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Reducing Wait Times in Child and Adolescent Ambulatory Mental Health: A Lean Six Sigma Process Improvement Study. 减少儿童和青少年门诊心理健康的等待时间：精益六西格玛流程改进研究》。
IF 1.6
JOURNAL OF AMBULATORY CARE MANAGEMENT Pub Date : 2025-01-01 Epub Date: 2024-11-19 DOI: 10.1097/JAC.0000000000000514
James Murphy, Tiffany Banks
{"title":"Reducing Wait Times in Child and Adolescent Ambulatory Mental Health: A Lean Six Sigma Process Improvement Study.","authors":"James Murphy, Tiffany Banks","doi":"10.1097/JAC.0000000000000514","DOIUrl":"https://doi.org/10.1097/JAC.0000000000000514","url":null,"abstract":"<p><p>Suicide remains a leading cause of death for youth nationally, with access to mental health care continuing to be an emergent care imperative for health care organizations that are struggling to triage and provide critically needed mental health services to the communities they serve. Administrative inefficiencies present a potentially life-threatening delay in access to children seeking mental health care. Health care organizations have successfully used evidence-based process improvement methodologies to improve efficiency and reduce waste, including the Lean Six Sigma methodology. This study highlights the successful use of Lean Six Sigma to create an ambulatory scheduling process that significantly reduced waitlist times and increased timeliness of access to mental health care in a large pediatric hospital.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"48 1","pages":"15-24"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677280","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: 0
Health Center Characteristics Associated With Hospital Care Among Medicare-Medicaid Dual Enrollees. 与医疗保险和医疗补助双重参保者住院治疗相关的医疗中心特征。
IF 1.6
JOURNAL OF AMBULATORY CARE MANAGEMENT Pub Date : 2025-01-01 Epub Date: 2024-11-06 DOI: 10.1097/JAC.0000000000000517
Brad Wright, Brianna Lombardi, Jill Akiyama, Andrew J Potter, Lindsay M Sabik, Grace G Stehlin, Amal N Trivedi, Fredric D Wolinsky
{"title":"Health Center Characteristics Associated With Hospital Care Among Medicare-Medicaid Dual Enrollees.","authors":"Brad Wright, Brianna Lombardi, Jill Akiyama, Andrew J Potter, Lindsay M Sabik, Grace G Stehlin, Amal N Trivedi, Fredric D Wolinsky","doi":"10.1097/JAC.0000000000000517","DOIUrl":"10.1097/JAC.0000000000000517","url":null,"abstract":"<p><p>Using 2012-2018 Medicare claims and health center data, we identified factors associated with variation in rates of hospital care among Medicare-Medicaid dual enrollees receiving primary care at health centers. In our sample ( n = 5961 health center-years), we found no evidence that patient-centered medical home designation or other modifiable health center characteristics were associated with reductions in hospital care use, which depends more on health center patient mix. Thus, policymakers should target efforts to health centers serving the most disadvantaged and marginalized communities.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"2-14"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584768","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: 0
From the Editors. 各种医疗机构的就医机会、公平性和提供者特征。
IF 1.6
JOURNAL OF AMBULATORY CARE MANAGEMENT Pub Date : 2025-01-01 Epub Date: 2024-11-19 DOI: 10.1097/JAC.0000000000000518
Megan B Cole, E Lee Rosenthal, Durrell J Fox
{"title":"From the Editors.","authors":"Megan B Cole, E Lee Rosenthal, Durrell J Fox","doi":"10.1097/JAC.0000000000000518","DOIUrl":"10.1097/JAC.0000000000000518","url":null,"abstract":"","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"1"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584763","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: 0
A Mixed-Methods Study to Understand Community Health Worker Integration With Health Care Teams. 通过混合方法研究了解社区医疗工作者与医疗团队的融合。
IF 1.6
JOURNAL OF AMBULATORY CARE MANAGEMENT Pub Date : 2025-01-01 Epub Date: 2024-08-01 DOI: 10.1097/JAC.0000000000000511
Jessica McCutcheon, Iris Cheng, Selina Quinones, Rohan Mahabaleshwarkar, Nancy Denizard-Thompson, Kimberly Wiseman, Yhenneko Taylor, Sherrie Wise Thomas, Deepak Palakshappa
{"title":"A Mixed-Methods Study to Understand Community Health Worker Integration With Health Care Teams.","authors":"Jessica McCutcheon, Iris Cheng, Selina Quinones, Rohan Mahabaleshwarkar, Nancy Denizard-Thompson, Kimberly Wiseman, Yhenneko Taylor, Sherrie Wise Thomas, Deepak Palakshappa","doi":"10.1097/JAC.0000000000000511","DOIUrl":"10.1097/JAC.0000000000000511","url":null,"abstract":"<p><p>Two models employed to integrate community health workers (CHWs) in health care settings are community-clinical linkages and employment within health care. Our objective was to understand the variability in how these models are implemented. We conducted a mixed-methods study across a large health system that included CHW focus groups and electronic health record data on patients referred to the teams. We identified three primary themes in the four focus groups (N = 29) and found differences in the demographics and health care use of the 1,097 patients. Both community- and clinically embedded CHWs reported addressing diverse patient needs; yet, challenges persist in integrating both models.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"25-38"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903152","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: 0
