How to Get Better Care with Lower Costs? See the Person, Not the Patient.

The U.S. health system perceives people as "patients" almost exclusively as they enter and exit the healthcare system, but with this emphasis on context, have we lost sight of the people who should be in the foreground of care? Does such a view impede care effectiveness and efficiency? How can we shift our frame of reference moving forward? To foster this needed conceptual shift, a group of national thought-leaders convened by the American Geriatrics Society (AGS) defined "person-centered care" to reorient the perspective toward individuals remaining in the center of pursuing high-quality care.

Targeting primary care referrals to smoking cessation clinics does not improve quit rates: implementing evidence-based interventions into practice.

Objective: To evaluate the impact of a locally adapted evidence-based quality improvement (EBQI) approach to implementation of smoking cessation guidelines into routine practice.

Data Sources/study Setting: We used patient questionnaires, practice surveys, and administrative data in Veterans Health Administration (VA) primary care practices across five southwestern states.

Study Design: In a group-randomized trial of 18 VA facilities, matched on size and academic affiliation, we evaluated intervention practices' abilities to implement evidence-based smoking cessation care following structured evidence review, local priority setting, quality improvement plan development, practice facilitation, expert feedback, and monitoring.

Assessing the structure of smoking cessation care in the Veterans Health Administration.

Purpose: National smoking cessation practice guidelines offer recommendations regarding the processes and structure of care. Facilities routinely measure the processes of care but not the structure of care. This pilot study assessed the structure of smoking cessation care at Veterans Health Administration facilities.

Modifying provider behavior: a low-tech approach to pharmaceutical ordering.

Objective: To determine if a clinically structured, paper-based prescription form can modify pharmaceutical prescribing behavior without restricting physician freedom to select the most appropriate medication for an individual patient.

Design: Uncontrolled, nonrandomized, time series design.

Setting: The urgent care clinic of a university-affiliated, county-supported hospital that provides care for underserved, vulnerable populations.