Bibliografías temáticas / Ambulatory Care Clinic

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Literatura académica sobre el tema "Ambulatory Care Clinic"

Autor: Grafiati
Publicado: 4 de junio de 2021
Última modificación: 15 de febrero de 2022

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Artículos de revistas sobre el tema "Ambulatory Care Clinic"

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Mason, Julie D. y Colleen A. Colley. "Effectiveness of an Ambulatory Care Clinical Pharmacist: A Controlled Trial". Annals of Pharmacotherapy 27, n.º 5 (mayo de 1993): 555–59. http://dx.doi.org/10.1177/106002809302700503.

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OBJECTIVE: To compare two general medicine clinics to determine the effectiveness of an ambulatory care clinical pharmacist in assisting recognition of drug therapy problems for physicians and decreasing drug therapy costs. DESIGN: Controlled trial SETTING: Two general medicine ambulatory care clinics associated with a large, tertiary-care teaching hospital. PATIENTS: Those with scheduled and completed appointments in the clinics during the two-week study period. METHODS: Medication profiles of patients attending clinic A (pharmacist intervention) and clinic B (no pharmacist intervention) were reviewed by the pharmacist prior to clinic appointments. Potential drug therapy problems were identified at each clinic, but interventions were performed only at clinic A. Postappointment audits determined the number of recommendations implemented at clinic A versus the number of drug therapy problems (potential interventions) recognized and addressed by clinic B physicians independently of pharmacist intervention. Potential and actual savings were extrapolated to one year from the two-week study period. RESULTS: Implementation of interventions at clinic A was greater than at clinic B (p<0.001). Drug therapy cost savings at clinic A were annualized to yield $185 per intervention. Potential cost savings of $176 724, or four times the pharmacist salary costs, is projected. CONCLUSIONS: An ambulatory care pharmacist is effective in identifying drug therapy problems, resulting in significant cost savings to the institution.
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Pincavage, Amber T., Rabia R. Razi, Vineet M. Arora, Julie Oyler y James N. Woodruff. "Resident Education in Free Clinics: An Internal Medicine Continuity Clinic Experience". Journal of Graduate Medical Education 5, n.º 2 (1 de junio de 2013): 327–31. http://dx.doi.org/10.4300/jgme-d-12-00127.1.

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Abstract Background Most internal medicine (IM) residency programs provide ambulatory training in academic medical centers. Community-based ambulatory training has been suggested to improve ambulatory and primary care education. Free clinics offer another potential training setting, but there have been few reports about the experience of IM residents in free clinics. Objective We assessed the feasibility and acceptability of inclusion of an ambulatory rotation in a free clinic and IM residency curriculum and the advantages of the free clinic setting over the traditional ambulatory clinic model. Methods In 2010, the University of Chicago Internal Medicine Residency Program partnered with a free clinic in order to establish a community-based continuity clinic experience. To assess the feasibility of this innovation, 16 residents were surveyed 9 months after implementation of the clinic to determine satisfaction, perceived preparation to address common medical conditions, and attitudes toward the underserved care population. A subset of these responses was compared to responses from residents in the traditional clinic model. Results Residents in the free clinic rotation were more satisfied and perceived they were more prepared to work in low-resource settings and reported similar levels of preparation regarding common outpatient conditions than residents in a traditional continuity clinic format. They reported increased future likelihood of working in an underserved clinic. Conclusions Our exploratory study suggests free clinics may be an effective platform for community-based continuity clinic training.
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Wieland, Mark L., Thomas M. Jaeger, John B. Bundrick, Karen F. Mauck, Jason A. Post, Matthew R. Thomas y Kris G. Thomas. "Resident Physician Perspectives on Outpatient Continuity of Care". Journal of Graduate Medical Education 5, n.º 4 (1 de diciembre de 2013): 668–73. http://dx.doi.org/10.4300/jgme-05-04-40.

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Abstract Background The outpatient continuity clinic is an essential component of internal medicine residency programs, yet continuity of patient care in these clinics is suboptimal. Reasons for this discontinuity have been inadequately explored. Objective We sought to assess perceived factors contributing to discontinuity in trainee ambulatory clinics. Methods The study encompassed 112 internal medicine residents at a large academic medical center in the Midwest. We conducted 2 hours of facilitated discussion with 18 small groups of residents. Residents were asked to reflect on factors that pose barriers to continuity in their ambulatory practice and potential mechanisms to reduce these barriers. Resident comments were transcribed and inductive analysis was performed to develop themes. We used these themes to derive recommendations for improving continuity of care in a resident ambulatory clinic. Results Key themes included an imbalance of clinic scheduling that favors access for patients with acute symptoms over continuity, clinic triage scripts that deemphasize continuity, inadequate communication among residents and faculty regarding shared patients, residents' inefficient use of nonphysician care resources, and a lack of shared values between patients and providers regarding continuity of care. Conclusions The results offer important information that may be applied in iterative program changes to enhance continuity of care in resident clinics.
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Hixson-Wallace, Julie A., Beth Barham, Randell K. Miyahara y Charles M. Epstein. "Pharmacist Involvement in a Seizure Clinic". Journal of Pharmacy Practice 6, n.º 6 (diciembre de 1993): 278–82. http://dx.doi.org/10.1177/089719009300600604.

