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1.
Diane Berish PhD Erica Husser PhD Jenny Knecht-Fredo MSN CRNP Jacqueline Sabol MEd George Garrow MD Judith Hupcey EdD CRNP FAAN Donna Fick RN GCNS-BC PhD FGSA FAAN 《Health services research》2023,58(Z1):78-88
Objective
To collaboratively implement the age-friendly health systems framework, known as the 4Ms: What Matters, Medication, Mentation, and Mobility, at The Primary Health Network (PHN), a federally qualified health center.Data Sources
Data were collected from PHN electronic medical records (EMRs) for individuals over age 65 from December 30, 2019 to December 24, 2021 and from Project ECHO© attendance and evaluation surveys.Study Design
The telementoring educational program, Project ECHO©, was used to engage PHN health care professionals working in rural areas of Pennsylvania to incorporate the 4Ms into their practice starting with the annual wellness visit (AWV). Project ECHO© was launched at three primary care sites. After 18 months, it was then disseminated to an additional 18 sites creating pilot and comparison groups. Outcomes included codesigned patient process metrics using EMR data and project ECHO© participant data.Data Collection Methods
EMR data were generated by system reports created by PHN's quality assurance program manager. Project ECHO© data were collected and managed using REDCap electronic data capture tools. Outcomes were aggregated, analyzed for trends over time, and compared between groups.Principal Findings
All nine process outcomes increased from baseline to follow-up at the three initial sites, ranging from 4% to 43% g. At year two, the three initial sites had higher rates on AWVs (pilot 24%, comparison 12%; p < 0.0001), Advance Care Planning (New on file, pilot 8%, comparison 2%; Discussed with patient, pilot 18%, comparison 13%; Patient declined, pilot 0%, comparison 0%; p = 0.0001), Dementia Screening (pilot 24%, comparison 12%; p < 0.0001), Fall Risk Management (pilot 43%, comparison 10%; p < 0.0001), and Mobility Goal (pilot 19%, comparison 9%; p < 0.0001); and lower rates on High-Risk Medication Elimination (pilot 54%, comparison, 63%, p < 0.02).Conclusions
Access to high-quality geriatric care for rural older adults can be improved by increasing health care professionals' knowledge of the 4Ms, beginning with its incorporation into the AWV. 相似文献2.
Jenna M. Peart B.A. Daniel J. Licht M.D. Erin O'Connor Prange M.S.N. CRNP James R. Treat M.D. 《Pediatric dermatology》2015,32(3):381-382
We report the case of a boy with trisomy 13 who developed severe nodulocystic acne with sinus tract formation that has been unresponsive to multiple courses of systemic antibiotics and isotretinoin. 相似文献
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Grisel Lopez MD Daniel P. Eisenberg MD Michael D. Gregory MD Angela M. Ianni PhD Shannon E. Grogans BA Joseph C. Masdeu MD PhD Jenny Kim BA Catherine Groden MS CRNP Ellen Sidransky MD Karen F. Berman MD 《Annals of neurology》2020,87(4):652-657
Mutations in GBA1, the gene mutated in Gaucher disease, are a common genetic risk factor for Parkinson disease, although the penetrance is low. We performed [18F]-fluorodopa positron emission tomography studies of 57 homozygous and heterozygous GBA1 mutation carriers (15 with parkinsonism) and 98 controls looking for early indications of dopamine loss using voxelwise analyses to identify group differences in striatal [18F]-fluorodopa uptake (Ki). Forty-eight subjects were followed longitudinally. Cross-sectional and longitudinal comparisons of Ki and Ki change found significant effects of Parkinson disease. However, at baseline and over time, striatal [18F]-fluorodopa uptake in mutation carriers without parkinsonism did not significantly differ from controls. ANN NEUROL 2020;87:652–657 相似文献
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Sonya S. Brady PhD Amanda Berry PhD CRNP Deepa R. Camenga MD MHS Colleen M. Fitzgerald MD MS Sheila Gahagan MD MPH Cecilia T. Hardacker MSN RN CNL Bernard L. Harlow PhD Jeni Hebert-Beirne PhD MPH D. Yvette LaCoursiere MD Jessica B. Lewis PhD MFT Lisa K. Low PhD CNM Jerry L. Lowder MD MSc Alayne D. Markland DO MSc Gerald McGwin PhD Diane K. Newman DNP ANP-BC FAAN Mary H. Palmer PhD David A. Shoham PhD Ariana L. Smith MD Ann Stapleton MD Beverly R. Williams PhD Siobhan Sutcliffe PhD Prevention of Lower Urinary Tract Symptoms 《Neurourology and urodynamics》2020,39(4):1185-1202
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Patient Preference and Perception of Care Provided by Advance Nurse Practitioners and Physicians in Outpatient Adult Congenital Clinics 下载免费PDF全文
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Achieving public and global health competencies: A teaching case study of Botswana's cervical cancer screening program 下载免费PDF全文