6 research outputs found
The Learning Healthcare System: How an Adult Education Lens Can Be Used to Inform a Paradigm Shift in US Healthcare Landscape
Adult education researchers and practitioners have an unprecedented opportunity to inform and learn with the health care system as it embraces learning as a process to provide the best care at lower cost
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Validation of a brief scale to assess ambulatory patients' perceptions of reading visit notes: a scale development study
Study 1 resulted in the selection of a 10-point importance response option format over a 4-point agreement scale. Exploratory factor analysis (EFA) in study 2 resulted in two-factor solution: a four-item benefits factor with good reliability (alpha=0.83) and a three-item risks factor with poor reliability (alpha=0.52). The factor structure was confirmed in study 3, and confirmatory factor analysis of benefit items resulted in an excellent fitting model, X2(2)=2.949; confirmatory factor index=0.998; root mean square error of approximation=0.04 (0.00, 0.142); loadings 0.68-0.86; alpha=0.88. Study 4 supported configural, measurement and structural invariance for the benefits scale across high and low-education patient groups.Open access journalThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]
Medically Complex Pediatric Patient Care Model: Coordinated Team-Based Care With Supporting Health Information Technology to Implement Best Practices and Address Care Gaps of Transitioning Age Patients and Family Caregivers
Background/Aims: Medically complex pediatric patients have multiple severe chronic conditions consuming disproportionate health care resources. The top 1% of Geisinger’s pediatric population uses health care representing 20% of total costs. Nationally, their needs are largely underserved by current delivery systems as they involve multiple specialists and settings, are challenging to coordinate, and place a tremendous burden on family caregivers. Providing effective care for children with special health care needs (CSHCN) requires a system that is integrated, comprehensive, coordinated and family-centered to foster positive experiences between families and providers. Advancing integrated systems of care for CSHCN and their families is a national priority and reflected in the Healthy People goals. Geisinger has developed a new innovative approach to CSHCN starting with ages 15 and over: the Medically Complex Pediatric Patient (MCPP) care model. Its objective is to address patient and family caregiver needs along with drivers of poor quality and unnecessarily high costs of care. This approach includes: (1) a comprehensive care clinic with an enhanced professional care team to provide and coordinate health care supported by (2) care bundles for reliable delivery of best practices and (3) advanced health information technology using Geisinger’s patient portal and Web-based applications to efficiently document and facilitate timely care, planning, management and coordination and promote good communication between families and providers.
Methods: Development and implementation of the MCPP care model and an evaluation plan are occurring simultaneously. The evaluation plan begins with newly developed patient and family caregiver assessment questionnaires administered to all eligible families to collect baseline and postimplementation measures, with questions corresponding to multiple nationally validated surveys (National Survey of CSHCN, GAD-7, PHQ-9, Caregiver Strain Index).
Results: Survey results of approximately 300 families will establish intensity of caregiving needs, caregiver challenges and ability to meet needs effectively, service quality and gaps consistent with national measures including CSHCN core outcomes that facilitate integrated systems of care for CSHCN such as care coordination, partners in decision-making, and medical home to assess preimplementation gaps and postimplementation performance.
Discussion: Baseline results will be used to inform MCPP care model implementation and to assess its progress and performance over time consistent with national priorities