ABSTRACT
In the Association of American Medical Colleges (AAMC's) Complexities of Physician Supply and Demand (IHS Markit Ltd., 2021), the authors acknowledged that primary care providers (PCPs) are essential in screening patients for mental health conditions; however, they did not explicitly acknowledge the PCPs play in management of these conditions. In fact, they mentioned that psychiatry is the only specialty "focused on addressing mental health needs." This statement fails to acknowledge the significant role of PCPs in addressing mental health needs in the context of providing whole person health. The American Academy of Family Physicians (AAFP) position statement extensively outlines this role and describes the use of a Collaborative Care Model, which centers around PCPs as the point provider for mental health management. The Collaborative Care Model was developed with the goal to increase the volume and effectiveness of mental health treatment in the primary care setting, recognizing the crucial role PCPs play in mental health care delivery. Provider associations representing primary care, mental health and psychiatry, and education must partner to rectify these identified problems and revise the understanding of primary care in mental health management and future workforce policy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Subject(s)
Mental Disorders , Physicians, Primary Care , Psychiatry , Health Workforce , Humans , Mental Disorders/therapy , Physicians, Family , Primary Health CareABSTRACT
As was experienced across the country, the COVID-19 pandemic reached Colorado in early spring 2020. Yet, unlike many of the early hotspots in other states, the initial cases in Colorado surfaced in rural areas. It was evident early on it would be a public health crisis unlike anything Colorado had ever faced. There was an urgent need for rapid dissemination of up-to-date information and practice support provided by a multidisciplinary task force of academic health center and state public health experts working collaboratively to meet these needs. This article provides a roadmap for the development of a similar model, a community-connected Extension for Community Health Outcomes (ECHO) program based at an academic medical center and its ability to facilitate the service rapidly and scale to need.
Subject(s)
COVID-19 , Primary Health Care/organization & administration , Public Health Administration , Telemedicine , Colorado/epidemiology , Health Plan Implementation , Humans , Pandemics , Public HealthABSTRACT
A daily dose of this prescription fish oil may be worth a trial in light of the cardiovascular benefits it affords statin-treated patients with high triglycerides.
Subject(s)
Dietary Supplements , Fatty Acids, Omega-3/therapeutic use , Fish Oils/therapeutic use , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Hypertriglyceridemia/drug therapy , Hypertriglyceridemia/epidemiology , Lipid Regulating Agents/therapeutic use , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Treatment Outcome , United States/epidemiologyABSTRACT
INTRODUCTION: To provide insight into how an innovation in healthcare is implemented and diffused, we studied the transition from routine use of general anesthesia to peripheral nerve blocks (PNBs) for ambulatory orthopedic extremity surgery. Rogers' diffusion of innovations (DOI) theory was used as our theoretical framework. We identified themes that would be helpful for others attempting to diffuse innovations into healthcare settings. MATERIAL AND METHODS: A mixed quantitative and qualitative methodology was used. We retrospectively reviewed operative and anesthesia records of patients who underwent ambulatory repair of distal radius fractures or arthroscopic knee meniscus procedures from 1998 to 2012 to identify whether general anesthetics or PNBs were used and the time course of the innovation. We interviewed orthopedic surgeons, anesthesiologists, and a nursing administrator working in the ambulatory surgery unit during the innovation to identify key themes associated with the adoption of PNBs. RESULTS: From 2003 to 2012, use of PNBs increased from less than 10% to 70% of cases studied. The adoption timeframe followed an S-shaped curve. Key themes included improved safety, quality, efficiency, physician leadership and trust, organizational structure, and technological change. The innovation involved an optional decision-making process and took root in a satellite facility and generally fit with Rogers DOI theory. CONCLUSIONS: The adoption and diffusion of PNBs provides a useful model for understanding innovations with optional decision-making in healthcare. Critical elements in our case were the characteristics of the innovation, which facilitated the decision-making process, and the positioning of the innovation in a peripheral structure away from core clinical facilities.
