JOURNAL OF AMBULATORY CARE MANAGEMENT最新文献

{"title":"Enhancing the Ability of Primary Care Practices to Report on Age-Friendly Quality of Care Measures: A Novel Approach.","authors":"Ashley A Park, Elizabeth A Phelan, Katherine A Bennett, Barbara B Cochrane, Michael V Vitiello, Aimee M Verrall, Allison M Cole","doi":"10.1097/JAC.0000000000000533","DOIUrl":"10.1097/JAC.0000000000000533","url":null,"abstract":"<p><p>Health systems are mandated to report on quality of care provided to older patients. However, reporting on quality of care remains challenging. The coordinating center for a practice-based research network collaborated with primary care practices to develop tools to facilitate data collection and reporting of age-friendly quality-of-care measures. Three practices informed design of the toolkit. Six additional practices (9 practices total) used the toolkit to report measurement data with technical assistance. All practices reported that quality-of-care assessment using the toolkit was feasible and acceptable. Providing tools and technical assistance are effective strategies for enabling primary care practices to report age-friendly quality metrics.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"169-183"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175297","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}

{"title":"Community Health Centers' Response to COVID-19 and Serving the Community: This Feeling of Never Being Enough and Never Doing Enough.","authors":"Cecilia Hurtado, James D Harrison, Susan L Ivey, Mark D Fleming, Michael B Potter, Gena Lewis, Stutee Khandelwal, Tung Nguyen, David Ofman, Lali Moheno, Maria Carbajal, Maria Echaveste, Kerrington Osborne, Gary Bossier, Nynikka R Palmer","doi":"10.1097/JAC.0000000000000530","DOIUrl":"10.1097/JAC.0000000000000530","url":null,"abstract":"<p><strong>Objective: </strong>Community health centers (CHCs) are a vital safety net for under-resourced and medically underserved patients. As few studies have explored how they implemented broad-based organizational changes throughout the COVID-19 pandemic, we aimed to qualitatively examine CHCs' longitudinal, comprehensive pandemic response through the perspectives of staff, administrators, and researchers working in CHCs.</p><p><strong>Methods: </strong>25 clinic leaders, staff, and researchers from three CHC networks and two academic medical centers in Northern California and the Central Valley of California participated in 18 focus groups and interviews between April and October 2022. We used thematic content analysis to identify key themes.</p><p><strong>Results: </strong>Key themes emerged for three pandemic phases: shutdown, pivot, and recovery. During the shutdown, CHCs paused non-urgent services and in-person outreach while facing increased strain on staff capacity. Although CHCs were traditionally siloed, the pivot phase yielded efforts to build trust through information dissemination, partnerships with other health care organizations, and unprecedented innovations in care delivery. During recovery, CHCs re-prioritized preventive care but continued to face poor access to specialty care and socioeconomic resources for their patients.</p><p><strong>Conclusions: </strong>The COVID-19 pandemic magnified extant barriers within CHCs, including limitations in funding, staff capacity, and infrastructure for collaboration. CHC constituents highlight lessons learned through organization-wide adaptations and opportunities for the continuation and expansion of pandemic-related changes (e.g., investments in CHCs' workforce, care delivery infrastructure, and avenues for multidisciplinary collaboration) to better serve their communities in the post-COVID era.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"136-146"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050159","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}

{"title":"From the Editors.","authors":"","doi":"10.1097/JAC.0000000000000534","DOIUrl":"https://doi.org/10.1097/JAC.0000000000000534","url":null,"abstract":"","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"48 3","pages":"135"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188267","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}

{"title":"The Value and Challenges of an Ambulatory Intermediate Care Clinic: A Mixed-Methods Analysis.","authors":"Seung-Yup Lee, Reid M Eagleson, Larry R Hearld, Madeline J Gibson, Allyson Hall, Michael Mugavero, Greer Burkholder, Kimberly L Payne, William M Brown, Lauren M Epp, Laurie Hunter, Corey T Spraberry, Kristine R Hearld","doi":"10.1097/JAC.0000000000000531","DOIUrl":"10.1097/JAC.0000000000000531","url":null,"abstract":"<p><strong>Background: </strong>Emergency department (ED) crowding is a persistent issue in health care, resulting in increased mortality and medical errors. This challenge is particularly pronounced in underserved populations, where a higher prevalence of chronic conditions and ED utilization exacerbates gaps in care. To address this, system-level strategies, including the establishment of intermediate care clinics, are essential. This study evaluates the first three years of a nurse-led ambulatory intermediate care clinic (AICC) in the Southern US, focusing on its role in enhancing care continuity and operational challenges for expansion.</p><p><strong>Methods: </strong>This study, conducted at the University of Alabama at Birmingham Medical Center in Birmingham, Alabama, the United States, used a convergent parallel mixed-methods design, analyzing quantitative data from 3137 AICC appointment records (May 2020-June 2023) and conducting qualitative interviews with AICC staff members. Quantitative data included patient demographics and appointment characteristics. Qualitative data were thematically analyzed to identify common themes around AICC benefits and challenges.</p><p><strong>Results: </strong>Our quantitative analysis showed that the AICC managed an increasing number of patient visits with a stable appointment adherence rate. However, rising clinic-initiated cancellations indicated resource limitations. Qualitative findings provided further context for these quantitative trends. Patients from racial minority groups and those with Medicaid insurance had significantly higher odds of missing appointments. The results highlighted the AICC's value in preventing ED visits but also revealed challenges related to patient acuity level, resource allocation, scheduling complexities, and appointment adherence barriers.</p><p><strong>Conclusions: </strong>Establishing a nurse-led AICC is feasible and beneficial in alleviating the care gap between primary and acute care and reducing ED crowding. Key considerations for sustainable success include determining patient acuity thresholds, streamlining same-day referral processes, and addressing capacity issues. These findings can guide health systems in implementing intermediate care clinics in ambulatory settings, particularly for those serving underserved communities.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"184-196"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991342","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}

