Literature Collection

7201

Patient- and family-centered care coordination: a framework for integrating care for children and youth across multiple systems

Type: Journal Article

Authors: Council on Children with Disabilities and Medical Home Implementation Project Advisory Committee

Year: 2014

Publication Place: United States

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7202

Patient- and Provider-Reported Experiences of a Mobile Novel Digital Therapeutic in People With Opioid Use Disorder (reSET-O): Feasibility and Acceptability Study

Type: Journal Article

Authors: S. Kawasaki, S. Mills-Huffnagle, N. Aydinoglo, H. Maxin, E. Nunes

Year: 2022

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7203

Patient-centered approach to building problem solving skills among older primary care patients: problems identified and resolved

Type: Journal Article

Authors: S. Enguidanos, Coulourides Kogan, B. Keefe, S. M. Geron, L. Katz

Year: 2011

Publication Place: England

Abstract: This article describes problems identified by older primary care patients enrolled in Problem Solving Therapy (PST), and explores factors associated with successful problem resolution. PST patients received 1 to 8, 45-min sessions with a social worker. Patients identified problems in their lives and directed the focus of subsequent sessions as consistent with the steps of PST. The 107 patients identified 568 problems, 59% of which were resolved. Most commonly identified problems included health related issues such as need for exercise or weight loss activities, medical care and medical equipment needs, home and garden maintenance, and gathering information on their medical condition. Problems identified by patients were 2.2 times more likely to be solved than those identified by a health care professional. Using PST in primary care may facilitate patients in addressing key health and wellness issues.

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7204

Patient-Centered Care Through Nurse Practitioner-Led Integrated Behavioral Health: A Case Study

Type: Journal Article

Authors: C. Weston, E. Wells-Beede, A. Salazar, D. Poston, S. Brown, M. Hare, R. Page

Year: 2023

Abstract:

Integrated behavioral health can improve primary care and mental health outcomes. Access to behavioral health and primary care services in Texas is in crisis because of high uninsurance rates, regulatory restrictions, and lack of workforce. To address gaps in access to care, a partnership formed among a large local mental health authority in central Texas, a federally designated rural health clinic, and the Texas A&M University School of Nursing to create an interprofessional team-based health care delivery model led by nurse practitioners in rural and medically underserved areas of central Texas. Academic-practice partners identified 5 clinics for an integrated behavioral health care delivery model. From July 1, 2020, through December 31, 2021, a total of 3183 patient visits were completed. Patients were predominantly female (n = 1719, 54%) and Hispanic (n = 1750, 55%); 1050 (33%) were living at or below the federal poverty level; and 1400 (44%) were uninsured. The purpose of this case study was to describe the first year of implementation of the integrated health care delivery model, barriers to implementation, challenges to sustainability, and successes. We analyzed data from multiple sources, including meeting minutes and agendas, grant reports, direct observations of clinic flow, and interviews with clinic staff, and identified common qualitative themes (eg, challenges to integration, sustainability of integration, outcome successes). Results revealed implementation challenges with the electronic health record, service integration, low staffing levels during a global pandemic, and effective communication. We also examined 2 patient cases to illustrate the success of integrated behavioral health and highlighted lessons learned from the implementation process, including the need for a robust electronic health record and organizational flexibility.

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7205

Patient-Centered Health Advisory Council

Type: Web Resource

Authors: Iowa Department of Public Health

Year: 2014

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This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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7206

Patient-centered health care : achieving co-ordination, communication and innovation

