Marlon Garzo Saria

Learn how to write a patient care report that meets industry standards. Craft an effective PCR narrative with this helpful checklist and examples. ⬇

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In an evaluation of a #PrimaryCare Transition Clinic for Patients Newly Initiated on #Buprenorphine in the #EmergencyDepartment: a #PCP transition clinic for patients initiating #BMOUD was associated with superior outcomes compared to usual care https://lnkd.in/gwTy_qAg Abstract Background: Care transitions represent vulnerable events for patients newly initiating medications for opioid use disorder (MOUD). Multidisciplinary primary care-based transition clinics may improve care linkage and retention in MOUD treatment. Additionally, these interventions may help primary care clinicians (PCPs) overcome barriers to adopting MOUD into practice. In this evaluation, we assessed the impact of a primary care-based transition clinic for patients newly initiating buprenorphine for opioid use disorder (OUD) in the emergency department. Methods: We conducted a retrospective program evaluation within a single academic health system involving adults who newly initiated buprenorphine for OUD through an emergency department-based program and were referred to follow up in either a dedicated multidisciplinary primary care-based transition clinic (SPARC) vs referral to usual primary care (UPC). We performed descriptive analyses comparing patient demographics, referral volume, linkage to care, treatment retention, and markers of high-quality care between the 2 groups. A log-rank test was used to determine the difference in probabilities of retention between SPARC and UPC over 6 months. Results: Over 12 months, the number of referrals to SPARC was greater than to UPC (N = 64 vs N = 26). About 58% of patients referred to SPARC attended an initial visit vs 38% referred to UPC. Treatment retention was consistently greater in SPARC than UPC (1 m: 90% vs 60%; 3 m: 76% vs 40%; 6 m: 60% vs 30%). Markers of care quality including naloxone provision (100% vs 80%) and infectious screening (81% vs 40%) were greater in SPARC clinic. SPARC was associated with a statistically significant increased probability of retention in treatment as compared to UPC (P < .01). Conclusions: In this observational evaluation, a primary care-based multidisciplinary transition clinic for patients initiating buprenorphine MOUD was associated with expanded access to longitudinal OUD treatment and superior linkage to care, retention in care, and quality of care compared to referral to usual primary care. Further research using a more rigorous research design is required to further evaluate these findings.

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UCSF Receives CDC Grant as one of 10 National Regional Centers for Public Health Preparedness and Response UCSF has received a five-year grant from the Centers for Disease Control as one of 10 regional centers for Public Health Preparedness and Response (PHPR), an effort to ensure the country is ready to meet any future health threats, from pandemics to extreme weather events. Public health emergencies such as COVID-19, hurricanes and extreme heat have underscored the critical need for a more robust and resilient U.S. public health system, the CDC said. UCSF received the grant as the lead institution for the newly established Region 9 Pacific Southwest Center for Emergency Public Health, which covers California, Arizona, Nevada, Hawaii and Pacific territories controlled by the U.S. “The Regional Centers will play a vital role in advancing the development and implementation of evidence-based strategies and interventions across communities, enhancing their ability to prepare for and respond to public health threats,” Lisa C. Barrios, DrPH, director of the Division of Readiness and Response Science at the CDC, said in a letter announcing the grants. Read full article at https://lnkd.in/gQczUGhi

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3 Key Takeaways from Dr. Persephone Vargas, DNP, APN, ANP-BC, FNP-BC, Associate Dean at Rutgers University School of Nursing 🌟 1. Passion for Filipino Health Dr. Vargas discovered her "why" during her DNP journey, uncovering a startling health disparity: Filipinos rank second in hypertension and diabetes prevalence among racial groups in the U.S. Her research highlights the critical need for early prevention and culturally tailored interventions to improve outcomes for Filipino Americans. 🌍 2. Championing Community Health Awareness She is a leading advocate for addressing Asian obesity, emphasizing how Filipinos face higher health risks at lower BMI thresholds. Dr. Vargas’s work underscores the importance of revising outdated health metrics and ensuring representation in research and policy. Check out her article here: https://lnkd.in/g8S-6qjC 🎓 3. Driving Excellence in Nursing Education As Associate Dean, Dr. Vargas oversees diverse programs, including FNP and Psychiatric Mental Health NP tracks, while tackling pressing issues like clinical placement shortages. Her leadership exemplifies how education can bridge gaps in healthcare access and quality. This is an inspiration to me, as the CNO of NPHub and NPHire. Dr. Vargas is proof that when passion meets purpose, meaningful change happens. Her journey is an inspiration for all of us striving to align our careers with the greater good. #FilipinoPride #HealthAdvocacy #NursingLeadership #DNPImpact

