15 results match your criteria integrated clinic-community

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Factors Impacting Physician Referral To and Patient Attendance at Weight Management Programs Within a Large Integrated Health System.

J Gen Intern Med 2021 Jan 22. Epub 2021 Jan 22.

Center for Value-Based Care Research, Cleveland Clinic Community Care, Cleveland, OH, USA.

Background: Identifying which patients receive referrals to and which ones attend weight management programs can provide insights into how physicians manage obesity.

Objective: To describe patient factors associated with referrals, which primarily reflect physician priorities, and attendance, which reflects patient priorities. We also examine the influence of the individual physician by comparing adjusted rates of referral and attendance across physicians. Read More

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January 2021

Patients Desire Personalized, Specific, and Continuous Advice on Weight Management.

South Med J 2021 01;114(1):41-45

From the Center for Value-Based Care Research and the Department of Family Medicine, Cleveland Clinic Community Care, the Strategy Office, Cleveland Clinic, and the Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio.

Objective: To deliver effective care, healthcare systems should understand patients' preferences for weight management across a spectrum of needs. Our objective was to describe patients' perceptions of what helps or hinders weight loss and maintenance.

Methods: Semistructured interviews were conducted with patients who accessed weight management services at a large integrated health system in 2018. Read More

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January 2021

The hospitalized patient with COVID-19 on the medical ward: Cleveland Clinic approach to management.

Cleve Clin J Med 2020 Nov 3. Epub 2020 Nov 3.

Chairman, Department of Hospital Medicine, Cleveland Clinic Community Care, Cleveland Clinic; Clinical Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH.

SARS-CoV-2-infected inpatients who are admitted to a noncritical care medical ward require a standardized approach that is based on evidence if available, and effective supportive and respiratory care. Outcomes are better when patients receive standardized care, in special COVID-19 wards in the hospital, from clinical teams with expertise. Available evidence and guidelines should be continuously appraised and integrated into clinical protocols for all domains of treatment, including isolation, and personal protective measures, pharmacologic therapy, and transitions of care. Read More

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November 2020

Association Between Pain, Blood Pressure, and Medication Intensification in Primary Care: an Observational Study.

J Gen Intern Med 2020 12 21;35(12):3549-3555. Epub 2020 Sep 21.

Center for Value-Based Care Research, Cleveland Clinic Community Care, Cleveland Clinic, 9500 Euclid Avenue, G10, Cleveland, OH, 44195, USA.

Background: Treating hypertension is important but physicians often do not intensify blood pressure (BP) treatment in the setting of pain.

Objective: To identify whether reporting pain is associated with (1) elevated BP at the same visit, (2) medication intensification, and (3) elevated BP at the subsequent visit.

Design: Retrospective cohort SETTING: Integrated health system PARTICIPANTS: Adults seen in primary care EXPOSURE: Pain status based on numerical scale: mild (1-3), moderate (4-6), or severe (≥ 7). Read More

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December 2020

Rationale and design of "Hearts & Parks": study protocol for a pragmatic randomized clinical trial of an integrated clinic-community intervention to treat pediatric obesity.

BMC Pediatr 2020 06 26;20(1):308. Epub 2020 Jun 26.

Duke Clinical Research Institute, Duke University, Durham, NC, 27710, USA.

Background: The prevalence of child and adolescent obesity and severe obesity continues to increase despite decades of policy and research aimed at prevention. Obesity strongly predicts cardiovascular and metabolic disease risk; both begin in childhood. Children who receive intensive behavioral interventions can reduce body mass index (BMI) and reverse disease risk. Read More

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The Probability of A1C Goal Attainment in Patients With Uncontrolled Type 2 Diabetes in a Large Integrated Delivery System: A Prediction Model.

Diabetes Care 2020 08 11;43(8):1910-1919. Epub 2020 Jun 11.

Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH.

Objective: To assess patient characteristics and treatment factors associated with uncontrolled type 2 diabetes (T2D) and the probability of hemoglobin A (A1C) goal attainment.

Research Design And Methods: This was a retrospective cohort study using the electronic health record at Cleveland Clinic. Patients with uncontrolled T2D (A1C >9%) were identified on the index date of 31 December 2016 ( = 6,973) and grouped by attainment ( = 1,653 [23. Read More

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Impact of a system-wide quality improvement initiative on blood pressure control: a cohort analysis.