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The role of the clinical pharmacist in ambulatory care settings has expanded in the last several years. Various types of clinical pharmacy services in ambulatory clinics have been reported in the literature. This article seeks to describe the involvement of clinical pharmacists as primary-care givers in an outpatient neurology-seizure clinic of the Veterans Affairs Medical Center in Atlanta, GA. The Neurology-Seizure clinical pharmacy services are provided by faculty, residents, and students from Mercer University Southern School of Pharmacy. The faculty members have been granted clinical privileges to practice in the ambulatory clinics in order to function with authority to perform such duties as giving medication renewals, and writing in the medical chart. In the clinic itself, the pharmacist is responsible for providing a medication profile, an initial interview with the patient, a minor neurological examination, presentation of the patient to the attending neurologist, writing of a SOAP (subjective, objective, assessment and plan) note, an end-of-appointment consultation, completion of a clinic flow sheet, maintenance of the clinic record, follow-up phone calls relating the results of anti-epileptic drug levels, and monthly quality assurance summaries. Clinical pharmacist-supervised primary care outpatient clinics can be rewarding endeavors. Through close patient contact and interaction with attending physicians, pharmacists can greatly assist with pharmaceutical care and provide expert drug management of seizure patients.
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Mohiuddin, AK. "The New Era of Pharmacists in Ambulatory Patient Care". INNOVATIONS in pharmacy 10, n.º 1 (15 de enero de 2019): 4. http://dx.doi.org/10.24926/iip.v10i1.1622.

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Ambulatory care pharmacy practice is defined as the provision of integrated, accessible healthcare services by pharmacists who are accountable for addressing medication needs, developing sustained partnerships with patients, and practicing in the context of family and community. This is accomplished through direct patient care and medication management for ambulatory patients, long-term relationships, coordination of care, patient advocacy, wellness and health promotion, triage and referral, and patient education and self-management. The ambulatory care pharmacists may work in both an institutional and community-based clinic involved in direct care of a diverse patient population. A variety of specialty clinics are available for allergy and immunology, pulmonology, endocrinology, cardiology, nephrology, neurology, behavioral health, and infectious disease. Such services for this population may exist as a primary care clinic or an independent specialty clinic, typically in a PCMH, which is instrumental in coordinating care between various providers. Once a practice site is identified, it is important to establish a strong, trusting, and mutually beneficial relationship with the various decision-makers (e.g., administrators, providers) involved with the clinic. If pharmacy services are currently in existence, the pharmacy director may be able to identify and initially contact the appropriate person. If another pharmacist is providing clinical services, this person would be a resource to help determine areas for expansion of patient care and to whom to direct the proposed business plan. Additional individuals to consider as an initial point of contact include the clinic manager, clinic medical director, or administrative assistant to either of these persons. If the clinic setting is affiliated with a medical school, it may be necessary to contact the Department of Family Medicine head. Article Type: Commentary
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Tafreshi, Javad, Michelle A. Chui y Amy B. Riley. "Implementation of an amiodarone ambulatory care clinic". American Journal of Health-System Pharmacy 66, n.º 22 (15 de noviembre de 2009): 1997–2001. http://dx.doi.org/10.2146/ajhp080555.

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Olson, Kimberly. "Integrating Pharmaceutical Care into an HIV Clinic". Journal of Pharmacy Practice 10, n.º 1 (febrero de 1997): 52–67. http://dx.doi.org/10.1177/089719009701000106.

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The purpose of this article is to describe the integration of clinical pharmacy services into an already exist ing HIV clinic. Ambulatory care pharmacy services were the only discipline not represented in the hospi tal based HIV clinic. With the move toward ambulatory care, the introduction of the new class of HIV drugs called the protease inhibitors, and the strong physician support of inpatient pharmacy services, the tim ing for pharmacy integration into the clinic was optimal. This article describes our goals for the clinic, the need for justification of pharmacy services through documentation, and the preparation steps made which established permanent pharmacy services in the HIV clinic. Daily procedures, interventions, statis tics of the pharmacy service, and barriers to success are also described. Patient information materials and examples of the documentation forms used by the clinic pharmacists are provided. This article is meant to aid other pharmacists who wish to integrate pharmacy services into an ambulatory HIV clinic setting.
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Siedner, Mark J., John D. Kraemer, Mark J. Meyer, Guy Harling, Thobeka Mngomezulu, Patrick Gabela, Siphephelo Dlamini et al. "Access to primary healthcare during lockdown measures for COVID-19 in rural South Africa: an interrupted time series analysis". BMJ Open 10, n.º 10 (octubre de 2020): e043763. http://dx.doi.org/10.1136/bmjopen-2020-043763.

