Relationship-Centered Care in a Multiple Sclerosis Comprehensive Care Center

2018 ◽  
Author(s):  
Adrienne Boissy ◽  
Claire Hara-Cleaver
Keyword(s):  
Multiple Sclerosis ◽  
Care Center ◽  
Comprehensive Care ◽  
Centered Care ◽  
Relationship Centered

scholarly journals COVID-19 OUTCOMES IN MS: EARLY EXPERIENCE FROM NYU MULTIPLE SCLEROSIS COMPREHENSIVE CARE CENTER

2020 ◽  
Author(s):  
Erica Parrotta ◽  
Ilya Kister ◽  
Leigh Charvet ◽  
Carrie Sammarco ◽  
Valerie Saha ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Critical Illness ◽  
Care Center ◽  
Fatal Outcome ◽  
Comprehensive Care ◽  
Entire Group ◽  
Neurologic Symptom ◽  
Increased Risk ◽  
Sphingosine 1 Phosphate ◽  
Anti Cd20

Objective: Report outcomes on patients with Multiple Sclerosis (MS) and related disorders with COVID-19 illness. Methods: From March 16 to April 30th, 2020, patients with MS or related disorders at NYU Langone MS Comprehensive Care Center (MSCC) were identified with laboratory-confirmed or suspected COVID-19. The diagnosis was established using a standardized questionnaire or by a review of in-patient hospital records. Results: We identified 76 patients (55 with relapsing MS of which 9 had pediatric-onset;17 with progressive MS; and 4 with related disorders). 37 underwent PCR testing and were confirmed positive. Of the entire group, 64 (84%) patients were on disease-modifying therapy (DMT) including anti-CD20 therapies (n=34, 44.7%) and sphingosine 1-phosphate receptor modulators (n=10, 13.5%). The most common COVID-19 symptoms were fever and cough, but 21.1% of patients had neurologic symptom recrudescence preceding or coinciding with the infection. A total of 18 (23.7%) were hospitalized; 8 (10.5%) had COVID-19 critical illness or related death. Features more common among those hospitalized or with critical illness or death were older age, presence of comorbidities, progressive disease, and a non-ambulatory status. No DMT class was associated with an increased risk of hospitalization or fatal outcome. Conclusions: Most MS patients with COVID-19 do not require hospitalization despite being on DMTs. Factors associated with critical illness were similar to the general at risk patient population. DMT use did not emerge as a predictor of poor COVID-19 outcome in this preliminary sample.

scholarly journals Comprehensive Care Centers and Treatment of People With Multiple Sclerosis

2007 ◽  
Vol 9 (3) ◽  
pp. 104-110 ◽  
Author(s):  
Janet P. Sutton ◽  
Claudia Schur ◽  
Jack Feldman ◽  
Tuula Tyry
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Access To Care ◽  
Access To Health Care ◽  
Health Care Services ◽  
Care Center ◽  
Comprehensive Care ◽  
Sampling Frame ◽  
Research Committee ◽  
The North

This study was conducted to determine how people with multiple sclerosis (MS) who receive care from a comprehensive care center (CCC) fare in terms of access to care, satisfaction, and perceptions of quality compared to people who are not treated at one of these centers. With data from the North American Research Committee on MS (NARCOMS) Patient Registry as the sampling frame, we administered a mixed-mode survey to 2300 people with MS to gather information about their experiences in accessing health services. A response rate of 63% was obtained, for a total of 1403 respondents. About half of the respondents indicated that they sometimes or always received care from an MS CCC. Although no differences were noted in terms of disease severity and diagnostic history, findings indicated that people treated at MS CCCs had better access to health care services and perceived their health care experiences more positively than those who never received MS care from a CCC. Even though the results provide evidence that CCCs enhanced access to care, further research is necessary to understand which organizational elements (eg, service integration services, staff training) contributed most strongly to these experiences.

scholarly journals Erratum to: Disentangling Multiple Sclerosis and depression: an adjusted depression screening score for patient-centered care

2015 ◽  
Vol 39 (1) ◽  
pp. 178-178
Author(s):  
Douglas D. Gunzler ◽  
Adam Perzynski ◽  
Nathan Morris ◽  
Robert Bermel ◽  
Steven Lewis ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Patient Centered Care ◽  
Depression Screening ◽  
Patient Centered ◽  
Centered Care

scholarly journals A Novel Approach to Supporting Relationship-Centered Care Through Electronic Health Record Ergonomic Training in Preclerkship Medical Education

