scholarly journals How a State Measures Up: Ambulatory Care Pharmacists’ Perception of Practice Management Systems for Comprehensive Medication Management in Utah

Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 136
Author(s):  
Kyle Turner ◽  
Alan Abbinanti ◽  
Bradly Winter ◽  
Benjamin Berrett ◽  
Jeff Olson ◽  
...  
Keyword(s):  
Ambulatory Care ◽  
Health Systems ◽  
Assessment Tool ◽  
Medication Management ◽  
Standard Of Care ◽  
The State ◽  
Practice Management ◽  
Patient Centered ◽  
University Of Utah ◽  
High Level

Comprehensive medication management (CMM) is a patient-centered standard of care that ensures a patient’s medications are optimized. The CMM Practice Management Assessment Tool (PMAT) is a tool to assess areas of CMM practice management. The purpose of this project was to assess the state of CMM practice management based on clinical pharmacist perception for two health systems in the state of Utah, and to identify areas of excellence and/or improvement utilizing a novel method for PMAT analysis. The PMAT was distributed to all primary care-focused ambulatory care pharmacists employed by University of Utah Health (U of U Health) and Intermountain Healthcare (Intermountain). Ordinal responses were assigned to three possible categories of CMM support (High, Indifferent, and Low). Ten surveys were completed from U of U Health, and nine were completed from Intermountain. Thirty-two of the 86 survey questions resulted in a high level of support, and 25 questions resulted in a low level of support from the majority of respondents. Statistically significant differences between the institutions were found for 18 questions. The utilization of the PMAT within two Utah health systems highlighted areas of excellence and improvement and demonstrates a unique method for analysis of PMAT results.

scholarly journals Landscape of Medication Management in the Minnesota Patient-Centered Medical Home (PCMH)

2013 ◽  
Vol 4 (1) ◽  
Author(s):  
Margaret L Wallace ◽  
Jean Moon ◽  
Jody L Lounsbery ◽  
Donald L Uden
Keyword(s):  
Care Coordination ◽  
Clinical Pharmacist ◽  
Medication Management ◽  
Final Analysis ◽  
The State ◽  
Original Research ◽  
Patient Centered ◽  
Department Of Health ◽  
Care Coordinators ◽  
Pharmacist Services

Purpose: To describe the landscape of medication management within the patient-centered medical homes (PCMH) in the state of Minnesota. Methods: An electronic survey of care coordinators within PCMHs certified with the Department of Health in state of Minnesota was conducted. The survey and follow up were distributed by the Minnesota Department of Health. At the time the survey was distributed, there were 161 certified PCMHs in the state. Results: The final analysis included 21 respondents. Size, setting, and time as a certified PCMH varied between practices. PCMHs reported a higher percentage of patients enrolled at lower complexity tiers (35.0 percent at tier I and 40.4 percent enrolled at tier II), with PCMHs with clinical pharmacist services reporting slightly increased frequency of higher complexity patients. The composition of the care team varied from clinic to clinic, but all clinics were multidisciplinary with a mean of 5.8 different provider types listed for each clinic. Physicians were the most common providers of medication management across all settings, and one respondent reported that medication management services are not formally provided in his/her clinic. The presence or absence of a clinical pharmacist did not significantly influence care coordination time dedicated to medication-related activities. Respondents residing in a clinic with clinical pharmacist services reported a high level of satisfaction with pharmacist-provided services. Conclusion: The implementation of the PCMH model in many of the participating clinics was relatively recent and there remains much to be learned regarding the landscape of comprehensive medication management in the PCMH. The reported distribution of patients in complexity tiers suggests that clinics may use different strategies to determine resource allocation. Although the presence of a clinical pharmacist did not influence care coordination time dedicated, care coordinators valued services provided by clinical pharmacists.   Type: Original Research

HiMAT: High-Level Mobility Assessment Tool

2018 ◽  
Vol 30 (2) ◽  
pp. 97-99
Author(s):  
Gretchen R. Pfost ◽  
Brett Cook ◽  
Chang Ha Doh ◽  
Jerome Uthapan
Keyword(s):  
Assessment Tool ◽  
Mobility Assessment ◽  
High Level

Multidimensional analysis of the state of Russian studies on the education issues over 1993–2016

2018 ◽  
pp. 50-62
Author(s):  
Дмитрий Рубвальтер ◽  
Dmitry Rubvalter ◽  
Александр Либкинд ◽  
Alexander Libkind ◽  
Валентина Маркусова ◽  
...  
Keyword(s):  
Web Of Science ◽  
The State ◽  
Multidimensional Analysis ◽  
Russian Regions ◽  
Global Flow ◽  
Educational Issues ◽  
Foreign Countries ◽  
High Level ◽  
The Web ◽  
Made In

