The patient experience: Patient characteristic differences in response.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 144-144
Author(s):  
Stephen Flaherty ◽  
Constance Barysauskas ◽  
Paul J. Catalano
Keyword(s):  
Patient Experience ◽  
Representative Sample ◽  
Sampling Strategy ◽  
Patient Characteristics ◽  
Population Based ◽  
Ambulatory Oncology ◽  
The Press ◽  
Oncology Care ◽  
And Performance ◽  
Oncology Center

144 Background: Understanding and addressing patient experience (PX) is an integral part of oncology care. The Press Ganey Outpatient Oncology instrument is used to better understand PX and performance differences at a large ambulatory oncology center. We investigated select patient characteristics of response among all eligible patients, the surveyed sample, and survey respondents. Methods: Over a six month period at a large ambulatory oncology center, 26,660 patients were eligible to report their PX. 11% of patients were identified following the center’s sampling criteria, of which Press Ganey applied their sampling strategy. Thus, 2,857 patients were randomly selected and sent the survey instrument, of which 828 patients responded. Patient characteristics of the three cohorts were compared across the center and by disease center. Results: Surveyed patients were a representative sample of eligible patients, as surveyed patients were of similar age (NS), gender (NS), education level (NS), and primary insurer (NS). In some dimensions, responders were not a representative sample of eligible/surveyed patients. Respondents were slightly older (p < 0.001), more often male (NS), more college educated (NS), and more frequently had a primary insurance of Medicare (p < 0.001). Similar population differences continued among eligible, surveyed and responders, in further comparisons by disease center. Conclusions: Population based sampling allowed the opportunity to investigate accuracy of the sampling strategy and the ability to identify a representative sample of patients across the oncology center. A comparison across the oncology center and disease centers revealed we cannot assume respondents are similar to the eligible and surveyed populations, thus we caution all assumptions made with unadjusted PX comparisons. Further research allows the opportunity to continuously update/improve the sampling strategy and administer electronic surveys to identify a more representative sample better positioned for future quality improvement opportunities. [Table: see text]

scholarly journals Commentary: Quality nutrition care is integral to the Oncology Care Model

2021 ◽  
Author(s):  
Mary Beth Arensberg ◽  
Beth Besecker ◽  
Laura Weldishofer ◽  
Susan Drawert
Keyword(s):  
Best Practice ◽  
Treatment Guidelines ◽  
Nutrition Therapy ◽  
Care Model ◽  
Nutrition Care ◽  
Ambulatory Oncology ◽  
Oncology Care ◽  
Improvement Programs ◽  
And Performance ◽  
Registered Dietitian Nutritionists

AbstractThe Oncology Care Model (OCM) is a US Centers for Medicare & Medicaid Services (CMS) specialty model implemented in 2016, to provide higher quality, more highly coordinated oncology care at the same or lower costs. Under the OCM, oncology clinics enter into payment arrangements that include financial and performance accountability for patients receiving chemotherapy treatment. In addition, OCM clinics commit to providing enhanced services to Medicare beneficiaries, including care coordination, navigation, and following national treatment guidelines. Nutrition is a component of best-practice cancer care, yet it may not be addressed by OCM providers even though up to 80% of patients with cancer develop malnutrition and poor nutrition has a profound impact on cancer treatment and survivorship. Only about half of US ambulatory oncology settings screen for malnutrition, registered dietitian nutritionists (RDNs) are not routinely employed by oncology clinics, and the medical nutrition therapy they provide is often not reimbursed. Thus, adequate nutrition care in US oncology clinics remains a gap area. Some oncology clinics are addressing this gap through implementation of nutrition-focused quality improvement programs (QIPs) but many are not. What is needed is a change of perspective. This paper outlines how and why quality nutrition care is integral to the OCM and can benefit patient health and provider outcomes.

Use of myelosuppressive chemotherapy and colony-stimulating factor (CSF) prophylaxis: A longitudinal assessment of practices participating in the Centers for Medicare and Medicaid Services (CMS) oncology care model (OCM).

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 12-12
Author(s):  
Derek Weycker ◽  
Ahuva Hanau ◽  
Alex Lonshteyn ◽  
Christopher Kim ◽  
Prasad L. Gawade ◽  
...  
Keyword(s):  
Patient Characteristics ◽  
Cancer Type ◽  
Longitudinal Assessment ◽  
Myelosuppressive Chemotherapy ◽  
Non Hodgkin Lymphoma ◽  
Performance Accountability ◽  
Study Population ◽  
Oncology Care ◽  
And Performance ◽  
Over Time

