The Experts below are selected from a list of 291 Experts worldwide ranked by ideXlab platform
Barry L. Carter - One of the best experts on this subject based on the ideXlab platform.
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Characteristics of Ambulatory Care clinics and pharmacists in Veterans Affairs medical centers
American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 1998Co-Authors: Salem Alsuwaidan, Daniel C. Malone, Sarah J. Billups, Barry L. CarterAbstract:The type and extent of Ambulatory Care clinical pharmaceutical services in selected Veterans Affairs medical centers (VAMCs) were studied as part of a larger project. Questionnaires were sent to the 174 VAMCs to determine the extent of clinical pharmacy activity in Ambulatory Care clinics, characteristics of outpatient pharmacies and clinics, and characteristics of Ambulatory Care pharmacists in VAMCs and to identify sites for the IMPROVE (Impact of Managed Pharmaceutical Care on Resource Utilization and Outcomes in Veterans Affairs Medical Centers) project. Fifty VAMCs responded to the survey. There were 512 Ambulatory Care clinics within these VAMCs. There was some pharmacist coverage in 75% of the clinics. The highest pharmacist coverage was in walk-in refill, therapeutic drug monitoring, and anticoagulation clinics. Clinical pharmacists at 68% of the VAMCs had prescribing privileges in Ambulatory Care clinics. Clinical pharmacists managed 29.9% of the clinics. The types of clinics most commonly managed by pharmacists were therapeutic drug monitoring, anticoagulation, walk-in refill, and lipid clinics. Nurse practitioners or physician assistants also were providing primary Care in 41% of the clinics. There were 242 Ambulatory Care clinical pharmacy specialists practicing in the 50 VAMCs. Of these, 41.3% had three years or less of Ambulatory Care experience. Most pharmacists were in the clinic five days per week. A Pharm.D. degree was the highest degree obtained for 76.9%. Ambulatory Care pharmaceutical services are common in VAMCs and are being provided by numerous clinical pharmacists.
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Ambulatory Care certificate program for pharmacists.
American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 1996Co-Authors: Roberta K. Jannsen, Barry L. Carter, Christine Murphy, Donald L. Kendzierski, Deborah Harper Brown, Elaine M. Furmaga, Marieke Dekker Schoen, David R. WokerAbstract:An Ambulatory Care certificate program tailored to meet the educational needs of Department of Veterans Affairs (VA) and Navy pharmacists is described. In 1992, the College of pharmacy, University of Illinois at Chicago, worked with the VA and the Navy to design an Ambulatory Care certificate program for pharmacists in VA and Navy hospitals. The pilot course consisted of 103 hours of didactic and experiential education. The 10 didactic modules covered both disease management and clinical skills. The experiential component incorporated pharmaceutical Care steps as applied to therapeutic areas taught in the course. Although the pilot course met most of the original objectives, several unanticipated problems emerged, including distance learning issues, the number of hours for completing the course requirements, learner variance, the impact of institutional support on participants' academic success, participants' difficulty in assimilating education into practice, and difficulty with the clinical evaluation tool developed for the course. The course was modified over the next year to address these problems. Now in its fourth year, the course is offered nationally to the VA and the Department of Defense. In the first three years, 72 of 99 enrolled pharmacists completed the course. An Ambulatory Care certificate program helps Navy and VA pharmacists develop patient Care skills.
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Comprehensive services in an Ambulatory Care pharmacy
American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists, 1995Co-Authors: Richard K. Lewis, Barry L. Carter, Darryl G. Glover, Richard A. HutchinsonAbstract:The development of a comprehensive model of pharmacy practice in an Ambulatory Care setting is described. From 1991 to 1994, the department of Ambulatory Care pharmacy services at The University of Illinois at Chicago Medical Center converted its main outpatient pharmacy into a Pharmaceutical Care Center to serve as a model for community and hospital-based Ambulatory Care pharmacy services. The Pharmaceutical Care Center includes a waiting area, five private patient-assessment rooms, an examination room, a place for reviewing patient profiles and reference materials, space for storage and automation, an i.v. admixture area, a conference room, and office space. It serves 120-150 patients per day (10% just discharged from the hospital, 90% seen in the clinic system). Pharmacy clerkship students and residents, under the oversight of faculty, conduct patient assessments, educate patients and family, monitor outcomes, and intervene when drug-related problems are detected. Patient assessments and therapeutic interventions are documented in the patient's medical record. Computers, automated medication filling, and technical support are used to enable pharmacists to concentrate on patient Care. A model Ambulatory Care pharmacy provides both drug distribution and direct patient Care services.
