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1
Hoke, Cassandra N., and Susan Franks. "Work site, physician's office, or medical university clinic." Eating Behaviors 3, no. 1 (March 2002): 93–100. http://dx.doi.org/10.1016/s1471-0153(01)00053-8.
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Davis, Victorja J., and Sheila Dunn. "Private Office Versus Clinic Medical Abortion in Young Women." Journal of Pediatric and Adolescent Gynecology 11, no. 4 (November 1998): 203. http://dx.doi.org/10.1016/s1083-3188(98)70285-2.
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Rader, Florian, Stanley S. Franklin, James Mirocha, Wanpen Vongpatanasin, Robert W. Haley, and Ronald G. Victor. "Superiority of Out-of-Office Blood Pressure for Predicting Hypertensive Heart Disease in Non-Hispanic Black Adults." Hypertension 74, no. 5 (November 2019): 1192–99. http://dx.doi.org/10.1161/hypertensionaha.119.13542.
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Black Americans suffer disproportionately from hypertension and hypertensive heart disease. Out-of-office blood pressure (BP) is more predictive for cardiovascular complications than clinic BP; however, the relative abilities of clinic and out-of-office BP to predict left ventricular hypertrophy in black and white adults have not been established. Thus, we aimed to compare associations of out-of-office and clinic BP measurement with left ventricular hypertrophy by cardiac magnetic resonance imaging among non-Hispanic black and white adults. In this cross-sectional study, 1262 black and 927 white participants of the Dallas Heart Study ages 30 to 64 years underwent assessment of standardized clinic and out-of-office (research staff-obtained) BP and left ventricular mass index. In multivariable-adjusted analyses of treated and untreated participants, out-of-office BP was a stronger determinant of left ventricular hypertrophy than clinic BP (odds ratio per 10 mm Hg, 1.48; 95% CI, 1.34–1.64 for out-of-office systolic BP and 1.15 [1.04–1.28] for clinic systolic BP; 1.71 [1.43–2.05] for out-of-office diastolic BP, and 1.03 [0.86–1.24] for clinic diastolic BP). Non-Hispanic black race/ethnicity, treatment status, and lower left ventricular ejection fraction were also independent determinants of hypertrophy. Among treated Blacks, the differential association between out-of-office and clinic BP with hypertrophy was more pronounced than in treated white or untreated participants. In conclusion, protocol-driven supervised out-of-office BP monitoring provides important information that cannot be gleaned from clinic BP assessment alone. Our results underscore the importance of hypertension management programs outside the medical office to prevent hypertensive heart disease, especially in high-risk black adults. Clinical Trial Registration— URL: https://www.clinicaltrials.gov . Unique identifier: NCT00344903.
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Nagovski, Neil, Amanda Brahim, Patrick Taylor Reynolds, and Marco Ruiz. "Successful integration of palliative care services into the multidisciplinary multiple myeloma clinics: An observational study based on a single institution experience." Journal of Clinical Oncology 35, no. 31_suppl (November 1, 2017): 142. http://dx.doi.org/10.1200/jco.2017.35.31_suppl.142.
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142 Background: The pain syndromes, both acute and chronic are prevalent and often the only complaints affecting the patients’ quality of life and functional capacity. Here we describe our experience of successful integration of palliative care service into multiple myeloma (MM) management in a form of the disease specific multidisciplinary clinic. Methods: We have established a dedicated monthly multidisciplinary clinic for all patients diagnosed with symptomatic MM as a pilot project to incorporate different specialties involved in MM care with the goal to improve on disease management, increase compliance with office visits, reduce emergency department visits and benefit a healthcare system. Patients were able to have the same day visits with medical oncologist, radiation oncologists, palliative care physician, integrative medicine and medical psychologist. Over the course of two years (April 2015 through March 2017), we provided care to 39 unique MM patient. Results: After medical/transplant oncology encounters (N = 601), the most encountered specialists were palliative care (N = 208), followed by radiation oncology (N = 34) and integrative medicine/medical psychology (N = 33). The rate of missed office visits for multidisciplinary clinic was 5%, compared to average 7% for all cancer patients at our center. The rates of emergency department visits were rising in proportion to non-compliance with multidisciplinary clinic visits (correlation coefficient 0.43) Conclusions: Patients with MM cared for at the multidisciplinary clinic had better compliance with office visits and fewer unplanned emergency department visits in comparison patients with other oncologic disorders. The rates of emergency departmentvisits were proportional to non-compliance with multidisciplinary clinic visits. The degree of utilization of integrative medicine and psychology was comparable to radiation oncology encounters suggesting that psychological, behavioral, dietary interventions, complementary, physical therapies and rehabilitation have an important and growing role in MM management.
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Kоpasov, Ye A. "Problems of management of commercial stomatological clinics." Bulletin of Siberian Medicine 2, no. 2 (June 30, 2003): 81–85. http://dx.doi.org/10.20538/1682-0363-2003-2-81-85.
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As economic conditions have changed the system of medical aid management requires the development and realization of new methodological-organizing principles. At present stomatologic clinics are working in conditions of severe competition. This dictates the necessity to arrange their work more efficiently and to forecast the development of these or that situations. Modern stomatologic clinic or private dentist’s office should be considered as a unified complex that requires the efficient management and supervision. There is required a constant analysis of efficiency and a timely revealing of neglects and defects. It is also critical to analyze an activity of a clinic in various situations and to forecast the main activities for future.
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Darr, Amber Y., and Sarah Gottfried. "Identifying vaccination rates of adult patients in ambulatory care clinics." SAGE Open Medicine 8 (January 2020): 205031212093546. http://dx.doi.org/10.1177/2050312120935461.
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Background: While pharmacists have provided vaccinations to patients in the community pharmacy setting, pharmacist involvement within the medical office setting is not well documented in the literature. The American Society of Health-System Pharmacists reports that ambulatory care pharmacists are screening for and administering vaccinations at a declining rate, despite standards of practice. Vaccination rates for adults 19–64 years of age remain low, based on Healthy People 2020 goals, putting them at risk for vaccine-preventable diseases. Objectives: The aim of the study was to assess vaccination rates of ambulatory care pharmacy clinic patients aged 19–64 years and to compare the rates between three clinics and to Healthy People 2020 goals. Methods: This was a baseline retrospective analysis of vaccination rates for patients aged 19–64 years who attended at least one pharmacy clinic visit at one of the three medical office practices. Age, sex, medical conditions, cigarette or alcohol use, immunosuppressive medications, and vaccines recommended and received were recorded. Vaccination status was assessed according to the Advisory Committee for Immunization Practices recommendations. Data were collected from January 2016 to March 2017. The percentage of eligible patients who received each vaccine was determined overall and for each clinic. Results: There were 240 patients who met the inclusion criteria, with a mean age of 52.8 years. The percentage of patients with vaccination documented in the medical record was 25% for pneumococcal conjugate, 35.7% for pneumococcal polysaccharide, 26.9% for zoster vaccine live, 6.4% for hepatitis B, and 50.6% for tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis. Vaccination rates for pneumococcal conjugate, pneumococcal polysaccharide, and zoster vaccine live were below established Healthy People 2020 goals. Conclusion: Vaccination rates remain low in adults 19–64 years of age. Ambulatory care pharmacists should consider assessing vaccination status during clinic visits as a component of comprehensive vaccination programs.
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Nemtyryova, L. F., K. I. Grigoriev, and I. V. Balashova. "Marketing analysis of the role of a nurse in counseling parents in the office of a healthy child in children's polyclinic." Experimental and Clinical Gastroenterology, no. 11 (November 20, 2019): 36–43. http://dx.doi.org/10.31146/1682-8658-ecg-171-11-36-43.
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The aim is to analyze the activities of nurses in the offices of a healthy child in children’s policlinics in Moscow to optimize counseling and improve the quality of preventive work. Materials and methods. The data of official statistics and statistical reports of the office of a healthy child clinic. The method of statistical analysis of data for the study period, analysis of medical services and quantitative method of SWOT-analysis of 75 parents of children who visited the office of a healthy child. Results and discussion. Analysis of the office of a healthy child clinic revealed additional opportunities for the organization of primary prevention of gastroenterological diseases. It was found that the leading position on perenatal counselling is given to the nurse, and nurses with higher medical education have the advantage. It is advisable to revise the regulatory framework for the functioning of the Cabinet of healthy child and provide modern equipment, the introduction of modern methods of organization of work taking into account the training/retraining of nurses with higher education. In the course of advisory and educational work, a nurse with higher education uses the accumulated psychological and pedagogical skills, and parents receive professional information on the development of young children, which ultimately ensures the introduction of new health-saving technologies into practice. Conclusion. The results of the situational analysis of the activities of a nurse in a healthy child’s office allow us to optimize the process of counseling the speed of decision-making to improve the quality of preventive work in a children’s policlinic.
