A Retrospective Study Comparing Shared Medical Appointments with Usual Health Care on Clinical Outcomes and Quality Measures in Veterans with Type 2 Diabetes

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ISBN 13 :
Total Pages : 148 pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis A Retrospective Study Comparing Shared Medical Appointments with Usual Health Care on Clinical Outcomes and Quality Measures in Veterans with Type 2 Diabetes by : Marianne DeMeo Harris

Download or read book A Retrospective Study Comparing Shared Medical Appointments with Usual Health Care on Clinical Outcomes and Quality Measures in Veterans with Type 2 Diabetes written by Marianne DeMeo Harris and published by . This book was released on 2013 with total page 148 pages. Available in PDF, EPUB and Kindle. Book excerpt: A Retrospective Study Comparing Shared Medical Appointments with Usual Health Care on Clinical Outcomes and Quality Measures in Veterans with Type 2 DiabetesAbstract by MARIANNE DeMEO HARRISThe Center for Disease Control (CDC) reports that chronic disease accounts for more than 75% of the nation's $2 trillion in medical care costs, and the direct and indirect costs of a chronic disease such as diabetes alone is estimated at $174 billion dollars a year. Diabetes and heart disease frequently occur reciprocally because over time, elevated blood sugar levels lead to microvascular alterations in the intimal layer of the blood vessels. Despite the serious risks of these two medical conditions, our current health care system has yet to develop effective strategies for managing diabetes, and minimizing heart disease risk. One model of care that shows promise, however, is shared medical appointments (SMA), also known as group medical visits where a multidisciplinary team of health professionals provide health care to a cohort of patients at the same time in a supportive, educational, and interactive environment. There are a limited number of studies on utilizing shared medical appointments to manage diabetes and heart disease, and most show mixed results. Therefore, the author proposed to continue to build evidence on this topic and promulgates the following hypothesis: Compared to veterans who receive usual care (UC), (n=617) veterans with type 2 diabetes who utilize shared medical appointments (n=371) will have significantly better clinical outcomes, and higher levels of provider adherence to accepted VA Department of Defense (DoD) diabetes clinical practice guidelines. This 3-year retrospective two-group observational study utilized an existing Veterans Administration (VA) VISN 10 database warehouse, and Computerized Patient Record System (CPRS). Emergency room data was also abstracted retrospectively over the same 3-year study period. Additional co-morbidities that were tracked included hypertension, dyslipidemia, coronary artery disease, and obesity, as well as demographic variables such as age, sex, marital status, and gender. Three moderator variables were tracked in the study: the presence of a mental health diagnosis, number of health care visits (UC and SMA) and participation in other VA self-management programs over the three-year study period. The study variables were analyzed using t-tests, X2, repeated measures ANOVA, and multiple regression to reveal the relationships among the variables. The clinical outcome variables of HbA1c, lipid panel and blood pressure were not significantly different in the SMA cohort over UC during the three year study period; however, several clinical practice guidelines were met annually for the SMA veterans that included having an angiotension-converting enzyme inhibitor/angiotension-receptor blockers and aspirin prescribed and having annual ophthalmology and podiatry exams. This research project enhances our knowledge on how using SMAs may produce improved provider adherence to diabetes care quality standards in veterans with type 2 diabetes who are at substantial risk for cardiovascular disease

Patient Safety and Quality

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Publisher : Department of Health and Human Services
ISBN 13 :
Total Pages : 592 pages
Book Rating : 4.:/5 (318 download)

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Book Synopsis Patient Safety and Quality by : Ronda Hughes

Download or read book Patient Safety and Quality written by Ronda Hughes and published by Department of Health and Human Services. This book was released on 2008 with total page 592 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

Registries for Evaluating Patient Outcomes

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Publisher : Government Printing Office
ISBN 13 : 1587634333
Total Pages : 385 pages
Book Rating : 4.5/5 (876 download)

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Book Synopsis Registries for Evaluating Patient Outcomes by : Agency for Healthcare Research and Quality/AHRQ

Download or read book Registries for Evaluating Patient Outcomes written by Agency for Healthcare Research and Quality/AHRQ and published by Government Printing Office. This book was released on 2014-04-01 with total page 385 pages. Available in PDF, EPUB and Kindle. Book excerpt: This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.

