Ornelas J.,The American College |
Dichter J.R.,Allina Health |
Dichter J.R.,Aurora Healthcare |
Devereaux A.V.,Sharp Hospital |
And 3 more authors.
Chest | Year: 2014
BACKGROUND: Natural disasters, industrial accidents, terrorism attacks, and pandemics all have the capacity to result in large numbers of critically ill or injured patients. This supplement provides suggestions for all those involved in a disaster or pandemic with multiple critically ill patients, including front-line clinicians, hospital administrators, professional societies, and public health or government officials. The field of disaster medicine does not have the required body of evidence needed to undergo a traditional guideline development process. In result, consensus statement-development methodology was used to capture the highest-caliber expert opinion in a structured, scientific approach. METHODS: Task Force Executive Committee members identified core topic areas regarding the provision of care to critically ill or injured patients from pandemics or disasters and subsequently assembled an international panel for each identified area. International disaster medicine experts were brought together to identify key questions (in a population, intervention, comparator, outcome [PICO]-based format) within each of the core topic areas. Comprehensive literature searches were then conducted to identify studies upon which evidence-based recommendations could be made. No studies of sufficient quality were identified. Therefore, the panel developed expert opinion-based suggestions that are presented in this supplement using a modified Delphi process. RESULTS: A total of 315 suggestions were drafted across all topic groups. After two rounds of a Delphi consensus-development process, 267 suggestions were chosen by the panel to include in the document and published in a total of 12 manuscripts composing the core chapters of this supplement. Draft manuscripts were prepared by the topic editor and members of the working groups for each of the topics, producing a total of 11 papers. Once the preliminary draft s were received, the Executive Committee (Writing Committee) then met to review, edit, and promote alignment of all of the primary draft s of the manuscripts prepared by the topic editors and their groups. The topic editors then revised their manuscripts based on the Executive Committee's edits and comments. The Writing Committee subsequently reviewed the updated draft s and prepared the final manuscripts for submission to the Guidelines Oversight Committee (GOC). Th e manuscripts subsequently underwent review by the GOC, including external review as well as peer review for the journal publication. The Writing Committee received the feedback from the reviewers and modified the manuscripts as required. CONCLUSIONS: Based on a robust and transparent process, this project used rigorous methodology to produce clinically relevant, trustworthy consensus statements, with the aim to provide needed guidance on treatment and procedures for practitioners, hospital administrators, and public health and government officials when addressing the care of critically ill or injured patients in disasters or pandemics. © 2014 AMERICAN COLLEGE OF CHEST PHYSICIANS.
Sidebottom A.C.,Allina Health |
Hellerstedt W.L.,Second Street |
Hennrikus D.,Second Street
Archives of Women's Mental Health | Year: 2014
We characterized depressive symptoms in the prenatal and/or postpartum periods and examined associated risk factors among 594 women who received care at community health care centers. Women were screened with comprehensive risk assessments, which included the Patient Health Questionnaire-9 depression screen, during pregnancy and at least 4 weeks after delivery. Fifteen percent had depressive symptoms in the prenatal period only; 6 % in the postpartum period only, and 8 % had depressive symptoms in both periods. Risk markers varied for women who reported depressive symptoms at one period only compared with those who reported persistent depressive symptoms. Age (25 years versus younger), having experienced abuse, not living with the infant's father, and cigarette smoking were associated with depressive symptoms at both periods; being US-born, lacking social support, and experiencing food insecurity were associated with reporting symptoms only in the prenatal period, and lack of phone access was associated with risk only in the postpartum period. Our findings confirm the importance of repeated screenings for depressive symptoms during the perinatal period. The variability in risk markers associated with periods of reported depressive symptoms may reflect their varying associations with persistence, new onset, or recovery from depressive symptoms. © 2013 Springer-Verlag Wien.
