5. Guided care boosts physician satisfaction with patient/family communications

By Sandra Yin

Guided care is becoming more enticing every minute. Earlier studies have linked guided care–a new model of comprehensive care designed to improve the quality and healthcare, while cutting the health care costs of chronically ill older patients–to less time spent in hospitals, fewer ED visits and home health episodes, and a net savings for health insurers of $1,365 per patient, or $75,000 per nurse. This time, a study by researchers at Johns Hopkins suggests that guided care can improve how physicians feel about their communications with  patients/families and by extension, actual patient health outcomes.

The study, which was published in the July/August edition ofAnnals of Family Medicine, involved a multi-site randomized controlled trial of guided care involving 49 physicians, 904 older patients and 319 family members in eight locations. Based on responses from 38 physicians, compared with physicians in a control group, those who provide guided care–an enhanced primary-care program for patients with multiple chronic conditions–were more satisfied with their patient/family communications and their knowledge of their patients’ clinical characteristics.

That’s good news, according to lead author Jill Marsteller, an assistant professor at Hopkins’ Bloomberg School of Public Health, because the quality of patient-physician communications affects patients’ knowledge of their illness, adherence to treatment recommendations and ultimately, their health.

In guided care, a practice-based team includes a registered nurse, two to five physicians, and the other members of the office staff. For each patient in a case load of 50 to 60 chronically ill older patients, the guided care nurse plays a big role, supplementing the work of other team members by:

(1) conducting in-home patient assessments;
(2) creating an evidence-based Care Guide and Action Plan;
(3) monitoring and coaching the patient monthly;
(4) coordinating the efforts of all clinicians involved in the patient’s health care;
(5) smoothing the patient’s transitions between different care sites;
(6) promoting the patient’s self-management;
(7) educating and supporting family caregivers;
(8) facilitating access to appropriate community resources to make sure nothing slips through the cracks.

To learn more:
– read the article in the Annals of Family Medicine
– read the press release from Johns Hopkins Bloomberg School of Public Health

Read more about: guided careDr. Jill Marstellerchronically ill

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