Association between care delivery interventions to enhance access and patients' perceived access in the Comprehensive Primary Care Initiative

Lin, Michelle; MacDonald, Lisa-Qiao; Jin, Julia; Reddy, Ashok

doi:10.1016/j.hjdsi.2020.100412

Cited by 3 publications

(1 citation statement)

References 9 publications

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“…Mount Sinai Hospital (MSH) is an academic teaching hospital in NYC. The Respectful and Equitable Access to Comprehensive Healthcare (REACH) Program, located at MSH, is a primary care program for PWUD that offers office-based buprenorphine treatment, harm reduction counseling, hepatitis C virus treatment, and integrated behavioral health services 13 . REACH is also a New York State Opioid Overdose Prevention Program and provides free take-home naloxone kits.…”

Section: Methodsmentioning

confidence: 99%

A Medical Student-Led Model for Telephone-Based Opioid Overdose Education and Naloxone Distribution during the COVID-19 Pandemic

et al. 2022

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Background: The co-occurrence of the COVID-19 pandemic and opioid epidemic has increased the risk of overdose and death for patients with opioid use disorder (OUD). COVID-19 has also exacerbated already limited access to opioid overdose education and naloxone distribution (OEND). In this context, we aim to increase access to OEND for patients at risk for opioid overdose. Methods: Medical student volunteers were trained to conduct telephone-based OEND, and subsequently contacted all patients at a NYC primary care clinic for people who use drugs as well as those presenting to the hospital with OUD or a history of opioid overdose. Interested patients who completed the training received naloxone kits via mail or at hospital discharge. Results: OEND provision was converted to a remote-only model from May to June 2020. During this time, eight pre-clinical medical students called a total of 503 high-risk patients. Of these patients, 165 were reached, with 90 (55%) accepting telephone-based OEND. Comparing across populations, 51% of primary care patients versus 76% of ED/hospitalized patients accepted opioid overdose education. Eighty-four total patients received naloxone. Conclusions: We have outlined a scalable, adaptable model by which clinics and hospitals with affiliated medical schools can provide OEND by telephone. Medical student-driven, telephone-based OEND efforts can effectively reach at-risk patients and increase naloxone access.

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Section: Methodsmentioning

confidence: 99%

A Medical Student-Led Model for Telephone-Based Opioid Overdose Education and Naloxone Distribution during the COVID-19 Pandemic

et al. 2022

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Associations of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician and Group Survey Scores with Interventions and Site, Provider, and Patient Factors: A Systematic Review of the Evidence

Quigley,

Elliott,

Qureshi

et al. 2024

Journal of Patient Experience

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Patient experience is a key aspect of care quality. Since the 2007 release of the Consumer Assessment of Healthcare Providers and Systems Clinician and Group (CG-CAHPS) survey, no systematic review of factors associated with CG-CAHPS scores has been reported. We reviewed 52 peer-reviewed English language articles published in the United States using CG-CAHPS data. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and used the Checklist for Analytical Cross-Sectional Studies. We identified several interventions (eg, adding a care coordinator focused on chronic care management) associated with improved overall provider rating and 2 interventions (eg, peer shadow coaching) that improved provider communication scores. Studies evaluating the implementation of patient-centered medical homes or patient-reported outcomes found mixed results. We identified site-level factors (eg, better team communication) and provider-level factors (eg, physician empathy) associated with better patient experience. In contrast, patient-level factors (eg, medication adherence) found mixed associations with patient experience. Policymakers, clinicians, and healthcare leaders can leverage this evidence for quality improvement efforts and interventions supporting patient-centered care.

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Airway, breathing, cellphone: a new vital sign?

Garcia,

Jacobson,

Moore

et al. 2024

Int J Emerg Med

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Introduction In emergency medicine, triage encompasses more than the initial prioritization of treatment; it also includes decisions about the most suitable level of care and disposition for each patient. However, the increasing use of mobile technology by patients in the emergency department (ED) introduces a new factor. This study aims to explore the relationship between patients' cellphone use at the time of initial assessment and final disposition in the ED.Methods A prospective, cross-sectional study was conducted on 292 patients who presented to the ED between 9/1/2021 and 8/9/2022. Patients were stratified into two cohorts based on their behavior during the initial assessment: actively using a cell phone (n = 32) or not using a cell phone (n = 259). Final disposition was dichotomously recorded as admission or discharge. Hospital admission, hospital observation, and admission to the ED observation unit were consolidated into the combined category of admission. ResultsPatients not actively using their cell phone on initial assessment exhibited a discharge rate of 64%, while those engaged with their cellphones displayed notably higher dismissal rates at 94%. The calculated odds ratio (OR) of 8.4 (95% confidence interval: 1.96-36.0, p = 0.004) underscores a significantly heightened likelihood of dismissal among individuals actively using their cellphones, suggesting a potential association between cellphone use and a reduced probability of hospital admission. ConclusionThe study suggests an association between cellphone use during initial ED assessment and higher discharge rates. While this introduces a novel concept, the study's potential contribution to more informed and efficient triage decisions warrants careful consideration in future research and clinical applications.

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Association between care delivery interventions to enhance access and patients' perceived access in the Comprehensive Primary Care Initiative

Cited by 3 publications

References 9 publications

A Medical Student-Led Model for Telephone-Based Opioid Overdose Education and Naloxone Distribution during the COVID-19 Pandemic

A Medical Student-Led Model for Telephone-Based Opioid Overdose Education and Naloxone Distribution during the COVID-19 Pandemic

Associations of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician and Group Survey Scores with Interventions and Site, Provider, and Patient Factors: A Systematic Review of the Evidence

Airway, breathing, cellphone: a new vital sign?

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