scholarly journals The Impact of Lifedoc Health’s Multidisciplinary Team Approach on Cardiometabolic Risk Profile in a Multiracial Cohort of Adults with Obesity: A 1-year Exploratory Pilot Study

2021 ◽  
Author(s):  
Pedro A Velasquez-Mieyer ◽  
Ramfis Nieto-Martinez ◽  
Andres Velasquez ◽  
Claudia P. Neira ◽  
Xichen Mou ◽  
...  
Keyword(s):  
Multidisciplinary Team ◽  
Cardiometabolic Risk ◽  
Weight Perception ◽  
Retrospective Chart Review ◽  
Background Information ◽  
Clinical Inertia ◽  
Team Approach ◽  
Routine Clinical Setting ◽  
One Year ◽  
The Impact

Background: Information regarding the effect of a multidisciplinary team (MDT) to improve cardiometabolic risk factors (CMRF) in routine clinical settings is lacking. Methods: In this one-year retrospective chart review (2018), 598 adults (African American 59%, Hispanic 35%, Caucasian 6%) with a mean age of 43.8 ± 14.0 were included. Qualifying patients (≥ 1 CMRF of overweight/obesity, prediabetes/diabetes, or hypertension) who were treated under an MDT protocol were compared to patients who qualified for MDT but were treated solely by a primary care provider (PCP). The MDT protocol included endocrinology-oriented visits, lifestyle counseling, care coordination, and shared medical appointments. Linear and binary regression were performed to identify the factors associated with CMRF changes. Results: Patients treated by MDT had a greater reduction (β, 95% CI) in weight (- 4.29 kg, -7.62, -0.97), BMI (-1.43 kg/m2, -2.68, -0.18), SBP (- 2.18 mmHg, -4.09, -0.26), and DBP (- 1.97 mmHg, -3.34, -0.60). They also had 77% higher odds of reducing ≥ 5% their initial weight, 83% higher odds of reducing 1 point of BMI, and 59% higher odds of reducing ≥2 mmHg DBP. No association was observed for MDT intervention and A1c changes. Conclusion: Compared to PCP, MDT-protocolized intervention improves CMRF in a multi-ethnic adult cohort in a routine clinical setting. Patient’s activation to access the best care and overcoming barriers from patients (weight perception, social determinants increasing no-shows to visits), providers (obesity stigma, clinical inertia), and health system (time constraints and high paperwork imposed by payers) is a priority.

scholarly journals Outcomes of Patients with Intestinal Failure after the Development and Implementation of a Multidisciplinary Team

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Sabrina Furtado ◽  
Najma Ahmed ◽  
Sylviane Forget ◽  
Ana Sant’Anna
Keyword(s):  
Multidisciplinary Team ◽  
Chart Review ◽  
Intestinal Failure ◽  
Retrospective Chart Review ◽  
Historical Cohort ◽  
Transplant Program ◽  
Multidisciplinary Program ◽  
Tertiary Center ◽  
The Impact ◽  
Overall Mortality

Aim. A multidisciplinary team was created in our institution to manage patients with intestinal failure (INFANT: INtestinal Failure Advanced Nutrition Team). We aimed to evaluate the impact of the implementation of the team on the outcomes of this patient population.Methods. Retrospective chart review of patients with intestinal failure over a 6-year period was performed. Outcomes of patients followed up by INFANT (2010–2012) were compared to a historical cohort (2007–2009).Results. Twenty-eight patients with intestinal failure were followed up by INFANT while the historical cohort was formed by 27 patients. There was no difference between the groups regarding remaining length of small and large bowel, presence of ICV, or number of infants who reached full enteral feeds. Patients followed up by INFANT took longer to attain full enteral feeds and had longer duration of PN, probably reflecting more complex cases. Overall mortality (14.8%/7.1%) was lower than other centers, probably illustrating our population of “early” intestinal failure patients.Conclusions. Our data demonstrates that the creation and implementation of a multidisciplinary program in a tertiary center without an intestinal and liver transplant program can lead to improvement in many aspects of their care.

scholarly journals The Impact of COVID-19 on Adolescents with Eating Disorders: A Cohort Study

