Key components of effective collaborative goal setting in the chronic care encounter

2015 ◽  
Vol 11 (2) ◽  
pp. 103-115 ◽  
Author(s):  
Sarah Bigi
Keyword(s):  
Goal Setting ◽  
Chronic Care ◽  
Health It ◽  
Chronic Patients ◽  
Pivotal Phase ◽  
Therapeutic Goals ◽  
Open Questions ◽  
Informed Preferences ◽  
Patient Provider Communication ◽  
Dialogue Types

Collaborative goal setting in patient–provider communication with chronic patients is the phase in which – after collecting the data regarding the patient’s health – it is necessary to make a decision regarding the best therapy and behaviors the patient should adopt until the next encounter. Although it is considered a pivotal phase of shared decision making, there remain a few open questions regarding its components and its efficacy: What are the factors that improve or impede agreement on treatment goals and strategies?; What are the ‘success conditions’ of collaborative goal setting?; How can physicians effectively help patients make their preferences explicit and then co-construct with them informed preferences to help them reach their therapeutic goals? Using the theoretical framework of dialogue types, an approach developed in the field of Argumentation Theory, it will be possible to formulate hypotheses on the ‘success conditions’ and effects on patient commitment of collaborative goal setting.

scholarly journals Chronic disease management: Discussing the perspectives of general practitioners in Italy

2019 ◽  
Vol 33 (1) ◽  
pp. 13-23
Author(s):  
Sara Barsanti ◽  
Francesca Guarneri
Keyword(s):  
Chronic Disease ◽  
Disease Management ◽  
General Practitioners ◽  
Chronic Care Model ◽  
Chronic Care ◽  
Chronic Disease Management ◽  
Point Of View ◽  
Care Model ◽  
Chronic Patients ◽  
Bonferroni Test

The aim of this paper is to provide an overview of general practitioners’ perspectives across key criteria for effective chronic disease management. The study setting is the Tuscany Region in Italy that implemented the Chronic Care Model in 2010 with multidisciplinary team to assist chronic patients. We used the results of a web-based survey of general practitioners (N = 1136) conducted in 2015 to compare the experiences and satisfaction of general practitioners involved (group 1) and not involved (group 2) in the Chronic Care Model. The analysis included all general practitioners, and compared the two groups’ perspectives of the different core aspects of Chronic Care Model through conducting an ANOVA analysis and Bonferroni test. General practitioners involved in the Chronic Care Model are found to be more favourably disposed toward measurement and benchmarking, and more satisfied in terms of decision support system. Conversely, no significant differences were found in terms of collaboration with specialists, which remains weak and in terms of community collaboration and involvement. This study provides a detailed investigation of the implementation of Disease Management Programs, by considering the professional point of view.

Implementing an oncology-specific health care IT portal to enhance patient-provider communication.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 31-31
Author(s):  
Debra A. Patt ◽  
Jennifer Trageser ◽  
Jeffrey A. Howard ◽  
Max Rush ◽  
Cara Heiman ◽  
...  
Keyword(s):  
Clinical Information ◽  
Patient Portal ◽  
Large Network ◽  
Health It ◽  
Patient Provider Communication ◽  
Extraneous Data ◽  
Key Participants ◽  
Workflow Planning ◽  
Improve Patient ◽  
Specific Health

