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Diane Berish PhD Erica Husser PhD Jenny Knecht-Fredo MSN CRNP Jacqueline Sabol MEd George Garrow MD Judith Hupcey EdD CRNP FAAN Donna Fick RN GCNS-BC PhD FGSA FAAN 《Health services research》2023,58(Z1):78-88
Objective
To collaboratively implement the age-friendly health systems framework, known as the 4Ms: What Matters, Medication, Mentation, and Mobility, at The Primary Health Network (PHN), a federally qualified health center.Data Sources
Data were collected from PHN electronic medical records (EMRs) for individuals over age 65 from December 30, 2019 to December 24, 2021 and from Project ECHO© attendance and evaluation surveys.Study Design
The telementoring educational program, Project ECHO©, was used to engage PHN health care professionals working in rural areas of Pennsylvania to incorporate the 4Ms into their practice starting with the annual wellness visit (AWV). Project ECHO© was launched at three primary care sites. After 18 months, it was then disseminated to an additional 18 sites creating pilot and comparison groups. Outcomes included codesigned patient process metrics using EMR data and project ECHO© participant data.Data Collection Methods
EMR data were generated by system reports created by PHN's quality assurance program manager. Project ECHO© data were collected and managed using REDCap electronic data capture tools. Outcomes were aggregated, analyzed for trends over time, and compared between groups.Principal Findings
All nine process outcomes increased from baseline to follow-up at the three initial sites, ranging from 4% to 43% g. At year two, the three initial sites had higher rates on AWVs (pilot 24%, comparison 12%; p < 0.0001), Advance Care Planning (New on file, pilot 8%, comparison 2%; Discussed with patient, pilot 18%, comparison 13%; Patient declined, pilot 0%, comparison 0%; p = 0.0001), Dementia Screening (pilot 24%, comparison 12%; p < 0.0001), Fall Risk Management (pilot 43%, comparison 10%; p < 0.0001), and Mobility Goal (pilot 19%, comparison 9%; p < 0.0001); and lower rates on High-Risk Medication Elimination (pilot 54%, comparison, 63%, p < 0.02).Conclusions
Access to high-quality geriatric care for rural older adults can be improved by increasing health care professionals' knowledge of the 4Ms, beginning with its incorporation into the AWV. 相似文献2.
Jacklyn Cho BS Brittany Toffey MD Ariel F. Silva NP Ariel Shalev MD Monika M. Safford MD Erica Phillips MD MS Ann Lee BS Faith Wiggins BS MS Elissa Kozlov PhD Emma K. Tsui PhD MPH Nicola Dell PhD Ariel C. Avgar PhD Susan J. Andreae PhD MPH Madeline R. Sterling MD MPH MS 《Health services research》2023,58(3):697-704
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Atujuna Millicent Montgomery Elizabeth T. Hartmann Miriam Ndwayana Sheily Browne Erica N. Sindelo Siyaxolisa Bekker Linda-Gail Minnis Alexandra M. 《AIDS and behavior》2022,26(5):1618-1632
AIDS and Behavior - While pre-exposure prophylaxis (PrEP) is a key HIV prevention tool for adolescents and young adults (AYAs), its initiation and sustained use is shaped by AYAs’ unique... 相似文献
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Tolley Elizabeth E. Hamilton Erica L. Eley Natalie Maragh-Bass Allysha C. Okumu Eunice Balán Iván C. Gamble Theresa Beyrer Chris Remien Robert 《AIDS and behavior》2022,26(9):3119-3130
AIDS and Behavior - Adherence to care and antiretroviral therapy is challenging, especially for people living with HIV (PLWH) with additional co-occurring risk factors. Case management... 相似文献
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Davis Victoria H. Nixon Stephanie A. Murphy Kathleen Cameron Cathy Bond Virginia A. Hanass-Hancock Jill Kimura Lauren Maimbolwa Margaret C. Menon J. Anitha Nekolaichuk Erica Solomon Patricia 《AIDS and behavior》2022,26(10):3386-3399
AIDS and Behavior - This scoping review assessed how the term ‘self-management’ (SM) is used in peer-reviewed literature describing HIV populations in low- and middle-income countries... 相似文献
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Hernandez Natalie D. Francis Sherilyn Allen Morgan Bellamy Erica Sims Omar T Oh Hyejung Guillaume Dominique Parker Andrea Chandler Rasheeta 《Maternal and child health journal》2022,26(4):770-777
Maternal and Child Health Journal - Data are scarce regarding the prevalence and predictors of perinatal mood and anxiety disorders (PMADs) among Black women. The purpose of this study was to... 相似文献
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