scholarly journals Impact of Interprofessional Primary Care Practice on Patient Outcomes: A Scoping Review

SAGE Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. 215824402093589
Author(s):  
Livia R. M. McCutcheon ◽  
Stuart T. Haines ◽  
Ruta Valaitis ◽  
Deborah A. Sturpe ◽  
Grant Russell ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Outcomes ◽  
Primary Care Practice ◽  
Collaborative Practice ◽  
Economic Outcomes ◽  
Future Research ◽  
Care Practice ◽  
Interprofessional Collaborative Practice ◽  
Primary Care Settings ◽  
The Impact

Systematic reviews have provided some insight into the impact of interprofessional collaborative practice on patient outcomes. Despite strong interest in interprofessional collaborative practice, relatively little is known about its impact in primary care settings. This scoping literature review describes the essential elements of an interprofessional primary care practice and explores what is known about its impact on patient care including clinical, humanistic, and economic outcomes. We completed a review of the literature examining the breadth of knowledge related to interprofessional collaborative practice in primary care settings. A search was conducted to identify studies based on predefined criteria. A total of 51 studies met the criteria. A total of 27 studies reported a significantly positive clinical outcome with the interprofessional collaborative practice model, 27 studies reported no difference, and one study reported negative outcome in mortality. A total of 15 studies reported a significantly positive humanistic outcome. There was little to no difference in economic outcomes. This study provides new insights for future research that examines the impact of interprofessional primary care practice.

scholarly journals An Effectiveness Trial of STEADI in an Outpatient, Primary Care Practice

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 774-774
Author(s):  
David Rein ◽  
Madeleine Hackney ◽  
Michele Dougherty ◽  
Camille Vaughan ◽  
Laurie Imhof ◽  
...  
Keyword(s):  
Primary Care ◽  
Medication Review ◽  
Primary Care Practice ◽  
Controlled Trial ◽  
Care Practice ◽  
Strength Assessment ◽  
Randomized Controlled ◽  
Study Team ◽  
One Year ◽  
The Impact

Abstract The STEADI Options trial uses a randomized, controlled-trial design to assess the effectiveness and cost-effectiveness of the STEADI Initiative . Beginning March, 2020, we will randomize 3,000 adults ≥ 65 years of age at risk for falls seen in an Emory Clinic primary care practice to: (1) full STEADI; (2) a STEADI-derived gait, balance, and strength assessment with physical therapy referrals; (3) a STEADI-derived medication review and management; or (4) usual care. This presentation will discuss decisions made by the study team to facilitate implementation of STEADI including electronically conducting screening prior to the date of encounter, the use of dedicated nursing staff to conduct assessments, implementation of strength, balance, orthostatic hypotension, and vision testing, methods to facilitate medication review, and communication of assessment information to providers. The results from this study will be used to estimate the impact of STEADI on falls, service utilization, and costs over one year.

Implementing the Chronic Care Model for Improvements in Diabetes Care and Education in a Rural Primary Care Practice

2005 ◽  
Vol 31 (2) ◽  
pp. 225-234 ◽  
Author(s):  
Linda M. Siminerio ◽  
Gretchen Piatt ◽  
Janice C. Zgibor
Keyword(s):  
Primary Care ◽  
Patient Outcomes ◽  
Chronic Care ◽  
Primary Care Practice ◽  
Self Management ◽  
Standards Of Care ◽  
Care Practice ◽  
Practice Setting ◽  
Care Model ◽  
Rural Primary Care

