Office Care of Women covers a wide range of topics which are pertinent to the provision of excellent healthcare. Common gynecologic topics are discussed in depth, as well as non-gynecologic medical conditions which are frequently faced by female patients. This book is designed as a single source reference which covers the majority of topics seen by clinicians as they care for women patients in the office setting. The fifty chapters include topics unique to female patients but also include other health conditions which are affected by the patient's gender. The authors of this book span six specialties and three continents thereby giving the reader a comprehensive source of information to improve the healthcare of women.

No description available.

No description available.

Case Report: Through the Tennessee Initiative for Perinatal Quality Care (www.tipqc.org), four pilot prenatal (Family Medicine and OB-GYN) practices representing academic and private groups from across the state established primary improvement teams including relevant stakeholders. An online toolkit of evidence-based practices and published tools from the AAP, ACOG, ABM, and elsewhere was developed by an interdisciplinary team and provided to pilot practices. The toolkit included a menu of “potentially better practices” (PBPs) that could be implemented individually, or as a bundle. Success of this project relied on use of rapid Plan-Do-Study-Act (PDSA) cycles. Pilot practices were educated on basic QI procedures, data collection, toolkit content, etc. and shared experiences through monthly webinars called “Huddles”. Regional trainings were also provided at various intervals by the TIPQC staff. Before implementation of a PBP, each practice collected their baseline breastfeeding rate at the 4-8 week postpartum visit. Practices used a web-based, HIPAA-compliant data-entry system through REDCap. The project was reviewed and approved by the Institutional Review Boards (IRBs) of participating pilots, and funded under an agreement with the state of Tennessee. PBPs implemented by the pilot practices included: - Providing resident and provider education - Distributing written literature on breastfeeding benefits and advice - Providing written breastfeeding prescriptions - Having patients view educational breastfeeding videos - Creating a breastfeeding-friendly office environment Baseline pilot data revealed that at presentation for the first postpartum visit, 28.1%, 23%, and 49% of mothers were exclusively feeding breastmilk, feeding a mix of breastmilk and formula, and exclusively feeding formula, respectively (n=196). Baseline data was successfully collected, and early data following the first PDSA has been collected across the four pilot participants. For participating practices, this is the first time they have systematically looked at their 6-week breastfeeding rates. Open communication and brainstorming across the various practices has been very helpful. A numbers of challenges have been cited, including time constraints related to large volumes of patients and inability to extract data electronically, coordination of efforts among large numbers of providers and staff who may be unfamiliar with breastfeeding, and a need for more family, hospital, and community provider support for breastfeeding. Discussion: This quality improvement prenatal breastfeeding promotion pilot project provides insight into the process of team building and use of thin data sets to drive practice level improvement, and lays the groundwork for statewide spread, where challenges encountered in the pilot centers can be addressed. Participants are now looking at the reliability of their implementation, and determining whether their initial selections from the menu/toolkit were effective.

No description available.

Abstract available in the Journal of Adolescent Health.

No description available.

Objective: Telementoring programs like Project ECHO® (Extension for Community Healthcare Outcomes) employ didactics, case-based learning and an “all teach-all learn”approach to increase PCP knowledge/confidence in managing chronic health conditions. The AAP Epilepsy and Comorbidities ECHO aimed to incorporate Quality Improvement (QI) methodology to create sustainable practice change, while increasing PCP knowledge/confidence/self-efficacy in epilepsy management using the ECHO model. Methods: ECHO sessions occurred monthly (5/2018-12/2018). Sessions included lectures, case presentations/discussion and QI review. Practices, recruited through the AAP, implementedmonthly PDSA cycles using team huddles, chart reviews, QI coaching calls and discussion. Measures for improvement were selected from the American Academy of Neurology Epilepsy Measures set. The AAP Quality Improvement Data Aggregator was used for data entry, run chart development, tracking outcomes. Participants completed pre and post-surveys and received Maintenance of Certification Part 4 credits. Results: Average session attendance was 14 (13-17), across 7 practices in 5 states. QI coaching facilitated practice change and development of resource toolkits with documentation templates, safety handouts, medication side effects sheets. Individual and aggregate run charts with data analysis augmented workflow changes. 479 chart reviews demonstrated improvement in 6/7 measures (Table1): documenting seizure frequency (7.1% increase), anti-seizure therapy side effects (23%), safety education(41.6%, p=0.036); Mental/behavioral health screening(32.2% p=0.027); Tertiary Center referral(26.7%); Health Care transition(45.3%, p=0.005). Counseling for women of childbearing age decreased by 7.8%. Participants reported gains in knowledge/confidence/self-efficacy regarding epilepsy management (p< 0.02). Conclusions: This project demonstrated that integrating QI into an ECHO model results in sustainable practice change and increases PCP knowledge/confidence/self-efficacy in managing epilepsy.

No description available.

No description available.