Medicine

High-quality primary care is the foundation of a high-functioning health care system. When it is high-quality, primary care provides continuous, personcentered, relationship-based care that considers the needs and preferences of individuals, families, and communities. Without access to high-quality primary care, minor health problems can spiral into chronic disease, chronic disease management becomes difficult and uncoordinated, visits to emergency departments increase, preventive care lags, and health care spending soars to unsustainable levels.

Unequal access to primary care remains a concern, and the COVID-19 pandemic amplified pervasive economic, mental health, and social health disparities that ubiquitous, high-quality primary care might have reduced. Primary care is the only health care component where an increased supply is associated with better population health and more equitable outcomes. For this reason, primary care is a common good, which makes the strength and quality of the country’s primary care services a public concern.

The National Academies of Sciences, Engineering, and Medicine formed the Committee on Implementing High-Quality Primary Care in 2019. Building on the recommendations of the 1996 Institute of Medicine report Primary Care: America’s Health in a New Era, the committee was tasked to develop an implementation plan for high-quality primary care in the United States.

The committee’s definition of high-quality primary care (see Box 1) describes what it should be, not what most people in the United States experience today. To rebuild a strong foundation for the U.S. health care system, the committee’s implementation plan includes objectives and actions targeting primary care stakeholders and balancing national needs for scalable solutions while allowing for adaptations to meet local needs.

The committee set five implementation objectives to make high-quality primary care available to all people living in the United States:

1. Pay for primary care teams to care for people, not doctors to deliver services.

2.Ensure that high-quality primary care is available to every individual and family in every community.

3.Train primary care teams where people live and work.

4.Design information technology that serves the patient, family, and the interprofessional care team.

5.Ensure that high-quality primary care is implemented in the United States.

Author/s:

The National Academy of Sciences

Sudden Sensorineural Hearing Loss: A Diagnostic and Therapeutic Emergency

Devin Evans — Fri, 26 Feb 2021 06:00:00 +0000

Date Added:

February 26, 2021

Journal/Publication:

Journal of the American Board of Family Medicine

Publication Date:

January 31, 2021

Issue:

Volume:

Pages:

216-223

URL:

Sudden Sensorineural Hearing Loss: A Diagnostic and Therapeutic Emergency

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.3122/jabfm.2021.01.200199

Keywords

Audiology

clinical decision-making

Conductive Hearing Loss

PMID (1):

33452100

MeSH

physicians, family

Hearing Loss, Sudden

Hearing Loss, Sensorineural

Otolaryngology

Medicine

primary health care

A summary for primary care clinicians of the recently updated ENT guidelines for evaluation and management of sudden acute hearing loss. James W. Mold, MD, MPH

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The family physician's role in recognizing and managing sudden sensorineural hearing loss (SSNHL) is crucial. A recently updated otolaryngologic clinical practice guideline has been released for this emergency syndrome, but dissemination is limited to a specialty journal. As a result, the guidelines may not be widely available in the primary care setting where patients often present. We provide this focused review to clarify and disseminate SSNHL guidelines for the frontline family physician.

Author/s:

Prince, Andrew D.P., Stucken, Emily Z.

Prevention, Diagnosis, and Management of Chronic Wounds in Older Adults

Brian Desmarais — Thu, 09 Apr 2020 00:38:07 +0000

Date Added:

April 8, 2020

Journal/Publication:

Mayo Clinic Proceedings

Publication Date:

October 1, 2020

URL:

Prevention, Diagnosis, and Management of Chronic Wounds in Older Adults

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

https://doi.org/10.1016/j.mayocp.2019.10.014

Keywords

MeSH

A nice review of chronic wound prevention and care principles from Mayo. James W. Mold, MD, MPH

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Chronic wounds are common, disproportionately affect older adults, and are likely to be encountered by providers across all specialties and care settings. All providers should be familiar with basic wound prevention, identification, classification, and treatment approach, all of which are outlined in this article.

Author/s:

Hoversten, K.P., Kiemele, L.J., Stolp, A.M., Verdoorn, B.

Assessment and Management of Patients at Risk for Suicide: Synopsis of the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guidelines.

Brian Desmarais — Wed, 28 Aug 2019 19:36:58 +0000

Date Added:

August 28, 2019

Journal/Publication:

Annals of Internal Medicine

Publication Date:

August 27, 2019

URL:

Assessment and Management of Patients at Risk for Suicide: Synopsis of the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guidelines.

Format:

Article

DOI (1):

10.7326/M19-0687

Keywords

MeSH

evidence-based practice

DESCRIPTION:

In May 2019, the U.S. Department of Veterans Affairs (VA) and U.S. Department of Defense (DoD) approved an update to the 2013 joint clinical practice guideline for assessing and managing patients who are at risk for suicide. This guideline provides health care providers with a framework by which to screen for, evaluate, treat, and manage the individual needs and preferences of VA and DoD patientswho may be at risk for suicide.

METHODS:

In January 2018, the VA/DoD Evidence-Based Practice Work Group convened to develop a joint VA/DoD guideline including clinical stakeholders and conforming to the National Academy of Medicine's tenets for trustworthy clinical practice guidelines. The guideline panel drafted key questions, systematically searched and evaluated the literature through April 2018, created algorithms, and advanced 22 recommendations in accordance with the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system.

RECOMMENDATIONS:

This synopsis, which includes 3 clinical practice algorithms, summarizes the key recommendations of the guideline related to screening and evaluation, risk management and treatment, and other management methods. Risk management and treatment recommendations address both pharmacologic and nonpharmacologic approaches for patients with suicidal ideation and behavior. Other management methods address lethal means safety (such as restricting access to firearms, poisons, and medications and installing barriers to prevent jumping from lethal heights) and population health strategies.

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These guidelines produced by the VA apply equally well to all adults. James W. Mold, MD, MPH

Author/s:

Sall, J., Brenner, J., Bell, A.M.M., Colston, M.J.