Pub Date : 2024-10-01Epub Date: 2024-08-23DOI: 10.1097/JAC.0000000000000505
Laura Schubel, Mihriye Mete, Allan Fong, Christian Boxley, Ana Barac, Christopher Gallagher, Michelle F Magee, Hannah Arem
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.
{"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}
Pub Date : 2024-10-01Epub Date: 2024-08-23DOI: 10.1097/JAC.0000000000000504
Jodi Simon, Maggie Hamielec, Aesha Patel, Eve Walter, Jeffrey Panzer
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.
{"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}
Pub Date : 2024-10-01Epub Date: 2024-08-23DOI: 10.1097/JAC.0000000000000513
{"title":"From the Editors.","authors":"","doi":"10.1097/JAC.0000000000000513","DOIUrl":"10.1097/JAC.0000000000000513","url":null,"abstract":"","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"213"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903155","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}
Pub Date : 2024-10-01Epub Date: 2024-08-23DOI: 10.1097/JAC.0000000000000513
{"title":"From the Editors.","authors":"","doi":"10.1097/JAC.0000000000000513","DOIUrl":"https://doi.org/10.1097/JAC.0000000000000513","url":null,"abstract":"","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":"47 4","pages":"213"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584771","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}
Pub Date : 2024-10-01Epub Date: 2024-08-23DOI: 10.1097/JAC.0000000000000507
Jennifer L Rankin, Jessica McCann, Michael Topmiller, Dave Grolling, Troyana Benjamin, Helen Yu-Lefler, Hank Hoang, Alek Sripipatana
The Health Resources and Services Administration's (HRSA) Health Center Program provides health care to vulnerable persons across the US, regardless of their ability to pay for health care. We examined characteristics of populations living within and outside a 30-minute drive-time to HRSA-supported health centers to establish a baseline to better understand the differences in these populations. Using a descriptive, cross-sectional study design and geographic information systems, we found that 94% of persons in the US live within a 30-minute drive-time of a health center. Of those outside a 30-minute drive-time to a health center, 11.7 million (60.11%) are rural and over 1.5 million households (20.32%) lack broadband internet access.
{"title":"Quantifying Population Characteristics Within and Outside a 30-Minute Drive-Time to Health Resources and Services Administration-Supported Health Centers.","authors":"Jennifer L Rankin, Jessica McCann, Michael Topmiller, Dave Grolling, Troyana Benjamin, Helen Yu-Lefler, Hank Hoang, Alek Sripipatana","doi":"10.1097/JAC.0000000000000507","DOIUrl":"10.1097/JAC.0000000000000507","url":null,"abstract":"<p><p>The Health Resources and Services Administration's (HRSA) Health Center Program provides health care to vulnerable persons across the US, regardless of their ability to pay for health care. We examined characteristics of populations living within and outside a 30-minute drive-time to HRSA-supported health centers to establish a baseline to better understand the differences in these populations. Using a descriptive, cross-sectional study design and geographic information systems, we found that 94% of persons in the US live within a 30-minute drive-time of a health center. Of those outside a 30-minute drive-time to a health center, 11.7 million (60.11%) are rural and over 1.5 million households (20.32%) lack broadband internet access.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"247-257"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724735","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}
Pub Date : 2024-10-01Epub Date: 2024-08-23DOI: 10.1097/JAC.0000000000000508
Hanlin Li, Michael De Francesco, Tincy Mathews, Goldie Singh, Yuliya Baratt, Kathleen Evans, Helen Jan
Annual wellness visits (AWVs) guide appropriate patient care through lifestyle modifications, medication intervention, or social assistance. We launched a quality improvement program to target Medicare beneficiaries as part of an Accountable Care Organization (ACO). Key stakeholders collectively implemented a process consisting of two cohorts: AWVs completed with the support of the pharmacy team or directly by providers. A standardized workflow for the pharmacy cohort involved the clinical pharmacists and pharmacy extenders, allowing a layered learning experience. The AWV completion rate was optimized with the interventions of the pharmacy team.
