Outcomes of Embedded Care Management in a Family Medicine Residency Patient-Centered Medical Home.

Abstract:

BACKGROUND AND OBJECTIVES:Much attention is devoted nationally to preventing hospital readmissions and emergency department (ED) use, given the high cost of this care. There is a growing body of evidence from the Patient Centered Primary Care Collaborative that a patient-centered medical home (PCMH) model successfully lowers these costs. Our study evaluates a specific intervention in a family medicine residency PCMH to decrease readmissions and ED utilization using an embedded care manager. METHODS:The Department of Family and Community Medicine at Eastern Virginia Medical School in Norfolk, VA, hired an RN care manager in May of 2013 with a well-defined job description focused on decreasing hospital readmissions and ED usage. Our primary outcomes for the study were number of monthly hospital admissions and readmissions over 23 months and monthly ED visits over 20 months. RESULTS:Readmission rates averaged 22.2% per month in the first year of the intervention and 18.3% in the second year, a statistically significant 3.9% decrease. ED visits averaged 176 per month in the first year and 146 per month in the second year, a statistically significant 17% reduction. CONCLUSIONS:Our study adds to the evidence that a PCMH model of care with an embedded RN care manager can favorably lower readmission rates and ED utilization in a family medicine residency practice. Developing a viable business model to support this important work remains a challenge.

journal_name

Fam Med

journal_title

Family medicine

authors

Newman RJ,Bikowski R,Nakayama K,Cunningham T,Acker P,Bradshaw D

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

46-51

issue

1

eissn

0742-3225

issn

1938-3800

journal_volume

49

pub_type

杂志文章
  • Qualitative and quantitative methods for the assessment of clinical preceptors.

    abstract::The improvement of clinical teaching skills has consistently been an important focus of faculty development in family medicine. Successful faculty development programs depend on an understanding of the components of clinical teaching and a profile of the strengths and weaknesses of each faculty member with respect to ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Lewis BS,Pace WD

    更新日期:1990-09-01 00:00:00

  • Area of Concentration programs in university-based family practice residency training.

    abstract::To encourage pursuit of focused academic and clinical interest by family practice residents, we developed an Area of Concentration (AOC) program at a university-based residency program. The program uses resources available throughout the university and permits residents to focus on a variety of interest areas, includi...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Frank SH,Smith CK

    更新日期:1993-04-01 00:00:00

  • Teaching family in family medicine residency programs: results of a national survey.

    abstract:BACKGROUND AND OBJECTIVES:Integrating family into family medicine has been recognized as important for the discipline, yet there is little known about how family-oriented care is taught in training environments. This paper presents results of a national survey assessing the status of teaching family concepts/skills in ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Korin EC,Odom AJ,Newman NK,Fletcher J,Lechuga C,McKee MD

    更新日期:2014-03-01 00:00:00

  • The central city site: an urban underserved family medicine training track.

    abstract:BACKGROUND AND OBJECTIVES:We describe the development of an urban track in family medicine residency designed to recruit a high percentage of minority students and promote their future practice in urban, underserved areas of Milwaukee. We report here on the residents and their first practice location and compared this ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Bade E,Baumgardner D,Brill J

    更新日期:2009-01-01 00:00:00

  • Early pregnancy failure management among family physicians.

    abstract:BACKGROUND AND OBJECTIVES:Family physicians, as primary care providers for reproductive-aged women, frequently initiate or refer patients for management of early pregnancy failure (EPF). Safe and effective options for EPF treatment include expectant management, medical management with misoprostol, and aspiration in the...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Wallace R,Dehlendorf C,Vittinghoff E,Gold KJ,Dalton VK

    更新日期:2013-03-01 00:00:00

  • Implementation of a smoking cessation counseling module in a preceptorship program.

    abstract:BACKGROUND:Family medicine preceptorships are underused opportunities for learning smoking cessation counseling skills. To prepare students for their future roles in preventing health problems in patients who use tobacco, we implemented a patient-centered instructional module within the elective Texas Statewide Family ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Nieman LZ,Velasquez MM,Groff JY,Cheng L,Foxhall LE

    更新日期:2005-02-01 00:00:00

  • Tying it all together? A competency-based linkage model for family medicine.

    abstract::Residency faculty in all specialties will be required by the Accreditation Council for Graduate Medical Education (ACGME) to fully implement competencies into residency programs by 2006. Understanding the new requirements is complicated by having several sets of guiding documents from different sources, including the ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: King RV,Murphy-Cullen CL,Krepcho M,Bell HS,Frey RD

    更新日期:2003-10-01 00:00:00

  • Contributions of US Medical Schools to Primary Care (2003-2014): Determining and Predicting Who Really Goes Into Primary Care.

