Articles: community-health-services.
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Community-based residency programs are an important strategy to address rural and underserved primary care shortages, however, health centers report both benefits and challenges to training. This study aims to understand the impact of new Teaching Health Center (THC) residency programs on health center staffing, patient service, quality of care, and provider productivity. ⋯ New residency programs are associated with increased provider recruitment, expanded patient service, and some improved health outcomes, but also with potential decreased provider productivity in health centers.
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Psychiatr Rehabil J · Sep 2021
Factors that affect quality of care among mental health providers: Focusing on job stress and resources.
Objective: High-quality, person-centered care is a priority for mental health services. The current study conducted secondary data analysis to examine the impact of job stress (i.e., interaction with high-risk consumer cases, increased caseload, emotional exhaustion) and resources (i.e., increased organizational and supervisory support, autonomy, role clarity) on providers' perceived quality of care. Methods: Data consisted of 145 direct care providers from an urban community mental health center. ⋯ Results: Person-centered care was positively associated with increased role clarity, organizational support, and larger caseload size, while a lower level of discordant care was associated with lower emotional exhaustion, smaller caseload size, less interaction with high-risk consumer cases, and with increased role clarity. Conclusions and Implications for Practice: Resources on the job may be particularly important for improved person-centered care, and lowering job stress may help reduce discordant care. The current study suggests the need for the mental health organizations to attend to both job stress and resources for providers to improve the quality of care. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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The COVID-19 pandemic has exacerbated disparities in poverty and illness for people in vulnerable circumstances in ethnocultural communities. We sought to understand the evolving impacts of COVID-19 on ethnocultural communities to inform intersectoral advocacy and community action. ⋯ The Illuminate Project has illustrated the entangled, systemic issues that result in poor health among vulnerable members of ethnocultural communities, and the exacerbating effects of COVID-19, which also increased barriers to mitigation. Cultural brokering and community social capital are key supports for people during the COVID-19 pandemic. These findings can inform policy to reduce harm and support community resiliency.
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The purpose of this review was to provide an evidence-based recommendation for community-based programs to mitigate gun violence, from the Eastern Association for the Surgery of Trauma (EAST). ⋯ Gun violence may be mitigated by community-based efforts, such as gun buybacks or violence prevention programs. These programs come with caveats, notably community cultural relevance and proper support and funding from local leadership.Level of Evidence: Review, Decision, level III.
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Although malignant hyperthermia (MH) is a well-known complication of anesthesia, it presents unique considerations in the military health system. In this case report, the authors present a 26-year-old male active duty service member who experienced an MH crisis during a routine bilateral sagittal split osteotomy. The case presented here, which occurred at Brian D Allgood Army Community Hospital at Camp Humphreys, South Korea, highlights the challenges presented when caring for these patients in minimally staffed environments with frequent turnover of staff. The authors discuss the challenges to the military system such as the importance of adequate documentation of MH-susceptible service members, the benefits of rapidly dissolving dantrolene sodium nanosuspension, and the necessity for frequent training of military medical staff in the recognition and management of MH.