The Annals of Family Medicine最新文献_第5页

Adapting an In-Clinic Resource Navigator Program to a Virtual Referral Model 将临床资源导航程序应用于虚拟转诊模型

The Annals of Family Medicine Pub Date : 2022-03-01 DOI: 10.1370/afm.2791

Kellia J. Hansmann, Julia Alberth, Robert Freidel, Allison Jenness

引用次数: 0

FROM AFMRD: WHO TO GO TO FOR WHAT: THE ABFM OR THE ACGME 从afmrd:谁去做什么:abfm或acme

The Annals of Family Medicine Pub Date : 2022-03-01 DOI: 10.1370/afm.2779

Sarah Z. Cole, Karen Elisa Milian Olmos

引用次数: 0

Failure of the Problem-Oriented Medical Paradigm and a Person-Centered Alternative 以问题为导向的医学范式的失败和以人为本的替代方案

The Annals of Family Medicine Pub Date : 2022-03-01 DOI: 10.1370/afm.2782

J. Mold

{"title":"Failure of the Problem-Oriented Medical Paradigm and a Person-Centered Alternative","authors":"J. Mold","doi":"10.1370/afm.2782","DOIUrl":"https://doi.org/10.1370/afm.2782","url":null,"abstract":"Our problem-oriented approach to health care, though historically reasonable and undeniably impactful, is no longer well matched to the needs of an increasing number of patients and clinicians. This situation is due, in equal parts, to advances in medical science and technologies, the evolution of the health care system, and the changing health challenges faced by individuals and societies. The signs and symptoms of the failure of problem-oriented care include clinician demoralization and burnout; patient dissatisfaction and non-adherence; overdiagnosis and labeling; polypharmacy and iatrogenesis; unnecessary and unwanted end-of-life interventions; immoral and intolerable disparities in both health and health care; and inexorably rising health care costs. A new paradigm is needed, one that humanizes care while guiding the application of medical science to meet the unique needs and challenges of individual people. Shifting the focus of care from clinician-identified abnormalities to person-relevant goals would elevate the role of patients; individualize care planning; encourage prioritization, prevention, and end-of-life planning; and facilitate teamwork. Paradigm shifts are difficult, but the time has come for a reconceptualization of health and health care that can guide an overdue transformation of the health care system.","PeriodicalId":22305,"journal":{"name":"The Annals of Family Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76719244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

FROM STFM: ADDICTION EXPERTS COLLABORATE WITH STFM TO CREATE NEW NATIONAL ADDICTION CURRICULUM 来自stfm:成瘾专家与stfm合作创建新的国家成瘾课程

The Annals of Family Medicine Pub Date : 2022-03-01 DOI: 10.1370/afm.2803

引用次数: 0

Clinic Factors Associated With Mailed Fecal Immunochemical Test (FIT) Completion: The Difference-Making Role of Support Staff 与邮寄粪便免疫化学测试(FIT)完成相关的临床因素:支持人员的差异作用

The Annals of Family Medicine Pub Date : 2022-03-01 DOI: 10.1370/afm.2772

Melinda M. Davis, J. Schneider, Amanda F. Petrik, Edward J. Miech, Brittany Younger, Anne L. Escaron, Jennifer S Rivelli, Jamie H. Thompson, Denis B Nyongesa, G. Coronado

{"title":"Clinic Factors Associated With Mailed Fecal Immunochemical Test (FIT) Completion: The Difference-Making Role of Support Staff","authors":"Melinda M. Davis, J. Schneider, Amanda F. Petrik, Edward J. Miech, Brittany Younger, Anne L. Escaron, Jennifer S Rivelli, Jamie H. Thompson, Denis B Nyongesa, G. Coronado","doi":"10.1370/afm.2772","DOIUrl":"https://doi.org/10.1370/afm.2772","url":null,"abstract":"PURPOSE Mailed fecal immunochemical test (FIT) programs can facilitate colorectal cancer (CRC) screening. We sought to identify modifiable, clinic-level factors that distinguish primary care clinics with higher vs lower FIT completion rates in response to a centralized mailed FIT program. METHODS We used baseline observational data from 15 clinics within a single urban federally qualified health center participating in a pragmatic trial to optimize a mailed FIT program. Clinic-level data included interviews with leadership using a guide informed by the Consolidated Framework for Implementation Research (CFIR) and FIT completion rates. We used template analysis to identify explanatory factors and configurational comparative methods to identify specific combinations of clinic-level conditions that uniquely distinguished clinics with higher and lower FIT completion rates. RESULTS We interviewed 39 clinic leaders and identified 58 potential explanatory factors representing clinic workflows and the CFIR inner setting domain. Clinic-level FIT completion rates ranged from 30% to 56%. The configurational model for clinics with higher rates (≥37%) featured any 1 of the following 3 factors related to support staff: (1) adding back- or front-office staff in past 12 months, (2) having staff help patients resolve barriers to CRC screening, and (3) having staff hand out FITs/educate patients. The model for clinics with lower rates involved the combined absence of these same 3 factors. CONCLUSIONS Three factors related to support staff differentiated clinics with higher and lower FIT completion rates. Adding nonphysician support staff and having those staff provide enabling services might help clinics optimize mailed FIT screening programs.","PeriodicalId":22305,"journal":{"name":"The Annals of Family Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90657859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

