Thematische Bibliographien / PCMHE

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Auswahl der wissenschaftlichen Literatur zum Thema „PCMHE“

Autor: Grafiati

Veröffentlicht am 11. September 2023

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Zeitschriftenartikel zum Thema "PCMHE"

Surendran, Shilpa, Chuan De Foo, Chen Hee Tam, Elaine Qiao Ying Ho, David Bruce Matchar, Josip Car und Gerald Choon Huat Koh. „The Missed Opportunity of Patient-Centered Medical Homes to Thrive in an Asian Context“. International Journal of Environmental Research and Public Health 18, Nr. 4 (13.02.2021): 1817. http://dx.doi.org/10.3390/ijerph18041817.

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In recent years, there is growing interest internationally to implement patient-centered medical homes (PCMHs), and Singapore is no exception. However, studies understanding the influence of contextual policy factors on the implementation of PCMHs are limited. We conducted 10 semi-structured in-depth interviews with general practitioners working in seven out of the nine PCMHs. Audio recordings were transcribed and analyzed by two study team members in NVivo 12 Software using grounded theory techniques. Power dynamics between the stakeholders and lack of shared decision-making among them in selecting the locale of the PCMH and formulating the practice fee and pharmacy structure were the key factors which negatively affected the implementation of PCMHs on a larger scale. Over time, lack of funding to hire dedicated staff to transfer patients and misalignment of various stakeholders’ interest to other right-siting programs also resulted in low number of patients with chronic conditions and revenue. Countries seeking to implement a successful PCMH may benefit from building trust and relationship between stakeholders, engaging in shared decision-making, ongoing cost-efficiency efforts, and formulating a clear delineation of responsibilities between stakeholders. For a healthcare delivery model to succeed in the primary care landscape, policies should be developed keeping mind the realities of primary care practice.

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Gregg, Abbey, Li-Wu Chen, Jungyoon Kim, Hyo Jung Tak und Melissa Tibbits. „Patient-Centered Medical Home Measurement in School-Based Health Centers“. Journal of School Nursing 35, Nr. 3 (13.12.2017): 189–202. http://dx.doi.org/10.1177/1059840517746728.

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School-based health centers (SBHCs) have been suggested as potential medical homes, yet minimal attention has been paid to measuring their patient-centered medical home (PCMH) implementation. The purposes of this article were to (1) develop an index to measure PCMH attributes in SBHCs, (2) use the SBHC PCMH Index to compare PCMH capacity between PCMH certified and non-PCMH SBHCs, and (3) examine differences in index scores between SBHCs based in schools with and without adolescents. A total of six PCMH dimensions in the SBHC PCMH Index were identified through factor analysis. These dimensions were collapsed into two domains: care quality and comprehensive care. SBHCs recognized as PCMHs had higher scores on the index, both domains, and four dimensions. SBHCs based in schools with just young children and those with adolescents scored similarly on the overall index, but analysis of individual index items shows their strengths and weaknesses in PCMH implementation.

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Maeng, Daniel D., Thomas R. Graf, Duane E. Davis, Janet Tomcavage und Frederick J. Bloom. „Can a Patient-Centered Medical Home Lead to Better Patient Outcomes? The Quality Implications of Geisinger’s ProvenHealth Navigator“. American Journal of Medical Quality 27, Nr. 3 (18.08.2011): 210–16. http://dx.doi.org/10.1177/1062860611417421.

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One of the primary goals of the patient-centered medical home (PCMH) is to provide higher quality care that leads to better patient outcomes. Currently, there is only limited evidence regarding the ability of PCMHs to achieve this goal. This article demonstrates the effect of PCMHs in improving certain clinical outcomes, as shown by the ProvenHealth Navigator (PHN), an advanced PCMH model developed and implemented by Geisinger Health System. In this study, the authors examined the claims data from Geisinger Health Plan between 2005 and 2009 and estimated the effect of PHN on reducing amputation rates among patients with diabetes, end-stage renal disease, myocardial infarction, and stroke. The results show that, despite its relatively short period of existence, PHN has led to significant improvements in certain outcomes, further illustrating its potential as a care delivery model to be adopted on a wider scale.

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Angelotti, Marietta, Kathryn Bliss, Dana Schiffman, Erin Weaver, Laura Graham, Thomas Lemme, Veronica Pryor und Foster C. Gesten. „Transforming the Primary Care Training Clinic: New York State’s Hospital Medical Home Demonstration Pilot“. Journal of Graduate Medical Education 7, Nr. 2 (01.06.2015): 247–52. http://dx.doi.org/10.4300/jgme-d-14-00782.1.

