Practice Transformation Under the University of Colorado’s Primary Care Redesign Model

Abstract Background Guidelines for patient decision aids (DA) recommend target population involvement throughout the development process, but developers may struggle because of limited resources. We sought to develop a feasible means of getting repeated feedback from users. Methods Between 2017 and 2020, two Swiss centers for primary care (Lausanne and Bern) created citizen advisory groups to contribute to multiple improvement cycles for colorectal, prostate and lung cancer screening DAs. Following Community Based Participatory Research principles, we collaborated with local organizations to recruit citizens aged 50 to 75 without previous cancer diagnoses. We remunerated incidental costs and participant time. One center supplemented in-person meetings by mailed paper questionnaires, while the other supplemented meetings using small-group workshops and analyses of meeting transcripts. Results In Lausanne, we received input from 49 participants for three DAs between 2017 and 2020. For each topic, participants gave feedback on the initial draft and 2 subsequent versions during in-person meetings with ~ 8 participants and one round of mailed questionnaires. In Bern, 10 participants were recruited among standardized patients from the university, all of whom attended in-person meetings every three months between 2017 and 2020. At both sites, numerous changes were made to the content, appearance, language, and tone of DAs and outreach materials. Participants reported high levels of satisfaction with the participative process. Conclusions Citizen advisory groups are a feasible means of repeatedly incorporating end-user feedback during the creation of multiple DAs. Methodological differences between the two centers underline the need for a flexible model adapted to local needs.

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Empirical Evidence for Professional Practice and Public Policies: An Exploratory Study on Social Exclusion in Users of Primary Care Social Services in Spain

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16234600 ◽

2019 ◽

Vol 16 (23) ◽

pp. 4600 ◽

Cited By ~ 2

Author(s):

Giménez‐Bertomeu ◽

Domenech‐López ◽

Mateo‐Pérez ◽

de‐Alfonseti‐Hartmann

Keyword(s):

Primary Care ◽

Social Exclusion ◽

Social Services ◽

Professional Practice ◽

Social Inclusion ◽

Social Acceptance ◽

Life Trajectories ◽

The Social ◽

Study Population ◽

The University

This study examines the social exclusion characteristics of a sample of users of primary care social services in two local entities in Spain. The objective of this study was to identify the intensity and scope of social exclusion in an exploratory way and to look at the typology of existing exclusionary situations to inform policy making and professional practice. Data from 1009 users were collected by primary care social services professionals, completing the Social Exclusion Scale of the University of Alicante (SES-UA). The dimensions with the greatest levels of social exclusion in the study population were those related to work/employment, income and education and training. The dimensions with an intermediate level of exclusion were those related to housing and social isolation. Social acceptance, family and social conflict and health were the dimensions with the lowest levels of exclusion. The analysis also showed the existence of five significantly different groups, that showed five different life trajectories along the continuum between social exclusion and social inclusion. The results show the importance and utility of developing professional and policy intervention protocols based on research evidence, with the objective of improving the quality of life of the users.

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Finding the path of least resistance: Locally adapting the MITIGATE toolkit in emergency departments and urgent care centers

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1394 ◽

2021 ◽

pp. 1-3

Author(s):

Joanne Huang ◽

Zahra Kassamali Escobar ◽

Todd S. Bouchard ◽

Jose Mari G. Lansang ◽

Rupali Jain ◽

...

Keyword(s):

Primary Care ◽

Emergency Department ◽

Antimicrobial Stewardship ◽

Emergency Departments ◽

Urgent Care ◽

Complex Data ◽

University Of Washington ◽

Primary Care Clinics ◽

Urgent Care Centers ◽

The University

Abstract The MITIGATE toolkit was developed to assist urgent care and emergency departments in the development of antimicrobial stewardship programs. At the University of Washington, we adopted the MITIGATE toolkit in 10 urgent care centers, 9 primary care clinics, and 1 emergency department. We encountered and overcame challenges: a complex data build, choosing feasible outcomes to measure, issues with accurate coding, and maintaining positive stewardship relationships. Herein, we discuss solutions to challenges we encountered to provide guidance for those considering using this toolkit.

