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Training Home Care Workers Reduces Emergency Room Service Utilization
03-01-24
Research by Susan A. Chapman and colleagues explored whether enhanced care training provided to trained home care workers would result in better client health outcomes. The researchers studied home-based personal care services provided through California’s IHSS program to compare IHSS consumers...
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State Scope of Practice Restrictions and Nurse Practitioner Practice in Nursing Homes: 2012-2019
02-12-24
Abstract: Increased engagement of nurse practitioners (NPs) has been recommended as a way to address care delivery challenges in settings that struggle to attract physicians, such as primary care and rural areas. Nursing homes also face such physician shortages. We evaluated the role of state scope...
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Disparities in Pre-Health Advising Across California’s Public Universities
02-09-24
Background: The Supreme Court’s decision in Students for Fair Admissions, Inc., v. Harvard College is likely to result in the matriculation of fewer students from historically excluded racial/ethnic groups at more selective colleges and universities and matriculation of more students at less...
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Quality Measure Adherence and Oral Health Outcomes in Children
01-30-24
IMPORTANCE: Process-based quality measures are generally intended to promote evidence-based practices that have been proven to improve outcomes. However, due to lack of standardized implementation of diagnostic codes in dentistry, assessing the association between process and oral health outcomes...
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Language Access Systems Improvement Initiative: Impact on Professional Interpreter Utilization, a Natural Experiment
01-04-24
This study aimed to evaluate the Language Access Systems Improvement (LASI) initiative’s impact on professional interpreter utilization in primary care and to explore patient and clinician perspectives on professional interpreter use. Participants included Cantonese, Mandarin, Spanish, or English-...
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The Association Between Cognitive Ability and Opioid Prescribing in Vulnerable Older Adults with Chronic Pain in Ambulatory Care
11-16-23
Background: Vulnerable older adults living with Alzheimer’s disease or Alzheimer’s disease and related dementia (AD/ADRD) and chronic pain generally receive fewer pain medications than individuals without AD/ADRD, especially in nursing homes. Little is known about pain management in older adults...
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Telehealth Outcomes and Impact on Care Delivery: A Review of Evidence
11-16-23
The COVID-19 pandemic rapidly reshaped health care delivery, notably with a surge in telehealth use driven by changes in Medicare and Medicaid reimbursement rates. The ensuing wave of research, spanning over 80 studies from 2021 to 2022, explored the impact of telehealth on health outcomes and care...
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Perspectives on APRN Prescribing of Medications for Opioid Use Disorder: Key Barriers Remain
11-16-23
Deaths from drug overdoses are rising dramatically in the United States. Treatment for opioid use disorders may include behavioral treatments as well as medications for opioid use disorders (MOUD). Buprenorphine can be prescribed by physicians, nurse practitioners (NPs), other advanced practice...
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Flavored Tobacco and Nicotine Use Among California Adolescents: Preferences by Use Experience and Survey Format Effects
10-01-23
This study assessed flavored tobacco use among adolescent e-cigarette, cigarette, cigar, hookah, and smokeless tobacco users; specific e-cigarette flavor preferences; risk profiles of youth that use various flavors; and the impact of survey question wording on prevalence. Cross-sectional data from...
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Health Workforce Research Centers Annual Report, 2023
08-30-23
Important health workforce research that we undertake here is part of a national effort to monitor and plan for the health care needs of US residents. The UCSF Health Workforce Research Center on Long-Term Care (UCSF HWRC), housed at Healthforce Center, is a dynamic hub of policy-oriented research...
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Impact of COVID‐19 on Occupational Injuries and Illnesses Among Nursing Care Facility Workers: Analysis of California Workers' Compensation Data, 2019–2021
08-28-23
Background: The COVID‐19 pandemic greatly affected health care workers, both physically and psychologically, by increasing their workload and stress. This may also have increased their risk of occupational injuries. This study analyzed workers' compensation (WC) claims among California nursing care...
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The Relationship Between Scope of Practice Laws for Task Delegation and Nurse Turnover in Home Health
08-24-23
Nurse turnover can compromise the quality and continuity of home health care. Scope of practice laws, which determine the tasks nurses are allowed to perform and delegate, are an important element of autonomy and vary across states. In this study, researchers used human resource records from a...
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Language-Concordant Care: A Qualitative Study Examining Implementation of Physician Non-English Language Proficiency Assessment
08-24-23
Clinicians who speak the language of the patients they care for can help increase access to care and improve patient health outcomes. Researchers, including Healthforce Center’s Director Sunita Mutha, looked at the barriers and facilitators to primary care physicians’ willingness to have their...
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Emerging Health Technologies in Long-Term Care and Suppliers’ Views on Their Potential to Assist and Support the Workforce
08-03-23
Emerging technological advances hold potential to assist the long-term care (LTC) workforce in caring for an aging population in the home and LTC settings. Technology may alter workforce needs and mitigate rising workforce demand. This study identified and assessed emerging technologies that may...
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COVID-19 Impact on Dental Service Delivery, Financing, Regulation, and Education Systems: An Environmental Scan
07-17-23
The COVID-19 pandemic had a profound impact on all aspects of the oral health care system. The temporary suspension of oral health services impacted patients seeking preventive and restorative dental services with enduring consequences. Dental providers faced threats to job security as well as to...
