scholarly journals Optimizing the implementation of a population panel management intervention in safety-net clinics for pediatric hypertension (The OpTIMISe–Pediatric Hypertension Study)

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Justin D. Smith ◽  
Nivedita Mohanty ◽  
Matthew M. Davis ◽  
Ashley A. Knapp ◽  
Yacob G. Tedla ◽  
...  
Keyword(s):  
Safety Net ◽  
Pediatric Hypertension ◽  
Management Intervention ◽  
Panel Management ◽  
Safety Net Clinics

Challenges of Using Videos in Exam Rooms of Safety-Net Clinics to Encourage Patient Self-Disclosure of Intimate Partner Violence and to Increase Provider Screening

2021 ◽  
pp. 107780122110001
Author(s):  
Paula Tavrow ◽  
Brittnie Bloom ◽  
Mellissa Withers
Keyword(s):  
Intimate Partner Violence ◽  
Partner Violence ◽  
Safety Net ◽  
Intimate Partner ◽  
High Turnover ◽  
Management Tools ◽  
Self Disclosure ◽  
Female Victims ◽  
Safety Net Clinics ◽  
Main Components

Identifying intimate partner violence (IPV) in clinics allows for early intervention. We tested a comprehensive approach in five safety-net clinics to encourage female victims to self-identify and providers to screen. The main components were (a) short, multilingual videos for female patients; (b) provider training; and (c) management tools. Although videos were viewed 2,150 times, only 9% of eligible patients watched them. IPV disclosure increased slightly (6%). Lack of internal champions, high turnover, increased patient load, and technological challenges hindered outcomes. Safety-net clinics need feasible methods to encourage IPV screening. Management champions and IT support are essential for video-based activities.

Medicaid Managed Care's Impact On Safety-Net Clinics In California

2000 ◽  
Vol 19 (1) ◽  
pp. 194-202 ◽  
Author(s):  
Andrew B. Bindman ◽  
Kevin Grumbach ◽  
Susannah Bernheim ◽  
Karen Vranizan ◽  
Michael Cousineau
Keyword(s):  
Safety Net ◽  
Safety Net Clinics

scholarly journals Assessing the Delivery of Cessation Services to Smokers in Urban, Safety-Net Clinics

2014 ◽  
Vol 39 (5) ◽  
pp. 879-885 ◽  
Author(s):  
Martin C. Mahoney ◽  
Annamaria Masucci Twarozek ◽  
Frances Saad-Harfouche ◽  
Christy Widman ◽  
Deborah O. Erwin ◽  
...  
Keyword(s):  
Safety Net ◽  
Safety Net Clinics ◽  
Urban Safety

scholarly journals Experiences and Perspectives on Adopting New Practices for Social Needs-targeted Care in Safety-net Settings: A Qualitative Case Series Study

2021 ◽  
Vol 12 ◽  
pp. 215013272110177
Author(s):  
Eileen Nehme ◽  
Sierra Castedo de Martell ◽  
Hannah Matthews ◽  
David Lakey
Keyword(s):  
Safety Net ◽  
Community Action ◽  
Social Needs ◽  
Screening Tools ◽  
System Level ◽  
Community Partner ◽  
Community Resource ◽  
Case Series Study ◽  
Outer Setting ◽  
Safety Net Clinics

Introduction Clinical settings are being encouraged to identify and address patients’ social needs within the clinic or through partner organizations. The purpose of this qualitative study was to describe the current practice of social needs-targeted care in 3 Texas safety net clinics, and facilitators and barriers to adopting new social needs-targeted care tools and practices. Methods Interviews were conducted with staff at 3 safety net clinics serving small and mid-sized communities. Analysis focused on perspectives and decisions around adopting new tools or practices related to social needs-targeted care, including standardized screening tools and community resource referral platforms. Results Nine staff across 3 organizations were interviewed. Two organizations were currently using a standard social needs screening tool in their routine practice, and a third was considering doing so. One organization had adopted a community resource referral platform in partnership with a large community collaboration. Three case studies illustrate a range of facilitators, barriers, perceived benefits, and drawbacks influencing social needs-targeted practices. Benefits of systematic data collection on social needs included the generation of data for community action. Drawbacks include concerns about data privacy. Community resource referral platforms were seen as valuable for creating accountability, but required an influential community partner and adequate community resources. Concerns about disempowering clients and blurring roles were voiced, and potential to increase provider job satisfaction was identified. Conclusions Benefits and drawbacks of adopting new tools and practices related to social needs-targeted care are strongly influenced by the community context. For the adoption of community resource referral platforms, the outer setting is particularly relevant; adoption readiness is best assessed at the community or regional level rather than the clinic system level. While screening tools are much easier than referral platforms for clinics to adopt, the ability to address identified needs remains heavily based on the outer setting.

scholarly journals Diabetes and Hypertension Quality Measurement in Four Safety-Net Sites

2014 ◽  
Vol 05 (03) ◽  
pp. 757-772 ◽  
Author(s):  
R. Benkert ◽  
P. Dennehy ◽  
J. White ◽  
A. Hamilton ◽  
C. Tanner ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Quality Measurement ◽  
Safety Net ◽  
Lessons Learned ◽  
Health Record ◽  
Partnership Model ◽  
Safety Net Clinics ◽  
Electronic Health ◽  
Query Algorithms

