Achieving Effective Care Coordination in the Medical Home

2009 ◽  
Vol 38 (9) ◽  
pp. 491-497 ◽  
Author(s):  
Jeanne W. McAllister ◽  
Elizabeth Presler ◽  
Renee Turchi ◽  
Richard C. Antonelli
Keyword(s):  
Care Coordination ◽  
Medical Home ◽  
Effective Care

Mental health and parenting stress in mothers of children with diabetes treated in a patient-centred medical home

2018 ◽  
Vol 36 (4) ◽  
pp. 486-492
Author(s):  
L Adelyn Cohen ◽  
Christine A Limbers
Keyword(s):  
Mental Health ◽  
Parenting Stress ◽  
Care Coordination ◽  
Medical Home ◽  
Emotional Health ◽  
Diabetic Child ◽  
Poverty Level ◽  
Hierarchical Multiple Regression ◽  
Effective Care ◽  
Race Ethnicity

Abstract Background Mothers of children with diabetes are at-risk for experiencing parenting stress and diminished mental/emotional health. To the best of our knowledge, no studies to date have examined whether there are differences in these outcomes between mothers whose diabetic child is managed in a patient-centred medical home or not. Objective The objective of the present study was to assess whether there were differences in mental health and parenting stress among mothers whose diabetic child was managed in a patient-centred medical home or not. Methods Two hundred fifty-three mothers of children with diabetes (mean age = 12.50 years; SD = 3.90) from the 2011–2012 National Survey of Children’s Health were included in this study. Hierarchical multiple regression was conducted to determine the amount of variance that having a patient-centred medical home contributed to maternal emotional/mental health and parenting stress. Results After controlling for child sex, age, race/ethnicity and family poverty level, patient-centred medical home status was associated with better mental health for mothers and less parenting stress. Effective care coordination was the only subcomponent of the patient-centred medical home that significantly contributed to the variance in mother’s mental/emotional health and parenting stress. Conclusions Receiving care in a patient-centred medical home, particularly the care coordination component, may mitigate some of the negative maternal effects of managing a child’s diabetes.

Clinical staff impressions on implementation of a teleophthalmology program to improve diabetic retinopathy surveillance informed by implementation science frameworks (Preprint)

2021 ◽  
Author(s):  
Rajeev S. Ramchandran ◽  
Reza Yousefi-Nooraie ◽  
Porooshat Dadgostar ◽  
Sule Yilmaz ◽  
Jesica Basant ◽  
...  
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Care Coordination ◽  
Low Income ◽  
Safety Net ◽  
The United States ◽  
Eye Care ◽  
Continuous Training ◽  
Effective Care ◽  
Store And Forward

BACKGROUND Store and forward camera based evaluation or teleophthalmology is considered an effective way to identify diabetic retinopathy, the leading cause of blindness in the United States, but uptake has been slow. OBJECTIVE Understanding the barriers and facilitators of implementing teleophthalmology programs from those actively adopting, running, and sustaining such programs is important for widespread adoption. METHODS This qualitative study in three urban low-income, largely minority-serving safety-net primary care clinics in Rochester, NY, USA interviewed nurses and doctors on implementing a teleophthalmology program using questions informed by Practical, Robust Implementation and Sustainability Model (PRISM) and Consolidated Framework for Implementation Research (CFIR) frameworks. RESULTS Primary care nurses operationalizing the program in their clinics saw increased work burden and lack of self-efficacy as barriers. Continuous training on the teleophthalmology process for nurses, doctors, and administrative staff through in-service and peer-training by champions/super-users were identified by interviewees as needs. Facilitators included the perceived convenience for the patient and a perceived educational advantage to the program as it gave an opportunity for providers to discuss the importance of eye care with patients. Concerns in making and tracking referrals to ophthalmology due to challenges related to care coordination were highlighted. Financial aspects of the program (e.g. patient coverage and care provider reimbursement) were unclear to many staff, influencing adoption and sustainability. CONCLUSIONS Streamlining of processes and workflows, training and assigning adequate staff, effective care coordination between primary care and eye care to improve follow-ups, and ensuring financial viability can all help streamline the adoption of teleophthalmology.

On the Threshold to the Adult Medical Home: Care Coordination in Transition

2009 ◽  
Vol 38 (9) ◽  
pp. 513-520 ◽  
Author(s):  
Patience H. White ◽  
Patti Hackett
Keyword(s):  
Home Care ◽  
Care Coordination ◽  
Medical Home

A Collaborative Perspectives Approach for Effective Care Coordination in Autism Spectrum Disorder

2020 ◽  
Vol 4 (2) ◽  
pp. 176-189
Author(s):  
Rachel N. Severs ◽  
Christina R. Noel ◽  
Ronda C. Talley ◽  
Yvette Q. Getch
Keyword(s):  
Autism Spectrum Disorder ◽  
Care Coordination ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Effective Care

scholarly journals Facilitators and Barriers to Implementing a Patient-Centered Oncology Care Model

2020 ◽  
Vol 16 (12) ◽  
pp. e1441-e1450
Author(s):  
Manasi A. Tirodkar ◽  
Lindsey Roth ◽  
Shelley Fuld Nasso ◽  
Mark W. Friedberg ◽  
Sarah H. Scholle
Keyword(s):  
Care Coordination ◽  
Medical Home ◽  
Financial Incentives ◽  
Technical Assistance ◽  
Patient Centered Care ◽  
Self Report ◽  
Patient Centered ◽  
Leadership Support ◽  
Centered Care