{"title":"Enhancing Annual Wellness Visits: A Pharmacy-Driven Quality Improvement Approach With Multidisciplinary Collaboration.","authors":"Hanlin Li, Michael De Francesco, Tincy Mathews, Goldie Singh, Yuliya Baratt, Kathleen Evans, Helen Jan","doi":"10.1097/JAC.0000000000000508","DOIUrl":"10.1097/JAC.0000000000000508","url":null,"abstract":"<p><p>Annual wellness visits (AWVs) guide appropriate patient care through lifestyle modifications, medication intervention, or social assistance. We launched a quality improvement program to target Medicare beneficiaries as part of an Accountable Care Organization (ACO). Key stakeholders collectively implemented a process consisting of two cohorts: AWVs completed with the support of the pharmacy team or directly by providers. A standardized workflow for the pharmacy cohort involved the clinical pharmacists and pharmacy extenders, allowing a layered learning experience. The AWV completion rate was optimized with the interventions of the pharmacy team.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"278-283"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727947","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}
Pub Date : 2024-10-01Epub Date: 2024-08-23DOI: 10.1097/JAC.0000000000000510
E Lee Rosenthal, Paige Menking, Durrell J Fox, Floribella Redondo-Martinez, Lily K Lee, Julie St John
{"title":"Commentary: Sustaining Community Health Workers-The Importance of Professional Self-Governance and Self-Determination.","authors":"E Lee Rosenthal, Paige Menking, Durrell J Fox, Floribella Redondo-Martinez, Lily K Lee, Julie St John","doi":"10.1097/JAC.0000000000000510","DOIUrl":"10.1097/JAC.0000000000000510","url":null,"abstract":"","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"239-246"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903154","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}
Pub Date : 2024-10-01Epub Date: 2024-08-23DOI: 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":"142037267","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}
Pub Date : 2024-10-01Epub Date: 2024-08-23DOI: 10.1097/JAC.0000000000000506
Ashley Wennerstrom, Kelsey N Witmeier, Kira Wortmann, Lisa Renee Holderby-Fox, Catherine G Haywood, Sherri L Ohly
In 2021, the Centers for Disease Control and Prevention (CDC) funded 67 health departments to implement community health worker (CHW) programs to enhance COVID-19 response. The CDC also funded a unique CHW-led Technical Assistance and Training (TTA) Center called Envision, which supported health departments to implement CHW programs and promote CHW workforce sustainability. After 1 year, Envision evaluators interviewed Envision staff to assess barriers and facilitators in developing the Center and the degree to which CHW leadership was operationalized. Thematic analysis revealed 3 themes regarding relationships, CHW values in practice, and operational challenges. Findings informed program updates. CHWs, funders, and policymakers may learn from these experiences.
{"title":"\"By Us for Us\": Lessons Learned in Developing a National Training and Technical Assistance Center by and for CHWs.","authors":"Ashley Wennerstrom, Kelsey N Witmeier, Kira Wortmann, Lisa Renee Holderby-Fox, Catherine G Haywood, Sherri L Ohly","doi":"10.1097/JAC.0000000000000506","DOIUrl":"10.1097/JAC.0000000000000506","url":null,"abstract":"<p><p>In 2021, the Centers for Disease Control and Prevention (CDC) funded 67 health departments to implement community health worker (CHW) programs to enhance COVID-19 response. The CDC also funded a unique CHW-led Technical Assistance and Training (TTA) Center called Envision, which supported health departments to implement CHW programs and promote CHW workforce sustainability. After 1 year, Envision evaluators interviewed Envision staff to assess barriers and facilitators in developing the Center and the degree to which CHW leadership was operationalized. Thematic analysis revealed 3 themes regarding relationships, CHW values in practice, and operational challenges. Findings informed program updates. CHWs, funders, and policymakers may learn from these experiences.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"215-227"},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727946","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}
Pub Date : 2024-07-01Epub Date: 2024-05-15DOI: 10.1097/JAC.0000000000000499
Kenneth Lim, Kevin H Nguyen, Demetri Goutos, Paul R Shafer, Pablo Buitron de la Vega, Megan B Cole
We explored the association between the use of a hospital-based food pantry and subsequent emergency department (ED) utilization among Medicaid patients with diabetes in a large safety-net health system. Leveraging 2015-2019 electronic health record data, we used a staggered difference-in-differences approach to measure changes in ED use before vs after food pantry use. Food pantry use was associated with a 7.3 percentage point decrease per patient per quarter (95% confidence interval, -13.8 to -0.8) in the probability of subsequent ED utilization ( P = .03). Addressing food insecurity through hospital-based food pantries may be one mechanism for reducing ED use among low-income patients with diabetes.
{"title":"The Association Between Hospital-Based Food Pantry Use and Subsequent Emergency Department Utilization Among Medicaid Patients With Diabetes.","authors":"Kenneth Lim, Kevin H Nguyen, Demetri Goutos, Paul R Shafer, Pablo Buitron de la Vega, Megan B Cole","doi":"10.1097/JAC.0000000000000499","DOIUrl":"10.1097/JAC.0000000000000499","url":null,"abstract":"<p><p>We explored the association between the use of a hospital-based food pantry and subsequent emergency department (ED) utilization among Medicaid patients with diabetes in a large safety-net health system. Leveraging 2015-2019 electronic health record data, we used a staggered difference-in-differences approach to measure changes in ED use before vs after food pantry use. Food pantry use was associated with a 7.3 percentage point decrease per patient per quarter (95% confidence interval, -13.8 to -0.8) in the probability of subsequent ED utilization ( P = .03). Addressing food insecurity through hospital-based food pantries may be one mechanism for reducing ED use among low-income patients with diabetes.</p>","PeriodicalId":46654,"journal":{"name":"JOURNAL OF AMBULATORY CARE MANAGEMENT","volume":" ","pages":"122-133"},"PeriodicalIF":2.3,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140922784","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}