Browsing by Subject "Patient Care"
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Item Open Access A Systematic Review of Conceptual Frameworks of Medical Complexity and New Model Development.(J Gen Intern Med, 2016-03) Zullig, Leah L; Whitson, Heather E; Hastings, Susan N; Beadles, Chris; Kravchenko, Julia; Akushevich, Igor; Maciejewski, Matthew LBACKGROUND: Patient complexity is often operationalized by counting multiple chronic conditions (MCC) without considering contextual factors that can affect patient risk for adverse outcomes. OBJECTIVE: Our objective was to develop a conceptual model of complexity addressing gaps identified in a review of published conceptual models. DATA SOURCES: We searched for English-language MEDLINE papers published between 1 January 2004 and 16 January 2014. Two reviewers independently evaluated abstracts and all authors contributed to the development of the conceptual model in an iterative process. RESULTS: From 1606 identified abstracts, six conceptual models were selected. One additional model was identified through reference review. Each model had strengths, but several constructs were not fully considered: 1) contextual factors; 2) dynamics of complexity; 3) patients' preferences; 4) acute health shocks; and 5) resilience. Our Cycle of Complexity model illustrates relationships between acute shocks and medical events, healthcare access and utilization, workload and capacity, and patient preferences in the context of interpersonal, organizational, and community factors. CONCLUSIONS/IMPLICATIONS: This model may inform studies on the etiology of and changes in complexity, the relationship between complexity and patient outcomes, and intervention development to improve modifiable elements of complex patients.Item Open Access Impact of ACGME Accreditation Process on Quality of Program and Patient Care in the Community.(Journal of graduate medical education, 2016-10) Das, Samrat UItem Open Access Telehealth transformation: COVID-19 and the rise of virtual care.(Journal of the American Medical Informatics Association : JAMIA, 2020-06) Wosik, Jedrek; Fudim, Marat; Cameron, Blake; Gellad, Ziad F; Cho, Alex; Phinney, Donna; Curtis, Simon; Roman, Matthew; Poon, Eric G; Ferranti, Jeffrey; Katz, Jason N; Tcheng, JamesThe novel coronavirus disease-19 (COVID-19) pandemic has altered our economy, society, and healthcare system. While this crisis has presented the U.S. healthcare delivery system with unprecedented challenges, the pandemic has catalyzed rapid adoption of telehealth, or the entire spectrum of activities used to deliver care at a distance. Using examples reported by U.S. healthcare organizations, including ours, we describe the role that telehealth has played in transforming healthcare delivery during the 3 phases of the U.S. COVID-19 pandemic: (1) stay-at-home outpatient care, (2) initial COVID-19 hospital surge, and (3) postpandemic recovery. Within each of these 3 phases, we examine how people, process, and technology work together to support a successful telehealth transformation. Whether healthcare enterprises are ready or not, the new reality is that virtual care has arrived.Item Open Access The Role of Doctor of Nursing Practice-Prepared Nurses to Improve Quality of Patient Care.(Creative nursing, 2023-05) Reynolds, Staci S; Sabol, Valerie KTranslating evidence-based practices (EBPs) and quality improvement (QI) initiatives to the bedside is a significant need among hospitals and outpatient settings to improve the provision of quality nursing care. However, health-care systems continue to struggle with implementing and sustaining EBPs. To improve the application of EBPs and QI initiatives, hospitals should consider using Doctor of Nursing Practice (DNP)-prepared nurses in Quality Improvement roles, as DNP graduates have acquired unique expertise in these topics. However, health-care settings do not routinely maximize the use of DNP-prepared nurses in these roles. This article provides an overview of the challenges to understanding the value and impact of DNP-prepared nurses, along with recommendations and opportunities for future practice.