Type: Book

Authors: Mary Keating, Aoife McDermott, Kathleen Montgomery

Year: 2013

Abstract: There are four core themes developed in "Patient-Centred Health Care" which deal with critical issues, models, theories and frameworks (both theoretical and empirical) that expound understandings of patient centred care and the processes, practices and behaviours supporting its attainment: 1. Conceptions and cultures of patient-centred care 2. Coordinating for care 3. Communicating for care 4. Innovations in patient centred care and the patient experience. Section 1 of this book sets out the origins of the approach of patient centredness, allowing the reader to recognise what this means and looks like, institutionally and educationally, as well as recognising the implications of its absence. Section 2 concentrates on the process of team working itself which may be patient centred but is also involved with co-operation and co-ordination across professional and organisational boundaries. Section 3 focuses on communication within, between and across patients and teams, and Section 4 highlights the innovations in patient centred care that will enable further progress in the field. In each section,the editors illuminate key issues through a case-study of a relevant intervention to support patient-centred care.; Conceptions and Cultures of Patient-Centred Care -- 1. Developments in conceptions of patient-centred care: implementation challenges in the context of high-risk therapy -- 2. The Continuum of Resident Centered Care in U.S. Nursing Homes -- 3. Reconceptualising institutional abuse: Formulating problems and solutions in residential care. -- 4. The place of patient-centred care in medical professional culture: a qualitative study -- Coordinating for Patient centred Care -- 5. Capacity for care: meta-ethnography of acute care nurses' experiences of the nurse-patient relationship -- 6. Creating an enriched environment of care for older people, staff and family carers: Relational practice and organisational culture change in health and social care -- 7. Promoting patient-centred healthcare: an empirically-derived organisational model of interprofessional collaboration -- 8. From a project team to a community of practice? An exploration of boundary and identity in the context of healthcare collaboration -- Communication in Patient-Centred Care -- 9. Is poor quality of care built into the system? 'Routinising' clinician communication as an essential element of care quality. -- 10. Giving Voice in a Multi-voiced Environment: The challenges of palliative care policy implementation in acute care -- 11. Rejections of treatment recommendations through humour -- 12. An expanded shared decision-making model for interprofessional settings -- Innovations in Patient Centred Care -- 13. Testing accelerated experience-based co-design: using a national archive of patient experience narrative interviews to promote rapid patient-centred service improvement. -- 14. Shared Decision Making and Decision Aid Implementation: Stakeholder Views -- 15. Coordination of care in emergency departments: A comparative international ethnography -- 16. Models of user involvement in mental health.

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This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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7207

Patient-Centered Homes and Integrated Behavioral Health Care: Reclaiming the Role of "Consultant" for Psychiatric-Mental Health Nurse Practitioner

Type: Journal Article

Authors: V. Soltis-Jarrett

Year: 2016

Publication Place: England

Abstract: The notion of patient-centered care has long been linked with nursing practice since Florence Nightingale. The discipline of nursing is focused on the holistic care of individuals, families, and communities in times of sickness and/or health. However, in psychiatric-mental health nursing, the concepts of mental health and psychiatric illness still remain marginalized in our health care delivery systems, as well as in nursing education, knowledge development, and practice. Even with the concept of patient-centered homes, acute and primary care providers are reluctant to embrace care of those with psychiatric illness in their respective settings. Psychiatric illness was and continues to be in the shadows, hidden and often ignored by the larger community as well as by health care providers. This paper describes a Health Resources Services Administration (HRSA) Advanced Nursing Education (ANE) training grant's objective of reintegrating psychiatric-mental health practice into ALL health care delivery systems using the concept of patient-centered nursing care as a foundation for, and promotion of, the Psychiatric-Mental Health Nurse Practitioner (PMH-NP) as the "navigator" for not only the patients and their families, but also for their acute and primary care colleagues using an Interprofessional Education Model. The major barriers and lessons learned from this project as well as the need for psychiatric-mental health nurses to reclaim their role as a consultant/liaison in acute, primary, and long-term care settings will be discussed. The PMHNP as a consultant/liaison is being revitalized as an innovative advanced practice nursing health care model in North Carolina.

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7208

Patient-Centered Integrated Behavioral Health Care Principle & Tasks

Type: Report

Authors: University of Washington Advancing Integrated Mental Health Solutions Center

Year: 2012

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This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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7209

Patient-Centered Medical Home

Type: Web Resource

Authors: National Committee for Quality Assurance

Year: 2011

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This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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7210

Patient-Centered Medical Home

Type: Web Resource

Authors: Primary Care Development Corporation

Year: 2021

Topic(s):

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This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.

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7211

Patient-Centered Medical Home Adoption

Type: Journal Article

Authors: Deborah Gurewich, Linda Cabral, Laura Sefton

Year: 2016

Publication Place: Baltimore, Maryland

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7212

Patient-centered medical home and quality measurement in small practices

Type: Journal Article

Authors: J. J. Wang, C. H. Winther, J. Cha, C. M. McCullough, A. S. Parsons, J. Singer, S. C. Shih

Year: 2014

Publication Place: United States

Abstract: OBJECTIVES: To assess performance on quality measures among small primary care practices that recently adopted an electronic health record (EHR), and how performance differs between practices that have achieved patient-centered medical home (PCMH) recognition and those that have not. STUDY DESIGN: Retrospective cohort study. METHODS: Comparison of practice characteristics and performance on quality measures across 150 independent practices from 2009 to 2011 by recognition status for Physician Practice Connections-PCMH. RESULTS: PCMH-recognized practices performed significantly better than nonrecognized practices on 5 out of 7 clinical quality measures at baseline, and the differences were maintained over the 2-year study period. Both groups improved on all clinical quality measures. Though the magnitude of differences was small, PCMHrecognized practices had a higher number of patients diagnosed with hypertension and proportionally more black patients. A significant difference in PCMH-recognized practices is that they received, on average, 4 additional quality improvement visits compared with nonrecognized practices. CONCLUSIONS: Among small practices that have adopted EHRs, practices with PCMH recognition consistently outperformed practices without recognition on most clinical quality measures. With adequate assistance, small, resource-strapped practices can continue to have higher performance on clinical quality measures.