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ObjectivesWe evaluated whether implementation of lockdown orders in South Africa affected ambulatory clinic visitation in rural Kwa-Zulu Natal (KZN).DesignObservational cohortSettingData were analysed from 11 primary healthcare clinics in northern KZN.ParticipantsA total of 46 523 individuals made 89 476 clinic visits during the observation period.Exposure of interestWe conducted an interrupted time series analysis to estimate changes in clinic visitation with a focus on transitions from the prelockdown to the level 5, 4 and 3 lockdown periods.Outcome measuresDaily clinic visitation at ambulatory clinics. In stratified analyses, we assessed visitation for the following subcategories: child health, perinatal care and family planning, HIV services, non-communicable diseases and by age and sex strata.ResultsWe found no change in total clinic visits/clinic/day at the time of implementation of the level 5 lockdown (change from 90.3 to 84.6 mean visits/clinic/day, 95% CI −16.5 to 3.1), or at the transitions to less stringent level 4 and 3 lockdown levels. We did detect a >50% reduction in child healthcare visits at the start of the level 5 lockdown from 11.9 to 4.7 visits/day (−7.1 visits/clinic/day, 95% CI −8.9 to 5.3), both for children aged <1 year and 1–5 years, with a gradual return to prelockdown within 3 months after the first lockdown measure. In contrast, we found no drop in clinic visitation in adults at the start of the level 5 lockdown, or related to HIV care (from 37.5 to 45.6, 8.0 visits/clinic/day, 95% CI 2.1 to 13.8).ConclusionsIn rural KZN, we identified a significant, although temporary, reduction in child healthcare visitation but general resilience of adult ambulatory care provision during the first 4 months of the lockdown. Future work should explore the impacts of the circulating epidemic on primary care provision and long-term impacts of reduced child visitation on outcomes in the region.
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Harrison, Joshua W., Astha Ramaiya y Peter Cronkright. "Restoring Emphasis on Ambulatory Internal Medicine Training—The 3∶1 Model". Journal of Graduate Medical Education 6, n.º 4 (1 de diciembre de 2014): 742–45. http://dx.doi.org/10.4300/jgme-d-13-00461.1.

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Abstract Background Resident dissatisfaction in ambulatory care training has prompted the need for new scheduling models that support a positive learning climate. Intervention We instituted a 3∶1 scheduling model for postgraduate year (PGY)–2 and PGY-3 residents. We hypothesized this model would provide a more structured ambulatory educational atmosphere, better continuity of care, and more exposure to subspecialty outpatient medicine. This model would also eliminate conflict with inpatient duties and contribute to enhance residents′ satisfaction with ambulatory medicine and their ambulatory education experience. The model used weeklong ambulatory blocks every fourth week, consisting of morning continuity clinic and afternoon subspecialty clinics. The PGY-1 residents maintained a traditional schedule. Results Residents were surveyed regarding their ambulatory experience, with an overall response rate of 73 of 80 (91%). The PGY-2 and PGY-3 responses were analyzed descriptively and compared with PGY-1 responses. Residents reported that the 3∶1 model positively affected their satisfaction with residency training in general, their satisfaction with outpatient/primary care training, and their outpatient/clinic educational experience. Residents in the 3∶1 model perceived improvements in continuity of care and in the quality of care they provided for patients. The experience in ambulatory subspecialty training was positive. Conclusions A 3∶1 scheduling model appears to mitigate some of the conflict between inpatient and outpatient duties. Residents agreed the new model promoted an improved ambulatory experience.
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Lampkin, Stacie J., Brooke Gildon, Sandra Benavides, Kelly Walls y Leslie Briars. "Considerations for Providing Ambulatory Pharmacy Services for Pediatric Patients". Journal of Pediatric Pharmacology and Therapeutics 23, n.º 1 (1 de enero de 2018): 4–17. http://dx.doi.org/10.5863/1551-6776-23.1.4.

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Pediatric clinical pharmacists are an integral part of the health care team. By practicing in an ambulatory care clinic, they can reduce the risk of medication errors, improve health outcomes, and enhance patient care. Unfortunately, because of limited data, misconceptions surrounding the role of pharmacists, and reimbursement challenges, there may be difficulty in establishing or expanding pediatric clinical pharmacy services to an ambulatory care setting. The purpose of this paper is to provide an overview of considerations for establishing or expanding pharmacy services in a pediatric ambulatory care clinic. The primer will discuss general and pediatric-specific pharmacy practice information, as well as potential barriers, and recommendations for identifying a practice site, creating a business plan, and integrating these services into a clinic setting.
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Tesis sobre el tema "Ambulatory Care Clinic"

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Lee, Amy y Nisha Patel. "A Consumer Assessment of Pharmaceutical Care Services in a Diabetes Ambulatory Clinic". The University of Arizona, 2009. http://hdl.handle.net/10150/623965.

