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Remote Monitoring Technologies in Long-Term Care: Implications for Care Team Organization and Training
01-05-17
There is a widely accepted observation that the current health care delivery model in the U.S was not developed to manage care needs associated with extended life expectancy and growing rates of chronic conditions. Remote monitoring programs aim to anticipate/identify illness exacerbations and...
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The Dental-Medical Divide
12-05-16
The importance of oral health for overall well-being cannot be overstated. Yet the US dental delivery system struggles to address effectively the two most common oral diseases (caries and periodontal disease), which are among the most prevalent of all chronic diseases and are largely preventable....
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California Pioneers New Workforce Models
10-01-16
Registered Dental Hygienists in Alternative Practice (RDHAP) are licensed registered dental hygienists with specialized training that allow them to practice in settings outside of the traditional dental office. RDHAPs have been shown over the past 20 years to practice safely and effectively, and...
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Few Hospital Palliative Care Programs Meet National Staffing Recommendations
09-07-16
This study, which was published in Health Affairs, was the first major data analysis of hospital palliative care programs’ workforce. The growing field of palliative care, which affects nearly all Americans, focuses on improving quality of life for patients with serious illnesses – including...
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Reducing Health Care Disparities for Minority Women in the Era of the Affordable Care Act: Opportunities within Primary Care
05-31-16
Despite improvements in overall health of the American population, disparities persist, particularly for minority women. The Affordable Care Act (ACA) offers the potential to reduce disparities through expanded insurance coverage, greater access to high-quality care, and bolstered prevention...
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Differences in Innovative Behavior Among Hospital-Based Registered Nurses
03-30-16
The 2010 Institute of Medicine report, "The Future of Nursing: Leading Change,Advancing Health," advocated for nurses to innovate in their practice, research, and education. However, little is known about the innovative behavior of registered nurses or whether there are differences in innovative...
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Provider Attitudes Toward the Implementation of Clinical Decision Support Tools in Dental Practice
12-10-15
This is the first study to examine dental provider attitudes toward the implementation of CDS tools incorporated within an electronic health record. Provider attitudes toward CDS tools can shape the entire implementation process for better or worse. This study contributes to the literature by...
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Impact of State Nurse Practitioner Scope-of-Practice Regulation on Healthcare Delivery: Systematic Review
09-09-15
One proposed strategy to expand primary care capacity is to use nurse practitioners (NPs) more effectively in health care delivery. However, the ability of NPs to provide care to the fullest extent of their education is moderated by state scope-of-practice (SOP) regulations. The purpose of this...
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Asian Health Services: Medical Assistants Improve Language Access and Patient-Centered Care
04-03-15
Asian Health Services (AHS) is an urban federally-qualified health center in Oakland, California. It has developed new roles for medical assistants and other frontline staff to capitalize on their language capacity and other skills to provide health coaching and health navigation services to an...
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Comparison of Nurse Staffing Measurements in Staffing-Outcomes Research
01-01-15
BACKGROUND: Investigators have used a variety of operational definitions of nursing hours of care in measuring nurse staffing for health services research. However, little is known about which approach is best for nurse staffing measurement.
OBJECTIVE: To examine whether various nursing hours...
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Direct Access to Midlevel Dental Providers: An Evidence Synthesis
06-20-14
Objectives: Direct access is a term that describes the ability of patients to seek health care from midlevel dental providers (MLDPs) without first seeing a dentist. The objective of this study was to synthesize the evidence for the effects and costs of direct access to MLDPs in a primary dental...
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What Do Health Care Unions Do? A Response to Manthous
05-01-14
In response to Manthous, we discuss the role of unions in health care. The ethical quandary that Manthous perceives in health care worker unions is overstated because patient and worker interests are frequently aligned. The search for a "selfless" union overlooks the importance of adequate...
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The Effect of Health Information Technology Implementation in Veterans Health Administration Hospitals on Patient Outcomes
03-01-14
The impact of health information technology (HIT) in hospitals is dependent in large part on how it is used by nurses. This study examines the impact of HIT on the quality of care in hospitals in the Veterans Health Administration (VA), focusing on nurse-sensitive outcomes from 1995 to 2005.
Full...
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Identifying Potential Predictors of a Safe Attending Physician Workload: A Survey of Hospitalists
11-11-13
Attending physician workload may be compromising patient safety and quality of care. Recent studies show hospitalists, intensivists, and surgeons report that excessive attending physician workload has a negative impact on patient care.1–3 Because physician teams and hospitals differ in composition...
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Baccalaureate Education in Nursing and Patient Outcomes
11-01-13
OBJECTIVES: The aim of this study was to examine the effects of registered nurse (RN) education by determining whether nurse-sensitive patient outcomes were better in hospitals with a higher proportion of RNs with baccalaureate degrees.