2014 ◽  
Vol 89 (9) ◽  
pp. 1230-1234 ◽  
Author(s):  
Howard Silverman ◽  
Yun-Xian Ho ◽  
Susan Kaib ◽  
Wendy Danto Ellis ◽  
Marícela P. Moffitt ◽  
...  
Keyword(s):  
Medical Education ◽  
Electronic Health Record ◽  
Health Record ◽  
Novel Approach ◽  
Centered Care ◽  
Electronic Health ◽  
Relationship Centered

scholarly journals Impact of Proactive Case Management by Multiple Sclerosis Specialist Nurses on Use of Unscheduled Care and Emergency Presentation in Multiple Sclerosis

2015 ◽  
Vol 17 (4) ◽  
pp. 159-163 ◽  
Author(s):  
Alison Leary ◽  
Debbie Quinn ◽  
Amy Bowen
Keyword(s):  
Multiple Sclerosis ◽  
United Kingdom ◽  
Hospital Admissions ◽  
Care Pathway ◽  
Care Center ◽  
Emergency Presentation ◽  
The United Kingdom ◽  
Proactive Management ◽  
Bed Days ◽  
The Impact

Background: Multiple sclerosis (MS) affects approximately 100,000 people in the United Kingdom, with rising emergency admissions to the hospital. The multiple sclerosis specialist nurse plays a pivotal role in managing MS care in the United Kingdom, and there is anecdotal evidence that this role can help avoid emergency presentations and unnecessary hospital admissions. Methods: A retrospective service evaluation took place in one established MS nursing service. The impact of the introduction of proactive nurse-led management and a rapid response service on rates of emergency presentation, hospital admission, and bed use was examined. The primary intervention was the introduction of extra nursing hours (6 hours per week) and the reallocation of some routine administrative duties, which allowed the service to move to a proactive management model aimed at avoiding the need for unplanned care. In addition, a care pathway was implemented in the emergency department for patients with MS who did present. Results: Reduction in utilization was from a mean of 2700 bed-days per year (2002–2006) to a mean of 198 bed-days per year (2007–2013). Conclusions: During a 10-year period, moving from reactive management to proactive management demonstrated an increase in complex specialist nursing interventions and led to a decrease in emergency presentation and bed use at the local acute-care center.

scholarly journals A home-based comprehensive care model in patients with Multiple Sclerosis: A study pre-protocol

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 872 ◽  
Author(s):  
Lufei Young ◽  
Kathleen Healey ◽  
Mary Charlton ◽  
Kendra Schmid ◽  
Rana Zabad ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Intervention Group ◽  
Care Program ◽  
Comprehensive Care ◽  
Care Model ◽  
Patient Centered ◽  
Home Based ◽  
Comprehensive Care Model

Background Disability is prevalent in individuals with multiple sclerosis (MS), leading to difficulty in care access, significant caregiver burden, immense challenges in self-care and great societal burden.  Without highly coordinated, competent and accessible care, individuals living with progressive MS experience psychological distress, poor quality of life, suffer from life-threatening complications, and have frequent but avoidable healthcare utilizations. Unfortunately, current healthcare delivery models present severe limitations in providing easily accessible, patient-centered, coordinated comprehensive care to those with progressive MS. We propose a home-based comprehensive care model (MAHA) to address the unmet needs, challenges, and avoidable complications in individuals with progressive MS with disabling disease.Objective The article aims to describe the study design and methods used to implement and evaluate the proposed intervention.  Method The study will use a randomized controlled design to evaluate the feasibility of providing a 24-month, home-based, patient-centered comprehensive care program to improve quality of life, reduce complications and healthcare utilizations overtime (quarterly) for 24 months. A transdisciplinary team led by a MS-Comprehensivist will carry out this project. Fifty MS patients will be randomly assigned to the intervention and usual care program using block randomization procedures. We hypothesize that patients in the intervention group will have fewer complications, higher quality of life, greater satisfaction with care, and reduced healthcare utilization. The proposed project is also expected to be financially sustainable in fee-for-service models but best suited for and gain financial success in valued-based care systems.  Discussion This is the first study to examine the feasibility and effectiveness of a home-based comprehensive care management program in MS patients living with progressive disability. If successful, it will have far-reaching implications in research, education and practice in terms of providing high quality but affordable care to population living with severe complex, disabling conditions.