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Abstract Background Training in patient-centered medical home (PCMH) settings may prepare new physicians to measure quality of care, manage the health of populations, work in teams, and include cost information in decision making. Transforming resident clinics to PCMHs requires funding for additional staff, electronic health records, training, and other resources not typically available to residency programs. Objective Describe how a 1115 Medicaid waiver was used to transform the majority of primary care training sites in New York State to the PCMH model and improve the quality of care provided. Methods The 2013–2014 Hospital Medical Home Program provided awards to 60 hospitals and 118 affiliated residency programs (training more than 5000 residents) to transform outpatient sites into PCMHs and provide high-quality, coordinated care. Site visits, coaching calls, resident surveys, data reporting, and feedback were used to promote and monitor change in resident continuity and quality of care. Descriptive analyses measured improvements in these areas. Results A total of 156 participating outpatient sites (100%) received PCMH recognition. All sites enhanced resident education using PCMH principles through patient empanelment, development of quality dashboards, and transforming resident scheduling and training. Clinical quality outcomes showed improvement across the demonstration, including better performance on colorectal and breast cancer screening rates (rate increases of 13%, P ≤ .001, and 11%, P = .011, respectively). Conclusions A 1115 Medicaid waiver is a viable mechanism for states to transform residency clinics to reflect new primary care models. The PCMH transformation of 156 sites led to improvements in resident continuity and clinical outcomes.

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Raphael, Jean L., und Suzette O. Oyeku. „Sickle cell disease pain management and the medical home“. Hematology 2013, Nr. 1 (06.12.2013): 433–38. http://dx.doi.org/10.1182/asheducation-2013.1.433.

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Abstract Pain is the most common cause for hospitalization and acute morbidity in sickle cell disease (SCD). The consequences of SCD-related pain are substantial, affecting both the individual and the health care system. The emergence of the patient-centered medical home (PCMH) provides new opportunities to align efforts to improve SCD management with innovative and potentially cost-effective models of patient-centered care. The Department of Health and Human Services has designated SCD as a priority area with emphasis on creating PCMHs for affected patients. The question for patients, clinicians, scientists, and policy-makers is how the PCMH can be designed to address pain, the hallmark feature of SCD. This article provides a framework of pain management within the PCMH model. We present an overview of pain and pain management in SCD, gaps in pain management, and current care models used by patients and discuss core PCMH concepts and multidisciplinary team–based PCMH care strategies for SCD pain management.

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Pain is the most common cause for hospitalization and acute morbidity in sickle cell disease (SCD). The consequences of SCD-related pain are substantial, affecting both the individual and the health care system. The emergence of the patient-centered medical home (PCMH) provides new opportunities to align efforts to improve SCD management with innovative and potentially cost-effective models of patient-centered care. The Department of Health and Human Services has designated SCD as a priority area with emphasis on creating PCMHs for affected patients. The question for patients, clinicians, scientists, and policy-makers is how the PCMH can be designed to address pain, the hallmark feature of SCD. This article provides a framework of pain management within the PCMH model. We present an overview of pain and pain management in SCD, gaps in pain management, and current care models used by patients and discuss core PCMH concepts and multidisciplinary team–based PCMH care strategies for SCD pain management.

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El Rayess, Fadya, Roberta Goldman, Christopher Furey, Rabin Chandran, Arnold R. Goldberg und Gowri Anandarajah. „Patient-Centered Medical Home Knowledge and Attitudes of Residents and Faculty: Certification Is Just the First Step“. Journal of Graduate Medical Education 7, Nr. 4 (01.12.2015): 580–88. http://dx.doi.org/10.4300/jgme-d-14-00597.1.

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ABSTRACT Background The patient-centered medical home (PCMH) is an accepted framework for delivering high-quality primary care, prompting many residencies to transform their practices into PCMHs. Few studies have assessed the impact of these changes on residents' and faculty members' PCMH attitudes, knowledge, and skills. The family medicine program at Brown University achieved Level 3 PCMH accreditation in 2010, with training relying primarily on situated learning through immersion in PCMH practice, supplemented by didactics and a few focused clinical activities. Objective To assess PCMH knowledge and attitudes after Level 3 PCMH accreditation and to identify additional educational needs. Methods We used a qualitative approach, with semistructured, individual interviews with 12 of the program's 13 postgraduate year 3 residents and 17 of 19 core faculty. Questions assessed PCMH knowledge, attitudes, and preparedness for practicing, teaching, and leading within a PCMH. Interviews were analyzed using the immersion/crystallization method. Results Residents and faculty generally had positive attitudes toward PCMH. However, many expressed concerns that they lacked specific PCMH knowledge, and felt inadequately prepared to implement PCMH principles into their future practice or teaching. Some exceptions were faculty and resident leaders who were actively involved in the PCMH transformation. Barriers included lack of time and central roles in PCMH activities. Conclusions Practicing in a certified PCMH training program, with passive PCMH roles and supplemental didactics, appears inadequate in preparing residents and faculty for practice or teaching in a PCMH. Purposeful curricular design and evaluation, with faculty development, may be needed to prepare the future leaders of primary care.

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Dettloff, Richard W., Patricia Glosner und Susannah Motl Moroney. „Establishing the Role of the Pharmacist in the Patient-Centered Medical Home… The Opportunity is Now“. Journal of Pharmacy Technology 25, Nr. 5 (September 2009): 287–91. http://dx.doi.org/10.1177/875512250902500502.