A multidimensional analysis of the state of Russian studies on the education issues over 1993–2016 was carried out based on the materials of the data contained in the Web of Science (SSCI, A & HCI and SCI-E databases). There were determined the dynamics and trends of a number of relevant indicators, such as the number of Russian publications by year, the share of these publications in the global flow of publications on education issues, the dynamics of the share of publications made in co-authorship with foreign colleagues, etc. A number of distributions of Russian publications on educational issues was compiled and analyzed: by journals, by Russian regions and cities, by organizations and authors of the publications. It was found that most of these distributions were characterized by a high level of non-uniformity. A list of journals (125 titles) in which Russian works on education issues had been published was compiled. Russian organizations (308) and domestic researchers (about two thousand) engaged in studying the issues of education were identified. It was discovered that more than 200 organizations and about 400 academicians from 60 foreign countries had participated in Russian studies on the education issues.

scholarly journals 22.F. Workshop: What makes for resilient health systems? Evidence from the State of Health in the EU country profiles

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Building Blocks ◽  
The State ◽  
Lessons Learned ◽  
Three Dimensions ◽  
Health System Strengthening ◽  
New Work ◽  
State Of Health ◽  
The Eu

Abstract The European Commission's State of Health in the EU (SoHEU) initiative aims to provide factual, comparative data and insights into health and health systems in EU countries. The resulting Country Health Profiles, published every two years (current editions: November 2019) are the joint work of the European Observatory on Health Systems and Policies and the OECD, in cooperation with the European Commission. They are designed to support the efforts of Member States in their evidence-based policy making and to contribute to health care systems' strengthening. In addition to short syntheses of population health status, determinants of health and the organisation of the health system, the Country Profiles provide an assessment of the health system, looking at its effectiveness, accessibility and resilience. The idea of resilient health systems has been gaining traction among policy makers. The framework developed for the Country Profiles template sets out three dimensions and associated policy strategies and indicators as building blocks for assessing resilience. The framework adopts a broader definition of resilience, covering the ability to respond to extreme shocks as well as measures to address more predictable and chronic health system strains, such as population ageing or multimorbidity. However, the current framework predates the onset of the novel coronavirus pandemic as well as new work on resilience being done by the SoHEU project partners. This workshop aims to present resilience-enhancing strategies and challenges to a wide audience and to explore how using the evidence from the Country Profiles can contribute to strengthening health systems and improving their performance. A brief introduction on the SoHEU initiative will be followed by the main presentation on the analytical framework on resilience used for the Country Profiles. Along with country examples, we will present the wider results of an audit of the most common health system resilience strategies and challenges emerging from the 30 Country Profiles in 2019. A roundtable discussion will follow, incorporating audience contributions online. The Panel will discuss the results on resilience actions from the 2019 Country Profiles evidence, including: Why is resilience important as a practical objective and how is it related to health system strengthening and performance? How can countries use their resilience-related findings to steer national reform efforts? In addition, panellists will outline how lessons learned from country responses to the Covid-19 pandemic and new work on resilience by the Observatory (resilience policy briefs), OECD (2020 Health at a Glance) and the EC (Expert Group on Health Systems Performance Assessment (HSPA) Report on Resilience) can feed in and improve the resilience framework that will be used in the 2021 Country Profiles. Key messages Knowing what makes health systems resilient can improve their performance and ability to meet the current and future needs of their populations. The State of Health in the EU country profiles generate EU-wide evidence on the common resilience challenges facing countries’ health systems and the strategies being employed to address them.

scholarly journals Benefit of a pharmacist-led intervention for medication management of renal transplant patients: a controlled before-and-after study

2021 ◽  
Vol 12 ◽  
pp. 204062232110052
Author(s):  
Jeremy Chambord ◽  
Lionel Couzi ◽  
Pierre Merville ◽  
Karine Moreau ◽  
Fabien Xuereb ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Immunosuppressive Therapy ◽  
Medication Management ◽  
Intervention Group ◽  
Knowledge Score ◽  
Control Group ◽  
Patient Knowledge ◽  
Transplant Patients ◽  
Before And After ◽  
High Level

Aims: To assess the effect of a pharmacist-led intervention, using Barrows cards method, during the first year after renal transplantation, on patient knowledge about their treatment, medication adherence and exposure to treatment in a French cohort. Methods: We conducted a before-and-after comparative study between two groups of patients: those who benefited from a complementary pharmacist-led intervention [intervention group (IG), n = 44] versus those who did not [control group (CG), n = 48]. The pharmacist-led intervention consisted of a behavioral and educational interview at the first visit (visit 1). The intervention was assessed 4 months later at the second visit (visit 2), using the following endpoints: treatment knowledge, medication adherence [proportion of days covered (PDC) by immunosuppressive therapy] and tacrolimus exposure. Results: At visit 2, IG patients achieved a significantly higher knowledge score than CG patients (83.3% versus 72.2%, p = 0.001). We did not find any differences in treatment exposure or medication adherence; however, the intervention tended to reduce the proportion of non-adherent patients with low knowledge scores. Using the PDC by immunosuppressive therapy, we identified 10 non-adherent patients (10.9%) at visit 1 and six at visit 2. Conclusions: Our intervention showed a positive effect on patient knowledge about their treatment. However, our results did not show any improvement in overall medication adherence, which was likely to be because of the initially high level of adherence in our study population. Nevertheless, the intervention appears to have improved adherence in non-adherent patients with low knowledge scores.

