analysis was conducted to determine key constructs that effect pediatric interventions for obesity. Survey response rate was 69% ( n = 109), with the majority of respondents being female (77%), physicians (67%), and without prior training in obesity management (74%). Time constraints during well visits (86%) and lack of ancillary staff (82%) were the most frequently reported barriers to obesity management. Information on community resources (99%), an on-site dietitian (96%), and patient educational materials (94%) were most frequently identified as potentially helpful for management of obesity in the primary care setting. Providers who desired more ancillary staff were significantly more likely to practice in clinics with a higher percentage of obese, Medicaid, and Hispanic patients. Integrating ancillary lifestyle expert support into primary care practices and connecting primary care practices to community organizations may be a successful strategy for assisting primary care providers with managing childhood obesity, especially among vulnerable populations.

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