This clinical practice guideline (CPG) has been developed under a project conducted by the American Medical Directors Association (AMDA), the national professional organization representing medical directors, attending physicians, and other practitioners who care for patients in the long-term care setting. This is one of a number of guidelines undertaken as part of the association’s mission to improve the quality of care delivered to patients in these settings. Original guidelines are developed by interdisciplinary workgroups, using a process that combines evidence and consensus-based approaches. Workgroups include practitioners and others involved in patient care in long-term care facilities. Beginning with a general guideline developed by an agency, association, or organization such as the Agency for Healthcare Research and Quality (AHRQ), pertinent articles and information, and a draft outline, each group works to make a concise, usable guideline that is tailored to the long-term care setting. Because scientific research in the long-term care population is limited, many recommendations are based on the expert opinion of practitioners in the field. A bibliography is provided for individuals who desire more detailed information. Guideline revisions are completed under the direction of the Clinical Practice Guideline Steering Committee. The committee incorporates information published in peer-reviewed journals after the original guidelines appeared as well as comments and recommendations not only from experts in the field addressed by the guideline but also from “hands-on” long-term care practitioners and staff.

August 7, 2019

Transitions of Care in the Long-Term Care Continuum: Practice Guideline

This clinical practice guideline (CPG) has been developed under a project conducted by the American Medical Directors Association (AMDA), the national professional organization representing medical directors, attending physicians, and other practitioners who care for patients in the long-term care setting. This is one of a number of guidelines undertaken as […]
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This clinical practice guideline (CPG) has been developed under a project conducted by the American Medical Directors Association (AMDA), the national professional organization representing medical directors, attending physicians, and other practitioners who care for patients in the long-term care setting. This is one of a number of guidelines undertaken as part of the association’s mission to improve the quality of care delivered to patients in these settings. Original guidelines are developed by interdisciplinary workgroups, using a process that combines evidence and consensus-based approaches. Workgroups include practitioners and others involved in patient care in long-term care facilities. Beginning with a general guideline developed by an agency, association, or organization such as the Agency for Healthcare Research and Quality (AHRQ), pertinent articles and information, and a draft outline, each group works to make a concise, usable guideline that is tailored to the long-term care setting. Because scientific research in the long-term care population is limited, many recommendations are based on the expert opinion of practitioners in the field. A bibliography is provided for individuals who desire more detailed information. Guideline revisions are completed under the direction of the Clinical Practice Guideline Steering Committee. The committee incorporates information published in peer-reviewed journals after the original guidelines appeared as well as comments and recommendations not only from experts in the field addressed by the guideline but also from “hands-on” long-term care practitioners and staff.
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http://www.amda.com/tools/clinical/toccpg.pdf

August 7, 2019

Health Information in Multiple Languages

Medline Plus. Health Information in Multiple Languages. [Web site]. http://www.nlm.nih.gov/medlineplus/languages/languages.html. Updated July 23, 2014. Accessed July 25, 2014. MedlinePlus, a service of the U.S. National Library of Medicine and the National Institutes of Health, has a multilingual feature that provides access to high quality health information for patients in multiple […]
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Medline Plus. Health Information in Multiple Languages. [Web site]. http://www.nlm.nih.gov/medlineplus/languages/languages.html. Updated July 23, 2014. Accessed July 25, 2014. MedlinePlus, a service of the U.S. National Library of Medicine and the National Institutes of Health, has a multilingual feature that provides access to high quality health information for patients in multiple languages. This collection contains more than 2,500 links to nearly 250 health topics.
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http://www.nlm.nih.gov/medlineplus/languages/languages.html

August 7, 2019

Reshaping the healthcare delivery network

Challenges that most healthcare organizations face today include: falling bond ratings and the scarcity of capital resources; delivery of consistently high-quality care despite budget cuts; changes in payer mix due to unemployed patients, the uninsured, early retirees, and an increase in patients postponing care; increasing competition from nontraditional competitors; the […]
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Challenges that most healthcare organizations face today include: falling bond ratings and the scarcity of capital resources; delivery of consistently high-quality care despite budget cuts; changes in payer mix due to unemployed patients, the uninsured, early retirees, and an increase in patients postponing care; increasing competition from nontraditional competitors; the need to prepare for healthcare reform without knowing what form it will take.
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http://www.readperiodicals.com/201001/1975387881.html

