Bridging the Gap: Improving Hospital Discharge through Utilization of a Priority Care Clinic

Abstract Background: Poorly coordinated care often results in poor health outcomes. Best practices in academic literature recommend effective programs that consist of comprehensive discharge planning, complete and timely communication of information, medication reconciliation, patient and caregiver education using the teach-back method, open communication among providers, and prompt follow-up visits with an outpatient provider after discharge. Using a priority care clinic (PCC) for follow-up is one approach to decrease hospital readmissions. Purpose: To implement an evidence-based program utilizing a PCC to facilitate post-discharge transition-in-care and reduce hospital readmissions. Evidence-based Intervention: A PCC assists patients in their transition of care from the hospital to home. Delays in follow-up appointments and lapse in medication adherence may occur between hospital discharge and the first follow-up visit, thus resulting in unnecessary hospital readmissions. Evaluation/Results: Data will be retrospectively collected and reviewed from patients’ charts to assess for compliance with (a) follow-up visit appointment, (b) medication adherence, and (c) readmission rates using a nurse practitioner-led a follow-up phone call and comparing results to the national benchmark. Implication for Practice: PCCs are the necessary bridge to facilitate increased compliance with prompt follow-up visits and medication reconciliation to ensure adherence. Conclusion: Implementation of a PCC addresses the need for reducing avoidable readmissions and complying with reimbursement standards required by the Centers for Medicare and Medicaid Services while meeting the best practice needs for patients

Health Care Reform in Virginia: Lessons Learned before, during, and after the 2011 Virginia General Assembly

This article surveys Virginia\u27s initial foray into health care reform. This process began with the Virginia Health Reform Initiative, which had a significant presence in the Virginia 2011 General Assembly session. While the nascent health care reform efforts this session reflect only incremental steps, they are indicative of Virginia\u27s direction and commitment to change. Such change, however, will carry great political and professional strife. This article highlights some examples of the challenges faced on the road to health care reform and discusses possible directions of future legislation in the Virginia General Assembly

Health Care Reform in Virginia: Lessons Learned before, during, and after the 2011 Virginia General Assembly

This article surveys Virginia\u27s initial foray into health care reform. This process began with the Virginia Health Reform Initiative, which had a significant presence in the Virginia 2011 General Assembly session. While the nascent health care reform efforts this session reflect only incremental steps, they are indicative of Virginia\u27s direction and commitment to change. Such change, however, will carry great political and professional strife. This article highlights some examples of the challenges faced on the road to health care reform and discusses possible directions of future legislation in the Virginia General Assembly

Training Model for Incorporating Interactive Whiteboards Into the K-12 Classroom

School divisions have been implementing interactive whiteboards, as well as other instructional technologies, in ever-increasing numbers with the intent to improve student performance. The benefits of these technologies have been hotly debated, with some researchers claiming that interactive whiteboards improve student achievement, while others claim that the technologies have no effect on student progress. Other researchers concluded that interactive whiteboards are tools which can improve student achievement only if they are used effectively. Research has further suggested that teachers need high quality professional development that incorporates both formal and informal elements to assist teachers incorporate interactive whiteboards into the K-12 classroom. The purpose of this study was to develop a model for providing effective professional development for teachers for incorporating interactive whiteboards, into the K-12 classroom. Three research objectives guided this study: (1) identify best practices for providing teacher professional development that incorporates formal training, (2) identify best practices for providing teacher professional development that incorporates informal training, and (3) integrate best practices for professional development into a model for incorporating interactive whiteboards, into the -12 classroom. Data for this study were collected from a review of literature to identify best practices to create a draft model of professional development and from a survey of Virginia Society for Technology in Education members who serve as instructional technology resource teachers to refine the proposed model. Forty instructional technology resource teachers completed the survey. Closed form questions were analyzed using descriptive statistics. Open-form questions were analyzed and coded to identify themes. The findings of this study suggested that professional development for incorporating interactive whiteboards and other instructional technologies should be carefully planned prior to implementation and should utilize both formal and informal methods. Best practices dictated that professional development should be sustained, ongoing, hands-on, job-embedded, scaffolded, individualized, differentiated by technology skill level of participants, differentiated by subject/grade level, and evaluated routinely using a variety of methods. The study determined that the professional development should conform to theories of adult learning by providing choices and relevancy, include troubleshooting tips, foster awareness of the many features of the interactive whiteboards, go beyond technological fluency but also focus on pedagogy and lesson planning, be validated through portable credentials, have administrative buy-in, provide time for reflection and practice, reflect budget constraints, provide options to overcome barriers to engaging in professional development, and identify ways to motivate learners

Evaluating the relative influence of soil water potential, soil moisture, and vapor pressure deficit on semi-arid vegetation dynamics

Knowledge of vegetation’s response to soil water availability and atmospheric demand is critical to understanding the impact of climate change on semi-arid ecosystems. However, limited field-based research has been conducted to assess the relative importance of these drivers and previous research has simplified the assessment of soil water availability by relying on soil volumetric water content (VWC) as a primary control on plant growth, which, as opposed to soil water potential (Ψsoil), does not account for the effects of soil texture on plant available water. To address these gaps, we compared remotely sensed indicators of vegetation response to field based measurements of VWC (at 20 cm depth), relative humidity and temperature (used to calculate the vapor pressure deficit, VPD) and soil temperature from 52 sites in Montana. Soil samples were collected at each site and were used to generate continuous time series of soil water potential (Ψsoil). We utilized statistical analysis to assess the relationship of our biophysical metrics to satellite-derived estimates of vegetation health and vigor, including the Enhanced Vegetation Index (EVI), near-infrared reflectance vegetation index (NIRv), and solar-induced fluorescence (SIF). Results from this analysis suggest that Ψsoil is a better biophysical indicator that VWC for driving seasonal vegetation productivity in semi-arid regions, while VPD emerges as a secondary driver in the absence of Ψsoil limitations. Finally, anomalies in subsurface soil moisture were the dominant driver for explaining anomalies in vegetation response. These findings emphasize the importance of soil water potential as the first order control on vegetation water stress across semi-arid landscapes

The Diabetes Subgroup Baseline Characteristics of the Avoiding Cardiovascular Events Through Combination Therapy in Patients Living With Systolic Hypertension (ACCOMPLISH) Trial

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73240/1/j.1559-4572.2008.00023.x.pd