News Article | November 30, 2016
MINNEAPOLIS - (Nov.30, 2016) - Women who had acupuncture treatments after breast cancer surgery at Abbott Northwestern Hospital had a greater reduction in pain, nausea, and anxiety and were better able to cope on the first post-operative day compared with patients who had traditional care, according to a study published in the Oncology Nursing Forum in November. "We are always looking for non-pharmacologic pain management options. This study showed that acupuncture in the hospital after mastectomy is not only feasible, it also appears to decrease patients' symptoms of pain, nausea, and anxiety," said Sue Sendelbach, RN, PhD, director of Nursing Research at Abbott Northwestern. Researchers chose the study variables -- pain, nausea, anxiety and ability to cope - based on an Oncology Nursing Society survey in which members were asked to report the symptoms that are the most distressing and difficult to manage. Abbott Northwestern study patients entered their levels -- on a zero to ten scale -- of pain, nausea, anxiety, and ability to cope into a tablet computer immediately before and after receiving acupuncture. Acupuncture was delivered as many as two times after surgery at least 12 hours apart. Patients in the usual care group were seen two times after surgery at least 12 hours apart to collect the same variables. "The results of this study demonstrate that acupuncture reduced patients' perception of pain, anxiety and nausea by about 1.5 units, which is both clinically and statistically significant. For comparison, it is known that opioid medications reduce patients' perception of pain by 1.9 units, which is comparable to the decrease for acupuncture in this study," said Jeffery A. Dusek, PhD, director of Research for the Penny George™ Institute for Health and Healing. The study was funded by the Abbott Northwestern Foundation, and study participants were sought from among patients at the Piper Breast Center® at Abbott Northwestern. When patients are hospitalized at the Virginia Piper Cancer Institute® at Abbott Northwestern, they are eligible to receive integrative medicine services from Penny George™ practitioners. Abbott Northwestern, Virginia Piper Cancer Institute® and Penny George™ Institute for Health and Healing are part of Allina Health. Allina Health is dedicated to the prevention and treatment of illness and enhancing the greater health of individuals, families and communities throughout Minnesota and western Wisconsin. A not-for-profit health care system, Allina Health cares for patients from beginning to end-of-life through its 90+ clinics, 13 hospitals, 14 retail pharmacies, specialty care centers and specialty medical services, home care, senior transitions, hospice care, home oxygen and medical equipment and emergency medical transportation services. For more information, visit us at allinahealth.org, Facebook, Twitter, YouTube or Healthy Set Go.
News Article | March 2, 2017
LEWISVILLE, Texas--(BUSINESS WIRE)--Teladoc, Inc. (NYSE:TDOC), the undisputed leader in telehealth, providing access to care for millions, today announced that it has appointed Kenneth H. Paulus, 57, to its board of directors. Mr. Paulus will serve on the board's Nominating & Corporate Governance committee and its Quality & Safety committee. "Ken is widely recognized as an outstanding leader in the provider market," said Jason Gorevic, president and CEO of Teladoc. "As Ken joins Teladoc on our mission to transform access to care, we look forward to his strategic insights that will enable us to further advance our footprint in hospitals and health systems across the U.S." "Having already achieved significant milestones in telehealth, Teladoc has an attractive value proposition and will clearly continue to positively shape the healthcare landscape," said Paulus. “I’m proud to join Teladoc at this important time, and to support the company as it drives telehealth to be mainstream.” As former president and CEO of Allina Health from 2009 to 2014, Paulus led one of the nation's largest not-for-profit integrated delivery systems consisting of nearly 1,500 employed physicians, 13 acute care hospitals, a freestanding emergency department and more than 100 ambulatory care clinics. Before joining Allina, Paulus was the CEO of Atrius Health System, one of the largest integrated physician organizations in New England and a teaching and research affiliate of Harvard Medical School. He previously served as the Chief Operating Officer of Partners Community HealthCare – the integrated medical network representing Massachusetts General Hospital and Brigham and Women’s Hospital. Paulus is currently an executive advisor at Water Street Healthcare Partners, a private investment firm. He received a Bachelor of Arts in biology at Augustana College and a Masters of Healthcare Administration and Management from the University of Minnesota. Teladoc, Inc. (NYSE:TDOC) is the nation’s leading provider of telehealth services and a pioneering force in bringing the virtual care visit into the mainstream of today’s health care ecosystem. Serving some 7,500 clients — including health plans, health systems, employers and other organizations — more than 17.5 million members can use phone, mobile devices and secure online video to connect within minutes to Teladoc’s network of more than 3,100 board-certified, state-licensed physicians and behavioral health specialists, 24/7. With national coverage, a robust, scalable platform and a Lewisville, TX-based member services center staffed by 400 employees, Teladoc offers the industry’s most comprehensive and complete telehealth solution including primary care, behavioral health care, dermatology, tobacco cessation and more. For additional information, please visit www.teladoc.com.