Purpose The purpose of this pilot study was to determine the impact of implementing elements of the chronic care model (CCM; decision support, self-management, and delivery system redesign) on providers' diabetes care practices and patient outcomes in a rural practice setting. Methods In this pilot study, 104 patients with type 2 diabetes and 6 providers in a rural primary care practice were involved in an intervention that included a certified diabetes educator (CDE) who educated and supported providers on diabetes management and adherence to the American Diabetes Association (ADA) Standards of Care over the year of the project. The CDE also provided diabetes self-management education (DSME) at the office site for 29 of the 104 patients who received their care in the practice. The following variables were evaluated: provider perceived barriers to care and adherence to ADA standards of care and patient A1C, blood pressure, cholesterol, knowledge, and empowerment levels. Results Provider adherence to ADA Standards of Care increased significantly across all process measures. Patients who received DSME at point of service in the primary care practice setting gained improvements in knowledge, empowerment, A1C, and high-density lipoprotein cholesterol levels. Conclusions Implementing systems to support decision support, selfmanagement education, and delivery system redesign has a positive influence on practices and patient outcomes in outlying rural communities.

scholarly journals The Impact of Pharmacist Care on Diabetes Outcomes in Primary Care Settings: An Umbrella Review of Systematic Reviews

2020 ◽  
Author(s):  
Sara Hamdi Abdulrhim ◽  
Sownd Sankaralingam ◽  
Mohamed Izham
Keyword(s):  
Primary Care ◽  
Usual Care ◽  
Systematic Reviews ◽  
Diabetes Care ◽  
Economic Outcomes ◽  
Diabetes Outcomes ◽  
Primary Care Settings ◽  
Pharmacist Interventions ◽  
The Impact ◽  
Pharmacist Care

Objective: To systematically review published systematic reviews (SRs) examining the impact of pharmacist interventions in multidisciplinary diabetes care teams on diabetes-related clinical, humanistic, and economic outcomes in primary care settings. Methods: PubMed, EMBASE, Scopus, Database of Abstracts of Reviews of Effects, Cochrane Library, Joanna Briggs Institute (JBI) Database, Google Scholar, and PROSPERO were searched from inception to 2018. Studies published in English evaluating the effect of pharmacist interventions on diabetes outcomes were included. Two independent reviewers were involved in the screening of titles and abstracts, selection of studies, and methodological quality assessment. Results: Seven SRs were included in the study. Three of them included only randomized controlled trials, while the rest involved other study designs. Educational interventions by clinical pharmacists within the healthcare team were the most common types of interventions reported across all SRs. Pharmacist’s interventions compared to usual care resulted in favorable significant improvements in hemoglobin A1c (HbA1c), fasting blood glucose, blood pressure, body mass index, total cholesterol, lowdensity lipoprotein, high-density lipoprotein and triglycerides in more than 50% of the SRs. Improvement in HbA1c was the mostly reported clinical outcome of pharmacist intervention in the literature (reported in six SRs). Pharmacist’s interventions led to significant cost-saving ($8–$85,000 per person per year), cost-utility, and cost-benefit (benefit-to-cost ratio range from 1:1 to 8.5:1) versus usual care. Pharmacist’s interventions improved patients’ quality of life (QoL) in three SRs; however, no conclusion can be drawn due to the use of diverse QoL assessment tools. Conclusion: Most SRs support the benefit of pharmacist care on diabetes-related clinical, humanistic, and economic outcomes in primary care settings. Improvements in diabetes outcomes can significantly reduce the burden of diabetes on the healthcare system. Hence, the incorporation of pharmacists into multidisciplinary diabetes care teams is beneficial and should be strongly considered by clinicians and health policymakers.

The Impact of Medical Scribes on Relative Value Units in a Pediatric Primary Care Practice

2020 ◽  
Author(s):  
Troy A. Phillips ◽  
Kasey A. Foley ◽  
Benjamin H. Levi ◽  
Pooja Jhaveri ◽  
Cynthia H. Chuang ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Practice ◽  
Pediatric Primary Care ◽  
Care Practice ◽  
Relative Value ◽  
Medical Scribes ◽  
The Impact

scholarly journals An audit of risk assessments and management for self-harm and suicide in patients with depressive symptoms at a primary care practice in the UK

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S89-S89
Author(s):  
Win Let Oo
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Depressive Symptoms ◽  
Primary Care Practice ◽  
Significant Risk ◽  
Care Practice ◽  
Nice Guidelines ◽  
Increased Risk ◽  
Self Harm ◽  
The Impact

