2024
Culture change and lessons learned from ten years in the VA centers of excellence in primary care education
Weppner W, Singh M, Wipf J, Shunk R, Woodard L, Brienza R. Culture change and lessons learned from ten years in the VA centers of excellence in primary care education. BMC Medical Education 2024, 24: 457. PMID: 38671440, PMCID: PMC11047004, DOI: 10.1186/s12909-024-05390-6.Peer-Reviewed Original ResearchConceptsPrimary care educationCare educationVeterans AffairsQuality of chronic disease managementInterprofessional clinical learning environmentTeam-based primary careVA primary care clinicsVA Centers of ExcellenceEducational strategiesPatient care metricsPrimary care clinicsChronic disease managementPatient outcomesPrimary care careersTeam training interventionsQuality improvement approachReduce emergency departmentClinical learning environmentHealth care valueInterprofessional learning environmentMultisite demonstration projectPatient-level outcomesTeam-based approachAmbulatory care trainingOperational improvement activities
2020
Impact of interprofessional embedding of physical therapy in a primary care training clinic
McKay SE, Buono FD, Walker J, Glinski C, Printz DMB, Brienza R. Impact of interprofessional embedding of physical therapy in a primary care training clinic. Journal Of Interprofessional Care 2020, 35: 532-537. PMID: 32917104, DOI: 10.1080/13561820.2020.1798898.Peer-Reviewed Original ResearchMeSH KeywordsAmbulatory Care FacilitiesHumansInterprofessional RelationsPhysical Therapy ModalitiesPrimary Health CareReferral and ConsultationConceptsPrimary care clinicsPhysical therapyCare clinicsPT referralPhysical therapistsDiscontinuation of carePrimary care visitsPrimary care settingTraining clinicDecreased turnaround timePrimary care educationCare visitsMusculoskeletal painPrimary careProminent complaintPost-graduate traineesCare settingsVHA sitesReferral systemReferral processClinicReferralInterprofessional clinicInterprofessional teamCare educationA Model for Rapid Transition to Virtual Care, VA Connecticut Primary Care Response to COVID-19
Spelman JF, Brienza R, Walsh RF, Drost P, Schwartz AR, Kravetz JD, Pitkin P, Ruser C. A Model for Rapid Transition to Virtual Care, VA Connecticut Primary Care Response to COVID-19. Journal Of General Internal Medicine 2020, 35: 3073-3076. PMID: 32705471, PMCID: PMC7377306, DOI: 10.1007/s11606-020-06041-4.Peer-Reviewed Original ResearchConceptsUrgent care clinicVirtual careVA Connecticut Health Care SystemCare clinicsPerson visitsValuable health care resourcesPrimary care responseStandardized note templatesFuture pandemic responsesVirtual care modelsHealth care resourcesCOVID-19 pandemicHealth care deliveryHealth care systemVideo visitsTelephone encountersCare modelCare responseCare resourcesPatient exposureCare deliveryNote templateVirtual visitsMedical staffCare system
2019
Association of a Multisite Interprofessional Education Initiative With Quality of Primary Care
Edwards ST, Hooker ER, Brienza R, O’Brien B, Kim H, Gilman S, Harada N, Gelberg L, Shull S, Niederhausen M, King S, Hulen E, Singh MK, Tuepker A. Association of a Multisite Interprofessional Education Initiative With Quality of Primary Care. JAMA Network Open 2019, 2: e1915943. PMID: 31747038, PMCID: PMC6902823, DOI: 10.1001/jamanetworkopen.2019.15943.Peer-Reviewed Original ResearchConceptsAmbulatory care sensitive conditionsPatients 65 yearsHigh-risk medicationsMental health referralsQuality of careResident cliniciansHealth referralsPatient outcomesVeterans Affairs (VA) electronic health record dataAcademic primary care clinicPrimary care mental healthProportion of patientsPrimary care clinicsElectronic health record dataHealth record dataInterprofessional educationImplementation of IPEHypertension controlPrimary care educationHemoglobin A1cCare clinicsRenal testsPrimary careNurse practitionersMAIN OUTCOMEDevelopment and Validation of a Polypharmacy Knowledge Assessment Instrument
