UC Davis Health’s Post

How might doctors and patients behave differently if acute care hospital patients had real time access to their medical records? In the UK, in the acute inpatient setting, the only information that a patient routinely receives about their medical care is verbal, and patients can’t routinely access their medical records in real time. A patients’ medical record is a working document used by clinicians to record their thoughts, as a form of communication between professionals and a record of what happens during a patient’s stay in hospital. It’s also a legal document. It can include a multitude of information, such as differential diagnoses (the process of diagnosing when there are two or more conditions which share similar signs or symptoms) planned investigations, results of investigations and treatments, and even trained administrative staff admit that they can’t always find the exact information they are searching for. Legally, in most countries, a medical record belongs to the institution in which it’s been written, but a patient has the right to access it. Guidance from the House of Commons library suggests that patients in the UK should have real-time access to their medical records. This could potentially have an effect both on clinicians and the patient experience so we wanted to explore their views on the impact this change might have. We asked doctors and patients for their thoughts, and while concerns were raised about the consequences of sharing written information in real time, there was support for the idea. So, what are the options for sharing written medical records, and what impact could making the information immediately available to patients have? Access the paper: https://ths.im/404dD4J Read THIS summary: https://ths.im/46BBpaY

We are thrilled to announce that our very own Chief Medical Officer, Dr. Kevin Chung, has been included in the Most Innovative Chief Medical Officers to Follow in 2023 by Insights Care Magazine. Read the full article here: https://lnkd.in/dUyaVEGg Kevin Chung #ICU #healthcareinnovation

The Eventus model is centered around delivering high-quality and patient-centered care. And AMDA - The Society for Post-Acute and Long-Term Care Medicine's core values directly align with what we’re all about: serving our frail and vulnerable patient population. AMDA is a comprehensive community of clinical leaders and medical professionals who work in post-acute and long-term care settings. AMDA promotes and enhances the development of its members to help them achieve quality, compassionate care for their long-term care patients. AMDA offers medical directorship training and resources which give physicians tools and training to step into medical director roles. The role of medical directors at Eventus helps create a better value-based care system and improve the efficiency of our care model through comprehensive and compassionate clinical leadership. Eventus’ AMDA certified medical directors are a massive asset to our facility partners. Our monthly QAPI forums bring together the Eventus medical director and our providers with facility administration and clinical staff to review performance, identify opportunities for improvement and develop action plans to realize actual improvement. Eventus WholeHealth’s Associate Chief Medical Officer for Primary Care & Board Member for the Carolinas Society for Post-Acute and Long-Term Care Medicine Sandeep Patel, MD, CMD recently discussed the impact medical directors have on the Eventus model: “Our model affords the ability to hold people accountable to the needs of the building, the needs of the patient, and therefore makes it much easier to demonstrate outcomes as a result of being able to hold that accountability over those key stakeholders.” Our involvement with AMDA, their medical directorship training resources and PALTC community allows us to maximize our efficiency and quality of care and align with our ultimate purpose of making a difference in the lives of our patients. #AMDA #PALTC #PALTC24 #eventus #longtermcare #skillednursing #valuebasedcare #assistedliving #medicaldirector #clinicalleadership

Elated to share my upcoming publication with my colleague and friend Angela Miller, DNP, CRNP in the Journal Of Ambulatory Care Management. An “Engage to Sustain” Intervention to Improve Process Performance Measures in Ambulatory Care Abstract: 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 and counseling) markedly increased following this intervention across 18 ambulatory departments with more than 2 million patient visits. Shifting responsibilities for patient screening from physicians and advanced practitioners to LPNs and CMAs improves screening rates. Link to Publication: https://lnkd.in/e_9Xp4S2

And the way to clinical excellence is to have the guidance of those who can truely advise…

Good morning, everyone. Do you know what a Hospitalist is? I didn't until this morning. Hospitalists are a group of individuals who make up the hospital medicine community and practice hospital medicine. This began with Society of Hospital Medicine which is founded through National Hospitalist Day in 1997. The Society of Hospital Medicine promote quality care by keeping hospitals up-to-date with education and industry-specific information. The National Hospitalist Day's goal is to recognize the contributors of specialist care doctors who make up the members of the Society of Hospital Medicine in the fastest-growing speciality of modern medicine. What's the difference between a primary health care doctor and a hospitalist, you ask? Your hospitalist are doctors who provide care for patients at a hospital and typically have the same training as primary care doctors but specialize in providing in-hospital care. Thank you for all the hospitalists who continue to make hospitals up to date and keeping their staff safe while still providing excellent health-care. BERTOLINO LLP, @national hospitalist day

