Redefining the Team in Team-Based Care

Kansagra, Susan M.; Herndon, Sally; Kimple, Kelly S.; Thomas, Cathy; Tomlinson, Sarah; Moore, Zack; Shehee, Mina; Tyson, Marshall; Lucas, Tara; Joyner, Dennis R.

doi:10.18043/ncm.79.4.235

Cited by 5 publications

(6 citation statements)

References 2 publications

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“…An example of such an expansion is North Carolina’s Pregnancy Care Management Program, which pairs low-income women who have medical needs with a social worker or nurse care manager to help address factors that affect low birth weight and preterm birth (24). The care managers communicate with providers to support the medical plan, inform providers about social conditions (eg, lack of stable housing, food insufficiency, intimate partner violence) that may jeopardize care and work to help resolve these social conditions.…”

Section: Resultsmentioning

confidence: 99%

Collaboration Between Maternal and Child Health and Chronic Disease Epidemiologists to Identify Strategies to Reduce Hypertension-Related Severe Maternal Morbidity

et al. 2019

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IntroductionMaternal and child health (MCH) and chronic disease programs at state health agencies may not routinely collaborate. The objective of this study was to describe a project that enhanced relationships between MCH and chronic disease epidemiologists at the Florida Department of Health, increased epidemiologic capacity, and informed both programs.MethodsWe collaborated to assess hypertension-related severe maternal morbidity (H-SMM) and hypertensive disorders (preexisting hypertension, gestational hypertension, and preeclampsia) among women at delivery of their live birth to help determine the burden on health care systems in Florida. We identified ways to improve the health of women before they conceive and to help them manage any chronic diseases during the perinatal period.ResultsWe found differences by maternal characteristics in H-SMM rates among 979,660 women who delivered live births. We proposed strategies to support collaboration between state MCH and chronic disease staff. First, increase the screening, monitoring, and management of hypertension before, during, and after pregnancy. Second, examine H-SMM concurrently with maternal mortality to help find prevention strategies. Third, include reproductive-aged women in ongoing hypertension prevention and intervention efforts. Fourth, expand team-based care to include obstetricians, midwives, and doulas who can work together with primary care providers for hypertension management. And fifth, create and share data products that guide various groups about hypertension and related risk factors among reproductive-aged women.ConclusionThe collaboration between the Florida Department of Health MCH and chronic disease epidemiologists produced 1) a program-relevant indicator, H-SMM and 2) strategies for enhancing program and clinical activities, communication, and surveillance to reduce H-SMM rates.

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Section: Resultsmentioning

confidence: 99%

Collaboration Between Maternal and Child Health and Chronic Disease Epidemiologists to Identify Strategies to Reduce Hypertension-Related Severe Maternal Morbidity

et al. 2019

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“…43 More than 60 years later, LHDs continue to be critical to southern prevention efforts. 44,45 Ninety-eight of 100 North Carolina counties fund disease prevention. 9 Indicative of gaps in North Carolina LHD resources, a 2018 study 41 found that only 4% of responding LHDs prescribed preexposure prophylaxis (PrEP); just 13% of LHDs refer for PrEP.…”

Section: Lhdsmentioning

confidence: 99%

Hepatitis C and HIV Screening, Testing, and Risk Perceptions among South-Central Appalachian County Health Department Staff

Harless¹,

Lugo²,

Ostrach³

2022

Southern Medical Journal

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Objectives: Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are significant public health concerns, especially given the risks for disease interactions. Rates of HCV and HIV are increasing, especially in rural areas. Local health departments (LHDs) play an important role in rural health care, offering screening, testing, and treatment for HCV and HIV. Gaps persist in LHD resources for meeting these demands, especially in Appalachia and the US South.Methods: To explore HCV/HIV screening, testing, and treatment approaches and perspectives in south-central Appalachian North Carolina, structured telephone questionnaires were administered to communicable disease nurses and other health department staff directly involved in screening and testing. Mixed-methods data analyses were conducted and triangulated with stakeholders.Results: Eighteen participants representing 19 counties completed the questionnaire, achieving a saturation sample. Participants reported barriers to screening and testing, including housing insecurity, lack of transportation and insurance, unemployment, and the isolation of living in a rural area. Divergence in perceptions of barriers between public health regions emerged, as did perceptions of who is at risk and use of stigmatizing language about people at risk for HCV/HIV.Conclusions: This study highlights the impact of LHD behaviors and perceptions on screening and testing, and offers recommendations to improve HCV/HIV screening and testing accessibility in south-central Appalachia, a high-risk region.

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“…This learning collaborative illustrates how public health efforts are necessary to help prevent and control chronic disease by supporting interventions that focus on clinical outcomes associated with CVD. Although clinical outcomes are challenging to attribute to a population health program, in part because of a lack of a comparison group, quality improvement programs have shown substantial improvements in management and control of chronic diseases when public health and clinical care services are integrated (10,13). However, implementing large program-based initiatives typically takes time, is contingent on both public and private partnerships, and requires multiple resources for implementation and evaluation.…”

Section: Implications For Public Health Practicementioning

confidence: 99%

A Public Health Framework to Improve Population Health Through Health Care and Community Clinical Linkages: The ASTHO/CDC Heart Disease and Stroke Prevention Learning Collaborative

et al. 2019

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Thirty-one state and territorial public health agencies participated in a learning collaborative to improve diagnosis and management of hypertension in clinical and community settings. These health agencies implemented public health and clinical interventions in medical settings and health organizations using a logic model and rapid quality improvement process focused on a framework of 4 systems-change levers: 1) data-driven action, 2) clinical practice standardization, 3) clinical–community linkages, and 4) financing and policy. We provide examples of how public health agencies applied the systems-change framework in all 4 areas to assess and modify population-based interventions to improve control of hypertension. This learning collaborative approach illustrates the importance of public health in the prevention and control of chronic disease by supporting interventions that address community and clinical linkages to address medical risk factors associated with cardiovascular disease.

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Redefining the Team in Team-Based Care

Cited by 5 publications

References 2 publications

Collaboration Between Maternal and Child Health and Chronic Disease Epidemiologists to Identify Strategies to Reduce Hypertension-Related Severe Maternal Morbidity

Collaboration Between Maternal and Child Health and Chronic Disease Epidemiologists to Identify Strategies to Reduce Hypertension-Related Severe Maternal Morbidity

Hepatitis C and HIV Screening, Testing, and Risk Perceptions among South-Central Appalachian County Health Department Staff

A Public Health Framework to Improve Population Health Through Health Care and Community Clinical Linkages: The ASTHO/CDC Heart Disease and Stroke Prevention Learning Collaborative

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