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Howard, Anna, Julia Kerr, Monica McLain, and Jessie Modlin. "Financial impact from in-office dispensing of oral chemotherapy." Journal of Oncology Pharmacy Practice 25, no. 7 (September 24, 2018): 1570–75. http://dx.doi.org/10.1177/1078155218799853.
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Background Oral chemotherapy agents are being prescribed more frequently in many cancer types. In-office dispensing of oral chemotherapy agents has demonstrated clinical benefits and also shown financial benefit to third-party payers. A previous publication estimated over $200,000 in cost savings annually from in-office dispensing solely from medications returned to stock for credit. However, pharmacists in the in-office setting perform many other interventions that may affect financial outcomes. Objective Assess financial impact of oral chemotherapy in-office dispensing by a clinic-based oral chemotherapy program serving five outpatient cancer centers in Southern Idaho. Outcomes include calculated monetary waste and cost avoidance of oral chemotherapy prescriptions from in-office dispensing and mail-order pharmacies. Methods Prescriptions received by the clinic-based oral chemotherapy program for filling through in-office dispensing and mail-order pharmacies were monitored for monetary waste and cost avoidance events from December 2016 through May 2017. Information was collected on the number of returned medications, therapy discontinuations, and dose adjustments. Monetary outcomes were calculated using average wholesale price. Results During the six-month evaluation, prescriptions filled through in-office dispensing had a total cost avoidance of $1,020,193 ( n = 154) and total waste of $154,985 ( n = 36) resulting in an estimated net cost avoidance annually of $1,730,416. Prescriptions filled through mail-order had a total cost avoidance of $20,497 ( n = 4) and a total waste of $80,394 ( n = 15) resulting in an estimated $119,794 net annual waste. Conclusions In-office dispensing of oral chemotherapy provided significant cost savings to third-party payers compared to mail-order pharmacy dispensing. Continued evaluation may help further justify the importance and value of in-office dispensing.
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Rohrer, James E., Kurt B. Angstman, and Joseph W. Furst. "Early return visits by primary care patients: a retail nurse-practitioner clinic versus a medical office walk-in clinic." Primary Health Care Research & Development 11, no. 01 (December 10, 2009): 87. http://dx.doi.org/10.1017/s1463423609990387.
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Faizullina, Elena V., N. A. Fedorova, A. A. Novruzova, and R. V. Leukhin. "PAGES OF HISTORY OF THE KAZAN SCIENTIFIC SCHOOL OF DERMATOVENEREOLOGY: THE LIFE AND WORK OF V.F. BURGSDORF." Russian Journal of Skin and Venereal Diseases 20, no. 5 (December 15, 2017): 316–19. http://dx.doi.org/10.18821/1560-9588-2017-20-5-316-319.
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The main stages of life and activity of V.F. Burgsdorf (1864-1935), his scientific achievements and priorities as the founder of one of the largest scientific schools in Russia are described. The representatives of this school made a huge contribution to the development of national dermatovenereology. Special attention was paid to the contribution of V.F. Burgsdorf in the creation of the second Russia svetlichnoe (phototherapy) offices in the STI clinic (Skin and Venereologic clinic) of A.G. Gе in Kazan on the territory of which currently is the Republican dermatovenerologic Dispensary. The work of A.G. Gе (1889-1925) in the STI clinic became one of the most productive periods of life and activities of V.F. Burgsdorf. In November 1900 V.F. Burgsdorf opens svetlichnoe (phototherapy) office with the support of prof. A.G. GE. Due to his medical and public authority, V.F. Borgsdorf received a large donation from the Empress Maria Feodorovna for his further development. V.F. Burgsdorf devoted much of his life to the development of treatment and prevention of skin and venereal diseases, organization of scientific researches and improvement of medical education in Russia. V.F. Burgsdorf greatly improved the system of medical care for patients.
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Fielden, Aaron D., Jacqueline M. Braden, Daniel Brooks, Susan G. Dunlow, Ernest G. Lockrow, and Scott Endicott. "Evaluating the Impact of Office Hysteroscopy in a Military Treatment Facility." Military Medicine 185, no. 9-10 (June 9, 2020): e1686-e1692. http://dx.doi.org/10.1093/milmed/usaa065.
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Abstract Introduction Office hysteroscopy has become a cornerstone of modern gynecologic care through the advent of advanced technology and emphasis on an efficient healthcare system. In 2017, Medicare announced an increase in office hysteroscopy reimbursement by 237%, giving an incentive for gynecologists to move from the operating room into the clinic. The U.S. military medical system needs more cost-effective and efficient healthcare, given that the cost of military healthcare increased by 130% between 2000 and 2012 (accounting for 10% or $52 billion of the Department of Defense budget). Within our institution, we have moved to conducting a regularly scheduled outpatient hysteroscopy clinic. Increased healthcare costs, decreased available operating room time, and efforts to boost patient and provider satisfaction drove the change. Materials and Methods After institutional review board approval, we performed a retrospective observational cost-benefit analysis of 235 outpatient and 45 inpatient records that included female military healthcare beneficiaries age 18 or older who had diagnostic or operative hysteroscopy performed in the operating room or office setting from January 2015 to October 2018. We specifically focused on diagnostic hysteroscopy, hysteroscopic biopsy and polypectomy, and hysteroscopic foreign body removal (intrauterine device removal). We then compared admission time, procedure time, reimbursement, and cost for each of the hysteroscopic procedure groups to yield a total cost-benefit value (TCBV). TCBV was defined as cost savings plus difference in reimbursement rate. Results This study analyzes the costs and benefits of a regularly scheduled hysteroscopy clinic within the U.S. military medical system. We performed a cost-benefit analysis that indicated a substantial difference between clinic and operating room TCBV, total relative value units or reimbursement rates, and total patient care time. We found the average admission time for an inpatient procedure was 6.23 hours compared to our standard 1-hour clinic time. The average success rate for procedure completion in the clinic was 89%. We found the average TCBV for 100 patients (after 11% reoperation rate) to be as high as $64,220, $159,940, and $66,709 for diagnostic hysteroscopy, hysteroscopic biopsy and polypectomy, and hysteroscopic foreign body (intrauterine device) removal, respectively. Conclusions Compared to traditional operating room hysteroscopy, we were able to demonstrate reduced costs with increased reimbursement while performing the same scope of care for patients undergoing office hysteroscopy. Decreased total time in performing office hysteroscopy suggests the potential benefit of increased patient and provider satisfaction. Our study indicated substantial incentive for military gynecologists to incorporate office hysteroscopy into their practice given the increased relative value units generated. Our office hysteroscopy protocol is discussed to encourage other military facilities to follow in our footsteps.
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Králíček, Jan, Miroslav Kučera, and jiří Králíček. "DESIGN OF SOUND INSULATION OF FULL GLAZED FACADE." Akustika 32 (March 1, 2019): 325–31. http://dx.doi.org/10.36336/akustika201932325.
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The paper deals with an office building project where one part of the building was changed to a clinic as a project modification before its finalization. However, the medical offices are in the noise protected indoor space where the hygienic noise limits are stricter. It leads to the higher standards of the facade, which was already designed by an architect. According to the traffic noise, there is an overload in that area of the office building, so it was necessary to develop the noise simulation of the outdoor noise and then to verify the sound insulation of the fully glazed facade or develop potential improvements in the construction. The mock-up was built for the verification of the model and the final results were confirmed by the measurement for the building’s approval.
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Edson, Daniel C., and Laura D. Massey. "Proficiency Testing Performance in Physician’s Office, Clinic, and Small Hospital Laboratories, 1994–2004." Laboratory Medicine 38, no. 4 (April 2007): 237–39. http://dx.doi.org/10.1309/6ev4qt8119du7lxe.
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Chaschina, Irina. "The role of the nurse in dental care provision in the State Budgetary Healthcare Institution of Samara Region Novokuybyshevsk Dental Polyclinic." Medsestra (Nurse), no. 10 (October 8, 2020): 54–59. http://dx.doi.org/10.33920/med-05-2010-06.
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The role of the nurse in providing dental care is to ensure the quality of care. The main parameters of the nurse's activity in the dental clinic are: observance of the sanitary and anti-epidemic regime, work with the patient and the dentist, organization of the dental office, and maintenance of medical documentation.
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Lee, Young, Afsha Aurshina, Aaron J. Lee, Israel M. Ackerman, Michael Chait, Daniel Novak, Anil Hingorani, Enrico Ascher, and Natalie Marks. "Routine colonoscopy, diabetic eye care, mammogram and pap smear screening in vascular surgery patients." Vascular 26, no. 4 (November 19, 2017): 372–77. http://dx.doi.org/10.1177/1708538117742830.