SummaryBackground: In this new era after the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, the literature on lessons learned with electronic health record (EHR) implementation needs to be revisited.Objectives: Our objective was to describe what implementation of a commercially available EHR with built-in quality query algorithms showed us about our care for diabetes and hypertension populations in four safety net clinics, specifically feasibility of data retrieval, measurements over time, quality of data, and how our teams used this data.Methods: A cross-sectional study was conducted from October 2008 to October 2012 in four safety-net clinics located in the Midwest and Western United States. A data warehouse that stores data from across the U.S was utilized for data extraction from patients with diabetes or hypertension diagnoses and at least two office visits per year. Standard quality measures were collected over a period of two to four years. All sites were engaged in a partnership model with the IT staff and a shared learning process to enhance the use of the quality metrics.Results: While use of the algorithms was feasible across sites, challenges occurred when attempting to use the query results for research purposes. There was wide variation of both process and outcome results by individual centers. Composite calculations balanced out the differences seen in the individual measures. Despite using consistent quality definitions, the differences across centers had an impact on numerators and denominators. All sites agreed to a partnership model of EHR implementation, and each center utilized the available resources of the partnership for Center-specific quality initiatives.Conclusions: Utilizing a shared EHR, a Regional Extension Center-like partnership model, and similar quality query algorithms allowed safety-net clinics to benchmark and improve the quality of care across differing patient populations and health care delivery models.Citation: Benkert R, Dennehy P, White J, Hamilton A, Tanner C, Pohl JM. Diabetes and hypertension quality measurement in four safety-net sites: Lessons learned after implementation of the same commercial electronic health record. Appl Clin Inf 2014; 5: 757–772http://dx.doi.org/10.4338/ACI-2014-03-RA-0019

scholarly journals Integrative Group Medical Visits: A National Scoping Survey of Safety-Net Clinics

Health Equity ◽  
2019 ◽  
Vol 3 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Ariana Thompson-Lastad ◽  
Paula Gardiner ◽  
Maria T. Chao
Keyword(s):  
Safety Net ◽  
Group Medical Visits ◽  
Medical Visits ◽  
Safety Net Clinics

Effective Strategies for Affordable Care Act Enrollment in Immigrant-Serving Safety Net Clinics in New Mexico

2017 ◽  
Vol 28 (2) ◽  
pp. 626-634 ◽  
Author(s):  
Christina M. Getrich ◽  
Jacqueline M. García ◽  
Angélica Solares ◽  
Miria Kano
Keyword(s):  
New Mexico ◽  
Affordable Care Act ◽  
Safety Net ◽  
Effective Strategies ◽  
Safety Net Clinics

The Experience of Primary Care Providers With an Integrated Mental Health Care Program in Safety-Net Clinics

2015 ◽  
Vol 38 (2) ◽  
pp. 158-168 ◽  
Author(s):  
Wayne D. Bentham ◽  
Anna Ratzliff ◽  
David Harrison ◽  
Ya-Fen Chan ◽  
Steven Vannoy ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Care Program ◽  
Primary Care Providers ◽  
Safety Net ◽  
Care Providers ◽  
Health Care Program ◽  
Safety Net Clinics ◽  
Integrated Mental Health

scholarly journals Acceptability of Naloxone Dispensing Among Pharmacists

2018 ◽  
Vol 33 (3) ◽  
pp. 247-254 ◽  
Author(s):  
Vivian Do ◽  
Emily Behar ◽  
Caitlin Turner ◽  
Michelle Geier ◽  
Phillip Coffin
Keyword(s):  
San Francisco ◽  
Safety Net ◽  
Instructional Materials ◽  
Primary Care Clinics ◽  
Prescriptive Authority ◽  
The Past ◽  
Mandatory Training ◽  
Safety Net Clinics ◽  
The Common

Background: The San Francisco Department of Public Health initiated naloxone prescribing at 6 safety net clinics. We evaluated this intervention, demonstrating that naloxone prescribing from primary care clinics is feasible and acceptable. Objective: To evaluate acceptability of naloxone dispensing to patients prescribed opioids among pharmacists serving clinics participating in a naloxone intervention. Methods: We surveyed 58 pharmacists from November 2013 through January 2015 at pharmacies that serviced San Francisco safety net clinics. Surveys collected information on demographics, experiences in dispensing naloxone, and interest in prescriptive authority. We conducted descriptive analyses and assessed bivariate relationships. Results: Most respondents were staff (56.9%) or supervising pharmacists (34.5%). Most (92.9%) were aware their pharmacy stocked naloxone and 86.8% felt it should be prescribed to some or all patients on long-term opioids. Most (82.1%) dispensed naloxone at least once in the past 12 months. More than half were comfortable providing naloxone education. Nearly half (43.4%) indicated they would want authority to furnish without a prescription. Over half (55.2%) reported no problems dispensing. The common problem was insufficient naloxone knowledge. Only 12% reported more than one problem in dispensing naloxone, which was associated with being uncomfortable with educating patients ( P = .03). Conclusion: Naloxone dispensing was acceptable among pharmacists. Their most cited problem was insufficient naloxone education. This may be resolved with improved instructional materials, incentives for patient education, or mandatory training.

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