scholarly journals Meeting Personal Health Care Needs in Primary Care: A Response From the Athletic Training Profession

2020 ◽  
Vol 15 (4) ◽  
pp. 278-288
Author(s):  
Wade Green ◽  
Eric Sauers
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Care ◽  
Medical Education ◽  
Athletic Training ◽  
Graduate Medical Education ◽  
Care Delivery ◽  
Graduate Medical ◽  
The Impact ◽  
Training Practice

Context Review of the origins, history, and attributes of primary care demonstrates continued challenges for the future of primary care and care delivery. The profession of athletic training may benefit from a critical self-review to examine its readiness to assist in reinventing primary care. Objective To explore parity between primary care attributes and athletic training practice and promote a timely and relevant discussion of primary care and public health integration native to athletic training practice, competency-based education with an emphasis on milestones, and the development of clinical specialists to prepare a well-trained workforce. Background General practitioners developed educational reforms through graduate medical education that resulted in primary care as it is known today. Graduate medical education has refined its assessment of students to include milestones for the purpose of describing the progression of clinical competence with identifiable behaviors. The development of future clinical specialists in primary care will also involve competence in public health. Recommendation(s) Practicing clinicians and educators should begin to critically explore the congruencies between the primary care attributes and athletic training practice. It is important to conceptualize traditional models of care within the frameworks of primary care and public health, given that athletic training practice routinely engages patients at personal, community, and environmental levels. The athletic training skill mix should be purposefully presented within interprofessional health care teams in primary care so that stakeholders can appropriately integrate athletic trainers (ATs) at the point of first contact. It is plausible that continued structural changes in the traditional practice settings will be required to facilitate integration of ATs into primary care. Conclusion(s) The impact of ATs in ambulatory settings and primary care possesses a foundation in the current literature. The ATs are uniquely suited to create a symbiotic pattern of care integrating both primary care and public health for improved outcomes.

scholarly journals Plug the Leak: Align Public Spending With Public Need

2012 ◽  
Vol 4 (3) ◽  
pp. 293-295 ◽  
Author(s):  
Donald E. Girard ◽  
Patrick Brunett ◽  
Andrea Cedfeldt ◽  
Elizabeth A. Bower ◽  
Christine Flores ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Medical Education ◽  
Graduate Medical Education ◽  
Public Spending ◽  
Education Spending ◽  
Graduate Medical ◽  
Workforce Needs ◽  
Training Physicians ◽  
And Training

Abstract We explore the history behind the current structure of graduate medical education funding and the problems with continuing along the current funding path. We then offer suggestions for change that could potentially manage this health care spill. Some of these changes include attracting more students into primary care, aligning federal graduate medical education spending with future workforce needs, and training physicians with skills they will require to practice in systems of the future.

scholarly journals The future of practice science: challenges and opportunities for neurosurgery

2013 ◽  
Vol 34 (1) ◽  
pp. E8 ◽  
Author(s):  
Nathan R. Selden ◽  
Zoher Ghogawala ◽  
Robert E. Harbaugh ◽  
Zachary N. Litvack ◽  
Matthew J. McGirt ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Patient Outcomes ◽  
Graduate Medical Education ◽  
Care Delivery ◽  
Clinical Environment ◽  
Patient Centeredness ◽  
Quality Reporting ◽  
Graduate Medical ◽  
Regulatory Mandates

Outcomes-directed approaches to quality improvement have been adopted by diverse industries and are increasingly the focus of government-mandated reforms to health care education and delivery. The authors identify and review current reform initiatives originating from agencies regulating and funding graduate medical education and health care delivery. These reforms use outcomes-based methodologies and incorporate principles of lifelong learning and patient centeredness. Important new initiatives include the Accreditation Council for Graduate Medical Education Milestones; the pending adoption by the American Board of Neurological Surgery of new requirements for Maintenance of Certification that are in part outcomes based; initiation by health care systems and consortia of public reporting of patient outcomes data; institution by the Centers for Medicare & Medicaid Services of requirements for comparative effectiveness research and the physician quality reporting system; and linking of health care reimbursement in part to patient outcomes data and quality measures. Opportunities exist to coordinate and unify patient outcomes measurement throughout neurosurgical training and practice, enabling effective patient-centered improvements in care delivery as well as efficient compliance with regulatory mandates. Coordination will likely require the development of a new science of practice based in the daily clinical environment and utilizing clinical data registries. A generation of outcomes science and quality experts within neurosurgery should be trained to facilitate attainment of these goals.

