Patient-Centered Primary Care Collaborative (PCPCC)
Questions to ask your doctor about patient-centered care
- What type of information will you provide to me about my condition and treatment options?
- Will you provide me with decision aids that will help me to make the best individualized care decisions?
- Am I able to access a patient portal to help me manage my personal health information?
- Am I able to update and contribute to the information in the patient portal or just review it?
- Am I able to review the doctor’s notes in my record? Do I have the option of adding my own information and perspectives into my record for the doctor to read and review?
- When my care team meets to discuss my plan of care, will I be invited to participate in those discussions?
- Is there a way for me to securely send questions/messages to my doctor in advance of (or outside of) a scheduled appointment?
This interactive tool shows the health care gains your state could achieve by improving its performance on measures of access, quality, and health outcomes. The tool draws on data from the 2015 Commonwealth Fund Scorecard on State Health System Performance.
Source: What Would Happen If Health Care in Your State Improved? – The Commonwealth Fund
The Commonwealth Fund’s Scorecard on State Health System Performance, 2017 Edition, assessed states on more than 40 indicators of health care access, quality, costs, and outcomes. Use this interactive tool to see the gains that your state could achieve by improving its performance to the level of better-performing states, as well as the losses that would result if your state failed to sustain its performance. You can also see the impact of reaching for a goal that is even better than the current best state’s performance.
In a new To the Point post, The Commonwealth Fund’s David Radley, Douglas McCarthy, and Susan Hayes show how states can use the tool to help achieve their goals. For example, by seeing the gains made in states that have already expanded Medicaid, policymakers in Georgia or another non-expansion state can calculate the improvements in insurance coverage and access to care that are within their reach.
Source: Pelleboer-Gunnink – 2017 – Journal of Intellectual Disability Research – Wiley Online Library
Equal access to mainstream healthcare services for people with intellectual disabilities (ID) still requires attention. Although recent studies suggest that health professionals hold positive attitudes towards people with ID, stigmatising attitudes may influence their efforts to serve people with ID in community healthcare practice. To stimulate inclusion in mainstream healthcare services, this systematic review focussed on barriers in attitudes of mainstream health professionals towards people with ID.
Five electronic databases were systematically searched and references in full text articles were checked for studies published in the English language between January 1994 and January 2016. A social–psychological triad of cognitive, affective and behavioural dimensions of stigmatising attitudes is used to structure and discuss the results.
The literature search generated 2190 records with 30 studies that passed our exclusion criteria. Studies were mostly cross-sectional and of moderate quality. With respect to stigma, a lack of familiarity with and knowledge about people with ID was found. ID was considered as a stable condition not under personal control. Moreover, mainstream health professionals had either low or high expectations of the capabilities of people with ID. Professionals reported stress, lack of confidence, fear and anxiety, a tendency to treat people with ID differently and a lack of supporting autonomy.
Stigmatising attitudes towards people with ID appeared to be present among mainstream health professionals. This might affect the ongoing challenges regarding inclusion in mainstream healthcare services. To facilitate inclusion in mainstream healthcare services, it is recommended to include contact and collaboration with experts-by-experience in education programs of health professionals. Future research should progress beyond descriptive accounts of stigma towards exploring relationships between cognitive, affective and behavioural dimensions as pointers for intervention. Finally, inclusion would benefit from an understanding of ‘equal’ treatment that means reasonable adjustments instead of undifferentiated treatment.
Source: Brown – 2017 – Journal of Intellectual Disability Research – Wiley Online Library
Globally, diabetes is increasing with concerns about the impact on outcomes, including premature death and the costs associated with managing the condition. Research indicates that adults with intellectual disabilities (ID) are two to three times more likely to develop diabetes; however, there has been limited focus on diabetes service utilisation in this population. The aim of this study is to explore the perceptions and experiences of diabetes and ID practitioners.
A series of 1:1 semi-structured interviews were undertaken in one Scottish health service area. In total, 29 qualitative interviews were conducted: 10 with diabetes practitioners from primary and secondary care, 14 from ID services and 5 from community care services regarding diabetes service provision for this population. Thematic content analysis was undertaken to identify the themes and subthemes.
Three main themes were identified: (1) enabling access to services to meet diabetes-related care needs of people with ID; (2) communication and service improvements between staff, patients and across services; and (3) providing person-centred diabetes care and developing adapted resources to increase patient self-care.
