Audience: Internists, Family Physicians, Nurse Practitioners, and Medical Students From the authors of the classic Understanding Health Policy 3e Discusses the huge challenges primary care clinicians face such as difficulty in managing chronic illness in their patients, failure to insure quick access to health care, and inability to guarantee continuity of care
High-quality primary care is the foundation of the health care system. It provides continuous, person-centered, relationship-based care that considers the needs and preferences of individuals, families, and communities. Without access to high-quality primary care, minor health problems can spiral into chronic disease, chronic disease management becomes difficult and uncoordinated, visits to emergency departments increase, preventive care lags, and health care spending soars to unsustainable levels. Unequal access to primary care remains a concern, and the COVID-19 pandemic amplified pervasive economic, mental health, and social health disparities that ubiquitous, high-quality primary care might have reduced. Primary care is the only health care component where an increased supply is associated with better population health and more equitable outcomes. For this reason, primary care is a common good, which makes the strength and quality of the country's primary care services a public concern. Implementing High-Quality Primary Care: Rebuilding the Foundation of Health Care puts forth an evidence-based plan with actionable objectives and recommendations for implementing high-quality primary care in the United States. The implementation plan of this report balances national needs for scalable solutions while allowing for adaptations to meet local needs.
Ensuring that members of society are healthy and reaching their full potential requires the prevention of disease and injury; the promotion of health and well-being; the assurance of conditions in which people can be healthy; and the provision of timely, effective, and coordinated health care. Achieving substantial and lasting improvements in population health will require a concerted effort from all these entities, aligned with a common goal. The Health Resources and Services Administration (HRSA) and the Centers for Disease Control and Prevention (CDC) requested that the Institute of Medicine (IOM) examine the integration of primary care and public health. Primary Care and Public Health identifies the best examples of effective public health and primary care integration and the factors that promote and sustain these efforts, examines ways by which HRSA and CDC can use provisions of the Patient Protection and Affordable Care Act to promote the integration of primary care and public health, and discusses how HRSA-supported primary care systems and state and local public health departments can effectively integrate and coordinate to improve efforts directed at disease prevention. This report is essential for all health care centers and providers, state and local policy makers, educators, government agencies, and the public for learning how to integrate and improve population health.
In recent decades most of the international effort given over to studying and improving the safety of patient care has been focused in acute hospital settings. To some extent this was always something of a puzzle to those of us with a direct interest in this important issue...Now, however, the tide is slowly turning. Policymakers, healthcare leader
As a primary care provider, you are on the front lines of medical treatment. Oftentimes, you're the first medical professional patients come to when they experience problems with their health. While some of these problems can be resolved by traditional medical treatment, many others are driven by underlying psychological issues and unhealthy lifestyle choices that you may feel powerless to affect. Between repeat patient visits and the frustrating progression of preventable symptoms and conditions, it's no wonder so many medical and behavioral health providers feel burned out and at a loss for effective solutions. This guide was designed to help you find those solutions and recapture the ability to effectively help patients achieve optimal health and happiness. Real Behavior Change in Primary Care offers ten-minute interventions that provide your patients with the tools they need to change unworkable and unhealthy behaviors. Each short yet powerful intervention utilizes empirically supported skills from acceptance and commitment therapy (ACT), a form of cognitive behavioral therapy, to help you empower patients to take charge of the psychological blocks that keep them from resolving their health problems. You'll also apply ACT skills to your own life and learn to better manage stress, recover from burnout, and rediscover the meaning behind your work as a health care provider. Help patients suffering with: Chronic disease Alcohol and substance abuse Chronic pain Anxiety and depression Trauma and abuse
Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.