AimsOver 5 million adults in England are living with depression, with the highest prevalence rates recorded in the North West and North East of England, 12.88% and 11.53%, respectively (NHS Digital, 2019). Depression is also associated with the highest rates of self-harm and suicide (SH&S) (Singhal, Ross, Seminog, Hawton, & Goldarce, 2014). The impact of SH&S on a family ranges from shock and horror to, blame, secrecy and shame. Survivors may also be negatively judged or self-stigmatise (Cerel, Jordan, & Duberstein, 2008). Managing self-harm episodes has a significant financial implication for the NHS (Tsiachristas, et al., 2017). If high-risk individuals are identified and intervened early, it would not only save lives but also potentially reduce financial strains. The aim of the audit is to evaluate the performance of risk assessment and management of self-harm and suicide at the Reedyford Healthcare Group, Nelson, England, and to determine whether the primary care practice is meeting the standards of the National Institute for Health and Care Excellence (NICE) guidelines for adults with depression.MethodA retrospective audit of 62 patients presenting with depressive symptoms over 3 months was performed at the Reedyford Healthcare Group.Two criteria from the NICE guidelines for adults with depression were included with associated standards of 100%:All patients with depression should be assessed for suicidal ideation and intent by asking direct questions.A patient presenting with significant risk to self/others should be referred to specialist mental health services the same day, as soon as possible.Result42 patients were asked direct questions about SH&S. 2 patients presenting with immediate risk were urgently referred to specialist services. Nonetheless, all those patients at increased risk of suicide were given an increased level of support by the practice. The results indicated that the practice could improve, and a quality improvement approach has been planned.ConclusionThe assessment of risk in patients presenting with depression is vital. This audit shows that it is not always done in practice. The author has not found other published audits on this topic and suggests that this may be appropriate for a national audit. This is particularly prudent with the current concern regarding mental health in the COVID-19 pandemic.

scholarly journals An Innovative Three-Step Method for Identifying Exemplars

2019 ◽  
Vol 18 ◽  
pp. 160940691986779
Author(s):  
Rebecca S. Etz ◽  
Martha M. Gonzalez ◽  
Benjamin F. Crabtree ◽  
Sarah R. Reves ◽  
Kurt C. Stange
Keyword(s):  
Primary Care ◽  
Primary Care Practice ◽  
Expert Knowledge ◽  
Sampling Strategy ◽  
Relevant Information ◽  
National Study ◽  
Care Practice ◽  
Step Method ◽  
Primary Care Settings ◽  
National Cohort

Purpose: To improve practices in rapidly changing environments, it is helpful to learn from relevant innovators. This article describes a well-defined and adaptable method for discovering innovative cases that inform best practices or positive/negative deviant research. Methods: As part of a national study of innovation in primary care settings, we developed a three-step method for identifying exemplar practices and applied that method to finding a sample of relevant innovators for in-depth case studies from which to draw transportable lessons about improving primary care practice. Results: Relevant, information-rich cases are uncovered using cycles of identification, sampling, and assessment. This cycle is repeated at each step of the defined three-step method. Step 1, a scan of the published literature, assesses both the state-of-the-art and the baseline characteristics of relevant cases; Step 2, a scan of practice settings, draws upon the expert knowledge of key informants to identify additional potentially relevant cases; and Step 3, sample refinement, evaluates potential cases for eligibility, purposeful diversity, and information-rich expressions of defined key domains. Using this three-step method, we identified a national cohort of primary care practice innovators. We found the method to be feasible, practical, and highly successful at identifying information-rich practices from which to draw transportable lessons about practice innovation. Conclusions: The three-step method outlines an effective sampling strategy for identifying innovation exemplars and information-rich cases that exceed measures of central tendency. By leveraging the collective knowledge of innovators, this method can support dynamic research and foster rapid cycle learning.

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