12 Background: The CMS OCM is a 5-year program (7/2016 – 6/2021) focused on improving oncology care by incentivizing practices via financial and performance accountability. Little is known about practices participating in the OCM and whether patterns of care have changed over time. Methods: We used a retrospective cohort with structured elements from national electronic health record dataset provided by Flatiron Health (1/2012-12/2017). Data were de-identified to prevent patient and provider re-identification. Study population included adults with breast, colorectal, lung, or ovarian cancer or non-Hodgkin lymphoma who received chemotherapy with intermediate/high-risk for febrile neutropenia (FN). Patient characteristics, treatment, and supportive care within OCM and non-OCM practices were evaluated overall and by calendar year. Results: Study population included 42,699 patients at 53 OCM practices, and 25,613 patients at 149 non-OCM practices. OCM practices were larger (mean: 806 vs. 172 patients); age (mean: 62 vs. 62 years), cancer type (breast cancer: 53% vs. 52%), chemotherapy (high FN-risk: 49% vs. 48%), and other characteristics were comparable between patients in OCM and non-OCM practices. Use of high (vs. intermediate) FN-risk chemotherapy in 2012, 2015, and 2017 was 48%, 50%, and 48% in OCM practices and 50%, 50%, and 48% in non-OCM practices. CSF prophylaxis use, while higher in OCM practices, decreased over time in both subgroups (OCM: 70% in 2012 to 65% in 2017; non-OCM: 63% in 2012 to 58% in 2017). Use of pegfilgrastim (vs. short-acting CSFs) was > 94% across years in OCM and non-OCM practices. Use of the on-body injector (vs. prefilled syringe) increased from 26% of pegfilgrastim use in 2015 to 73% in 2017 in OCM practices and from 16% to 63% in non-OCM practices. Conclusions: Although OCM practices are larger and more commonly use CSF prophylaxis than non-OCM practices, trends in use of high FN-risk chemotherapy and declining prophylactic support appear to be similar between subgroups. Additional research is needed to evaluate whether such changes impacted health outcomes.

Incidence of paediatric 10-fold medication errors in Wales

2020 ◽  
pp. archdischild-2020-319130
Author(s):  
Yincent Tse ◽  
David Tuthill
Keyword(s):  
Medication Errors ◽  
Reporting System ◽  
Patient Characteristics ◽  
Population Based ◽  
Population Surveillance ◽  
Near Miss ◽  
Surveillance Study ◽  
High Resource ◽  
Improvement Strategies ◽  
Iatrogenic Harm

ObjectivesTo estimate the incidence, characteristics and outcomes of 10-fold or greater or a tenth or less medication errors in children aged <16 years in Wales.DesignPopulation-based surveillance study July 2017 to June 2019. Cases were identified by paediatricians and hospital pharmacists using monthly electronic Welsh Paediatric Surveillance Unit (WPSU) reporting system.Patients‘Definite’ incident occurred when children received all or any of the incorrect dose of medication. ‘Near miss’ was where the prescribed, prepared or dispensed medication was not administered to the child.Main outcome measuresIncidence, patient characteristics, setting, drug characteristics, outcome, harm and enabling or preventive factors.ResultsIn total, 50 10-fold errors were reported; 20 definite and 30 near miss cases. This yields a minimum annual incidence of 1 per 3797 admissions, or 4.6/100 000 children. Of these, 43 were overdoses and 7 underdoses. 33 incidents occurred in children <5 years of age. Overall, 37 different medications were involved with the majority, 31 cases, being administered enterally. Of these 31 enteral medication errors, all definite cases (10) had received liquid preparations. Temporary harm occurred in 5/20 (25%) definite cases with one requiring intensive care; all fully recovered.ConclusionsIn this first ever population surveillance study in a high-resource healthcare system, 10-fold errors in children were rare, sometimes prevented and uncommonly caused harm. We recommend country-wide improvements be made to reduce iatrogenic harm. Understanding the enabling and preventive factors may help national improvement strategies to reduce these errors.

Inappropriate outpatient antibiotic use in children insured by Kentucky Medicaid

2021 ◽  
pp. 1-7
Author(s):  
Bethany A. Wattles ◽  
Kahir S. Jawad ◽  
Yana Feygin ◽  
Maiying Kong ◽  
Navjyot K. Vidwan ◽  
...  
Keyword(s):  
Claims Data ◽  
Inappropriate Prescribing ◽  
Patient Characteristics ◽  
Antibiotic Use ◽  
Population Based ◽  
Antibiotic Prescribing ◽  
Cross Sectional ◽  
Inappropriate Use ◽  
Pharmacy Claims ◽  
Medicaid Children