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Implementation of a Novel Program to Support Colorectal Cancer Screening in a Community Health Center Consortium Before and After Onset of COVID-19
05-22-23
In 2017, the San Francisco Cancer Initiative (SF CAN) established the Colorectal Cancer (CRC) Screening Program to provide technical assistance and financial support to improve CRC screening processes, and outcomes in a consortium of community health centers (CHCs) serving low-income communities in...
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Advanced Practice Clinician Care and End-of-life Outcomes for Community- and Nursing Home-dwelling Medicare Beneficiaries with Dementia
04-18-23
Older adults with Alzheimer's disease and related dementias (ADRD) often face burdensome end-of-life care transfers. Advanced practice clinicians (APCs), which include nurse practitioners and physician assistants, increasingly provide primary care to this population. To fill current gaps in the...
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Direct Care Workers Are the Foundation of a Dementia-Capable Workforce
04-12-23
Up to half of all individuals who receive long-term services and supports (LTSS) are living with Alzheimer’s disease or another form of dementia. Direct care workers provide most of the care across LTSS and are the foundation of a dementia-capable workforce — yet they are underprepared, under-...
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Influences on Advance Practice Nursing Education to Prescribe Medications for Opioid Use Disorder
03-30-23
Opioid misuse is a major public health concern in the United States. Opioid agonist medications are evidence-based treatments for opioid use disorders (OUD) that can be prescribed by advance practice registered nurses (APRNs) with prescriptive authority and appropriate training. This article...
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Defining a Long-term Care Workforce Shortage Designation: A Conceptual Approach
03-30-23
The aging of the US population is a well-documented phenomenon. In just 7 years, an estimated 73 million Americans will be aged 65 and over, equal to 21% of the population. Aging is associated with increased consumption of health care, and more specifically, long-term care services and supports (...
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Racial-Ethnic Composition of Primary Care Practices and Comprehensive Primary Care Plus Initiative Participation
03-20-23
It remains unclear whether the racial-ethnic composition or the socioeconomic profiles of eligible primary care practices better explain practice participation in the Centers for Medicare and Medicaid Services’ (CMS) Comprehensive Primary Care Plus (CPC+) program.
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Two Questions Before Health Care Organizations Plunge into Addressing Social Risk Factors
03-08-23
As experience with social risk interventions matures, and federal and state agencies consider ways to incentivize social risk interventions, this is an ideal time to pause and ask whether we are going in the right direction with this work.
In this perspective piece, the authors highlight that the...
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Characteristics of California’s EMT and Paramedic Workforce
02-21-23
Emergency medical technicians (EMTs) and paramedics play critical roles in delivering emergency services to Californians. Since the beginning of the COVID-19 pandemic employers have reported increased difficulty recruiting and retaining EMTs and paramedics. In light of this situation, there is a...
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"Long Overdue": Nurse and Resident Physician Perspectives on Implementation of Dual-Handset Interpreter Phones in the Inpatient Setting
02-16-23
Patients with language barriers suffer significant health disparities, including adverse events and poor health outcomes. While remote language services can help improve language access, these modalities remain persistently underused. The objective of this study was to understand clinician...
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Paraprofessionals in California’s Behavioral Health Workforce
02-13-23
One in five adults in California had a mental illness in 2018-2019. Some 23.5% of these adults had unmet need for mental health services as did an estimated 64.5% adolescents with major depression.
The shortage of licensed behavioral health professionals, which affects communities throughout...
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Building the Future Behavioral Health Workforce: Needs Assessment
02-13-23
The County Behavioral Health Directors Association of California (CBHDA) is developing a 10-year strategic plan for strengthening the county behavioral health safety net workforce to meet the needs of a rapidly evolving safety net delivery system and the people it serves. This workforce encompasses...
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Rollout of the Oral Health Literacy Toolkit in California: A Mixed-Methods Analysis
01-31-23
Formative assessment of the rollout process of the California Oral Health Literacy (OHL) toolkit uses a mixed-methods approach. The OHL toolkit is an educational resource for dental professionals to improve communication with patients. This study was intended to obtain user feedback and suggestions...
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Be Kind. Use Systems. Improve Care
01-26-23
Most people’s perspective of health care carries an expectation that patients will be treated with kindness and empathy by health care workers. However as rates of burnout among workers rise, empathy and patience are in shorter supply. What can organizations do to support their staff to deliver...
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Linking Patient Safety Climate With Missed Nursing Care in Labor and Delivery Units: Findings From the LaborRNs Survey
01-13-23
This study aimed to explore the association of nurses’ perceptions of patient safety climate with missed nursing care in labor and delivery (L&D) units. We recruited nurse respondents via email distribution of an electronic survey between February 2018 and July 2019. Hospitals with L&D...
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Eliminate the Buprenorphine DEA X Waiver: Justification Using a Policy Analysis Approach
01-09-23
Drug overdoses have reached a historic milestone of over 100,000 deaths in a single year, 75,673 related to opioids. The acceleration in opioid-related deaths coupled with stark health inequities demands a close examination of opioid use disorder (OUD) treatment barriers and swift consideration of...