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Objective An increasing emphasis on preventive medicine has been supported by the recent reforms in United States health care system. Majority of the patients seen in vascular surgery clinics are elderly with more extensive medical comorbidities compared to the general population. Thus, these patients would be expected at higher risk for common malignant pathologies such as colon, breast and cervical cancer, and nonmalignant diseases such as diabetic retinopathy. This study looked at the screening compliance of vascular patients compared to data provided by Centers for Disease Control on the national and state levels. Methods The office records of 851 consecutive patients seen in Brooklyn and Staten Island vascular clinics were examined. We queried patients regarding their last colonoscopy, diabetic eye exams, recent mammograms, and Pap smears. Our patient screening compliance was compared between the two clinics as well as to the national and New York state data provided by Centers for Disease Control. Compliance with regard to patient’s age was also examined. Results Patients referred to the Staten Island office have a better colonoscopy compliance compared to the Brooklyn office ( P = .0001) and the national Centers for Disease Control average ( P = .026). Compliance for mammography and cervical cancer screening was higher in Staten Island office compared to the Brooklyn office ( P = .0001, P < .0001), respectively. Compliance was lower for Pap smear ( P = .0273) in Brooklyn when compared to the national average. Compliance for colonoscopy increased with age for both clinics ( P = .001, P < .001), while Pap smear decreased ( P < .001, P = .004). Conclusion Patients in vascular clinics in an urban setting had better adherence to screening protocol than the national and state average, with the exception of female patients for colonoscopy in our Brooklyn vascular office. There exists variability in both patient populations based on sub-specific locality and demographics including socioeconomic status. Overall, however patients in Staten Island had better compliance and adherence to the screening protocol than Brooklyn vascular clinic.
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Nishihata, Shin-ichi, and Yozo Saito. "Medical Consultation Dynamics in Japanese Cedar Pollinosis Patients at an Office Building Clinic in Central Tokyo." Nippon Jibiinkoka Gakkai Kaiho 105, no. 6 (2002): 751–58. http://dx.doi.org/10.3950/jibiinkoka.105.751.
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Pujadi, Tri. "Prototipe E-Klinik untuk Layanan Kesehatan Berbasis Web pada Balai Pengobatan Kantor Pusat Kementerian Pertanian." ComTech: Computer, Mathematics and Engineering Applications 1, no. 1 (June 1, 2010): 157. http://dx.doi.org/10.21512/comtech.v1i1.2210.
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This report discusses about the administration service at House of Medicinal Treatment in Central Office of The Ministry of Agriculture Republic of Indonesia. The administration service build in a web-based system, which has changed the administration system from manual to computerized. This system, which is known as Clinic Information System, facilitate the employee at House of Medicinal Treatment when they do their medical service in clinic from patient registration, medical record and report. The conclusion of this report is that the employees in the house of medicinal treatment is assisted enough with the design of this web-based system, but the function and the accuracy of the system should still be improved.
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Ginting, Eva Valentina, and Shinta Wahyu Hati. "PENGARUH INTERNAL MARKETING TERHADAP ORGANIZATIONAL PERFORMANCE DI ERHA CLINIC DENGAN MARKET ORIENTATION SEBAGAI VARIABEL INTERVENING." Jurnal Ilmiah Administrasi Bisnis dan Inovasi 4, no. 1 (November 25, 2020): 72. http://dx.doi.org/10.25139/jai.v4i1.2523.
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This study aims to determine and analyze how the influence of internal marketing to organizational performance in ERHA Clinic with market orientation as intervening variable. The type of research used is quantitative research with saturated sampling technique or examine the total population amounted to 60 people as many as 30 employees of ERHA Clinic Batam and 30 employees of ERHA Clinic Medan. The respondents consisted of staff working in Pharmacy, Frontliner, Nurse, Therapist, Medical Record, and all staff working in the Back Office unit. Data processing method using path analysis with SPSS 20 software. Based on the results of research stated that (1) internal marketing positively significant to market orientation in ERHA Clinic Sig. 0.000 (<0,05), (2) market orientation have positive and significant influence to organizational performance in ERHA Clinic Sig. 0,000 (<0,05), and (3) internal marketing have positive and significant effect to organizational performance in ERHA Clinic Sig. 0,000 (<0.05). This means that internal marketing affects organizational performance in ERHA Clinic.
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Evans, Jack B., and Edward Logsdon. "Acoustical Conformance with FGI for Tenant Improvements in Outpatient, Medical Office or Clinic Facility Sound Isolation/Privacy Design." INTER-NOISE and NOISE-CON Congress and Conference Proceedings 263, no. 5 (August 1, 2021): 1664–75. http://dx.doi.org/10.3397/in-2021-1892.
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Acoustical privacy and noise control design and implementation guidance is needed, regarding Facility Guidelines Institute (FGI) criteria for outpatient medical facilty tenant improvements (TI). TI in existing commercial buildings or medical office buildings may not have capital budgets or expected facility/lease life that hospitals enjoy. Full conformance to FGI criteria and guidelines may be limited; by economic feasibility and by constructability. Design professionals can use "good practice" space planning, demising assembly selection, and electronic sound masking to achieve appropriate acoustical privacy within reasonable capital expense budgets. Consider FGI criteria for demising partition, ceiling, door and window selections plus infrastructure equipment and material selections that can provide cost-effective lightweight, common construction standards. The objectives are to protect the privacy of patient information and provide quiet spaces, free of transient disturbance for clear speech communications. Continuous ambient sound increases speech privacy including speech transmitted from enclosed quiet spaces. Criteria for acoustics, speech privacy,continuous noise and masking exists in FGI. Temporal level changes (on/off, transients) and tonality (spectrum smoothness or balance) should be considered in basis-of-design (BoD). This paper will present design guidelines for selecting demising assemblies and supplemental sound masking for outpatient clinical spaces in commercial or medical office buildings.
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Pham, Clarabelle T., Catherine L. Gibb, Robert A. Fitridge, Jon Karnon, and Elizabeth Hoon. "Supporting surgeons in patient-centred complex decision-making: a qualitative analysis of the impact of a perioperative physician clinic." BMJ Open 9, no. 12 (December 2019): e033277. http://dx.doi.org/10.1136/bmjopen-2019-033277.
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ObjectivePatients with comorbidities can be referred to a physician-led high-risk clinic for medical optimisation prior to elective surgery at the discretion of the surgical consultant, but the factors that influence this referral are not well understood. The aims of this study were to understand the factors that influence a surgeon’s decision to refer a patient to the clinic, and how the clinic impacts on the management of complex patients.DesignQualitative study using theoretical thematic analysis to analyse transcribed semi-structured interviews.SettingInterviews were held in either the surgical consultant’s private office or a quiet office/room in the hospital ward.ParticipantsSeven surgical consultants who were eligible to refer patients to the clinic.ResultsWhen discussing the factors that influence a referral to the clinic, all participants initially described the optimisation of comorbidities and would then discuss with examples the challenges with managing complex patients and communicating the risks involved with having surgery. When discussing the role of the clinic, two related subthemes were dominant and focused on the management of risk in complex patients. The participants valued the involvement of the clinic in the decision-making and communication of risks to the patient.ConclusionsThe integration of the high-risk clinic in this study appears to offer additional value in supporting the decision-making process for the surgical team and patient beyond the clinical outcomes. The factors that influence a surgeon’s decision to refer a patient to the clinic appear to be driven by the aim to manage the uncertainty and risk to the patient regarding surgery and it was seen as a strategy for managing difficult and complex cases.
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Gerzon, M.D., Rowel A., and John Clifford P. Salugsugan. "Patient Satisfaction and Challenges of the Health Care Services of Negros Occidental Provincial Medical Clinic." Philippine Social Science Journal 3, no. 1 (June 22, 2020): 70–81. http://dx.doi.org/10.52006/main.v3i1.122.
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The Medical Clinic provides outpatient health services to the employees of the Provincial Government of Negros Occidental. Patient satisfaction gauges the quality of health care services. This study assessed the level of patient satisfaction on the health services and identified the challenges encountered by patients. Also, it compared the level of patient satisfaction in terms of their demographic profile. This descriptive-comparative design used a researcher-made survey questionnaire which was administered to 307 employees. The study revealed that the overall level of satisfaction was very high. A significant difference was found in the level of patient satisfaction when respondents were categorized according to sex and age. The most significant challenge encountered by patients was insufficient medicines and medical supplies. The findings were used as baseline data in designing a Clinic Manual of Procedures and Holistic Health Program for the Provincial Health Office.
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Rohrer, James E., Kurt B. Angstman, and Gregory Garrison. "Early Return Visits by Primary Care Patients: A Retail Nurse Practitioner Clinic Versus Standard Medical Office Care." Population Health Management 15, no. 4 (August 2012): 216–19. http://dx.doi.org/10.1089/pop.2011.0058.
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Heningtyas, Afina Hasnasari, and Iwan Dewanto. "Dental Visit, Dental Diseases, and Dental Therapist Pattern in The Implementation of NHI at Private Clinics." Journal of Indonesian Dental Association 1, no. 2 (April 30, 2019): 63. http://dx.doi.org/10.32793/jida.v1i2.354.