The Impact of Graduate Medical Education Financing Policies on Pediatric Residency Training

PEDIATRICS ◽  
1998 ◽  
Vol 101 (Supplement_3) ◽  
pp. 785-794
Author(s):  
Carol Bazell ◽  
Edward Salsberg
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Managed Care ◽  
Residency Training ◽  
Graduate Medical Education ◽  
Graduate Medical ◽  
Pediatric Residency ◽  
The Impact ◽  
Managed Care Organizations ◽  
Future Practice

Objective. To review special issues related to pediatric residency training in managed care organizations, the effects of the changing health care system on the demand for pediatricians and the potential impact on financial support for residency training, current methods of financing graduate medical education (GME), possible future approaches to financing GME, and policy directions to support training of pediatricians well prepared for future practice. Methods. We reviewed current information on residency education in managed care settings, including the rationale for training in such settings and the realities of such educational experiences. We then assessed the evidence concerning the supply and demand for pediatricians in the present health care marketplace, with its evolution to managed systems of health care. We summarized current approaches to financing GME through Medicare, Medicaid, private insurers and purchasers, and direct federal and state support, with emphasis on the financing of ambulatory training which could occur in managed care settings. Lastly, we described factors influencing the upcoming revolution in GME financing and outlined possible new policy directions for the financing of relevant GME training experiences. Results. Appropriate training experiences in managed care organizations may be a valuable strategy to address the current disconnect between the traditional hospital-based education of pediatricians and the expanded competencies necessary to practice in intensively managed, integrated and accountable health systems. Present pediatrician supply appears to be in relative balance with health maintenance organization staffing patterns and with needs-based requirements estimates. However, the pediatrician-to-child population ratio is predicted to increase rapidly over the next decade, leading to an oversupply of pediatricians under likely future health care delivery system scenarios. Medicare is the largest explicit payer of GME training costs, historically directing reimbursement primarily for hospital-based education. Numerous innovative financing strategies are being considered to facilitate funding of GME training in ambulatory settings and to open up funding to greater public scrutiny and accountability. Conclusions. Although reforms in federal GME financing have been limited to date and other significant changes have been largely state-based, it is likely in the future that explicit funds will be targeted to specialties in demand that prepare physicians well for future practice. Pediatricians and medical educators must intensify their voices in the financing debate to ensure a productive future for quality pediatric residency training.

scholarly journals Restructuring Graduate Medical Education to Meet the Health Care Needs of Emirati Citizens

2013 ◽  
Vol 5 (2) ◽  
pp. 195-200 ◽  
Author(s):  
Sawsan Abdel-Razig ◽  
Hatem Alameri
Keyword(s):  
Health Care ◽  
Medical Education ◽  
United Arab Emirates ◽  
Graduate Medical Education ◽  
Health Care Systems ◽  
Abu Dhabi ◽  
Care Needs ◽  
Graduate Medical ◽  
Comprehensive Health ◽  
The Government