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Class of 2009 Abstract
OBJECTIVES: To assess patients’ satisfaction with pharmaceutical care services provided in a community health center diabetes management clinic. METHODS: Patients who received diabetes-related pharmaceutical services from the clinical pharmacist at El Rio Health Center in Tucson, Arizona from November 2008 to January 2009 were contacted during a visit to the diabetes clinic and asked to complete the consumer assessment of pharmaceutical services questionnaire. The questionnaire included 14 likert-type items with response options ranging from “Never” to “Always” or “Disagree” to “Agree.” In addition, the patient’s most recent hemoglobin A1C (HgbA1C) was obtained from the electronic medical record. The survey instrument was also translated from English to Spanish to serve the Hispanic participants who could not communicate fluently in English. A descriptive cross-sectional analysis was completed in order to assess patient satisfaction. Dependent variables extracted from the survey were analyzed by Mann-Whitney U test. Interval and ratio data were analyzed by calculating means, standard deviations, and an independent t-test. Nominal data were analyzed using the Chi-Square test. RESULTS: A total of 46 patients completed the questionnaires, including 17 men and 29 women (mean age = 56, SD = 11.3, 80% Hispanic). All patients had seen the clinical pharmacist at least 3 times. Overall, this study showed that majority of the patients were satisfied with the service provided in the clinic. There was no statistically significant difference between English and Spanish patient populations in terms of satisfaction with pharmaceutical services provided about their disease management. CONCLUSIONS: Patients in this clinic were highly satisfied with the pharmaceutical care services provided by the clinical pharmacist.
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Bolhuis, Rebecca. "A Description of a Pharmacist-Based Treatment Adherence Program at Special Immunology Associates, an HIV Ambulatory Care Clinic". The University of Arizona, 2008. http://hdl.handle.net/10150/624307.

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Class of 2008 Abstract
Objectives: To describe a pharmacist-based treatment adherence program at an HIV ambulatory care clinic setting; to describe the patient population that the pharmacist provided services to from 2005 to 2007; and to describe the clinical outcomes of the program. Methods: A retrospective chart review of 381 patients enrolled in the pharmacist-based treatment adherence program from 2/01/05 to 03/01/2007. Inclusion criteria: HIV positive; greater than or equal to 18 years of age; a medical record; and enrollment in the treatment adherence program. The program provided support, education, and clinical management. Results: Patients were predominately male (86%), ages 45-64 (58%) or 25-44 (38%), identifying as Caucasian (57%) or Hispanic (31%), with psychiatric (50%) or substance abuse (39%) comorbidities (with 25% reporting both comorbidities). Baseline HIV viral loads were compared at four different follow-up periods: 90-180 days, 181-365 days, greater than 365 days, and the entire period of follow-up through the pharmacist-based HIV treatment adherence program. At baseline 34% of the patients had an undetectable HIV viral load (< copies/mL) and a mean CD4 count of 340. All follow-up periods reported significant improvements. At follow-up >365 days, 76% of the patients had undetectable virus (p<0.001) and a mean CD4 count of 442 (p<0.001). There were no significant results when viral load and mean CD4 counts were examined within the context of number of pharmacist visits and SA and/or psychiatric comorbidities. Conclusions: Patients in the pharmacist-based treatment adherence program showed significant improvements in CD4 count and percent of patients with undetectable virus from baseline to all follow-up periods. The magnitude of the improvement increased during each follow-up period suggesting an additive effect of continued enrollment in the program.
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Net, Ny Santhat Sermsri. "Patient satisfaction with health services at the Out-patient department clinic of Wangnumyen Community Hospital, Sakaeo province, Thailand /". Abstract, 2007. http://mulinet3.li.mahidol.ac.th/thesis/2550/cd399/4937988.pdf.

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Schmitz, Tyler. "Effectiveness of Home Directional Preference Exercise/Stretch Program for Reducing Disability in Mechanical Chronic Low Back Pain in a Residency Clinic, a Quality Improvement Project". Digital Commons @ East Tennessee State University, 2020. https://dc.etsu.edu/asrf/2020/presentations/19.

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Chronic low back pain (CLBP) is defined as pain, muscle tension, or stiffness localized below the costal margin and above the inferior gluteal folds, with or without sciatica, that lasts for at least twelve weeks.1 It is the leading cause of disability and loss of productivity in the United States.2 There is conflicting evidence on what is the most effective nonpharmacological treatment for CLBP. Many studies have shown that any general exercise routine is effective for improving symptoms, but the literature provides conflicting evidence about what specific type of exercise is best.3 A few studies have demonstrated decreased pain and disability with supervised directional preference exercise routines compared to non-directional preference routines. The objective of this study was to determine the effectiveness of a home directional preference exercise/stretch program for reducing disability in mechanical CLBP in patients in a residency clinic and to expand on the limited evidence of directional preference exercise effectiveness. Unlike other directional preference interventional studies, this program’s simplicity and convenience of performing at home potentially could increase patient compliance and therefore effectiveness. Patients were screened at a routine clinic visit and considered eligible if they had a known diagnosis of CLBP. They were excluded if they were in an acute exacerbation. Participating patients were categorized on directional range of motion preference based on their physical exam, either flexion or extension, whichever improved their pain. They were given a simple routine with instructions and pictures consisting of three exercises and stretches that emphasized their specific directional preference. Subjects performed three sets of each routine two to three days per week. Degree of disability score was measured at initial visit by completing the gold standard disability index questionnaire, the Oswestry Disability Index (ODI). Degree of disability was reassessed with ODI at a follow-up assessment four to eight weeks later with five follow-up questions regarding compliance and acute exacerbation. Patients were excluded if they were in an acute exacerbation. Pre-interventional disability scores were then compared to post-interventional disability scores. Twelve total patients enrolled in the program. Seven were lost to follow up. Five completed the study at the proper follow up interval; however, one was in an acute exacerbation so was excluded. Of the four patients included, two had extension and two had flexion preference. Three out of four patients had decreased disability scores at follow up. Total post-intervention score on ODI improved by an average of 10 points compared to pre-intervention score for the patients who improved. The most improved post-interventional ODI score category was walking and changing degree of pain. Seventy-five percent of the patients who completed the study had an improvement in their CLBP disability score. However, due to a small sample size and study power, the results are not statistically significant. Therefore, a conclusion cannot be appropriately drawn about the effectiveness of performing a home directional preference exercise/stretch program for reducing disability in mechanical CLBP in patients at a residency clinic. Nevertheless, the results are promising and deserve further investigation with a larger sample size.
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Lucas, D. Pulane. "Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital". VCU Scholars Compass, 2013. http://scholarscompass.vcu.edu/etd/2996.

