communication

Ensuring accessibility helps reduce missed health care for autistic people. Health care delivery should be adapted in light of autism-related sensory profiles. Tailored accommodations should be implemented for each autistic patient’s unique communication profiles and preferences. Health care encounters should be as predictable, clear, and unrushed as possible. Autistic people with intersectional (e.g., cultural, gender) identities often experience discrimination in health care settings, which should be mitigated.

Author/s:

Louisa Lok Yee Man, Adeline Lacroix, Meng-Chuan Lai

Suicide Prevention in Primary Care: A Toolkit for Primary Care Clinicians and Leaders

Aubrey Delammermore — Sat, 19 Nov 2022 06:00:00 +0000

Date Added:

November 19, 2022

Journal/Publication:

Association of Clinicians for the Underserved

Publisher:

Centene Corporation

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

Keywords

evidence-based medicine

MeSH

primary health care

Suicide

Vulnerable Populations

risk assessment

communication

A suicide prevention toolkit developed for primary care practices recommended by the Oklahoma Department of Mental Health. James W. Mold, MD, MPH

Free full text

Suicide prevention has been named a national priority and much work has been done to review existing evidence and identify gaps in how our nation’s mental health and health care systems address this public health challenge. A national task force that was part of the effort to update the national suicide prevention strategy reviewed research and best practices from the field and
concluded that suicide prevention could be improved in health care. The task force found three common characteristics among successful suicide prevention programs in health care settings. Health care staff in these organizations:
Believed that suicide can be prevented in the population they serve through improvements in service access and quality, and through systems of continuous improvement;
Created a culture that finds suicide unacceptable and sets and monitors ambitious goals to prevent suicide; and
Employed evidence-based clinical care practice, including standardized risk stratification, evidence-based interventions, and patient engagement approaches1.

The task force’s recommendations formed the foundation of the Zero Suicide Approach for health care organizations. The recommendations contained in this guide are based on those offered in the comprehensive Zero Suicide in Health and Behavioral Health Care Toolkit [http://zerosuicide.sprc.org/toolkit]. Here they have been adapted specifically for primary care organizations and clinicians who care for underserved populations.
The guide focuses on two core components:
1. Screening and assessment
2. Care management and referral processes
The final section contains some additional information on administrative and legal issues providers and leaders may find helpful to support integration of safer suicide care in practice. Many providers and clinical leaders erroneously assume if they discuss suicide with a patient they open up themselves to liability. Utilizing a patient safety approach, primary care organizations can
establish safer suicide care practices that deliver high quality care to patients and reduce risk to the organization.
In each section of this guide you will find:
Information summarized for providers, including some helpful provider communication tips.
A list of recommended trainings and resources to learn more.
Leadership actions organizations may wish to undertake to help providers reduce suicide in their organization’s
patient population, and
Relevant tools, templates and case studies.
This toolkit begins with a brief background on the impact of suicide and offers a case study illustrating how one federally qualified health center adopted a safer suicide care model.

Author/s:

Institute of Family Health, Little, V.

Patient-Reported Needs Following a Referral for Colorectal Cancer Screening

Brian Desmarais — Tue, 29 Sep 2020 13:30:42 +0000

Date Added:

September 29, 2020

Journal/Publication:

American Journal of Preventive Medicine

Publication Date:

February 1, 2019

URL:

Patient-Reported Needs Following a Referral for Colorectal Cancer Screening

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1016/j.amepre.2018.08.017. Epub 2018 Dec 13.

MeSH

decision support techniques

early detection of cancer

Physician-Patient Relations

patient acceptance of healthcare

Patients referred for colonoscopy have lots of questions that are not always being answered by primary care clinicians. Many would appreciate being able to access additional information through the the practice’s portal. James W. Mold, MD, MPH

Free full text

View

Abstract

Introduction: Patient-physician communication about colorectal cancer screening can affect screening use, but discussions often lack information that patients need for informed decision making and seldom address personal preferences or barriers. To address this gap, a series of patient focus groups was conducted to guide the development of an online, interactive decision support program. This article presents findings on patient information needs and barriers to colorectal cancer screening after receiving a screening recommendation from a physician, and their perspectives on using electronic patient portals as platforms for health-related decision support.

Methods: Primary care patients with recent colonoscopy or stool testing orders were identified via the centralized data repository of a large Midwestern health system. Seven gender-stratified focus groups (N=45 participants) were convened between April and July 2016. Sessions were audio recorded, transcribed, coded, and analyzed for commonly expressed themes beginning in August 2016.

Results: Findings reveal a consistent need for simple and clear information on colorectal cancer screening. Participants desired step-by-step explanations of the colonoscopy procedure and information about bowel preparation options/alternatives. The desired level of additional information varied: some patients wanted to know about and act on test options, whereas others preferred following their physician-recommended testing path. Fears and concerns were prevalent, particularly about colonoscopy, and patients reported challenges getting these concerns and their informational needs addressed. Finally, they expressed consistent support for using the patient portal to gather additional information from their physician.

Conclusions: Patient portals may offer an opportunity to build sustainable programs for decision support and assistance that are integrated with clinic workflows and processes.

Trial registration: ClinicalTrials.gov NCT02798224.

Author/s:

Dyer, Karen E., Shires, Deirdre A.

