The Journal of Ambulatory Care Management This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Clinical Workflows and the Associated Tasks and Behaviors to Support Delivery of Integrated Behavioral Health and Primary Care
Integrating primary care and behavioral health is an important focus of health system transformation. Cross-case comparative analysis of 19 practices in the United States describing integrated care clinical workflows. Surveys, observation visits, and key informant interviews analyzed using immersion-crystallization. Staff performed tasks and behaviors—guided by protocols or scripts—to support 4 workflow phases: (1) identifying; (2) engaging/transitioning; (3) providing treatment; and (4) monitoring/adjusting care. Shared electronic health records and accessible staffing/scheduling facilitated workflows. Stakeholders sh...
Source: The Journal of Ambulatory Care Management - December 1, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

eConsult Mental Health: Electronic Referral and Consultation to Integrate Primary Care and Mental Health
We describe the implementation of a novel electronic platform for specialty referral and consultation, eConsult Mental Health. This innovation aims to address mental health care access and coordination challenges in the nation's second largest public health system in Los Angeles. eConsult Mental Health is one of the largest documented electronic platforms to facilitate the integration of behavioral health services in primary care. Although implementation has been met with barriers unique to mental health care, eConsult Mental Health appears to be a promising tool to expand the spectrum of care for Los Angeles County safety...
Source: The Journal of Ambulatory Care Management - December 1, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Preparing for Community Health Worker Integration Into Clinical Care Teams Through an Understanding of Patient and Community Health Worker Readiness and Intent
There is a rising demand to expand the successful roles community health workers (CHWs) offer into clinical settings (clinic-based community health worker [cCHW]) to support patient services. Using survey data, we evaluated patient and CHW readiness and intent to adopt cCHW clinical care integration. We found CHW and patient readiness to become or utilize a cCHW significantly predicted CHW and patient intent to become or utilize a cCHW; however, in our study, CHWs experienced greater readiness to serve as cCHWs than did patients to utilize cCHWs. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - December 1, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Psychometric Testing of a Measure of Patient Experience in an Ambulatory Surgery Setting
The purpose of this research was to develop a psychometrically sound survey for use with the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Services (OAS CAHPS) survey. Both an exploratory pilot and a confirmatory pilot were conducted in hospital outpatient departments and freestanding ambulatory surgery centers eligible for participation in the OAS CAHPS program. Analyses indicated an internally consistent and valid 18-item survey with 6 measures, including Access, Moving Through the Visit, Nurses, Anesthesiologist, Doctor, and Coordinated Care. The measures are small, maximizing the num...
Source: The Journal of Ambulatory Care Management - December 1, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

A Brief Review of Single-Item and Multi-Item Quality-of-Life Measures for Medicare Patients
Using responses to HowsYourHealth.org from 9068 patients aged 65 years or older, I illustrate measurement compromises for quality-of-life assessment and management. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - December 1, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Health Status in Adults With Chronic Conditions: Intervention Strategies for Improving Patient-Reported Outcomes
This literature review analyzes 418 articles from 2 periods (2000-2010 and 2011-2017) to provide interpretative guidelines for the change in physical (PCS) and mental component summaries (MCS) of well-established patient-reported measures (MOS SF-36 V1, HOS SF-12, VR-36, and VR-12). The magnitude of the intervention effects was calculated using baseline and follow-up data. Results were similar across the 2 periods, although the effects of social and behavioral interventions are less consistent and are smaller for PCS. Both single interventions and multicomponent interventions met the moderate to large effect size criterion...
Source: The Journal of Ambulatory Care Management - December 1, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

From the Editor
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - December 1, 2018 Category: Emergency Medicine Tags: From the Editor Source Type: research