BMJ Qual Saf 2020 03 31;29(3):225-231. Epub 2019 Aug 31.

Center for Value-Based Care Research, Cleveland Clinic Community Care, Cleveland Clinic, Cleveland, Ohio, USA.

Objective: To assess the impact of a quality improvement programme on blood pressure (BP) control and determine whether medication intensification or repeated measurement improved control.

Design: Retrospective cohort comparing visits in 2015 to visits in 2016 (when the programme started).

Subjects: Adults with ≥1 primary care visit between January and June in 2015 and 2016 and a diagnosis of hypertension in a large integrated health system. Read More

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Pilot evaluation of HEAL - A natural experiment to promote obesity prevention behaviors among low-income pregnant women.

Prev Med Rep 2018 Jun 9;10:254-262. Epub 2018 Apr 9.

Department of Health Promotion & Behavioral Sciences, Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston, School of Public Health in Austin, Austin, TX, United States.

Instituting interventions during the prenatal period is optimal for early obesity prevention in the child. Healthy Eating Active Living (HEAL) is a six-week, multi-component program to promote breastfeeding, healthy dietary habits, cooking skills and physical activity among Medicaid-eligible pregnant-women in Texas. HEAL is integrated into the healthcare system and offered as a standard-of-care for eligible patients. Read More

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Integrating community-based health promotion programs and primary care: a mixed methods analysis of feasibility.

BMC Health Serv Res 2018 01 31;18(1):72. Epub 2018 Jan 31.

Knowledge and Evaluation Research Unit, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.

Background: Implementation of evidence-based programs (EBPs) for disease self-management and prevention is a policy priority. It is challenging to implement EBPs offered in community settings and to integrate them with healthcare. We sought to understand, categorize, and richly describe key challenges and opportunities related to integrating EBPs into routine primary care practice in the United States. Read More

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January 2018

An Integrated Clinic-Community Partnership for Child Obesity Treatment: A Randomized Pilot Trial.

Pediatrics 2018 01 13;141(1). Epub 2017 Dec 13.

Department of Pediatrics, and.

Background And Objectives: Effective treatment of childhood obesity remains elusive. Integration of clinical and community systems may achieve effective and sustainable treatment. However, the feasibility and effectiveness of this integrated model are unknown. Read More

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January 2018

Type 2 Diabetes and Depression: Patient, Family Member, and Primary Care Provider Perspectives on the Development of an Integrated Self-Management Intervention.

Diabetes Educ 2015 12 8;41(6):763-72. Epub 2015 Oct 8.

American University, Washington, DC (Ms Cohen)

Purpose: The purpose of the current study was to engage a local primary care clinic community that serves the Latino immigrant population to obtain their input regarding the design and implementation of a proposed integrated behavioral intervention that will simultaneously target T2DM and depression self-management in this high risk patient population.

Methods: Nine key informant interviews and 3 focus groups were conducted. Key informant interviews were conducted with the medical director, a primary care provider, a diabetes educator, and a medical assistant from each site, as well as the counselor who serves both sites. Read More

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December 2015

Description of an integrated framework for building linkages among primary care clinics and community organizations for the prevention of type 2 diabetes: emerging themes from the CC-Link study.

Chronic Illn 2010 Jun 19;6(2):89-100. Epub 2010 May 19.

Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.

Strong clinic-community linkages are pivotal for the success of preventive services that combine clinical and community resources. Unfortunately, there has been limited guidance for how clinical and community groups can partner to improve self-care and prevention for chronic conditions. This manuscript describes the development and implementation of an integrated framework to guide clinic-community linkages for the prevention of type 2 diabetes in an ongoing randomized effectiveness trial known as Clinical-Community Linkages to Prevent Diabetes (CC-Link) study. Read More

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Process-optimized operating room: implementation of an integrated OR system into clinical routine.

Surg Technol Int 2002 Sep;10:67-70

Surgical Clinic Community Hospital, Lueneburg, Germany.

The surgeon's working environment has changed continuously in recent years regarding the technical complexity of the components in use in the operating room (OR). Parallel to this development, demands for process-optimized procedures have also grown constantly. The impetus for these changes was the beginning of use of minimally invasive techniques in surgery. Read More

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September 2002
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