2021 ◽  
Author(s):  
Wendy Spettigue ◽  
Nicole Obeid ◽  
Madison Erbach ◽  
Stephen Feder ◽  
Natalie Finner ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Chart Review ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Time Frame ◽  
Lower Percentage ◽  
Average Percentage ◽  
Psychological Measures ◽  
One Year ◽  
The Impact

Abstract Background: There is a noticeable lack of evidence regarding the impact of COVID-19 and the associated lockdown on young people with eating disorders. The goals of this study were 1) to examine characteristics of adolescents presenting for eating disorder (ED) assessment since the onset of the COVID-19 pandemic; 2) to compare adolescents presenting for ED assessment since the onset of the COVID-19 pandemic to those that presented for assessment one year previously; 3) to examine implications of the pandemic on the system of care. Methods: A retrospective chart review was completed on all patients assessed at a pediatric tertiary care ED program during the pandemic between April 1 and October 31, 2020, and on youth assessed during the same time frame one year previously. Data including body measurements and results of psychological measures was extracted from patients’ charts. Clinician reports were utilized for accounts of ED symptoms. Referrals to our program were also compared for the two time periods.Results: Of the 48 youth assessed between April and October 2020, average age was 14.6 years and average percentage of treatment goal weight was 77.7%. 40% cited the pandemic as a trigger for their ED; of these youth, 78.9% were medically unstable compared to 55.2% of those whose ED was not triggered by the pandemic. When comparing the 2020 cohort to those assessed in 2019, youth who presented for assessment during the pandemic trended towards having lower percentage of goal weights and higher rates of self-reported impairment, and were significantly more likely to be medically unstable and to require hospitalization. Higher rates of inpatient admissions, emergency room consultation requests and outpatient referrals deemed “urgent” were likewise associated with the pandemic period.

HIV outcomes at a Canadian remand centre

2016 ◽  
Vol 12 (3) ◽  
pp. 145-156 ◽  
Author(s):  
Yazhini Subramanian ◽  
Muhammad Naeem Khan ◽  
Sara Berger ◽  
Michelle Foisy ◽  
Ameeta Singh ◽  
...  
Keyword(s):  
Community Care ◽  
Retrospective Chart Review ◽  
Virologic Suppression ◽  
Art Adherence ◽  
Health Coverage ◽  
Short Term ◽  
Hiv Viral Load ◽  
Content Type ◽  
One Year ◽  
The Impact

Purpose The purpose of this paper is to assess the impact of short-term incarceration on antiretroviral therapy (ART) adherence, virologic suppression, and engagement and retention in community care post-release. Design/methodology/approach A retrospective chart review of patients who attended the human immunodeficiency virus (HIV) Outreach Clinic at a Canadian remand center between September 2007 and December 2011 was carried out. Data extraction included CD4 lymphocyte count, HIV viral load, ART prescription refills, and community engagement and retention during and one-year pre- and post-incarceration. Findings Outpatient engagement increased by 23 percent (p=0.01), as did ART adherence (55.2-70.7 percent, p=0.01), following incarceration. Retention into community care did not significantly improve following incarceration (22.4 percent pre-incarceration to 25.9 percent post-release, p=0.8). There was a trend toward improved virologic suppression (less than 40 copies/ml; 50-77.8 percent (p=0.08)) during incarceration and 70. 4 percent sustained this one-year post-incarceration (p=0.70). Originality/value The impact of short-term incarceration in a Canadian context of universal health coverage has not been previously reported and could have significant implications in optimizing HIV patient outcomes given the large number of HIV-positive patients cycling through short-term remand centers.

scholarly journals Introducing the care programme approach to a multidisciplinary team: the impact on clinical practice

1995 ◽  
Vol 19 (3) ◽  
pp. 143-145 ◽  
Author(s):  
Barry Matthews
Keyword(s):  
Clinical Practice ◽  
Multidisciplinary Team ◽  
Professional Staff ◽  
Care Programme ◽  
Simple Computer ◽  
Computer Based ◽  
One Year ◽  
The Impact

This paper describes the development of a simple computer-based care programme system. An important issue in its development was the attitude of professional staff. After one year of use staff recognised the system as a useful and practical aid in the management of their cases.

