Southern medical journal
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Southern medical journal · Dec 2024
Reducing Unnecessary Laboratory Testing: A Quality Improvement Initiative at Wellstar Spalding Medical Center.
The healthcare industry is grappling with escalating expenses, partially attributed to the inefficient use of medical resources, particularly by ordering unnecessary laboratory tests. Such practices not only increase costs but also result in extended hospital stays, patient discomfort, and potential clinical complications such as iatrogenic anemia. Blood tests, although essential for guiding medical decisions, are associated with significant clinical and financial costs. This quality improvement project aimed to decrease unnecessary laboratory testing at Wellstar Spalding Medical Center, a community hospital with a newly established residency program. ⋯ Our project has yielded clinically and administratively meaningful results. We have seen a measurable decrease in costs and the prevention of unnecessary laboratory testing. If it also can be shown that we have prevented iatrogenic anemia, our project could be seen as enhancing the patient experience and reducing hospital length of stay. We also have raised awareness about high-value care and instilled clinical awareness among residents regarding ordering daily blood tests contributing to an improvement in patient care.
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Southern medical journal · Dec 2024
Examining Provider Attitudes and Barriers toward Prescribing PrEP within Primary Care Settings in Alabama.
Human immunodeficiency virus (HIV) preexposure prophylaxis (PrEP) is an effective HIV prevention tool. Expanding PrEP access and utilization is made possible by incorporating it into primary care practice. This study explored the barriers in and attitudes toward prescribing PrEP to adults among primary care providers (PCPs) in Alabama, a priority HIV jurisdiction with low PrEP uptake. ⋯ With barriers hindering PrEP prescribing by Alabama's PCPs, in addition to preexisting healthcare barriers experienced by patients in the US Deep South, immediate attention is warranted. Further exploration into developing policies for streamlining sexual history intake and inclusive medical education and training regarding PrEP is needed in Alabama.
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Free clinics provide care to underserved populations nationwide. The Birmingham Free Clinic offers dermatology care and operates an onsite dispensary. Little is known about specialty care services and medication optimization in the free clinic setting. This study analyzed dermatologic diagnoses and medication distribution patterns to optimize the dermatologic formulary at a free clinic. ⋯ Eighty-gram tubes of triamcinolone 0.1% ointment were added to the dermatologic formulary, and low-cost alternatives were suggested for ketoconazole 2% shampoo. This study provides a model for formulary optimization in free clinics with specialty care services.
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This study used a qualitative research approach to grounded theory to identify factors that contributed to resident distress during 2021-2022 in multiple different specialties and at different postgraduate years of residency. By better understanding these contributors to distress, the aim was to inform the design of optimal interventions to reduce burnout and other emotional distress. ⋯ The findings of the grounded theory qualitative analysis were used to examine ways to better mitigate the sources of distress that the residents enrolled in this study described. As institutions strive to diminish distress among residents, they can consider opportunities to assess environmental factors and design targeted interventions for their institutions or programs.
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Southern medical journal · Dec 2024
Qualitative Exploration of Contraceptive Knowledge in Men and Women.
The level of knowledge about contraceptives overall is low in the United States. This qualitative study adds to the literature that explores gendered differences in contraceptive knowledge. Specifically, we examined knowledge regarding different contraceptive methods, directions on use, mechanism of action, efficacy, and adverse effects. We also looked at men's perspectives on their partner's knowledge. ⋯ A low level of knowledge about contraceptives is associated with increased rates of unintended pregnancy. This study demonstrates a need for improved education about contraception. Given the impact of male opinion in contraceptive use, efforts to increase their knowledge could be important interventions to increase contraceptive uptake.