Abstract Many nations are struggling with the design, implementation, and ongoing improvement of health care systems to meet the needs of their citizens. In the United Arab Emirates, a small nation with vast wealth, the lives of average citizens have evolved from a harsh, nomadic existence to enjoyment of the comforts of modern life. Substantial progress has been made in the provision of education, housing, health, employment, and other forms of social advancement. Having covered these basic needs, the government of Abu Dhabi, United Arab Emirates, is responding to the challenge of developing a comprehensive health system to serve the needs of its citizens, including restructuring the nation's graduate medical education (GME) system. We describe how Abu Dhabi is establishing GME policies and infrastructure to develop and support a comprehensive health care system, while also being responsive to population health needs. We review recent progress in developing a systematic approach for developing GME infrastructure in this small emirate, and discuss how the process of designing a GME system to meet the needs of Emirati citizens has benefited from the experience of “Western” nations. We also examine the challenges we encountered in this process and the solutions adopted, adapted, or specifically developed to meet local needs. We conclude by highlighting how our experience “at the GME drawing board” reflects the challenges encountered by scholars, administrators, and policymakers in nations around the world as they seek to coordinate health care and GME resources to ensure care for populations.

scholarly journals Primary care teams’ experiences of delivering mental health care during the COVID-19 pandemic: a qualitative study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Rachelle Ashcroft ◽  
Catherine Donnelly ◽  
Maya Dancey ◽  
Sandeep Gill ◽  
Simon Lam ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Qualitative Study ◽  
Mental Health Care ◽  
Focus Groups ◽  
Care Delivery ◽  
Virtual Care ◽  
Primary Care Teams ◽  
The Impact

Abstract Background Integrated primary care teams are ideally positioned to support the mental health care needs arising during the COVID-19 pandemic. Understanding how COVID-19 has affected mental health care delivery within primary care settings will be critical to inform future policy and practice decisions during the later phases of the pandemic and beyond. The objective of our study was to describe the impact of the COVID-19 pandemic on primary care teams’ delivery of mental health care. Methods A qualitative study using focus groups conducted with primary care teams in Ontario, Canada. Focus group data was analysed using thematic analysis. Results We conducted 11 focus groups with 10 primary care teams and a total of 48 participants. With respect to the impact of the COVID-19 pandemic on mental health care in primary care teams, we identified three key themes: i) the high demand for mental health care, ii) the rapid transformation to virtual care, and iii) the impact on providers. Conclusions From the outset of the COVID-19 pandemic, primary care quickly responded to the rising mental health care demands of their patients. Despite the numerous challenges they faced with the rapid transition to virtual care, primary care teams have persevered. It is essential that policy and decision-makers take note of the toll that these demands have placed on providers. There is an immediate need to enhance primary care’s capacity for mental health care for the duration of the pandemic and beyond.

scholarly journals Can the Health-Care System Meet the Challenge of Pandemic Flu? Planning, Ethical, and Workforce Considerations

2007 ◽  
Vol 122 (5) ◽  
pp. 573-578 ◽  
Author(s):  
Peter J. Levin ◽  
Eric N. Gebbie ◽  
Kristine Qureshi
Keyword(s):  
Public Health ◽  
Health Care ◽  
Ethical Issues ◽  
Care Delivery ◽  
Care Staff ◽  
Health Care Staff ◽  
Accurate Information ◽  
The Public ◽  
Health Care Delivery Systems ◽  
The Impact

The federal pandemic influenza plan predicts that 30% of the population could be infected. The impact of this pandemic would quickly overwhelm the public health and health-care delivery systems in the U.S. and throughout the world. Surge capacity for staffing, availability of drugs and supplies, and alternate means to provide care must be included in detailed plans that are tested and drilled ahead of time. Accurate information on the disease must be made available to health-care staff and the public to reduce fear. Spokespersons must provide clear, consistent messages about the disease, including actions to be taken to contain its spread and treat the afflicted. Home care will be especially important, as hospitals will be quickly overwhelmed. Staff must be prepared ahead of time to assure their ability and willingness to report to work, and public health must plan ahead to adequately confront ethical issues that will arise concerning the availability of treatment resources. The entire community must work together to meet the challenges posed by an epidemic. Identification and resolution of these challenges and issues are essential to achieve adequate public health preparedness.

scholarly journals Graduate Medical Education on the Frontlines during the COVID-19 Pandemic in New York City- A Response to Promote Well-being

2021 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Medical Education ◽  
Graduate Medical Education ◽  
Health Program ◽  
Mental Health Program ◽  
Well Being ◽  
The United States ◽  
Personal Factors ◽  
Graduate Medical