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Ambulatory Care Pharmacy Services: The Incomplete Agenda
The Annals of pharmacotherapy, 1992Co-Authors: Barry L. Carter, Dennis K. HellingAbstract:OBJECTIVE:To review studies that document the impact of clinical pharmacy services in Ambulatory Care settings and to propose standards of practice and resource allocation needs in Ambulatory Care.DATA SOURCES:English-language literature from 1970 through 1991 was reviewed and the representative literature is described.STUDY SELECTION:Studies were selected that examined the impact of clinical pharmacy services on patient outcomes and costs. Studies that evaluated pharmacist consultations by blind peer-review panels were also evaluated.DATA EXTRACTION:Trials were assessed based on their methodologies and ability to assess the value of clinical pharmacy services on patient outcomes.DATA SYNTHESIS:Numerous studies from the past 20 years are described illustrating the impact that Ambulatory Care pharmacy practitioners have made on patient Care. These studies demonstrate that clinical pharmacists in Ambulatory Care not only serve as consultants on pharmacotherapy issues, but also can improve the quality of car...
Renee Charbonneausmith - One of the best experts on this subject based on the ideXlab platform.
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cost effectiveness of nurse practitioners in primary and specialised Ambulatory Care systematic review
BMJ Open, 2015Co-Authors: Ruth Martinmisener, Patricia Harbman, Faith Donald, Kim Reid, Kelley Kilpatrick, Nancy Carter, Denise Bryantlukosius, Sharon Kaasalainen, Deborah A Marshall, Renee CharbonneausmithAbstract:Objective To determine the cost-effectiveness of nurse practitioners delivering primary and specialised Ambulatory Care. Design A systematic review of randomised controlled trials reported since 1980. Data sources 10 electronic bibliographic databases, handsearches, contact with authors, bibliographies and websites. Included studies Randomised controlled trials that evaluated nurse practitioners in alternative and complementary Ambulatory Care roles and reported health system outcomes. Results 11 trials were included. In four trials of alternative provider Ambulatory primary Care roles, nurse practitioners were equivalent to physicians in all but seven patient outcomes favouring nurse practitioner Care and in all but four health system outcomes, one favouring nurse practitioner Care and three favouring physician Care. In a meta-analysis of two studies (2689 patients) with minimal heterogeneity and high-quality evidence, nurse practitioner Care resulted in lower mean health services costs per consultation (mean difference: −€6.41; 95% CI −€9.28 to −€3.55; p Conclusions Nurse practitioners in alternative provider Ambulatory primary Care roles have equivalent or better patient outcomes than comparators and are potentially cost-saving. Evidence for their cost-effectiveness in alternative provider specialised Ambulatory Care roles is promising, but limited by the few studies. While some evidence indicates nurse practitioners in complementary specialised Ambulatory Care roles improve patient outcomes, their cost-effectiveness requires further study.
Darren M Ashcroft - One of the best experts on this subject based on the ideXlab platform.
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prevalence of adverse drug events in Ambulatory Care a systematic review
Annals of Pharmacotherapy, 2011Co-Authors: Stephanie V Tache, Andreas Sonnichsen, Darren M AshcroftAbstract:Objective:Most medications are prescribed, dispensed, and administered in Ambulatory Care settings, yet little information exists on the adverse effects of drugs in this setting. This review was conducted to estimate the prevalence of adverse drug events (ADEs) and the proportion of preventable ADEs in Ambulatory Care settings; compare data for different age groups including children, adults, and elderly patients; and review drug classes most commonly associated with ADEs.Data Sources:Four electronic databases–PubMed (1966-March 2011), International Pharmaceutical Abstracts (1970-March 2011), EMBASE (1980-March 2011), and the Cochrane Database of Systematic Reviews (1993-March 2011)—were systematically searched for published data. Bibliographies of retrieved articles were searched individually for additional relevant studies.Study Selection:A standardized definition of an ADE was used to select studies in populations living in the community, with medical visits to primary Care facilities, nonspecialty amb...