    abstract:BACKGROUND AND OBJECTIVES:Schools of medicine in the United States may overstate the placement of their graduates in primary care. The purpose of this project was to determine the magnitude by which primary care output is overestimated by commonly used metrics and identify a more accurate method for predicting actual p...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:10.22454/FamMed.2020.785068

    authors: Deutchman M,Macaluso F,Chao J,Duffrin C,Hanna K,Avery DM Jr,Onello E,Quinn K,Griswold MT,Alavi M,Boulger J,Bright P,Schneider B,Porter J,Luke S,Durham J,Hasnain M,James KA

    更新日期:2020-06-01 00:00:00

  • Collecting data to evaluate the effect of health policies on vulnerable populations.

    abstract::Public health policies often have disproportionate effects on the poor and other vulnerable groups. Standard survey techniques are often difficult to apply to these vulnerable populations, and many data bases systematically omit such individuals. The purpose of this paper is to review our experience in collecting prim...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Bindman AB,Grumbach K,Keane D,Lurie N

    更新日期:1993-02-01 00:00:00

  • Attitudes, experience, and influence of family medicine predoctoral education directors.

    abstract:BACKGROUND AND OBJECTIVES:While debate surrounds the determinants of medical students' specialty choices, the presence of favorable role models is generally agreed upon as beneficial to students' selection of a specialty. This study assessed the influence of family medicine predoctoral education directors on students' ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Johnson VK,Michener JL

    更新日期:1994-05-01 00:00:00

  • Personality profiles of rural longitudinal integrated clerkship students who choose family medicine.

    abstract:BACKGROUND AND OBJECTIVES:Physician workforce projections fuel interest in addressing the shortage of family physicians. Copious research has investigated personality as a variable influencing specialty intention. Medical school rural longitudinal integrated clerkships (LICs) nurture interest in family medicine. This s...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Eley DS,Brooks KD,Zink T,Cloninger CR

    更新日期:2015-03-01 00:00:00

  • Triple Aim Is Triply Tough: Can You Focus on Three Things at Once?

    abstract:BACKGROUND AND OBJECTIVES:The I3 POP Collaborative sought to improve health of patients attending North Carolina, South Carolina, and Virginia primary care teaching practices using the triple aim framework of better quality, appropriate utilization, and enhanced patient experience. We examined change in triple aim meas...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:10.22454/FamMed.2018.885946

    authors: Donahue KE,Reid A,Baxley EG,Carter C,Carek PJ,Robinson M,Newton WP

    更新日期:2018-03-01 00:00:00

  • The epidemiologic basis for family medicine research.

    abstract::Epidemiology, historically the study of communicable disease, has evolved to include the use of certain epidemiologic precepts in more diverse studies of human health and disease. Most especially, epidemiology offers a distinctly useful mechanism for research involving clinical, cultural, and economic factors impingin...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: McKay DA

    更新日期:1988-05-01 00:00:00

  • Sudanese refugees in a Minnesota family practice clinic.

    abstract:BACKGROUND AND OBJECTIVES:During the 1990s, African refugees from the southern Sudan were resettled in Minnesota. This research characterizes the health care utilization of a small sample of these recently arrived refugees and describes their health histories. METHODS:Data were abstracted from the medical charts of al...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Power DV,Shandy DJ

    更新日期:1998-03-01 00:00:00

  • Curriculum planning: a needs assessment for complementary and alternative medicine education in residency.

    abstract:BACKGROUND AND OBJECTIVES:The curricular needs in complementary and alternative medicine (CAM) of family medicine residents are unknown. Our objective was to assess perceptions of knowledge, attitudes, practice behaviors, and interest toward CAM by family medicine residents. METHODS:A questionnaire was administered to...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Prajapati SH,Kahn RF,Stecker T,Pulley L

    更新日期:2007-03-01 00:00:00

  • Finding the Words: Medical Students' Reflections on Communication Challenges in Clinic.

    abstract:BACKGROUND AND OBJECTIVES:Interpersonal communication is essential to providing excellent patient care and requires ongoing development. Although aspects of medical student interpersonal communication may degrade throughout career progression, it is unknown what specific elements pose challenges. We aimed to characteri...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Braverman G,Bereknyei Merrell S,Bruce JS,Makoul G,Schillinger E

    更新日期:2016-11-01 00:00:00

  • Students' evaluations of teaching and learning experiences at community- and residency-based practices.

    abstract:BACKGROUND:Research has identified students' preferences for clinical sites and the clinical teaching behaviors of preceptors valued by students. This study investigated medical students' perceptions of preceptor teaching behaviors and student performance information at community- and residency-based sites. METHODS:Th...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Leone-Perkins M,Schnuth RL,Lipsky MS

    更新日期:1999-09-01 00:00:00

  • Screening for mental health using adolescent-reported parenting.

    abstract:BACKGROUND AND OBJECTIVES:Little is known in primary care practices about the relationship between parenting and adolescent mental health. In addition, current parenting measures have a narrow focus or do not lend themselves to clinical intervention. This study examined the clinical utility of a new instrument measurin...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Godkin MA,Baker S,Paradise JE,Domal L,Grant L

