排序方式: 共有12条查询结果,搜索用时 421 毫秒
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W.E. Rosa PhD MBE NP-BC FAANP FAAN M. Fitzgerald FNP-BC NP-C DNP FAANP CSP FAAN DCC FNAP S. Davis ANP-BC DNP FAAN J.E. Farley ANP-BC PhD MPH FAAN J. Khanyola RCHN MSc J. Kwong AGPCNP-BC DNP MPH FAANP FAAN P.J. Moreland RN PhD CPNP FAAN M. Rogers RGN PhD B. Sibanda RN ANP MSc S. Turale RN DEd FACN FACMHN 《International nursing review》2020,67(4):554-559
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Siran M. Koroukian PhD Guangjin Zhou PhD Suparna M. Navale MS MPH Nicholas K. Schiltz PhD Uriel Kim PhD Johnie Rose MD PhD Gregory S. Cooper MD MA Scott Emory Moore PhD APRN AGPCNP-BC Laura J. Mintz MD PhD Ann K. Avery MD Sudipto Mukherjee MD PhD MPH Sarah C. Markt ScD MPH 《Cancer》2022,128(10):1987-1995
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Anne M. Pohnert MSN RN FNP-BC Nicholas K. Schiltz PhD Lilia Pino PhD RN FNP-C Sarah Ball MSN RN APRN Evelyn G. Duffy DNP AGPCNP-BC FAANP Mary E. McCormack MSN MPH RN APNC Brant Oliver PhD MS MPH FNP-BC PMHNP-BC Angela Patterson DNP FNP-BC NEA-BC FAANP Leslie Pelton MPA Mary A. Dolansky PhD RN FAAN 《Health services research》2023,58(Z1):89-99
Objective
To describe the implementation of the age-friendly health systems (AFHS) 4Ms Framework, an evidence-based framework to assess and act on “What Matters, Medication, Mentation and Mobility to deliver Age-Friendly health care for patients 65 and older”, to achieve the Institute for Health care Improvement (IHI) Committed to Care Excellence recognition in a convenient care health system and test two novel implementation strategies.Setting
The study was conducted in over 1100 convenient care clinics in 35 states and DC. MinuteClinics are located in community-based retail pharmacies in rural, suburban, and urban areas and staffed with approximately 3300 nurse practitioners and physician associates.Design
In Year 1, the project used a quality improvement design, and in Year 2, a quasi-experimental implementation research design to pilot two strategies at the provider level (Virtual Clinic and Plan-Do-Study-Act (PDSA)). Statistical process control charts were used to assess changes in 4Ms documentation over time. Mixed-effects Poisson regression was used to assess the effectiveness of the pilot studies.Data Collection
The electronic health record (EHR) was enhanced to capture documentation of the AFHS 4Ms assessments and actions. A learning platform was created to teach and evaluate provider 4Ms competency, and the two data sources were merged into a registry. A formative evaluation was conducted using Tableau and reporting dashboards.Findings
After 18 months and the implementation of 20 strategies to improve the uptake of the 4Ms, MinuteClinic achieved the IHI Committed to Care Excellence recognition. A significant increase over time in the reliable delivery of all 4Ms and each M component individually was found. For the research, there were significant improvements in the mean number of Ms delivered per visit (M-Score) in the Virtual Clinic (Incident Rate Ratio [IRR]: 2.47, p = 0.001) and PDSA (IRR: 3.08, p = 0.002) strategy intervention groups when compared to controls.Conclusions
Application of quality improvement and implementation methodologies contributed to the success of implementing age-friendly 4Ms evidence-based practice. 相似文献9.
Timothy W. Farrell MD AGSF Tiffany A. Volden MD Jorie M. Butler PhD G. Paul Eleazer MD Randall W. Rupper MD MPH Katharina V. Echt PhD Marianne Shaughnessy PhD AGPCNP-BC GS-C Mark A. Supiano MD AGSF 《Journal of the American Geriatrics Society》2023,71(1):18-25
The Veterans Health Administration (VHA) has long recognized the need for age-friendly care. VHA leadership anticipated the impact of aging World War II veterans on VA healthcare systems and in 1975 developed Geriatric Research, Education, and Clinical Centers (GRECCs) to meet this need. GRECCs catalyzed a series of innovations in geriatric models of care that span the continuum of care, most of which endure. These innovative care models also contributed to the evidence base supporting the present-day Age-Friendly Health Systems movement, with which VHA is inherently aligned. As both a provider of and payor for care, VHA is strongly incentivized to promote coordination across the continuum of care, with resultant cost savings. VHA is also a major contributor to developing the workforce that is essential for the provision of age-friendly care. As VHA continues to develop and refine innovative geriatric models of care, policymakers and non-VHA health care systems should look to VHA programs as exemplars for the development and implementation of age-friendly care. 相似文献