Abstract Objective: To describe risk factors associated with inappropriate antibiotic prescribing to children. Design: Cross-sectional, retrospective analysis of antibiotic prescribing to children, using Kentucky Medicaid medical and pharmacy claims data, 2017. Participants: Population-based sample of pediatric Medicaid patients and providers. Methods: Antibiotic prescriptions were identified from pharmacy claims and used to describe patient and provider characteristics. Associated medical claims were identified and linked to assign diagnoses. An existing classification scheme was applied to determine appropriateness of antibiotic prescriptions. Results: Overall, 10,787 providers wrote 779,813 antibiotic prescriptions for 328,515 children insured by Kentucky Medicaid in 2017. Moreover, 154,546 (19.8%) of these antibiotic prescriptions were appropriate, 358,026 (45.9%) were potentially appropriate, 163,654 (21.0%) were inappropriate, and 103,587 (13.3%) were not associated with a diagnosis. Half of all providers wrote 12 prescriptions or less to Medicaid children. The following child characteristics were associated with inappropriate antibiotic prescribing: residence in a rural area (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.07–1.1), having a visit with an inappropriate prescriber (OR, 4.15; 95% CI, 4.1–4.2), age 0–2 years (OR, 1.39; 95% CI, 1.37–1.41), and presence of a chronic condition (OR, 1.31; 95% CI, 1.28–1.33). Conclusions: Inappropriate antibiotic prescribing to Kentucky Medicaid children is common. Provider and patient characteristics associated with inappropriate prescribing differ from those associated with higher volume. Claims data are useful to describe inappropriate use and could be a valuable metric for provider feedback reports. Policies are needed to support analysis and dissemination of antibiotic prescribing reports and should include all provider types and geographic areas.

The Psychometric Properties of the Measure of Adolescent Relationship Harassment and Abuse (MARSHA) With a Nationally Representative Sample of U.S. Youth

2021 ◽  
pp. 088626052098548
Author(s):  
Emily F. Rothman ◽  
Carlos A. Cuevas ◽  
Elizabeth A. Mumford ◽  
Eva Bahrami ◽  
Bruce G. Taylor
Keyword(s):  
Representative Sample ◽  
Reliability And Validity ◽  
Population Based ◽  
Good Reliability ◽  
Adolescent Dating ◽  
Dating Abuse ◽  
New Instrument ◽  
Convergent And Divergent Validity ◽  
Nationally Representative ◽  
Adolescent Relationship

This article describes a new instrument that assesses adolescent dating abuse (ADA) victimization and perpetration. The Measure of Adolescent Relationship Harassment and Abuse (MARSHA) is a comprehensive instrument that includes items on physical, sexual, and psychological ADA, as well as cyber dating abuse, social control, and invasion of privacy. Data for this study came from a population-based, nationally representative sample of adolescents ages 11 to 21 years old ( N = 1,257). Exploratory factor analysis was conducted for the victimization and perpetration versions of the MARSHA, and convergent and divergent validity were assessed using the Conflict in Adolescent Dating Relationships Inventory (CADRI) and the juvenile victimization questionnaire (JVQ), respectively. Results suggest that the MARSHA has good reliability and validity, and that each subscale had good internal consistency. The authors propose that the MARSHA may be a strong alternative to the CADRI or the conflict tactics scale (CTS) because it reflects contemporary forms of abuse, such as online harassment and pressure to send nude selfies, and the nonconsensual dissemination of sexually explicit images.

scholarly journals Cultivating Connection: The Magic of Attuning, Wondering, Following & Holding

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Ann Flanagan Petry
Keyword(s):  
Health Care ◽  
Patient Experience ◽  
Nursing Care ◽  
Interpersonal Relations ◽  
Care Delivery ◽  
Employee Attitudes ◽  
Patient Centered ◽  
Caring Relationships ◽  
Award Winning ◽  
And Performance

Remember what drew you to health care? And what makes your work meaningful now? Chances are caring for people is the answer to both questions. In fact, healthcare is provided through relationships. Over a decade ago we developed a care delivery framework described in the award-winning book Relationship-Based Care: A Model for Transforming Practice. We were on the vanguard of a revolution toward more patient-centered caring. Indeed, we have always known the importance of connection to patient experience, employee attitudes, interpersonal relations, teams and performance. For nurses, caring relationships are so essential at work that it is inseparable from the work itself. We believe the best nursing care requires understanding of three key relationships: A. Relationship to one’s self, B. Relationship to co-workers and C. Relationship to patients and families. And, the hallmark of meaningful connection is attunement or tuning-in to others with genuine interest and care.

scholarly journals Electronic Health Use in a Representative Sample of 18,497 Respondents in Norway (The Seventh Tromsø Study - Part 1): Population-Based Questionnaire Study

