Quality improvement in neurology

Odenheimer, Germaine L.; Borson, Soo; Sanders, Amy; Swain-Eng, Rebecca J.; Kyomen, Helen H.; Tierney, Samantha; Gitlin, Laura N.; Forciea, Mary Ann; Absher, John R.; Shega, Joseph W.; Johnson, Jerry

doi:10.1212/wnl.0b013e3182a956bf

Cited by 47 publications

(14 citation statements)

References 53 publications

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“…(4) Proactive dementia care and care management have the potential to avert preventable health crises, thereby reducing avoidable emergency department visits and hospitalizations. (5) Care management is the application of systems, science, incentives, and information to improve medical practice and help patients manage medical conditions more effectively. (6) Dementia care management has been shown to result in significant improvement in the quality of care and in behavioral and psychological symptoms of dementia among primary care patients and their caregivers (7) and can lower health care costs by reducing emergency department visits, inpatient hospitalizations, and thirty-day readmissions.…”

Section: Gaps In Dementia Carementioning

confidence: 99%

Coordinated Care Management For Dementia In A Large Academic Health System

Tan

Jennings²,

Reuben³

2014

Health Affairs

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Alzheimer’s disease and other dementias are chronic, incurable diseases that require coordinated care that addresses the medical, behavioral, and social aspects of the disease. With funding from the Center for Medicare and Medicaid Innovation (the Innovation Center), we launched a dementia care program in which a nurse practitioner acting as a dementia care manager worked with primary care physicians to develop and implement a dementia care plan that offers training and support to caregivers, manages care transitions, and facilitates access to community-based services. Post-visit surveys showed high levels of caregiver satisfaction. As program enrollment grows, outcomes will be tracked based on the triple aim developed by the Institute for Healthcare Improvement and adopted by the Centers for Medicare and Medicaid Services: better care, better health, and lower cost and utilization. The program, if successful at achieving the triple aim, may serve as a national model for how dementia and other chronic diseases can be managed in partnership with primary care practices. The program may also inform policy and reimbursement decisions for the recently released transitional care management codes and the complex chronic care management codes to be released by Medicare in 2015.

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Section: Gaps In Dementia Carementioning

confidence: 99%

Coordinated Care Management For Dementia In A Large Academic Health System

Tan

Jennings²,

Reuben³

2014

Health Affairs

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“…Thus, without adequate healthcare coordination, patients with dementia are at a heightened risk for preventable medical errors. 19 , 20 , 21 Utilizing the full spectrum of available healthcare providers can alleviate physician burden, 22 and given that medication management is a significant component to improving care in this population, pharmacists are well-suited to augment the healthcare team for patients with dementia. For chronic disease such as diabetes and hypertension, pharmacists already provide services including improving medication adherence, providing patient education, monitoring laboratory values or adverse effects of medications to ensure safety and effectiveness, and conducting prior authorizations in hospital, ambulatory, and community settings.…”

Section: Introductionmentioning

confidence: 99%

An investigation of new medications initiation during ambulatory care visits in patients with dementia

Wallem

Martinez

Vickers

et al. 2021

Exploratory Research in Clinical and Social Pharmacy

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“…The American Academy of Neurology (AAN) has proposed quality measures for the care of adults with neurological disease (Cheng 2010;Fountain et al 2011;Miller et al 2013;Odenheimer et al 2013;England et al 2014), and guidelines for restless legs syndrome/Willis-Ekbom disease (RLS/WED) are under development (Guidelines Projects in Process, 2019). The American Academy of Sleep Medicine recently published quality measures (Trotti et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Quality improvement and practice-based research in sleep medicine using structured clinical documentation in the electronic medical record

Maraganore

Freedom

Simon

et al. 2020

Sleep Science Practice

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Background We developed and implemented a structured clinical documentation support (SCDS) toolkit within the electronic medical record, to optimize patient care, facilitate documentation, and capture data at office visits in a sleep medicine/neurology clinic for patient care and research collaboration internally and with other centers. Methods To build our SCDS toolkit, physicians met frequently to develop content, define the cohort, select outcome measures, and delineate factors known to modify disease progression. We assigned tasks to the care team and mapped data elements to the progress note. Programmer analysts built and tested the SCDS toolkit, which included several score tests. Auto scored and interpreted tests included the Generalized Anxiety Disorder 7-item, Center for Epidemiological Studies Depression Scale, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Insomnia Severity Index, and the International Restless Legs Syndrome Study Group Rating Scale. The SCDS toolkits also provided clinical decision support (untreated anxiety or depression) and prompted enrollment of patients in a DNA biobank. Results The structured clinical documentation toolkit captures hundreds of fields of discrete data at each office visit. This data can be displayed in tables or graphical form. Best practice advisories within the toolkit alert physicians when a quality improvement opportunity exists. As of May 1, 2019, we have used the toolkit to evaluate 18,105 sleep patients at initial visit. We are also collecting longitudinal data on patients who return for annual visits using the standardized toolkits. We provide a description of our development process and screenshots of our toolkits. Conclusions The electronic medical record can be structured to standardize Sleep Medicine office visits, capture data, and support multicenter quality improvement and practice-based research initiatives for sleep patients at the point of care.

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Quality improvement in neurology

Cited by 47 publications

References 53 publications

Coordinated Care Management For Dementia In A Large Academic Health System

Coordinated Care Management For Dementia In A Large Academic Health System

An investigation of new medications initiation during ambulatory care visits in patients with dementia

Quality improvement and practice-based research in sleep medicine using structured clinical documentation in the electronic medical record

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