BACKGROUND: The Future of Nursing report recommends increasing...
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Using Minimum Nurse Staffing Regulations to Measure the Relationship Between Nursing and Hospital Quality of Care
08-01-13
This study tests whether changes in licensed nurse staffing led to changes in patient safety, using the natural experiment of 2004 California implementation of minimum staffing ratios. We calculated counts of six patient safety outcomes from California Patient Discharge Data from 2000 through 2006...
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Greater Bay Area Mental Health and Education Workforce Collaborative Evaluation
07-14-13
The Greater Bay Area Mental Health & Education Workforce Collaborative (the Collaborative), is a regional partnership of mental health providers, educators, advocacy and consumer groups, and other stakeholders who are engaged in a collaborative process to improve the mental health workforce in...
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Developing a model for attending physician workload and outcomes
06-11-13
With increased economic pressures on hospitals, limitations on resident physician hours, and payment reductions for preventable harms, hospitals seek to increase productivity while improving the quality of patient care. Frequently, relative value units and patient encounters are used to track...
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Mission Possible - Improving the Lives of All Older Adults in Marin: Needs and Assets Scan of Culturally Appropriate Services for Older Adults in Marin County
03-27-13
The demographics of Marin County, California are changing. One of the most dramatic examples is the increase in the number of older adults. Between 2000 and 2010, the number of people over 60 years old living in Marin grew significantly, from 44,000 to 61,000, making this group 24% of the county’s...
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The Impact of the Elimination of Adult Dental Benefits from Denti-Cal on the California Dental Safety Net
11-21-12
This research brief presents a qualitative assessment of the impacts of the elimination of dental benefits for Medicaid-eligible adults in California on the oral health safety-net workforce. To understand the workforce impacts, this study examined the effects of the policy change on patient...
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Bringing Equity Into Quality Improvement
09-25-12
A decade after the Institute of Medicine focused national attention on quality in health care, robust resources and strategies exist to help organizations strive toward five domains of quality: safe, effective, patient-centered, timely, and efficient care. There has been much less progress in the...
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California's Minimum Nurse Staffing Legislation: Results from a Natural Experiment
09-21-12
Objective To determine whether, following implementation of California’s minimum nurse staffing legislation, changes in acuity-adjusted nurse staffing and quality of care in California hospitals outpaced similar changes in hospitals in comparison states without such regulations.
Data Sources/Study...
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Patient Turnover as a Moderator of the Relationship between Nurse Staffing and Patient Outcomes
06-01-12
High patient turnover (patient throughput generated by admissions, discharges, and transfers) contributes to increased demands and resources for care. We examined how the relationship between registered nurse (RN) staffing and failure-to-rescue (FTR) varied with patient turnover levels by analyzing...
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Health Reform and the Health Care Workforce
03-06-12
This monograph assesses how the Affordable Care Act will influence the demand for health care workers, as well as the nature of care they provide.
Full Publication
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Comparison of Patient Outcomes in Magnet and Non-Magnet Hospitals
12-11-11
OBJECTIVE: This study compared patient outcomes and staffing in Magnet® and non-Magnet hospitals.
BACKGROUND: The pursuit of Magnet designation is a highly regarded program for improving staff and patient outcomes. Research has confirmed that Magnet hospitals provide positive work environments for...
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Nurse Practitioners and Physician Assistants Providing Primary Care in California Community Clinics
10-13-11
As reported earlier, nurse practitioners (NPs) and physician assistants (PAs) play a critical role in the delivery of primary care in California, providing the majority of primary care services in over 20% of the state’s community clinics. This follow-up, qualitative research explores how and why...
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Advancing Oral Health in America
10-07-11
Institute of Medicine Report to the US Department of Health and Human Services about the state of oral health in America.
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WellMed’s Medical Assistant Training Program Prepares Students for Health Care Career Ladder
07-28-11
In the course of rapid expansion, WellMed Medical Group found itself hiring increasing numbers of medical assistants (MAs). However, quality and turnover issues with the existing pool of externally-trained MAs inspired the organization to develop its own medical assistant training school. The...
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Franklin Square Hospital Center—Medication Safety Initiative Empowers Medical Assistants
07-27-11
Concern about medication errors inspired Franklin Square Hospital Center to develop a medication safety training program for medical assistants. This initiative empowered medical assistants to think independently, and inspired administrators to offer more standardized training and advancement...
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DFD Russell Medical Centers: Engaging Medical Assistants in Quality Improvement Efforts
06-28-11
DFD Russell Medical Centers in rural central Maine involve medical assistants in quality improvement efforts through a) engaging them in small scale testing and refinement of practice improvements (PDSAs), b) providing them with periodic reports on quality measures directly related to their...