7 results on '"Washington DR"'
Search Results
2. Developing Emerging Leaders to Support Team-Based Primary Care.
- Author
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Coleman K, Wagner EH, Ladden MD, Flinter M, Cromp D, Hsu C, Crabtree BF, and McDonald S
- Subjects
- Career Mobility, Humans, Program Development, Program Evaluation, United States, Leadership, Patient Care Team organization & administration, Primary Health Care organization & administration, Staff Development
- Abstract
Teams are increasingly used to deliver high-quality, accessible primary care, yet few leadership programs support the development of team-based care leadership capabilities. The 12-month Emerging Leaders program presents a prototype for how interdisciplinary training targeting frontline staff might be implemented. Emerging Leaders training included didactic content, mentorship, applied peer-to-peer learning, and personal leadership development components delivered in person and virtually. Attendance at training events was high. Nominators and Emerging Leaders noted improvements in knowledge, skills, and attitudes of program participants. Forty percent of participants went on to promotions or new jobs.
- Published
- 2019
- Full Text
- View/download PDF
3. Cost Estimates for Designing and Implementing a Novel Team Care Model for Chronically Ill Patients.
- Author
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Panattoni L, Dillon E, Hurlimann L, Durbin M, and Tai-Seale M
- Subjects
- California, Female, Health Services Research, Humans, Male, Middle Aged, Chronic Disease, Costs and Cost Analysis, Diabetes Mellitus therapy, Hypertension therapy, Models, Economic, Patient Care Team economics, Primary Health Care economics
- Abstract
Little is known about the cost of implementing chronic care models. We estimate the human resource cost of implementing a novel team-based chronic care model "Champion," at a large multispecialty group practice. We used activity-based costing to calculate costs from development through rollout and stabilization in 1 clinic with 12 000 chronic care patients. Data analyzed included Microsoft Outlook meeting metadata, supporting documents, and 2014 employee wages. Implementation took more than 29 months, involved 168 employees, and cost the organization $2 304 787. Payers may need to consider a mixed-payment model to support the both implementation and maintenance costs of team-based chronic care.
- Published
- 2018
- Full Text
- View/download PDF
4. Comparing Patient-Centered Medical Home Implementation in Urban and Rural VHA Clinics: Results From the Patient Aligned Care Team Initiative.
- Author
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Johnson V, Wong E, Lampman M, Curtis I, Fortney J, Kaboli P, Fihn S, and Nelson K
- Subjects
- Cross-Sectional Studies, Health Services Research, Humans, Puerto Rico, United States, United States Department of Veterans Affairs, Patient Care Team organization & administration, Patient-Centered Care, Primary Health Care organization & administration, Rural Health Services organization & administration, Urban Health Services organization & administration
- Abstract
Rural Veterans Health Administration (VHA) primary care clinics are smaller, have fewer staff, and serve more rural patients compared with urban VHA primary care clinics. This may lead to different challenges to implementation of the Patient-Centered Medical Home (PCMH) model, the Patient Aligned Care Team, in the VHAs' large integrated health system. In this cross-sectional observational study of 905 VHA primary clinics in the United States and Puerto Rico, we found overall PCMH implementation was greater in rural compared to urban primary care clinics. Urban-rural differences in PCMH implementation may largely be related to clinic organizational factors.
- Published
- 2018
- Full Text
- View/download PDF
5. Barriers to Engagement in Collaborative Care Treatment of Uncontrolled Diabetes in a Safety-Net Clinic.
- Author
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Belyeu B, Chwastiak L, Russo J, Kiefer M, Mertens K, Chew L, and Jackson SL
- Subjects
- Adolescent, Adult, Chronic Pain psychology, Depression psychology, Diabetes Mellitus blood, Diabetes Mellitus therapy, Female, Glycated Hemoglobin analysis, Humans, Male, Middle Aged, Multivariate Analysis, Patient Participation psychology, Primary Health Care methods, Retrospective Studies, Safety-net Providers methods, Young Adult, Diabetes Mellitus psychology, Patient Care Team statistics & numerical data, Patient Participation statistics & numerical data, Primary Health Care statistics & numerical data, Safety-net Providers statistics & numerical data
- Abstract
Purpose The purpose of the study was to evaluate patient factors associated with nonengagement in a Diabetes Collaborative Care Team (DCCT) program in a safety-net clinic. Methods The first 18 months of a multidisciplinary care, team-based diabetes care management program in a safety-net primary care clinic were studied. Nonengagement was defined as fewer than 2 visits with a team member during the 18 months of the program. Patients who did not engage in the program were compared with those who did engage on demographics, comorbid medical and psychiatric diagnoses, and cardiovascular risk factors, using univariate and multivariable analyses. Results Of the 151 patients referred to the DCCT, 68 (45%) were nonengaged. In unadjusted analyses, patients who did not engage were more likely to be female and have higher baseline A1C values; they were less likely to have major depressive disorder, anxiety disorder, any depression diagnosis, and hyperlipidemia. Female gender and chronic pain were independently associated with nonengagement after multivariable adjustment. Conclusions The findings suggest that among patients with uncontrolled diabetes in an urban safety-net primary care clinic, there is a need to address barriers to engagement for female patients and to integrate chronic pain management strategies within multicondition collaborative care models.
