Promoting Documentation of Suicidality in a Family Medicine Residency Clinic.

Abstract:

BACKGROUND AND OBJECTIVES:Careful assessment of depression and suicidality are important given their prevalence and consequences for quality of life. Our study evaluated the impact of an educational intervention in a family medicine residency clinic on rates of provider documentation regarding suicidality. METHODS:We offered two brief workshops to our clinic staff and created two standardized charting templates to empower and educate providers. One template used with the patient during the clinic visit elicited key factors (eg, plan, intent, barriers) and offered treatment plan options. The second template included supportive text and resources to include in the after-visit summary. A chart review was completed, examining 350 patient records in which the patient reported thoughts of death or suicide in the preceding 2 weeks on the Patient Health Questionnaire-9 ([PHQ-9], 150 over a 5-month baseline period, 150 in months 1 through 4 immediately following the workshops and template development, and 50 at follow-up months 7 through 8 following the intervention). We examined use of the templates and changes in rates of documentation of suicidality. RESULTS:Rates of provider documentation of suicidality for patients who had expressed suicidal ideation on the PHQ-9 increased significantly from 57% at baseline to 78% in the postintervention phase; the rise persisted at follow-up. Rates of use of the assessment template were 58% (postintervention) and 49% (follow-up). Anecdotal provider feedback reflected appreciation of the templates for assessing and documenting challenging issues. CONCLUSIONS:Brief educational interventions were associated with improved rates of provider documentation of suicidality. The longer-term impact of the workshops and templates warrant further investigation.

journal_name

Fam Med

journal_title

Family medicine

authors

Sherman MD,Justesen K,Okocha EA

doi

10.22454/FamMed.2018.158642

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

138-141

issue

2

eissn

0742-3225

issn

1938-3800

journal_volume

50

pub_type

杂志文章
  • Decentralized medical education in rural communities: the circuit rider connection.

    abstract:BACKGROUND AND OBJECTIVES:Successful community-based medical education requires an ongoing relationship among the school, medical students, and community preceptors. The use of medical school faculty as "circuit riders" helps to develop and maintain these relationships. We studied the benefits, challenges, and barriers...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: McGrew M,Solan B,Hoff T,Skipper B

    更新日期:2008-05-01 00:00:00

  • Opportunities and Barriers for Family Physician Contribution to the Maternity Care Workforce.

    abstract:BACKGROUND AND OBJECTIVES:The number of family physicians providing obstetric deliveries is decreasing, but high numbers of new graduates report they intend to include obstetric deliveries in their practices. The objective of this study was to understand barriers to providing obstetrical care faced by recent family med...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:10.22454/FamMed.2019.845581

    authors: Barreto TW,Eden A,Hansen ER,Peterson LE

    更新日期:2019-05-01 00:00:00

  • The impact of a health screening flow sheet on the performance and documentation of health screening procedures.

    abstract::We monitored physician performance of stool occult blood testing and breast exams during health maintenance visits of patients aged 50 or greater, to assess the impact of a physician education program and the use of a health screening flow sheet on performance of these health screening procedures. During the baseline ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Prislin MD,Vandenbark MS,Clarkson QD

    更新日期:1986-09-01 00:00:00

  • Heart failure in Vietnam.

    abstract:BACKGROUND:Students are increasingly participating in international health experiences during their medical training. This essay explores one student's perspective on the importance of relationship development with both patients and health care systems in global settings. The essay also reflects on the unique learning ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Tong ST

    更新日期:2012-10-01 00:00:00

  • Beta-blockers and depression in elderly hypertension patients in primary care.

    abstract:BACKGROUND AND OBJECTIVES:Previous findings regarding a possible association between beta-blocker use and depression are mixed. To our knowledge there have been no studies investigating the association of beta-blockers with depression in primary care hypertension patients without previous myocardial infarction. The aim...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Ringoir L,Pedersen SS,Widdershoven JW,Pouwer F,Keyzer JM,Romeijnders AC,Pop VJ

    更新日期:2014-06-01 00:00:00

  • Physician attitudes and the use of office-based activities for tobacco control.

    abstract:OBJECTIVES:This study explored family physicians' attitudes about smoking cessation counseling-its importance, their confidence in their ability to counsel, outcome expectations of counseling, perception of their influence on patient behavior types of counseling skills used, and the extent to which office-based activit...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: McIlvain HE,Backer EL,Crabtree BF,Lacy N

    更新日期:2002-02-01 00:00:00

  • Geriatric medicine training for family practice residents in the 21st century: a report from the Residency Assistance Program/Harfford Geriatrics Initiative.

    abstract::Increasing the quality and quantity of geriatric medicine training for family practice residents is a particular challenge for community-based programs. With support from the John A. Hartford Foundation of New York City, the American Academy of Family Physicians (AAFP) implemented in 1995 a multi-part project to impro...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Warshaw G,Murphy J,Buehler J,Singleton S,Residency Assistance Program\/Harfford Geriatrics Initiative.

