Journal of health care for the poor and underserved
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J Health Care Poor Underserved · Aug 2012
Multicenter StudyCombating slavery in the 21st century: the role of emergency medicine.
Human trafficking (HT) victims may present to emergency departments (ED) as patients, but are infrequently identified. To address this issue, we developed and piloted a training intervention for emergency providers on HT and how to identify and treat these patients. Included in the intervention participants were emergency medicine residents, ED attendings, ED nurses, and hospital social workers. ⋯ After the 20-minute intervention, 53.8% felt some degree of confidence in their ability to identify and 56.7% care for this patient population. Because this problem is global, we created a Website that includes an instructive toolkit and an interactive course for self-learning and/or assessment. This intervention will give ED providers the tools they need to assess and treat a patient who might be a victim of human trafficking.
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J Health Care Poor Underserved · Aug 2012
ReviewElectronic health records improve the quality of care in underserved populations: a literature review.
Organizations in underserved settings are implementing or upgrading electronic health records (EHRs) in hopes of improving quality and meeting Federal goals for meaningful use of EHRs. However, much of the research that has been conducted on health information technology does not study use in underserved settings, or does not include EHRs. We conducted a structured literature search of MEDLINE to find articles supporting the contention that EHRs improve quality in underserved settings. ⋯ The articles provide evidence that EHRs can improve documentation, process measures, guideline-adherence, and (to a lesser extent) outcome measures. Providers and managers believed that EHRs would improve the quality and efficiency of care. The limited quantity and quality of evidence point to a need for ongoing research in this area.
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J Health Care Poor Underserved · Aug 2012
Redesigning the system from the bottom up: lessons learned from a decade of federal quality improvement collaboratives.
The Health Resources and Services Administration (HRSA) is a federal agency that provides support and resources for America's safety-net providers. For more than 10 years, HRSA has engaged in Quality Improvement Breakthrough Collaboratives that have brought together multiple stakeholders to improve quality of care and enhance patient outcomes for the most vulnerable populations. Many of these collaboratives followed the Institute for Healthcare Improvement's Breakthrough Series Collaborative model and methodology to implement small tests of change that helped generate process improvements and clinical outcomes. This commentary summarizes HRSA's experience with these Quality Improvement Breakthrough Collaboratives, focusing on key lessons learned, in order to help inform and enhance future quality improvement efforts in both the public and the private sectors.
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J Health Care Poor Underserved · Aug 2012
Safe sobering: San Francisco's approach to chronic public inebriation.
Dedicated to the care of alcohol dependent people, the San Francisco Sobering Center cares for intoxicated clients historically treated via emergency services. With 29,000 encounters and 8,100 unduplicated clients, the Sobering Center safely and efficiently provides sobering and health care services to some of the City's most vulnerable people.
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J Health Care Poor Underserved · Aug 2012
Geographic proximity of HRSA, VA, and DOD clinics: opportunities for interagency collaboration to improve quality.
Clinics funded by the Department of Veterans Affairs (VA), Department of Defense's Military Health System (MHS), and Department of Health and Human Services' Health Resources and Services Administration (HRSA) all play a role in serving the military, veterans, and their families. Publicly available location data on federal health care clinics was merged, analyzed, and geographically overlaid using GIS. Results showed that 20% of U. ⋯ Additionally, 80% of VA and 76% of MHS clinics are within 10 miles of a HRSA clinic. Specific clinic types of interest also overlay; for instance, 90% of HRSA homeless clinics are in the same county as a VA facility. This demonstrated geographic proximity of health care sites may indicate prime opportunities for collaboration between HRSA, VA, and MHS systems to improve quality of care for the military, veterans, and their families.