Margaret Mastal - One of the best experts on this subject based on the ideXlab platform.
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Evolution of a Conceptual Model: Ambulatory Care Nursing
Nursing Economics, 2018Co-Authors: Margaret MastalAbstract:Executive Summary▸ The growth of Ambulatory Care nursing as a profession and how it is delivered has evolved over time.▸ The specialty's theoretical professional growth began in 1998 with the development of the first conceptual model.▸ Conceptualizing professional Ambulatory Care nursing has been an
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Ambulatory Care Nurse-Sensitive Indicators Series: Capturing the Role of Nursing in Ambulatory Care--The Case for Meaningful Nurse-Sensitive Measurement.
Nursing economic$, 2016Co-Authors: Margaret Mastal, Ann Marie Matlock, Rachel StartAbstract:The nation has been on a quest to advance quality in providing health Care services and improving patient outcomes. The challenge has been to identify and define metrics that will demonstrate improvement. Acute Care settings have a fairly well-established system of quality measurement, but Ambulatory Care systems are in less-developed stages. Imperative to accurate quality measurement in Ambulatory Care is to identify and define metrics that reflect the value of registered nurses to improved patient Care and outcomes as well as to the organization. The American Academy of Ambulatory Care Nursing (AAACN) established a task force to determine appropriate measures of nursing quality. The task force spent 2 years investigating measures and produced an Industry Report that addresses measures of nursing quality. This article is the first in a series of articles that will reveal and discuss the contents of the Industry Report.
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Nursing-Sensitive Indicators in Ambulatory Care.
Nursing economic$, 2015Co-Authors: Kathleen Martinez, Margaret Mastal, Rosemarie Battaglia, Rachel Start, Ann Marie MatlockAbstract:Ambulatory nursing Care can be difficult to comprehend in all its complexity. In August 2013, the American Academy of Ambulatory Care Nursing commissioned a task force to identify nursing-sensitive indicators specific to Ambulatory Care settings. Given the great variation in settings, staff mix, patient populations, role dimensions, skill sets, documentation systems, and resources, determining metrics that apply across the entire continuum of Care is a daunting task. However, it is incumbent upon nurse leaders to define the metrics that will promote the value of the registered nurse in Ambulatory practice and Care coordination. Once initial measures are identified, piloted, and validated, the infrastructure can be created for ongoing benchmarking and collaboration. The long-term goal is to leverage professional nursing practice, based in the Ambulatory Care setting, to improve quality, safety, and cost in health Care.
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Ambulatory Care nursing: growth as a professional specialty.
Nursing economic$, 2010Co-Authors: Margaret MastalAbstract:Ambulatory Care nursing has emerged as a distinct professional nursing specialty. Many characteristics differentiate Ambulatory Care nursing from other specialty practices, including the settings, the characteristics of the patient encounters and the focus upon groups, communities, and populations, as well as individual patients and their families. A conceptual framework for Ambulatory Care nursing was developed in 1998 and recently revised, through consensus of leaders in the specialty. The key elements of the Ambulatory Care Nursing Conceptual Framework are the patient, the environment (both internal and external), and the nurse, practicing in three major roles.
Michael Von Korff - One of the best experts on this subject based on the ideXlab platform.
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depression and risk of hospitalizations for Ambulatory Care sensitive conditions in patients with diabetes
Journal of General Internal Medicine, 2013Co-Authors: Dimitry S Davydow, Wayne Katon, Elizabeth Lin, Paul Ciechanowski, Evette Ludman, Malia Oliver, Michael Von KorffAbstract:BACKGROUND Hospitalizations for Ambulatory Care-sensitive conditions (ACSCs), conditions that should not require inpatient treatment if timely and appropriate Ambulatory Care is provided, may be an important contributor to rising healthCare costs and public health burden.