Team-based care: an expanded medical assistant role - enhanced rooming and visit assistance.

Primary care practices face significant challenges as they pursue the Quadruple Aim. Redistributing care across the interprofessional primary care team by expanding the role of the medical assistant (MA) is a potential strategy to address these challenges. Two sequential, linked processes to expand the role of the MA, called Enhanced Rooming and Visit Assistance, were implemented in four family medicine residency clinics in Minnesota.

Video Review Process: Enhancing Impact and Resident/Faculty Satisfaction.

Introduction: Although video review (VR) is a common component of family medicine (FM) resident education, levels of faculty and resident satisfaction and the perceived impact of the VR process are unknown. Our FM residency program made several changes to our VR process, including a new feedback form highlighting strengths and areas for growth, a post-VR email to the resident including a tip sheet on an identified skill, and follow-up shadowing by a behavioral health clinician to increase VR impact and reinforce skill development.

Methods: FM residency faculty (n=11) and residents (n=34) completed an anonymous 20-item online survey.

Integrated care clinic: Creating enhanced clinical pathways for integrated behavioral health care in a family medicine residency clinic serving a low-income, minority population.

Introduction: Research examining the implementation and effectiveness of integrated behavioral health (BH) care in family medicine/primary care is growing. However, research identifying ways to consistently use integrated BH in busy family medicine/primary care settings with underserved populations is limited. This study describes 1 family medicine clinic's transformation into a fully integrated BH care clinic through the development of an Integrated Care Clinic (ICC) and enhanced clinical pathways to promote regular use of behavioral health clinicians (BHCs).

PURLs: skip this step when checking lipid levels.

Although most guidelines recommend that patients fast before lipid testing, this study found no difference between fasting and nonfasting testing for predicting mortality.

What to do when warfarin therapy goes too far.

Warfarin is certainly a lifesaver--but it can also lead to potentially fatal hypocoagulability. Here we recommend best reversal options based on the type of bleed. For patients with an elevated international normalized ratio (INR) with mild or no bleeding, withhold the warfarin and recheck INR in 1 to 2 days; if INR >5, add oral vitamin K supplementation.