Introduction: The COVID-19 pandemic has driven many health care institutions in the United States beyond their capacity. Physicians-in-training in graduate medical education programs have suffered the strain of providing patient care during this unprecedented time of crisis. The significant prevalence of pre-existing resident and fellow burnout and depression makes the need for action by institutions to support the well-being of residents and fellows even more urgent. We aim to describe innovative adaptations our Office of Graduate Medical Education implemented with the support of institutional leadership as responses to promote the well-being of residents and fellows on the frontlines during the COVID-19 pandemic. Methods: The Office of Graduate Medical Education (GME), in collaboration with the Office of Well-being and Resilience, developed a set of resources and interventions to support trainees during the pandemic based on four major categories: workplace culture, personal factors and health, mental health support, and workplace efficiency and function. Examination of the capacity of existing services and gaps that needed to be filled in the rapidly evolving early days of the COVID pandemic led to a robust growth in resources. For example, the already established Student and Trainee Mental Health program was able to expand and adapt its role to serve trainee needs more effectively. Results: We expanded resources to target trainee well-being across a broad array of domains within a short time frame. With investment in access to the Student and Trainee Mental Health program, utilization increased by 25.7%, with 1,231 more visits in 2020 compared to the number of visits in 2019, prior to the COVID-19 pandemic. The creation of Recharge Rooms had a positive impact on the well-being of health care workers. After a single fifteen-minute experience in the Recharge Room, an average 59.6% reduction in self-reported stress levels was noted by users. Other interventions were noted to be helpful in regular town hall meetings with trainees. Conclusion: Addressing trainee well-being is an essential aspect of a crisis response. The Mount Sinai Health System was able to care for the physical, mental, psychosocial, and safety needs of our trainees thanks to the collaborative effort of a pre-existing institutional well-being program and the GME Office. The ability to implement such a response was enabled by our well-being foundation, which allowed leadership at the highest institutional level and the Office of GME to provide support in response to this unprecedented crisis.

Integration of Web Analytics into Graduate Medical Education: Usability Study (Preprint)

2021 ◽  
Author(s):  
Jackson Massanelli ◽  
Kevin W Sexton ◽  
Chris T Lesher ◽  
Hanna K Jensen ◽  
Mary K Kimbrough ◽  
...  
Keyword(s):  
Medical Education ◽  
Graduate Medical Education ◽  
Web Applications ◽  
Group Analysis ◽  
User Engagement ◽  
Web Analytics ◽  
Graduate Medical ◽  
Main Page ◽  
Session Duration ◽  
The Impact

BACKGROUND Web analytics is the measurement, collection, analysis, and reporting of websites’ and web applications’ usage data. While common in the e-commerce arena, web analytics are underutilized in graduate medical education. OBJECTIVE The UAMS Department of Surgery website was revamped with input from in-house surgeons in August 2017. This study investigated the use of web analytics to gauge the impact of our department’s website redesign project. METHODS Google Analytics software was used to measure website performance before and after implementation of the new website. Eight-month matched periods were compared. Factors tracked included total users, new users, total sessions, sessions per user, pages per session, average session duration, total page views, and bounce rate (the percentage of visitors who visit a site then leave [i.e. bounce] without continuing to another page on the same site). RESULTS Analysis using a non-paired Student’s t-test demonstrated a statistically significant increase for total page views (33,065 vs 81,852; p<0.0001) and decrease for bounce rate (50.70% vs 0.23%; p<0.0001). Total users, new users, total sessions, sessions per user, and pages per sessions showed improvement; average session duration was unchanged. Sub-group analysis showed that after the main page, the next three most frequently visited pages relate to GME programs in our department. CONCLUSIONS Web analytics are practical measures of a website’s efficacy. Our data suggest that a modern website significantly improves user engagement. An up-to-date website is essential for contemporary GME recruitment, will likely enhance engagement of residency applicants with our GME programs, and warrants further investigation.

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