August 7, 2019

Top EHR challenges in light of the stimulus. Enabling effective interdisciplinary, intradisciplinary and cross-setting communication

US healthcare is undergoing a transformation. The economic stimulus plan is intended to transform healthcare through health IT. The government has defined “meaningful use” of health IT. Healthcare is a team activity, and as such presents a challenge to the concept of meaningful use. While encoding clinical data into a […]
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US healthcare is undergoing a transformation. The economic stimulus plan is intended to transform healthcare through health IT. The government has defined "meaningful use" of health IT. Healthcare is a team activity, and as such presents a challenge to the concept of meaningful use. While encoding clinical data into a computer is a positive step, it is not enough. A continuity-of-care record is needed to document and measure care; support clinical care; and coordinate care with public health agencies. This paper examines current research to assist decisionmakers moving forward. To realize the promise, integration across all clinical disciplines is critical. There are many challenges. These include: the threat of information overload, both at the transitions of care and between disciplines; the need to provide for data-sharing between clinical and public health agencies, an important component in both local community and national health issues; how to use health IT to improve the delivery of healthcare, especially with unintended outcomes of any change in healthcare and paper persistence; and addressing different views of "meaningful" for different uses and users of health IT. All of these challenges need to be considered for wise installation of health IT. In addition, attention must be paid to weaknesses in the current healthcare system to prevent codifying them in health IT.
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http://www.himss.org/content/files/jhim/24-1/JHIM_Boyd.pdf

August 7, 2019

The Effect of the Program of All-Inclusive care for the Elderly (PACE) on Quality: Final Report

The Balanced Budget Act (BBA) of 1997 authorized Medicare coverage of the Program of All-Inclusive Care for the Elderly (PACE) and established PACE as a state plan option under Medicaid. It authorized a demonstration of for-profit PACE sites, and mandated that the U.S. Secretary of Health and Human Services (HHS) […]
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The Balanced Budget Act (BBA) of 1997 authorized Medicare coverage of the Program of All-Inclusive Care for the Elderly (PACE) and established PACE as a state plan option under Medicaid. It authorized a demonstration of for-profit PACE sites, and mandated that the U.S. Secretary of Health and Human Services (HHS) conduct a study of the quality and cost of providing PACE program services under the amendments of the BBA of 1997. This report assesses the quality of PACE care.
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http://www.cms.gov/reports/downloads/Beauchamp_2008.pdf

August 7, 2019

The Dartmouth Atlas of Health Care

The Trustees of Dartmouth College. The Dartmouth Atlas of Health Care. [Web site]. http://www.dartmouthatlas.org/ . 2014. Accessed July 25, 2014. Understanding of the Efficiency and Effectiveness of the Health Care System. For more than 20 years, the Dartmouth Atlas Project has documented glaring variations in how medical resources are distributed […]
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The Trustees of Dartmouth College. The Dartmouth Atlas of Health Care. [Web site]. http://www.dartmouthatlas.org/ . 2014. Accessed July 25, 2014. Understanding of the Efficiency and Effectiveness of the Health Care System. For more than 20 years, the Dartmouth Atlas Project has documented glaring variations in how medical resources are distributed and used in the United States. The project uses Medicare data to provide information and analysis about national, regional, and local markets, as well as hospitals and their affiliated physicians. This research has helped policymakers, the media, health care analysts and others improve their understanding of our health care system and forms the foundation for many of the ongoing efforts to improve health and health systems across America.
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http://www.dartmouthatlas.org/