Improving Diagnosis in Health Care

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Publisher : National Academies Press
ISBN 13 : 0309377722
Total Pages : 473 pages
Book Rating : 4.3/5 (93 download)

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Book Synopsis Improving Diagnosis in Health Care by : National Academies of Sciences, Engineering, and Medicine

Download or read book Improving Diagnosis in Health Care written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2015-12-29 with total page 473 pages. Available in PDF, EPUB and Kindle. Book excerpt: Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

Managing Diabetes and Hyperglycemia in the Hospital Setting

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Publisher : American Diabetes Association
ISBN 13 : 1580406572
Total Pages : 338 pages
Book Rating : 4.5/5 (84 download)

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Book Synopsis Managing Diabetes and Hyperglycemia in the Hospital Setting by : Boris Draznin

Download or read book Managing Diabetes and Hyperglycemia in the Hospital Setting written by Boris Draznin and published by American Diabetes Association. This book was released on 2016-05-20 with total page 338 pages. Available in PDF, EPUB and Kindle. Book excerpt: As the number of patients with diabetes increases annually, it is not surprising that the number of patients with diabetes who are admitted to the hospital also increases. Once in the hospital, patients with diabetes or hyperglycemia may be admitted to the Intensive Care Unit, require urgent or elective surgery, enteral or parenteral nutrition, intravenous insulin infusion, or therapies that significantly impact glycemic control (e.g., steroids). Because many clinical outcomes are influenced by the degree of glycemic control, knowledge of the best practices in inpatient diabetes management is extremely important. The field of inpatient management of diabetes and hyperglycemia has grown substantially in the last several years. This body of knowledge is summarized in this book, so it can reach the audience of hospitalists, endocrinologists, nurses and other team members who take care of hospitalized patients with diabetes and hyperglycemia.

Developing a Protocol for Observational Comparative Effectiveness Research: A User's Guide

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Publisher : Government Printing Office
ISBN 13 : 1587634236
Total Pages : 236 pages
Book Rating : 4.5/5 (876 download)

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Book Synopsis Developing a Protocol for Observational Comparative Effectiveness Research: A User's Guide by : Agency for Health Care Research and Quality (U.S.)

Download or read book Developing a Protocol for Observational Comparative Effectiveness Research: A User's Guide written by Agency for Health Care Research and Quality (U.S.) and published by Government Printing Office. This book was released on 2013-02-21 with total page 236 pages. Available in PDF, EPUB and Kindle. Book excerpt: This User’s Guide is a resource for investigators and stakeholders who develop and review observational comparative effectiveness research protocols. It explains how to (1) identify key considerations and best practices for research design; (2) build a protocol based on these standards and best practices; and (3) judge the adequacy and completeness of a protocol. Eleven chapters cover all aspects of research design, including: developing study objectives, defining and refining study questions, addressing the heterogeneity of treatment effect, characterizing exposure, selecting a comparator, defining and measuring outcomes, and identifying optimal data sources. Checklists of guidance and key considerations for protocols are provided at the end of each chapter. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews. More more information, please consult the Agency website: www.effectivehealthcare.ahrq.gov)

Returning Home from Iraq and Afghanistan

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Publisher : National Academies Press
ISBN 13 : 0309152852
Total Pages : 193 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Returning Home from Iraq and Afghanistan by : Institute of Medicine

Download or read book Returning Home from Iraq and Afghanistan written by Institute of Medicine and published by National Academies Press. This book was released on 2010-03-31 with total page 193 pages. Available in PDF, EPUB and Kindle. Book excerpt: Nearly 1.9 million U.S. troops have been deployed to Afghanistan and Iraq since October 2001. Many service members and veterans face serious challenges in readjusting to normal life after returning home. This initial book presents findings on the most critical challenges, and lays out the blueprint for the second phase of the study to determine how best to meet the needs of returning troops and their families.

