Nolte E.,Cambridge Healthcare |
McKee C.M.,London School of Hygiene and Tropical Medicine
Health Affairs | Year: 2012
We examined trends and patterns of amenable mortality- deaths that should not occur in the presence of timely and effective health care-in the United States compared to those in France, Germany, and the United Kingdom between 1999 and 2007. Americans under age sixty-five during this period had elevated rates of amenable mortality compared to their peers in Europe. For Americans over age sixty-five, declines in amenable mortality slowed relative to their peers in Europe. Overall, amenable mortality rates among men from 1999 to 2007 fell by only 18.5 percent in the United States compared to 36.9 percent in the United Kingdom. Among women, the rates fell by 17.5 percent and 31.9 percent, respectively. Although US men and women had the lowest mortality from treatable cancers among the four countries, deaths from circulatory conditions-chiefly cerebrovascular disease and hypertension- were the main reason amenable death rates remained relatively high in the United States. These findings strengthen the case for reforms that will enable all Americans to receive timely and effective health care. © 2012 Project HOPE- The People-to-People Health Foundation, Inc.
Schuetz B.,Cambridge Healthcare |
Mann E.,New England Healthcare Institute |
Everett W.,New England Healthcare Institute
Health Affairs | Year: 2010
Team-based primary care offers the potential to dramatically improve the quality and efficiency of care, but its broader adoption is hindered by an education system that trains health professions in silos. Collaborative models that educate multiple practitioners together are needed to create a new generation of health professionals able to work in efficiently functioning teams. Changes in professional cultures, organizational structures, clinical partnerships, admissions, accreditation, and funding models will be required to support the expansion of collaborative education effectively. ©2010 Project HOPE - The People-to-People Health Foundation, Inc.
Knaepel A.,Cambridge Healthcare
Journal of perioperative practice | Year: 2012
Up to 70% of surgical patients develop hypothermia perioperatively. Inadvertent hypothermia can be caused by a cold operating theatre, anaesthetic effects, exposure to the environment and administration of cold intravenous or irrigation fluids. The adverse effects of unplanned hypothermia include increased blood loss, morbid cardiac events, impaired wound healing and increased mortality. Preventing unplanned hypothermia increases patient comfort and prevents associated complications. It can be achieved by simple preventative measures (Burger & Fitzpatrick 2009, Lynch et al 2010).
Evaluating large-scale health programmes at a district level in resource-limited countries [Évaluation des programmes sanitaires à grande échelle au niveau du district dans des pays aux ressources limitées]
Svoronos T.,Cambridge Healthcare |
Mate K.S.,Cambridge Healthcare
Bulletin of the World Health Organization | Year: 2011
Recent experience in evaluating large-scale global health programmes has highlighted the need to consider contextual differences between sites implementing the same intervention. Traditional randomized controlled trials are ill-suited for this purpose, as they are designed to identify whether an intervention works, not how, when and why it works. In this paper we review several evaluation designs that attempt to account for contextual factors that contribute to intervention effectiveness. Using these designs as a base, we propose a set of principles that may help to capture information on context. Finally, we propose a tool, called a driver diagram, traditionally used in implementation that would allow evaluators to systematically monitor changing dynamics in project implementation and identify contextual variation across sites. We describe an implementation-related example from South Africa to underline the strengths of the tool. If used across multiple sites and multiple projects, the resulting driver diagrams could be pooled together to form a generalized theory for how, when and why a widely-used intervention works. Mechanisms similar to the driver diagram are urgently needed to complement existing evaluations of large-scale implementation efforts.