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Introduction: Since 2014 through the National Health Insurance (JKN) program, the pattern of health financing in Indonesia has been changed, in the first level health facilities (FKTP), from the fee for service payment to capitation payments system. Reports from the Public Health Office of Yogyakarta City showed that in 2014 there was an increased in basic dental services in the city of Yogyakarta by 68.01% from 2013. The Firdaus Pratama Clinic Yogyakarta is a primary clinic with medical and dental services as one of the providers of the JKN program since 2015. Objective: The purpose of this study was to evaluate the implementation of the national health insurance program in dentistry at Firdaus Pratama Clinic, Yogyakarta. Methods: The type of this research was descriptive observational study, with the method used in the form of secondary data observation. Secondary data was obtained through electronic medical records at Firdaus Pratama Clinic. This research was conducted at the Firdaus Pratama Clinic in Yogyakarta which has been working with BPJS since 2015. Results: The number of participants and the number of dental visits at the Firdaus Pratama Clinic continued to increase. The 3 diagnoses in dental services at the Firdaus Pratama Clinic that frequently found in the form of consultation were necrosis of pulp, dental caries, and pulpitis. Conclusion: The category of dental visits at Firdaus Pratama Clinic was high, which found more than 2% utilization based on the number of participants and dental visits
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Cottrell, David, Adrian Childs-Clarke, and A. Hamid Ghodse. "British Opiate Addicts: An 11-Year Follow-up." British Journal of Psychiatry 146, no. 4 (April 1985): 448–50. http://dx.doi.org/10.1192/bjp.146.4.448.
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SummaryA cohort of 83 British addicts from one clinic was followed-up after 11 years; Home Office records and medical notes were personally searched to trace current status. Twenty-nine were still using drugs, 37 were not known to be using drugs, and 17 had died. The group still using drugs had become markedly more stable on parameters of drug use, criminality, and social stability over the follow-up period.
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de Heus, Rianne AA, Maxime V. Tumelaire, Marcel GM Olde Rikkert, and Jurgen AHR Claassen. "Diagnostic accuracy of office blood pressure compared to home blood pressure in patients with mild cognitive impairment and dementia." European Journal of Cardiovascular Nursing 18, no. 7 (July 2, 2019): 637–42. http://dx.doi.org/10.1177/1474515119855822.
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Background: Hypertension and cognitive impairment often coexist in older people. Office blood pressure measurement is a poor indicator for diagnosing hypertension in the general population. However, its diagnostic accuracy has not been substantially studied in patients with cognitive impairment. Aim: The aim of this study was to determine the proportion of misdiagnosis of hypertension in patients with mild cognitive impairment and dementia compared to no cognitive impairment, by comparing office blood pressure measurement with home blood pressure measurement. Methods: A cross-sectional study including consecutive patients visiting a memory clinic between 2014 and 2017. Home blood pressure was measured for one week according to the European guidelines. Office blood pressure was assessed during routine clinical practice. Using guideline definitions for normal blood pressure and hypertension, we investigated the proportion of disagreement between office blood pressure measurement and home blood pressure measurement. Univariable and multivariable logistic regression compared disagreement in diagnosis between patients with dementia, mild cognitive impairment and no cognitive impairment. Results: Of 213 patients (aged 73.4±9.0 years, 42% women) 82 had dementia, 65 had mild cognitive impairment and 66 had no cognitive impairment. Mean office blood pressure was 156/84±23/11 mmHg and mean home blood pressure was 139/79±16/10 mmHg. In 31% of patients, there was disagreement in hypertension diagnosis. This proportion was higher for mild cognitive impairment (38.5%) and dementia (35.4%) compared to no cognitive impairment (18.2%), with adjusted odds ratios of 3.7 (95% confidence interval 1.5–9.0), P=0.005 for mild cognitive impairment and 3.4 (1.3–8.6), P=0.011 for dementia. Conclusions: In memory clinic patients with dementia and mild cognitive impairment, the diagnostic accuracy of office blood pressure measurement is lower compared to patients without cognitive impairment. To avoid the risk of making improper treatment decisions in this vulnerable group, a diagnosis of hypertension should be based on home blood pressure measurement, not office blood pressure measurement.
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Heningtyas, Afina Hasnasari, and Iwan Dewanto. "Dental Visit, Dental Diseases, and Dental Therapist Pattern in The Implementation of NHI at Private Clinics." Journal of Indonesian Dental Association 2, no. 1 (April 30, 2019): 29. http://dx.doi.org/10.32793/jida.v2i1.354.
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Introduction: Since 2014 through the National Health Insurance (JKN) program, the pattern of health financing in Indonesia has been changed, in the first level health facilities (FKTP), from the fee for service payment to capitation payments system. Reports from the Public Health Office of Yogyakarta City showed that in 2014 there was an increased in basic dental services in the city of Yogyakarta by 68.01% from 2013. The Firdaus Pratama Clinic Yogyakarta is a primary clinic with medical and dental services as one of the providers of the JKN program since 2015.
Objective: The purpose of this study was to evaluate the implementation of the national health insurance program in dentistry at Firdaus Pratama Clinic, Yogyakarta.
Methods: The type of this research was descriptive observational study, with the method used in the form of secondary data observation. Secondary data was obtained through electronic medical records at Firdaus Pratama Clinic. This research was conducted at the Firdaus Pratama Clinic in Yogyakarta which has been working with BPJS since 2015.
Results: The number of participants and the number of dental visits at the Firdaus Pratama Clinic continued to increase. The 3 diagnoses in dental services at the Firdaus Pratama Clinic that frequently found in the form of consultation were necrosis of pulp, dental caries, and pulpitis.
Conclusion: The category of dental visits at Firdaus Pratama Clinic was high, which found more than 2% utilization based on the number of participants and dental visits
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Keefe, Katherine R., Jessica R. Levi, and Christopher D. Brook. "The Impact of Medical Scribes on Patient Satisfaction in an Academic Otolaryngology Clinic." Annals of Otology, Rhinology & Laryngology 129, no. 3 (October 22, 2019): 238–44. http://dx.doi.org/10.1177/0003489419884337.
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Objectives: Evidence shows that scribes can improve provider efficiency and satisfaction in several settings, but is mixed on whether scribes improve patient satisfaction. We studied whether scribes improved patient satisfaction in an academic otolaryngology clinic. Methods: The authors performed a retrospective review of patient responses to the Press Ganey survey between 12/2016 and 12/2017. Their responses about satisfaction with the provider and wait times were examined. Three providers worked with scribes during this year; each spent six months with a scribe and six without. The authors compared survey responses from periods with and without scribes using the Fischer exact test. Average overall provider ratings were compared using the Student’s t-test. Results: A total of 87 patients filled out Press Ganey surveys for the 3 providers over the year: 54 for visits without scribes, and 33 for visits with scribes. Fischer exact analysis demonstrated no significant difference in satisfaction with providers and wait times for both individual providers and all providers combined (all P > .05). There was also no difference in patients’ likelihood of recommending the provider’s office ( P = .91). Overall provider rating (0-10 scale) was high without scribes (9.48 ± 1.06) and was unchanged by the presence of scribes (9.53 ± 0.8) ( P = .97). Conclusion: Patient satisfaction with wait times and providers was high overall and was not affected by the presence of a medical scribe.
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Liyanage, Nadeeja Roshini, Mahendra Arnold, and Supun Wijesinghe. "Utilization of government healthcare services by adult leprosy patients in the Western Province, Sri Lanka." PLOS Neglected Tropical Diseases 14, no. 12 (December 31, 2020): e0008973. http://dx.doi.org/10.1371/journal.pntd.0008973.
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Background The leprosy services utilization by the patients at the clinic and field level should be high to achieve the target of eliminating leprosy as a public health problem in Sri Lanka. Furthermore, assessing patient and health system delay of a diagnosis and patient knowledge on disease are of equal importance to reveal the accurate picture. Methods and findings A descriptive cross-sectional study was conducted to assess the utilization of government healthcare services by 672 adult leprosy patients in Western Province (WP). Paucibacillary patients diagnosed at least six months and above, and Multibacillary patients diagnosed at least 12 months and above were selected by consecutive sampling method. An interviewer-administered questionnaire (IAQ) was used for data collection. Clinic utilization by leprosy patients was 87.8%. The mean patient-related delay (time taken from the onset of symptoms to the encounter of a doctor/health facility for the first time) was 16.8 months and health care system delay (time taken from the date of clinic registration to start of treatment) was 21.2 days. The overall delay was 17.5 months. Services provided by the Medical Officer of Health (MOH) office for families affected with leprosy was known by 53.8% (n = 298) of patients. Majority of family contacts were examined at the hospitals (n = 299, 44%), 30.8% (n = 207) by the Public Health Inspectors (PHI) and 7% (n = 46) at the MOH offices. PHIs had visited 56.7% (n = 401) of the patient’s houses and 54% (n = 363) had received health education by PHI. Mean knowledge score was 50.7 (SD = 17.9). More than half (57.9%, n = 389) of the study sample had a good or very good knowledge level. Conclusions Utilization of clinic services was satisfactory. However, a considerable patient-related delay was found. Half of the patients were aware of available field services and a majority of contact screening was conducted at hospitals. Patient knowledge on leprosy was satisfactory.