Signals in Health Inequity: Examining Social Needs and Costs in a Large Health System. 健康不公平的信号：检查大型医疗系统的社会需求和成本。
IF 1.6
JOURNAL OF AMBULATORY CARE MANAGEMENT Pub Date : 2025-01-01 Epub Date: 2024-10-10 DOI: 10.1097/JAC.0000000000000515
Kevin P Fiori, Samantha R Levano, Silvie Colman, Jason Oliveira, Jessica Haughton, Miya Lemberg, Earle C Chambers, Andrew Telzak, Elizabeth Spurrell-Huss, Adam Sirois, Allison Stark, Andrew Racine
{"title":"Signals in Health Inequity: Examining Social Needs and Costs in a Large Health System.","authors":"Kevin P Fiori, Samantha R Levano, Silvie Colman, Jason Oliveira, Jessica Haughton, Miya Lemberg, Earle C Chambers, Andrew Telzak, Elizabeth Spurrell-Huss, Adam Sirois, Allison Stark, Andrew Racine","doi":"10.1097/JAC.0000000000000515","DOIUrl":"https://doi.org/10.1097/JAC.0000000000000515","url":null,"abstract":"<p><p>Previous research has demonstrated that social determinants of health are drivers of medical utilization, cost, and health outcomes. In this study, we compared the mean annual total cost to deliver health services per patient by health-related social need (HRSN) status and total HRSNs using linear regression and ANOVA, respectively. Patients with ≥1 HRSN (n = 8409) yielded $1772 higher annual costs compared to patients without HRSNs (n = 34 775) (P < .0001). Compared to patients without HRSNs, delivering care to patients with 1 HRSN (n = 4222) cost $1689 (P < .0001) more and to patients with ≥2 HRSN (n = 4187) cost $1856 (P < .0001) more per year.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"48 1","pages":"39-51"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677281","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: 0
The Relationship Between Leadership Characteristics and Services Provided Among IHS Urban Indian Health Programs. 美国国土安全部城市印第安人健康计划中领导特点与所提供服务之间的关系。
IF 1.6
JOURNAL OF AMBULATORY CARE MANAGEMENT Pub Date : 2025-01-01 Epub Date: 2024-11-11 DOI: 10.1097/JAC.0000000000000516
G Grant Tribble, Nancy M Borkowski, Phaedra S Corso, Allyson G Hall, Kristine R Hearld
{"title":"The Relationship Between Leadership Characteristics and Services Provided Among IHS Urban Indian Health Programs.","authors":"G Grant Tribble, Nancy M Borkowski, Phaedra S Corso, Allyson G Hall, Kristine R Hearld","doi":"10.1097/JAC.0000000000000516","DOIUrl":"10.1097/JAC.0000000000000516","url":null,"abstract":"<p><p>The Urban Indian Health Program was created by the Indian Health Service to establish a culturally appropriate health care delivery model for Native Americans who relocate to urban areas. The 31 community-based Indian Health Programs under the Office of Urban Indian Health Program vary in culture, socioeconomic, and patient mix. Strategic decision-making by these community-based Indian Health Programs depends upon various factors, including leaders' characteristics, organizational characteristics, and service area market factors.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"52-68"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630087","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: 0
Association of Federal COVID-19 Funding Distributions With Workforce and Capacity in Health Centers. 联邦 COVID-19 资金分配与医疗中心劳动力和能力的关系。
IF 1.6
JOURNAL OF AMBULATORY CARE MANAGEMENT Pub Date : 2024-10-01 Epub Date: 2024-08-23 DOI: 10.1097/JAC.0000000000000509
Paula Kett, Megan B Cole, Brad Wright, Bianca K Frogner
{"title":"Association of Federal COVID-19 Funding Distributions With Workforce and Capacity in Health Centers.","authors":"Paula Kett, Megan B Cole, Brad Wright, Bianca K Frogner","doi":"10.1097/JAC.0000000000000509","DOIUrl":"10.1097/JAC.0000000000000509","url":null,"abstract":"<p><p>Using novel national data, we examined the association between 2020 federal COVID-related funding targeted to health centers (i.e., H8 funding) and health center workforce and operational capacity measures that may be important for preserving patient access to care and staff safety. We assigned health centers to quartiles based on federal funding distribution per patient and used adjusted linear probability models to estimate differences in workforce and operational capacity outcomes across quartiles from April 2020 to June 2022. We found a nearly 6-fold difference in 2020 H8 funding per patient when comparing health centers in the lowest versus highest quartiles. Despite this difference, health centers' outcomes improved similarly across quartiles over time, with the lowest-funded health centers having the greatest staffing and service capacity challenges. Our findings suggest that COVID-related health center funding may have contributed to stabilization of health centers' workforce and operations. Amid concerns about staff turnover, sustained investments targeted to supporting workforce retention at health centers can help to ensure ongoing delivery of critical services.