Nurse Practitioner−led Intensive Outpatient Team: Effects on End-of-life Care

Hummel, D; Hill, Constance D.; Shaw, Jonathan G.; Slightam, Cindie; Asch, Steven M.; Zulman, Donna M.

doi:10.1016/j.nurpra.2017.01.007

Cited by 9 publications

(22 citation statements)

References 6 publications

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“…The PIM Demonstration Program has been described previously. 19,23 Building on effective intensive outpatient interventions such as GRACE, 13 a VA Intensive Management PACT (ImPACT) pilot, 14,15,24,25 and lessons learned from other early programs, 4,5,7 the five PIM programs incorporated features such as regular interdisciplinary team meetings, medication management, home visits, mental health/substance use assessment and support, health coaching, and intensive social work case management. In addition, the teams engaged in a number of specific activities to coordinate care within VA and across VA and other settings (Table 1).…”

Section: Methodsmentioning

confidence: 99%

“…13 In a pilot Veterans Affairs (VA) intensive primary care program, enrollment was associated with significantly more visits with an assigned primary care physician, higher rates of advance directive completion, and higher rates of hospice referral near end of life. 14,15 Fewer studies have examined the impact of intensive primary care on patient experience. A recent evaluation of Comprehensive Primary Care among fee-for-service Medicare beneficiaries found that there was no appreciable improvement in beneficiary experience compared to individuals in matched practices.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Intensive Primary Care on High-Need Patient Experiences: Survey Findings from a Veterans Affairs Randomized Quality Improvement Trial

et al. 2019

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of Intensive Primary Care on High-Need Patient Experiences: Survey Findings from a Veterans Affairs Randomized Quality Improvement Trial

et al. 2019

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“…Literature is emerging on this topic. Taking into account that high risk patients have complex medical and psychosocial needs; the Veterans Affair health care system in Palo Alto, California instituted an intensive nurse practitioner led program for patients in need of end of life care [48]. It was found that patients who took part in the program had higher rates of hospice referrals (74%) as compared to patients enrolled in primary care (44%) P = (.025); [48].…”

Section: Discussionmentioning

confidence: 99%

The Solitary Thoracic Schwannoma of the Intercostal Nerve: A Case Operated

2019

JCRC

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One of the most daunting challenges faced in the health care delivery system is the complexity of cancer care, and the process of care coordination, a subcomponent of patient navigation. A study was undertaken to identify a central navigation process utilized by nurse practitioners practicing oncology. The data in this article is a component of a larger study entitled: The Process of Oncology Nurse Practitioner Patient Navigation: A Grounded Theory Approach. Utilizing a grounded theory approach N = 20 oncology nurse practitioners (ONP) were recruited. To be eligible for the study the ONP had to have a: 1) license to practice in their respective state; 2) certification to practice as an oncology nurse; 3) minimum of 5 years full time experience in oncology nursing; and 4) English speaking. The participants were recruited by: 1) word of mouth networking with peers: 2) Soliciting volunteers through public announcements at professional nursing conferences; 3) Contacting authors of oncology NP navigation articles or convention pamphlets via telephone or e-mail; 4) Posting information soliciting oncology NP volunteers on blogs or websites of professional organizations with organizational director approval; and, 5) Recruiting by snowball sampling. Telephone interviews were conducted utilizing an open-ended questionnaire. Data analysis and coding revealed the central navigation processes. The triage process was carried out in a variety of unique settings, and utilized in some instances within navigation subsystems. Key triage paths were identified along the cancer continuum; documenting the need for ONP navigators to strategically place these systems in areas along the cancer continuum, to expedite timely delivery of patient care. Literature search revealed that cancer specific triage tools are lacking. Implications for research and practice include the development of these tools for cancer care. Of critical importance is the need to identify service gaps in cancer care, and strategically place triage systems, to offset these service gaps. Practical application of the research findings in relationship to current literature is integrated for discussion.

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“…Previous evaluations 1,19,20 describe the ImPACT intervention in further detail, and Online Appendix Box 1 provides additional information regarding the intervention's core elements.…”

Section: Intervention and Patient Populationmentioning

confidence: 99%

“…Previous evaluations found that, at 16 months, the program was cost-neutral with positive effects on patient experience, continuity and access, and end-of-life care. 1,19,20 Based on literature describing characteristics common among high-need patients, 21 we anticipated that lower level of multimorbidity (e.g., no MH diagnosis, fewer chronic medical conditions) and less social isolation and social needs (e.g., living with others, no history of homelessness, health insured) would be associated with goal progress.…”

Section: Introductionmentioning

confidence: 99%