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Innovative Partnership Between Primary Care, AAA, and Academia Connects 4Ms and Social Determinants of Health

Innovation in Aging ◽

10.1093/geroni/igaa057.352 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 107-107

Author(s):

Suzanne Leahy ◽

Katie Ehlman ◽

Lisa Maish ◽

Brad Conrad ◽

Jillian Hall ◽

...

Keyword(s):

Older Adults ◽

Primary Care ◽

Health System ◽

Preliminary Evaluation ◽

Language And Literacy ◽

Community Based ◽

Primary Care Clinics ◽

College Of Nursing ◽

Value Based Care ◽

The University

Abstract Nationally, there is a growing focus on addressing geriatric care in primary care settings. HRSA’s Geriatric Workforce Enhancement Program (GWEP) has called for academic and health system partners to develop a reciprocal, innovative, cross-sector partnership that includes primary care sites and community-based agencies serving older adults. Through the University of Southern Indiana’s GWEP, the College of Nursing and Health Professions, the Deaconess Health System, three primary care clinics, and two Area Agencies on Aging (AAA) have joined to transform the healthcare of older adults regionally, including rural residents in the 12-county area. Core to the project is a value-based care model that “embeds” AAA care managers in primary care clinics. Preliminary evaluation indicates early success in improving the healthcare of older adults at one primary clinic, where clinical teams have referred 64 older adult patients to the AAA care manager. Among these 64 patients, 80% were connected to supplemental, community-based health services; 22% to programs addressing housing and transportation; and, nearly 10% to a range of other services (e.g., job training; language and literacy; and technology). In addition to presenting limited data on referred patients and referral outcomes, the presentation will share copies of the AAA referral log, to illustrate how resources were categorized by SDOH and added to support integration of the 4Ms.

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Population-Based Pragmatic Trial of Advance Care Planning in Primary Care in the University of California Health System

Journal of Palliative Medicine ◽

10.1089/jpm.2019.0142 ◽

2019 ◽

Vol 22 (S1) ◽

pp. S-72-S-81 ◽

Cited By ~ 9

Author(s):

Anne M. Walling ◽

Rebecca L. Sudore ◽

Doug Bell ◽

Chi-Hong Tseng ◽

Christine Ritchie ◽

...

Keyword(s):

Primary Care ◽

Health System ◽

Advance Care Planning ◽

Pragmatic Trial ◽

Population Based ◽

University Of California ◽

Care Planning ◽

Advance Care ◽

The University

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The University Medical Centre: A student’s perspective

10.32920/ryerson.14635596 ◽

2021 ◽

Author(s):

Gabrielle Hubert ◽

Cameron Pow ◽

Sandra Tullio-Pow

Keyword(s):

Primary Care ◽

Healthcare Professionals ◽

Care Physician ◽

Medical Centre ◽

First Year ◽

Patient Centered ◽

First Year Students ◽

Centered Care ◽

The University ◽

University Setting

Over 515,000 students attended Ontario Universities in 2015/16, including 60,000 international students from abroad (https://ontario universityes.ca/resources/data/numbers). First-year students who are away from home find themselves needing a new primary care physician. While a few researchers have examined student health care within the university setting in regard to mental health (Evans, 1999), sexual health (Habel et al., 2018)., and health promotion (Griebler et al., 2017), there has been little research focused on the first-year student experience in finding primary care. Our study examined communication pathways, wayfinding and misconceptions students have related to the university medical centre. Patient centered care involves a partnership between a healthcare provider and their patient. In this partnership healthcare professionals must consider the patient experience and be more informative, mindful, empathic and collaborative to provide the best possible care (Epstein & Street, 2011).

