Annals of family medicine
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Annals of family medicine · May 2023
Patient-Guided Tours: A Patient-Centered Methodology to Understand Patient Experiences of Health Care.
The experience-based design approach using patient-guided tours (PGT) has been suggested as an effective way to understand the patient experience and may better allow the patient to recall thoughts and feelings. The objective of this study was to assess how patients with a disability perceive the effectiveness of PGTs for understanding their experiences of receiving primary health care. ⋯ This method was perceived as effective at eliciting experiences of patients with a disability. It has benefits over more traditional research methods by allowing the participant to refresh their memory at "touchpoints" and enabling them to be active participants.
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Annals of family medicine · May 2023
Randomized Controlled TrialBaseline Characteristics of PATHWEIGH: A Stepped-Wedge Cluster Randomized Study for Weight Management in Primary Care.
To describe the characteristics of patients and practice of clinicians during standard-of-care for weight management in a large, multiclinic health system before the implementation of PATHWEIGH, a pragmatic weight management intervention. ⋯ Of patients aged ≥18 years and with a BMI ≥25 kg/m2 in a large health system, 12% had a weight-prioritized visit during the baseline period. Despite most patients being commercially insured, referral to any weight-related service or prescription of antiobesity drug was uncommon. These results fortify the rationale for trying to improve weight management in primary care.
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Annals of family medicine · May 2023
Community Support Persons and Mitigating Obstetric Racism During Childbirth.
We undertook a study to assess whether presence of community support persons (CSPs), with no hospital affiliation or alignment, mitigates acts of obstetric racism during hospitalization for labor, birth, and immediate postpartum care. ⋯ Our findings suggest that CSPs may be an effective way to reduce obstetric racism as part of quality improvement initiatives, emphasizing the need for democratizing the birthing experience and birth space, and incorporating community members as a way to promote the safety of Black birthing people in hospital settings.Annals "Online First" article.
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Annals of family medicine · May 2023
Refining Vendor-Defined Measures to Accurately Quantify EHR Workload Outside Time Scheduled With Patients.
Accurately quantifying clinician time spent on electronic health record (EHR) activities outside the time scheduled with patients is critical for understanding occupational stress associated with ambulatory clinic environments. We make 3 recommendations regarding EHR workload measures that are intended to capture time working in the EHR outside time scheduled with patients, formally defined as work outside of work (WOW): (1) separate all time working in the EHR outside of time scheduled with patients from time working in the EHR during time scheduled with patients, (2) do not exclude any time before or after scheduled time with patients, and (3) encourage the EHR vendor and research communities to develop and standardize validated, vendor-agnostic methods for measuring active EHR use. Attributing all EHR work outside time scheduled with patients to WOW, regardless of when it occurs, will produce an objective and standardized measure better suited for use in efforts to reduce burnout, set policy, and facilitate research.
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Being a resident is hard. Being a resident dealing with a recent breakup is even harder. I wrote this piece after a serendipitous encounter on Valentine's Day with an elderly woman who embraced her messy journey to finding love, no matter her age or circumstance. ⋯ Looking back, I think about how easily I almost missed this heartfelt connection by being absorbed in my usual checklist of tasks for a new hospital admission. My patient's keen insight into her own romantic life taught me a vital skill in both medicine and personal relationships: the importance of being open to the unexpected. Annals "Online First" article.