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Do Penalty-Based Pay-for-Performance Programs Improve Surgical Care More Effectively than Other Payment Strategies? A Systematic Review
12-01-20
The aim of this systematic review is to assess if penalty-based pay-for-performance (P4P) programs are more effective in improving quality and cost outcomes compared to two other payment strategies (i.e., rewards and a combination of rewards and penalties) for surgical care in the United States. A...
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CIN Connections, Fall 2020: Emerging Innovations: Health Care During a Pandemic
11-16-20
The year 2020 has been unlike any other. The changes we’re now seeing in our clinics and through our screens, and the methods being used to address patient needs that we hadn’t previously considered will impact health care for years to come. This issue of CIN Connections features reflections from...
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Role of Nurse Practitioners in Caring for Patients With Complex Health Needs
10-01-20
The objective of this study was to estimate trends in the percentage of Medicare beneficiaries cared for by nurse practitioners from 2012 to 2017, to characterize beneficiaries cared for by nurse practitioners in 2017, and to examine how the percentage of beneficiaries cared for by nurse...
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The Impact of Nurse Delegation Regulations on the Provision of Home Care Services: A Four-State Case Study
09-23-20
The objective of this study was to explore how home care workers and the agencies that employ them interact with their state’s nurse practice act in the provision of care. Using a qualitative case study approach, they selected four states with varying levels of restrictiveness in their nurse...
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Nursing Home Patient Safety Culture Perceptions Among US and Immigrant Nurses
09-01-20
Patient safety is a global concern, yet little is known about how and whether perceptions of patient safety culture (PSC) vary by nurses' countries of origin and preparation. This is particularly important in American nursing homes (NHs), which are increasingly hiring non-US born and prepared...
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Nurse Staffing and Coronavirus Infections in California Nursing Homes
07-07-20
In the US, nursing home residents and staff have been severely impacted by the COVID-19 pandemic. This study compares nursing homes in California with and without COVID-19 positive residents. They found that nursing homes with less than the recommended RN staffing levels, those with lower Medicare...
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Measurement of Nonbillable Service Value Activities by Nurse Practitioners, Physicians Assistants, and Clinical Nurse Specialists in Ambulatory Specialty Care
06-30-20
Revenue-generating health care activities, generally accepted as a measure of productivity, do not account for the full range of health care activities that enhance patient care. We analyzed the quantity, duration, and type of "service value activities" performed by nurse practitioners (NPs),...
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Missed Nursing Care During Labor and Birth and Exclusive Breastfeeding During Hospitalization for Childbirth
05-28-20
The purpose of this study was to determine associations between missed nursing care and nurse staffing during labor and birth, and exclusive breast milk feeding at hospital discharge. Labor and birth nurses in three states were surveyed about missed nursing care and their maternity units' adherence...
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Factors Associated with Physical Injury of Police Involvement During Incidents of Workplace Violence in Hospitals: Findings from the First Year of California’s New Standard
03-12-20
Violence against healthcare workers is a pervasive safety issue that impacts patient care and workforce stability. Workplace violence in healthcare settings is known to be a costly and often underreported problem. In California, hospitals are required to report incidents of violence towards workers...
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Constructing Matched Groups in Dental Observational Health Disparity Studies for Causal Effects
01-01-20
Electronic health record (EHR) systems provide investigators with rich data from which to examine actual impacts of care delivery in real-world settings. However, confounding is a major concern when comparison groups are not randomized. This article introduced a step-by-step strategy to construct...
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Developing and Testing Electronic Health Record-Derived Caries Indices
11-01-19
Caries indices, the basis of epidemiologic caries measures, are not easily obtained in clinical settings. This study’s objective was to design, test, and validate an automated program (Valid Electronic Health Record Dental Caries Indices Calculator Tool [VERDICT]) to calculate caries indices from...
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CIN Connections, Summer 2019: Leadership for Continuous Change and Improvement
07-18-19
With rising costs, increasing burnout, and a rapidly changing environment, health care leaders may feel like they’re facing an uphill battle. This issue of CIN Connections features tips, advice, and actionable information for health care leaders to effectively lead change in their organizations....
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Practice Patterns of Postgraduate Dental Residency Completers From Select Long-Term HRSA-Funded Primary Dental Care Training Programs
07-15-19
The purpose of this study is to examine practice patterns of graduates of primary care dental postgraduate (PGD) training programs with a longstanding history of Health Resources and Services Administration (HRSA) funding. Primary care fields supported include Advanced Education in General...
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Home Health Aides and Personal Care Assistants: Scope of Practice Regulations and Their Impact on Care
06-27-19
By 2030, California’s senior population will double to 9 million, but the state faces an estimated shortage of 200,000 home health and home care aides. To exacerbate the problem, California’s home health and home care aides are underutilized because of some of the most restrictive scope of practice...