    更新日期:1994-09-01 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

  • The relationship between medical student career choice and a required third-year family practice clerkship.

    abstract::Family practice as a career choice has been related to a number of educational variables, including the presence of a required clinical clerkship. In order to determine whether or not the timing of the required clinical clerkship was also related to family practice residency selection, a study was undertaken to invest...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Rabinowitz HK

    更新日期:1988-03-01 00:00:00

  • Levels of family involvement by resident and attending physicians.

    abstract:BACKGROUND:Family-oriented medical care is one of the basic tenets of family practice. However, little is known about the extent to which: 1) resident physicians discuss family issues during outpatient office visits and 2) attending physicians address family issues during teaching consultations. METHODS:Two hundred an...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Marvel MK,Morphew PK

    更新日期:1993-01-01 00:00:00

  • Changes in ambulatory care with patient age: is geriatric care qualitatively different?

    abstract::Approximately 25,000 recorded visits between primary care physicians and adults aged 25 and older in the 1985 National Ambulatory Medical Care Survey were analyzed to study the relationship between patient age and selected process measures of the physician-patient encounter. Multiple presenting complaints and visit di...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Sloane PD

    更新日期:1991-01-01 00:00:00

  • 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 ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:10.22454/FamMed.2018.158642

    authors: Sherman MD,Justesen K,Okocha EA

    更新日期:2018-02-01 00:00:00

  • Face protection in recreational hockey players.

    abstract:BACKGROUND AND OBJECTIVES:Our primary objective was to determine the percentage of recreational hockey players who do not wear face protection while playing hockey. METHODS:We randomly surveyed recreational hockey players at two indoor hockey rinks in Evandale, Ohio. Data were collected on face protection, injuries, d...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Woods SE,Zabat E,Daggy M,Diehl J,Engel A,Okragly R

    更新日期:2007-07-01 00:00:00

  • Family medicine faculty development fellowships and the medically underserved.

    abstract:OBJECTIVE:This study measured the prevalence of service in federally designated medically underserved communities (FD-MUC) by Title VII-funded, full-time faculty development fellowship alumni. METHODS:A two-stage survey of alumni of full-time, family medicine faculty development fellowships was completed. Alumni were ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Kohrs FP,Mainous AG 3rd,Fernandez ES,Matheny SC

    更新日期:2001-02-01 00:00:00

  • Evidence-based and patient-centered care: results from an STFM group project.

    abstract:OBJECTIVES:This study's purpose was to identify the elements of a definition of evidence-based patient-centered care (EBPCC), the barriers to using EBPCC, and strategies for overcoming these barriers. METHODS:This research project used focus group methodology with participants drawn from Society of Teachers of Family ...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Lacy NL,Backer EL

    更新日期:2008-06-01 00:00:00

  • Translating family medicine's educational expertise into academic success.

    abstract:BACKGROUND:Today's family medicine educator occupies a position of increasing stature in medical education. The recognition of education as scholarship creates a framework for the evaluation of clinician-educators for promotion. A system is needed to document educational excellence, peer review, and public disseminatio...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Lindemann JC,Beecher AC,Morzinski JA,Simpson DE

    更新日期:1995-05-01 00:00:00

  • Assessing medical decision making using human patient simulation.

    abstract:BACKGROUND:This pilot study describes an Objective Structured Clinical Examination (OSCE) developed using Human Patient Simulation (HPS). METHODS:Eight residents completed two iterations of this HPS OSCE containing seven stations and utilizing checklists, global ratings, and scoring sheets. RESULTS:The first- and sec...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Fox BA

    更新日期:2010-10-01 00:00:00

  • Teaching Primary Care Genetics: A Randomized Controlled Trial Comparison.

    abstract:BACKGROUND AND OBJECTIVE:Given the increasing discussions of the impact of genetic medicine within family medicine, it is important to determine the most effective way of teaching this material to family medicine residents (FMRs). The objective of this study was to evaluate and compare the impact of three methods of de...

    journal_title:Family medicine

    pub_type: 杂志文章,随机对照试验

    doi:

    authors: Telner D,Carroll JC,Regehr G,Tabak D,Semotiuk K,Freeman R

    更新日期:2017-06-01 00:00:00

  • The association of Title VII funding to departments of family medicine with choice of physician specialty and practice location.

    abstract:BACKGROUND:Title VII predoctoral and departmental grants for departments of family medicine are intended to increase the number of family and primary care physicians in the United States and increase the number of practices in rural and underserved communities. This study assessed the relationships of Title VII funding...

    journal_title:Family medicine

    pub_type: 杂志文章

    doi:

    authors: Fryer GE Jr,Meyers DS,Krol DM,Phillips RL,Green LA,Dovey SM,Miyoshi TJ

    更新日期:2002-06-01 00:00:00