Whittington J.W.,Cambridge Healthcare |
Nolan K.,Cambridge Healthcare |
Lewis N.,Cambridge Healthcare |
Torres T.,Cambridge Healthcare
Milbank Quarterly | Year: 2015
Policy Points: In 2008, researchers at the Institute for Healthcare Improvement (IHI) proposed the Triple Aim, strategic organizing principles for health care organizations and geographic communities that seek, simultaneously, to improve the individual experience of care and the health of populations and to reduce the per capita costs of care for populations. In 2010, the Triple Aim became part of the US national strategy for tackling health care issues, especially in the implementation of the Patient Protection and Affordable Care Act (ACA) of 2010. Since that time, IHI and others have worked together to determine how the implementation of the Triple Aim has progressed. Drawing on our 7 years of experience, we describe 3 major principles that guided the organizations and communities working on this endeavor: creating the right foundation for population management, managing services at scale for the population, and establishing a learning system to drive and sustain the work over time. Context In 2008, researchers at the Institute for Healthcare Improvement (IHI) described the Triple Aim as simultaneously "improving the individual experience of care; improving the health of populations; and reducing the per capita costs of care for populations." IHI and its close colleagues had determined that both individual and societal changes were needed. Methods In 2007, IHI began recruiting organizations from around the world to participate in a collaborative to implement what became known as the Triple Aim. The 141 participating organizations included health care systems, hospitals, health care insurance companies, and others closely tied to health care. In addition, key groups outside the health care system were represented, such as public health agencies, social services groups, and community coalitions. This collaborative provided a structure for observational research. By noting the contrasts between the contexts and structures of those sites in the collaborative that progressed and those that did not, we were able to develop an ex post theory of what is needed for an organization or community to successfully pursue the Triple Aim. Findings Drawing on our 7 years of experience, we describe the 3 major principles that guided the organizations and communities working on the Triple Aim: creating the right foundation for population management, managing services at scale for the population, and establishing a learning system to drive and sustain the work over time. Conclusions The concept of the Triple Aim is now widely used, because of IHI's work with many organizations and also because of the adoption of the Triple Aim as part of the national strategy for US health care, developed during the implementation of the Patient Protection and Affordable Care Act of 2010. Even those organizations working on the Triple Aim before IHI coined the term found our concept to be useful because it helped them think about all 3 dimensions at once and organize their work around them. © 2015 Milbank Memorial Fund.
Litvak E.,Institute for Healthcare Optimization |
Bisognano M.,Cambridge Healthcare
Health Affairs | Year: 2011
A major issue for the US health care system will be accommodating the needs of the estimated thirty-two million Americans who will gain insurance coverage under the Affordable Care Act by 2019. For hospitals, a traditional response to this increased demand might be to add resources, such as more staff and beds. We argue that such actions would be unaffordable and unnecessary. Research has demonstrated that large gains in efficiency can be made through streamlining patient flow and redesigning care processes. We argue that once managed efficiently, US hospitals, on average, could achieve at least an 80-90 percent bed occupancy rate-at least 15 percent higher than the current level-without adding beds at capital costs of approximately $1 million per bed. This article outlines a plan for hospitals to accommodate more patients without increasing beds or staff, and for policy makers to require hospitals to make these changes or provide incentives for them to do so. ©2011 Project HOPE - The People-to-People Health Foundation, Inc.
Haraden C.,Cambridge Healthcare
Health Affairs | Year: 2011
What does it take to transform the safety of health care across a nation, even a small one? The Scottish Patient Safety Programme, mandated by the government, began in January 2008 with the aim of reducing mortality in Scotland's hospitals by 15 percent in five years. With the collaboration of political leaders, senior health care managers, clinicians, and patients, the program has improved the quality and safety of hospital care. At the halfway point, in-hospital mortality rates have declined by 5 percent, and infection rates for certain hospital-associated infections have been cut by more than half. The Scottish Patient Safety Programme continues to prove that a national strategic approach can lead to unprecedented improvements in patient safety. © 2011 by Project HOPE - The People-to-People Health Foundation, Inc.