Thomas JM, Mecca MC, Niehoff KM, Mecca AP, Van Ness PH, Brienza R, Hyson A, Jeffery S. Development and Validation of a Polypharmacy Knowledge Assessment Instrument. American Journal Of Pharmaceutical Education 2019, 83: 6435. PMID: 31333246, PMCID: PMC6630871, DOI: 10.5688/ajpe6435.Peer-Reviewed Original ResearchConceptsNP residentsGeriatric primary careGroup differencesWilcoxon rank sum testKnowledge assessment instrumentInternal medicine residentsRank sum testPrimary careOverall group differencesAcceptable internal consistencyKruskal-Wallis testResponse rateGroup validityPharmacistsSum testDelphi processSix-item versionEducational interventionMedicine residentsResidents' knowledgeBrief instrumentPharmacy residentsPolypharmacyMean scoreAttendingsAssessing an Interprofessional Polypharmacy and Deprescribing Educational Intervention for Primary Care Post-graduate Trainees: a Quantitative and Qualitative Evaluation
Mecca MC, Thomas JM, Niehoff KM, Hyson A, Jeffery SM, Sellinger J, Mecca AP, Van Ness PH, Fried TR, Brienza R. Assessing an Interprofessional Polypharmacy and Deprescribing Educational Intervention for Primary Care Post-graduate Trainees: a Quantitative and Qualitative Evaluation. Journal Of General Internal Medicine 2019, 34: 1220-1227. PMID: 30972554, PMCID: PMC6614292, DOI: 10.1007/s11606-019-04932-9.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overCohort StudiesDeprescriptionsDrug-Related Side Effects and Adverse ReactionsFemaleFollow-Up StudiesHumansInternship and ResidencyMalePharmacy ResidenciesPolypharmacyPotentially Inappropriate Medication ListPrimary Health CareProspective StudiesQualitative ResearchVeteransConceptsComplex medication managementMedication managementCardiovascular medicationsInternal medicineOlder adultsOutpatient medication managementProspective cohort studyType of medicationPre-post knowledge testInternal comparison groupPrimary care trainingAdverse health effectsInappropriate medicationsCohort studyMain MeasuresWeIntervention groupPost-graduate traineesMedical appointmentsMedicationsControl groupIndividual appointmentsCare trainingNP residentsPolypharmacyClinical setting
2018
Qualitative study of perspectives concerning recent rehospitalisations among a high-risk cohort of veteran patients in Connecticut, USA
Antony SM, Grau LE, Brienza RS. Qualitative study of perspectives concerning recent rehospitalisations among a high-risk cohort of veteran patients in Connecticut, USA. BMJ Open 2018, 8: e018200. PMID: 29960998, PMCID: PMC6042565, DOI: 10.1136/bmjopen-2017-018200.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overConnecticutDelivery of Health Care, IntegratedFemaleHospitals, VeteransHumansInterviews as TopicMaleMiddle AgedPatient DischargePatient ReadmissionPatient SatisfactionPrimary Health CareQualitative ResearchRisk FactorsUnited StatesUnited States Department of Veterans AffairsVeteransConceptsPrimary care providersMental health disordersPCP involvementPostdischarge planHealth disordersHealth statusVA Connecticut Healthcare SystemVeterans Affairs patientsHigh-risk patientsHigh-risk cohortMedical inpatient unitsPoor social supportSerious medical conditionLow socioeconomic statusRehospitalisation riskMultiple comorbiditiesVeteran patientsClinic hoursPostdischarge servicesMean ageSpecialty careMedication managementRehospitalisationVA inpatientMedical conditions
2017
Modifying the Primary Care Exception Rule to Require Competency-Based Assessment