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The patient-centered medical home (PCMH) is an approach to delivering comprehensive, continuous, coordinated care across all life stages and has been hypothesized to be one potential solution to the discrepancy between the high cost but low quality of health care in the US. Although a plethora of literature exists on how pharmacy interventions can improve the quality of patient care through medication therapy management programs, there is a paucity of data supporting pharmacists' involvement in PCMHs. Pharmacists are uniquely trained and positioned to make important contributions to PCMHs as medication care coordinators. The opportunity is now for pharmacists to establish their role within this medical setting.

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Butler, Danielle, Anton Clifford-Motopi, Saira Mathew, Carmel Nelson, Renee Brown, Karen Gardner, Lyle Turner et al. „Study protocol: primary healthcare transformation through patient-centred medical homes—improving access, relational care and outcomes in an urban Aboriginal and Torres Strait Islander population, a mixed methods prospective cohort study“. BMJ Open 12, Nr. 9 (September 2022): e061037. http://dx.doi.org/10.1136/bmjopen-2022-061037.

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IntroductionFor over 40 years, Aboriginal and Torres Strait Islander Community-Controlled Health Services (ACCHS) in Australia have led strategic responses to address the specific needs of Aboriginal and Torres Strait Islander populations. Globally, there has been rapid growth in urban Indigenous populations requiring an adaptive primary healthcare response. Patient-centred medical homes (PCMH) are an evidenced-based model of primary healthcare suited to this challenge, underpinned by principles aligned with the ACCHS sector—relational care responsive to patient identified healthcare priorities. Evidence is lacking on the implementation and effectiveness of the PCMH model of care governed by, and delivered for, Aboriginal and Torres Strait Islander populations in large urban settings.Method and analysisOur multiphased mixed-methods prospective cohort study will compare standard care provided by a network of ACCHS to an adapted PCMH model of care. Phase 1 using qualitative interviews with staff and patients and quantitative analysis of routine primary care health record data will examine the implementation, feasibility and acceptability of the PCMH. Phase 2 using linked survey, primary care and hospitalisation data will examine the impact of our adapted PCMH on access to care, relational and quality of care, health and wellbeing outcomes and economic costs. Phase 3 will synthesise evidence on mechanisms for change and discuss their implications for sustainability and transferability of PCMHs to the broader primary healthcare systemEthics and disseminationThis study has received approval from the University of Queensland Human Research Ethics Committee (2021/HE00529). This research represents an Aboriginal led and governed partnership in response to identified community priorities. The findings will contribute new knowledge on how key mechanisms underpinning the success and implementation of the model can be introduced into policy and practice. Study findings will be disseminated to service providers, researchers, policymakers and, most importantly, the communities themselves.

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Heisey-Grove, Dawn, und Vaishali Patel. „National findings regarding health IT use and participation in health care delivery reform programs among office-based physicians“. Journal of the American Medical Informatics Association 24, Nr. 1 (16.05.2016): 130–39. http://dx.doi.org/10.1093/jamia/ocw065.

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Objective: Our objective was to characterize physicians’ participation in delivery and payment reform programs over time and describe how participants in these programs were using health information technology (IT) to coordinate care, engage patients, manage patient populations, and improve quality. Materials and Methods: A nationally representative cohort of physicians was surveyed in 2012 (unweighted N = 2567) and 2013 (unweighted N = 2399). Regression analyses used those survey responses to identify associations between health IT use and participation in and attrition from patient-centered medical homes (PCMHs), accountable care organizations (ACOs), and pay-for-performance programs (P4Ps). Results: In 2013, 45% of physicians participated in PCMHs, ACOs, or P4Ps. While participation in each program increased (P < .05) between 2012 and 2013, program attrition ranged from 31–40%. Health IT use was associated with greater program participation (RR = 1.07–1.16). PCMH, ACO, and P4P participants were more likely than nonparticipants to perform quality improvement and patient engagement activities electronically (RR = 1.09–1.14); only ACO participants were more likely to share information electronically (RR = 1.07–1.09). Discussion: Participation in delivery and payment reform programs increased between 2012 and 2013. Participating physicians were more likely to use health IT. There was significant attrition from and switching between PCMHs, ACOs, and P4Ps. Conclusion: This work provides the basis for understanding physician participation in and attrition from delivery and payment reform programs, as well as how health IT was used to support those programs. Understanding health IT use by program participants may help to identify factors enabling a smooth transition to alternative payment models.

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Dissertationen zum Thema "PCMHE"

Moore, Rick A. „Measuring the Impact of Recognized Patient-Centered Medical Homes (PCMH)“. Thesis, Virginia Commonwealth University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=3746418.

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It has been estimated that by 2020 nearly one-third of all Americans (almost 160 million people) will have at least one chronic disease to manage and the cost of health care will consume over 20 percent of the GDP. The Obama Administration responded to this pending crisis by passing the Patient Protection and Affordable Care Act (PPACA) in 2010. This major legislation aims to instill patient-centered, accountable care into the health care delivery system. Specifically, the United States government is on a mission to reduce the utilization of expensive inpatient care, while increasing access to primary care for all Americans, thereby lowering the total cost of health care.

Primary care practices organized around the principles of the patient-centered medical home (PCMH) can better manage their patients, especially their patients with chronic conditions; and become accountable for their care. In 2008, the National Committee for Quality Assurance (NCQA) released practice-level recognition standards based on the seven Joint Principles of the PCMH, to aid doctors seeking to transform their practices into effective patient-centered delivery systems.