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Shahangian, Shahram, Richard D. Cohn, Edward E. Gaunt, and John M. Krolak. "System to Monitor a Portion of the Total Testing Process in Medical Clinics and Laboratories: Evaluation of a Split-Specimen Design." Clinical Chemistry 45, no. 2 (February 1, 1999): 269–80. http://dx.doi.org/10.1093/clinchem/45.2.269.
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Abstract To evaluate a split-specimen design to identify problems in the testing process in hospital and physician office laboratories, we examined the testing for serum total cholesterol (n = 646) and potassium (n = 732) at 11 medical clinics evaluating 30–199 patients (mean, 125). Clinic personnel collected three tubes of blood from each patient. One specimen was processed routinely, the second was sent to a referral laboratory (RL), and the third specimen was sent to a holding facility for storage. The corresponding stored sample was retrieved and divided into three audit samples randomly and when result difference for the first two specimens exceeded critical values; one audit sample was sent to the original participant, the second to the RL, and the third to a referee laboratory. When three criteria were used, the result discrepancy rates were 2.5–8.7% for potassium and 1.5–4.6% for cholesterol. The split-specimen design could be implemented and evaluated as a monitoring system for a portion of the testing process.
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Hickman, David E., Marilyn R. Stebbins, John R. Hanak, and B. Joseph Guglielmo. "Pharmacy-Based Intervention to Reduce Antibiotic Use for Acute Bronchitis." Annals of Pharmacotherapy 37, no. 2 (February 2003): 187–91. http://dx.doi.org/10.1177/106002800303700204.
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BACKGROUND: Intervention programs can reduce inappropriate antibiotic use for the treatment of acute bronchitis in a closed health maintenance organization model. OBJECTIVE: To evaluate the impact of a pharmacy-based intervention program intended to reduce antibiotic use in the treatment of acute bronchitis in a community-based physician group model. SUBJECTS: Adult and pediatric patients with an office or urgent care visit for acute bronchitis during the baseline and study periods were included in the study. The clinicians were primary care physicians, nurse practitioners, and physician assistants in a suburban community-based physician group setting. METHODS: All patients treated for acute bronchitis from January 1 through June 30, 1998, were evaluated for initial receipt of antibiotics and use of clinic resources (office visits, additional antibiotics). From September through December of 1998, physicians were provided literature from the Centers for Disease Control and Prevention (CDC), cough and cold package inserts, and newsletters intended to educate the providers regarding the inappropriateness of antibiotics in the treatment of acute bronchitis. Patient-directed literature from the CDC was placed in the examination rooms and clinic waiting areas beginning September 1998. From January 1 through June 30, 1999, all patients treated for acute bronchitis were assessed for receipt of antibiotics and use of clinic resources. A separate geographic clinic site served as a control during both study periods. RESULTS: During 1998, 888 of 1840 patients (48.3%) received antibiotics for treatment of acute bronchitis; this total decreased to 924 of 2392 (38.6%; p ≤ 0.001) in 1999, a reduction of 20%. The rate of antibiotic prescribing in control patients was unchanged during the concomitant time periods (142/446, 31.8% vs. 102/321, 31.8%). The rate of subsequent physician visits was similar (8% vs. 9%) between patients receiving antibiotics and those who did not. However, significantly more patients initially receiving antibiotics required a subsequent antibiotic prescription (45/1812, 2.5% vs. 24/2420, 1.0%; p ≤ 0.001). CONCLUSIONS: A pharmacy-based intervention program reduces the incidence of inappropriate antibiotic use in the treatment of acute bronchitis. Reduced antibiotic prescribing does not increase consumption of healthcare resources; patients who receive antibiotics for acute bronchitis are more likely to subsequently require additional antibiotic prescriptions. While a significant decrease in antibiotic use was realized, other interventions are required to further reduce the prevalence of antibiotic use in acute bronchitis.
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Nguyen, Douglas L., Ramona S. DeJesus, and Mark L. Wieland. "Missed Appointments in Resident Continuity Clinic: Patient Characteristics and Health Care Outcomes." Journal of Graduate Medical Education 3, no. 3 (September 1, 2011): 350–55. http://dx.doi.org/10.4300/jgme-d-10-00199.1.
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Abstract Background Frequent missed patient appointments in resident continuity clinic is a well-documented problem, but whether rates of missed appointments are disproportionate to standard academic practice, what patient factors contribute to these differences, and health care outcomes of patients who frequently miss appointments are unclear. Methods The overall population for the study was composed of patients in an academic internal medicine continuity clinic with 5 or more office visits between January 2006 and December 2008. We randomly selected 325 patients seen by resident physicians and 325 patients cared for by faculty. Multivariate linear regression was used to examine the relationship between patient factors and missed appointments. Health outcomes were compared between patients with frequent missed appointments and the remainder of the study sample, using Cox regression analysis. Results Resident patients demonstrated significantly higher rates of missed appointments than faculty patients, but this difference was explained by patient factors. Factors associated with more missed appointments included use of a medical interpreter, Medicaid insurance, more frequent emergency department visits, less time impanelled in the practice, and lower proportion of office visits with the primary care provider. Patients with frequent missed appointments were less likely to be up to date with preventive health services and more likely to have poorly controlled blood pressure and diabetes. Conclusions We found that the disproportionate frequency of missed appointments in resident continuity clinic is explained by patient factors and practice discontinuity, and that patients with frequent missed appointments demonstrated worse health care outcomes.
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Garris, Joel J. "The Case for Patenting Medical Procedures." American Journal of Law & Medicine 22, no. 1 (1996): 85–108. http://dx.doi.org/10.1017/s0098858800010303.
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In contrast to the few medical procedure patents granted in the three decades following the 1950s, patent attorneys now estimate that the Patent and Trademark Office (PTO) grants at least a dozen medical procedure patents each week. This growing trend heightened the medical community’s concerns that such patents may adversely affect the cost, quality, and patient accessibility of medical care. Additionally, attempts by physicians to enforce medical procedure patents against other physicians further increased these concerns. One of the more widely publicized patented medical procedure cases involves an infringement suit over a patent for a method of making self-sealing episcleral incisions during cataract operations. On July 6, 1993, Dr. Samuel Pallin filed a lawsuit against fellow opthalmologist Dr. Jack Singer, accusing Dr. Singer and his clinic of performing hundreds of cataract operations using the patented procedure. The medical community views this case as an illustration of the problems that may arise in patenting medical procedures because Dr. Pallin’s suit restricts Dr. Singer’s use of a procedure that benefits patients.
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Olawole, W., and K. Kanmodi. "Factors Responsible for Delayed Presentation at the Dental Clinic of the Federal Medical Centre, Birnin Kebbi, Nigeria." Medical University 2, no. 1 (January 1, 2019): 12–20. http://dx.doi.org/10.2478/medu-2019-0004.
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Abstract Background: It is a very sad experience, as a clinician, to see a patient presenting very late at a dental office with complicated oral health-related problems when the initial causal problem is very cheap, easy, and simple to treat. This study aims to determine the factors causing delay in seeking dental treatment among the patients visiting the dental clinic of the Fedearal Medical Centre, Birnin Kebbi, Kebbi State, Nigeria. Methodology: This study was questionnaire-based survey of 172 non-paediatric patients attending the dental clinic of the Federal Medical Centre, Birnin Kebbi, Nigeria. Data was obtained on their socio-demographic characteristics and the reasons behind their late presentation. Data analysis was done using the SPSS Version 20 Software. Results: Most of the participating patients were males (57.6%), Muslims (73.8%) and of age 16 – 35 years (65.1%). Also, 66.9% of them were from the Hausa tribe, 62.8% were married, and 40.1% had polytechnic/university education. The reasons indicated by the respondents for their delay in seeking early oral healthcare services at our dental clinic were diverse. However, the three most commonly given reason were: busy work schedules, dental anxiety, and preference for traditional treatment options. Conclusion: This study provides evidence of delayed presentation among patients visiting the dental clinic of the Federal Medical Centre situated in the Birnin Kebbi metropolis. This study also identified the reasons for such delays. This study also corroborates other studies in ascertaining that delayed dental visit is a public health and clinical problem in the Nigerian setting. Hence, there is an imminent need to ensure that the public are educated on oral health issues.
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Volk, Angela S., Stephanie A. Marton, Brittany S. Richardson, Luis Rauda, Heidi L. Schwarzwald, and Neel M. Naik. "Oral Dexamethasone to Control Wheezing in Children at an Outpatient Clinic." Clinical Pediatrics 58, no. 2 (October 31, 2018): 151–58. http://dx.doi.org/10.1177/0009922818809466.