The findings of this study have important international implications in how diabetes practitioners plan and deliver services for people with ID and other vulnerable groups with limited cognitive ability and communication skills and difficulties in self-management. The findings highlight that access to diabetes education and adapted resources is needed, and if ‘reasonable adjustments’ are made to service provision and practice, people with ID can benefit from improved healthcare. Developing joint clinics to share knowledge and resources between diabetes and ID practitioners may improve service delivery and continuity of care, and thereby diminish the costs of not providing quality care.
Source: “I’m still here”: Exploring what matters to people with intellectual disability during advance care planning – McKenzie – 2017 – Journal of Applied Research in Intellectual Disabilities – Wiley Online Library
This study sought to identify, from the perspective of people with intellectual disabilities and life limiting conditions, the factors that strengthened and inhibited their Advance Care Planning.
This in depth qualitative study explored the experiences of four people with intellectual disability and life limiting conditions, through interviews and documentation reviews.
There was strong agreement across all participants about what positively influenced Advance Care Planning, namely; going at my pace; supporting me to make my own choices; adapting the process to suit me, and, most importantly; continuing to support and plan the life I’m still living. With the exception of being comfortable/skilled in end-of-life support, the skills required of facilitators were similar to those required for all forms of person-centred planning.
The findings are encouraging and demonstrate that Advance Care Planning is a useful tool in ensuring that people with intellectual disability have control and choice over their lives, right to the end.
People with intellectual disabilities and developmental disabilities (IDD) face poorer care and outcomes when hospitalized than patients without IDD. A panel discussion “Hospital care for individuals with IDD: The Issues and Challenges” was held at the Annual Conference of the American Academy of Developmental Medicine and Dentistry, held in Chicago July 8–10, 2016. Among the panelists were representatives from Rush University Medical Center in Chicago, IL and Saint Barnabas Medical Center in Livingston, NJ who discussed efforts to improve hospital care of patients with IDD at their institutions.
Source: Improving hospital care of patients with intellectual and developmental disabilities – Disability and Health Journal
Sarah H. Ailey, PhD RN, Paula J. Brown, MBA, Caitlin M. Ridge, BA, CCLS
Findings from the National Longitudinal Transition Study 2012. Volume 1: Comparisons with Other Youth (Full Report)
Key Findings: Youth with an IEP are more likely than their peers to be socioeconomically disadvantaged and to face problems with health, communication, and completing typical tasks independently. The vast majority of youth with and without an IEP feel positive about school, but those with an IEP experience bullying and are suspended at higher rates, and are less engaged in school and social activities. Youth with an IEP are more likely than youth without an IEP to struggle academically, yet less likely to
Source: Preparing for Life After High School: The Characteristics and Experiences of Youth in Special Education. Findings from the National Longitudinal Transition Study 2012. Volume 1: Comparisons with Other Youth (Full Report)
Policymakers and educators have long recognized the importance of addressing the needs of youth in special education, who today account for 12 percent of all youth in the United States. Concern that this objective was not being adequately met led Congress to pass landmark legislation in 1975, now known as the Individuals with Disabilities Education Act (IDEA) (U.S. Department of Education, 2010). IDEA mandates that children and youth with disabilities have access to a free appropriate public education.
Toward Data-Driven, Cross-Sector, and Community-Led Transformation: Academy Health provides an overview of the findings including the who, the what and the how.
The Community Health Peer Learning Program (CHP), a partnership of AcademyHealth and the Office of the National Coordinator for Health Information Technology (ONC), conducted an environmental scan of multisector initiatives driving toward population health improvement at the community level, many with a focus on capturing, sharing, integrating, and using data to support their work. The scan and ensuing report confirm the emergence and rapid expansion of such efforts, and reflect a growing recognition that local conditions often drive the environmental and social determinants of health. Many place-based population health improvement efforts, therefore, involve sectors outside of health care (e.g., housing, education, criminal justice), and this report profiles several different programs and strategies designed to build and sustain these cross-sector collaborations. The report also conveys the scale, scope, and diversity of ongoing efforts, and offers insights into common challenges, emerging strategies, and promising practices to accelerate progress.Ultimately, the scan and associated report reveal the emergence of a movement—a convergence of programs and people connecting across traditional and non-traditional boundaries, and working together to improve community health.
Download the Executive Summary above, or click here for the full report.
Source: Toward Data-Driven, Cross-Sector, and Community-Led Transformation: Executive Summary | Academy Health