The results of several published studies have touted the successes (e.g., reduced emergency department visits, reduced hospitalizations) of the PCMH model at individual practice sites. These localized successes demonstrated that the principle tenets of the PCMH model—care coordination, team-based care, population management—helped lower utilization of more expensive health care services within the specific practice settings evaluated. However, there has been no study to determine if these core tenets are having a broader impact on the health care delivery system within a community.

One hypothesized outcome of a health care system centered on the PCMH care model is better care coordination and more effective, whole-person care management across the continuum of health care; resulting in a more efficient system that can prevent avoidable hospitalizations.

1. Establish constructs and hypotheses to measure the effect of the increasing numbers of NCQA-Recognized PCMH practices in communities (counties).

2. Using an outcomes-based measurement approach, investigate the relationship between growing densities of NCQA-Recognized PCMH practice doctors among all primary care doctors (PCD) in a community and the associated impact on the utilization of inpatient care, specifically related to ACSCs, as measured by the AHRQ Composite PQIs.

The research is quasi-experimental in design and is based on a retrospective (2008–2011) analysis of existing data from the NCQA PCMH program, the AHRQ Composite PQI and the Centers for Medicare & Medicaid Services (CMS) National Provider Identification (NPI) databases. Analysis will link NCQA-Recognized PCMH practices (independent variable), AHRQ Risk Adjusted Composite PQIs (dependent variable), and the CMS NPI (total PCDs) on Federal Information Processing Standard (FIPS) identifiers across 114 state and county-level geographical areas in Vermont and North Carolina. The research will inform the following hypotheses:

1. Does the research literature support the measurement construct proposed in this study?

2. Communities with concentrations of recognized PCMH practices among primary care practices will have lower risk-adjusted avoidable hospital admission rates.

3. The use of technology and care coordination will have a greater predictive correlation on risk-adjusted avoidable hospital admission rates than other PCMH capabilities.

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Moore, Rick. „Measuring the Impact of Recognized Patient-Centered Medical Homes (PCMH)“. VCU Scholars Compass, 2015. http://scholarscompass.vcu.edu/etd/4069.

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This dissertation proposal seeks to understand if the increasingnumbers (density) of recognized PCMH practices incommunities affect avoidable hospitalizations related toambulatory care sensitive conditions (ACSC), as measured bythe AHRQ Composite Prevention Quality Indicators (PQI). Theresearch has two purposes: 1. Establish constructs and hypotheses to measurethe effect of the increasing numbers of NCQA-Recognized PCMH practices in communities(counties). 2. Using an outcomes-based measurement approach,investigate the relationship between growingdensities of NCQA-Recognized PCMH practicedoctors among all primary care doctors (PCD) ina community and the associated impact on theutilization of inpatient care, specifically related toACSCs, as measured by the AHRQ CompositePQIs. The research is quasi-experimental in design and is based on aretrospective (2008–2011) analysis of existing data from theNCQA PCMH program, the AHRQ Composite PQI and theCenters for Medicare & Medicaid Services (CMS) NationalProvider Identification (NPI) databases. Analysis will linkNCQA-Recognized PCMH practices (independent variable),AHRQ Risk Adjusted Composite PQIs (dependent variable),and the CMS NPI (total PCDs) on Federal InformationProcessing Standard (FIPS) identifiers across 114 state andcounty-level geographical areas in Vermont and North Carolina.

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Shinde, Nikhil Vijay. „A Study on the Impact of Patient Centered Medical Home (PCMH) Implementation on Nursing Work Practice“. Thesis, North Dakota State University, 2012. https://hdl.handle.net/10365/26660.

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Primary care and nursing are important components of the U.S. healthcare system and are facing challenges of quality, access, cost, time spent and inefficiencies of clinical activities. Patient Centered Medical Home (PCMH) is a newly developed care model which has the potential to overcome these challenges. The present study uses a questionnaire approach to find the impact PCMH implementation may have on nursing practice and subsequently primary care. Analysis of the data collected from the questionnaire revealed some surprising results about the nursing practice. For example nurses spend less time on direct care and more time on indirect care and documentation. The nursing demand in terms of Full Time Equivalent (FTE) for nurses decreases. The future demand for nurses (not in FTE) shows an increase after PCMH implementation. The satisfaction level and overall health of patients, patient readmission, job satisfaction of nurses and department productivity shows improvement after PCMH implementation.

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Culcuoglu, Mustafa U. „Reengineering Community Based Chronic Care Delivery Systems: Theory and Applications“. University of Akron / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=akron1627573050496332.

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Wegman, Kevin R. „Numerical Modeling of a Printed Circuit Heat Exchanger Based on Experimental Results from the High-Temperature Helium Test Facility“. The Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1461266010.

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Nix, Tanya J. „Evolution of Physician-Centric Business Models Under Patient Protection and Affordable Care Act“. ScholarWorks, 2014. http://scholarworks.waldenu.edu/dissertations/123.