Finding What Works in Health Care

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Publisher : National Academies Press
ISBN 13 : 0309164257
Total Pages : 267 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Finding What Works in Health Care by : Institute of Medicine

Download or read book Finding What Works in Health Care written by Institute of Medicine and published by National Academies Press. This book was released on 2011-07-20 with total page 267 pages. Available in PDF, EPUB and Kindle. Book excerpt: Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.

Running Group Visits in Your Practice

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Publisher : Springer Science & Business Media
ISBN 13 : 0387686800
Total Pages : 544 pages
Book Rating : 4.3/5 (876 download)

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Book Synopsis Running Group Visits in Your Practice by : Edward B. Noffsinger

Download or read book Running Group Visits in Your Practice written by Edward B. Noffsinger and published by Springer Science & Business Media. This book was released on 2009-07-21 with total page 544 pages. Available in PDF, EPUB and Kindle. Book excerpt: A Fateful Meeting A year and a half ago, I was sitting at a conference listening to Ed Noffsinger speak, and suddenly had the most profound ‘‘Aha’’ moment of my professional career. Here was someone presenting a practical and tested solution to some of the most challenging problems currently plaguing the US healthcare system, problems such as poor access to primary and specialty care; the uncontainable and rising costs of healthcare; our nation’s relatively poor quality outcomes; and finally, the sense of frustration, disempowerment, loneliness, and disenfranchisement that patients and their families too often experience. Dr. Noffsinger’s solution seemed deceptively simple—shared medical appointments (SMAs) that afford the highest quality healthcare to be delivered in the highest quality care experience—a group setting. Experience collected over a decade and involving more than 100,000 patient visits throughout the United States, Canada, and parts of Europe has demonstrated that SMAs, when used in primary care as well as in the medical and surgical subspecialties, lead to increased access to care, enhanced quality of care, and improved patient satisfaction. For physicians, the efficiency gains and team support from their participation in SMAs translate into much needed relief and improved career satisfaction.

Crossing the Quality Chasm

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Publisher : National Academies Press
ISBN 13 : 0309132967
Total Pages : 359 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Crossing the Quality Chasm by : Institute of Medicine

Download or read book Crossing the Quality Chasm written by Institute of Medicine and published by National Academies Press. This book was released on 2001-07-19 with total page 359 pages. Available in PDF, EPUB and Kindle. Book excerpt: Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

The Veterans Choice Program (VCP)

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Publisher : Nova Snova
ISBN 13 : 9781536148190
Total Pages : 0 pages
Book Rating : 4.1/5 (481 download)

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Book Synopsis The Veterans Choice Program (VCP) by : Mabel Page

Download or read book The Veterans Choice Program (VCP) written by Mabel Page and published by Nova Snova. This book was released on 2019-01-29 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: In response to concerns about access to medical care at many Department of Veterans Affairs (VA) hospitals and clinics across the country in spring 2014,1 Congress passed the Veterans Access, Choice, and Accountability Act of 2014 (VACAA, P.L. 113-146, as amended). On August 7, 2014, President Obama signed the bill into law. Among other things, the act establishes a new program that would allow the VA to authorize care for enrolled veterans through the Veterans Choice Program if they meet the eligibility requirements.

