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991.
L. Brannon Traxler MD Monique L. Martin MPH CHES Alice S. Kerber MN APRN APNG Cecelia A. Bellcross PhD MS CGC Barbara E. Crane MN APRN Victoria Green MD JD MHSA MBA Roland Matthews MD Nancy M. Paris MS FACHE Sheryl G. A. Gabram MD MBA 《Annals of surgical oncology》2014,21(10):3342-3347
Background
The Georgia Breast Cancer Genomic Health Consortium is a partnership created with funding from the Centers for Disease Control and Prevention (CDC) to the Georgia Department of Public Health to reduce cancer disparities among high-risk minority women. The project addresses young women at increased risk for hereditary breast and ovarian cancer (HBOC) syndrome through outreach efforts.Methods
The consortium provides education and collects surveillance data using the breast cancer genetics referral screening tool (B-RST) available at www.BreastCancerGeneScreen.org. The HBOC educational protocol was presented to 73 staff in 6 public health centers. Staff used the tool during the collection of medical history. Further family history assessments and testing for mutations in the BRCA1/2 genes were facilitated if appropriate.Results
Data was collected from November 2012 through December 2013, including 2,159 screened women. The majority of patients identified as black/African American and were 18–49 years old. Also, 6.0 % (n = 130) had positive screens, and 60.9 % (n = 67) of the 110 patients who agreed to be contacted provided a detailed family history. A total of 47 patients (42.7 %) met National Comprehensive Cancer Network guidelines when family history was clarified. Fourteen (12.7 %) underwent genetic testing; 1 patient was positive for a BRCA2 mutation, and 1 patient was found to carry a variant of uncertain significance.Conclusions
The introduction of genomics practice within public health departments has provided access to comprehensive cancer care for uninsured individuals. The successful implementation of the B-RST into public health centers demonstrates the opportunity for integration of HBOC screening into primary care practices. 相似文献992.
EL Jones TW Wainwright JD Foster JRA Smith RG Middleton NK Francis 《Annals of the Royal College of Surgeons of England》2014,96(2):89-94
Introduction
Orthopaedic enhanced recovery after surgery (ERAS) providers are encouraged to estimate the actual benefit of ERAS according to the patient’s opinion by using patient generated data alongside traditional measures such as length of stay. The aim of this paper was to systemically review the literature on the use of patient generated information in orthopaedic ERAS across the whole perioperative pathway.Methods
Publications were identified using Embase™, MEDLINE®, AMED, CINAHL® (Cumulative Index to Nursing and Allied Health Literature), the Cochrane Library and the British Nursing Index. Search terms related to experiences, acceptance, satisfaction or perception of ERAS and quality of life (QoL).Findings
Of the 596 abstracts found, 8 papers were identified that met the inclusion criteria. A total of 2,208 patients undergoing elective hip and knee arthroplasty were included. Patient satisfaction was reported in 6 papers. Scores were high in all patients and not adversely affected by length of stay. QoL was reported in 2 papers and showed that QoL scores continued to increase up to 12 months following ERAS. Qualitative methods were used in one study, which highlighted problems with support following discharge. There is a paucity of data reporting on patient experience in orthopaedic ERAS. However, ERAS does not compromise patient satisfaction or QoL after elective hip or knee surgery. The measurement of patient experience should be standardised with further research. 相似文献993.
994.
Phillip M. Cox Esq. II Jan Rebstock RHIT LHRM CPHRM Randall C. Jenkins Esq. Marvin A. Dewar MD JD Laura Gruber MBA MHS 《Journal of healthcare risk management》2014,33(3):34-42
The financial success of a malpractice insurance program is directly influenced by how effectively the covered providers respond to risk. This article describes a University Self‐Insurance Program partnership to provide small grants to providers who have the expertise and passion for a specific risk reduction activity that is cost effective and measurable and has a high probability of improving patient care and reducing claims or lawsuits. Implementation of this small grant concept can be tailored to become operational in virtually any setting from an independent medical practice to a multistate healthcare system. 相似文献
995.
Shailaja Menon PhD MPH Hardeep Singh MD MPH Ashley N. D. Meyer PhD Elisabeth Belmont JD Dean F. Sittig PhD 《Journal of healthcare risk management》2014,34(1):14-26
Federal electronic health record (EHR)–related initiatives are leading to rapid increases in their adoption. Despite their benefits, EHRs also introduce new risks that can lead to serious safety events. We conducted a Web‐based survey of the American Society for Healthcare Risk Management and the American Health Lawyers Association to elicit perceptions regarding the frequency and types of EHR‐related serious safety events. We received 369 responses. The majority (66%) worked for large hospitals and health systems with varying degrees of EHR adoption. More than half (53%) of respondents reported at least one EHR‐related serious safety event in the previous 5 years, and 10% reported more than 20 events. EHR workflow (63%), user familiarity with the EHR system (63%), and integration with existing systems (59%) were most frequently endorsed as variables associated with EHR‐related serious safety events. Because EHR‐related safety concerns are underreported, organizations should consider implementing robust measures of EHR safety within their institution as a key step for mitigating these concerns. 相似文献
996.
997.
Zhong Cordelia Freeman Rain E. Boggs Krislyn M. Zachrison Kori S. Gao Jingya Espinola Janice A. Camargo Carlos A. 《The Psychiatric quarterly》2021,92(3):1109-1127
Psychiatric Quarterly - Telepsychiatry has made psychiatric care more accessible to emergency department (ED) patients. To date, most telepsychiatry studies have focused on specific populations or... 相似文献
998.
999.
1000.
Gregg M. Stave MD MPH JD Joseph J. Mignogna MD Gwendolyn S. Powell MD MPH Christine M. Hunt MD 《American journal of preventive medicine》1999,16(4):224-306
Hemochromatosis is a common inherited disorder of iron metabolism with significant health consequences for the employed population. Although screening for hemochromatosis has been recommended, workplace screening programs remain uncommon. In the first year of a newly initiated corporate screening program, 1968 employees were tested. The screening algorithm included measurement of serum iron and transferrin and subsequent ferritin levels in those employees with elevated iron/transferrin ratios. Thirteen percent of men and 21% of women had elevated iron/transferrin ratios. Of these, 14 men and 2 women had elevated ferritin levels. Of these 16, three had liver biopsies and all three have hemochromatosis. The cost of the screening program was $27,850. The cost per diagnosis was $9283 and the cost per year of life saved was $928. These costs compare very favorably with other common workplace screening programs. Several barriers to obtaining definitive diagnoses on all patients with a positive screening result were identified; strategies to overcome these barriers would further enhance the cost effectiveness of the program. We conclude that workplace hemochromatosis screening is highly cost effective and should be incorporated into health promotion/disease prevention programs. 相似文献