10.2196/13106 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e13106 ◽  
Author(s):  
Rolf Wynn ◽  
Sunday Oluwafemi Oyeyemi ◽  
Andrius Budrionis ◽  
Luis Marco-Ruiz ◽  
Kassaye Yitbarek Yigzaw ◽  
...  
Keyword(s):  
Higher Education ◽  
Heart Disease ◽  
Health Services ◽  
Representative Sample ◽  
Large Scale ◽  
Population Based ◽  
Age Group ◽  
Traditional Health ◽  
Ehealth Services ◽  
Electronic Health

Background Electronic health (eHealth) services may help people obtain information and manage their health, and they are gaining attention as technology improves, and as traditional health services are placed under increasing strain. We present findings from the first representative, large-scale, population-based study of eHealth use in Norway. Objective The objectives of this study were to examine the use of eHealth in a population above 40 years of age, the predictors of eHealth use, and the predictors of taking action following the use of these eHealth services. Methods Data were collected through a questionnaire given to participants in the seventh survey of the Tromsø Study (Tromsø 7). The study involved a representative sample of the Norwegian population aged above 40 years old. A subset of the more extensive questionnaire was explicitly related to eHealth use. Data were analyzed using logistic regression analyses. Results Approximately half (52.7%; 9752/18,497) of the respondents had used some form of eHealth services during the last year. About 58% (5624/9698) of the participants who had responded to a question about taking some type of action based on information gained from using eHealth services had done so. The variables of being a woman (OR 1.58; 95% CI 1.47-1.68), of younger age (40-49 year age group: OR 4.28, 95% CI 3.63-5.04), with a higher education (tertiary/long: OR 3.77, 95% CI 3.40-4.19), and a higher income (>1 million kr [US $100,000]: OR 2.19, 95% CI 1.77-2.70) all positively predicted the use of eHealth services. Not living with a spouse (OR 1.14, 95% CI 1.04-1.25), having seen a general practitioner (GP) in the last year (OR 1.66, 95% CI 1.53-1.80), and having had some disease (such as heart disease, cancer, asthma, etc; OR 1.29, 95% CI 1.18-1.41) also positively predicted eHealth use. Self-rated health status did not significantly influence eHealth use. Taking some action following eHealth use was predicted with the variables of being a woman (OR 1.16, 95% CI 1.07-1.27), being younger (40-49 year age group: OR 1.72, 95% CI 1.34-2.22), having a higher education (tertiary/long: OR 1.65, 95% CI 1.42-1.92), having seen a GP in the last year (OR 1.58, 95% CI 1.41-1.77), and having ever had a disease (such as heart disease, cancer or asthma; OR 1.26, 95% CI 1.14-1.39). Conclusions eHealth appears to be an essential supplement to traditional health services for those aged above 40 years old, and especially so for the more resourceful. Being a woman, being younger, having higher education, having had a disease, and having seen a GP in the last year all positively predicted using the internet to get health information and taking some action based on this information.

scholarly journals Awareness about breast feeding practices and vitamin A deficiency among mothers in Srikakulam district of Andhra Pradesh, South India

2021 ◽  
Vol 8 (5) ◽  
pp. 2346
Author(s):  
Vasantha Rao Sappati ◽  
Sannapaneni Krishnaiah ◽  
Suneetha Sapur
Keyword(s):  
Vitamin A ◽  
Breast Feeding ◽  
Andhra Pradesh ◽  
Vitamin A Deficiency ◽  
Sampling Strategy ◽  
Signs And Symptoms ◽  
Feeding Practices ◽  
Population Based ◽  
Cross Sectional Study ◽  
Cross Sectional

Background: To assess the awareness about breast feeding practices and to assess the knowledge, attitude and practice about the signs and symptoms of vitamin A deficiency (VAD) and vitamin A rich foods intake among mothers of children below 5 years in the Srikakulam district of Andhra Pradesh (AP) in South India.Methods: A population based cross-sectional study was conducted on 284 mothers (age range 14 to 36 years) during June 2011 and September 2011. A combined simple and systematic random sampling strategy was used to select mothers from one tribal, rural and semi urban area with a representative sample of the Srikakulam district. A standardized structured questionnaire that was developed and validated by the National institute of nutrition, Hyderabad was utilized for this study.Results: The awareness of vitamin A and night blindness was 68.7% (95% confidence intervals (CI): 62.9–74.0) (n=195) and 93.7% (95% CI: 90.2–96.2) (n=266) respectively. The knowledge of signs and symptoms of vitamin A deficiency (VAD) was nil among illiterate mothers and low among literates; with primary education, adjusted odds ratio (OR): 0.01 (95% CI: 0.00, 0.06) and with secondary education, OR: 0.19 (95% CI: 0.06, 0.62) compared to mothers with graduation and above.Conclusions: There is a need to increase the awareness and knowledge about VAD among mothers with children below 5 years in the southern state of AP.

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