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Advances in medical technology have altered the need for certain types of surgery to be performed in traditional inpatient hospital settings. Less invasive surgical procedures allow a growing number of medical treatments to take place on an outpatient basis. Hospitals face growing competition from ambulatory surgery centers (ASCs). The competitive threats posed by ASCs are important, given that inpatient surgery has been the cornerstone of hospital services for over a century. Additional research is needed to understand how surgical volume shifts between and within acute care general hospitals (ACGHs) and ASCs. This study investigates how medical technology within the hospital industry is changing medical services delivery. The main purposes of this study are to (1) test Clayton M. Christensen’s theory of disruptive innovation in health care, and (2) examine the effects of disruptive innovation on appendectomy, cholecystectomy, and bariatric surgery (ACBS) utilization. Disruptive innovation theory contends that advanced technology combined with innovative business models—located outside of traditional product markets or delivery systems—will produce simplified, quality products and services at lower costs with broader accessibility. Consequently, new markets will emerge, and conventional industry leaders will experience a loss of market share to “non-traditional” new entrants into the marketplace. The underlying assumption of this work is that ASCs (innovative business models) have adopted laparoscopy (innovative technology) and their unification has initiated disruptive innovation within the hospital industry. The disruptive effects have spawned shifts in surgical volumes from open to laparoscopic procedures, from inpatient to ambulatory settings, and from hospitals to ASCs. The research hypothesizes that: (1) there will be larger increases in the percentage of laparoscopic ACBS performed than open ACBS procedures; (2) ambulatory ACBS will experience larger percent increases than inpatient ACBS procedures; and (3) ASCs will experience larger percent increases than ACGHs. The study tracks the utilization of open, laparoscopic, inpatient and ambulatory ACBS. The research questions that guide the inquiry are: 1. How has ACBS utilization changed over this time? 2. Do ACGHs and ASCs differ in the utilization of ACBS? 3. How do states differ in the utilization of ACBS? 4. Do study findings support disruptive innovation theory in the hospital industry? The quantitative study employs a panel design using hospital discharge data from 2004 and 2009. The unit of analysis is the facility. The sampling frame is comprised of ACGHs and ASCs in Florida and Wisconsin. The study employs exploratory and confirmatory data analysis. This work finds that disruptive innovation theory is an effective model for assessing the hospital industry. The model provides a useful framework for analyzing the interplay between ACGHs and ASCs. While study findings did not support the stated hypotheses, the impact of government interventions into the competitive marketplace supports the claims of disruptive innovation theory. Regulations that intervened in the hospital industry facilitated interactions between ASCs and ACGHs, reducing the number of ASCs performing ACBS and altering the trajectory of ACBS volume by shifting surgeries from ASCs to ACGHs.
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Chang, Elizabeth H. "Implementation of the physician-pharmacist collaborative model in primary care clinics". Diss., University of Iowa, 2013. https://ir.uiowa.edu/etd/2190.

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In the modern society, chronic diseases have become the leading causes of death. With early recognition and proper management, however, many of the complications from chronic diseases could be prevented or delayed. Taking such a proactive approach in managing a population often requires the use of team-based approaches and delegation of certain clinical and nonclinical tasks to nonphysician team members. This three-study dissertation used a combination of methods to explore contextual factors that influence primary care teamwork and physician-pharmacist collaboration. The first study quantitatively examined baseline barriers and facilitators of physician-pharmacist collaboration in clinics participating in the Collaboration Among Pharmacists and Physicians To Improve Outcomes Now (CAPTION) Trial. Pharmacist expertise and clinic staff support were found to be the most important facilitators for physicians, while insurance reimbursement and task design factors were important for pharmacists. The second study characterized clinic personnel experience participating in the CAPTION trial and explored determinants of disease state control. Higher proportions of indigent and minority populations and higher baseline pharmacy structure scores were found to be associated with lower blood pressure control. The third study qualitatively examined organizational influences on primary care team effectiveness and the roles of pharmacists in a separate sample of primary care clinics. A lack of organizational rewards for teamwork in primary care was identified and pharmacists were integrated into clinic workflow in various degrees. These findings will be informative for practice managers and health care professionals seeking to redesign their practice to meet increasing needs of patients with chronic diseases.
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Alfaiz, Abdullah. "Urgent Care Center Location: an Empirical Analysis of their Locations in Relation to Demographic, Socioeconomic, and Land Use Factors: a Case Study of Portland, Oregon". PDXScholar, 1996. https://pdxscholar.library.pdx.edu/open_access_etds/1328.