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"258-270"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903153","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: 0
The Journal of Ambulatory Care Management Thanks Our Reviewers. 门诊护理管理》杂志感谢我们的审稿人。
IF 1.6
JOURNAL OF AMBULATORY CARE MANAGEMENT Pub Date : 2024-10-01 Epub Date: 2024-08-23 DOI: 10.1097/JAC.0000000000000512
{"title":"The Journal of Ambulatory Care Management Thanks Our Reviewers.","authors":"","doi":"10.1097/JAC.0000000000000512","DOIUrl":"https://doi.org/10.1097/JAC.0000000000000512","url":null,"abstract":"","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"47 4","pages":"214"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584774","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: 0
Understanding Perceptions of Care Coordination and Chronic Illness Management among Black Breast and Prostate Cancer Survivors and Providers: Findings from a Quality Improvement Study. 了解黑人乳腺癌和前列腺癌幸存者及医疗服务提供者对护理协调和慢性病管理的看法：一项质量改进研究的结果。
IF 1.6
JOURNAL OF AMBULATORY CARE MANAGEMENT Pub Date : 2024-10-01 Epub Date: 2024-08-23 DOI: 10.1097/JAC.0000000000000505
Laura Schubel, Mihriye Mete, Allan Fong, Christian Boxley, Ana Barac, Christopher Gallagher, Michelle F Magee, Hannah Arem
{"title":"Understanding Perceptions of Care Coordination and Chronic Illness Management among Black Breast and Prostate Cancer Survivors and Providers: Findings from a Quality Improvement Study.","authors":"Laura Schubel, Mihriye Mete, Allan Fong, Christian Boxley, Ana Barac, Christopher Gallagher, Michelle F Magee, Hannah Arem","doi":"10.1097/JAC.0000000000000505","DOIUrl":"10.1097/JAC.0000000000000505","url":null,"abstract":"<p><p>Navigating cancer care is complex and is exacerbated by pre-existing comorbidities managed by multiple providers. In this quality improvement study, we evaluated changes in perceived care coordination, navigation, and chronic illness care with community health worker (CHW) and mHealth support among Black breast cancer and prostate cancer patients with hypertension and/or diabetes. We collected patient and provider surveys on chronic illness care coordination at baseline and six months and found improvements in multiple domains. These findings support engaging CHWs to improve care coordination among cancer patients with comorbidities and demonstrate a use case of importance with emerging navigation reimbursement policies.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"228-238"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724737","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: 0
The Potential of Advanced Rooming to Improve Communication and Visit Efficiency in Federally Qualified Health Centers. 在联邦合格医疗中心中，高级病房在改善沟通和就诊效率方面的潜力。
IF 1.6
JOURNAL OF AMBULATORY CARE MANAGEMENT Pub Date : 2024-10-01 Epub Date: 2024-08-23 DOI: 10.1097/JAC.0000000000000504
Jodi Simon, Maggie Hamielec, Aesha Patel, Eve Walter, Jeffrey Panzer
{"title":"The Potential of Advanced Rooming to Improve Communication and Visit Efficiency in Federally Qualified Health Centers.","authors":"Jodi Simon, Maggie Hamielec, Aesha Patel, Eve Walter, Jeffrey Panzer","doi":"10.1097/JAC.0000000000000504","DOIUrl":"10.1097/JAC.0000000000000504","url":null,"abstract":"<p><p>Advanced rooming is a workflow that enables non-clinician staff to take on additional responsibilities to improve quality and productivity. However, the impact is not well understood, particularly in Federally Qualified Health Centers (FQHCs). In this observational study at two FQHC sites, we found that in advanced rooming more questions were asked by patients and staff and more problems were identified and addressed. Advanced rooming medical assistants spent more time with patients and huddled longer with clinicians without significant differences in the clinical portion of the visit or total visit length. Advanced rooming may be a way to enhance care, ease clinician burden, and increase efficiency.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"271-277"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724736","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: 0
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