    更新日期:2003-01-01 00:00:00

  • Graduating Medical Student Perspectives on Factors Influencing Specialty Choice An AAFP National Survey.

    abstract:BACKGROUND AND OBJECTIVES:Fewer than 10% of US medical school graduates enter family medicine residencies each year. Little is known about the perceptions and attitudes of senior medical students as they make final decisions about specialty choice, especially those that support a decision to pursue family medicine. The...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:10.22454/FamMed.2019.136973

    authors: Kost A,Bentley A,Phillips J,Kelly C,Prunuske J,Morley CP

    更新日期:2019-02-01 00:00:00

  • Future vision: is family medicine ready for patient-directed care?

    abstract::A growing number of Americans will soon have a Web-based personal medical home with connectedness to their chosen providers of care. The personal health record will become integrated with the electronic health record. Like other services on the Internet, patients will be able to direct much of their health care using ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Scherger JE

    更新日期:2009-04-01 00:00:00

  • The educational effect of clinical rotations in nonindustrialized countries.

    abstract:BACKGROUND:Rotations by American medical students in foreign countries have been common in US medical schools for nearly half a century. Although anecdotal literature makes claims for the significant educational value of these foreign rotations, neither the nature and educational consequences of these experiences, nor ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Bissonette R,Routé C

    更新日期:1994-04-01 00:00:00

  • Accounting for graduate medical education funding in family practice training.

    abstract:BACKGROUND AND OBJECTIVES:Medicare provides the majority of funding to support graduate medical education (GME). Following the flow of these funds from hospitals to training programs is an important step in accounting for GME funding. METHODS:Using a national survey of 453 family practice residency programs and Medica...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Chen FM,Phillips RL Jr,Schneeweiss R,Andrilla CH,Hart LG,Fryer GE Jr,Casey S,Rosenblatt RA

    更新日期:2002-10-01 00:00:00

  • Practical tools for qualitative community-oriented primary care community assessment.

    abstract:BACKGROUND AND OBJECTIVES:The evolution of managed care is creating a need for feasible methods for clinical practices to perform community assessments. Since some types of clinically useful data are best obtained through a qualitative community assessment, practical methods of carrying out this type of assessment are ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Williams RL,Crabtree BF,O'Brien C,Zyzanski SJ,Gilchrist VJ

    更新日期:1999-07-01 00:00:00

  • A gain in cultural competence through an international acupuncture elective.

    abstract:OBJECTIVE:This study describes an international acupuncture elective and its impact on medical students' development of cultural competence. METHODS:Collaborating with Chinese colleagues, we created a 4-week elective that teaches medical students about acupuncture in its native cultural environment. Three focus groups...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Mao JJ,Wax J,Barg FK,Margo K,Walrath D

    更新日期:2007-01-01 00:00:00

  • Experiences of a support group for interns in the setting of war and political turmoil.

    abstract:BACKGROUND AND OBJECTIVES:Intern support groups have been instituted in many residency programs to improve resident well-being. In this article, we discuss the themes that emerged in intern support group meetings in a family medicine program operating in a setting of war and political instability. METHODS:We held supp...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: El Jamil F,Hamadeh GN,Osman H

    更新日期:2007-10-01 00:00:00

  • Whither Family Medicine? Our Past, Future, and Enduring Scope of Practice.

    abstract::After 3 decades in private practice, I joined the faculty of a nearby residency program. Like most family medicine residencies, it follows a curriculum that my physician father would have recognized: heavy emphasis on inpatient medicine; short shrift to continuity care. Despite a changing marketplace, there is still a...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:10.22454/FamMed.2019.633317

    authors: Loxterkamp D

    更新日期:2019-07-01 00:00:00

  • Teaching geriatric assessment: use of a hybrid method in a family medicine clerkship.

    abstract:BACKGROUND AND OBJECTIVES:We addressed a lack of geriatric content in our third-year family medicine clerkship. Adding this content posed a challenge in that students are dispersed to clinical sites across New England. Our goal was to promote student skill in functional assessment of elderly patients. METHODS:We used ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Goldman LN,Wiecha J,Hoffman M,Levine SA

    更新日期:2008-11-01 00:00:00

  • Participation by sedentary elderly persons in an exercise promotion session.

    abstract:BACKGROUND:Little is known regarding the dynamics of elderly persons' participation in health promotion programs. We studied factors influencing the participation of 337 sedentary elderly persons in an exercise promotion session. All study participants were members of a health maintenance organization. METHODS:Baselin...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Elward KS,Wagner EH,Larson EB

    更新日期:1992-11-01 00:00:00

  • "Routine" chemistry testing.

    abstract::This study examines the use and results of a multichannel chemistry test (SMAC) in asymptomatic patients attending a family practice center. Of 288 patients, 71 (25%) presenting for complete physical examinations had apparently "routine" or baseline SMACs. Forty-three (61%) had at least one abnormal value in their che...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Romm FJ

    更新日期:1986-07-01 00:00:00

  • EHR Overtime: An Analysis of Time Spent After Hours by Family Physicians.

