Public Health and Interprofessional Collaboration

What type of prevention is described

• Preventing a disease before it develops

  • Brushing teeth prevents cavities

  • Adding Fluoride to water is a policy prevention change

Primary

What type of prevention is described

• Identifying a disease early in its process to maximize the success of treatment and decrease the incidence of morbidity and mortality

  • Screening for diabetes, cancer, hypertension

Secondary

What type of prevention is described

• Managing established disease in a patient/community and avoiding further complications

  • Care after an MI

  • Cardiac revascularization, rehab

Tertiary

What does this refer to

• Alienating patients-evil of technology

  • Stop the cycle

  • Example of the error of way

What does this refer to

Distractions

What does this refer to

• Control of and elimination of prevalent communicable diseases that cause illness, hospitalization, morbidity, and mortality across the lifespan

• Vaccine-mimicking disease in a person without actually causing the disease in order to stimulate the immune system

  • Schedules are developed and posted by the Advisory Committee on Immunization Practices (ACIP)

  • Centers for Disease Control and prevention (CDC)

Immunizations

What does this refer to

• Precontemplation

  • May or may not be informed appropriately, may have made unsuccessful attempts

• Contemplation

  • Has made a decision to take action and make a change in the next 6 months and is open to communication about it

• Preparation

  • Has made a decision and planning a change in the next 30 days

• Action

  • Has made an overt behavior change in the last 6 months

  • Risky for relapse

• Maintenance

  • Has maintained the behavior change for 6 months or greater

Transtheoretical model of change(Provider strategies)

What Transtheoretical model of change does this refer to

• May or may not be informed appropriately, may have made unsuccessful attempts

Precontemplation

What Transtheoretical model of change does this refer to

• Has made a decision to take action and make a change in the next 6 months and is open to communication about it

Contemplation

What does this refer to (patient characteristics and provider strategies)

Precontemplation

What does this refer to (patient characteristics and provider strategies)

Contemplation

What does this refer to (patient characteristics and provider strategies)

Preparation and determination

What does this refer to (patient characteristics and provider strategies)

Action

What does this refer to (patient characteristics and provider strategies)

Maintenance

What does this refer to

• Identify those at risk

• Screen appropriately

• Prescribe guideline directed therapy

• Be educated in order to appropriately counsel and educate on safety and efficacy

• Be observant and a good listener to identify needs of patient (temptations, risks, etc…)

• Be a good communicator with patients and professionals

Role as a PA

What does this refer to

H – Honor the “golden minute.” Make the start of the visit technology free and focus solely on the patient’s concerns.

U – Use the “triangle of trust.” Create a triangle configuration so that both you and the patient can see the screen.

M – Maximize patient interaction. Encourage the patient to interact with the graphs and trending tools for their own education.

A – Acquaint yourself with the chart. Review the chart before entering the patient’s room to allow for less chart review “screen time” when in the room with the patient.

N – Nix the screen. Disengage from the computer completely when discussing sensitive issues with the patient.

L – Let the patient look on. Allow the patient to see the screen and follow your actions.

E – Eye contact. Maintain eye contact with the patient as much as possible.

V – Value the computer. Use the EMR as a tool to engage patients and discuss its potential benefits.

E – Explain what you’re doing. Avoid long periods of silence by explaining what you’re doing as you’re doing it.

L – Log off. Log off at the end of the visit to ensure that medical information is secure.

Ways to enhance patient-centered EMR use

What does this refer to

• Mandatory written reporting

  • Gonorrhea and salmonellosis

• Mandatory by telephone

  • Rubeola and pertussis

• Number of cases

  • Chicken pox and influenza

• Cancer to cancer registries

What does this refer to

• Volunteer panel of national experts in prevention and EBM

• Goal is to improve the health of all Americans by making EBM recommendation about clinical preventive services.

• They do not do trials but research populations and outcomes and develop recommendations and give these recommendations a letter grade based upon supportive data.

United States Preventive services task force

What does this refer to

Provider barriers

What does this refer to

• _________ includes 358 core — or measurable — objectives. This is a change from Healthy People 2020, which had more than 1,000 measurable objectives. With fewer objectives, the workgroups were able to avoid overlap and prioritize the most pressing public health issues.

  • Emphasizes nutrition, exercise, environmental factors, and occupational safety in advancing health

• 39 targets with 600 measurable outcomes

  • Reduction of the number of new cases of Diabetes

  • Increasing the number of HgA1c measurements

• Program established in 1979

Healthy People 2030