Objectives: Health care teams may be used to improve quality in the primary care setting. Absent in the extant literature on health care teams is knowledge of how physicians seek to deploy this innovation on an everyday basis to improve care quality. This study's aim was to explore how physicians use teams in practice to deliver higher-quality care.
Methods: A qualitative study using data collected through 39 interviews with primary care physicians and 9 interviews with medical assistants, employed across different primary care settings in the northeastern region of the United States.
Results: Physicians used teams for 2 care quality functions: "getting basic care duties off their plate" to have more time for complex care delivery and "as relational extensions" of themselves to enhance the patient experience and provide care continuity. Physicians identified the following ingredients for using teams for these functions: (a) achieving long-term continuity working with the same team members; (b) having the correct mix of personalities and skills sets on the team; and (c) a "who is doing what" focus in the team for achieving role clarity.
Conclusions: The findings illuminate how primary care physicians attempt to use teams to improve care quality and enhance their role as care providers.
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http://dx.doi.org/10.1097/QMH.0000000000000216 | DOI Listing |
JAMA Cardiol
January 2025
Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia.
Importance: A comprehensive lipid panel is recommended by guidelines to evaluate atherosclerotic cardiovascular disease risk, but uptake is low.
Objective: To evaluate whether direct outreach including bulk orders with and without text messaging increases lipid screening rates.
Design, Setting, And Participants: Pragmatic randomized clinical trial conducted from June 6, 2023, to September 6, 2023, at 2 primary care practices at an academic health system among patients aged 20 to 75 years with at least 1 primary care visit in the past 3 years who were overdue for lipid screening.
JAMA
January 2025
Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis.
Importance: Care management benefits community-dwelling patients with dementia, but studies include few patients with moderate to severe dementia or from racial and ethnic minority populations, lack palliative care, and seldom reduce health care utilization.
Objective: To determine whether integrated dementia palliative care reduces dementia symptoms, caregiver depression and distress, and emergency department (ED) visits and hospitalizations compared with usual care in moderate to severe dementia.
Design, Setting, And Participants: A randomized clinical trial of community-dwelling patients with moderate to severe dementia and their caregivers enrolled from March 2019 to December 2020 from 2 sites in central Indiana (2-year follow-up completed on January 7, 2023).
JAMA Netw Open
January 2025
Department of Medicine, University of Chicago, Chicago, Illinois.
JAMA Netw Open
January 2025
Department of Pediatrics, The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York.
Importance: Pediatric obesity and hypertension are highly correlated. To mitigate both conditions, provision of counseling on nutrition, lifestyle, and weight to children with high blood pressure (BP) measurements is recommended.
Objective: To examine racial and ethnic disparities in receipt of nutrition, lifestyle, and weight counseling among patients with high BP at pediatric primary care visits stratified by patients' weight status.
JAMA Netw Open
January 2025
Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California.
Importance: Limited research explores mental health disparities between individuals in sexual and gender minority (SGM) populations and cisgender heterosexual (non-SGM) populations using national-level data.
Objective: To explore mental health disparities between SGM and non-SGM populations across sexual orientation, sex assigned at birth, and gender identity within the All of Us Research Program.
Design, Setting, And Participants: This cross-sectional study used survey data and linked electronic health records of eligible All of Us Research Program participants from May 31, 2017, to June 30, 2022.
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