scholarly journals Community-informed, integrated, and coordinated care through a community-level model: A narrative synthesis on community hubs

2021 ◽  
pp. 084047042110466
Author(s):  
Derek R. Manis ◽  
Iwona A. Bielska ◽  
Kelly Cimek ◽  
Andrew P. Costa
Keyword(s):  
Models Of Care ◽  
Decision Makers ◽  
System Level ◽  
Original Research ◽  
Coordinated Care ◽  
Model Of Care ◽  
Community Based ◽  
System Leaders ◽  
Level Model ◽  
Hub Model

We identify the core services included in a community hub model of care to improve the understanding of this model for health system leaders, decision-makers in community-based organizations, and primary healthcare clinicians. We searched Medline, PubMed, CINAHL, Scopus, Web of Science, and Google from 2000 to 2020 to synthesize original research on community hubs. Eighteen sources were assessed for quality and narratively synthesized (n = 18). Our analysis found 4 streams related to the service delivery in a community hub model of care: (1) Chronic disease management; (2) mental health and addictions; (3) family and reproductive health; and (4) seniors. The specific services within these streams were dependent upon the needs of the community, as a community hub model of care responds and adapts to evolving needs. Our findings inform the work of health leaders tasked with implementing system-level transformations towards community-informed models of care.

Implementing Interprofessional Collaboration to Improve Patient Outcomes: A Caring and Social Approach to Integrated Nurse-Led Community Based-Care

2020 ◽  
Vol 24 (1) ◽  
pp. 39-49
Author(s):  
Eugenia Millender ◽  
Kathleen Valentine ◽  
Terry Eggenberger ◽  
Cristina Lucier ◽  
Heather Sandala ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Interprofessional Collaboration ◽  
Treatment Plan ◽  
Models Of Care ◽  
Theory And Practice ◽  
Model Of Care ◽  
Community Based ◽  
Social Approach ◽  
History Of ◽  
Improve Patient

Nurses have a history of providing compassionate care while caring for patients living with co-occurring medical and mental conditions. Therefore, it is reasonable to develop and implement nurse-led interprofessional (IP) models of care to address chronic illness. A nurse-led IP model of care was evaluated utilizing three selected patient outcomes. Results revealed an increase in mental health stability and access to care and successful completion of a treatment plan. Integrating caring theory and practice with social determinants of health and nurse-led IP models of care is a valuable approach to improving patient outcomes and addressing health disparity.

scholarly journals Reaching Urban Poor Hypertensive Patients

2016 ◽  
Vol 8 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Jim Sanders ◽  
Clare E. Guse
Keyword(s):  
Blood Pressure ◽  
Chronic Disease ◽  
Urban Poor ◽  
Models Of Care ◽  
Blood Pressure Goal ◽  
Fee For Service ◽  
Model Of Care ◽  
Community Based ◽  
Chronic Disease Care ◽  
Barriers To Access

Background: There is a significant disparity in hypertensive treatment rates between those with and without health insurance. If left untreated, hypertension leads to significant morbidity and mortality. The uninsured face numerous barriers to access chronic disease care. We developed the Community-based Chronic Disease Management (CCDM) clinics specifically for the uninsured with hypertension utilizing nurse-led teams, community-based locations, and evidence-based clinical protocols. All services, including laboratory and medications, are provided on-site and free of charge. Methods: In order to ascertain if the CCDM model of care was as effective as traditional models of care in achieving blood pressure goals, we compared CCDM clinics’ hypertensive care outcomes with 2 traditional fee-for-service physician-led clinics. All the clinics are located near one another in poor urban neighborhoods of Milwaukee, Wisconsin. Results: Patients seen at the CCDM clinics and at 1 of the 2 traditional clinics showed a statistically significant improvement in reaching blood pressure goal at 6 months ( P < .001 and P < .05, respectively). Logistic regression analysis found no difference in attaining blood pressure goal at 6 months for either of the 2 fee-for-service clinics when compared with the CCDM clinics. Conclusion: The CCDM model of care is at least as effective in controlling hypertension as more traditional fee-for-service models caring for the same population. The CCDM model of care to treat hypertension may offer another approach for engaging the urban poor in chronic disease care.

