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Improving smoking cessation counseling and blood pressure quality metrics in primary care


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In order to make meaningful gains in cardiovascular disease care, primary care medical practices should adopt a set of care improvements specific to their practice size and type, according to a new study from the national primary care quality improvement initiative EvidenceNOW. High blood pressure and smoking are among the biggest risk factors associated with cardiovascular disease. Primary care physicians help patients manage high blood pressure and provide smoking cessation interventions.
Researchers found that there is no one central playbook for all types of practices, but they did identify combinations of practice characteristics, amount of practice facilitation, and operational changes linked with improved cardiovascular disease care. Smaller, solo and clinician-owned practices that changed routine aspects of their process, such as training medical assistants to perform accurate blood pressure readings; allowing staff to take repeated blood pressure measures ....

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May/June 2021 Annals of Family Medicine tip sheet


Greater Presence of Family Physicians, Midwives May Be Key Component to Decreasing Cesarean Delivery Rates
Surgical cesarean births can expose new mothers to a range of health complications, including infection, blood clots and hemorrhage. As part of Healthy People 2020 and other maternal health objectives, the state of California exerted pressure to reduce cesarean deliveries, and statewide organizations established quality initiatives in partnership with those goals. In this study, researchers from Stanford University and the University of Chicago examined unit culture and provider mix differences on hospital and delivery units to identify characteristics of units that successfully reduced their cesarean delivery rates. The mixed-methods study surveyed and interviewed labor and delivery teams from 37 California hospitals that were participating sites in the California Maternal Quality Care Collaborative s Supporting Vaginal Birth initiative. Respondents at successful hospita ....

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Implementing High-Quality Primary Care: A Report From the National Academies of Sciences, Engineering, and Medicine


Samuel T. Edwards, MD, MPH; Elizabeth R. Hooker, MS, MPH; Rebecca Brienza, MD, MPH; Bridget O’Brien, PhD; Hyunjee Kim, PhD; Stuart Gilman, MD; Nancy Harada, PhD, PT; Lillian Gelberg, MD, MSPH; Sarah Shull, PhD; Meike Niederhausen, PhD; Samuel King, MS, MDiv; Elizabeth Hulen, MA; Mamta K. Singh, MD, MS; Anaïs Tuepker, PhD, MPH
Twenty-seven years ago, the Institute of Medicine launched a primary care consensus study that, at the time, seemed highly aligned with the country’s appetite for health reform and managed care.
Primary Care: America’s Health in a New Era produced a primary care definition still used around the world; however, the report’s recommendations received no traction in the US. Similarly, a 2012 Institute of Medicine report on the integration of primary care and public health largely went unheeded. ....

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