- Published
- 2017
- Full Text
- View/download PDF
6. Leadership training in health care action teams: a systematic review.
- Author
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Rosenman ED, Shandro JR, Ilgen JS, Harper AL, and Fernandez R
- Subjects
- Curriculum, Humans, United States, Health Personnel education, Leadership, Patient Care Team
- Abstract
Purpose: To identify and describe the design, implementation, and evidence of effectiveness of leadership training interventions for health care action (HCA) teams, defined as interdisciplinary teams whose members coordinate their actions in time-pressured, unstable situations., Method: The authors conducted a systematic search of the PubMed/MEDLINE, CINAHL, ERIC, EMBASE, PsycINFO, and Web of Science databases, key journals, and review articles published through March 2012. They identified peer-reviewed English-language articles describing leadership training interventions targeting HCA teams, at all levels of training and across all health care professions. Reviewers, working in duplicate, abstracted training characteristics and outcome data. Methodological quality was evaluated using the Medical Education Research Study Quality Instrument (MERSQI)., Results: Of the 52 included studies, 5 (10%) focused primarily on leadership training, whereas the remainder included leadership training as part of a larger teamwork curriculum. Few studies reported using a team leadership model (2; 4%) or a theoretical framework (9; 17%) to support their curricular design. Only 15 studies (29%) specified the leadership behaviors targeted by training. Forty-five studies (87%) reported an assessment component; of those, 31 (69%) provided objective outcome measures including assessment of knowledge or skills (21; 47%), behavior change (8; 18%), and patient- or system-level metrics (8; 18%). The mean MERSQI score was 11.4 (SD 2.9)., Conclusions: Leadership training targeting HCA teams has become more prevalent. Determining best practices in leadership training is confounded by variability in leadership definitions, absence of supporting frameworks, and a paucity of robust assessments.
- Published
- 2014
- Full Text
- View/download PDF
7. The emerging primary care workforce: preliminary observations from the primary care team: learning from effective ambulatory practices project.
- Author
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Ladden MD, Bodenheimer T, Fishman NW, Flinter M, Hsu C, Parchman M, and Wagner EH
- Subjects
- Ambulatory Care organization & administration, Humans, Organizational Innovation, United States, Workforce, Patient Care Team organization & administration, Primary Health Care organization & administration, Professional Practice organization & administration, Professional Role
- Abstract
Many primary care practices are changing the roles played by the members of their health care teams. The purpose of this article is to describe some of these new roles, using the authors' preliminary observations from 25 site visits to high-performing primary care practices across the United States in 2012-2013. These sites visits, to practices using their workforce creatively, were part of the Robert Wood Johnson Foundation-funded initiative, The Primary Care Team: Learning From Effective Ambulatory Practices.Examples of these new roles that the authors observed on their site visits include medical assistants reviewing patient records before visits to identify care gaps, ordering and administering immunizations using protocols, making outreach calls to patients, leading team huddles, and coaching patients to set self-management goals. The registered nurse role has evolved from an emphasis on triage to a focus on uncomplicated acute care, chronic care management, and hospital-to-home transitions. Behavioral health providers (licensed clinical social workers, psychologists, or licensed counselors) were colocated and integrated within practices and were readily available for immediate consults and brief interventions. Physicians have shifted from lone to shared responsibility for patient panels, with other team members empowered to provide significant portions of chronic and preventive care.An innovative team-based primary care workforce is emerging. Spreading and sustaining these changes will require training both health professionals and nonprofessionals in new ways. Without clinical experiences that model this new team-based care and role models who practice it, trainees will not be prepared to practice as a team.
- Published
- 2013
- Full Text
- View/download PDF
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