Outcomes in Different Residential Settings for People With Intellectual Disability: A Systematic Review

2009 ◽  
Vol 114 (3) ◽  
pp. 193-222 ◽  
Author(s):  
Agnes Kozma ◽  
Jim Mansell ◽  
Julie Beadle-Brown
Keyword(s):  
Intellectual Disability ◽  
Large Scale ◽  
English Language ◽  
Community Living ◽  
Original Research ◽  
Model Of Care ◽  
Community Based ◽  
Residential Settings ◽  
Basic Model ◽  
Community Based Services

Abstract Large-scale reviews of research in deinstitutionalization and community living were last conducted about 10 years ago. Here we surveyed research from 1997 to 2007. Articles were included if the researchers based the study on original research, provided information on the participants and methodology, compared residential arrangements for adults with intellectual disability, and were published in English-language peer-reviewed journals. Sixty-eight articles were found. In 7 of 10 domains, the majority of studies show that community-based services are superior to congregate arrangements. These studies provide more evidence of the benefits of deinstitutionalization and community living and continue to indicate variability in results, suggesting that factors other than the basic model of care are important in determining outcomes.

Implementing Cancer Exercise Rehabilitation: An Update on Recommendations for Clinical Practice

2019 ◽  
Vol 15 (2) ◽  
pp. 100-109 ◽  
Author(s):  
Kirsten Suderman ◽  
Carolyn McIntyre ◽  
Christopher Sellar ◽  
Margaret L. McNeely
Keyword(s):  
Cancer Survivors ◽  
Research Evidence ◽  
Clinical Care ◽  
Preliminary Evidence ◽  
Model Of Care ◽  
Community Based ◽  
Exercise Rehabilitation ◽  
Barriers To Exercise ◽  
Growing Body ◽  
After Cancer

A growing body of research evidence supports the benefit of exercise for cancer survivors both during and after cancer treatment. The purpose of this paper is to provide an update on our previously published review in 2006 on the state of the evidence supporting exercise for survivors of cancer as well as guidelines for integrating exercise programming in the cancer clinical setting. First, we provide a brief overview on the benefits of exercise as well as preliminary evidence supporting the implementation of community-based exercise programs. Second, we summarize the principles and goals of exercise, and the identified barriers to exercise among cancer survivors. Finally, we propose an interdisciplinary model of care for integrating exercise programming into clinical care including guidelines for medical and pre-exercise screening, exercise testing and programming considerations.

scholarly journals Taking advantage of Covid-19 to improve hospital models of care: are we moving in the right direction?

2021 ◽  
pp. 1-7
Author(s):  
Raffaella Gualandi ◽  
Anna De Benedictis
Keyword(s):  
Hospital Management ◽  
Models Of Care ◽  
Patient Needs ◽  
Model Of Care ◽  
Letter To The Editor ◽  
Rapid Changes ◽  
Improve Hospital ◽  
The Right ◽  
Shed Light

Abstract In this letter to the Editor, we shed light on the rapid changes the Covid-19 virus has generated in hospital management. Recent experiences in the field aim to reorganizing hospital processes and policies. In this new scenario, new patient needs emerge, and a change in the hospital model of care should include them.

scholarly journals Reducing youth suicide: systems modelling and simulation to guide targeted investments across the determinants

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jo-An Occhipinti ◽  
Adam Skinner ◽  
Frank Iorfino ◽  
Kenny Lawson ◽  
Julie Sturgess ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Determinants ◽  
Suicide Attempts ◽  
Expert Knowledge ◽  
Population Level ◽  
Modelling And Simulation ◽  
Decision Makers ◽  
Public Health Issue ◽  
Coordinated Care ◽  
Systems Modelling

