Introducing diversity to Balint Groups: Leadership challenges

2019 ◽  
Vol 55 (1) ◽  
pp. 25-29
Author(s):  
Jeffrey L Sternlieb
Keyword(s):  
The United States ◽  
Policy Statement ◽  
Group Leaders ◽  
Patient Centered ◽  
Leadership Challenges ◽  
Patient Centered Medicine ◽  
Balint Group ◽  
Patient Relationships ◽  
Interactive Exercises ◽  
The Impact

In an effort to more fully integrate Michael Balint’s vision of Patient Centered Medicine with the explosive emergence in the United States of issues of diversity and social determinants of health, the American Balint Society has placed a high priority to develop an explicit initiative designed to emphasize the importance of diversity issues in patient care. This initiative began with the discernment of a policy statement and has continued with interactive exercises at National meetings, first designed to create an understanding of the impact of marginalization and next to explore the responsibility and options for Balint Group leaders to guide their groups in considering the impact of diversity in the challenging doctor–patient relationships frequently presented to their groups. This article is a description of such an effort, including results and discussion of continued development of Balint Group leadership.

The Impact of Marijuana Policies on Youth: Clinical, Research, and Legal Update

2017 ◽  
pp. 39-55
Author(s):  
Seth Ammerman ◽  
Sheryl Ryan ◽  
William P. Adelman
Keyword(s):  
Marijuana Use ◽  
The United States ◽  
Criminal Prosecution ◽  
Policy Statement ◽  
American Academy Of Pediatrics ◽  
Technical Report ◽  
The Impact ◽  
Recreational Use ◽  
Adolescent Marijuana Use ◽  
Adolescent Brain Development

This technical report updates the 2004 American Academy of Pediatrics technical report on the legalization of marijuana. Current epidemiology of marijuana use is presented, as are definitions and biology of marijuana compounds, side effects of marijuana use, and effects of use on adolescent brain development. Issues concerning medical marijuana specifically are also addressed. Concerning legalization of marijuana, 4 different approaches in the United States are discussed: legalization of marijuana solely for medical purposes, decriminalization of recreational use of marijuana, legalization of recreational use of marijuana, and criminal prosecution of recreational (and medical) use of marijuana. These approaches are compared, and the latest available data are presented to aid in forming public policy. The effects on youth of criminal penalties for marijuana use and possession are also addressed, as are the effects or potential effects of the other 3 policy approaches on adolescent marijuana use. Recommendations are included in the accompanying policy statement.

The patient-centered medical home as an intervention strategy for diabetes mellitus: A systematic review of the literature

2020 ◽  
Vol 16 ◽  
Author(s):  
Lisa S. McManus ◽  
Karen A. Dominguez-Cancino ◽  
Michele K. Stanek ◽  
Juan. M. LeyvaMoral ◽  
Carola E. Bravo-Tare ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Care Coordination ◽  
Medical Home ◽  
Health Care Expenditures ◽  
The United States ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Team Based Care ◽  
The Impact

Background: Poorly managed diabetes mellitus increases health care expenditures and negatively impact health outcomes. There are 34 million people living with diabetes in the United States with a direct annual medical cost of $237 billion. The patient-centered medical home (PCMH) was introduced to transform primary care by offering teambased care that is accessible, coordinated, and comprehensive. Although the PCMH is believed to address multiple gaps in delivering care to people living with chronic diseases, the research has not yet reported clear benefits for managing diabetes. Objective: To review the scientific literature about diabetes mellitus outcomes reported by PCMHs, and understand the impact of team-based care, interdisciplinary communication, and care coordination strategies on the clinical, financial, and health related outcomes. Method: The systematic review was performed according to the Cochrane method and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Eight databases were systematically searched for articles. The Oxford Centre for Evidence-based Medicine levels of evidence and the Critical Appraisal Skills Programme systematic review checklist were used to evaluate the studies. Results: The search resulted in 596 articles, of which 24 met all the inclusion criteria. Care management resulted in more screenings and better preventive care. Pharmacy-led interventions and technology were associated with positive clinical outcomes, decreased utilization, and cost savings. Most studies reported decreased emergency room visits and less inpatient admissions. Conclusion : The quality and strength of the outcomes were largely inconclusive about the overall effectiveness of the PCMH. Defining and comparing concepts across studies was difficult as universal definitions specific to the PCMH were not often applied. More research is needed to unpack the care model of the PCMH to further understand how the individual key components, such as care bundles, contribute to improved outcomes. Further evaluations are needed for team-based care, communication, and care coordination with comparisons to patient, clinical, health, and financial outcomes.

