What Works In Primary Care

Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.

Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.

This practical ‘How To’ guide talks the reader step-by-step through designing, conducting and disseminating primary care research, a growing discipline internationally. The vast majority of health care issues are experienced by people in community settings, who are not adequately represented by hospital-based research. There is therefore a great need to upskill family physicians and other primary care workers and academics to conduct community-based research to inform best practice. Aimed at emerging researchers, including those in developing countries, this book also addresses cutting edge and newly developing research methods, which will be of equal interest to more experienced researchers.

Patients with chronic conditions often need psychosocial support and brief counseling to help them make the lifestyle and behavioral changes required to prevent disease complications. This innovative text, with contributions from respected clinicians and researchers in all arenas of behavioral health, provides comprehensive training for all health professionals including those in medicine, nursing, social work, mental health, and clinical and health psychology who desire targeted evidence-based training in Behavioral Health skills . Rich case examples drawn from typical patient presentations demonstrate the relationship between physical and psychological health and the complexity of behavior change in chronic illness. This text is a timely, relevant and practical resource for all members of the primary care team. It prepares team members to work in the model of patient-centered integrated care in accordance with the recommendations of the Affordable Health Care Act (ACA) and the National Committee for Quality Assurance (NCQA) medical home standards for identifying patient needs and providing coordinated and comprehensive patient care. It focuses on knowledge and skills needed for working with the most common chronic conditions such as diabetes, obesity, chronic pain, cardiovascular conditions, sleep disorders, geriatric conditions, cancer-related conditions, and substance abuse. It includes chapters on epidemiological trends in chronic illness and systems medicine. Theories of health behavior and behavior change and evidence-based interventions provide a foundation for skill development, followed by detailed coverage of the requirements for behavioral management of specific chronic conditions. Sample referrals and consultation notes provide concrete examples of how the behavioral health specialist might respond to a referral. . Key Features: Provides comprehensive graduate-level training for the role of Behavioral Health Specialist Describes the health promotion and counseling skills needed to function as part of an integrated health team Focuses on proficiencies needed for working with common chronic conditions Addresses the psychosocial components of primary care disorders Includes case examples demonstrating the relationship between physical and psychological health and the complexity of behavior change in chronic illness

High-quality primary care is the foundation of the health care system. It provides continuous, person-centered, relationship-based care that considers the needs and preferences of individuals, families, and communities. Without access to high-quality primary care, minor health problems can spiral into chronic disease, chronic disease management becomes difficult and uncoordinated, visits to emergency departments increase, preventive care lags, and health care spending soars to unsustainable levels. Unequal access to primary care remains a concern, and the COVID-19 pandemic amplified pervasive economic, mental health, and social health disparities that ubiquitous, high-quality primary care might have reduced. Primary care is the only health care component where an increased supply is associated with better population health and more equitable outcomes. For this reason, primary care is a common good, which makes the strength and quality of the country's primary care services a public concern. Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care puts forth an evidence-based plan with actionable objectives and recommendations for implementing high-quality primary care in the United States. The implementation plan of this report balances national needs for scalable solutions while allowing for adaptations to meet local needs.

Ensuring that members of society are healthy and reaching their full potential requires the prevention of disease and injury; the promotion of health and well-being; the assurance of conditions in which people can be healthy; and the provision of timely, effective, and coordinated health care. Achieving substantial and lasting improvements in population health will require a concerted effort from all these entities, aligned with a common goal. The Health Resources and Services Administration (HRSA) and the Centers for Disease Control and Prevention (CDC) requested that the Institute of Medicine (IOM) examine the integration of primary care and public health. Primary Care and Public Health identifies the best examples of effective public health and primary care integration and the factors that promote and sustain these efforts, examines ways by which HRSA and CDC can use provisions of the Patient Protection and Affordable Care Act to promote the integration of primary care and public health, and discusses how HRSA-supported primary care systems and state and local public health departments can effectively integrate and coordinate to improve efforts directed at disease prevention. This report is essential for all health care centers and providers, state and local policy makers, educators, government agencies, and the public for learning how to integrate and improve population health.

This work provides an overview of the difficult research methods available in primary care. explains how to find an appropriate method. It indicates when specialist advice is needed and where to find it and exercises are included to encourage readers to check their understanding.

Real-life primary care case studies* from more than 50 primary care providers, including physician assistants, nurse practitioners, and physicians! 101 Primary Care Case Studies offers real-life patient scenarios and critical thinking exercises to help you work through a patient’s chief complaint. Through narrative case studies, you will determine how best to diagnose, treat, and manage your patient based on the history of present illness, review of systems, relevant history, and physical examination findings. This workbook will ask probing questions to help you determine differential and most likely diagnoses, diagnostic tests to order, and appropriate patient management strategies using relevant and timely references to support your decisions. The organization of each case study simulates the patient care journey from chief complaint to outcome. Serving as a virtual clinical preceptor, this workbook can be used independently or in a classroom setting. It is accompanied by a robust online student supplement that provides answers to all questions, real outcomes of the cases, and valuable personal insights from the authors on how the patient was successfully managed. Not only will this workbook help you work through patient cases clinically, it will also share important, but often overlooked, bedside manner skills needed to successfully communicate with and care for your patients. Covering conditions across all organ systems and across the lifespan, this workbook is organized by chief complaint, providing an authentic perspective on what to expect in the patient care environment. It even includes information on pathophysiology and how to use ICD-10 and CPT (E/M) codes in your documentation. The book uniquely weaves together both the science and art of medicine by including personal insights into quality and compassionate care. Key Features Provides real-life patient cases from an interprofessional author team of physician assistants, nurse practitioners, and physicians Uses a templated case study design and critical thinking exercises to help you methodically work through various patient scenarios Teaches clinical and bedside manner skills imperative for delivering quality patient care Covers patients across the lifespan, including pediatric, adolescent, adult, and geriatric populations Offers additional insight on patient education, medical and legal concerns, and interprofessional collaboration Includes a robust online student supplement with valuable insights from the authors on how they successfully managed the cases Provides instructors with a table of contents that is filterable by chief complaint, diagnosis, patient population, and organ system *Details changed to protect patient information.