Christian M.D.,Mount Royal College, Calgary |
Devereaux A.V.,Sharp Hospital |
Dichter J.R.,Allina Health |
Dichter J.R.,Aurora Healthcare |
And 2 more authors.
Chest | Year: 2014
Natural disasters, industrial accidents, terrorism attacks, and pandemics all have the capacity to result in large numbers of critically ill or injured patients. This supplement provides suggestions for all of those involved in a disaster or pandemic with multiple critically ill patients, including front-line clinicians, hospital administrators, professional societies, and public health or government officials. The current Task Force included a total of 100 participants from nine countries, comprised of clinicians and experts from a wide variety of disciplines. Comprehensive literature searches were conducted to identify studies upon which evidence-based recommendations could be made. No studies of sufficient quality were identified. Therefore, the panel developed expert-opinion-based suggestions that are presented in this supplement using a modified Delphi process. The ultimate aim of the supplement is to expand the focus beyond the walls of ICUs to provide recommendations for the management of all critically ill or injured adults and children resulting from a pandemic or disaster wherever that care may be provided. Considerations for the management of critically ill patients include clinical priorities and logistics (supplies, evacuation, and triage) as well as the key enablers (systems planning, business continuity, legal framework, and ethical considerations) that facilitate the provision of this care. The supplement also aims to illustrate how the concepts of mass critical care are integrated across the spectrum of surge events from conventional through contingency to crisis standards of care. © 2014 AMERICAN COLLEGE OF CHEST PHYSICIANS.
Kim J.I.,Minneapolis Heart Institute Foundation |
Sillah A.,Allina Health |
Boucher J.L.,Minneapolis Heart Institute Foundation |
Sidebottom A.C.,Allina Health |
Knickelbine T.,Minneapolis Heart Institute
Journal of the American Heart Association | Year: 2013
Background--The American Heart Association (AHA) recently created the construct of "ideal cardiovascular health" based on 7 cardiovascular health metrics to measure progress toward their 2020 Impact Goal. The present study applied this construct to assess the baseline cardiovascular health of a rural population targeted with a community-based cardiovascular disease prevention program. Methods and Results--The sample consists of 4754 New Ulm, Minn, adult residents who participated in either the 2009 or 2011 community heart health screenings offered by the Hearts Beat Back: The Heart of New Ulm (HONU) Project (mean age 52.1 years, 58.3% women). Data collected at the screenings were analyzed to replicate the AHA's ideal cardiovascular health measure and the 7 metrics that comprise the construct. Screening participants met, on average (±SD), 3.4 (±1.4) ideal cardiovascular health metrics. Only 1.0% of participants met the AHA's definition of ideal health in all metrics and 7.1% met ≤1 ideal health metric. Higher proportions of women met the ideal category in all metrics except physical activity. Women over the age of 60 were less likely to meet the ideal category for cholesterol and hypertension than were men in the same age range. Conclusion--Prevalence of ideal cardiovascular health is extremely low in this rural population. To make progress toward the 2020 Impact Goal, targeted community-based interventions must be implemented based on the most prevalent cardiovascular risk factors. © 2013 The Authors.
News Article | November 8, 2016
Allina Health LifeCourse researchers will present new insights to the Gerontological Society of America An analysis of patients' physical, functional, emotional and social quality of life trajectories over the last 18 months of life as they live with serious illness shows that late life isn't all bad. "Our research shows that despite significant physical and functional challenges, emotional quality of life is maintained and social quality of life improves in the last three months of life," says Monica Frazer, senior research scientist for Allina Health. Frazer's study is one of several that Allina Health LifeCourse researchers will present at the Gerontological Society of America's 69th Annual Scientific Meeting that begins on November 16 in New Orleans, La. Eric Anderson, MD, hospice and palliative care physician and LifeCourse principal investigator, will present "Understanding the Lives of Caregivers: Opening the Door to Important Conversations." He says building meaningful partnerships in serious illness care begins with understanding the whole-person concerns of the caregivers. Sandra Schellinger, MSN, NP-C, hospice and palliative care nurse practitioner and LifeCourse co-investigator, will discuss the dynamic nature of patient self-defined goals over the serious illness experience. She says changing goals affect care, advance care planning, decision making, normalizing difficult conversations, and accessing end of life resources. Soo Borson, MD, who created the widely-used Mini-Cog, will present data from LifeCourse on a caregiver self-appraisal tool called Managing Your Loved One's Health. Even though family and friends are essential partners in health care, Borson says many have little training or support for this role. MYLOH identifies caregivers' skills and specific coaching and support they need. Borson is a LifeCourse National Advisory Committee member. LifeCourse is a late life supportive care approach that aims to maintain or improve quality of life and care experience, improve service utilization, and lower total cost of care. LifeCourse is a study funded by the Robina Foundation that has enrolled more than 900 participants and is being conducted by the Division of Applied Research at AllinaHealth. Allina Health is dedicated to the prevention and treatment of illness and enhancing the greater health of individuals, families and communities throughout Minnesota and western Wisconsin. A not-for-profit health care system, Allina Health cares for patients from beginning to end-of-life through its 90+ clinics, 13 hospitals, 13 retail pharmacies, services, home, senior transitions, hospice care, home oxygen and medical equipment and emergency medical transportation services. For more information, visit us at allinahealth.org, Facebook, Twitter, YouTube or Healthy Set Go.