“Don’t talk to them about goals of care”: Understanding disparities in advance care planning

2021 ◽  
Author(s):  
Deepshikha Charan Ashana ◽  
Noah D’Arcangelo ◽  
Priscilla K Gazarian ◽  
Avni Gupta ◽  
Stephen Perez ◽  
...  
Keyword(s):  
Native American ◽  
Ethnic Groups ◽  
Health Systems ◽  
Advance Care Planning ◽  
Religious Beliefs ◽  
Barriers And Facilitators ◽  
National Study ◽  
Care Planning ◽  
Patient Centered ◽  
Advance Care

Abstract Background Structurally marginalized groups experience disproportionately low rates of advance care planning (ACP). To improve equitable patient-centered end-of-life care, we examine barriers and facilitators to ACP among clinicians as they are central participants in these discussions. Methods In this national study, we conducted semi-structured interviews with purposively selected clinicians from six diverse health systems between August 2018 and June 2019. Thematic analysis yielded themes characterizing clinicians’ perceptions of barriers and facilitators to ACP among patients, and patient-centered ways of overcoming them. Results Among 74 participants, 49 (66.2%) were physicians, 16.2% were nurses, and 13.5% were social workers. Most worked in primary care (35.1%), geriatrics (21.1%), and palliative care (19.3%) settings. Clinicians most frequently expressed difficulty discussing ACP with certain racial and ethnic groups (African American, Hispanic, Asian, and Native American) (31.1%), non-native English speakers (24.3%), and those with certain religious beliefs (Catholic, Orthodox Jewish, and Muslim) (13.5%). Clinicians were more likely to attribute barriers to ACP completion to patients (62.2%), than to clinicians (35.1%) or health systems (37.8%). Three themes characterized clinicians’ difficulty approaching ACP (Preconceived views of patients’ preferences; narrow definitions of successful ACP; lacking institutional resources), while the final theme illustrated facilitators to ACP (Acknowledging bias and rejecting stereotypes; mission-driven focus on ACP; acceptance of all preferences). Conclusions Most clinicians avoided ACP with certain racial and ethnic groups, those with limited English fluency, and persons with certain religious beliefs. Our findings provide evidence to support development of clinician-level and institutional-level interventions and to reduce disparities in ACP.

scholarly journals Overview of Tertiary Addictions Services response to Opioid dependence during the COVID-19 Pandemic

2021 ◽  
pp. 1-14
Author(s):  
K Hennigan ◽  
E Corrigan ◽  
N Killeen ◽  
E Keenan ◽  
M Scully
Keyword(s):  
At Risk ◽  
Opioid Dependence ◽  
Medication Management ◽  
Health Problems ◽  
Healthcare Staff ◽  
Addiction Services ◽  
Patients At Risk ◽  
Guidance Documents ◽  
High Level ◽  
Opioid Users

Abstract The emergence of the COVID-19 pandemic has presented the addiction services with an unprecedented set of challenges. Opioid users are particularly vulnerable because of their high level of pre-existing health problems and lifestyle factors. In order to minimise their risks to self and to others in the current Covid-19 crisis, the service has sought to urgently identify vulnerable individuals, and induct them into OST treatment promptly. Additionally, several guidelines have been created and regularly updated by the HSE for any healthcare staff working with opioid users. These include guidance documents, to facilitate prompt induction of patients onto the OST programme, the prescribing of naloxone to all patients at risk of overdose, eConsultation, medication management for those in self-isolation, and the delivery of injecting equipment. The guidance documents and resources will provide a template for a new way of working for the sector during these challenging times and into the future.

scholarly journals Courage and Cowardice in the North African Campaign: The Eighth Army and Defeat in the Summer of 1942

2013 ◽  
Vol 20 (1) ◽  
pp. 99-122 ◽  
Author(s):  
Jonathan Fennell
Keyword(s):  
North Africa ◽  
The State ◽  
The Other ◽  
Human Dimension ◽  
North African ◽  
The North ◽  
High Level ◽  
Eighth Army

High rates of desertion and surrender during the battles in North Africa in the summer of 1942 were a major factor in Eighth Army’s poor combat performance. At the time, some suggested that these problems were symptomatic of a lack of courage or even of cowardice. There are two broad strands to the conceptualization of courage and cowardice. One focuses on the willingness of the person to fight; the other puts emphasis on how actions express an individual’s ability to cope with fear. Whichever conceptualization is used, high morale motivates the soldier to fight and shields the ordinary recruit from his fear, preventing it from overcoming him in battle. Where morale fails, the soldier is left demotivated and burdened with his terror and, therefore, and is therefore prone to desertion or surrender. Because it is extremely difficult to maintain morale at a continuously high level in an environment governed by chance and managed by humans, all soldiers can find themselves in situations where their actions may be judged as cowardly. Alternatively, if they are properly motivated to fight and prepared by the state and military to deal with the unavoidable fear of combat, all soldiers can be labelled courageous. Accordingly, emotive terms should be avoided when attempting to describe rationally explainable outcomes. The undoubtedly negative connotations attached to cowardice in battle and the positive ones attached to courage are, therefore, arguably unhelpful in understanding Eighth Army’s performance in the summer of 1942 and the human dimension in warfare more generally.

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