How did seven low- and middle-income countries, inspired by the landmark Alma-Ata Declaration, dramatically improve citizen health by focusing on primary health care? The Alma-Ata Declaration of 1978 marked a potential turning point in global health, signaling a commitment to primary health care that could have improved the safety of air, food, water, roads, homes, and workplaces in all 180 countries that signed it. Unfortunately, progress in many countries stalled in the 1980s. The declaration was, however, embraced by a number of countries, where its implementation led to substantial improvement in citizen health. Achieving Health for All reveals how, inspired by Alma-Ata, the governments of seven countries executed comprehensive primary health care systems, deploying new cadres of community-based health workers to bring relevant services to ordinary households. Drawing on a set of narrative case studies from Bangladesh, Indonesia, Ethiopia, Nepal, Ghana, Sri Lanka, and Vietnam,the book explains how a primary health care focus succeeded in improving population health. The book also conclusively demonstrates that comprehensive, multisector, community-controlled, and population-level primary health care is a viable strategy that, against the odds, has led to sustainable, scalable good health at lower cost. Bringing together a group of experts to analyze the forty-year legacy of the Alma-Ata Declaration, Achieving Health for All is a fascinating look at the work needed to transform nations from places that make people sick to places where they stay healthy. An inspiring array of lessons learned along the way shows how readers can make policies that support the health of all people. Contributors: Onaopemipo Abiodun, Vinya Ariyaratne, John Koku Awoonor-Williams, Kedar Prasad Baral, Ayaga A. Bawah, Pedro Más Bermejo, Fred N. Binka, David Bishai, Carolina Cardona, Dennis Carlson, Chala Tesfaye Chekagn, Hoang Khanh Chi, Svea Closser, Luc Barrière Constantin, Zufan Abera Damtew, Marlou de Rouw, Nadia Diamond-Smith, Philip Forth, Mignote Solomon Haile, Nguyen Thanh Huong, Taufique Joarder, Alice Kuan, Seblewengel Lemma, Sasmira Matta, Ahmed Moen, Rituu B. Nanda, Frank K. Nyonator, Ferdous Arfina Osman, Claudia Pereira, Henry B. Perry, James F. Phillips, Meike Schleiff, Melissa Sherry, Rita Thapa, Kebede Worku
There have been great strides made in designing the administrative structures of patient-centered care, but it is still difficult to design truly patient-centered clinical routines that the entire healthcare team can enact. The kind of partnership, in which patients are fully part of the team that guides their own care, goes against so much of the training and socialization of health professionals and, for that matter, the expectations of many patients. This is particularly true for patients we sometimes call “complex.” In other contexts, we call them “high utilizers,” “disadvantaged,” “heartsink patients,” or “people with trauma histories.” Blount calls them “multiply-disadvantaged” patients. To successfully serve these patients requires our best versions of team-based care, including behavioral health and care management team members, though every member of the team needs help in engaging these patients and mutual support in adapting to the rapid changes in roles that new team approaches are creating. This book offers a summary of the approaches that are currently in growing use, such as health literacy assessment, motivational interviewing, appreciative inquiry, shared decision making, minimally disruptive care, trauma informed care, enfranchisement coaching, relationship-centered care, and family-informed care. Finally, it offers a transformative method, based on familiar elements, that is Transparent, Empowering, Activating, and Mutual: the T.E.A.M. Way.
Interpersonal trauma is ubiquitous and its impact on health has long been understood. Recently, however, the critical importance of this issue has been magnified in the public eye. A burgeoning literature has demonstrated the impact of traumatic experiences on mental and physical health, and many potential interventions have been proposed. This volume serves as a detailed, practical guide to trauma-informed care. Chapters provide guidance to both healthcare providers and organizations on strategies for adopting, implementing and sustaining principles of trauma-informed care. The first section maps out the scope of the problem and defines specific types of interpersonal trauma. The authors then turn to discussion of adaptations to care for special populations, including sexual and gender minority persons, immigrants, male survivors and Veterans as these groups often require more nuanced approaches. Caring for trauma-exposed patients can place a strain on clinicians, and approaches for fostering resilience and promoting wellness among staff are presented next. Finally, the book covers concrete trauma-informed clinical strategies in adult and pediatric primary care, and women’s health/maternity care settings. Using a case-based approach, the expert authors provide real-world front line examples of the impact trauma-informed clinical approaches have on patients’ quality of life, sense of comfort, and trust. Case examples are discussed along with evidence based approaches that demonstrate improved health outcomes. Written by experts in the field, Trauma-Informed Healthcare Approaches is the definitive resource for improving quality care for patients who have experienced trauma.