News Article | November 29, 2016
Courage Kenny Rehabilitation Institute researchers recently presented results from two studies at the American Congress of Rehabilitation Medicine. The annual conference is an expansive educational program covering brain injury, spinal cord injury, stroke, neurodegenerative diseases, pain, cancer, pediatric rehabilitation and neuroplasticity. Nancy Flinn, PhD, OTR/L, senior scientific adviser, showed how new gait guidelines have improved the walking speed of stroke patients. Courage Kenny developed more aggressive guidelines based on best practices and began using them during physical therapy sessions in 2015. On average, patients doubled their improvement in speed during therapy after the implementation of the guidelines. "Gait speed has a big impact of how people do in the community. The gains patients made in gait speed meant that, on average, patients were now walking at community walking speeds. If they went to the mall or the grocery store, they would be able to move at the speed of others, so they are safer, because they are less likely to get bumped by others who are passing them," said Flinn. Mary Vining Radomski, PhD, OTR/L, senior scientific adviser, presented the results of study on cancer-related cognitive dysfunction, also known as chemobrain that involved 28 patients treated for breast cancer. "Patients describe feeling as if in a cognitive fog - difficulty concentrating, forgetfulness, inability to multitask - all of which interferes with performing the tasks and roles that they value. For some, these are short term problems; for others, the problem lingers for months, even years," said Radomski. The study, which was funded by the Courage Kenny Foundation, concluded that occupational therapy can improve everyday functioning and a patient's ability to manage issues with mood, stress, and fatigue, even though brain-related factors do not change. "While the cause of cancer-related cognitive dysfunction is unclear, it seems that multiple factors associated with the cancer experience - stress, fatigue, disruption of daily routines - are at least in part to blame," Radomski said. Radomski reported that cancer survivors may be able to lift the cognitive fog by learning strategies to manage some of these factors. Robin Newman, OTD, OTR of Boston University, co-presented with Radomski. Courage Kenny Rehabilitation Institute, part of Allina Health, was created in 2013 by the merger of Courage Center and Sister Kenny Rehabilitation Institute. The Institute provides a continuum of rehabilitation services for people with short- and long-term conditions, injuries and disabilities in communities throughout Minnesota and western Wisconsin. Courage Kenny Rehabilitation Institute has multiple locations, and numerous programs and services. For more information visit allinahealth.org/couragekenny. Allina Health is dedicated to the prevention and treatment of illness and enhancing the greater health of individuals, families and communities throughout Minnesota and western Wisconsin. A not-for-profit health care system, Allina Health cares for patients from beginning to end-of-life through its 90+ clinics, 13 hospitals, 14 retail pharmacies, specialty care centers and specialty medical services, home care, senior transitions, hospice care, home oxygen and medical equipment and emergency medical transportation services. For more information, visit us at allinahealth.org, Facebook, Twitter, YouTube or Healthy Set Go.
Adair R.,Medicine Clinic |
Wholey D.R.,University of Minnesota |
Christianson J.,University of Minnesota |
White K.M.,University of Minnesota |
And 2 more authors.