Community Health Workers as an Extension of Care Coordination in Primary Care: A Community-Based Cosupervisory Model
We describe the collaborative development of a community-based CHW program to address the social determinants of health that affect patients. This cosupervisory, generalist CHW model provides an innovative template for cocreation of patient-centered infrastructure and resourcing within an evolving and replicable holistic care continuum across patient ages, diagnoses, health care payers, and communities to promote health equity. The program has been effective in decreasing health care utilization and cost. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - August 28, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Lessons Learned From a Quad-State Postdisaster Project: Developing Accessible and Sustainable Integrated Mental and Physical Health Care Services
The Mental and Behavioral Health (MBH) Capacity Project had a mission shared among 4 states to support MBH sustainability along the Gulf Coast. Integration of mental health into undersourced primary health clinics was an important goal of the project. The findings from the collaborative evaluation demonstrate long-term outcomes including the following: community has greater capacity and sustainability for quality health care; better informed and connected communities; and individuals are more informed, connected, and resilient. Lessons learned indicate that improved population health outcomes are possible even in low-incom...
Source: The Journal of Ambulatory Care Management - August 28, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Transitioning Patients From Specialty Care to Primary Care: What We Know and What We Can Do
Growing demand for specialty care has resulted in longer wait times for appointments, particularly at US academic referral centers. A proportion of specialty visits are for routine follow-up care of stable problems, and there is evidence that primary care providers are willing and able to take responsibility for a significant proportion of these patients. However, little is known about how to transition care back to a referring primary care clinician in a manner that is acceptable to everyone involved. In this article, we describe social, legal, and financial barriers to effective care transition and propose communication ...
Source: The Journal of Ambulatory Care Management - August 28, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Improving Provider Experience and Increasing Patient Access Through Nurse Practitioner–Physician Primary Care Teams
This article describes a model of NP-MD care teams in an urban safety-net primary care practice. Average time to third next available appointment with a team provider (either NP or MD) decreased by nearly 20 days after implementation of the model. In total, 79% of MDs reported that the model was very or extremely helpful in reducing the burden of work between visits and 100% of NPs reported that they were very or extremely satisfied with their current job. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - August 28, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Building a Framework for Community Health Worker Skills Proficiency Assessment to Support Ongoing Professional Development
Although community health workers (CHWs) continue to gain credibility and recognition in the health care and public health sectors, there is still a need to expand workforce identity and development efforts, including identifying best practices for assessing CHW skill proficiencies. During this qualitative study, we interviewed 32 CHWs, trainers, and supervisors to understand current practice, perspectives, and perceived importance in assessing CHW skills and guiding principles for CHW skill assessment. Results from these interviews can be used to inform CHW workforce development to enhance efforts among those who are acti...
Source: The Journal of Ambulatory Care Management - August 28, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

How Do Innovative Primary Care Practices Achieve the Quadruple Aim?
We report the findings from 38 such practices that fill this gap. We describe how they execute 8 functions that collectively meet patient needs. They include managing populations, providing self-management support coaching, providing integrated behavioral health care, and managing referrals. The functions provide a more actionable perspective on the work of primary care. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - August 28, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Implementation of the PROMIS-29 in Routine Care for People With Diabetes: Challenges and Opportunities
This report describes factors influencing the PROMs process and the results of interviews with patients and members of the care team about PROMs' implementation and impact. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - August 28, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Multiple Chronic Conditions and Disparities in 30-Day Hospital Readmissions Among Nonelderly Adults
This study examines the patterns of 30-day hospital readmissions by race/ethnicity and multiple chronic conditions (MCC) burden among nonelderly adult patients. We used hospital discharge data of patients in the 18- to 64-year age group in 5 US states, California, Florida, Missouri, New York, and Tennessee, for 2009 from the Healthcare Cost and Utilization Project State Inpatient Database (HCUP-SID) of the Agency for Healthcare Research and Quality, linked to contextual and provider data from the Health Resources and Services Administration. A multilevel logistic regression model was used for data pooled over 5 states, adj...
Source: The Journal of Ambulatory Care Management - August 28, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research