31 Background: Our large network of oncology practices (PRs) launched a health IT (HIT) patient portal (PP) to improve patient (PT) access to clinical information (CI) and serve as a platform to enhance PR-to-PT communication (C). Methods: A team of HIT specialists and oncologists engaged in development of the PP to develop a platform to facilitate PR-to-PT C, satisfy meaningful use (MU) requirements, and have brand identification (ID) for PRs. Workflow planning for implementation was conducted including ID and education of key participants at PRs. Educational signage was posted at PRs during initiation partnered with information at check-in at clinic visits to inform PTs about PP benefits and registration steps. After consent was obtained, pts were invited by email to the PP and could access their PP and view and download their secure CI. A review of support calls from both PR personnel and pts highlighted opportunities for enhanced PP engagement. Enrollment (E) was captured monthly. Results: From April 2012 to June 2013 more than 34,000 pts have enrolled in the PP across over 47 PRs (Table). In addition, inclusion of the PR brand and removing extraneous data capture during E are critical to success. Comparing E data from April 2012 to April 2013 after increased PR brand ID and reduction of pt validation changes were implemented, there was an increase of 13% of opened Is and 22% increase in Es. Conclusions: By engaging a development team, and strategically planning content dissemination and education around initiation, implementation of the PP was widely utilized throughout the PRs. By monitoring adoption rates and capturing the PT feedback, incremental enhancements can positively affect PT engagement with PRs. This functional mechanism can now serve as a platform to facilitate C between PRs and PTs, fulfill MU requirements, and plan future dissemination of educational content. [Table: see text]

scholarly journals Chronic Care Model in Italy: a narrative review of the literature

2021 ◽  
Vol 22 ◽  
Author(s):  
Fabio Petrelli ◽  
Giovanni Cangelosi ◽  
Giulio Nittari ◽  
Paola Pantanetti ◽  
Giulia Debernardi ◽  
...  
Keyword(s):  
Chronic Diseases ◽  
Chronic Care Model ◽  
Chronic Care ◽  
Health Management ◽  
Clinical Care ◽  
Cochrane Library ◽  
Care Model ◽  
Chronic Patients ◽  
Eligibility Criteria ◽  
Critical Appraisal Skills

Abstract Aim: To analyze scientific literature on the development and implementation of the Chronic Care Model (CCM) in treating chronic diseases in the Italy context. Besides, to evaluate the effects of the activities carried out by the operators participating in the CCM on clinical care. Background: Italy is the second country globally for longevity, with 21.4% of citizens over 65 and 6.4% over 80. The CCM fits into this context, a care model aimed primarily at patients suffering from chronic diseases, especially in emergencies, as the recent COVID-19 pandemic. Methods: PubMed, Embase, Scopus, Cinahl, and Cochrane Library scientific databases were consulted, and the records selected as relevant by title and abstract by nine independent scholars, and disagreements were resolved through discussion. Finally, the studies included in this review were selected based on the eligibility criteria. Results: Twenty potentially relevant studies were selected, and after applying the eligibility criteria and screening by the Critical Appraisal Skills Program tool, eight included in this review. The studies showed the effectiveness of CCM for managing patients with heart failure in primary care settings and significant improvements in clinical outcomes, the reduction of inappropriate emergency room access for chronic patients, and the improvement of patients’ overall health with diabetes. The CCM organizational model is effective in improving the management of metabolic control and the main cardiovascular risk factors. Furthermore, this modality also allows doctors to dedicate more space to patients in the disease’s acute phase. Conclusion: The CCM, with its fundamental pillars of empowering self-management of care, could represent a valid alternative to health management. The managers of health services, especially territorial ones, could consider the CCM for the improvement of the treatments offered.

Chronic Patients’ Emotions toward Self-managing Care IT

2022 ◽  
Vol 34 (4) ◽  
pp. 0-0
Keyword(s):  
Healthy Lifestyle ◽  
Sense Of Self ◽  
Health It ◽  
Chronic Patients ◽  
Activity Trackers ◽  
Identity Centrality ◽  
The Individual

Patients’ emotions toward health IT can play an important role in explaining their usage of it. One form of health IT is self-managing care IT, such as activity trackers that can be used by chronic patients to adopt a healthy lifestyle. The goal of this study is to understand the factors that influence the arousal of emotions in chronic patients while using these tools. Past studies, in general, tend to emphasize how IT shapes emotions, underplaying the role of the individual user’s identity and, specifically, how central health is to the user’s self in shaping emotions. In this research, the authors argue that patients’ health identity centrality (i.e., the extent to which they consider health as central to their sense of self) can play an important role in forming their dependence on health IT by affecting their use of it directly and shaping their emotions around it.