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Urgent Care Centers (UCCs) are a recent innovation in the American system of health care delivery. The number of UCCs has increased significantly in recent years. Many researchers point out that the rapid growth of UCCs is expected to escalate during the next few decades. This growth will create more competition among providers of these facilities in the health care market, and the competition could lead to an uneven distribution of UCCs within cities. While health officials and planners are interested in attracting more patients by expanding UCC services, they are often unfamiliar with the factors that go into site selection decisions. Understanding the factors influencing UCC location is crucial to explaining why UCCs cluster in certain urban areas, while other areas are under-served. It is also important for providers who want to enhance accessibility of special population segments to UCC locations. This study uses the Portland metropolitan area as a case study. Due to the lack of access to providers' propriety data, the specific problem targeted here uses publicly available data as a proxy for providers' data to determine the factors influencing UCC location. The essence of this research is to show how these factors explain and predict existing locations of UCCs and to find out how well this publicly available data explains UCC providers' locational behavior. Most of the data for this study is provided by Metro of Portland. Other data are collected utilizing surveys and data from different public agencies and published reports. Logit analysis is used to find out which factors explain existing UCC location. The empirical findings of this research substantiate the existence of a strong relationship between the location of UCCs and land use factors. This study highlights the complexity and importance of understanding the factors influencing the location of UCCs. It rejects prior arguments that UCC location is influenced by some demographic and socioeconomic factors, while it introduces land use factors as the major determinants of UCC location. However, this study concluded that land use factors influence considered a rare phenomena that should be carried out for future research and that demographic factors may still have an indirect effect on UCC location.
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Mai, Yvonne M. "Use of various health care providers and the associated clinical and humanistic outcomes in an ambulatory Medicare population". Scholarly Commons, 2016. https://scholarlycommons.pacific.edu/uop_etds/265.

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Background: The use of complementary and alternative medicine (CAM) and other non-physician health care providers (dentists, optometrists, etc.) has steadily increased in the United States; however, the associated outcomes reported in the Medicare beneficiary population are limited. Objective: To evaluate the utilization of different healthcare providers by Medicare beneficiaries and assess resultant beneficiary outcomes. Methods: Fourteen outreach events targeting Medicare beneficiaries were conducted throughout Northern/Central California during the 2014 open enrollment period. Trained student pharmacists (working under licensed pharmacist supervision) provided beneficiaries with comprehensive medication therapy management (MTM) services. During each intervention, demographic, quality-of-life, health behavior and health provider/service utilization data were collected. Results: Of 620 respondents, 525 (84%) and 84 (14%) reported using at least one non-physician healthcare professional or CAM provider, respectively. Beneficiaries who reported using non-physician healthcare providers were significantly (p < 0.05) more likely to indicate being ‘very confident’ in managing their chronic health conditions. The number of providers seen with prescriptive authority was positively correlated with the number of prescription medications taken (r s =0.342, p < 0.001). The total number of providers seen was positively correlated with the number of drug-related issues identified (r s = 0.179, p < 0.001). Conclusion: Many beneficiaries have multiple chronic conditions and increasingly utilize a variety of healthcare professionals. As such, bridging the communication chasm between these professionals can improve humanistic outcomes and minimize medication related issues of Medicare beneficiaries. Coordinated care, a key strategy for improving healthcare delivery under the Affordable Care Act, is a step in the right direction.
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Chang, Andrew Yee. "A web accessible clinical patient information networked system". CSUSB ScholarWorks, 2006. https://scholarworks.lib.csusb.edu/etd-project/2980.

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Developed with the intention to make the patient data storage system in the clinical outpatient area more efficient, this system stores all pertinent and relevant patient data such as lab results, patient history and X-ray images. The system is accessible via the internet as well as operable over a local area network (LAN). The intended audience for this program is essentially the clinical staff (e.g., physicians, nursing staff, secretarial staff). The computer program was developed using Java Server Pages (JSP) and utilizes the Oracle 9i database.
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Machingaidze, Pamela Rudo. "The clinical use and indications for head computed tomography scans in paediatric ambulatory care (short stay ward and medical emergencies) at a children’s hospital over a one-year period, 1st January-31st December 2013". Master's thesis, University of Cape Town, 2018. http://hdl.handle.net/11427/29345.