PURPOSE: Oncology practices often serve as the “medical home” for patients but may not have systems to support all aspects of patient-centered care. We piloted a new set of oncology medical home standards that call for accessible, continuous, coordinated, and team-based care. We examined how adoption of the standards varies across a variety of practices and compared practice self-report with external evaluation of implementation. METHODS: Five medical oncology practices in southeastern Pennsylvania implemented the standards from 2014 into 2016. Implementation support included training webinars and technical assistance. External reviewers evaluated practices’ implementation of the standards. We conducted site visits to interview providers and patients. RESULTS: Between baseline and follow-up, practice self-assessments and independent audits showed practices increased implementation of the patient-centered oncology standards. The largest improvement was seen in continuous quality improvement (QI). Practices were less successful in implementing care coordination: achievement on two standards (access and evidence-based decision support) declined from baseline to follow-up. Qualitative analyses revealed that practices focused QI in five areas: goals of care, engaging patients in QI, financial counseling, symptom management, and care coordination. Interviewees talked about facilitators, such as leadership support and physician buy-in, and barriers to transformation, including inadequate resources and staffing. Health information technology both supported and limited implementation. CONCLUSION: Oncology practices showed some progress in their implementation of patient-centered care processes over the course of the pilot program. Systems for tracking and documenting improvement, training for staff and clinicians, leadership support, and alignment of financial incentives are critical to transformation.

A centralized, primary care medical home survivorship model at the GW Cancer Center.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 45-45
Author(s):  
Elizabeth Hatcher ◽  
Farzana L. Walcott ◽  
Cam Ha ◽  
April Barbour
Keyword(s):  
Primary Care ◽  
Physical Therapy ◽  
Cancer Survivors ◽  
Weight Management ◽  
Care Coordination ◽  
Medical Home ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
The Impact ◽  
Primary Care Medical Home

45 Background: Models for survivorship care are often oncology-based. George Washington (GW) Adult Cancer Survivorship Clinic (ACS) has developed a unique, centralized model for survivorship care delivery staffed by internal medicine providers. The objective is to provide care to survivors that encompass the broad array of chronic issues they face, in addition to guidance on cancer surveillance and prevention. Methods: We implemented a centralized, primary care, consultative model of survivorship care, emphasizing care coordination. A personalized, evidence based survivorship care plan (SCP) is provided to each patient. Patients with complex needs may be seen for follow-up. A copy of the SCP is sent to the patient’s primary care provider (PCP). Referrals are made to our network of specialists within the GW system including: cardiology, neurology, weight management, genetic counseling, dermatology, physical therapy, integrative medicine, psycho-oncology, sexual health, and oncofertility. Referrals are tracked to specialty services using the electronic medical record (EMR). Results: Based on preliminary data, from January 2016 to October 2017, 261 cancer survivors were seen in the survivorship clinic. The majority were breast cancer survivors (166). Referral records were available for 225 patients. Most common were dermatology for baseline skin cancer screening (28%), physical therapy (16%), social work and psycho-oncology (15%), and weight management (15%). Conclusions: Our clinic is based on a primary care medical home model for each survivor, which includes care coordination and referral to specialty services. Limitations include inconsistent referral tracking methods with our EMR and incomplete data for all survivorship patients. Future research plans include assessing the impact of referrals on patient-reported outcomes and morbidity.

scholarly journals Measuring care coordination in German primary care – adaptation and psychometric properties of the Medical Home Care Coordination Survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aleida Ringwald ◽  
Katja Goetz ◽  
Jost Steinhaeuser ◽  
Nina Fleischmann ◽  
Alexandra Schüssler ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Home Care ◽  
Care Coordination ◽  
Medical Home ◽  
Health Care Team ◽  
Healthcare Team ◽  
Team Members ◽  
Care Practices ◽  
Primary Care Practices

Abstract Background Continuity of care is associated with many benefits for patients and health care systems. Therefore measuring care coordination - the deliberate organization of patient care activities between two or more participants - is especially needed to identify entries for improvement. The aim of this study was the translation and cultural adaptation of the Medical Home Care Coordination Survey (MHCCS) into German, and the examination of the psychometric properties of the resulting German versions of the MHCCS-P (patient version) and MHCCS-H (healthcare team version). Methods We conducted a paper-based, cross-sectional survey in primary care practices in three German federal states (Schleswig-Holstein, Hamburg, Baden-Württemberg) with patients and health care team members from May 2018 to April 2019. Descriptive item analysis, factor analysis, internal consistency and convergent, discriminant and predictive validity of the German instrument versions were calculated by using SPSS 25.0 (Inc., IBM). Results Response rates were 43% (n = 350) for patients and 34% (n = 141) for healthcare team members. In total, 300 patient questionnaires and 140 team member questionnaires could be included into further analysis. Exploratory factor analyses resulted in three domains in the MHCCS-D-P and seven domains in the MHCCS-D-H: “link to community resources”, “communication”, “care transitions”, and additionally “self-management”, “accountability”, “information technology for quality assurance”, and “information technology supporting patient care” for the MHCCS-D-H. The domains showed acceptable and good internal consistency (α = 0.838 to α = 0.936 for the MHCCS-D-P and α = 0.680 to α = 0.819 for the MHCCS-D-H). As 77% of patients (n = 232) and 63% of health care team members denied to have or make written care plans, items regarding the “plan of care” of the original MHCCS have been removed from the MHCCS-D. Conclusions The German versions of the Medical Home Care Coordination Survey for patients and healthcare team members are reliable instruments in measuring the care coordination in German primary care practices. Practicability is high since the total number of items is low (9 for patients and 27 for team members).

Sign in / Sign up

Export Citation Format

Share Document