August 7, 2019

Bridging troubled waters: family caregivers, transitions, and long-term care

Families are the bedrock of long-term care, but policymakers have traditionally considered them “informal” caregivers, as they are not part of the formal paid caregiving workforce. As chronic and long-term care systems have become more complex and as more demanding tasks have been shifted to families, this view is no […]
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Families are the bedrock of long-term care, but policymakers have traditionally considered them "informal" caregivers, as they are not part of the formal paid caregiving workforce. As chronic and long-term care systems have become more complex and as more demanding tasks have been shifted to families, this view is no longer sustainable. The care transition process offers a critical opportunity to treat family caregivers as important care partners. Enhancing their involvement, training, and support will contribute to reducing unnecessary rehospitalizations and improving patient outcomes. The contributions and experiences of family caregivers should be considered in gathering information to shape policies and practice; training health care professionals; developing programs; and reforming financing.
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http://content.healthaffairs.org/content/29/1/116.abstract

August 7, 2019

Maryland Promotes Patient Centered Medical Home Pilot

Maryland Health Care Commission News Release: Legislation creating a three-year Patient Centered Medical Home Pilot program passed the General Assembly earlier this year and was championed by Lieutenant Governor Anthony G. Brown. The legislation grew out of the Maryland Health Quality and Cost Council, established by Governor Martin O’Malley and […]
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Maryland Health Care Commission News Release: Legislation creating a three-year Patient Centered Medical Home Pilot program passed the General Assembly earlier this year and was championed by Lieutenant Governor Anthony G. Brown. The legislation grew out of the Maryland Health Quality and Cost Council, established by Governor Martin O'Malley and chaired by Lt. Governor Brown and Maryland Department of Health and Mental Hygiene Secretary John M. Colmers. "Our newly established Patient Centered Medical Home program will allow Maryland to move forward with health care reform, improve the quality of care, and reduce costs by offering primary care providers responsible incentives to spend more time with patients, coordinate care, and promote prevention and wellness," said Lt. Governor Brown. "We are incredibly grateful that Dr. Grundy has joined our efforts and is sharing his expertise with our primary care providers."
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http://dhmh.maryland.gov/publicrelations/pr/pdfs/pr062910.pdf

August 7, 2019

Transitions of elders between long-term care and hospitals

Elderly long-term care recipients who require acute hospitalizations must navigate a fragmented system with poor “handoffs,” often resulting in negative outcomes. This article makes the case that reducing preventable hospitalizations and improving transitions to and from hospitals will enhance health care quality and outcomes among these elders. Immediate action targeting […]
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Elderly long-term care recipients who require acute hospitalizations must navigate a fragmented system with poor "handoffs," often resulting in negative outcomes. This article makes the case that reducing preventable hospitalizations and improving transitions to and from hospitals will enhance health care quality and outcomes among these elders. Immediate action targeting diffusion of evidence-based care is recommended to decrease avoidable rehospitalizations and achieve cost savings. Policy changes are needed to address barriers to high-quality transitional care, including deficits in health professionals' and caregivers' knowledge and resources, regulatory obstacles, and inadequate financial incentives and clinical information systems.
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http://ppn.sagepub.com/content/10/3/187.abstract

August 7, 2019

Why Not the Best? A Health Care Quality Improvement Resource

The Commonwealth Fund. Why Not The Best? Quality improvement resources for health care professionals. [Web site]. Http://whynotthebest.org/ Updated 2014. Accessed July 29, 2014. WhyNotTheBest.org was created and is maintained by The Commonwealth Fund, a private foundation working toward a high performance health system. It is a free resource for health […]
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The Commonwealth Fund. Why Not The Best? Quality improvement resources for health care professionals. [Web site]. Http://whynotthebest.org/ Updated 2014. Accessed July 29, 2014. WhyNotTheBest.org was created and is maintained by The Commonwealth Fund, a private foundation working toward a high performance health system. It is a free resource for health care professionals interested in tracking performance on various measures of health care quality. It enables organizations to compare their performance against that of peer organizations, against a range of benchmarks, and over time. Case studies and improvement tools spotlight successful improvement strategies of the nation’s top performers. A regional map shows performance at the county, HRR, state, and national levels. WhyNotTheBest.org is recognized as a “Health Data All Star.” Health Data All Stars is a directory of 50 prominent domestic resources for health data at the federal, state and local levels housed on the Health Data Consortium’s website. To compile the directory, consortium leaders spoke with leading health researchers, government officials, entrepreneurs, advocates and others to identify the health data resources that matter most.
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http://whynotthebest.org/