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Asthma, a chronic childhood disease, has resulted in increased emergency department (ED) visits with high costs. Many asthma ED visits are nonemergent and could be treated in outpatient clinics. Literature has concluded that a 2-day course of oral dexamethasone has comparable outcomes to a 5-day course of prednisone in the ED and hospital setting. A retrospective chart review was performed on children requiring in-house treatment with a corticosteroid (dexamethasone n = 23, prednisone n = 40) for acute asthma exacerbations at an ambulatory medical home. The rates of hospital admissions, ED visits, and symptom follow-up were similar between the 2 groups ( P > .05). The cost for a course of dexamethasone was US$1.28 versus US$16.20 for prednisolone. The average cost for an asthma exacerbation office visit was US$79.89 compared with US$3113.28 for an ED visit. A 2-day course of oral dexamethasone appears to be a promising clinical and cost-effective treatment for acute asthma exacerbations at the primary care level.
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Richards, Michael R., and Daniel Polsky. "Influence of provider mix and regulation on primary care services supplied to US patients." Health Economics, Policy and Law 11, no. 2 (October 7, 2015): 193–213. http://dx.doi.org/10.1017/s1744133115000390.
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AbstractAccess to medical care and how it differs for various patients remain key policy issues. While existing work has examined clinic structure’s influence on productivity, less research has explored the link between provider mix and access for different patient types – which also correspond to different service prices. We exploit experimental data from a large field study spanning 10 US states where trained audit callers were randomly assigned an insurance status and then contacted primary care physician practices seeking new patient appointments. We find clinics with more non-physician clinicians are associated with better access for Medicaid patients and lower prices for office visits; however, these relationships are only found in states granting full practice autonomy to these providers. Substituting more non-physician labor in primary care settings may facilitate greater appointment availability for Medicaid patients, but this likely rests on a favorable policy environment. Relaxing regulations for non-physicians may be an important initiative as US health reforms continue and also relevant to other countries coping with greater demands for medical care and related financial strain.
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Lisovskii, Oleg, Alexandr Gostimskii, Ivan Lisitsa, Anna Zavyalova, and Igor Karpatsky. "Optimization of the work of a nutritionist physician using tools of lean technologies in a simulated clinic." Vestnik of Saint Petersburg University. Medicine 15, no. 4 (2020): 283–89. http://dx.doi.org/10.21638/spbu11.2020.406.
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The article presents the possibilities of implementing the priority project “New model of medical organization providing primary health care” aimed at increasing the accessibility and satisfaction of patients with the quality of medical care. An example of an outpatient dietary consultation shows the resources for detecting medical losses and ways of optimizing the activities of medical personnel using the tools of lean technologies. The article reflects the experience of the Training Centre for lean technologies in health care of the Saint Petersburg State pediatric medical university, created in 2018 with the aim of training medical workers of different specialties to use tools of economical production in conditions of simulated clinic. The conduct of business games and “The Factories of Processes” makes it possible to reconstruct the work of the individual office or the entire polyclinic. The possibility of standardization of medical processes, use of check-lists in the work and organization of each cabinet, introduction of the system “5S” and identification of medical losses with subsequent optimization of the initial reception is presented. In this work “The Process Factory” “The optimization of the appointment of a doctor-specialist” is presented, allowing to make a detailed analysis of the duration and structure of the reception, to perform the mapping of medical processes and to use visual management, considering the efficiency, Safety and quality of the doctor’s work. The acquired skills in simulated conditions help to implement this methodology and effectively use the tools of lean technologies in practice.
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Wilgucki, J. D., Parker J. Williams, Ellie Westfall, Nieraj Jain, and Jiong Yan. "Feasibility and Efficacy of Same-Day, In-Office Genetic Testing for Inherited Retinal Diseases." Journal of VitreoRetinal Diseases 4, no. 3 (October 29, 2019): 181–85. http://dx.doi.org/10.1177/2474126419878145.
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Purpose: This article analyzes 2 practice patterns our institution uses for genetic testing of patients with inherited retinal diseases (IRDs) and compares testing completion and diagnostic yield rates. Methods: A retrospective, consecutive chart review series was conducted of patients with a clinically diagnosed rod-mediated IRD. All IRDs were diagnosed between 2 intervals: November 1, 2015, through November 30, 2016 (referral to a medical genetics clinic for testing) or December 1, 2016, through December 30, 2017 (same-day, in-office genetic testing). Results: A total of 189 patients were included in the study. Of patients who received an out-of-office referral for genetic testing, 10 of 84 (12%) patients proceeded with testing, whereas 74 of 84 (88%) patients did not complete testing. For patients who received in-office genetic testing, 104 of 105 (99%) completed testing. The difference in test completion was statistically significant ( P < .001). In addition, genetic testing for out-of-office referrals identified a causative mutation in 5 of 10 (50%) patients, whereas in-office genetic testing identified a causative mutation in 42 of 104 (40.4%) patients. The difference in causative mutation discovery was not statistically significant ( P = .18) between the 2 groups. Conclusions: In-office genetic testing is a novel practice pattern that provides a more consistent and accessible method for IRD genetic diagnosis. Compared with an out-of-office referral for genetic testing, in-office genetic testing offers a similar rate of causative gene mutation identification but a greatly higher rate of test completion, therefore potentially offering a much higher yield for genetic diagnosis of IRDs.
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Gabriel, Radu, Solomon Maria, Hostiuc Marinela, Bulescu I. Alexandru, and Purcarea Lorin Victor. "The efficiency of marketing strategies in health care - using social vouchers and coupons." Global Journal of Business, Economics and Management: Current Issues 8, no. 3 (November 27, 2018): 89–94. http://dx.doi.org/10.18844/gjbem.v8i3.3649.
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Introduction: Marketing strategies in the field of health care represent the health care organizations’ attitude towards the marketing environment and also their conduct in relation to its components. In this case, the product being sold is the medical service provided to the patient.Purpose of study: The purpose was to determine the efficiency of social voichers and coupons for marketing strategies.Methods: We have conducted a retrospective study using 2 groups of patients .In group A were included 220 patients of a dental clinic who have received 330 vouchers with 25% discount with the purpose of promoting medical services, by four different marketing strategies (E- mail, websites, distribution of coupons in the dental office and office area).In group B, 124 people were included, who have acquired vouchers through the internet for a free consultation and dental scaling. 142 vouchers were sold and 124 patients turned up, with an average age of 32.1 years. The 220 patients from group A were asked to complete a four-question survey, which allowed us to evaluate the effectiveness of the applied strategies. After the dental appointment, 97 patients from the group B were informed they require further treatment.Findings and results: The patients' response to recommendations was the marker for evaluating the marketing strategies.Conclusions: There are many marketing strategies. Through this study we wanted to evaluate their effectiveness in the case of a private medical practice, aiming to obtain patients’ loyalty, to increase the number of patients and performed treatments. We consider that the significant number of enrolled patients gives the study relevancy, analysing various promoting techniques.
Keywords: marketing strategies, dental clinic, coupons, vouchers, discount, patients
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Claire Simon, Kelly, Afif Hentati, Susan Rubin, Tiffani Franada, Darryck Maurer, Laura Hillman, Samuel Tideman, et al. "Successful utilization of the EMR in a multiple sclerosis clinic to support quality improvement and research initiatives at the point of care." Multiple Sclerosis Journal - Experimental, Translational and Clinical 4, no. 4 (October 2018): 205521731881373. http://dx.doi.org/10.1177/2055217318813736.
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Background Many physicians enter data into the electronic medical record (EMR) as unstructured free text and not as discrete data, making it challenging to use for quality improvement or research initiatives. Objectives The objective of this research paper was to develop and implement a structured clinical documentation support (SCDS) toolkit within the EMR to facilitate quality initiatives and practice-based research in a multiple sclerosis (MS) practice. Methods We built customized EMR toolkits to capture standardized data at office visits. Content was determined through physician consensus on necessary elements to support best practices in treating patients with demyelinating disorders. We also developed CDS tools and best practice advisories within the toolkits to alert physicians when a quality improvement opportunity exists, including enrollment into our DNA biobanking study at the point of care. Results We have used the toolkit to evaluate 541 MS patients in our clinic and begun collecting longitudinal data on patients who return for annual visits. We provide a description and example screenshots of our toolkits, and a brief description of our cohort to date. Conclusions The EMR can be effectively structured to standardize MS clinic office visits, capture data, and support quality improvement and practice-based research initiatives at the point of care.
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Fenn, Norman E., Natalie R. Gadbois, Gwen J. Seamon, Shannon L. Castek, and Kimberly S. Plake. "Development of a Unique Student Pharmacist Internship in a Primary Care Provider System." Pharmacy 7, no. 2 (April 13, 2019): 36. http://dx.doi.org/10.3390/pharmacy7020036.