Patient Centered Medicine and Technology Adaptation

2011 ◽  
pp. 1-22
Author(s):  
Brett Harnett
Keyword(s):  
United States ◽  
Primary Care ◽  
The United States ◽  
International Perspective ◽  
Patient Centered ◽  
Technology Adaptation ◽  
The World ◽  
Patient Centered Medicine ◽  
Effectiveness And Efficiency

In many locations throughout the world, the optimal process is non-existent or has broken down; the United States is no exception as explained from a national, (Sarfaty, 2010) as well as an international perspective by Zwar (2010). The situation has become inefficient because of poorly coordinated, acute-focused, episodic care. The solution lies in the most basic role of the healthcare continuum; primary care. However, to achieve maximum effectiveness and efficiency, adoption of various technologies need to be embraced. While it is referenced by different terms, the concept is often termed patient centered medicine.

Patient Centered Medicine and Technology Adaptation

2012 ◽  
pp. 77-98
Author(s):  
Brett Harnett
Keyword(s):  
United States ◽  
Primary Care ◽  
The United States ◽  
International Perspective ◽  
Patient Centered ◽  
Technology Adaptation ◽  
The World ◽  
Patient Centered Medicine ◽  
Effectiveness And Efficiency

In many locations throughout the world, the optimal process is non-existent or has broken down; the United States is no exception as explained from a national, (Sarfaty, 2010) as well as an international perspective by Zwar (2010). The situation has become inefficient because of poorly coordinated, acute-focused, episodic care. The solution lies in the most basic role of the healthcare continuum; primary care. However, to achieve maximum effectiveness and efficiency, adoption of various technologies need to be embraced. While it is referenced by different terms, the concept is often termed patient centered medicine.

A Pharmacy Director's Primer on the American Recovery and Reinvestment Act of 2009

2009 ◽  
Vol 44 (9) ◽  
pp. 813-818
Author(s):  
Lindsey R. Kelley ◽  
Shelby L. Corman ◽  
Robert J. Weber
Keyword(s):  
Patient Safety ◽  
Health Systems ◽  
Hospital Pharmacy ◽  
Patient Centered ◽  
Leadership Challenges ◽  
Specific Goal ◽  
Pharmacy Management ◽  
The Many ◽  
The Impact ◽  
Pharmacy Leaders

The Director's Forum series is written and edited by Michael Sanborn and Robert Weber and is designed for guiding pharmacy leaders in establishing patient-centered services in hospitals and health systems. Another specific goal of this column is addressing many of the key challenges that pharmacy directors currently face, while also providing information that will foster growth in pharmacy leadership and patient safety. Previous articles in this series have discussed the many different aspects of pharmacy management and leadership challenges. This feature addresses the impact of the American Recovery and Reinvestment Act (the Stimulus Program) on hospital pharmacy practices.

scholarly journals Self-Measured Blood Pressure Monitoring at Home: A Joint Policy Statement From the American Heart Association and American Medical Association

Circulation ◽  
2020 ◽  
Vol 142 (4) ◽  
Author(s):  
Daichi Shimbo ◽  
Nancy T. Artinian ◽  
Jan N. Basile ◽  
Lawrence R. Krakoff ◽  
Karen L. Margolis ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
The United States ◽  
White Coat ◽  
Policy Statement ◽  
Masked Hypertension ◽  
Financial Investment ◽  
Diagnosis And Management ◽  
The Impact ◽  
At Home

The diagnosis and management of hypertension, a common cardiovascular risk factor among the general population, have been based primarily on the measurement of blood pressure (BP) in the office. BP may differ considerably when measured in the office and when measured outside of the office setting, and higher out-of-office BP is associated with increased cardiovascular risk independent of office BP. Self-measured BP monitoring, the measurement of BP by an individual outside of the office at home, is a validated approach for out-of-office BP measurement. Several national and international hypertension guidelines endorse self-measured BP monitoring. Indications include the diagnosis of white-coat hypertension and masked hypertension and the identification of white-coat effect and masked uncontrolled hypertension. Other indications include confirming the diagnosis of resistant hypertension and detecting morning hypertension. Validated self-measured BP monitoring devices that use the oscillometric method are preferred, and a standardized BP measurement and monitoring protocol should be followed. Evidence from meta-analyses of randomized trials indicates that self-measured BP monitoring is associated with a reduction in BP and improved BP control, and the benefits of self-measured BP monitoring are greatest when done along with cointerventions. The addition of self-measured BP monitoring to office BP monitoring is cost-effective compared with office BP monitoring alone or usual care among individuals with high office BP. The use of self-measured BP monitoring is commonly reported by both individuals and providers. Therefore, self-measured BP monitoring has high potential for improving the diagnosis and management of hypertension in the United States. Randomized controlled trials examining the impact of self-measured BP monitoring on cardiovascular outcomes are needed. To adequately address barriers to the implementation of self-measured BP monitoring, financial investment is needed in the following areas: improving education and training of individuals and providers, building health information technology capacity, incorporating self-measured BP readings into clinical performance measures, supporting cointerventions, and enhancing reimbursement.

