J Am Board Fam Med
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Quality Improvement has gone from practice by practice piecework to an industry driven by expertise that lies within corporate offices rather than within patient care. Using for her 20 years of experience leading and teaching quality improvement as a lens, the author makes the case for quality improvement teams to ensure a key role for clinicians and direct care staff who are closest to the patients and the improvements that need to be made.
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Traditionally the role of certifying boards has been to hold physicians accountable for demonstrating standards of competence. In recent years, the authority of continuing board certification has been challenged, due to multiple factors that have shifted the dynamics. The breadth and depth of new information, combined with the pressures of system barriers and administrative burdens, can make it challenging for clinicians stay current and maintain their own competency. Absent feedback about their performance, physicians presume they're practicing effectively. The resulting gap between confidence and competence can also lead physicians to make errors of which they may be unaware. In this environment, assessment and accountability are more important than ever. ⋯ Boards have a critical role in professional self-regulation. They should not compromise on their primary responsibility to set and evolve standards for competence and to conduct rigorous assessments of physicians. The methods boards use for assessments should evolve to meet the changing needs of physicians. Collaboration between educators and assessors provides more educational choice, relieves burdens, and supports physicians' commitment to lifelong learning. By working together with physicians, educators and assessors advance their shared goal of supporting physicians to work at the top of their capability and ultimately, optimize patient care.
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Randomized Controlled Trial
Practice Transformation Support and Patient Engagement to Improve Cardiovascular Care: From EvidenceNOW Southwest (ENSW).
To improve cardiovascular care through supporting primary care practices' adoption of evidence-based guidelines. ⋯ Practice transformation support can assist practices with improving quality of care. Patient engagement in practice transformation can further enhance practices' implementation of aspects of new models of care.
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The quality of care for children and adults in the United States is variable and often suboptimal. Approaches that improve the systems of care for entire patient populations are needed. ⋯ The American Board of Pediatrics has catalyzed collaborative improvement networks, resulting in improved health outcomes for children, fostered partnerships with patients and families, and brought together key stakeholders to advocate for network improvement efforts for sickle cell disease as one action to address health disparities. Similar concerted efforts by certifying boards in collaboration with physicians and patients can improve the quality of care and lead to better patient outcomes.
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To understand patient attitudes, access toward video calling to enhance efficiency of after-hours triage calls. ⋯ Patients seem to have access and interest in video communication for after-hours calls. Further studies are needed to evaluate whether addition of video component to after-hours triage calls will help reduce unnecessary emergency department visits.