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7213

Patient-Centered Medical Home Care for Adolescents in Need of Mental Health Treatment

Type: Journal Article

Authors: J. C. Yonek, N. Jordan, D. Dunlop, R. Ballard, J. Holl

Year: 2018

Publication Place: United States

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7214

Patient-centered medical home cyberinfrastructure current and future landscape

Type: Journal Article

Authors: J. Finkelstein, M. S. Barr, P. P. Kothari, D. K. Nace, M. Quinn

Year: 2011

Publication Place: Netherlands

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7215

Patient-centered medical home initiative produced modest economic results for Veterans Health Administration, 2010-12

Type: Journal Article

Authors: P. L. Hebert, C. F. Liu, E. S. Wong, S. E. Hernandez, A. Batten, S. Lo, J. M. Lemon, D. A. Conrad, D. Grembowski, K. Nelson, S. D. Fihn

Year: 2014

Publication Place: United States

Abstract: In 2010 the Veterans Health Administration (VHA) began a nationwide initiative called Patient Aligned Care Teams (PACT) that reorganized care at all VHA primary care clinics in accordance with the patient-centered medical home model. We analyzed data for fiscal years 2003-12 to assess how trends in health care use and costs changed after the implementation of PACT. We found that PACT was associated with modest increases in primary care visits and with modest decreases in both hospitalizations for ambulatory care-sensitive conditions and outpatient visits with mental health specialists. We estimated that these changes avoided $596 million in costs, compared to the investment in PACT of $774 million, for a potential net loss of $178 million in the study period. Although PACT has not generated a positive return, it is still maturing, and trends in costs and use are favorable. Adopting patient-centered care does not appear to have been a major financial risk for the VHA.

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7216

Patient-Centered Medical Home Membership Is Associated with Decreased Hospital Admissions for Emergency Department Behavioral Health Patients

Type: Journal Article

Authors: A. Adaji, G. J. Melin, R. L. Campbell, C. M. Lohse, J. J. Westphal, D. J. Katzelnick

Year: 2017

Publication Place: United States

Abstract: The objective was to examine the impact of a multipayer patient-centered medical home (PCMH) on health care utilization for behavioral health patients seen at a tertiary care emergency department (ED). A retrospective health records review was performed for PCMH and non-PCMH patients who presented and received a psychiatric consultation during a 2-year period in the ED of the Mayo Clinic Hospital in Rochester, Minnesota. Univariable and multivariable associations with the outcomes of admission and return visits within 72 hours were evaluated using logistic regression models and summarized with odds ratios (ORs) and 95% confidence intervals (CIs). There were 5398 visits among 3815 patients during the study period. Among these, there were 2440 (45%) PCMH patient visits. There were 2983 (55%) total patient visits resulting in an admission. In a univariable model, PCMH patients (53%) were less likely to be admitted from the ED compared with non-PCMH patients (57%) (OR 0.84; 95% CI 0.76-0.94; P = 0.002) and this remained statistically significant (OR 0.83; 95% CI 0.74-0.93; P = 0.001) after multivariable adjustment. Among the 2415 non-admitted patients, there was no significant difference in returns within 72 hours between PCMH patients (13%) and non-PCMH patients (12%) (OR 1.12; 95% CI 0.83-1.43; P = 0.36). PCMH membership was associated with a lower probability of inpatient hospitalization from the ED. PCMH interventions may be associated with a reduction in health care utilization.