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Purpose: To describe a unique pharmacy intern program in a group of federally qualified health center (FQHC) outpatient primary care provider clinics. Summary: A pharmacy intern program was created at the North Central Nursing Clinics in Indiana, a group of four FQHC outpatient primary care provider facilities. Intern-performed tasks included: Prior authorization (PA) requests, medication assistance program (MAP) applications, sample procurement and inventory, and contraceptive devices for implantation inventory management. Interns interacted with clinic administration, nurse practitioners, and medical staff to complete their assigned responsibilities. Over a one-year period, the interns completed documentation on more than 2000 charts during a combined 12 h a week. Interns identified the interprofessional interactions as the most beneficial experience, while providers acknowledged no difference in the processing of paperwork during the transition of duties from pharmacy fellow to intern. Conclusion: This unique pharmacy intern program was successfully created and implemented in a primary care provider office, resulting in learning opportunities for pharmacy interns, as well as operational efficiencies to fellows, providers, and the organization.
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Trisna, Dhanasari Vidiawati, Riri Indriyanti, and Mora Claramita. "Starting Online Services at University Clinics at the Beginning of the Covid-19 Pandemic." Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) 3, no. 3 (January 2, 2021): 2. http://dx.doi.org/10.22146/rpcpe.62772.
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The UI Makara Satellite Clinic (KSUI) is a university clinic that serves UI residents and the public as well as a vehicle for education and health research in primary services. It has been a BPJS Outpatient Service Clinic (KPRJ) since October 2018. It is called a Satellite Clinic because it is planned to become a satellite for university hospitals in the academic health system at the University of Indonesia. Currently, KSUI is located on the Depok campus and the Salemba campus. In its daily services at the Depok campus, KSUI provides services for doctors, dentists, nursing, pharmacy, laboratories, action rooms, and psychological counseling.KSUI’s mission is not the same as an ordinary outpatient clinic, but because KSUI is a health service facilitated by the university, KSUI has a mission to maintain the health of the academic community, and not only treat them when they fall ill. Therefore, in addition to services that respond to patients coming to the clinic, KSUI also organizes periodic health check services, facilitates Posbindu activities in the faculties and office buildings on campus, and participates in medical care at any gathering or sports activities provided on campus.With the Covid-19 case being found in Indonesia, KSUI decided to change its service method as quickly and as firmly as possible from face-to-face services to online services, following the Chancellor’s Decree to close the campus from face-to-face learning and other student activities. With the return of the UI dormitory students and the implementation of work from home (WFH) for lecturers and education staff, KSUI must provide safe services during a pandemic and can be accessed by service users without having to come to campus. Therefore, this article is a brief piece of information that has been done by KSUI when it decided that services should be carried out online. It is not easy for the officer, because it has never been done, and it is not easy for the patient.
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Schuh, Michael J., and Sheena Crosby. "Description of an Established, Fee-for-Service, Office-Based, Pharmacist-Managed Pharmacogenomics Practice." Senior Care Pharmacist 34, no. 10 (December 1, 2019): 660–68. http://dx.doi.org/10.4140/tcp.n.2019.660.
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OBJECTIVE: To describe an established, pharmacist-managed, fee-for-service, office-based pharmacogenomics (PGx) practice.<br/> SETTING: Multi-specialty, academic, tertiary care medical clinic and hospital.<br/> PRACTICE DESCRIPTION: Physician office-based PGx fee-for-service (FFS) pharmacist practice. Patients seen are complex and most are older adults.<br/> INNOVATION: Established service in a new area of ambulatory practice that is financially self-sustaining. Patients who received PGx testing were seen within the medication therapy management polypharmacy practice since 2015, with the PGx practice becoming official in 2018.<br/> MAIN OUTCOME MEASUREMENTS: Growth of practice, evaluated by referred patient consults ordered per month by providers.<br/> RESULTS: Because of insufficient third-party payment for PGx services, the practice was developed as a selfpay, FFS practice and growing because of patient and provider demand.<br/> CONCLUSION: It is quite possible pharmacists in greater numbers can expand PGx services into ambulatory and inpatient areas they may have never otherwise entered now that PGx has grown in use and relevance. PGx presents additional opportunities and service lines for pharmacists to practice how they were trained and assist them in collaborative integration onto the medical team.
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Andress, K. "(A332) Increasing Medical Situational Awareness and Interoperability via “Virtual USA”." Prehospital and Disaster Medicine 26, S1 (May 2011): s93. http://dx.doi.org/10.1017/s1049023x11003165.
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IntroductionHistory is replete with interoperability and resource reporting deficits during disaster that impact medical response and planning. Situational awareness for disaster and emergency medical response includes communicating health hazards as well as infrastructure and resource status, capability and GIS location. The need for actionable, real-time data is crucial to response. Awareness facilitates medical resource placement, response and recovery. A number of internet, web-based disaster resource and situational status reporting applications exist but may be limited or restricted by functional, jurisdictional, proprietary and/or financial requirements. Restrictions prohibit interoperability and inhibit information sharing that could affect health care delivery. Today multiple United States jurisdictions are engaged in infrastructure and resource situation status reporting via “virtual” states and regional projects considered components of “Virtual USA”.MethodsThis report introduces the United States' Department of Homeland Security's “Virtual USA” initiative and demonstrates a health application and interoperability via “Virtual Louisiana's” oil spill related exposure reporting during the 2010, British Petroleum Gulf Horizon catastrophe. Five weekly Louisiana Department of Health and Hospital summary reports from the Louisiana Poison Center; Hospital Surveillance Systems; Public Health Hotline; and Physician Clinic Offices were posted on the Louisiana Office of Homeland Security and Emergency Preparedness's “Virtual Louisiana”.Results227 total spill-related, exposure cases from five reporting weeks were provided by five Louisiana source agencies and reported in Virtual Louisiana. Cases were reported weekly and classified as “workers” or “population”; associated with the parish exposure locations (8), offshore (1), or unknown (1); and shared with four other virtual states.ConclusionsReal-time health and medical situation status, resource awareness, and incident impact could be facilitated through constructs demonstrated by “Virtual USA”.
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Li Huang, Yu. "The Development of Patient Scheduling Groups for an Effective Appointment System." Applied Clinical Informatics 07, no. 01 (January 2016): 43–58. http://dx.doi.org/10.4338/aci-2015-08-ra-0097.
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SummaryPatient access to care and long wait times has been identified as major problems in outpatient delivery systems. These aspects impact medical staff productivity, service quality, clinic efficiency, and health-care cost.This study proposed to redesign existing patient types into scheduling groups so that the total cost of clinic flow and scheduling flexibility was minimized. The optimal scheduling group aimed to improve clinic efficiency and accessibility.The proposed approach used the simulation optimization technique and was demonstrated in a Primary Care physician clinic. Patient type included, emergency/urgent care (ER/UC), follow-up (FU), new patient (NP), office visit (OV), physical exam (PE), and well child care (WCC). One scheduling group was designed for this physician. The approach steps were to collect physician treatment time data for each patient type, form the possible scheduling groups, simulate daily clinic flow and patient appointment requests, calculate costs of clinic flow as well as appointment flexibility, and find the scheduling group that minimized the total cost.The cost of clinic flow was minimized at the scheduling group of four, an 8.3% reduction from the group of one. The four groups were: 1. WCC, 2. OV, 3. FU and ER/UC, and 4. PE and NP. The cost of flexibility was always minimized at the group of one. The total cost was minimized at the group of two. WCC was considered separate and the others were grouped together. The total cost reduction was 1.3% from the group of one.This study provided an alternative method of redesigning patient scheduling groups to address the impact on both clinic flow and appointment accessibility. Balance between them ensured the feasibility to the recognized issues of patient service and access to care. The robustness of the proposed method on the changes of clinic conditions was also discussed.
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Doty, Richard L. "Office Procedures for Quantitative Assessment of Olfactory Function." American Journal of Rhinology 21, no. 4 (July 2007): 460–73. http://dx.doi.org/10.2500/ajr.2007.21.3043.
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Background Despite the importance of the sense of smell for establishing the flavor of foods and beverages, as well as protecting against environmental dangers, this primary sensory system is commonly ignored by the rhinologist. Methods In this article basic issues related to practical measurement of olfactory function in the clinic are described and examples of the application of the two most common paradigms for such measurement—odor identification and detection–are presented. A listing is made of the 27 olfactory tests currently used clinically, along with their strengths and weaknesses. A brief review of common nasosinus-related disorders for which quantitative olfactory testing has been performed is provided. Results Although many psychophysical tests are available for quantifying olfactory loss, it is apparent that a number are limited in terms of practicality, sensitivity, and reliability. In general, sensitivity and reliability are positively correlated with test length. Given the strengths of the more reliable forced-choice pyschophysical tests and the limitations of electrophysiological tests, the common distinction between “subjective” and “objective” tests is misleading and should not be used. Complete recovery of olfactory function, as measured quantitatively, rarely follows surgical or medical interventions in patients with rhinosinusitis. Conclusion Given the availability of practical clinical olfactory tests, the modern rhinologist can easily quantify cranial nerve (CN) I function. The application of such tests has led to a new understanding of the effects of nasal disease on olfactory function. Except in cases of total or near-total nasal obstruction, olfactory and airway patency measures usually are unrelated, in accord with the concept that rhinosinusitis primarily influences olfactory function by apoptotic pathological changes within the olfactory neuroepithelium.
