June 14, 2012
Abstract:
Practice coaching, also called practice facilitation, assists physician practices with the desire to improve in such areas as patient access, chronic and preventive care, electronic medical record use, patient-centeredness, cultural competence, and team-building. This issue brief clarifies the essential features of practice coaching and offers guidance for health system leaders, public and private insurers, and federal and state policymakers on how best to structure and design these programs in primary care settings. Good-quality evidence demonstrates that practice coaching is effective. The authors argue that primary care delivery in the United States would benefit from a more systematic approach to the training and deployment of primary care practice coaches.
Posted in READ Portal, Reports & Papers | Tagged with Patient-centered care, Primary health care, Quality improvement, Quality of care | No Comments
May 24, 2012
“The patient-centered medical home has emerged as a promising solution to address the significant fragmentation, poor quality, and high costs that afflict the U.S. health care system. The medical home model includes core components of primary and patient-centered care, recent innovations in practice redesign and health information technology, and changes to the way practices and providers are paid. There are initiatives across the country testing the promise of the medical home model. However, to properly evaluate and compare results that will aid in the implementation of these and other initiatives, researchers need a standard set of core measures. This brief describes the process and recommendations of more than 75 researchers who came together to identify a core set of standardized measures to evaluate the patient-centered medical home. It focuses on two domains of medical home outcomes: cost/utilization and clinical quality.”
Posted in READ Portal, Reports & Papers | Tagged with Indicators, Patient-centered care, Quality assessment, Statistics & numerical data | No Comments
May 18, 2012
Cathie Scott & Laura Lagendyk. (2012). Contexts and Models in Primary Healthcare and their Impact on Interprofessional Relationships. Canadian Health Services Research Foundation. Retrieved from http://www.chsrf.ca/Libraries/Commissioned_Research_Reports/ScottLagendyk-April2012-E.sflb.ashx “Key Messages: Nationally and internationally, the need to effectively coordinate provision of care to meet the needs of patients and to make optimal use of resources have been identified […]
Posted in READ Portal, Reports & Papers | Tagged with Canada, Health planning, Integrated care, Patient-centered care | No Comments
May 17, 2012
“Key messages:
Continuity is fundamental to high-quality care. Without it, care is unlikely to be clinically effective, safe, personalised, efficient or cost-effective. Breakdowns in continuity of care put patients at risk, cause duplication and add avoidable costs to both health and social care.
This paper focuses on the experiences of older people with multiple health problems, and particularly on their experiences inside hospital. Continuity is especially important for these older patients because: they are more likely to spend time in hospital and to be in hospital for longer; if they are frail, a stay in hospital can be life-changing; and, regrettably, in some hospitals and some wards older patients are exposed to unacceptable standards of care….”
Posted in READ Portal, Reports & Papers | Tagged with Health services for the aged, Hospitals, Patient-centered care, Quality of care | No Comments
May 2, 2012
“In October 2011, the Health Council of Canada hosted a national symposium on patient engagement. The plan was simple enough: we wanted to explore how good ideas have been, and could be, turned into action. As we began to develop the agenda for the day, we learned there is no shortage of Canadians—both within and outside the health system—with much to say on the matter. The over 160 people who attended collectively represented the Canadian health care system: patients; representatives from patient organizations; federal and provincial governments, regional health authorities, and local health integration networks; health system administrators; health care providers; and researchers.
We heard many perspectives. Patients told us what it is like to navigate the often intimidating and confusing Canadian health care system. Health care providers gave us an insider’s view of how they would improve this same system for their patients, and planners and administrators told us how they’re working to make patient centred care a reality. Our intention was three-fold: to raise awareness of the potential of patient engagement as an instrument of change; to spark a national dialogue that would build support for patient engagement; and to help those who are entering this burgeoning field of system-level change to gain insight into tools and experiences that are available to either start or advance their patient engagement work. To keep the momentum from that day going, we developed this commentary and proceedings report to inspire governments, health care workers, and patients to take up patient engagement in their own ways.
For the Health Council of Canada, our work didn’t end with the symposium. We will keep what we learned in October fresh in our minds, and embed it into all that we do. Patient engagement at all levels happens when we ask ourselves, “Is this the right thing to do so that patients and their caregivers have a voice?” We hope all symposium participants are doing the same.
We can learn from one another, share what others are doing well, and, more importantly, not be afraid to ask them how they did it. The ideas for change are out there. By sharing what we learn from those actively involved in health care, and putting that knowledge into practice, we can start to turn ideas and experience into a better reality for all Canadian patients.
Posted in READ Portal, Reports & Papers | Tagged with Canada, Health care reform, Patient-centered care, Quality improvement | No Comments
April 24, 2012
“The Canadian Hospital Reporting Project (CHRP) is a national quality improvement initiative from the Canadian Institute for Health Information (CIHI). CHRP’s web-based, interactive tool gives hospital decision-makers, policy-makers and Canadians access to indicator results for more than 600 facilities from every province and territory in Canada.