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Background: Computed tomography (CT) imaging is an indispensable tool in the management of acute paediatric illness. It offers quick answers, allowing timely lifesaving decision-making. Clinical evidence is required to maximise its benefits against radiation-exposure risks to patients and cost to the healthcare system. Aims: The study aimed to retrospectively investigate clinical presentation and indications of head CT at a tertiary paediatric hospital. Methods: Records of children presenting with acute illness to the medical emergency unit, excluding trauma, of Red Cross War Memorial Children’s Hospital, Cape Town, over one year (2013) were retrospectively reviewed. Participants were included if they underwent head CT scan within 24 hours of presentation. Clinical data were extracted from records and CT findings reported by a paediatric radiologist. Results: Inclusion criteria were met by 311 patients; 188 (60.5%) were boys. The median age was 39.2 (IQR 12.6-84.0) months. Commonest indications were seizures (n=169;54.3%), reduced level of consciousness (n=140;45.0%), headache (n=74;23.8%) and suspected ventriculoperitoneal shunt (VPS) malfunction (n=61;19.7%). In 217 (69.8%) patients CT showed no adverse findings. In the 94 (30.2%) patients in whom CT abnormalities were detected, the predominant findings were hydrocephalus (n=54;57.4%) and cerebral oedema (n=29;30.9%). Abnormal CT findings were commoner in patients with nausea or vomiting (n=21;9.3%, p=0.05) papilloedema (n=3;1.3%, p=0.015) and long tract signs (n=23;10.2%, p=0.02). Forty-seven patients (15.1%) required surgical intervention after CT of which 40 (85.1%) needed a ventricular drainage procedure. A larger proportion of patients with VPS (25/62;40.3%) required surgical intervention compared to patients without VPS (22/249;8.8%, p <0.001) Conclusion: Most children presenting with acute illness (excluding trauma) and undergoing emergency head CT have normal findings. Patients with ventriculoperitoneal shunts constituted a large proportion of patients requiring intervention after CT. Considerations should be made to use clinical presentation to select patients most likely to benefit from CT.
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Libros sobre el tema "Ambulatory Care Clinic"

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United Hospital Fund of New York., ed. Beyond the clinic: Redefining hospital ambulatory care. New York: United Hospital Fund of New York, 1997.

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Extreme clinic: An outpatient doctor's guide to the perfect 7-minute visit. Philadelphia: Hanley & Belfus, 2004.

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Audits, California Bureau of State. Department of Corrections: Though improving, the Department still does not identify and service all parolees needing outpatient clinic program services, but increased caseloads might strain clinic resources. Sacramento, Calif: Bureau of State Audits, 2001.

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Rubin, Irwin M. My pulse is not what it used to be: The leadership challenges in health care. Honolulu, Hawaii: Temenos Foundation, 1991.

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1950-, Ginn Katy, ed. Ambulatory care planning: Changing the focus of care. Toronto: Agnew Peckham, 1997.

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Cohen, Matthew M. Ambulatory family practice protocols. Tallahassee, FL: Sunbelt Medical Publishers, 1994.

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Komorowski-Swiatek, Denise. Ambulatory care clinical skills program: Anticoagulation management module. Bethesda, MD: American Society of Health-System Pharmacists, 2001.

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Hospitals, Pennsylvania Division of. Rules and regulations for ambulatory surgical facilities. [Harrisburg, PA]: The Division, 1987.

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Cherney, Alison. Ambulatory infusion centers: A guide to business development. Alexandria, Va: National Home Infusion Association, 1998.

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C, Garcia Daniel y Delafield Judith P, eds. Outpatient care handbook. 2a ed. Philadelphia: Hanley & Belfus, 1999.

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Capítulos de libros sobre el tema "Ambulatory Care Clinic"

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Willsie, S. K., T. L. Willoughby, G. A. Salzman y S. C. Hamburger. "An Effective Educational Model for Tuberculosis in the Ambulatory Care Clinic: Documentation of Clinical Competence and Skills". En Advances in Medical Education, 597–98. Dordrecht: Springer Netherlands, 1997. http://dx.doi.org/10.1007/978-94-011-4886-3_181.

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Blum, Bruce I. "Ambulatory Care Systems". En Clinical Information Systems, 253–93. New York, NY: Springer US, 1986. http://dx.doi.org/10.1007/978-1-4613-8593-6_8.

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Blum, Bruce I. "Ambulatory Care Systems". En Clinical Information Systems, 253–93. Berlin, Heidelberg: Springer Berlin Heidelberg, 1986. http://dx.doi.org/10.1007/978-3-662-26537-6_8.

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Fulton, Yvonne y Linda Phillips. "Nurse-led Clinics in Ambulatory Care". En Innovations in Paediatric Ambulatory Care, 115–25. London: Macmillan Education UK, 1998. http://dx.doi.org/10.1007/978-1-349-14367-2_9.

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Demakis, John G. "Meeting Clinical Needs in Ambulatory Care". En Computerizing Large Integrated Health Networks, 231–39. New York, NY: Springer New York, 1997. http://dx.doi.org/10.1007/978-1-4612-0655-2_16.

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Glasper, E. A. y Susan Lowson. "The Role of the Clinical Nurse Specialist in the Provision of Paediatric Ambulatory Care". En Innovations in Paediatric Ambulatory Care, 126–38. London: Macmillan Education UK, 1998. http://dx.doi.org/10.1007/978-1-349-14367-2_10.

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Brock-Utne, John G. "Case 17: An Ambulatory Surgical Patient with No Escort". En Case Studies of Near Misses in Clinical Anesthesia, 45–47. New York, NY: Springer New York, 2011. http://dx.doi.org/10.1007/978-1-4419-1179-7_17.