    abstract:BACKGROUND AND OBJECTIVES:Time spent in the electronic health record (EHR), away from direct patient care, is associated with physician burnout. Yet there is a lack of evidence quantifying EHR use among family physicians. The purpose of the study was to describe a method for quantifying habits and duration of use withi...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:10.22454/FamMed.2020.942762

    authors: Anderson J,Leubner J,Brown SR

    更新日期:2020-02-01 00:00:00

  • The domain of family practice: scope, role, and function.

    abstract::The family physician is the physician generalist who takes professional responsibility for the comprehensive care of unselected patients with undifferentiated problems and who is committed to the person regardless of age, gender, illness, or organ system. The clinical specialty of family practice is patient centered, ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Phillips WR,Haynes DG

    更新日期:2001-04-01 00:00:00

  • Behavioral science in family medicine residencies: Part II. Teacher roles, relationships, and rewards. The STFM Task Force on Behavioral Science.

    abstract::A survey of members of the Society of Teachers of Family Medicine provided information about roles, relationships, and rewards for teachers involved in family medicine residency behavioral science education. Family physicians and behavioral scientists perceive their own roles in behavioral teaching and patient care as...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors:

    更新日期:1985-03-01 00:00:00

  • Cancer and colorectal cancer: knowledge, beliefs, and screening preferences of a diverse patient population.

    abstract:BACKGROUND:Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States, with African Americans having the highest incidence and mortality of all racial and ethnic groups. CRC screening is widely recommended but remains underused, especially in minority populations. This study's pur...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Shokar NK,Vernon SW,Weller SC

    更新日期:2005-05-01 00:00:00

  • Utilizing Practice-Based Research Networks to Teach and Implement Quality Improvement in Academic Medicine.

    abstract:BACKGROUND AND OBJECTIVES:A 2019 study found that between 2014 and 2017, family medicine residents had little improvement in self-assessed preparedness to lead quality improvement projects. This study explored the effectiveness of leveraging a practice-based research network (PBRN) across multiple family medicine resid...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:10.22454/FamMed.2020.411271

    authors: Hoff C,Caleon L,Lee G,Quan M

    更新日期:2020-10-01 00:00:00

  • Inpatient experience of family practice residents in a community hospital.

    abstract::Decisions regarding residency training require repeated reevaluation of organization and curriculum. Developing an autonomous inpatient teaching service may become necessary in many community hospitals because of a new competitive environment. To predict the impact of this possible change in one community program, we ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Ferrante JA,Bakkila HA,Hirsch RP,Merenstein JH

    更新日期:1985-07-01 00:00:00

  • Preparing Family Physicians to Care for Underserved Populations: A Historical Perspective.

    abstract:BACKGROUND:Family physicians have been involved in the care of rural and urban underserved populations since the founding of the specialty. In the early 1970s family medicine training programs specifically focused on training residents to work with the underserved were established in both urban and rural settings. Key ...

    journal_title:Family medicine

    pub_type: 历史文章,杂志文章

    doi:

    authors: Rodgers DV,Wendling AL,Saba GW,Mahoney MR,Brown Speights JS

    更新日期:2017-04-01 00:00:00

  • Using ICPC in a computer-based primary care information system.

    abstract:INTRODUCTION:Although the framework of the episode of care offers much promise in examining the process of primary health care, the development of episode-oriented, automated data sources has proceeded slowly. Experience with the International Classification of Primary Care (ICPC) in the European Community has confirme...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Klinkman MS,Green LA

    更新日期:1995-07-01 00:00:00

  • Multiple-level goals in clinical teaching.

    abstract::The maturation process of family practice intensifies the need for our educators to unify their material into concepts specific to our specialty. A method of teaching clinical topics is described in which integrative goals are combined with knowledge, skill, and attitudinal goals. The attitudinal goals are designed to...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Calico FW

    更新日期:1985-05-01 00:00:00

  • 2011 ACGME duty hour week proposal--a national survey of family medicine residents.

    abstract:BACKGROUND AND OBJECTIVES:In July 2010, the Accreditation Council for Graduate Medical Education (ACGME) published its proposed duty-hour regulations. We conducted a national online survey to assess current family medicine residents' perceptions of the proposed changes. METHODS:A 27-question survey was used to assess ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Lo V,Ward C

    更新日期:2011-05-01 00:00:00

  • Impact of the Introduction of the Clinical Science Mastery Series on Family Medicine NBME Subject Examination Performance.

    abstract:BACKGROUND AND OBJECTIVES:Many medical schools assess student clinical knowledge using the National Board of Medical Examiners (NBME) subject examinations. The Family Medicine Clinical Science Mastery Series (CSMS) self-assessments, which are made up of former Family Medicine NBME examination questions, became availabl...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:10.22454/FamMed.2019.253577

    authors: Minor S,Stumbar SE,Bonnin R

    更新日期:2019-09-01 00:00:00

  • Financial and clinical relationships between family practice and the academic medical center.

    abstract::The clinical relationship of academic family practice units to their parent tertiary care medical centers was studied. We surveyed the designated family practice contacts in all U.S. medical schools and achieved a response rate of 84%. We found wide variations in the degree to which academic family practice units prov...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Schwenk TL,Davies TC

    更新日期:1987-03-01 00:00:00