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For several decades, the cost of medical care in the United States has increased exponentially. Congress enacted the Patient Protection and Affordable Care Act (PPACA) of 2010 to ensure affordable healthcare to the citizens of the United States. The purpose of this case study was to explore physicians' perspectives regarding physician-centric business models evolving under the requirements of PPACA legislation. Complex adaptive systems formed the conceptual framework for this study. Data were gathered through face-to-face, semistructured interviews and e-mail questionnaires with a purposeful sample of 20 participants across 14 medical specialties within Northeast Texas. Participant perceptions were elicited regarding opinions of PPACA legislation and the viability of business models under the PPACA. In addition, a word cloud was used to identify 3 prevalent or universal themes that emerged from participant interviews and questionnaires, including (a) use of mid-level practitioners, (b) changes to provider practices, and (c) lack of business education. The implications for positive social change include the potential to develop innovative models for the delivery of medical care that will improve the health of the aggregate population. Healthcare leaders may use the findings to advance the evolution of physician business models that meet the needs of healthcare stakeholders. These findings may also inform healthcare leaders of the need to develop cost-effective and innovative organizational models that are distinct to individual patient populations.

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Mylavarapu, Sai K. „Development of Compact Heat Exchangers for Very High-Temperature Gas-Cooled Reactors“. The Ohio State University, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=osu1228150070.

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Mylavarapu, Sai Kiran. „Design, Fabrication, Performance Testing, and Modeling of Diffusion Bonded Compact Heat Exchangers in a High-Temperature Helium Test Facility“. The Ohio State University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=osu1321996306.

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Watkins, Sydney L. „Patient-Centered Medical Homes and Parental Attention-Deficit Hyperactivity Disorder Medication Beliefs and Adherence“. ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5044.

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As many as 87% of children discontinue ADHD medication, which can lead to clinically significant academic, cognitive, and social impairment. ADHD costs billions of dollars to the healthcare and educational systems, and previous attempts to stem these costs and increase ADHD medication adherence have been unsuccessful. The purpose of this study was to determine if patient-centered medical homes (PCMH), which have been shown to improve patient health outcomes, impact parental beliefs (benefits vs. risks) about ADHD medication and adherence to ADHD medication. The theory of planned behavior was the theoretical framework for this study. There were 294 parents of children between the ages of 5 and 12 who had been prescribed ADHD medication who participated in a quantitative self-administered survey. Parental beliefs were assessed using the Beliefs About Medicines Questionnaire-Specific, and medication adherence was assessed using the Morisky Medication Adherence Scale-8. The 2007 National Survey of Children's Health was used to determine group assignment. A MANCOVA was used to analyze the data and found parents in the PCMH group scored significantly higher in their beliefs that the benefits outweighed the risks of ADHD medication. However, no significant differences were found between groups related to parental adherence to ADHD medication. More research is recommended to learn how PCMHs can change positive ADHD medication beliefs into better ADHD medication adherence. This study has social change implications as it increases what is known about PCMHs and how they impact health outcomes. It also supports previous literature in the need to deliver all PCMH services, which is required to realize the full benefit of PCMHs.

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Figley, Justin T. „Numerical Modeling and Performance Analysis of Printed Circuit Heat Exchanger for Very High-Temperature Reactors“. The Ohio State University, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=osu1244036854.

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Bücher zum Thema "PCMHE"

Association, Medical Group Management, Hrsg. PCMH policies & procedures guidebook. Englewood, CO: MGMA-ACMPE, 2013.

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Ana-Elena, Jensen, TransforMED und Medical Group Management Association, Hrsg. Patient-centered medical home: Is PCMH right for my practice : workbook. Englewood: TransforMED/MGMA, 2010.

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Online-Hamilton, Steven BXS. (WCS)PCMH Management 2005. Wiley & Sons, Incorporated, John, 2005.

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Parker, Graham. Pche La Carpe Sous Valium. Contemporary French Fiction, 2010.

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Conry, Colleen, Shandra Brown Levy und Bonnie T. Jortberg. The Patient-Centered Medical Home. Herausgegeben von Robert E. Feinstein, Joseph V. Connelly und Marilyn S. Feinstein. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190276201.003.0005.

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The Patient-Centered Medical Home (PCMH) involves an organizing set of principles for the delivery of primary care that has become widely accepted by primary care medical associations, policymakers, businesses, and insurance companies. The PCMH places the patient at the center of the delivery of care. One physician directs the patient’s care. The PCMH emphasizes a whole-person orientation and coordinated care, including integration of physical health with behavioral health. Care is coordinated across the health care system. Use of a PCMH enhances access to medical care and ensures quality and safety. This chapter reviews the history of the PCMH and discusses joint principles of the PCMH; models of care, space, and payment; and the newer concept of the “medical neighborhood.”

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PCMH: A tradition of excellence : Pitt County Memorial Hospital's first fifty years. Pitt County Memorial Hospital, 2001.

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Hannibal, Martin, und Lisa Mountford. 13. Crown Court Proceedings Pre-Trial. Oxford University Press, 2016. http://dx.doi.org/10.1093/he/9780198765905.003.0013.