Resident Training in Chronic Care and Rehabilitation

1987 ◽  
Vol 32 (2) ◽  
pp. 151-152 ◽  
Author(s):  
Samuel Packer
Keyword(s):  
Royal College ◽  
Chronic Care ◽  
Psychiatric Patients ◽  
Resident Training ◽  
Chronic Patients ◽  
University Of Toronto ◽  
Specific Program ◽  
Mcgill University ◽  
Program Content ◽  
The University

Although the Royal College requires that residents receive training in the rehabilitation of psychiatric patients, much leeway has been given to individual departments of psychiatry as to program content. This has often led to inadequate training since residents may be exposed to chronic patients without any training in rehabilitation. In order to meet this deficiency McGill University and the University of Toronto have developed specific program requirements. These are described below.

Patients’ Experiences of Comorbid HIV/AIDS and Diabetes Care and Management in Soweto, South Africa

2020 ◽  
Vol 31 (2) ◽  
pp. 373-384
Author(s):  
Edna N. Bosire
Keyword(s):  
South Africa ◽  
Chronic Care ◽  
Critical Role ◽  
Tertiary Hospital ◽  
Ethnographic Study ◽  
Public Hospitals ◽  
Conflicting Information ◽  
Patient Provider Communication ◽  
Living With Hiv

More people with HIV live in South Africa than anywhere else in the world. As people with HIV increasingly confront comorbid conditions, such as Type 2 diabetes, the need for integrated chronic care continues to grow. However, chronic care for patients with multimorbidities is limited in many public hospitals in South Africa. This ethnographic study describes patients’ experiences seeking care for comorbid HIV and diabetes at a public tertiary hospital in Soweto, South Africa, and self-management at home. Findings illustrate how fragmented care, multiple clinic appointments, conflicting information, and poor patient–provider communication impeded patients’ access to care for their multimorbidities. Socio-economic factors such as poverty, costly transport to the hospital, and food insecurity impeded management of multimorbidities. Integrated care for patients with multimorbidities in Soweto is imperative and must recognize the critical role social and economic conditions play in shaping the experiences of living with HIV, diabetes, and their overlap.

scholarly journals FORMAÇÃO PROFISSIONAL EM SAÚDE: PERSPECTIVAS INTERDISCIPLINARES EM EXTENSÃO

2018 ◽  
Vol 2 ◽  
pp. 179
Author(s):  
Victória Branca Moron ◽  
Aline Da Silva Pinto ◽  
Magale Konrath
Keyword(s):  
Undergraduate Students ◽  
Health It ◽  
Professional Qualification ◽  
Interdisciplinary Work ◽  
Know How ◽  
Health Area ◽  
Open Questions ◽  
The One ◽  
The University ◽  
Participatory Observation

