Patient Engagement in Patient Portals in Appalachia v. Surrounding U.S. Census Regions: An Analysis of HINTS (Health Information National Trends Survey) Data, 2017-2020.

Introduction: Those living in the Appalachian Region face a greater number of significant health disparities than residents of other areas of the U.S. Patient portals can decrease disparities, increase health literacy, and improve health outcomes.

Lean in Healthcare: Time for Evolution or Revolution?

Lean has gained recognition in healthcare as a quality improvement tool. The purpose of this research was to examine the extent to which quality improvement projects in healthcare adhered to Lean's eight-step process. We analyzed 605 publications identified through a systematic literature review following PRISMA guidelines.

Improvement through Small Cycles of Change: Lessons from an Academic Medical Center Emergency Department.

This article describes the experiences of a quality improvement team that used small cycles of change to improve the emergency department (ED) of an academic medical center. The role of EDs in the provision of healthcare continues to increase in importance. ED bottlenecks contribute to long waits and diminished outcomes for ED patients as well as more system-wide issues, such as inefficiencies in inpatient admission processes.

Does vigilance in decision-making matter for dementia family caregivers?

Objectives: Family responsibilities and social expectations often prompt conflict in caregivers' decision-making processes. Janis and Mann's (1977) conflict model describes vigilance as high-quality decision-making resulting in optimal outcomes. The purpose of our research was threefold: (1) to describe decision styles in a population of family caregivers of persons with dementia; (2) to examine the socio-economic characteristics associated with caregivers who are more likely to be vigilant decision-makers; and (3) to assess differences in caregiving experiences between vigilant and non-vigilant caregivers.

Age Differences in Information Use While Making Decisions: Resource Limitations or Processing Differences?

Recent research on the decision-making abilities of older adults has shown that they use less information than young adults. One explanation ascribes this age difference to reductions in cognitive abilities with age. The article includes three experimental studies that focused on determining the conditions in which older and young adults would display dissimilar information processing characteristics.

Taking the Pulse of a Target Population: Assessing Change Readiness.

Objective: Implementing change in a health care organization poses structural and cultural challenges.

Design: We developed a survey derived from an existing organizational change model and distributed it to the target population of an impending change initiative.

Results: The respondents (59.

The human side of lean teams.

Organizations use lean principles to increase quality and decrease costs. Lean projects require an understanding of systems-wide processes and utilize interdisciplinary teams. Most lean tools are straightforward, and the biggest barrier to successful implementation is often development of the team aspect of the lean approach.

Colorectal cancer screening: patients' and physicians' perspectives on decision-making factors.

While patient barriers to colorectal cancer (CRC) screening have been identified, how well this knowledge is utilized during the patient-physician interaction is not fully understood. This study aims to assess among primary care physicians the degree of consensus between perceived and actual patients' CRC screening decision-making influential factors. During 2004-2006, 30 patients were interviewed to identify factors influencing screening decisions and 66 physicians were interviewed to understand what factors they thought were important to patients.

Modeling the decision to undergo colorectal cancer screening: insights on patient preventive decision making.

Background: Little is known about how patients decide whether or not to undergo colorectal cancer screening. Although low screening rates evidence the outcome of these decisions, the processes patients use to balance benefits, risks, and costs with their own values and preferences are unclear. To increase screening rates, and ultimately save lives, it is important for providers to be aware of how patients make screening decisions.

Using decision tree models to depict primary care physicians CRC screening decision heuristics.

Objective: The purpose of this study was to identify decision heuristics utilized by primary care physicians in formulating colorectal cancer screening recommendations.

Design: Qualitative research using in-depth semi-structured interviews.

Participants: We interviewed 66 primary care internists and family physicians evenly drawn from academic and community practices.

Physician colorectal cancer screening recommendations: an examination based on informed decision making.

Objective: The purpose of this research was to examine the content of physicians' colorectal cancer screening recommendations. More specifically, using the framework of informed decision making synthesized by Braddock and colleagues, we conducted a qualitative study of the content of recommendations to describe how physicians are currently presenting this information to patients.

Methods: We conducted semi-structured interviews with 65 primary care physicians.

"Do we really need all that equipment?": factors influencing colorectal cancer screening decisions.

The lifetime risk of developing colorectal cancer is 2.5 to 5% in the general population. Colorectal screening can prevent mortality, and there are a number of screening methods, ranging from noninvasive to highly invasive.

Diagnosis-seeking at subspecialty memory clinics: trigger events.

Background: Research has shown that dementia often goes unrecognized, and diagnostic assessment is often further delayed. Understanding families' decision to seek care at memory clinics is relevant to efforts to facilitate early diagnosis.

Objective: To examine the population seeking care at two memory clinics and the triggers causing caregivers to seek diagnostic assessment for a family member.

The characteristics of dementia caregiving onset.

This study examined the characteristics of entry into the caregiving role for family and friends of older adults suffering from dementia. Using data from a large community survey of informal caregivers of patients who visited the University of Kentucky's Alzheimer's Disease Research Center (n = 1055), respondents were classified into one of four onset sequences: recognition-diagnosis, care provision, recognition-care, and diagnosis dependent. A multinomial logistic regression identified several characteristics (i.

The carrot and the stick: benefits and barriers in getting a diagnosis.

The goals of this study were to identify the benefits and barriers perceived by family caregivers of persons who have been through a diagnostic assessment for dementia symptoms and to determine which caregivers experience more benefits and barriers associated with assessments. A survey was mailed to caregivers involved in the decision to seek a diagnostic assessment for a family member at a University of Kentucky memory disorders clinic. A total of 528 family caregivers (response rate 71.

Capturing the insights of family caregivers: survey item generation with a coupled interview/focus group process.

The usefulness of qualitative methodologies to augment and enrich quantitative studies is often overlooked. The authors' goals are to describe the qualitative process employed to generate survey items and to compare the results to those of studies that used different methodologies for item generation. The study identified barriers to and benefits of memory assessments.

Essential information and support needs of family caregivers.

The purpose of this study was to identify essential information and support needs of family caregivers for individuals with Alzheimer's disease or a related dementia, and to examine the relationship between caregiver characteristics and needs. Caregivers (n=128, response rate=49.4%) returned a survey detailing information needs, support needs, and personal information.