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Showing results for "improving clinical-community linkages in primary care for patients with multiple chronic conditions".

81. AHRQ National Advisory Council (NAC) Meeting Minutes from November 17, 2021 (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/news/events/nac/nac-meeting-minutes-2021-nov.pdf
    January 01, 2021 - for improving primary care. … Networks and research in patient-centered medical homes, primary care transformation, care coordination … , team-based care, and multiple chronic conditions. … in many primary care settings. … Activities of strong interest will include care for people with multiple chronic conditions, advancing

82. AHRQ Multiple Chronic Conditions Research Network Publications | Agency for Healthcare Research and Quality
    www.ahrq.gov/prevention/chronic-care/decision/mcc/mccpublications.html
    May 01, 2014 - Assessment and management of patients with cognitive impairment and dementia in primary care. … Heterogeneity in the quality of care for patients with multiple chronic conditions by psychiatric comorbidity … The AHRQ Multiple Chronic Conditions Research Network conceptual model for research on complex patient … strategies for patients with multiple chronic conditions. … Out of context: clinical practice guidelines and patients with multiple chronic conditions.

83. Findings From the AHRQ Transforming Primary Care Grant Initiative: A Synthesis Report (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/primary-care/tpc/tpc-synthesis-report.pdf
    July 22, 2015 - physician was associated with a small increase (+0.05 visits per patient year) in primary care office … for tracking care for patients with chronic conditions; designated primary care teams that collaborate … For patients whose level was greater than 9 percent, encounters with primary care providers declined … comments in which physicians and staff noted that the PCMH focus on improving primary care performance … A Multi-Payer Patient-Centered Medical Home Initiative in Pennslyvania.

84. Appendix C. Detailed Descriptions of Agency Research Portfolios | Agency for Healthcare Research and Quality
    www.ahrq.gov/healthsystemsresearch/hspc-research-study/appendix-c.html
    July 01, 2021 - patients to rate experiences with hospitals, other providers, and health plans ( Agency for Healthcare … As described above, CDC projects also have examined primary care linkages to broader public health and … primary care. … , and Advanced Primary Care Practice demonstrations for PCMHs in multipayer settings and FQHC safety-net … The agency’s Bureau of Primary Health Care not only provides major service funding for community health

85. New Models of Primary Care Workforce and Financing - Case Example #4: Foresight Family Physicians (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/primary-care/workforce-financing/case_example_4.pdf
    October 01, 2016 - primary care workforce, and conducted site visits to primary care practices with innovative workforce … Foresight aspires to be the premier primary care practice in its area. … health patients, since Foresight physicians are not their primary care providers. … as evidenced in meetings with all MAs to talk about procedures, improving individuals’ skills, and … primary care.

86. New Models of Primary Care Workforce - Case Example #6: Henry Ford Health System (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/primary-care/workforce-financing/case_example_6.pdf
    October 01, 2016 - primary care workforce, and conducted site visits to primary care practices with innovative workforce … patients with multiple chronic diseases. … as use of CHWs in primary care because of the Detroit area's diverse patient population and integrated … , secure room for dementia clients, and transportation services. … health care and support services to all community residents.

87. New Models of Primary Care Workforce and Financing - Case Example #1: Stanford Coordinated Care (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/primary-care/workforce-financing/case_example_1.pdf
    October 01, 2016 - primary care workforce, and conducted site visits to primary care practices with innovative workforce … interest because nationwide, the number and percentage of adults living with multiple chronic conditions … SCC patients have risk factors that are about 2.5 times higher than average primary care patients in … and self-management support, with the three in-house physicians providing primary care. … -SCC physician ▌pg. 3 Most patients seen at SCC have difficulty managing their multiple chronic

88. Biosketches | Agency for Healthcare Research and Quality
    www.ahrq.gov/news/events/ahrq-research-summit-diagnostic-safety-biosketches.html
    September 01, 2016 - She has a special interest in the care of persons with multiple chronic conditions and functional limitations … Ling represents CMS on the Health and Human Services (HHS) Multiple Chronic Conditions Workgroup, and … care, especially among patients presenting with acute, severe vertigo or dizziness. … Primary Care Dr. … the Harvard Medical School Center for Primary Care.

89. New Models of Primary Care Workforce - Case Example #8: Methodist Healthcare Ministries: Wesley Health & Wellness Center (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/primary-care/workforce-financing/case_example_8.pdf
    October 01, 2016 - primary care workforce, and conducted site visits to primary care practices with innovative workforce … For this reason, the primary care team is more broadly defined. … - primary care connectivity. … Wesley nurses have some communication with primary care physicians, but challenges with the Wesley Clinic … They attend huddles and alert the primary care team if a patient is running late or needs to complete

90. Case Example #6: Henry Ford Health System | Agency for Healthcare Research and Quality
    www.ahrq.gov/ncepcr/tools/workforce-financing/case-example-6.html
    July 01, 2019 - primary care workforce, and conducted site visits to primary care practices with innovative workforce … with multiple chronic diseases. … use of CHWs in primary care because of the Detroit area's diverse patient population and integrated … , secure room for dementia clients, and transportation services. … health care and support services to all community residents.