FROM ADFM: KNOWLEDGE, ATTITUDES, AND SKILLS FOR FAMILY MEDICINE LEADERS: COMPETENCIES FOR SUCCESS 来自adfm:家庭医学领导者的知识、态度和技能:成功的能力

The Annals of Family Medicine Pub Date : 2022-03-01 DOI: 10.1370/afm.2805

J. Borkan, Peter A. Catinella, M. Muramoto

引用次数: 1

FROM NAPCRG: NAPCRG 50TH ANNIVERSARY – A YEAR-LONG CELEBRATION 源自napcrg: napcrg 50周年纪念——为期一年的庆祝活动

The Annals of Family Medicine Pub Date : 2022-03-01 DOI: 10.1370/afm.2804

J. Brown, Jack Westfall, D. Harper, L. Green

引用次数: 1

Connecting Group Care Patients to Mental Health and Food Resources During the COVID-19 Pandemic 在COVID-19大流行期间，将团体护理患者与精神卫生和食物资源联系起来

The Annals of Family Medicine Pub Date : 2022-03-01 DOI: 10.1370/afm.2790

C. Wolcott, Lisa Wanger, Lara Penny

引用次数: 0

Social Risk Factors and Desire for Assistance Among Patients Receiving Subsidized Health Care Insurance in a US-Based Integrated Delivery System 美国综合输送系统中接受补贴医疗保险患者的社会风险因素和援助意愿

The Annals of Family Medicine Pub Date : 2022-03-01 DOI: 10.1370/afm.2774

L. Tuzzio, R. Wellman, E. D. De Marchis, L. Gottlieb, Callie Walsh-Bailey, Salene M. W. Jones, C. Nau, J. Steiner, M. Banegas, A. Sharp, Alphonse J Derus, C. Lewis

{"title":"Social Risk Factors and Desire for Assistance Among Patients Receiving Subsidized Health Care Insurance in a US-Based Integrated Delivery System","authors":"L. Tuzzio, R. Wellman, E. D. De Marchis, L. Gottlieb, Callie Walsh-Bailey, Salene M. W. Jones, C. Nau, J. Steiner, M. Banegas, A. Sharp, Alphonse J Derus, C. Lewis","doi":"10.1370/afm.2774","DOIUrl":"https://doi.org/10.1370/afm.2774","url":null,"abstract":"PURPOSE Because social conditions such as food insecurity and housing instability shape health outcomes, health systems are increasingly screening for and addressing patients’ social risks. This study documented the prevalence of social risks and examined the desire for assistance in addressing those risks in a US-based integrated delivery system. METHODS A survey was administered to Kaiser Permanente members on subsidized exchange health insurance plans (2018-2019). The survey included questions about 4 domains of social risks, desire for help, and attitudes. We conducted a descriptive analysis and estimated multivariate modified Poisson regression models. RESULTS Of 438 participants, 212 (48%) reported at least 1 social risk factor. Housing instability was the most common (70%) factor reported. Members with social risks reported more discomfort being screened for social risks (14.2% vs 5.4%; P = .002) than those without risks, although 90% of participants believed that health systems should assist in addressing social risks. Among those with 1-2 social risks, however, only 27% desired assistance. Non-Hispanic Black participants who reported a social risk were more than twice as likely to desire assistance compared with non-Hispanic White participants (adjusted relative risk [RR] 2.2; 95% CI, 1.3-3.8). CONCLUSIONS Athough most survey participants believed health systems have a role in addressing social risks, a minority of those reporting a risk wanted assistance and reported more discomfort being screened for risk factors than those without risks. Health systems should work to increase the comfort of patients in reporting risks, explore how to successfully assist them when desired, and offer resources to address these risks outside the health care sector. VISUAL ABSTRACT","PeriodicalId":22305,"journal":{"name":"The Annals of Family Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83424032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 6

The Food Box Pilot 食品盒飞行员

The Annals of Family Medicine Pub Date : 2022-03-01 DOI: 10.1370/afm.2769

B. Engebretsen, Allison Kane, H. Laroche

引用次数: 1