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HEALTH ACTIVIST EDUCATION FOR BRAZIL

International Journal for Innovation Education and Research ◽

10.31686/ijier.vol6.iss7.1092 ◽

2018 ◽

Vol 6 (7) ◽

pp. 53-63

Author(s):

Rita de Cássia Gabrielli Souza Lima

Keyword(s):

Primary Care ◽

The Elderly ◽

Community Center ◽

Community Garden ◽

Local Health ◽

Antonio Gramsci ◽

Primary Care Unit ◽

Health Council ◽

The University ◽

Extension Program

The article socializes a few sectoral bonds as managed in an experience of the Extension Project Antonio Gramsci: fostering the activist conception of education, of the University of Vale do Itajaí. The experience took place in 2016 with elderly people from the Community Center for the Elderly from Itaipava section of Itajaí city, Brazil, in partnership with workers of a local Health Primary Care Unit and of the Local Health Council. The testimonies were analyzed dialectically by means of the category “We want to dance again, and we appreciate plants”, while the narratives expressed a symbolic pain in view of the cut of municipal resources to guarantee the trips and balls that used to take place monthly and the willingness to make a community garden. The involved sectors recognized the extension program as an effective class and the locus to develop the praxis.

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When a Whole Practice Model Is the Intervention: Developing Fidelity Evaluation Components Using Program Theory-Driven Science for an Integrative Medicine Primary Care Clinic

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2013/652047 ◽

2013 ◽

Vol 2013 ◽

pp. 1-11 ◽

Cited By ~ 8

Author(s):

Sally E. Dodds ◽

Patricia M. Herman ◽

Lee Sechrest ◽

Ivo Abraham ◽

Melanie D. Logue ◽

...

Keyword(s):

Primary Care ◽

Integrative Medicine ◽

Practice Theory ◽

Primary Care Clinic ◽

Services Research ◽

Practice Model ◽

Care Clinic ◽

Intervention Integrity ◽

Integrative Health ◽

The University

Integrative medicine (IM) is a clinical paradigm of whole person healthcare that combines appropriate conventional and complementary medicine (CM) treatments. Studies of integrative healthcare systems and theory-driven evaluations of IM practice models need to be undertaken. Two health services research methods can strengthen the validity of IM healthcare studies, practice theory, and fidelity evaluation. The University of Arizona Integrative Health Center (UAIHC) is a membership-supported integrative primary care clinic in Phoenix, AZ. A comparative effectiveness evaluation is being conducted to assess its clinical and cost outcomes. A process evaluation of the clinic’s practice theory components assesses model fidelity for four purposes: (1) as a measure of intervention integrity to determine whether the practice model was delivered as intended; (2) to describe an integrative primary care clinic model as it is being developed and refined; (3) as potential covariates in the outcomes analyses, to assist in interpretation of findings, and for external validity and replication; and (4) to provide feedback for needed corrections and improvements of clinic operations over time. This paper provides a rationale for the use of practice theory and fidelity evaluation in studies of integrative practices and describes the approach and protocol used in fidelity evaluation of the UAIHC.

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Primary care redesign: A simulation study at a pediatric clinic

2014 IEEE International Conference on Automation Science and Engineering (CASE) ◽

10.1109/coase.2014.6899379 ◽

2014 ◽

Cited By ~ 1

Author(s):

Xiang Zhong ◽

Molly Williams ◽

Jingshan Li ◽

Sally A. Kraft ◽

Jeffrey S. Sleeth

Keyword(s):

Primary Care ◽

Simulation Study ◽

Primary Care Redesign ◽

Pediatric Clinic

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Student Education in a University-Based General Pediatric Clinic

PEDIATRICS ◽

10.1542/peds.54.3.384b ◽

1974 ◽

Vol 54 (3) ◽

pp. 384-385

Author(s):

Jay E. Berkelhamer ◽

Janis Mendelsohn ◽

John D. Madden

Keyword(s):

Primary Care ◽

Child Care ◽

Medical Students ◽

Care Facility ◽

University Of Chicago ◽

Primary Care Facility ◽

Well Child Care ◽

Pediatric Clinic ◽

The Subject ◽

The University

Since effective education of medical students in general pediatric clinics has been the subject of much review lately,1-6 a survey of the General Pediatric Clinic of the University of Chicago was conducted. Medical students and patients appeared to be satisfied with their experience in our clinic. The clinic is a primary care facility where patients are seen on a nonreferral basis. Approximately 70% of the 12,000 patient visits per year are for continuous well child care.

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