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2 results

  • Chapter 61 - Practice Transformation for Better Care of Older Adults

  • from Section IV - Principles of Care for the Elderly
  • Edited by Jan Busby-Whitehead, University of North Carolina, Chapel Hill, Samuel C. Durso, The Johns Hopkins University, Maryland, Christine Arenson, Thomas Jefferson University, Philadelphia, Rebecca Elon, The Johns Hopkins University School of Medicine, Mary H. Palmer, University of North Carolina, Chapel Hill, William Reichel
  • Book:
    Reichel's Care of the Elderly
    Published online:
    30 June 2022
    Print publication:
    21 July 2022, pp 736-749

  • Summary

    Transformation of our health-care systems is required to better meet the complex needs of our aging population as we confront the rise of health-care costs around the world. Older adults with multiple chronic health conditions can receive care that is fragmented, incomplete, inefficient, and ineffective. Care delivery and coordination of the complicated needs of older adults resides primarily in outpatient practice, both sub-specialty and primary care. However, the overall coordination is dependent on primary care practices, which through transformation into highly effective interprofessional teams can be designed and equipped to guide comprehensive care for all patients. The term “practice transformation” refers to a process of change in the organization and delivery of care to advance quality improvement and patient-centered care. Practice transformation is a continuous process that involves leadership, goal-setting, workflow changes, quality improvement, and reporting of outcomes. It requires adapting organizational tools and processes to support advances in models of team-based care.

  • Pediatrician preferences, local resources, and economic factors influence referral to a subspecialty access clinic

  • Matthew D. Di Guglielmo, Jay S. Greenspan, Diane J. Abatemarco
  • Journal:
    Primary Health Care Research & Development / Volume 17 / Issue 6 / November 2016
    Published online by Cambridge University Press:
    17 May 2016, pp. 628-635
    • Article
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  • Background

    Pediatric patients seek timely access to subspecialty care within a complex delivery system while facing barriers: distance, economics, and clinician shortages.

    Aim

    We examined stakeholder perceptions about solutions to the access challenge. We engaged over 300 referring primary care pediatricians in the evaluation of Access Clinics at an academic children’s hospital.

    Methods

    Using an anonymous online survey, we asked pediatricians about their and their patients’ experiences and analyzed factors that may influence referrals.

    Findings

    Referring pediatricians reported satisfaction; they provided feedback about their patients’ experiences, physician communication, and referral influences. Distance from the Access Clinic does not correlate with differences in referral volume; living in areas with higher child populations and higher median income is associated with more referrals. Referring pediatricians have strong opinions about referrals, are attuned to patient experiences, and desire bi-directional communication. Multiple factors influence referral to and acceptance of Access Clinics, but external influences have less impact than expected.