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#DYK? Since 1992, the Traumatic Brain Injury Center of Excellence has published over 700 peer-reviewed manuscripts in collaboration with other institutions. The work aligns and responds to trends, gaps, and priorities of the DHA and broader United States Department of Defense to inform policy, resource management, and state of the science for warfighters, veterans, their families and caregivers, and health care providers. See what TBICoE researchers published in 2023 here: https://lnkd.in/gXbA-6ah #MilitaryMedicine | #TBICoE

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The #IHIForum is officially underway, and Alexia Jaouich was part of opening day panels discussing implementation of measure-informed care. As SCS’ Vice President, Implementation and System Impact, Dr. Jaouich has been a strategic lead on development of SC2.0’s core components and implementation guide and continues to lead the effort to build implementation best practices into the SC2.0 model. As an advisor to this work by the IHI Leadership Alliance, Dr. Jaouich spoke alongside representatives of the NARBHA Institute and IHI on advancing measure-informed care at healthcare organizations. With examples from member organizations and research from IHI’s Innovation team, the panel discussed core elements of effective strategies for implementing evidence-based measurement systems for mental health and substance use health care, as well as addressing the role of leadership in advancing measure-informed care and determining evaluation methods and key metrics. SCS is proud to be part of IHI Leadership Alliance work on measure-informed care. IHI Forum details: https://lnkd.in/e2S7W6rn #WellbeingEverywhere #SteppedCareSolutions

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🗞 CU Emergency Medicine Faculty Help Meet Colorado’s Need for First Responders with UCHealth MEDIC Program 🗞 Angela Wright, MD, Andra Farcas, MD, and Jacqueline Ward-Gaines MD, celebrate one year of leading education for the program. “Health equity training needs to be a part of paramedic training across the country. If we start there, and work with our providers, there's no limit to how great our [nation’s] healthcare can be.” Read our latest article to learn more about what program leaders have accomplished over the past year and what their goals are to improve for the future. #EMS #Paramedics

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This new study from our June issue, surveyed anesthesia department chairs about environmental sustainability initiatives of their programs. ➡️Sustainability program activities are more common if chairs are evaluated based on such initiatives. 🔗https://lnkd.in/efypFk5h

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Congrats to HERC health economist David Chan on receiving the 2023 HSR Best Research Paper of the Year Award. His paper, “Is There a VA Advantage? Evidence from Dually Eligible Veterans,” published in the American Economic Review, focuses on a question central to VA’s mission: Does the VA deliver better outcomes for Veterans—and at what cost—relative to the private sector? The authors developed an innovative strategy to shed light on this question: They examine Veterans enrolled in both VA and Medicare and focus on emergencies in which such a Veteran may be transported by ambulance to a VA hospital or a private, non-VA hospital. Their strategy builds on recent advances in the literature, leveraging ambulance companies that are quasi-randomly assigned to patients and have preferences to deliver their patients to specific hospitals. Using this clever quasi-experimental design, the authors arrive at a striking and policy-relevant set of findings: 1. VA hospitals reduce 28-day mortality by 46%. This survival benefit persists for a year after the ambulance ride. Survival benefits are greatest for the most vulnerable Veterans. 2. VA reduces spending by 21%. They uncover striking differences in services provided between the VA and private hospitals. While private hospitals are much more likely to report high-cost services, VA hospitals are overwhelmingly more likely to report low-cost services, such as telephone calls. These groundbreaking results suggest the VA saves lives and saves money for this sample of high-risk patients. Read the full paper: https://lnkd.in/eUh2Yk4E

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Find out which questions to ask your health care provider about managing AFib. Download National Forum for Heart Disease & Stroke Prevention's free shared decision-making guide at natforum.org/AFIB_Guide. #AFib #HeartHealth #StrokePrevention #PatientEmpowerment #AFibAwarenessMonth

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Prevalence of Burn Pit Associated Symptoms Among US Veterans Who Utilize Non-Veteran’s Affairs Private Healthcare Conti, Michael A. BA; Bardes, James M. MD; Oury, Jeffrey MD; Goodboy, Alan K. PhD; Shin, Matt MA; Wilson, Alison MD Journal of Occupational and Environmental Medicine 66(5):p 439-444, May 2024. | DOI: 10.1097/JOM.0000000000003085 The majority of the 3.5 million Gulf War and Post-9/11 era US military veterans exposed to toxins from open air burn pits utilize private non-VA related healthcare. They have significantly higher odds of developing extremity neuropathies and pulmonary diseases. Optimal veteran care may require greater awareness from the medical community LEARNING OUTCOMES The majority of the 3.5 million U.S. Gulf War and Post-9/11 era US military veterans exposed to toxins from open-air burn pits are within the current labor force and utilize private non-VA-related healthcare. Our data indicates burn pit exposed veterans have significantly higher odds of extremity neuropathies and pulmonary diseases; some of which are not currently covered in the 2022 federal PACT Act law veteran medical benefits. Optimal veteran care may require greater awareness from the medical community and continued federal policy maker review for expansion of PACT Act law benefits. https://lnkd.in/e7ZThqt5 #JOEM #burnpit #Veterans

