A Primary Care Quality Improvement Approach to Health Care Transition

2012 ◽  
Vol 41 (5) ◽  
pp. e98-e105 ◽  
Author(s):  
Patience H. White ◽  
Margaret A. McManus ◽  
Jeanne W. McAllister ◽  
W. Carl Cooley
PEDIATRICS ◽  
2018 ◽  
Vol 141 (Supplement 4) ◽  
pp. S346-S354 ◽  
Author(s):  
Alice A. Kuo ◽  
Mary R. Ciccarelli ◽  
Niraj Sharma ◽  
Debra S. Lotstein

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Joe Feinglass ◽  
Samuel Wein ◽  
Caroline Teter ◽  
Christine Schaeffer ◽  
Angela Rogers

This study is part of a mixed methods evaluation of a large urban medical center transitional care practice (NMG-TC). The NMG-TC provides integrated physical and behavioral health care for high need patients referred from the hospital emergency department or inpatient units and who lack a usual source of primary care. The study was designed for internal quality improvement and sought to evaluate staff perceptions of successful transitions for their medically and socially complex patients, and alternatively, the obstacles most likely to negatively impact patient outcomes. All 16 NMG-TC patient care staff were interviewed in a collaborative effort to produce empowered testimony that might go beyond expected clinical narratives. The interview schedule included questions on risk stratification, integrated mental health care, provider to provider handoffs, and how staff deal with key social determinates of patients’ health. The constant comparative method was used to deductively derive themes reflecting key domains of transitional care practice. Seven themes emerged: i) the need to quickly assess patient complexity; ii) emphasizing caring for major mental health and substance use issues; iii) obstacles to care for uninsured, often undocumented patients; iv) the intractability of homelessness; v) expertise in advancing patients’ health literacy, engagement and activation; vi) fragmented handoffs from hospital care and vii) to primary care in the community. Respondent stories emphasized methods of nurturing patients’ self-efficacy in a very challenging urban health environment. Findings will be used to conceptualize pragmatic, potentially high-impact transitional care quality improvement initiatives capable of better addressing frequent hospital use.


2014 ◽  
Vol 15 (1) ◽  
Author(s):  
Clare E Liddy ◽  
Valeriya Blazhko ◽  
Molly Dingwall ◽  
Jatinderpreet Singh ◽  
William E Hogg

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Wenhua Wang ◽  
Leiyu Shi ◽  
Aitian Yin ◽  
Zongfu Mao ◽  
Elizabeth Maitland ◽  
...  

Objective.To compare the primary care quality among different health care structures in Tibet, China.Methods.A self-administered questionnaire survey including Primary Care Assessment Tool-Tibetan version was used to obtain data from a total of 1386 patients aged over 18 years in the sampling sites in two prefectures in Tibet. Multivariate analysis was performed to assess the association between health care structures and primary care quality while controlling for sociodemographic and health care characteristics.Results.The services provided by township health centers were more often used by a poor, less educated, and healthy population. Compared with prefecture (77.42) and county hospitals (82.01), township health centers achieved highest total score of primary care quality (86.64). Factors that were positively and significantly associated with higher total assessment scores included not receiving inpatient service in the past year, less frequent health care visits, good self-rated health status, lower education level, and marital status.Conclusions.This study showed that township health centers patients reported better primary care quality than patients visiting prefecture and county hospitals. Government health reforms should pay more attention to THC capacity building in Tibet, especially in the area of human resource development.


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