Comprehensive Care Center und § 116b SGB V

2008 ◽  
Vol 28 (S 01) ◽  
pp. S13-S20
Author(s):  
G. Glaeske ◽  
W. Schramm ◽  
D. Herzig
Keyword(s):  
Ambulante Versorgung ◽  
Care Center ◽  
Comprehensive Care

ZusammenfassungDurch das Gesundheitsmodernisierungsgesetz (GMG) wurde 2004 § 116b äAmbulante Behandlung im Krankenhaus“ neu ins fünfte Sozialgesetzbuch (SGB V) eingeführt. Damit wurde den Krankenkassen die Möglichkeit eröffnet, mit Krankenhäusern Verträge über die ambulante Versorgung seltener Erkrankungen wie z. B. die Hämophilie abzuschließen. Auf dieser Basis wurde 2005 ein Versorgungsvertrag zwischen der Universitätsklinik Eppendorf in Hamburg und drei großen Krankenkassen geschlossen. Im Ergebnis führte dies zu positiven Veränderungen für alle Beteiligten: Den Patienten konnte bei einer adäquaten Vergütung der Gerinnungsambulanz eine optimale Versorgung durch Anbindung an ein CCC angeboten werden. Die Transparenz der Therapie wurde verbessert und die Kommunikation zwischen den Vertragspartnern wandelte sich zu einem konstruktiven Austausch. Mit dem GKV-Wettbewerbsstärkungsgesetz (WSG) trat 2007 eine Änderung des § 116b SGB V in Kraft. Damit wurde die gesetzliche Grundlage für den genannten Vertrag entzogen. Es ist nun Aufgabe der Vertragspartner, einen Weg zu finden, die aus der Vertragsbeziehung gewonnenen Vorteile für Patienten, Gerinnungsambulanz und Kostenträger auch zukünftig sicherzustellen.

Balancing Support for Staff and Patient Centeredness Through the Design of Immediate and Relational Space: A Case Study of Ambulatory Care Center Layouts

2020 ◽  
pp. 193758672096155
Author(s):  
Julie Zook ◽  
Timothy J. Spence ◽  
Teri Joy
Keyword(s):  
Ambulatory Care ◽  
Care Center ◽  
Team Work ◽  
Care Team ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Descriptive Case Study ◽  
Centered Care ◽  
Visual Properties

Purpose: This descriptive case study of ambulatory care center typologies builds a layout-based approach to patient-centered care and care team work using theory and methods from space syntax and a recently developed approach to floorplan analysis focused on visibility. Background: Calibrating support for care team work and patient centeredness is a persistent dilemma in ambulatory care settings. Method: A review of literature and floorplan layout analysis are used. Results: The center-stage layout more strongly integrates staff and patients, while the onstage–offstage layout provides greater privacy to the care team. The integration values for exam rooms in each layout were roughly equivalent. Analysis of variations on each floor plan demonstrates ways relatively small variations can modulate visibility conditions without altering integration patterns. Conclusion: Decoupling design of immediate visual properties and relational layout properties can act as a strategy to address competing demands.

scholarly journals Night beds in psychosocial attention care centers for alcohol and drugs: analysis and characterization

2018 ◽  
Vol 71 (suppl 5) ◽  
pp. 2251-2257
Author(s):  
Gabriella de Andrade Boska ◽  
Márcia Aparecida Ferreira de Oliveira ◽  
Heloísa Garcia Claro ◽  
Thalita Silva Gomes de Araujo ◽  
Paula Hayasi Pinho
Keyword(s):  
Retrospective Study ◽  
Medical Records ◽  
Social Issues ◽  
Care Center ◽  
Study Data ◽  
Comprehensive Care ◽  
Continuous Variables ◽  
Daily Lives ◽  
Alcohol And Drugs ◽  
Drugs Analysis

ABSTRACT Objective: To analyze and characterize the use of night beds in a Psychosocial Attention Care Center for Alcohol and Drugs (Centro de Atenção Psicossocial Álcool e Drogas – CAPS ad). Method: It is a quantitative, documental, descriptive and retrospective study. Data were gathered from 565 medical records. An analysis of continuous variables was performed. Results: When admitted to the beds, most users (87.6%) consumed multiple substances daily and were vulnerable, specially in street situation (68.3%). These users were admitted on an average of two times, undergoing a previous evaluation by the nurse (85.8%), usually for detoxication or due to the vulnerable condition. They stayed in the center for an average of seven days and 31.1% did not finish what was proposed. For a few cases, hospital support was needed. Overall, discharges were planned, but the return happened without booking. Conclusion: Social issues cut through the use of night beds, however, it is a therapeutic resource that meets significant demands and is present in the daily lives of vulnerable users as a comprehensive care.

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