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The Impact of Involvement in Whole Health System for Veterans or Participating in It for Oneself on Job Attitudes in VA Employees Schult, Tamara M. PhD, MPH; Mohr, David C. PhD; Greenfield, Russell H. MD; Reddy, Kavitha P. MD, FACEP, ABoIM Journal of Occupational and Environmental Medicine 66(4):p e131-e136, April 2024. | DOI: 10.1097/JOM.0000000000003062 Veterans Health Administration is undergoing a system-wide transformation. The Whole Health System (WHS) is designed to empower and equip all people to take charge of their health and well-being. Based on the WHS, an employee well-being initiative was implemented. Providing WHS care and experiencing it for oneself impact job attitudes. LEARNING OBJECTIVES Describe the influence of providing the Whole Health System of care to veterans on job attitudes. Describe the influence of participating in Whole Health for oneself on job attitudes. Appraise the potential impacts of an employee well-being initiative, Employee Whole Health, that is being implemented within the context of a larger healthcare delivery system transformation. https://lnkd.in/dSXCiBUx #JOEM #veterans #healthcaresystems #healthcare

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⚕ Public Health Uncoded - Episode 08: Sargassum 🌿 Host: Dr. Saroj Pachauri Guest: Dr. Norma Muñoz In this episode, Dr. Saroj Pachauri explored the pressing issue of sargassum with Dr. Norma Patricia Muñoz Sevilla, a leading expert in #marinebiology. Discover the far-reaching #impacts of this invasive #seaweed on #health, #tourism, and #localeconomies in the #Caribbean. Learn about its #ecologicaleffects, the #healthrisks posed by #heavymetals, and explore #innovativesolutions to turn this #environmentalchallenge into an opportunity. This insightful discussion bridges #climatechange and #publichealth, offering valuable perspectives on a complex issue. 🎧 Listen now: https://lnkd.in/gEUBDz24

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Most viewed in the last 7 days from JAMA Health Forum: This JAMA Forum discusses the responsibilities of public health agencies that overlap with those of the CDC and argues that the role of the CDC could be redirected to better meet the needs of its core mission. https://ja.ma/40jMUU6

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"However, these savings—as much as $50 billion annually1—are unreported and not shown to improve care access for patients without adequate insurance.2,3" ---Well, the financial design is so bad that it has closed over 600 hospitals since DRG and the era of cost cutting. The financial design is the reason for closures and compromises. The 50 billion distributed to hospitals serving vulnerable populations (40 - 50% of US pop) would be some help due to the Era of Cost Cutting 1983 to 2030 or longer. "Per CMS’s budget neutrality principle in the Outpatient Prospective Payment System (OPPS), the $9 billion repayment must be offset by $7.8 billion of cuts to nondrug reimbursements." ---Budget neutrality and regulatory capture prevent any true reform to add support to the hospitals and practices serving most Americans most behind. Once again CMS is not accountable and must be reigned in even if it takes 50 years as it did for physician accountability over the last half of the 19th century and for human subject researchers over the last half of the 20th century. Medicare and Medicaid have failed for 2621 counties (40% of US) most behind and has primary care and basic health access except 1965 to 1978. What about the Belmont Principles and numerous violations? What about protection of vulnerable populations, informed consent (which requires prior study of consequences poorly done by CMS), or beneficent intent - especially with all three lining up consistently against the majority of the nation most behind time after time! Strike 1 for ethical and moral violations - CMS has demonstrated time and again the inability to protect their charges - vulnerable Americans. CMS most fails where there are concentrations of elderly, poor, disabled, and their worst public plans. Strike 2 - CMS has failed to do adequate studies of consequences prior to the implementations of policies since 1983 and including Medicaid Waivers which will steal more from team member support and give more for team members to do - with worst impacts on Community Health Centers with 50% Medicaid and in the most vulnerable populations highest in concentrations of Medicare, Medicaid, and Dual plans. Studies are done more to justify what CMS is doing rather than to protect most Americans most behind from consequences such as their providers rated poorly or penalized just for caring for these populations inherently lower in outcomes and drivers of outcomes (Readmissions, ACO shared savings, Star Ratings, others) Strike 3 - CMS fails for beneficent intent. The intent is cost cutting. CMS harms tens of millions with designs that have killed hundreds of hospitals and countless practices, delivery team members, and local leaders in health and other community areas. We know about some economic and access impacts from these losses, but the full impact and cascades of impacts are never studied. See comments for losses of jobs, income, leadership, and better health insurance