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Gerka Stuyt, John A., Lauren Luk, David Keschner, and Rohit Garg. "Evaluation of In-Office Cryoablation of Posterior Nasal Nerves for the Treatment of Rhinitis." Allergy & Rhinology 12 (January 2021): 215265672098856. http://dx.doi.org/10.1177/2152656720988565.
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Background Chronic rhinitis is a common condition generally treated with medical therapies. However, 10–22% of patients are refractory to medical therapies. A cryotherapy handheld device targeting the postganglionic nerve fibers of the posterior nasal nerve (PNN) now serves as an additional option for therapy. This study evaluates the efficacy of the cryosurgical ablation device of the PNN in the clinic setting. Methods This was a prospective single-arm trial of 24 adult patients at seven locations within a large health maintenance organization. Patients with chronic rhinitis that failed medical therapy were offered an in-office cryoablation of PNN. Patients completed the Total Nasal Symptom Score (TNSS) questionnaire consisting of 5 items reported based on the previous 12 hours and 2 weeks at the following time points: pre-treatment, 30 days, 90 days and 1 year post-treatment. Results Following cryoablation of the PNN, the TNSS 12-hour symptom score improved from 6.92 (±2.9) to 3.17 (±2.4, P < 0.001) at 30 days, 2.92 (±1.4, P < 0.001) at 90 days and 3.08 (±2.6, P < 0.001) at 1 year post treatment. Similar results were noted for the 2 weeks scores improving from 7.75 (±3.1) to 3.79 (±2.1, P < 0.001) at 30 days, 3.88 (±1.9, P < 0.001) at 90 days and 3.76 (±2.1, P < 0.001) at 1 year post-treatment. 64.7% of respondents stated the procedure decreased or eliminated nasal sprays. Conclusions Our independent evaluation of cryoablation of the PNN shows improvement in nasal symptoms over a 1 year period and is consistent with other published data.
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Graff, Kerry. "A Micropractice/Community Partnership Model for Lifestyle Medicine." American Journal of Lifestyle Medicine 12, no. 2 (August 17, 2017): 124–27. http://dx.doi.org/10.1177/1559827617726524.
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Lifestyle medicine (LM) has been shown to be effective at preventing and reversing disease, while simultaneously reducing overall medical expenses. However, the current health care system is not designed to reimburse LM clinicians for the value that they provide. The micropractice model is an innovative approach to deliver LM in a financially viable manner. Costs are minimized by automating much of the practice through a website, limiting physical clinic space, and employing only essential staff. Described in this article is a unique micropractice family medicine/lifestyle medicine hybrid office that has partnered with a local health system and a culinary center to offer additional services.
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Kwon, Michelle, Chung Sang Tse, Michael Danielewicz, Welmoed van Deen, and Samir Shah. "P028 URGENT MEDICAL ACCESS FOR PATIENTS WITH INFLAMMATORY BOWEL DISEASE AT A PRIVATE COMMUNITY GASTROENTEROLOGY PRACTICE." Inflammatory Bowel Diseases 26, Supplement_1 (January 2020): S57—S58. http://dx.doi.org/10.1093/ibd/zaa010.147.
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Abstract Background Patients with inflammatory bowel disease (IBD) have chronic, life-long diseases with relapsing-remitting pattern that often require frequent utilization of healthcare services.[1] Urgent access to specialty care can help identify patients with acute medical needs so they can receive appropriate care in a timely manner. This can avoid unnecessary high-cost medical interventions, such as visits to the emergency department (ED), which often lead to excess use of steroids, narcotics, and radiographic imaging, all important measures of quality of IBD care.[2] We sought to introduce an access/quality improvement program at a private gastroenterology practice with the goal of triaging and returning urgent calls from IBD patients in a timely manner and mitigate avoidable visits to the ED. Methods Gastroenterologists, nurses, and support staff at our private practice developed four criteria for “urgent” IBD calls: new, severe abdominal pain; new, severe anal pain; fever greater than 101 Fahrenheit; and refractory emesis. Patient calls that met any of these criteria were highlighted with a red flag and labelled as “IBD URGENT” by support staff in the electronic medical system. The primary gastroenterologist (or covering provider) then responded to these calls as soon as possible with a goal of responding within 4 hours. Subsequently, patients were advised to go to the ED for further emergent evaluation, given same/next day clinic visits, and/or given advice, such as medication changes, by the gastroenterologists. Results Over a 15-month period from June 2018 to August 2019, we received a total of 167 “IBD URGENT” calls (average 11 calls per month); of these, 92% (153 calls) received a response from a gastroenterologist within 4 hours. Abdominal pain, diarrhea, blood in the stools, and vomiting were the most common reasons for urgent calls. Only 10% (16 calls) of calls were patients with worrisome symptoms in which they were advised to go to the ED, 37% of calls led to same/next day clinic visits (62 calls), and 58% resulted in advice/orders from the gastroenterologist such as laboratory testing, medication continuation/changes (97 calls); 12% (20 calls) resulted in both urgent clinic visits and advice (e.g., obtain laboratory testing and then present for office visit). Conclusion We piloted an urgent care hotline for IBD patients to receive rapid medical access at a private community gastroenterology practice. The majority of patients were successfully managed with outpatient medical care, including same/next-day office visits and advice for laboratory testing/medication changes. Only a minority (10%) of calls resulted in ED visits. We plan to continue this project with the aim to return more than 90% of the urgent calls within 4 hours. References
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Sari, Murni Mala, and Pitri Yandri. "ANALISIS KORELASI RASIO KEUANGAN ( Rasio Likuiditas, Solvabilitas, Aktivitas, Dan Rentabilitas )." BALANCE : JURNAL AKUNTANSI DAN BISNIS 4, no. 2 (November 13, 2019): 622. http://dx.doi.org/10.32502/jab.v4i2.1988.
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This study aims to analyze the relationship between financial ratios at PT SWA Indomedika Prima. PT SWA Indomedika Prima is a company engaged in the field of health services by managing a group practice clinic specialist to serve Outpatient and Medical check-ups in BNI's Big Office divisions, Regional offices and BNI Branches throughout Jabodetabek and Karawang, Serang and Credit Centers Middle and small and Non BNI. This study uses the Structual Equation Modeling (SEM) analysis method. This research was conducted to find out how the relationships that occur in financial ratios, whether there is a positive or negative relationship. The ratio used in this study is Current Ratio (CR), Quick Ratio (QR), Cash Ratio (CsR), Debt Ratio (DR), Debt to Equity (DER), Total Asset Turn Over (TATO), Working Capital Turn Over (WCT), Return on Assets (ROA), Return on Equity (ROE). This study uses financial statements of PT SWA Indomedika Prima for 8 (eight) years, namely the period 2010-2017. The results of testing this study will be discussed further in this article.
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Nowakowski, Sara, Emily Arentson-Lantz, Ahmad Debian, Manasa Kokanda, and Fidaa Shaib. "710 Association of Social Isolation, Perceived Stress, and CPAP Use in Sleep Medicine Patients during the COVID-19 Pandemic." Sleep 44, Supplement_2 (May 1, 2021): A277. http://dx.doi.org/10.1093/sleep/zsab072.708.
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Abstract Introduction Due to the COVID-19 pandemic, many individuals are likely experiencing increased stress and social isolation. This study aimed to examine the effect of perceived stress and social isolation on self-reported continuous positive airway pressure (CPAP) use and treatment adherence among sleep medicine clinic patients during the pandemic. Methods Between June-November 2020, 81 sleep medicine clinic patients (54.8±15.9y, 44% male, 69% Caucasian) completed an online survey that included self-reported changes in CPAP use and using CPAP as advised; and PROMIS Social Isolation and Perceived Stress Scale (PSS). CPAP measures were categorized based on reported changes during the pandemic. Stepwise logistic regression was performed using SAS to determine if Social Isolation and PSS predicted change in CPAP measures. Results Among participants, 53% reported using CPAP. Out of those, 61% reported change, 16% reported no change, and 23% reported they do not know if there is a change in using CPAP as advised during the pandemic. Social Isolation predicted an increase in odds of CPAP use by a factor of 1.15 (p=0.024). PSS predicted a decrease in odds of using CPAP therapy as advised by a factor of 0.86 (p=0.049). Conclusion Increases in perceived stress predicted lower odds of utilizing CPAP as advised. Increases in self-reported social isolation predicted greater odds of CPAP use in sleep medicine clinic patients during the COVID-19 pandemic. Addressing stressors/coping and social isolation/support as part of routine clinical care in sleep medicine clinic patients is advised. Support (if any) This work is supported by National Institutes of Health Grant # R01NR018342 (PI: Nowakowski) and by the Department of Veteran Affairs, Veterans Health Administration, Office of Research and Development, and the Center for Innovations in Quality, Effectiveness and Safety (CIN 13–413).