Abstract Background Reducing suicidal behaviour (SB) is a critical public health issue globally. The complex interplay of social determinants, service system factors, population demographics, and behavioural dynamics makes it extraordinarily difficult for decision makers to determine the nature and balance of investments required to have the greatest impacts on SB. Real-world experimentation to establish the optimal targeting, timing, scale, frequency, and intensity of investments required across the determinants is unfeasible. Therefore, this study harnesses systems modelling and simulation to guide population-level decision making that represent best strategic allocation of limited resources. Methods Using a participatory approach, and informed by a range of national, state, and local datasets, a system dynamics model was developed, tested, and validated for a regional population catchment. The model incorporated defined pathways from social determinants of mental health to psychological distress, mental health care, and SB. Intervention scenarios were investigated to forecast their impact on SB over a 20-year period. Results A combination of social connectedness programs, technology-enabled coordinated care, post-attempt assertive aftercare, reductions in childhood adversity, and increasing youth employment projected the greatest impacts on SB, particularly in a youth population, reducing self-harm hospitalisations (suicide attempts) by 28.5% (95% interval 26.3–30.8%) and suicide deaths by 29.3% (95% interval 27.1–31.5%). Introducing additional interventions beyond the best performing suite of interventions produced only marginal improvement in population level impacts, highlighting that ‘more is not necessarily better.’ Conclusion Results indicate that targeted investments in addressing the social determinants and in mental health services provides the best opportunity to reduce SB and suicide. Systems modelling and simulation offers a robust approach to leveraging best available research, data, and expert knowledge in a way that helps decision makers respond to the unique characteristics and drivers of SB in their catchments and more effectively focus limited health resources.

scholarly journals Dynamic modelling of a servo self-pierce riveting (SPR) process

2021 ◽  
pp. 095440542110374
Author(s):  
Daniel Tang ◽  
Mike Evans ◽  
Paul Briskham ◽  
Luca Susmel ◽  
Neil Sims
Keyword(s):  
Dynamic Modelling ◽  
System Level ◽  
Optimum Process ◽  
Current Limit ◽  
Level Model ◽  
System Level Model ◽  
Head Height ◽  
Extensive Experimental Data ◽  
High Level

Self-pierce riveting (SPR) is a complex joining process where multiple layers of material are joined by creating a mechanical interlock via the simultaneous deformation of the inserted rivet and surrounding material. Due to the large number of variables which influence the resulting joint, finding the optimum process parameters has traditionally posed a challenge in the design of the process. Furthermore, there is a gap in knowledge regarding how changes made to the system may affect the produced joint. In this paper, a new system-level model of an inertia-based SPR system is proposed, consisting of a physics-based model of the riveting machine and an empirically-derived model of the joint. Model predictions are validated against extensive experimental data for multiple sets of input conditions, defined by the setting velocity, motor current limit and support frame type. The dynamics of the system and resulting head height of the joint are predicted to a high level of accuracy. Via a model-based case study, changes to the system are identified, which enable either the cycle time or energy consumption to be substantially reduced without compromising the overall quality of the produced joint. The predictive capabilities of the model may be leveraged to reduce the costs involved in the design and validation of SPR systems and processes.

scholarly journals Effect of 2 Models of Care and Factors Predicting Patients’ Adherence to Doctor’s Appointment Attendance in Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria

2016 ◽  
Vol 16 (3) ◽  
pp. 296-302 ◽  
Author(s):  
Roseline Iberi Aderemi-Williams ◽  
Fola Tayo ◽  
Aba Sagoe ◽  
Mathew P. Zachariah
Keyword(s):  
Models Of Care ◽  
University Teaching ◽  
Adherence Rate ◽  
State University ◽  
Cd4 Cells ◽  
Model Of Care ◽  
Appointment Attendance ◽  
Drinking Habits ◽  
Resource Limited ◽  
Predictors Of Adherence

Background: Provision of antiretroviral therapy in resource limited settings has put pressure on the available infrastructure. Objectives: The study examined patients’ adherence to Doctor’s appointment attendance after an intervention changing the model of care and factors that predicted adherence. Methods: Observational study was carried out over four years. The model of care was changed in the last year and the effect assessed. SPSS version 15.0 was used for analysis. Predictors of adherence were determined using logistic regression model. Results: Over half 148 (59.7%) of the patients were females, with a mean age of 40.4±8.8 years and baseline CD4 cells of 143.5±92.7cells/microliters. “Adherence” rates were 51.3% in 2007, 35.9% in 2008 and 14.9% in 2009 giving patients’ average adherence to Doctor’s appointment attendance of 34.03%. Intervention changing the model of care in 2010 recorded an adherence rate of 93.1%. Conclusions: The change in model of care greatly improved patients’ “adherence”. Patients’ knowledge of management, adherence, and smoking and drinking habits were identified as statistically significant predictors of adherence.

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