91. Case Example #4: Foresight Family Physicians | Agency for Healthcare Research and Quality
    www.ahrq.gov/ncepcr/tools/workforce-financing/case-example-4.html
    July 01, 2019 - primary care workforce, and conducted site visits to primary care practices with innovative workforce … Foresight aspires to be the premier primary care practice in its area. … health patients, since Foresight physicians are not their primary care providers. … as evidenced in meetings with all MAs to talk about procedures, improving individuals' skills, and problem … primary care.

92. Case Example #8: Methodist Healthcare Ministries: Wesley Health & Wellness Center | Agency for Healthcare Research and Quality
    www.ahrq.gov/ncepcr/tools/workforce-financing/case-example-8.html
    July 01, 2019 - Primary Care Staffing Models Acknowledgements Introduction The Agency for Healthcare Research … primary care workforce, and conducted site visits to primary care practices with innovative workforce … For this reason, the primary care team is more broadly defined. … Wesley nurses have some communication with primary care physicians, but challenges with the Wesley Clinic … They attend huddles and alert the primary care team if a patient is running late or needs to complete

93. Meeting Minutes, March 2023 | Agency for Healthcare Research and Quality
    www.ahrq.gov/news/events/nac/2023-03-nac/nacmtg030623-minutes.html
    July 01, 2023 - Ensure connections between primary care and specialists. … How can we strengthen the backbone of primary care? Dr. … access for patients. … Ting, M.D., agreed on the importance of addressing the linkages between primary care and specialty care … Address training, communication, primary care, accountability, and payment models. Dr.

94. Improving Healthcare Safety by Enhancing Medication Safety (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/highlights/ps-project-highlights-medication-safety.pdf
    September 30, 2024 - Based Approach to Improving Opioid Management in Primary Care … Guide for primary care practices to assist them in managing patients with chronic pain on long-term … patient advisors in primary care. … patients with noncancer pain in rural primary care clinics across Washington and Idaho. … for chronic pain in a manner that improves patient safety and the work life of primary care clinicians

95. Case Example #1: Stanford Coordinated Care | Agency for Healthcare Research and Quality
    www.ahrq.gov/ncepcr/tools/workforce-financing/case-example-1.html
    July 01, 2019 - primary care workforce, and conducted site visits to primary care practices with innovative workforce … because nationwide, the number and percentage of adults living with multiple chronic conditions who … SCC patients have risk factors that are about 2.5 times higher than average primary care patients in … and self-management support, with the three in-house physicians providing primary care. … -SCC physician Most patients seen at SCC have difficulty managing their multiple chronic conditions

96. Lexicon for Behavioral Health and Primary Care Integration: Concepts and Definitions Developed by Expert Consensus (pdf file)
    integrationacademy.ahrq.gov/sites/default/files/2020-06/Lexicon.pdf
    January 01, 2020 - for integration of behavioral health in a primary care setting is all the patients in the clinic panel … with treatment adjustments if not improving 76% to 100% of patients in target group or practice … The target population for integration of behavioral health in a primary care setting is all the patients … care home” (Mauer 2009) emphasizing behavioral health in primary care and primary care in specialty … Primary care, psychology, and primary care psychology. In Haas, L.J.

97. An Introduction to Assessing Practices: Issues to Consider (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/ncepcr/tools/PCMH/pcpf-module-12-intro-to-assessing-practices.pdf
    September 01, 2015 - For example, in a practice interested in improving its lab reporting process, observation and document … of HRSA Primary Care Programs. … linkages • Patients are linked to outside resources • Practice partners with community organizations … self- management goals developed with patient • Community programs provide feedback about patients … care for low-income patients in the region. 1 Module12 Module 12 Intro to assessing practices

98. Final Contract Report -- State and Regional Demonstrations in Health IT: Outline for Final Impact Report (pdf file)
    digital.ahrq.gov/sites/default/files/docs/citation/state-regional-demonstration-hit-in-final-report.pdf
    July 01, 2015 - It is also used as the basis for an access control method, which allows a patient’s primary care provider … RTA provides automated alerts to primary care providers (PCPs) for recommended services for their patients … In this pilot study, we evaluated RTA’s performance for alerting PCPs when their patients with asthma … It is also used as the basis for an access control method, which allows a patient’s primary care provider … RTA provides automated alerts to primary care providers (PCPs) for recommended services for their patients

99. Electronic Records to Improve Care for Children (pdf file)
    digital.ahrq.gov/sites/default/files/docs/publication/uc1hs015420-shiffman-final-report-2007.pdf
    January 01, 2007 - with asthma and diabetes having a continuous relationship with a primary care provider is associated … Site Number of pediatric asthma patients Primary care site: PCC 700 Primary care site: Hill Health … Health Record for Health Care Providers in Pediatric Primary Care, School Health, Specialty Care, and … The hand-off of patient care from emergency to primary care providers has been associated with critical … care providers for pediatric patients seeking acute asthma treatment.

100. Chapter 1: Attaining Zoning and Building Permits | Agency for Healthcare Research and Quality
     www.ahrq.gov/ncepcr/tools/obesity/obpcp1.html
     May 01, 2014 - Integrating Primary Care Practices and Community-based Resources to Manage Obesity Chapter 1: Attaining … In more than 10 years of experience working with rural primary care practices, we have found that clinicians … Staff not directly involved in patient care might fill some of the important linkage roles with limited … with patients and be recognized and valued by their superiors. … Primary care was seen as a potential resource for weight-related conversations and health behavior change