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This chapter deals with pre-trial practices and procedures of indictable-only offences. It covers sending indictable-only cases to the Crown Court under s. 51 Crime and Disorder Act 1998 (CDA 1998); preparing for the preliminary hearing in the Crown Court; preparing for trial on indictment; pre-trial disclosure issues and defence statements; instructing counsel; and pre-trial hearings including the Plea and Case Management Hearing (PCMH).

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Hannibal, Martin, und Lisa Mountford. 13. Crown Court Proceedings Pre-Trial. Oxford University Press, 2017. http://dx.doi.org/10.1093/he/9780198787679.003.0013.

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Arrantza eta itsasoa Euskal Herrian = La pche et la mer en Euskal Herria = La pesca y el mar en Euskal Herria. San Sebastián: Eusko Ikaskuntza, 2002.

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Buchteile zum Thema "PCMHE"

Lee, Jason F. „Patient-Centered Medical Home (PCMH) and the Care of Older Adults“. In Primary Care for Older Adults, 29–34. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-61329-1_5.

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Khan, Hamid Hassan, A. M. Aneesh, Atul Sharma, Atul Srivastava und Paritosh Chaudhuri. „CFD Study on Thermal Hydraulic Performance of A Wavy Channel Based PCHE Model“. In Fluid Mechanics and Fluid Power – Contemporary Research, 497–506. New Delhi: Springer India, 2016. http://dx.doi.org/10.1007/978-81-322-2743-4_48.

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„PCHE“. In Springer Reference Medizin, 1840. Berlin, Heidelberg: Springer Berlin Heidelberg, 2019. http://dx.doi.org/10.1007/978-3-662-48986-4_312898.

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Berhe, Solomon, Steven A. Demurjian, Jaime Pavlich-Mariscal, Rishi Kanth Saripalle und Alberto De la Rosa Algarín. „Leveraging UML for Access Control Engineering in a Collaboration on Duty and Adaptive Workflow Model that Extends NIST RBAC“. In Research Anthology on Recent Trends, Tools, and Implications of Computer Programming, 916–39. IGI Global, 2021. http://dx.doi.org/10.4018/978-1-7998-3016-0.ch042.

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To facilitate collaboration in emerging domains such as the Patient-Centered Medical Home (PCMH), the authors' prior work extended the NIST Role-Based Access Control (RBAC) model to yield a formal Collaboration on Duty and Adaptive Workflow (CoD/AWF) model. The next logical step is to place this work into the context of an integrated software process for security engineering from design through enforcement. Towards this goal, the authors promote a secure software engineering process that leverages an extended Unified Modeling Language (UML) to visualize CoD/AWF policies to achieve a solution that separates concerns while still providing the means to securely engineer dynamic collaborations for applications such as the PCMH.

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Bojadzievski, Trajko, und Robert Gabbay. „The Patient-Centered Medical Home (PCMH) Improves Diabetes Care“. In The Endocrine Society's 93rd Annual Meeting & Expo, June 4–7, 2011 - Boston, P2–762—P2–762. The Endocrine Society, 2011. http://dx.doi.org/10.1210/endo-meetings.2011.part3.p15.p2-762.

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„Case 21: The Lunchroom: Physician Engagement at a PCMH“. In Healthcare Quality Management. New York, NY: Springer Publishing Company, 2020. http://dx.doi.org/10.1891/9780826145147.0027.

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Guo, Jiangfeng, Haiyan Zhang und Xinying Cui. „Heat Transfer Enhancement and Coordination Optimization for Supercritical CO2 Heat Exchanger“. In Handbook of Research on Advancements in Supercritical Fluids Applications for Sustainable Energy Systems, 270–337. IGI Global, 2021. http://dx.doi.org/10.4018/978-1-7998-5796-9.ch008.

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The heat transfer performance of supercritical CO2 (sCO2) in straight and three enhanced tubes were presented firstly, and then a distributed coordination principle was proposed for the design and optimization of heat exchangers. The field synergy principle could explain the thermal-hydraulic performance of sCO2 in different channels very well. The ratio of secondary number to Reynolds number Se/Re could give great predictions for the buoyancy effect. The local heat transfer coefficient also has a lot to do with the near-wall effective thermal conductivity. Zigzag channels with bend angles between 110° to 130° exhibit the best comprehensive performance. With smaller curvature diameter or larger camber, the serpentine channel has better overall performance. Two novel fins were proposed to further improve the performance of PCHE. The heat exchanger performance depends not only on the values of parameters but also on their distributed coordination, which provides a novel approach to heat exchanger optimization of sCO2 through the coordination improvement of distributed parameters.

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Konferenzberichte zum Thema "PCMHE"

Mahajan, Heramb P., Urmi Devi und Tasnim Hassan. „Finite Element Analysis of Printed Circuit Heat Exchanger Core for High Temperature Creep and Burst Responses“. In ASME 2018 Pressure Vessels and Piping Conference. American Society of Mechanical Engineers, 2018. http://dx.doi.org/10.1115/pvp2018-84748.

