Incremental benefit of interdisciplinary care in resource identification in an adolescent and young adult (AYA) oncology care model.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 228-228
Author(s):  
Amanda Marie Parkes ◽  
Cathy Lee-Miller

228 Background: Conventional health care models inadequately address the complex needs of adolescents and young adults (AYAs, defined as patients aged 15-39) with cancer, thus necessitating AYA programs. While grounded in the integration of medical and psychosocial care, the best AYA care model has not been identified. We sought to evaluate the comparative impact of one-on-one AYA clinic visits versus interdisciplinary team care on AYA-specific resource identification. Methods: We identified patients seen at the University of Wisconsin (UW) AYA Oncology program between 1/21/2021-5/13/2021. Patients in this program have a one-on-one clinic visit with an AYA physician followed four days later by case presentation at an AYA interdisciplinary team (IDT) meeting. We conducted retrospective chart review to evaluate novel resources identified by the AYA IDT meeting versus those previously identified during the one-on-one AYA clinic visit. Resources identified had to be novel from those already used by or identified for the patient. Results: We identified 32 patients seen by the UW AYA Oncology program. Prior to their AYA clinic visit, patients saw an average of 2.0 AYA-specific services (range 0-6, defined as those services listed in table). As seen in table, an average of 2.8 novel AYA-specific resources were identified for each patient (range 0-5) during the one-on-one AYA clinic visit. Following the AYA IDT meeting, additional novel resources were identified in 100% of patients, with an average of 2.6 additional resources identified per patient (range 1-7). Considering all resources identified by the AYA Oncology program (clinic visit + IDT), an average of 5.4 novel resources were identified per patient (range 2-10). AYA-Specific Resource Identification (n=32). Conclusions: Supporting the importance of dedicated AYA care models, we found that all patients in our study had novel AYA-specific resources identified by the UW AYA Oncology program. Resources identified by the physician-led one-on-one AYA clinic visit were not comprehensive as additional resources were identified for each patient at the AYA IDT meeting only four days later. These objective data support the critical importance of AYA interdisciplinary care as well as the use of an AYA IDT meeting model as a method to include interdisciplinary team care in AYA programs despite possible resource constraints.[Table: see text]

2019 ◽  
Vol 4 (5) ◽  
pp. 850-856 ◽  
Author(s):  
Adriane L. Baylis ◽  
Jamie Perry ◽  
Kristina Wilson ◽  
Scott Dailey ◽  
Anne Bedwinek ◽  
...  

Purpose This article aims to provide a set of guiding principles for interdisciplinary team care of velopharyngeal inadequacy (VPI) for speech, regardless of the etiology. Method A working group of practitioners with advanced training and experience in the management of patients with cleft palate/velopharyngeal disorders, including representatives from speech-language pathology, otolaryngology, and plastic surgery, was formed. Pertinent literature was reviewed, and practical suggestions for clinicians were developed through consensus discussion. Results Seven key principles were identified as being integral to the provision of interdisciplinary team care for VPI. Conclusion Collaborative interdisciplinary team care for persons with velopharyngeal disorders is key to optimal management and outcomes. Practical suggestions for implementing an interdisciplinary team care model for management of cleft-related and noncleft VPI are described.


2017 ◽  
Vol 7 (2) ◽  
pp. 109-117 ◽  
Author(s):  
Chloe E. Hill ◽  
Bethany Thomas ◽  
Kimberly Sansalone ◽  
Kathryn A. Davis ◽  
Judy A. Shea ◽  
...  

AbstractBackground:This study investigated the quality of care delivered by nurse practitioner (NP)–physician teams employed to expand clinic appointment availability for patients with epilepsy.Methods:We performed a retrospective observational cohort study of patients with epilepsy presenting to the Penn Epilepsy Center for a new patient appointment in 2014. During this time, patients were seen either by an NP–physician team care model or a more traditional physician-only care model. These care models were compared with regard to adherence to the 2014 American Academy of Neurology epilepsy quality measures at the initial visit. Clinical outcomes of seizure frequency, presentations to the Emergency Department, injury, and death were assessed over the subsequent year.Results:A total of 169 patients were identified by our inclusion and exclusion criteria: 65 patients in the NP–physician team care model cohort and 104 patients in the physician-only care model cohort. The NP–physician team care model saw, on average, 3 more patients per clinic session. There were no meaningful differences between these cohorts in baseline characteristics. The NP–physician team care model showed equivalent adherence to the physician-only care model for the epilepsy quality measures, with superior adherence to the counseling measures of querying for side effects, provision of personalized epilepsy safety education, and screening for behavioral health disorders. The 2 care models performed similarly in all clinical outcomes.Conclusions:An NP–physician team care model employed to increase availability of care could also improve quality of care delivered.


2021 ◽  
Vol 14 ◽  
pp. 117863292110224
Author(s):  
Lisanne I van Lier ◽  
Henriëtte G van der Roest ◽  
Vjenka Garms-Homolová ◽  
Graziano Onder ◽  
Pálmi V Jónsson ◽  
...  

This study aims to benchmark mean societal costs per client in different home care models and to describe characteristics of home care models with the lowest societal costs. In this prospective longitudinal study in 6 European countries, 6-month societal costs of resource utilization of 2060 older home care clients were estimated. Three care models were identified and compared based on level of patient-centered care (PCC), availability of specialized professionals (ASP) and level of monitoring of care performance (MCP). Differences in costs between care models were analyzed using linear regression while adjusting for case mix differences. Societal costs incurred in care model 2 (low ASP; high PCC & MCP) were significantly higher than in care model 1 (high ASP, PCC & MCP, mean difference €2230 (10%)) and in care model 3 (low ASP & PCC; high MCP, mean difference €2552 (12%)). Organizations within both models with the lowest societal costs, systematically monitor their care performance. However, organizations within one model arranged their care with a low focus on patient-centered care, and employed mainly generalist care professionals, while organizations in the other model arranged their care delivery with a strong focus on patient-centered care combined with a high availability of specialized care professionals.


