{"title":"Editorial: Meeting the Needs of Federally Qualified Health Center Patients Following the Public Health Emergency Unwinding.","authors":"Kevin H Nguyen, Megan B Cole","doi":"10.1097/JAC.0000000000000485","DOIUrl":"10.1097/JAC.0000000000000485","url":null,"abstract":"","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"47 1","pages":"43-47"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138296240","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}
Lisa Knoll, Joy Elwell, Jill Arcari-Couture, Nanette Alexander
{"title":"The Standardization of Home Blood Pressure Monitoring in Primary Care: A Quality Improvement Project.","authors":"Lisa Knoll, Joy Elwell, Jill Arcari-Couture, Nanette Alexander","doi":"10.1097/JAC.0000000000000482","DOIUrl":"10.1097/JAC.0000000000000482","url":null,"abstract":"<p><p>Current guidelines recommend the use of home blood pressure monitoring (HBPM) to screen for and manage hypertension. In this study, a quality improvement project was designed to standardize the use of HBPM in a primary care setting and demonstrate improved blood pressure outcomes. Initial systolic and diastolic values were compared to averages from patient logs. Patient and provider feedback was collected. Only 40% of patients enrolled presented to follow-up with actionable HBPM data. Patients encountered logistical challenges in obtaining and presenting HBPM data. Interprofessional collaboration and improved information technology systems would improve outcomes. This will require increased policy and insurer support to make this possible in small settings.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"47 1","pages":"14-21"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138296244","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.0000000000000487","DOIUrl":"10.1097/JAC.0000000000000487","url":null,"abstract":"","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"47 1","pages":"1-2"},"PeriodicalIF":1.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138296242","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}
David M Mosen, Julie Schmittdiel, Judith Hibbard, David Sobel, Carol Remmers, Jim Bellows
{"title":"Is Patient Activation Associated With Outcomes of Care for Adults With Chronic Conditions?","authors":"David M Mosen, Julie Schmittdiel, Judith Hibbard, David Sobel, Carol Remmers, Jim Bellows","doi":"10.1097/JAC.0000000000000477","DOIUrl":"10.1097/JAC.0000000000000477","url":null,"abstract":"","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"46 4","pages":"306-314"},"PeriodicalIF":1.2,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10128049","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.0000000000000480","DOIUrl":"10.1097/JAC.0000000000000480","url":null,"abstract":"","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"46 4","pages":"263-264"},"PeriodicalIF":1.6,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10501950","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":"Appointment Pathways: Yield Management via Cause-and-Effect Modeling in the Outpatient Setting at Mayo Clinic.","authors":"Adrian C Keister, Derek R Munden, Brian S Bailey","doi":"10.1097/JAC.0000000000000473","DOIUrl":"10.1097/JAC.0000000000000473","url":null,"abstract":"<p><p>Patients have multiple outpatient appointments for various reasons. Analyzing patients' related appointments provides insight into referral patterns, leading to recommendations for ideal care and more efficient planning. We model these appointments with causal graphs via Judea Pearl's causal graph approach. Once we define the causal relationships in the appointment data, we leverage a graph database and visualization software to investigate valuable patterns and relationships in patient care over time. The Pathways tool allows yield management at specialty, provider, or appointment levels. Leaders use this tool to anticipate a patient's downstream appointments; the tool provides insights into staffing and the impact of growing demand.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"46 4","pages":"298-305"},"PeriodicalIF":1.6,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10126739","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}
Kerstin M Reinschmidt, Timothy J Philip, Zahra A Alhay, Tamara Braxton, Lee A Jennings