Cognitive Aging

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Publisher : National Academies Press
ISBN 13 : 0309368650
Total Pages : 300 pages
Book Rating : 4.3/5 (93 download)

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Book Synopsis Cognitive Aging by : Institute of Medicine

Download or read book Cognitive Aging written by Institute of Medicine and published by National Academies Press. This book was released on 2015-07-21 with total page 300 pages. Available in PDF, EPUB and Kindle. Book excerpt: For most Americans, staying "mentally sharp" as they age is a very high priority. Declines in memory and decision-making abilities may trigger fears of Alzheimer's disease or other neurodegenerative diseases. However, cognitive aging is a natural process that can have both positive and negative effects on cognitive function in older adults - effects that vary widely among individuals. At this point in time, when the older population is rapidly growing in the United States and across the globe, it is important to examine what is known about cognitive aging and to identify and promote actions that individuals, organizations, communities, and society can take to help older adults maintain and improve their cognitive health. Cognitive Aging assesses the public health dimensions of cognitive aging with an emphasis on definitions and terminology, epidemiology and surveillance, prevention and intervention, education of health professionals, and public awareness and education. This report makes specific recommendations for individuals to reduce the risks of cognitive decline with aging. Aging is inevitable, but there are actions that can be taken by individuals, families, communities, and society that may help to prevent or ameliorate the impact of aging on the brain, understand more about its impact, and help older adults live more fully and independent lives. Cognitive aging is not just an individual or a family or a health care system challenge. It is an issue that affects the fabric of society and requires actions by many and varied stakeholders. Cognitive Aging offers clear steps that individuals, families, communities, health care providers and systems, financial organizations, community groups, public health agencies, and others can take to promote cognitive health and to help older adults live fuller and more independent lives. Ultimately, this report calls for a societal commitment to cognitive aging as a public health issue that requires prompt action across many sectors.

Psychosocial Care for People with Diabetes

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Publisher : American Diabetes Association
ISBN 13 : 1580404391
Total Pages : 330 pages
Book Rating : 4.5/5 (84 download)

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Book Synopsis Psychosocial Care for People with Diabetes by : Deborah Young-Hyman

Download or read book Psychosocial Care for People with Diabetes written by Deborah Young-Hyman and published by American Diabetes Association. This book was released on 2012-12-25 with total page 330 pages. Available in PDF, EPUB and Kindle. Book excerpt: Psychosocial Care for People with Diabetes describes the major psychosocial issues which impact living with and self-management of diabetes and its related diseases, and provides treatment recommendations based on proven interventions and expert opinion. The book is comprehensive and provides the practitioner with guidelines to access and prescribe treatment for psychosocial problems commonly associated with living with diabetes.

Closing the Quality Gap

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Publisher :
ISBN 13 : 9781587632594
Total Pages : 7 pages
Book Rating : 4.6/5 (325 download)

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Book Synopsis Closing the Quality Gap by : Kaveh G. Shojania

Download or read book Closing the Quality Gap written by Kaveh G. Shojania and published by . This book was released on 2004 with total page 7 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Taking Control of Your Diabetes

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Publisher :
ISBN 13 : 9781932610291
Total Pages : 0 pages
Book Rating : 4.6/5 (12 download)

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Book Synopsis Taking Control of Your Diabetes by : Steven V. Edelman

Download or read book Taking Control of Your Diabetes written by Steven V. Edelman and published by . This book was released on 2007-08 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This information-packed text is designed to educate and motivate diabetic patients to be active members of their health care teams. Guidance is provided on how to prevent or delay the onset of potential complications. Oral medication and insulin therapy are described, with suggestions for achieving the best possible control. Proactive health maintenance steps, including recommended diet, appropriate exerices, and foot and eye care, are delineated. Advances in home glucose monitoring are presented, including continuous glucose monitoring.

Government Code

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Publisher :
ISBN 13 :
Total Pages : 556 pages
Book Rating : 4.3/5 (511 download)

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Book Synopsis Government Code by : Texas

Download or read book Government Code written by Texas and published by . This book was released on 2000 with total page 556 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Nutrition Abstracts and Reviews

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Publisher :
ISBN 13 :
Total Pages : 776 pages
Book Rating : 4.3/5 ( download)

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Book Synopsis Nutrition Abstracts and Reviews by :

Download or read book Nutrition Abstracts and Reviews written by and published by . This book was released on 2005 with total page 776 pages. Available in PDF, EPUB and Kindle. Book excerpt: