The Journal of ambulatory care management
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J Ambul Care Manage · Jan 2017
Integration of Medical Scribes in the Primary Care Setting: Improving Satisfaction.
There are little published data on the use of medical scribes in the primary care setting. We assessed the feasibility of incorporating medical scribes in our ambulatory clinic to support provider documentation in the electronic medical record. ⋯ Overall indicators of patient satisfaction were slightly decreased. Providers found scribe support to be valuable and overall clinician documentation time was reduced by more than 50% using scribes.
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J Ambul Care Manage · Jul 2016
Demonstration of the Health Literacy Universal Precautions Toolkit: Lessons for Quality Improvement.
The Agency for Healthcare Research and Quality Health Literacy Universal Precautions Toolkit was developed to help primary care practices assess and make changes to improve communication with and support for patients. Twelve diverse primary care practices implemented assigned tools over a 6-month period. ⋯ Practices used the Toolkit flexibly and recognized the efficiencies of implementing tools in tandem and in coordination with other quality improvement initiatives. Practices recommended reducing Toolkit density and making specific refinements.
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The UK government recently stated its intention to impose a new junior doctor contract in England. Related negotiations between the British Medical Association and government representatives started in 2013. ⋯ With the impending imposition of the new contract, and lack of progress, junior doctors felt the risks of striking had fallen below those of inaction. Hence, the first strike staged by the English medical workforce for 40 years occurred in January 2016.
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J Ambul Care Manage · Jan 2015
Homeless patients' use of urban emergency departments in the United States.
Data from the 2009-2010 National Hospital Ambulatory Care Survey-Emergency Department were used to compare homeless patients' utilization of the urban emergency department (ED) in the United States with nonhomeless patients and to examine the relationship between homelessness and demographics and ED utilization measures. The weighted sample size was 200 645 347. A total of 1 302 256 patients (0.65%) were homeless. Homeless patients were significantly more likely to be older, male, have self-pay, have no charge/charity or other as payment type, arrive via ambulance, have a longer ED visit, and a past visit to the same ED in the last year.
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J Ambul Care Manage · Jul 2014
Secure e-mailing between physicians and patients: transformational change in ambulatory care.
Secure e-mailing between Kaiser Permanente physicians and patients is widespread; primary care providers receive an average of 5 e-mails from patients each workday. However, on average, secure e-mailing with patients has not substantially impacted primary care provider workloads. ⋯ Separate studies associated patient portal and secure e-mail use with both decreased and increased use of other health care services, such as office visits, telephone encounters, emergency department visits, and hospitalizations. Directions for future research include more granular analysis of associations between patient-physician secure e-mail and health care utilization.