Integrating primary care providers in the care of cancer survivors: gaps in evidence and future opportunities

Since the release of the Institute of Medicine report: From cancer patient to cancer survivor: lost in transition, in 2005, there has been a national call in the USA to provide coordinated, comprehensive care for cancer survivors, with an emphasis on the role of primary care. Several models of care have been described, which focus on primary care providers (PCPs) as receiving cancer survivors who are transferred after successful treatment, and who are given specific types of information from oncology-based care (eg, survivorship care plans), and not as active members of the cancer survivorship team. They provide recommendations for education ...

Optimising the community-based aproach to health care improvement comparative case studies of the clinical community model in practice

Community-based approaches to healthcare improvement are receiving increasing attention. Such approaches could offer an infrastructure for efficient knowledge-sharing and a potent means of influencing behaviours, but their potential is yet to be optimised. After briefly reviewing challenges to community based approaches this study describes in detail the clinical community model. Through exploring clinical communities in practice, they seek to identify practical lessons for optimising this community-based approach to healthcare improvement. 

Achieving Health Equity: A Guide for Health Care Organizations

This white paper provides guidance on how health care organizations can reduce health disparities related to racial or ethnic group, religion; socioeconomics status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity, geographic location; or other characteristics historically linked to discrimination or exclusion. 

It includes: 

-A framework, with five key components, for health care organizations to improve health equity in the communities they serve

- Guideance for measuring health equity

- A case study of one health care organization that has strategically integrated work to improve health equity throughout their system

- A self- assessment tool for health ...

4 Steps to Sustaining Improvement in Health Care

Leading health care organizations recognize that improving care isn´t enough; having a systematic approach to sustaining improvement is equally important.

To learn how to build systems that sustain improvement, the Institute for Healthcare Improvement studied health care organizations that were able to achieve standout results and ten build on them- organizations such as Intermountain Healthcare in Salt Lake City; Saskatoon Health Region in Saskatchewan, Canada; and Virginia Mason Health System in Seattle. These high-performing health systems affered a key insight: To sustain change, you need a strong strategy for engaging and standardizing the work of frontline managers. From their ...

Community health center provider ability to identify, treat and account for the social determinants of health: a card study

The social determinants of health (SDH) are conditions that shape the overall health of an individual on a continuous basis. As momentum for addressing social factors in primary care settings grows, provider ability to identify, treat and assess these factors remains unknown. Community health centers care for over 20- million of America´s highest risk populations. This study at three centers evaluates provider ability to identify, treat and code for the SDH.

The results suggest simple methods of identification may be sufficient. The addition of searchable codes and reimbursements may improve the way social factors are addressed for individuals and ...

How do we know? An assessment of integrated community case management data quality in four districts of Malawi

The World Health Organization contracted annual data quality assessments of Rapid Access Expansion (RAcE) proyects to review integrated community case management (iCCM) data quality and the monitoring and evaluation (M&E) system for iCCM, adn to suggest ways to improve data quality. 

This data quality assessment illuminates where an otherwise strong M&E system for iCCM fails to ensure some aspects of data quality. Prioritizing data management with documented protocols, additional training and approaches to create efficient supervision practices may improve iCCM data quality. 

Zero to 50,000 — The 20th Anniversary of the Hospitalist

Twenty years ago, were describe the emergence of a new type of specialist that is called a "Hospitalist". Since then, the number of hospitalists has grown from a few hundred to more  than 50.000- making this new field substantially larger than any subspecialty of internal medicine, about the same size as pediatrics, and in fact larger than any specialty except general internal medicine and family medicine. Approximately 75% of U.S hospitals, including all highly ranked academic health centers, now have hospitalists. The field´s rapid growth has both reflected and contributed to the evolution of clinical practice over ...

Early Performance of Accountable Care Organizations in Medicare

In the Medicare Shared Savings Program (MSSP), accountable care organizations (ACOs) have financial incentives to lower spending and improve quality. In this article they used quasi-experimental methods to assess the early performance of MSSP and ACOs. In the conclusions they found that the first full year of contracts MSSP was associated with reductions in Medicare Early pass between the 2012 participants but not among the 2013 participants. Economies higher in primary care groups independent groups in integrated hospitals. 

Changes in Low-Value Services in Year 1 of the Medicare Pioneer Accountable Care Organization Program

Wasteful practices are widespread in the US health care system. It is unclear if payment models intended to improve health care efficiency, such as the Medicare accountable care organization (ACO) programs, discourage the provision of low-value services. So the objective in this study is to assess whether the first year of the Medicare Pioneer ACO program was associated with a reduction in use of low-value services. 

Integrating a palliative approach into the management of chronic, life-threatening diseases: Who, How and When?

Palliative care has a great deal to offer individuals and families faced with chronic, life-threatening illnesses. Medical advances means that many people will live many  years with these illnesses; however, most will eventually die of these diseases  and should have the right and support to make  informed decisions about their care at the end-of-life. rather than dimming people’s hope, frankdiscussions about the prognosis and trajectory of these illnesses can help people enhance theirquality of both living and dying with these diseases.

Over the past 15 years, canada has made progress in providing high quality palliative care —particularly in the ...