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Adaptation of the Missed Nursing Care (MISSCARE) Survey to the Maternity Care Setting
06-10-19
Missed nursing care is an important measure of nursing care quality that is sensitive to nurse staffing and is associated with patient outcomes in medical–surgical and pediatric inpatient settings. Missed nursing care during labor and birth has not been studied, yet childbirth represents the most...
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Adherence to the to Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) Staffing Guidelines as Perceived by Labor Nurses
05-02-19
The objective of this study was to evaluate the degree to which registered nurses perceive their labor and delivery units to be adhering to Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) staffing guidelines. In late 2016 and early 2017, labor nurses in selected hospitals in...
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Fundamental Concepts for Managing Risk and Understanding the Total Cost of Care
04-23-19
This resource is designed to serve as a primer for anyone interested in gaining a better understanding of health payment models in California and nationally. It focuses on concepts and terminology related to value-based payment models and to health care delivery models and systems.
The publication...
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Enhancing Psychiatric Mental Health Nurse Practitioner Practice: Impact of State Scope of Practice Regulations
04-10-19
Introduction
Shortages of behavioral health providers, particularly prescribing clinicians, are widespread nationally. Although rapidly increasing numbers of psychiatric mental health nurse practitioners (PMHNPs) could increase access to behavioral health services, state limitations on scope of...
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CIN Connections, Fall 2018: Integrating Primary Care and Substance Use Disorder Treatment
10-18-18
Ensuring that Californians have timely access to substance use disorder (SUD) treatment that is appropriately linked to their physical health care represents a huge challenge and opportunity for health leaders, providers, and care teams throughout the state. This issue of CIN Connections features...
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Breaking Barriers for Underrepresented Minorities in the Health Professions
07-30-18
In spite of the United States’ racial and ethnic diversity, the health care workforce remains predominately white, particularly in professions that require doctoral degrees. This has a real and negative impact on both patients and health professionals. Diversity in the classroom can translate into...
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More Nurses with Bachelor's Degrees Required to Meet Future Health Care Needs
05-03-18
In 2011, the Institute of Medicine (IOM, now part of the National Academy of Science, Engineering, and Medicine) released a report, “The Future of Nursing: Leading Change, Advancing Health,” which contained eight recommendations regarding how the nursing workforce can best meet health-care needs in...
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California's San Joaquin Valley Faces Nurse Shortfall
03-26-18
While the demand for registered nurses (RNs) in California’s San Joaquin Valley is projected to grow by more than 35 percent by 2030, the region’s total number of RNs will decline. This will result in a serious shortfall that must be addressed now, according to our new report.
This report presents...
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The Roles and Value of Geriatricians in Healthcare Teams: A Landscape Analysis
12-21-17
While it is difficult to know the true number of practicing geriatricians, the supply has been negatively affected by tightening certification requirements, relatively low income and negative return on investment. There appears to be consensus that clinical care by geriatricians should be reserved...
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Nurses’ Communication of Safety Events to Nursing Home Residents and Families
10-09-17
Although communication is an essential part of the nursing process, nurses have little to no formal education in how to best communicate patient safety event (PSE) information to nursing home (NH) residents and their family members. The current mixed-methods study tested an intervention aimed at...
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California's Primary Care Workforce: Forecasted Supply, Demand, and Pipeline of Trainees, 2016-2030
08-15-17
This second report in a series of three Healthforce Center reports on primary care in California, unveils projections of a statewide primary care clinician shortfall in the next 15 years, with the most severe shortages in the Central Valley, Central Coast and Southern Border areas.
Key Findings...
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The Pediatric Dental Workforce is Changing: What Does it Mean for Patient Outcomes?
06-02-17
Research examining productivity, quality and outcomes of traditional pediatric dental care are generally lacking. The literature shows that education, qualifications, and roles are changing with case examples of success, but what these changes portend for patient care remains an open question. New...
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Dementia-Capable Care Coordination
05-25-17
This study describes the program requirements, workforce competencies, and barriers for dementia capable care coordination within health plans from seven states participating in the Center for Medicare and Medicaid Services demonstration programs for dually-eligible Medicare and Medicaid...
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How do Stakeholders Perceive Labor Nurses' Influence on Birth Outcomes?
04-21-17
Background
Childbirth is a leading reason for hospital admission in the USA, and most labor care is provided by registered nurses under physician or midwife supervision in a nurse-managed care model. Yet, there are no validated quality measures for maternity care that are thoughtful about the role...
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Thematic Analysis of US Stakeholder Views on the Influence of Labor Nurses’ Care on Birth Outcomes
04-20-17
Childbirth is a leading reason for hospital admission in the USA and most labor care is provided by registered nurses under physician or midwife supervision in a nurse-managed care model. Yet, there are no validated nurse-sensitive quality measures for maternity care. We aimed to engage primary...
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California's Primary Care Workforce: Supply, Characteristics and Pipeline
02-16-17
Is California prepared to meet growing demand for primary care?
This report is the first in a series of three Healthforce Center at UCSF reports that will provide information to help policymakers, consumers and leaders of health care delivery organizations and educational institutions understand...