{"title":"A Case Study of CHW Integration in Two Health Departments in Southern Arizona.","authors":"Maia Ingram, Andi Medrano, Dolores Encinas, Lee Itule-Klasen, Gloria Coronado, Maria Esparza, Rodrigo Valenzuela Cordova, Jax Seline, Raleigh C Addington, Ada M Wilkinson-Lee","doi":"10.1097/JAC.0000000000000529","DOIUrl":"10.1097/JAC.0000000000000529","url":null,"abstract":"<p><p>The objective of our participatory case study of community health worker (CHW) integration was to describe the role of CHWs in two local health departments (LHDs). Study partners co-developed an interview guide based on an existing framework. Fourteen staff participated in interviews. CHWs build community trust for LHDs, provide LHD core services, identify community concerns and priorities, and address social determinants of health. Integration barriers include hiring protocols, lack of understanding of the CHW role, inadequate compensation, and sustainable funding. The study identified key factors for an integration process that promotes the effectiveness, wellbeing, and sustainability of the workforce.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"147-158"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987880","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}

{"title":"Erratum: Characteristics of Persons Using Convenience Clinics for Usual Care in 2022.","authors":"Hannah M Johnson, Bianca K Frogner, Edwin S Wong, Paul A Fishman","doi":"10.1097/JAC.0000000000000528","DOIUrl":"https://doi.org/10.1097/JAC.0000000000000528","url":null,"abstract":"","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"48 3","pages":"197"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188266","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}

{"title":"Sustaining Communities and Community Health Workers: Lessons Learned From Community Health Workers' Experience During the COVID-19 Pandemic.","authors":"Alexandra Coritsidis, Guedy Arniella, Timnit Berhane, Devin Madden, Jessica Ruiz, Nita Vangeepuram, Kristin Oliver","doi":"10.1097/JAC.0000000000000532","DOIUrl":"10.1097/JAC.0000000000000532","url":null,"abstract":"<p><p>During the COVID-19 pandemic, community health workers (CHWs) played a significant role in providing health information and addressing health inequities exacerbated by the pandemic. We conducted four focus groups (21 individuals) with New York City CHWs with the aim to learn their perspectives on practices to sustain CHWs work engagement. The following themes emerged through deductive coding: (1) need for mental health support, (2) desire for broader acknowledgment of their value through compensation, and (3) need for continuous training and job growth opportunities. Implementing workplace policies that address these themes could improve CHW well-being and support them to more effectively impact the health of their communities.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"159-168"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121143","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}

{"title":"Characteristics of Persons Using Convenience Clinics for Usual Care in 2022.","authors":"Hannah M Johnson, Bianca K Frogner, Edwin S Wong, Paul A Fishman","doi":"10.1097/JAC.0000000000000524","DOIUrl":"10.1097/JAC.0000000000000524","url":null,"abstract":"<p><p>Little is known about the characteristics of individuals using urgent care centers or walk-in retail clinics, collectively called convenience clinics (CC), as places of usual care. Using 2022 National Health Interview Survey data and logistic regression, we identified the factors associated with adults using CCs regularly. Among adults with a place of usual care, 7.5% reported receiving usual care at CCs. Individuals who were younger, working, and uninsured were significantly more likely to report CCs as their usual source of care. Understanding the characteristics of CC users is critical to inform policy for this evolving segment of the health care sector.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"95-107"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441843","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}

{"title":"Frontline Clinic Administrator Perspectives on Extreme Weather Events, Clinic Operations, and Climate Resilience.","authors":"Tess Wiskel, Nathaniel Matthews-Trigg, Kristin Stevens, Thomas T Miles, Caleb Dresser, Aaron Bernstein","doi":"10.1097/JAC.0000000000000519","DOIUrl":"10.1097/JAC.0000000000000519","url":null,"abstract":"<p><p>Climate-sensitive extreme weather events are increasingly impacting frontline clinic operations. We conducted a national, cross-sectional survey of 284 self-identified administrators and other staff at frontline clinics determining their attitudes toward climate change and the impacts, resilience, and preparedness of clinics for extreme weather events. Most respondents (80.2%) reported that humans are causing climate change, and nearly half (45.9%) reported concerns about extreme weather impacting their job, with barriers to preparedness including financing and knowledge and resources. Over a third (41.8%) of respondents reported taking steps to protect their clinic infrastructure from extreme weather, including by addressing power and improving ventilation.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"73-83"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013822","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}

{"title":"From the Editors.","authors":"E Lee Rosenthal, Megan B Cole Brahim, Durrell J Fox","doi":"10.1097/JAC.0000000000000525","DOIUrl":"https://doi.org/10.1097/JAC.0000000000000525","url":null,"abstract":"","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"48 2","pages":"69-70"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494203","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}