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"3 Setting Up the Clinic for Teaching". En Medical Teaching in Ambulatory Care, Third Edition, 43–67. University of Toronto Press, 2012. http://dx.doi.org/10.3138/9781442662339-005.

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Davies, Pamela Stitzlein. "Palliative care nursing in the outpatient setting". En Oxford Textbook of Palliative Nursing, 761–76. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199332342.003.0055.

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Nurses and advanced practice nurses (APNs), with their extensive psychosocial training, and in collaboration with a multidisciplinary team, play an important role in helping ambulatory clinic patients and caregivers navigate concerns that arise as the end of life approaches. This chapter addresses the provision of palliative care in the adult outpatient setting, with a focus on the role of nurses and APNs.
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Palmer, Brian A. "Psychotic and Somatic Symptom and Related Disorders". En Mayo Clinic Internal Medicine Board Review, 707–10. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190464868.003.0068.

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Since 30% to 40% of ambulatory primary care visits have a psychiatric component, successful patient management often hinges on successful treatment of comorbid psychiatric illness. The key concept when assessing psychiatric symptoms is whether the symptom interferes with a patient’s functioning or causes distress. For example, a patient may have a fear of heights. If this acrophobia never causes an alteration in activity, intervention is unnecessary. If, however, this acrophobia causes distress and interferes with the patient’s functioning, intervention may be warranted.
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Actas de conferencias sobre el tema "Ambulatory Care Clinic"

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Barraclough, H., S. Suri, D. Patel, E. Strawinski y J. Campbell. "G109(P) Rotherham rapid access clinic: an ambulatory care model service evaluation". En Royal College of Paediatrics and Child Health, Abstracts of the Annual Conference, 13–15 March 2018, SEC, Glasgow, Children First – Ethics, Morality and Advocacy in Childhood, The Journal of the Royal College of Paediatrics and Child Health. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2018. http://dx.doi.org/10.1136/archdischild-2018-rcpch.106.

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Meinert, David. "Resistance to Electronic Medical Records (EMRs): A Barrier to Improved Quality of Care". En InSITE 2005: Informing Science + IT Education Conference. Informing Science Institute, 2005. http://dx.doi.org/10.28945/2896.

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While most industries have aggressively leveraged information technology (IT) to improve quality and reduce costs the healthcare sector has lagged behind. Electronic Medical Records (EMRs) hold great promise for improving quality of care yet widespread adoption is lacking. Physician acceptance is critical to widespread adoption of ambulatory EMRs, yet there is little independent research on physician perceptions. This paper attempts to address this void by reporting the results of a study of physician perceptions related to EMRs in a large, multi-specialty clinic. Physician perceptions of select EMR functions and general attitudes and beliefs are reported. While the importance and anticipated utilization of EMR functions varied, nearly 80 percent of the respondents felt an EMR should be implemented. The findings have implications for both vendors attempting to design and market EMR systems and physician executives and practice managers seeking to solicit support for EMR adoption and/or develop a successful implementation strategy.
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Saldarriaga, Alvaro J., Jairo J. Perez, J. Restrepo y J. Bustamante. "A mobile application for ambulatory electrocardiographic monitoring in clinical and domestic environments". En 2013 Pan American Health Care Exchanges (PAHCE). IEEE, 2013. http://dx.doi.org/10.1109/pahce.2013.6568306.

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Desikan, Prasanna, Nisheeth Srivastava, Tamara Winden, Tammie Lindquist, Heather Britt y Jaideep Srivastava. "Early Prediction of Potentially Preventable Events in Ambulatory Care Sensitive Admissions from Clinical Data". En 2012 IEEE Second International Conference on Healthcare Informatics, Imaging and Systems Biology (HISB). IEEE, 2012. http://dx.doi.org/10.1109/hisb.2012.49.

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Bidargaddi, Niranjan y Antti Sarela. "Ambulatory monitor derived clinical measures for continuous assessment of cardiac rehabilitation patients in a community care model". En 2008 Second International Conference on Pervasive Computing Technologies for Healthcare (PervasiveHealth). IEEE, 2008. http://dx.doi.org/10.1109/pcthealth.2008.4571077.

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Bidargaddi, Niranjan y Antti Sarela. "Ambulatory monitor derived clinical measures for continuous assessment of cardiac rehabilitation patients in a community care model". En 2nd International ICST Conference on Pervasive Computing Technologies for Healthcare. ICST, 2008. http://dx.doi.org/10.4108/icst.pervasivehealth2008.2544.

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Informes sobre el tema "Ambulatory Care Clinic"

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Dolfini-Reed, Michelle. Patterns of Ambulatory Mental Health Care in Navy Clinics. Fort Belvoir, VA: Defense Technical Information Center, junio de 2001. http://dx.doi.org/10.21236/ada401074.

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Lowry, Sventlana Z., Mala Ramaiah, Emily S. Patterson, David Brick, Ayse P. Gurses, Ant Ozok, Debora Simmons y Michael C. Gibbons. Integrating electronic health records into clinical workflow : an application of human factors modeling methods to ambulatory care. National Institute of Standards and Technology, marzo de 2014. http://dx.doi.org/10.6028/nist.ir.7988.

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