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Printed Circuit Heat Exchangers (PCHEs) have high compactness and efficiency for heat transfer, which makes them an attractive option for the Very High Temperature Reactors (VHTRs). Design methodology of PCHE for non-nuclear service is well established in the ASME Code, Section VIII; however, ASME Code rules for PCHE nuclear services are yet to be developed. Towards developing the ASME Section III code rules for PCHE, the study started with the design of PCHE core specimens for testing following the ASME section VIII methodology. The failure responses of these PCHE specimens are investigated by using Finite Elements Analyses (FEA). Two dimensional isothermal plane strain analyses are performed using an uncoupled constitutive material model. Parametric studies by varying shape and size of semicircular channels, PCHE core size, and loading cases are performed to quantify the critical parameters which influence the PCHE failure responses under pressure creep and pressure burst loadings. Results indicate that the maximum creep strain and its location are dependent on the PCHE core size. Significant reduction in creep strains are observed at the channel sharp corners by considering a realistic semielliptical channel shape instead of a semicircular channel in the analysis.

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Jun, Xie, und Wang Li. „PCMHS-Based Algorithm for Bayesian Networks Online Structure Learning“. In 2009 International Forum on Computer Science-Technology and Applications. IEEE, 2009. http://dx.doi.org/10.1109/ifcsta.2009.316.

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Davis, Darius, Xiuli Qu und Xiaohong Yuan. „Evaluation of WorldVistA and OpenEMR for PCMH care“. In SoutheastCon 2017. IEEE, 2017. http://dx.doi.org/10.1109/secon.2017.7925323.

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Mahajan, Heramb P., Lucas Maciel, Gracious Ngaile und Tasnim Hassan. „Mechanical Performance Evaluation of the Printed Circuit Heat Exchanger Core Experiments Under Tension and Pressure Loading“. In ASME 2022 Pressure Vessels & Piping Conference. American Society of Mechanical Engineers, 2022. http://dx.doi.org/10.1115/pvp2022-81247.

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Abstract The printed circuit heat exchanger (PCHE) has small channels with high surface area, making them an efficient solution for next-generation nuclear plants (NGNPs). These PCHEs are fabricated through a diffusion bonding process. This fabrication step changes the microstructure of wrought metal plates. The current ASME design code does not support the PCHE design for NGNPs due to a lack of test data. Hence, there has been initiative towards elevated temperature mechanical property characterization of the diffusion bonded material. One of the most common channel shapes is a semicircular channel with sharp corners. These corners act as a stress riser at the diffusion bonding interface. Evaluating elevated temperature mechanical performance of diffusion bonded material in the presence of stress risers is an essential step towards the ASME code development of PCHE design. This study selected two specimen geometries: the first is a PCHE bar specimen for tensile loading with three rows and three columns of channels, and the second is a lab-scaled PCHE with six rows and eight columns of channels. A set of elevated temperature monotonic and cyclic tests were conducted on the PCHE bar specimen to evaluate the mechanical performance under axial tensile loadings to study the failure mechanism. The lab-scaled PCHE specimens were tested under overpressure loads at room temperature, and pressure creep and pressure creep-fatigue loadings to mimic the realistic loading conditions observed in typical NGNPs. The X-ray scans of channeled specimens show interesting observations. The test results and observations are presented in the paper.

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Liang, Guohu, Deqi Chen, Feng Jin, Lian Hu, Shanshan Bu und Hanzhou Liu. „Numerical Investigation on Thermal-Hydraulic Characteristics of Supercritical CO2 in Multiple Compact Channels“. In 2022 29th International Conference on Nuclear Engineering. American Society of Mechanical Engineers, 2022. http://dx.doi.org/10.1115/icone29-93241.

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Abstract Printed circuit heat exchanger (PCHE) is promising in the application of energy conversion system with its high compactness and efficiency. In this paper, the flow and heat transfer performance of supercritical carbon dioxide (SCO2) PCHE are numerically investigated with multiple channels and different channel lengths. The results show that the heat transfer performance of the Zigzag channel PCHE is increased more than 11% comparing to the wavy channel, while it brings more flow resistance. The pressure drop in the Zigzag cold and hot channels was about two and four times of the wavy channel, respectively. It is recommended for the wavy channel PCHE on account of its better overall performance factor than zigzag channel PCHE. Through the analyses of flow characters among multiple channels, it shows good homogeneity of flow distribution for the flow distribution coefficient in each channel close to 1.0, which is able to effectively avoid uneven flow distribution resulting in high local temperature of the heat exchanger. Furthermore, the overall performance of PCHEs with different core lengths are compared, presenting nearly 10% difference on the thermal efficiency.

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Rangel Freire, Lucas, und Carolina Palma Naveira Cotta. „APPLICATIONS OF NEURAL NETWORKS INTO HEAT EXHANGERS TYPE PCHE“. In 26th International Congress of Mechanical Engineering. ABCM, 2021. http://dx.doi.org/10.26678/abcm.cobem2021.cob2021-2257.

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Yoon, Seok Ho, Jeong Heon Shin, Dong Ho Kim und Jun Seok Choi. „Design of Printed Circuit Heat Exchanger (PCHE) for LNG Re-Gasification System“. In ASME 2017 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2017. http://dx.doi.org/10.1115/imece2017-70379.