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7217

Patient-Centered Medical Home Membership Is Associated with Decreased Hospital Admissions for Emergency Department Behavioral Health Patients

Type: Journal Article

Authors: A. Adaji, G. J. Melin, R. L. Campbell, C. M. Lohse, J. J. Westphal, D. J. Katzelnick

Year: 2018

Publication Place: United States

Abstract: The objective was to examine the impact of a multipayer patient-centered medical home (PCMH) on health care utilization for behavioral health patients seen at a tertiary care emergency department (ED). A retrospective health records review was performed for PCMH and non-PCMH patients who presented and received a psychiatric consultation during a 2-year period in the ED of the Mayo Clinic Hospital in Rochester, Minnesota. Univariable and multivariable associations with the outcomes of admission and return visits within 72 hours were evaluated using logistic regression models and summarized with odds ratios (ORs) and 95% confidence intervals (CIs). There were 5398 visits among 3815 patients during the study period. Among these, there were 2440 (45%) PCMH patient visits. There were 2983 (55%) total patient visits resulting in an admission. In a univariable model, PCMH patients (53%) were less likely to be admitted from the ED compared with non-PCMH patients (57%) (OR 0.84; 95% CI 0.76-0.94; P = 0.002) and this remained statistically significant (OR 0.83; 95% CI 0.74-0.93; P = 0.001) after multivariable adjustment. Among the 2415 non-admitted patients, there was no significant difference in returns within 72 hours between PCMH patients (13%) and non-PCMH patients (12%) (OR 1.12; 95% CI 0.83-1.43; P = 0.36). PCMH membership was associated with a lower probability of inpatient hospitalization from the ED. PCMH interventions may be associated with a reduction in health care utilization.

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7218

Patient-Centered Medical Home Membership Is Associated with Decreased Hospital Admissions for Emergency Department Behavioral Health Patients

Type: Journal Article

Authors: A. Adaji, G. J. Melin, R. L. Campbell, C. M. Lohse, J. J. Westphal, D. J. Katzelnick

Year: 2018

Publication Place: United States

Abstract: The objective was to examine the impact of a multipayer patient-centered medical home (PCMH) on health care utilization for behavioral health patients seen at a tertiary care emergency department (ED). A retrospective health records review was performed for PCMH and non-PCMH patients who presented and received a psychiatric consultation during a 2-year period in the ED of the Mayo Clinic Hospital in Rochester, Minnesota. Univariable and multivariable associations with the outcomes of admission and return visits within 72 hours were evaluated using logistic regression models and summarized with odds ratios (ORs) and 95% confidence intervals (CIs). There were 5398 visits among 3815 patients during the study period. Among these, there were 2440 (45%) PCMH patient visits. There were 2983 (55%) total patient visits resulting in an admission. In a univariable model, PCMH patients (53%) were less likely to be admitted from the ED compared with non-PCMH patients (57%) (OR 0.84; 95% CI 0.76-0.94; P = 0.002) and this remained statistically significant (OR 0.83; 95% CI 0.74-0.93; P = 0.001) after multivariable adjustment. Among the 2415 non-admitted patients, there was no significant difference in returns within 72 hours between PCMH patients (13%) and non-PCMH patients (12%) (OR 1.12; 95% CI 0.83-1.43; P = 0.36). PCMH membership was associated with a lower probability of inpatient hospitalization from the ED. PCMH interventions may be associated with a reduction in health care utilization.

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7219

Patient-Centered Medical Home With Colocation: Observations and Insights From an Academic Family Medicine Clinic

Type: Journal Article

Authors: George G. A. Pujalte, Sally Ann Pantin, Thomas A. Waller, Livia Y. Maruoka Nishi, Floyd B. Willis, Tarang P. Jethwa, Richard J. Presutti

Year: 2020

Publication Place: Thousand Oaks, California

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7220

Patient-centered medical home: how it affects psychosocial outcomes for diabetes

Type: Journal Article

Authors: B. T. Jortberg, B. F. Miller, R. A. Gabbay, K. Sparling, W. P. Dickinson

Year: 2012

Publication Place: United States

Abstract: Fragmentation of the current U.S. health care system and the increased prevalence of chronic diseases in the U.S. have led to the recognition that new models of care are needed. Chronic disease management, including diabetes, is often accompanied by a myriad of associated psychosocial issues that need to be addressed as part of a comprehensive treatment plan. Diabetes care should be aligned with comprehensive whole-person health care. The patient-centered medical home (PCMH) has emerged as a model for enhanced primary care that focuses on comprehensive integrated care. PCMH demonstration projects have shown improvements in quality of care, patient experience, care coordination, access to care, and quality measures for diabetes. Key PCMH transformative features associated with psychosocial issues related to diabetes reviewed in this article include integration of mental and behavioral health, care management/coordination, payment reform, advanced access, and putting the patient at the center of health care. This article also reviews the evidence supporting comprehensive and integrated care for addressing psychosocial issues associated with diabetes in the medical home.

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