A Multidisciplinary Approach to Impact Acute Care Utilization in Sickle Cell Disease

Powell, Rhea E.; Lovett, Paris B; Crawford, Albert; McAna, John; Axelrod, David; Ward, Lawrence; Pulte, Dianne

doi:10.1177/1062860617707262

Cited by 16 publications

(12 citation statements)

References 21 publications

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“…Interprofessional collaboration has been shown to improve patient care in studies, including randomized controlled trials, comparing populations receiving multidisciplinary care interventions versus the standard of care. [1][2][3][4] Improved patient outcomes range from decreased readmissions for heart failure 1 to improved quality of life satisfaction in older adults. 2…”

Section: Introductionmentioning

confidence: 99%

Interprofessional Education Without Limits: A Video-Based Workshop

et al. 2021

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Introduction: Interprofessional collaboration improves patient outcomes. Many institutions lack access to learners from other health care professions, limiting the feasibility of many published interprofessional curricula. We created a video-based workshop to fill the need for an introductory interactive interprofessional activity for third-year medical students (MS 3) in their internal medicine clerkship, in which other health care students and standardized patients were not readily accessible. Methods: This session introduced medical students to the interprofessional model of care through a video workshop. Learners engaged in reflective observation as a video presented a physician interviewing a patient. The training and roles of interprofessional providers were discussed with the aid of video demonstrations. Learners completed postworkshop and postmedicine clerkship surveys with responses indicated using a Likert scale (1 = strongly disagree, 5 = strongly agree). Results: Sixty-seven MS 3s participated in this workshop; postworkshop survey response rate was 82%. Of students who responded to the surveys, 87% agreed that the video increased their understanding of when it would be beneficial to consult interprofessional team members. Students' confidence in interacting with interprofessional team members improved from a mean of 3.0 before the workshop to 3.7 after the workshop. At the end of the medicine clerkship, 71% indicated that the video improved their ability to work with interprofessional team members at least moderately. Discussion: This video-based workshop improved students' self-rated understanding of interprofessional team members' roles and increased their confidence interacting with other members of the interprofessional health care team.

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Section: Introductionmentioning

confidence: 99%

Interprofessional Education Without Limits: A Video-Based Workshop

et al. 2021

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“…Providers from several institutions have reported successful initiatives to reduce high utilization. Many of these focus upon PLOS ONE creation of a day hospital or infusion center for the administration of parenteral opioids, as well as other treatments, outside of the ED or an inpatient unit [44,[50][51][52][53][54]. This approach generally has reduced ED visits, hospital days, and associated costs, and presumably decreased patient inconvenience and increased patient satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Utilization, financial outcomes and stakeholder perspectives of a re-organized adult sickle cell program

et al. 2020

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In 2011 Yale New Haven Hospital, in response to high utilization of acute care services and widespread patient and health care personnel dissatisfaction, set out to improve its care of adults living with sickle cell disease. Reorganization components included recruitment of additional personnel; relocating inpatients to a single nursing unit; reducing the number of involved providers; personalized care plans for pain management; setting limits upon access to parenteral opioids; and an emphasis upon clinic visits focused upon home management of pain as well as specialty and primary care. Outcomes included dramatic reductions in inpatient days (79%), emergency department visits (63%), and hospitalizations (53%); an increase in outpatient visits (31%); and a decrease in costs (49%). Providers and nurses viewed the reorganization and outcomes positively. Most patients reported improvements in pain control and life style; many patients thought the reorganization process was unfair. Their primary complaint was a lack of shared decision-making. We attribute the contrast in these perspectives to the inherent difficulties of managing recurrent acute and chronic pain with opioids, especially within the context of the imbalance in wellness, power, and privilege between persons living with sickle cell disease, predominantly persons of color and poor socioeconomic status, and health care organizations and their personnel.

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“…The effectiveness of this model in SCD and non-SCD pain conditions has been demonstrated previously. 42,43…”

Section: Psychosocial Aspects Of Scd Painmentioning

confidence: 99%

Key Components of Pain Management for Children and Adults with Sickle Cell Disease

Brandow

DeBaun

2018

Hematology/Oncology Clinics of North America

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Sickle cell disease pain manifests as severe acute pain episodes and a debilitating chronic pain syndrome. Acute pain episodes are the most common reason for health care use; however, acute pain episodes are also frequently managed at home. Chronic pain syndrome develops in 30% to 40% of individuals with sickle cell disease, with an increasing incidence and severity with age. We review the critical aspects of pain management that are integral to the comprehensive approach to sickle cell disease pain and are rooted in the biopsychosocial model. The review focuses on opioid pharmacology and psychosocial comorbidities.

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A Multidisciplinary Approach to Impact Acute Care Utilization in Sickle Cell Disease

Cited by 16 publications

References 21 publications

Interprofessional Education Without Limits: A Video-Based Workshop

Interprofessional Education Without Limits: A Video-Based Workshop

Utilization, financial outcomes and stakeholder perspectives of a re-organized adult sickle cell program

Key Components of Pain Management for Children and Adults with Sickle Cell Disease

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