{"title":"Training Community Health Workers to Address Disparities in Dementia Care: A Case Study From Oklahoma With National Implications.","authors":"Kerstin M Reinschmidt, Timothy J Philip, Zahra A Alhay, Tamara Braxton, Lee A Jennings","doi":"10.1097/JAC.0000000000000470","DOIUrl":"10.1097/JAC.0000000000000470","url":null,"abstract":"<p><p>The projected increase of dementia in the diverse aging US population calls for a well-prepared public health workforce. Community health workers (CHWs) can address dementia in culturally appropriate ways. Collaborating with stakeholders, we developed a train-the-trainer curriculum for CHWs and used a virtual training platform to test its feasibility with 77 CHWs. Pre-/post-evaluation data demonstrated modestly increased dementia knowledge scores. Training participants valued the resources shared and interacting with peers. Disseminating this training could contribute to closing gaps in dementia care in diverse communities, along with policies supporting CHWs as a workforce that reduces age-related disparities and promotes health equity.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"46 4","pages":"272-283"},"PeriodicalIF":1.6,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10121464","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}
Angela Miller, Allen K Skoranski, Barbara Prior, Rebecca Fitzpatrick, Cindy Morgan, Philynn Hepschmidt, Beth A Smith, Michael Cella, Dawn Brown McGlotten, Kenya Pitt, Rosemary C Polomano
{"title":"An \"Engage to Sustain\" Intervention to Improve Process Performance Measures in Ambulatory Care.","authors":"Angela Miller, Allen K Skoranski, Barbara Prior, Rebecca Fitzpatrick, Cindy Morgan, Philynn Hepschmidt, Beth A Smith, Michael Cella, Dawn Brown McGlotten, Kenya Pitt, Rosemary C Polomano","doi":"10.1097/JAC.0000000000000474","DOIUrl":"10.1097/JAC.0000000000000474","url":null,"abstract":"<p><p>In ambulatory care, monitoring process performance measures (PPMs) is essential to meet regulatory requirements, establish targets for care, seek reimbursement, and evaluate patient care responsibilities. We implemented a comprehensive program, \"Engage to Sustain,\" for licensed practical nurses (LPNs) and certified medical assistants (CMAs) to practice at the top of their licensure/certification. Screening rates for 4 key PPMs (depression screening, fall risk screening, and tobacco use screening and counseling) markedly increased following this intervention across 18 ambulatory departments with more than 2 million patient visits. These results suggest that shifting responsibilities for patient screening from physicians and advanced practitioners to LPNs and CMAs may improve screening rates.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"46 4","pages":"284-297"},"PeriodicalIF":1.6,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10182237","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}
Cameron Hill, Stacy Justo, Hannah Park, Megan Bair-Merritt, Anita Morris, Emily Feinberg, R Christopher Sheldrick
{"title":"Pediatric Provider and Staff Burnout in Federally Qualified Community Health Centers.","authors":"Cameron Hill, Stacy Justo, Hannah Park, Megan Bair-Merritt, Anita Morris, Emily Feinberg, R Christopher Sheldrick","doi":"10.1097/JAC.0000000000000472","DOIUrl":"10.1097/JAC.0000000000000472","url":null,"abstract":"<p><p>This study examined changes in provider and staff burnout in 4 Boston-area federally qualified community health centers (FQHCs) participating in a pediatric behavioral health integration project. Utilizing the Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSSMP), the study found that emotional exhaustion among primary care providers ( M = 20.5; confidence interval [CI], 17.8-23.2) was higher ( P = .001) than that among behavioral health clinicians ( M = 13.6; CI, 10.4-16.8) and ( P = .00005) community health workers ( M = 10.8; CI, 7.3-14.2). Emotional exhaustion among staff increased ( P = .04) from baseline ( M = 16.8; CI, 15.0-18.6) to follow-up ( M = 20.8; CI, 17.5-24.2), but burnout at follow-up was lower than national averages. FQHCs are integral in caring for marginalized patients; therefore, supporting a stable workforce by minimizing burnout is essential.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"46 4","pages":"265-271"},"PeriodicalIF":1.6,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10126736","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}
J Nell Brownstein, Gail R Hirsch, E Lee Rosenthal, Carl H Rush
{"title":"Community Health Workers \"101\" for Primary Care Providers and Other Stakeholders in Health Care Systems.","authors":"J Nell Brownstein, Gail R Hirsch, E Lee Rosenthal, Carl H Rush","doi":"10.1097/JAC.0000000000000478","DOIUrl":"10.1097/JAC.0000000000000478","url":null,"abstract":"","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"46 4","pages":"315-325"},"PeriodicalIF":2.3,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10501948","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}