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In this paper, we present the ongoing process of the research and development of the Printed Circuit Heat Exchanger (PCHE) on Floating Storage Regasification Unit (FSRU). We performed a structural simulation work to find the optimal design of fluid channels on heat transfer plates, fabricated the heat transfer plates, and calculated the capacity of the PCHE using our analytical tool. In the simulation work, the plates having channels of 1 mm semicircular cross section were designed by varying the wall thickness between channels. At a temperature, 1373 K, compressing pressures were varied as 30, 85.7, and 500 bars. Based on the simulation results, we fabricated and bonded heat transfer plates using the diffusion bonding equipment which our department developed. Then, the sizing of PCHE was done with analytical calculation for the developing PCHE on FSRU.

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Alam, Tanjebul, Daniel Bacellar, Jiazhen Ling und Vikrant Aute. „Effect of Thermal Expansion Coefficient, Viscosity and Melting Range in Simulation of PCM Embedded Heat Exchangers With and Without Fins“. In ASME 2021 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2021. http://dx.doi.org/10.1115/imece2021-70401.

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Abstract Phase change material heat exchangers (PCMHX) have animportant role in integrating renewable energy systems. PCMHX can offer high storage density at various temperatures of interest and can be used for grid load shifting purposes. Numerical models enable engineers to estimate PCMHX performance for different design parameters and operating conditions. Modeling phase change phenomena is challenging due to the complex time-dependent nature of the process. The accuracy of models is highly sensitive to PCM thermo-physical properties. Thermal expansion coefficient (β), viscosity (μ) and melting temperature range (MR) of a PCM are important properties, especially when natural convection is not negligible. In PCMHX modeling, using less than accurate values for these properties can have significant impact on the simulation outcomes. These propertiesand discussions thereof are not readily available in the literature. This paper presents a brief review of the literature and a numerical study investigating the model sensitivity to the above-mentioned properties for PCMHX with and without fins. CFD is used to evaluate the charging (melting) phenomena. The study quantifies the impact of uncertainty in these properties on the melting rate and temperature profile. Constant wall temperature was consideredas heat source with no heat loss to ambient. The results show that β and μ has significant effect on the melting rate andevolution of the melting front. For a non-finned domain when comparing results for different published values of β and μ, the deviation in melting time can be up to 12.9% and 57.6% respectively. For high wall temperatures, change in melting range did not impact melting time. But when the wall temperature is reduced, up to 9.8% deviation in melting time is observed.

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Mahajan, Heramb P., und Tasnim Hassan. „Finite Element Analysis of Printed Circuit Heat Exchanger Core for Creep and Creep-Fatigue Responses“. In ASME 2019 Pressure Vessels & Piping Conference. American Society of Mechanical Engineers, 2019. http://dx.doi.org/10.1115/pvp2019-93416.

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Abstract Printed circuit heat exchangers (PCHEs) have a high heat transfer coefficient which makes them a suitable option for very high temperature reactors (VHTRs). ASME Section VIII design code provide PCHE design rules for non-nuclear applications. The PCHE design methodology for nuclear applications is yet to be established. Towards developing the ASME Section III code rules, this study started with the PCHE design as per section VIII. An experimental set up is developed to evaluate the designed PCHE for creep and creep-fatigue performances. This study performed pretest finite element analysis to estimate experimental responses and failure loads for setting up the experiments. Three dimensional isothermal analyses of the PCHE’s were conducted by using an advanced unified constitutive model to simulate the creep-fatigue interaction. The sub-modeling technique was used to analyze the channel scale response of the PCHE. Analysis results indicate that the failure may be governed by the channel corner responses, which is influenced by the creep-fatigue interaction. Analysis based creep-fatigue damage curve is plotted as per ASME code to evaluate the design of PCHEs for nuclear application.

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Baik, Seungjoon, Seong Gu Kim, Seong Jun Bae, Yoonhan Ahn, Jekyoung Lee und Jeong Ik Lee. „Preliminary Experimental Study of Precooler in Supercritical CO2 Brayton Cycle“. In ASME Turbo Expo 2015: Turbine Technical Conference and Exposition. American Society of Mechanical Engineers, 2015. http://dx.doi.org/10.1115/gt2015-42915.

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The supercritical carbon dioxide (S-CO2) Brayton power conversion cycle has been receiving worldwide attention because of high thermal efficiency due to relatively low compression work near the critical point (30.98°C, 7.38MPa) of CO2. The S-CO2 Brayton cycle can achieve high efficiency with simple cycle configuration at moderate turbine inlet temperature (450∼650°C) and relatively high density of S-CO2 makes possible to design compact power conversion cycle. In order to achieve compact cycle layout, a highly compact heat exchanger such as printed circuit heat exchanger (PCHE) is widely used. Since, the cycle thermal efficiency is a strong function of the compressor inlet temperature in the S-CO2 power cycle, the research team at KAIST is focusing on the thermal hydraulic performance of the PCHE as a precooler. The investigation was performed by first developing a PCHE in-house design code named KAIST-HXD. This was followed by constructing the designed PCHE and testing it in the KAIST experimental facility, S-CO2PE. The test results of the PCHE were compared to the test results of a shell and tube type heat exchanger as well.

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