Enhancing patient-health care provider (HCP) communication in oncology care in the United States.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 99-99
Author(s):  
Suzanne Lane ◽  
Shelagh Szabo ◽  
Ron Halbert ◽  
Hans-Peter Goertz ◽  
Catherine Lai ◽  
...  
Keyword(s):  
Quality Care ◽  
Qualitative Interviews ◽  
The United States ◽  
Patient Centered Care ◽  
Communication Tool ◽  
Patient Centered ◽  
Communication Tools ◽  
Patient Goals ◽  
Centered Care ◽  
The Impact

99 Background: Patient engagement is essential for high-quality care. This study aimed to develop novel communication tools to be used between patients and HCPs to address current gaps in cancer care. Methods: Qualitative interviews were conducted with 16 US patients with various cancers and stage, 6 oncology nurses, and 4 oncologists. Goals were to understand: patients’ changing concerns at diagnosis and during treatment; HCPs views on eliciting patient preferences; and perspectives from both on improving care. A thematic analysis was conducted to identify gaps in care. 8 patients rated their experience and importance of quality care items on a scale of 1 (not experienced/not important) to 5 (experienced/very important). Two draft tools were developed to address identified gaps. Results: None of the 16 patients reported using a communication tool before or during treatment. Gaps in quality care were identified, including communication, patient-centered care, education, and comprehensive care. Communication and patient-centered care items important to patients, but not always experienced, included clearly explained treatment options, time to discuss topics of concern, patient-led decision making, an open-minded care team, and the ability to change one’s mind (mean experience ≤ 4). The first tool assesses patient’s life and treatment goals and establishes early expectations through an open-ended questionnaire. This tool aims to enrich communication between patients and HCPs, enabling more patient-centered care. The second tool addresses the importance of ongoing education using a checklist. Treatment outcomes and the impact of treatment on QOL were identified as the two most important education items for patients when making treatment decisions (mean importance = 5). This tool aims to enhance educational discussions and enable patients to specify where more information is desired. Conclusions: Patients reported a need for communication tools at the beginning of treatment, specifically related to patient goals and educational needs. With patient and HCP input, two novel communication tools were developed to improve quality care. Future studies will validate and implement the tools in clinical practice.

Clinton's Foreign Drug Policy

1994 ◽  
Vol 35 (4) ◽  
pp. 143-152 ◽  
Author(s):  
Raphael F. Perl
Keyword(s):  
Inner City ◽  
Drug Policy ◽  
Urban Areas ◽  
Policy Issue ◽  
Clinton Administration ◽  
The United States ◽  
Policy Statement ◽  
Relative Priority ◽  
National Drug ◽  
The Impact

An important issue for many US citizens, particularly those who live in the inner city and in major urban areas, is the level of administration concern regarding the impact of drugs on US society and the relative priority the administration assigns to drugs as a policy issue.In mid-October 1993, the Clinton administration released an interim policy statement setting forth its proposed strategy for national drug control. Consisting of both domestic and international components, this strategy seeks to downplay the drug issue as a priority driving the new administration's policy agenda. Within the United States, the drug policy is linked to other important domestic goals and is envisioned as just one of the elements in efforts to spur economic growth, reform health care, curb violence among the nation's youth, and “empower communities.”

scholarly journals Health-Related Quality of Life (HRQOL) Measures: There are Still Many Unanswered Questions about Human Life

2008 ◽  
Vol 8 ◽  
pp. 357-363 ◽  
Author(s):  
Mayowa Ojo Owolabi
Keyword(s):  
Quality Of Life ◽  
Human Life ◽  
Health Related Quality ◽  
Patient Centered ◽  
Related Quality ◽  
Health Related ◽  
Patient Centered Medicine ◽  
Correct Understanding ◽  
The Impact

Health-related quality of life (HRQOL) measures are used to assess the multifaceted impact of disease, and determine the utility and associated disability. In addition, the impact of medical interventions must be assessed by psychometrically robust HRQOL measures based on a comprehensive and dynamic model. To develop such a model, the concepts of life, its quality, domains, essence, and purpose must be properly and clearly understood. The correct understanding of these entities is specifically important for patient-centered medicine and has universal implications for all fields of human endeavor. Therefore, in order to explore questions about life and quality of life adequately, every necessary field of knowledge should be employed. A multilinguistic and etymological appraisal reveals that life is related to medicine, freedom, being, soul, and spirit, all of which must therefore be considered in its conceptualization.

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