Annals of Internal Medicine | Year: 2013
Background: Improving the quality and efficiency of chronic disease care is an important goal. Objective: To test whether patients with chronic disease working with lay "care guides" would achieve more evidence-based goals than those receiving usual care. Design: Parallel-group randomized trial, stratified by clinic and conducted from July 2010 to April 2012. Patients were assigned in a 2:1 ratio to a care guide or usual care. Patients, providers, and persons assessing outcomes were not blinded to treatment assignment. (ClinicalTrials.gov: NCT01156974) Setting: 6 primary care clinics in Minnesota. Patients: Adults with hypertension, diabetes, or heart failure. Intervention: 2135 patients were given disease-specific information about standard care goals and asked to work toward goals for 1 year, with or without the help of a care guide. Care guides were 12 laypersons who received brief training about these diseases and behavior change. Measurements: The primary end point for each patient was change in percentage of goals met 1 year after enrollment. Results: The percentage of goals met increased in both the care guide and usual care groups (changes from baseline, 10.0% and 3.9%, respectively). Patients with care guides achieved more goals than usual care patients (82.6% vs. 79.1%; odds ratio, 1.31 [95% CI, 1.16 to 1.47]; P < 0.001); reduced unmet goals by 30.1% compared with 12.6% for usual care patients; and improved more than usual care patients in meeting several individual goals, including not using tobacco. Estimated cost was $286 per patient per year. Limitations: Providers' usual care may have been influenced by contact with care guides. Last available data in the electronic health record were used to assess end points. Conclusion: Adding care guides to the primary care team can improve care for some patients with chronic disease at low cost. Primary Funding Source: The Robina Foundation. © 2013 American College of Physicians.
News Article | February 15, 2017
MINNEAPOLIS--(BUSINESS WIRE)--Allina Health and HealthPartners are extending a partnership called the Northwest Metro Alliance. The alliance serves more than 300,000 patients in Anoka County and southern Sherburne County. The patients have HealthPartners or Medicaid insurance and receive care at the five Allina Health Clinics and four HealthPartners clinics in the community and at Mercy Hospital with its affiliated specialists. This extension carries the partnership through 2019. “The Northwest Metro Alliance has been a success for patients, and for the partners because it created a framework for collaboration that allows us to address the health challenges of the community. The Northwest Metro Alliance is a learning lab for a new and unique care model – and we truly need new care models – that focus on delivering care of the highest quality and value,” said Penny Wheeler M.D., president and CEO of Allina Health. When it began in 2010, the Northwest Metro Alliance was one of the first demonstrations of an accountable care organization in the region. It was formed by HealthPartners and Allina Health as an innovative, local solution to address health concerns and have a positive impact on the cost of care in the community. From prevention to end of life care, numerous programs have been implemented that are proving to make a difference, including costs, which are now equal to or lower than the metro average. Some examples include: More details are included in this executive summary. “This partnership was the first of its kind in our region to coordinate the resources of two organizations to achieve the Triple Aim,” said Mary Brainerd, president and CEO of HealthPartners. “We’re pleased to be able to build on the work of the past seven years to improve care, provide an outstanding experience and make care more affordable for the patients we serve.” About Allina Health Allina Health is dedicated to the prevention and treatment of illness and enhancing the greater health of individuals, families and communities throughout Minnesota and western Wisconsin. A not-for-profit health care system, Allina Health cares for patients from beginning to end-of-life through its 90+ clinics, 12 hospitals, 15 pharmacies, specialty care centers and specialty medical services that provide home care, home oxygen and medical equipment, and emergency medical transportation services. Learn more at allinahealth.org. About HealthPartners Founded in 1957, HealthPartners is the largest consumer-governed, non-profit health care organization in the nation. The organization is dedicated to improving health and well-being in partnership with members, patients and the community, and provides a full-range of health care delivery and health plan services including insurance, administration and health and well-being programs. HealthPartners serves more than 1.8 million medical and dental health plan members nationwide. The care system includes more than 1,700 physicians, seven hospitals, 55 primary care clinics, 22 urgent care locations and numerous specialty practices in Minnesota and western Wisconsin. HealthPartners Clinic, Park Nicollet Clinic, Lakeview Health, Physicians Neck & Back Center, TRIA Orthopaedic Center and virtuwell.com are all part of HealthPartners. In addition, HealthPartners Dental Group has more than 60 dentists and 23 dental clinics. HealthPartners also provides medical education and conducts research through HealthPartners Institute. For more information, visit healthpartners.com.