2020 ◽  
Vol 38 (02/03) ◽  
pp. 227-234
Author(s):  
Catherine Allaire ◽  
Alicia Jean Long ◽  
Mohamed A. Bedaiwy ◽  
Paul J. Yong

AbstractEndometriosis-associated chronic pelvic pain can at times be a complex problem that is resistant to standard medical and surgical therapies. Multiple comorbidities and central sensitization may be at play and must be recognized with the help of a thorough history and physical examination. If a complex pain problem is identified, most endometriosis expert reviews and guidelines recommend multidisciplinary care. However, there are no specific recommendations about what should be the components of this approach and how that type of team care should be delivered. There is evidence showing the effectiveness of specific interventions such as pain education, physical therapy, psychological therapies, and pharmacotherapies for the treatment of chronic pain. Interdisciplinary team models have been well studied and validated in other chronic pain conditions such as low back pain. The published evidence in support of interdisciplinary teams for endometriosis-associated chronic pain is more limited but appears promising. Based on the available evidence, a model for an interdisciplinary team approach for endometriosis care is outlined.


2018 ◽  
Vol 29 (2) ◽  
pp. 173-183 ◽  
Author(s):  
Danielle Tindle ◽  
Carol Windsor ◽  
Patsy Yates

Drawing on Gadamer’s hermeneutic philosophy, this article presents a key outcome of broader research into the phenomenon of adolescent and young adult cancer survivorship. Data were generated through semi-structured interviews with 45 participants from Australia, England, and the United States. The participants received a cancer diagnosis between the ages of 15 and 29 years and were aged 18 to 40 years at the time of interview. The key analytical finding depicts the concept of time as central to the experiences in survivorship. Altered beliefs in temporal progression and biographical chronology affected the organization of time, the structuring and value of life events, and the use of time as a resource. The significance of temporality in young survivors’ experiences warrants its centrality in the design of survivorship care models that reflect a broader understanding of the life experiences of this population.


2015 ◽  
Vol 175 (8) ◽  
pp. 1288 ◽  
Author(s):  
Samuel Pannick ◽  
Rachel Davis ◽  
Hutan Ashrafian ◽  
Ben E. Byrne ◽  
Iain Beveridge ◽  
...  

PEDIATRICS ◽  
1987 ◽  
Vol 79 (4) ◽  
pp. 576-581
Author(s):  
J. ALEX HALLER

Comprehensive pediatric emergency care should be integrated into an overall emergency care system and organized regionally to address the special needs of children. Some pediatric voices have suggested that emergency care for children be organized separately in a parallel system with adult emergency systems, but this plan would put children in competition with adults for federal and state funding. Equally important is the natural overlap of many emergency services with obstetric, perinatal, adolescent, and young adult programs, all of which will be strengthened by integration, not by separation. The one non-negotiable principle must be that any emergency medical system that includes children must use the best and most experienced pediatric specialists available in the area.


2018 ◽  
Vol 111 ◽  
pp. e845-e849 ◽  
Author(s):  
Owoicho Adogwa ◽  
Aladine A. Elsamadicy ◽  
Amanda R. Sergesketter ◽  
Michael Ongele ◽  
Victoria Vuong ◽  
...  

1999 ◽  
Vol 47 (9) ◽  
pp. 1145-1148 ◽  
Author(s):  
Steven R. Counsell ◽  
Robert D. Kennedy ◽  
Peggy Szwabo ◽  
Nancy S. Wadswortb ◽  
Clare Wohlgemutb

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 83-83
Author(s):  
Robert D. Siegel ◽  
Hal E. Crosswell ◽  
Terra Dillard ◽  
Jennifer Bayne ◽  
Tina Redenz ◽  
...  

83 Background: Although cancer centers have focused on optimizing seamless Multidisciplinary Care (MDC) at tumor boards and/or clinics, there has been little published on effective ways to involve supportive services into the management of cancer patients. Historically, supportive services have been initiated when there is an active need rather than in anticipation of that need. As an alternative to pursuing such "crisis management" in our patients, Bon Secours St. Francis Cancer Center (BSSF) initiated Interdisciplinary Care (IDC) Rounds in an effort to anticipate patient needs, enhance quality of life (QoL), and potentially limit avoidable emergency room and hospital admissions. Methods: We initiated IDC Rounds with participants from the following disciplines: medical oncology, navigation, clinic nursing, palliative medicine, financial counseling, psychology, nutrition, clinical research, adolescent and young adult, and oncology rehabilitation/survivorship (ORS). A database was created to track new patients with malignancies within three weeks of presentation and the subsequent recommendations made by the IDC team. Those recommendations are then forwarded to the primary medical oncologist who has the ability to agree to those recommendations in full or in part before they are actuated. Results: BSSF is a non-academic, community-based cancer program and receives over 1,300 referrals annually from a referral population of 1.32 million in 10 counties. Short term metrics demonstrate a 57% and 100% increase in referrals to ORS and palliative care, respectively. Successes and challenges including sustainability, cost and measurable impact will be discussed. Conclusions: We have shown that it is feasible in the community setting to create a process that will allow early integration of supportive services into the full service care of cancer patients. Results demonstrate an increase in short-term metrics such as referrals to supportive services. Our ultimate goal is that formalized IDC results not only in earlier involvement by needed services but enhanced QoL for our patients with fewer emergency room and hospital admissions. Those data will be compiled as the program matures.


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