Human Papillomavirus Immunization in Rural Primary Care

Brian Desmarais — Mon, 29 Jun 2020 17:01:39 +0000

Date Added:

June 29, 2020

Journal/Publication:

American Journal of Preventive Medicine

URL:

Human Papillomavirus Immunization in Rural Primary Care

Type:

Best Local Practices

Format:

Article

DOI (1):

https://doi.org/10.1016/j.amepre.2020.03.018

Keywords

vaccination

MeSH

Papillomavirus Infections

Papillomavirus Vaccines

The results might be helpful to practices trying to increase HPV immunization rates. James W. Mold, MD, MPH

Free full text

View

Not available.

Author/s:

Gunn, R., Ferrara, L.K., Dickinson, C., Fagnan, L.J., Carney, P.A., Davis, M.M.

Canadian guideline for Parkinson disease

Brian Desmarais — Mon, 03 Feb 2020 17:28:55 +0000

Date Added:

February 3, 2020

Journal/Publication:

Canadian Medical Association Journal

Publication Date:

September 9, 2019

Issue:

Volume:

191

Pages:

E989-E1004

URL:

Canadian guideline for Parkinson disease

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1503/cmaj.181504

MeSH

Hospice and Palliative Care Nursing

Parkinsonian Disorders

decision making

communication

Canada

Updated Canadian guidelines for management of Parkinson’s Disease. James W. Mold, MD, MPH

Free full text

View

KEY POINTS

This guideline update reflects substantial changes in the literature on diagnosis and treatment of Parkinson disease, and adds information on palliative care.
Impulse control disorders can develop in a person with Parkinson disease who is on any dopaminergic therapy at any stage in the disease course, especially for those taking dopamine agonists.
Advanced therapies like deep brain stimulation and intrajejunal levodopa-carbidopa gel infusion are now routinely used in Parkinson disease to manage motor symptoms and fluctuations.
Evidence exists to support early institution of exercise at the time of diagnosis of Parkinson disease, in addition to the clear benefit now shown in those with well-established disease.
Palliative care requirements of people with Parkinson disease should be considered throughout all phases of the disease, which includes an option of medical assistance in dying.

Author/s:

Grimes,D., Fitzpatrick, M., Gordon, J., Miyasaki, J., Fon, E.A., Schlossmacher, M., Suchowersky, O., Rajput, A., Lafontaine, A.L, Mestre, T., Appel-Cresswell, S., Kalia, S., Schoffer, K., Zurowski, M., Postuma, R.B., Udow, S., Fox, S., Barbeau, P., Hutton, B.

Organizational Health Literacy: Quality Improvement Measures with Expert Consensus

Brian Desmarais — Thu, 18 Jul 2019 13:21:14 +0000

Date Added:

July 18, 2019

Journal/Publication:

Health Literacy Research and Practice

Publication Date:

July 1, 2019

Issue:

Volume:

Pages:

e127-e146

URL:

Organizational Health Literacy: Quality Improvement Measures with Expert Consensus

Type:

Practice Management Research Results

DOI (1):

10.3928/24748307-20190503-01

Keywords

health literacy

MeSH

health literacy

quality improvement

delivery of health care

Telecommunications

communication

RPR Commentary: Table 2 lists proposed quality indicators that can be used to assess your organization’s/practice’s efforts to help patients improve their health literacy. James W. Mold, MD, MPH

Free full text

View

Abstract

BACKGROUND:

Organizational health literacy (OHL) is the degree to which health care organizations implement strategies to make it easier for patients to understand health information, navigate the health care system, engage in the health care process, and manage their health. Although resources exist to guide OHL-related quality improvement (QI) initiatives, little work has been done to establish measures that organizations can use to monitor their improvement efforts.

OBJECTIVE:

We sought to identify and evaluate existing OHL-related QI measures. To complement prior efforts to develop measures based on patient-reported data, we sought to identify measures computed from clinical, administrative, QI, or staff-reported data. Our goal was to develop a set of measures that experts agree are valuable for informing OHL-related QI activities.

METHODS:

We used four methods to identify relevant measures computed from clinical, administrative, QI, or staff-reported data. We convened a Technical Expert Panel, published a request for measures, conducted a literature review, and interviewed 20 organizations working to improve OHL. From the comprehensive list of measures identified, we selected a set of high-priority measures for review by a second expert panel. Using a modified Delphi review process, panelists rated measures on four evaluation criteria, participated in a teleconference to discuss areas of disagreement among panelists, and rerated all measures.

KEY RESULTS:

Across all methods, we identified 233 measures. Seventy measures underwent Delphi Panel review. For 22 measures, there was consensus among panelists that the measures were useful, meaningful, feasible, and had face validity. Five additional measuresreceived strong ratings for usefulness, meaningfulness, and face validity, but failed to show consensus among panelists regarding feasibility.

CONCLUSIONS:

We identified OHL-related QI measures that have the support of experts in the field. Although additional measure development and testing is recommended, the Consensus OHL QI Measures are appropriate for immediate use. [HLRP: Health LiteracyResearch and Practice. 2019;3(2):e127-e146.].

PLAIN LANGUAGE SUMMARY:

The health care system is complex. Health care organizations can make things easier for patients by making changes to improve communication and to help patients find their way around, become engaged in the health care process, and manage their health. We identify 22 measures that organizations can use to monitor their efforts to improve communication with and support for patients.

Author/s:

Brega, A.G., Hamer, M.K., Albright, K., Brach, C., Saliba, D., Abbey, D., Gritz, R.M.