CIHI selected 21 clinical and 9 financial indicators for CHRP, based on their relevance to performance measurement and quality improvement. The selected indicators measure:
- Clinical effectiveness;
- Patient safety;
- Appropriateness of care;
- Accessibility; and
- Financial performance.
These indicators were chosen after reviewing existing hospital performance indicators and collaborating with experts in the field. The goal of CHRP is to foster quality improvement, learning and action.
Posted in Multimedia, READ Portal | Tagged with Canada, Patient-centered care, Quality of care, Safety | No Comments
April 9, 2012
“The Issue: When patients have an active role in their own health care, the quality of their care, and of their care experience improves, studies show. Efforts to increase patients’ engagement in their care—for example, through shared decision-making and self-management of a chronic condition—have proliferated internationally as nations strive for high-value, high-performance health systems. This study, authored by Commonwealth Fund researchers, examines results from a 2011 Fund survey in 11 countries focusing on patients with complex health care needs.
Key Findings:
- To assess the level of patients’ engagement with their regular doctors, the researchers analyzed responses to survey items on whether the doctor spends enough time with patients, explains things in a way that is easy to understand, and encourages questions. Patients in Norway and Sweden were the least likely to be engaged by their regular providers, with only about one of three responding positively to all three questions. At the top end of the range, at least two of three patients in Australia, New Zealand, Switzerland, the U.K., and the U.S. reported positive care interactions.
- In seven of the 11 countries—Australia, Canada, the Netherlands, Norway, Sweden, the U.K., and the U.S.—patients with below-average incomes were significantly less likely to have been engaged by their regular doctor in their care. The U.S. stood out for the widest income-based disparities.
- Survey participants were asked how often the specialist physicians treating them provide opportunities to ask questions about recommended treatments, tell them about their treatment choices, and involve them as much as they would like in decisions about their care. Four-fifths of patients in Switzerland and the U.K. replied “always” or “often” to all three questions, as did two-thirds or more of Dutch, New Zealand, and U.S. respondents. Respondents in France, Germany, Norway, and Sweden were the least likely to report shared decision-making with specialists.
- In all countries, patients reporting positive communication and engagement with their regular doctor were far more likely to rate the quality of care they received in the past year as “excellent” or “very good.” The difference was greatest in the U.S.: 78 percent of patients who said they were engaged in their care rated the quality of their care highly, compared with 43 percent of those who said they were not engaged.
- Engaged patients were also less likely to report a medical, medication, or lab test error in the past two years, and had more positive views of the health system as a whole.”
Posted in READ Portal, Reports & Papers | Tagged with Patient satisfaction, Patient-centered care | No Comments
March 22, 2012
This article looks at how advances in healthcare have impacted the delivery of care. It talks about the history of the term “patient-centered care” and the intended meaning of the term. The authors review the importance of including patients in the decision-making process. Additionally, they examine scenarios where, despite patient preference, there may be a superior method of care that should be chosen. Finally, the author’s argue that by including patients in the care process, clinicians will be able to become more considerate of and responsive to patient needs, and thereby become better healthcare practitioners.
Posted in Journal Articles, READ Portal | Tagged with Patient-centered care | No Comments
March 21, 2012
“This toolkit is designed to help your hospital understand the Quality Indicators (QIs) from AHRQ, and support your use of them to successfully improve quality and patient safety in your hospital. Created by the RAND Corporation and the University HealthSystem Consortium with funding from AHRQ, it is available for all hospitals to use free of charge. The toolkit is a general guide to using improvement methods, with a particular focus on the QIs.
The AHRQ QIs use hospital administrative data to assess the quality of care provided, identify areas of concern in need of further investigation, and monitor progress over time. This toolkit focuses on the 17 Patient Safety Indicators (PSIs) and the 28 Inpatient Quality Indicators (IQIs).”
Posted in Multimedia, READ Portal | Tagged with Indicators, Patient-centered care, Process improvement, Quality improvement, Safety | No Comments
March 15, 2012
“Abstract: Unsustainable rising health care costs in the United States have made reducing costs while maintaining high-quality health care a national priority. The overuse of some screening and diagnostic tests is an important component of unnecessary health care costs. More judicious use of such tests will improve quality and reflect responsible awareness of costs. Efforts to control expenditures should focus not only on benefits, harms, and costs but on the value of diagnostic tests—meaning an assessment of whether a test provides health benefits that are worth its costs or harms. To begin to identify ways that practicing clinicians can contribute to the delivery of high-value, cost-conscious health care, the American College of Physicians convened a workgroup of physicians to identify, using a consensus-based process, common clinical situations in which screening and diagnostic tests are used in ways that do not reflect high-value care. The intent of this exercise is to promote thoughtful discussions about these tests and other health care interventions to promote high-value, cost-conscious care.”
Posted in Journal Articles, READ Portal | Tagged with Cost effectiveness, Health care costs, Patient-centered care | No Comments
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