Biomedical subjects

Debra Thompson

Publications and source records attributed to Debra Thompson.

3 recordsLinked to original sources

PubMed2005

Confronting disparities in diabetes care: the clinical effectiveness of redesigning care management for minority patients in rural primary care practices.

CONTEXT: Diabetes mellitus and its complications disproportionately affect minority citizens in rural communities, many of whom have limited access to comprehensive diabetes management services. PURPOSE: To explore the efficacy of combining care management and interdisciplinary group visits for rural African American patients with diabetes mellitus. METHODS: In the intervention practice, an advanced practice nurse visited the practice weekly for 12 months and facilitated diabetes education, patient flow, and management. Patients participated in a 4-session group visit education/support program led by a nurse, a physician, a pharmacist, and a nutritionist. The control patients in a separate practice received usual care. FINDINGS: Median hemoglobin A1c (HbA1c) was not significantly different at baseline in the intervention and control groups but was significantly different at the end of the 12-month follow-up period (P < .05). In the intervention group, median HbA1c at baseline was 8.2 +/- 2.6%, and median HbA1c at an average follow-up of 11.3 months was 7.1 +/- 2.3%, (P < .0001). In the control group, median HbA1c increased from 8.3 +/- 2.0% to 8.6 +/- 2.4% (P < .05) over the same time period. In the intervention group, 61% of patients had a reduction in HbA1c, and the percentage of patients with a HbA1c of less than 7% improved from 32% to 45% (P < 05). CONCLUSIONS: These findings suggest that a redesigned care management model that combines nurse-led case management with structured group education visits can be successfully incorporated into rural primary care practices and can significantly improve glycemic control.

Adult↗

PubMedDate not supplied

Real-time reporting drives the race toward zero.

LifeCare Hospitals of Pittsburgh is a 155-bed freestanding, Acute Long Term Care Hospital, one of 333 nationwide. Patients with complex care needs who are recovering from acute events, postsurgical interventions, and multiple comorbidities stay an average of 25 days. Like other hospitals, reducing medication errors is a focus of the quality improvement program. Provision of a safe environment is tantamount to achieving quality patient outcomes. Creative solutions to the problem of medication errors are needed. Healthcare executives need effective strategies to engage care providers in solving problems in the course of work and in a nonpunitive environment. Over the period of 1 year, medication errors reaching patients at LifeCare decreased by 50% through culture changes, rapid learning cycles, and strong support from the hospital's leaders.

Forms and Records Control↗

PubMedDate not supplied

Administrative data versus corrected administrative data.

The purpose of this research was to provide insight into the use of existing administrative data and to identify changes that could be made to improve broad-based use of administrative data. Data were collected on patients hospitalized with pneumonia at a 715 bed hospital in North Carolina in 1996-1997. Patients were selected from administrative databases via diagnosis and charge codes. Outcome variables were length of stay and total hospital charges. Explanatory variables were age, sex, race, insurance type, season of year, admission source (emergency department or other), comorbidity score, care path designation, physician specialty and teaching appointment. These data were collected from administrative data and then from a limited chart review to correct the administrative data. We found no significant differences in economic outcomes between the administrative data and the corrected administrative data. Administrative data appear to be a reliable and cost-effective data source for quality assessment.

Aged↗