Journal of general internal medicine
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Medical scribes have been proposed as a solution to the problems of excessive documentation, work-life balance, and burnout facing general internists. However, their acceptability to patients and effects on provider experience have not been tested in a real-world model of effectiveness. ⋯ In this test of a modified practice model, scribes supported greater patient throughput and improved provider perceptions of documentation burden with no decrement in high patient satisfaction.
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Practice facilitation is an implementation strategy used to build practice capacity and support practice changes to improve health care outcomes. Yet, few studies have investigated how practice facilitation strategies are tailored to different primary care contexts. ⋯ Despite significant infrastructure and resource differences between SIPs and FQHCs, the contextual factors that influenced the facilitator's change process and the strategies used to address those factors were remarkably similar. The findings emphasize that facilitators require multidisciplinary skills to support sustainable practice improvement in the context of varying complex health care delivery settings.
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Evidence is limited and mixed as to how the Patient Protection and Affordable Care Act (ACA) Medicaid expansions affected the utilization of primary care physicians (PCPs) and emergency departments (EDs) at the national level. ⋯ Using the nationally representative data of individuals who were affected by the ACA, we found that the ACA Medicaid expansions were associated with a modest improvement in access to PCPs without an increase in ED use.
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A clinical practice guideline (CPG) reporting checklist is used to assist CPG developers in recording what content should be provided in a CPG report. Recently, two checklists have become available on the Enhancing the QUAlity and Transparency Of health Research Network website: AGREE (Appraisal of Guidelines, Research and Evaluation) published in 2016 and RIGHT (Reporting Items for practice Guidelines in HealThcare) published in 2017. The objective of this study was to describe the advantages and disadvantages of these two CPG reporting checklists. ⋯ We recommend that CPG developers use either AGREE plus items unique to RIGHT or RIGHT plus items unique to AGREE.
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This capsule commentary, Capsule Commentary on Liaw et al., "Getting everyone on the same page": interprofessional team training to develop shared mental models on interprofessional rounds," was to have accompanied the article, DOI: https://doi.org/10.1007/s11606-019-05320-z, which appeared in the December 2019 issue.