Boehmer U.,Cambridge Healthcare
Medical Care | Year: 2016
BACKGROUND:: Racial disparities in dental care have previously been shown in the Veterans Health Administration (VA)—a controlled access setting valuing equitable, high-quality care. OBJECTIVES:: The aim of this study is to examine current disparities in dental care by focusing on the receipt of root canal therapy (RCT) versus tooth extraction. RESEARCH DESIGN:: This is a retrospective analysis of data contained in the VA’s electronic health records. We performed logistic regressions on the independent measures along with a facility-specific random effect, using dependent binary variables that distinguished RCT from tooth extraction procedures. SUBJECTS:: VA outpatients who had at least 1 tooth extraction or RCT visit in the VA in fiscal year 2011. MEASURES:: A dependent binary measure of tooth extraction or RCT. Other measures are medical record data on medical comorbidities, dental morbidity, prior dental utilization, and demographic characteristics. RESULTS:: The overall rate of preferred tooth-preserving RCT was 18.1% during the study period. Black and Asian patients were most dissimilar with respect to dental morbidity, medical and psychological disorders, and black patients had the least amount of eligibility for comprehensive dental care. After adjustment for known confounding factors of RCT, black patients had the lowest RCT rates, whereas Asians had the highest. CONCLUSIONS:: Current quality improvement efforts and a value to improve the equity of care are not sufficient to address racial/ethnic disparities in VA dental care; rather more targeted efforts will be needed to achieve equity for all. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
Agency: GTR | Branch: Innovate UK | Program: | Phase: Feasibility Study | Award Amount: 24.75K | Year: 2011
Abstracts are not currently available in GtR for all funded research. This is normally because the abstract was not required at the time of proposal submission, but may be because it included sensitive information such as personal details.
News Article | February 20, 2017
Silverado today is pleased to announce that it has entered into a management agreement with Cambridge Healthcare to open and operate a state-of-the-art memory care community in Alexandria, Virginia. The new community is expected to open its doors in the first quarter of 2018 on a site just outside of Old Town. The three-story community with underground parking – located on King Street –will serve 66 people with Alzheimer’s disease and other memory-impairing conditions. The property will feature indoor space specifically designed to meet the unique needs of the memory impaired, as well as outside space purposefully built to give residents freedom to enjoy the outdoors. The overall design serves to bring the Silverado experience to residents and their families, providing individuals with dignity, respect and the best quality of life possible. “For years we have been asked when a Silverado community will open on the East Coast, specifically in the Washington D.C. greater metropolitan area. Our new Alexandria community marks a milestone in that Silverado will become a coast-to-coast company,” says Silverado President, Chief Executive Officer and Chairman Loren Shook. “Our entire team is energized by the opportunity to bring the Silverado environment to life in Alexandria, a care model that has resulted in the best clinical outcomes across our industry and truly changes lives.” Graham Adelman, Chief Executive Officer of Cambridge, states, “From 2012, when Cambridge conceived the community now under construction on King Street, until late last year, our intention was to manage its operation ourselves. After visiting Silverado communities in California, evaluating their model of care, and watching Silverado’s staff interact with residents and their families, we changed our mind. Silverado’s accomplishments in caring for those with Alzheimer’s disease and other forms of dementia are remarkable, recognized by academicians and physicians internationally, and well documented. We feel the basis for this is Loren’s heartfelt commitment to enriching the lives of all persons experiencing cognitive decline and his profound belief that respect for them should not diminish with the loss of their memories. Cambridge is pleased and excited that Silverado chose Alexandria for the location of its first community on the East Coast. We look forward to working with Silverado to increase awareness in Northern Virginia of what is truly possible for those with decline in cognition.” Shook adds, “We are excited to be working with Graham and his team at Cambridge Healthcare in the completion of the design and construction of this community – an effort that supports our founding vision to change the way the world cares for and perceives people with cognitive decline.” Cambridge will remain the operator of Alexandria’s Woodbine Rehabilitation & Healthcare, whose renovation will be completed in August 2017, and will be the licensed operator of the memory care community which Silverado will be managing. Development of the new property is already contributing to the local economy with the creation of dozens of construction jobs as well as local spending. Once open, the community will support more than 65 new healthcare jobs. Ongoing project updates are available at silveradocare.com/Alexandria, and a time-lapse of the project site can be found at app.oxblue.com/open/WT/Alexandria. About Silverado Silverado was founded in 1996 with the goal of enriching the lives of those with memory loss by changing how the world cares for people with cognitive decline. Establishing this mindset as the foundation allows Silverado – and its associates – to leave behind previous misconceptions and operate in a way that provides clients, residents and patients with utmost dignity, freedom, respect and quality of life. Silverado has grown to become a nationally recognized provider of home care, memory care assisted living and hospice services. With 52 locations across Arizona, California, Illinois, Texas, Washington, Utah and Wisconsin – the company strives to deliver world-class care and unmatched service. To learn more, visit silveradocare.com or call (866) 522-8125.