A interdisciplinaridade apresenta-se como uma nova postura frente a formação profissional, em especial na área da saúde. Visa garantir a construção de uma educação de forma contextual, integral e global, rompendo os limites de cada área do saber. Neste sentido, o objetivo deste artigo é conhecer as percepções de acadêmicos dos cursos de Educação Física, Fisioterapia e Nutrição, da Universidade Feevale, sobre a atuação interdisciplinar no projeto de extensão “Saúde em Ação”, e a relevância desse processo para a sua formação profissional. O presente estudo caracterizou-se como uma pesquisa qualitativa descritiva da qual participaram 6 acadêmicos da Universidade Feevale, que fizeram parte do projeto “Saúde em Ação” durante o ano de 2016. Utilizou-se como instrumentos de coleta de dados o diário de campo da pesquisadora, no qual eram realizados os registros da observação participante. Além disto, foi aplicado com os acadêmicos um questionário contendo questões abertas. A análise de dados seguiu o proposto por Minayo (2012), com análise de conteúdo, sendo elencadas duas categorias: a) A extensão universitária como espaço de formação e b) A atuação interdisciplinar na extensão universitária. É possível concluir que os acadêmicos reconhecem e identificam o projeto de extensão como uma experiência enriquecedora em seu processo de formação. A atuação interdisciplinar é valorizada como forma de interagir e compartilhar conhecimentos. Através da extensão os acadêmicos tiveram a oportunidade de ultrapassar os limites e o campo de conhecimento da sala de aula, compreendendo a área da saúde de forma mais ampla e com suas diferentes interfaces.Palavras-chave: Formação. Interdisciplinaridade. Extensão.ABSTRACTAn interdisciplinarity presents as a new attitude towards professional formation, especially in the area of health. It aims to ensure the construction of a education in a contextual, integral and global way, breaking the limits of each area of knowledge. In this sense, the objective of this article is to know how the perceptions of the students of the Physical Education, Physical Therapy and Nutrition courses of the University Feevale, about an interdisciplinary update in the extension project “Health in Action”, and its relevance to the process of its professional qualification. The present study was characterized as a descriptive qualitative research in which 6 undergraduate students from the Feevale University participated in the project “Health in Action” during the year 2016. It was used as data collection tools or researcher’s field diary. Participatory observation records were not conducted. In addition, a questionnaire with open questions was applied with the academics. A data analysis followed the one proposed by Minayo (2012), with content analysis, being listed two categories: a) The university extension like space of formation; B) Interdisciplinary work in university extension. It is possible to conclude that academics recognize and identify the extension project as an enriching experience in their formation process. Interdisciplinary and valued acting as a way of interacting and sharing knowledge. Through the extension of academics with an opportunity to exceed the limits and the field of knowledge of the classroom, comprehending a health area in a broader way and with its different interfaces.Keywords: Formation. Interdisciplinarity. Extension.

scholarly journals Patient Accessible Electronic Health Records for the Chronically Ill: A Review of the Literature

2012 ◽  
Vol 1 (2) ◽  
pp. 64 ◽  
Author(s):  
Sara Urowitz ◽  
Kevin Smith ◽  
Nour Alkazaz ◽  
Emma Apatu ◽  
Naa Kwarley Quartey ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Chronic Care Model ◽  
Chronic Care ◽  
Chronic Illnesses ◽  
Provider Communication ◽  
Review Of The Literature ◽  
Care Model ◽  
Health Records ◽  
Patient Provider Communication ◽  
Electronic Health

Background: Consumers with chronic conditions account for approximately 70% of all healthcare spending. The Chronic Care Model is a healthcare paradigm whose purpose is the achievement of improved patient outcomes by facilitating the delivery of patient-centered, evidence-based care. We conducted a review of the literature to examine the role patient accessible electronic health records (PAEHR) may play in implementing and supporting the Chronic Care Model. Methods: A review of the literature was conducted using multiple databases (1950-2012). Publications included in the review were restricted to those using experimental or quasi-experimental methodology, English language and peer review. Results: Published results indicated that PAEHR facilitated improvements in health literacy and patient-provider communication, and that personalization of content was viewed favourably. Research on the use of PAEHR by some disease groups suggest improvements in clinical outcomes. Conclusions: The literature reviewed indicated that the patient experience for individuals with chronic illnesses could be enhanced through access to PAEHR. Improved satisfaction was noted for individuals with access to PAEHR with personalized content (e.g lab results etc). Use of PAEHR also improved patient-provider communication and increased personal knowledge and comprehension concerning individual condition and state of health. PAEHR for individuals living with chronic illnesses are an effective management technique that can help patients better manage the challenges of living with a chronic illness. These results indicate PAEHR have the potential to be a key component for actualizing the theoretical constructs of the Chronic Care Model by providing a platform for increased patient-provider collaboration.

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