On the topic of books by doctors, particularly emergency physicians, I'm pasting in here my Amazon review following a recent read of Dr. Joan Naidorf's book: 5.0 out of 5 stars Overcoming Difficult Healthcare Conversations Reviewed in the United States on March 31, 2024 I heartily endorse Dr. Joan Naidorf’s book Changing How We Think About Difficult Patients. She has overwhelmingly succeeded in her goal of producing a pithy and insightful resource for readers working in all aspects of the healthcare field, especially those just embarking on their careers. I’ve also concluded that additionally even non-medical readers can benefit from her insights into how the often-challenging interactions between suffering patients and those dedicated to relieving that suffering can inadvertently, but readily, go astray. Each side of that interaction can benefit from trying to be more consciously aware of the often subconscious emotional and psychosocial elements influencing our behavior and decision making, as Dr. Naidorf outlines so clearly. As a fellow emergency physician, I can recognize my own shortcomings in much of what she describes. Particularly useful is her guidance on how to recognize and reframe our problematic cognitive shortcuts. This can assist us to avoid our natural reflexive but unhelpful tendency to see our patients as “the problem,” rather than their problems as the problem. As I address in my own recent book, we are all also currently laboring under externally imposed time limitations by a healthcare system motivated by a misplaced dollar-driven focus on “productivity.” This makes Dr. Naidorf’s message even more critically important and relevant in its timeliness; as she envisions it, refocusing medical decision-making to always be based on what is best for the patient. Reading her book will ideally motivate medical and non-medical people alike to recognize and forestall the tendency to categorize each other as not being either “good patients” or “good doctors,” and instead focus our joint attention on “good communication” as the most reliable way to reach excellent results. Drew Remignanti, MD, MPH Joan Naidorf DO

The PA-C is now the healthcare gatekeeper. Rarely do you see a doctor unless the issue becomes serious. This is where a better job of patient education is necessary. The average patient has certain expectations, but is not informed on the process. Result = perception of fragmentation and disconnection in the care journey. Being better informed is the foundation for the patient experience. Excellent post by Erik Pearson, MD FACS #healthcare #hospitals #physicians #physicianassistants #nursepractitioners Forum for Healthcare Strategists

Inside Our Department of Hospital Medicine: A Collaborative Ecosystem At MD Anderson Cancer Center, the Department of Hospital Medicine is a cornerstone of excellence, embodying a comprehensive approach to patient care. Here's a glimpse into how our dedicated teams collaborate and contribute to our mission: Advanced Practice Providers (APPs): Our APPs, including nurse practitioners and physician assistants, are at the forefront of patient management, ensuring high-quality care through acute and complex case management. Pharmacy: Integral to our team, our pharmacists bring in-depth pharmacological expertise, participating directly in patient care rounds to provide critical insights on medication management and safety. Faculty Members: Our esteemed faculty are committed to patient care and leaders in research and education, fostering a learning environment that keeps us at the cutting edge of medical advances. Administration: The backbone of our department, our administrative professionals ensure seamless operations and support our clinical teams in delivering the best possible care.  Collaboration Is Key: Our department thrives on a solid partnership with hospital staff and other departments. From nursing to specialties like surgery and cardiology, we work hand-in-hand to create a multidisciplinary approach to healthcare that promotes better outcomes for our patients. Together, we're more than just a department; we're a dynamic community dedicated to health and healing. Josiah Kwesi Halm and the esteemed DHM Team are proud of what we achieve together daily, and we strive for excellence in every aspect of our work. #DepartmentofHospitalMedicine #DHM #MDA #MDAnderson #Hospitalist #Teamwork #PatientCare #HealthcareExcellence #EndCancer #MakingCancerHistory

Research Article | Do mid-level providers enhance hospital cost per discharge or triple aim performance efficiency? An exploratory analysis Aaron W. Bonnett, Gregory R. Heim https://lnkd.in/gAhVNpgT Hospital administrators are shifting care delivery models toward an approach that uses more caregivers in the form of mid-level providers (MLPs), such as nurse practitioners, physician assistants, and clinical nurse specialists. To date, however, healthcare operations management (OM) literature remains ambiguous about longitudinal empirical associations between mid-level providers and hospital costs, quality, and other performance measures. We analyze how the extent of MLP employment used by a hospital is associated with hospital operational outcomes, as reflected by hospital cost per discharge and Triple Aim Performance (TAP) efficiency metrics. Our findings indicate percent MLP usage is positively associated with efficiency metrics for hospital clinical quality, technical efficiency, and patient experience, but not associated with hospital costs. We also find percent MLP usage is associated with the likelihood that hospitals excel on all TAP metrics simultaneously. Post-hoc exploratory analyses suggest the associations exhibit differential outcomes across hospital efficiency quantiles, while sub-sample analyses motivate boundary conditions for some hypothesized MLP associations. We contribute to healthcare OM research by providing one of the first panel data analyses of MLPs, improving insights relative to extant work. By giving key stakeholders useful findings about outcomes associated with hospital staffing trends, our managerial contribution helps hospital administrators understand empirical consequences of the increasing use of MLPs.