The Effect of Teamwork on Children With Cleft Lip and Palate and Their Mother’s Quality of Life

2019 ◽  
Vol 56 (10) ◽  
pp. 1353-1358
Author(s):  
Fatemeh Khanchezar ◽  
Negin Moradi ◽  
Neda Tahmasebi Fard ◽  
Seyyed Mahmoud Latifi ◽  
Soodabeh Bassak Nejad ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Dental Care ◽  
Multidisciplinary Team ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Team Approach ◽  
Life Questionnaire ◽  
The Impact

Objective: Maintaining and improving patients’ quality of life (QOL) are regarded as the most important aims in health-care systems. These are directly associated with intervention of health-care providers across the world. The aim of the present study was to evaluate the impact of teamwork on frequency of care provided to children with cleft lip and palate and their mothers’ QOL. Methods: This analytical epidemiology study was conducted on 101 children with cleft lip and palate and their mothers who were divided into 2 groups: a multidisciplinary team and a group of individual providers. Data were collected using convenience sampling. Quality of Life Questionnaire (Short Form-36) was assessed. The statistical analysis was performed using the χ2 test, independent t test, and Mann-Whitney U test in SPSS (20). Results: Both groups were matched. There was a significant statistical difference among the members of multidisciplinary team who received surgery, genetic counseling, and dental care ( P ≤ .043) and the individual providers groups. The 2 groups did not have significant difference in receiving the hearing test, speech therapy, and dental care 12 months before the interview. There were significant differences in QOL scores between the multidisciplinary team and the group of individual providers ( P = .013). Conclusions: The services provided as a multidisciplinary team leads to a better outcome and improves the QOL of our patients and their families. It is recommended that services should be provided in the team approach for patients with cleft lip and palate.

scholarly journals Effectiveness of a Multidisciplinary Team-Approach on Central-Line–Associated Bloodstream Infections

2021 ◽  
Vol 1 (S1) ◽  
pp. s7-s7
Author(s):  
Geehan Suleyman ◽  
Melissa Ahrens ◽  
Ann Keegan
Keyword(s):  
Multidisciplinary Team ◽  
Infection Prevention ◽  
Central Line ◽  
Physician Education ◽  
P Value ◽  
Team Approach ◽  
Multidisciplinary Team Approach ◽  
Sterile Technique ◽  
The Impact ◽  
Clabsi Rate

Background: Although there has been a significant reduction in central-line–associated bloodstream infection (CLABSI) rates in the past decade with the implementation of evidence-based practices, an estimated 30,100 CLABSI occur each year in acute-care facilities. CLABSIs are associated with increased length of stay, cost, morbidity, and mortality, and they are preventable. In this study, we assessed the impact of a multidisciplinary team approach on CLABSI rates at a 319-bed teaching hospital in northwestern Ohio. Methods: In this before-and-after retrospective study, we compared the CLABSI rate per 1,000 central-line days, standardized infection ratio (SIR), and standardized utilization ratio (SUR) in the preintervention period (January 1, 2016, to December 31, 2018) to those of the intervention period (January 1, 2019, to December 31, 2020). Despite hospital-wide nursing education focusing on central-line maintenance in 2017, our SIR and SUR remained above the national benchmark. Starting in August 2018, we began to focus on insertion practices and physician education. An infection preventionist observed resident central-line insertion training and noted that there was no emphasis on infection prevention measures. There was a best practice knowledge gap. Thus, the indications for central-line use were updated, the insertion checklist was standardized, and the vascular access policy was revised to limit femoral and internal jugular vein use. Infection prevention training was provided to all providers involved in central-line insertions. Nurses were tasked with observing insertion of every central line and stopping the procedure if there is was an observed break in sterile technique. A central-line report listing indications and duration was developed and was sent to the nursing directors who assessed daily need with providers and prompted removal of unnecessary lines. The infection prevention medical director provided CLABSI prevention education to providers. Results: The CLABSI rate per 1,000 central-line days decreased from 0.90 in the preintervention period to 0.34 in the postintervention period, resulting in a 62% reduction in CLABSI rate. The SIR decreased from 0.886 to 0.323 (p-value <0.05), yielding a 64% reduction. The SUR also decreased from 1.156 to 0.874 (p-value <0.001) with a 24% reduction. Conclusion: A multidisciplinary team-approach with emphasis on standardized insertion checklist to ensure adherence to sterile technique and prompt removal of unnecessary central lines, and physician insertion training focusing on IP practices may potentially reduce CLABSI rates.Funding: NoDisclosures: None

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