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
June 7, 2012
More than 4 million people in England with a long-term physical health condition also have mental health problems, and many of them experience significantly poorer health outcomes and reduced quality of life as a result. In terms of NHS spending, at least £1 in every £8 spent on long-term conditions is linked to poor mental health and well-being – between £8 billion and £13 billion in England each year.
Posted in READ Portal, Reports & Papers | Tagged with Chronic disease, Mental health, Primary health care | No Comments
June 5, 2012
Health Council of Canada. (2012). Progress Report 2012: Health care renewal in Canada. Retrieved from http://healthcouncilcanada.ca/tree/ProgressReport2012_FINAL_EN.pdf Monitoring progress on the accords—the 2003 First Ministers’ Accord on Health Care Renewal1 and the 2004 10-Year Plan to Strengthen Health Care2—is a key element of the Health Council of Canada’s mandate. But the challenge is to determine how […]
Posted in 2014 Health Accord, READ Portal, Reports & Papers | Tagged with Canada, Health care reform, Indicators, Policy, Primary health care | No Comments
May 28, 2012
“Abstract: The ratio of patients to physicians has long been used as a tool for measuring and planning healthcare resources in Canada. Some current changes in primary care, such as enrolment of patients with physicians, make this ratio easier to calculate, while others, such as changing practice structure, make it more complex to interpret. Based on information gleaned from a review of the literature, we argue that before panel size can be used as an accountability measure for individual physicians or practices in primary care, we must understand its relationship to quality and outcomes at individual and population levels, as well as the contextual factors that affect it.”
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May 25, 2012
“KEY MESSAGES:
- The performance of Canada’s primary healthcare (PHC) system lags behind that of other industrialized countries. Well-targeted investments in PHC can improve the health of individuals and populations, which can in turn have a positive impact on macro-economic indicators, such as employment rates, productivity and economic growth.
Posted in READ Portal, Reports & Papers | Tagged with Canada, Economics, Primary health care, Quality improvement | No Comments
May 23, 2012
“We recommend that health care systems across Canada move actively to provide self-management
supports in a more systematic way. We see four key areas for action:
1) Create an integrated, system-wide approach to self-management support. Current efforts to promote,
deliver, and evaluate self-management support are often fragmented. This report highlights several integrated approaches that we can learn from. Continued progress on the delivery and uptake of self-management support should be monitored against specific health system performance objectives, measures, and targets. Further research in key areas, such as cost-effectiveness and how best to sustain program effects in the longer-term, is also needed.
Posted in READ Portal, Reports & Papers | Tagged with Canada, Chronic disease, Primary health care | No Comments
May 22, 2012
“Background: Emergency department (ED) utilization has dramatically increased in developed countries over the last twenty years. Because it has been associated with adverse outcomes, increased costs, and an overload on the hospital organization, several policies have tried to curb this growing trend. The aim of this study is to systematically review the effectiveness of organizational interventions designed to reduce ED utilization.
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April 25, 2012
“across the nation. Although they each share a common goal, historically they have operated independently of each other. However, new opportunities are emerging that could bring the two sectors together in ways that will yield substantial and lasting improvements in the health of individuals, communities, and populations. Because of this potential, the Centers for Disease Control and Prevention and the Health Resources and Services Administration asked the IOM to examine the integration of primary care and public health.
The interactions between the two sectors are so varied that it is not possible to prescribe a specific model or template for how integration should look. Instead, the IOM identifies a set of core principles derived from successful integration efforts – including a common goal of improving population health, as well as involving the community in defining and addressing its needs. The time is right for action, and the principles provided in this report can serve as a roadmap to move the nation toward a more efficient health system. The challenges in integrating primary care and public health are great – but so are the opportunities and rewards.”
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March 9, 2012
“This report uses the 2008 Canadian Survey of Experiences With Primary Health Care to fill an important gap in our knowledge of primary health care for individuals who have ambulatory care sensitive conditions. An examination of differences in access, use and appropriateness of care
according to income, geography, health conditions and sex reveals the following:
- Individuals with ambulatory care sensitive conditions in the lowest income group, in rural areas or with multiple chronic conditions were twice as likely to report that their last visit to an emergency department was for a condition that they perceived as being treatable by their primary health care provider.
- Women with ambulatory care sensitive conditions were less likely than men to report receiving all four recommended tests for chronic disease monitoring, to have medication side effects explained or to be provided with tools to self-manage their condition.
- Compared with those in the highest income group, individuals with ambulatory care sensitive conditions in the lowest income group were less likely to report that their primary health care physician involved them in clinical decisions or helped them make a treatment plan to manage
their conditions.”
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March 6, 2012
“A robust primary care sector is the foundation of a more effective and efficient health care system. However, achieving a robust primary care sector will require widespread practice transformation. A growing consensus supports the patient-centered medical home (PCMH) model, proposed as joint principles by the major primary care professional associations, as the blueprint for practice transformation. Under these principles, a PCMH would provide each person with a personal physician who leads a team that takes responsibility for ongoing care for all health issues and coordinates care with other service providers. Medical homes would also ensure the quality and safety of their care through performance measurement and continuous quality improvement and provide their patients with enhanced access. Finally, payment systems would reward the added value provided by medical homes. While these joint principles describe the general expectations of a PCMH, they do not make concrete suggestions for how primary care organizations can change their practices to become one.
As part of The Commonwealth Fund’s Safety Net Medical Home Initiative (SNMHI), this report sought to develop a more detailed and concrete definition that describes the changes that most practices would need to make to become PCMHs. After reviewing the literature, the study team proposed eight characteristics of medical homes—called change concepts—which provide general directions for transforming a practice. We further identified more specific practice modifications called key changes for each change concept. A technical expert panel assembled for the SNMHI reviewed the change concepts and key changes and suggested alterations. A second panel, convened for another PCMH transformation project, also provided feedback.”
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