Tobin DG, Doolittle BR, Ellman MS, Ruser CB, Brienza RS, Genao I. Modifying the Primary Care Exception Rule to Require Competency-Based Assessment. Academic Medicine 2017, 92: 331-334. PMID: 27355783, DOI: 10.1097/acm.0000000000001293.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsPrimary care practicesResident competenceClinical competenceGraduate Medical EducationResidents' clinical competenceMonths of trainingAmbulatory careCare practicesMedicaid ServicesExamination roomCarePhysiciansBilling requirementsTraining programMilestones frameworkBilling rulesResidents' readinessResidentsTeaching residents
2016
At a Crossroads
Brienza RS. At a Crossroads. Academic Medicine 2016, 91: 621-623. PMID: 26839946, DOI: 10.1097/acm.0000000000001119.Peer-Reviewed Original ResearchMeSH KeywordsAmbulatory CareBostonDelivery of Health CareFemaleHumansPrimary Health CareQuality of Health CareConceptsPrimary care providersPrimary carePatient careVeterans Affairs Boston Healthcare SystemHigh-quality primary careInterprofessional teamPC training programAcademic medical centerVeterans Affairs centersCare education programHigh-quality carePanel of patientsComplex patientsPatient visitsPC settingsMedical CenterCare providersTreatment centersPatientsPC educationAmbulatory DiagnosticCareImproved satisfactionHealth professional educationHealthcare systemAddressing outpatient continuity for ambulatory training: A novel tool for longitudinal primary care sign out
Long T, Uradu A, Castillo R, Brienza R. Addressing outpatient continuity for ambulatory training: A novel tool for longitudinal primary care sign out. Education For Health 2016, 29: 51-55. PMID: 26996800, DOI: 10.4103/1357-6283.178923.Peer-Reviewed Original ResearchConceptsHigh-risk patientsPatient care issuesInternal medicine residentsOutpatient continuityHealth professional traineesInterprofessional training modelPrimary care educationPrimary carePatient followInterprofessional traineesAmbulatory settingCare issuesAmbulatory trainingPatientsCare educationMedicine residentsSignsProfessional traineesTrainees' attitudesTraineesClinicFollowCareNovel tool
2015
The Development of Professional Identity and the Formation of Teams in the Veterans Affairs Connecticut Healthcare System’s Center of Excellence in Primary Care Education Program (CoEPCE)
Meyer EM, Zapatka S, Brienza RS. The Development of Professional Identity and the Formation of Teams in the Veterans Affairs Connecticut Healthcare System’s Center of Excellence in Primary Care Education Program (CoEPCE). Academic Medicine 2015, 90: 802-809. PMID: 25551857, DOI: 10.1097/acm.0000000000000594.Peer-Reviewed Original ResearchConnecticutCooperative BehaviorEducation, Medical, GraduateEducation, Nursing, GraduateHumansInternal MedicineInterprofessional RelationsLongitudinal StudiesModels, EducationalNurse PractitionersPatient Care TeamPrimary Health CareQualitative ResearchSelf ConceptSocial IdentificationUnited StatesUnited States Department of Veterans Affairs
2014
The Case for Interprofessional Learning and Collaborative Practice in Graduate Medical Education
Brienza RS, Zapatka S, Meyer EM. The Case for Interprofessional Learning and Collaborative Practice in Graduate Medical Education. Academic Medicine 2014, 89: 1438-1439. PMID: 25350333, DOI: 10.1097/acm.0000000000000490.Peer-Reviewed Original ResearchMoving from silos to teamwork: integration of interprofessional trainees into a medical home model
Long T, Dann S, Wolff ML, Brienza RS. Moving from silos to teamwork: integration of interprofessional trainees into a medical home model. Journal Of Interprofessional Care 2014, 28: 473-474. PMID: 24593328, DOI: 10.3109/13561820.2014.891575.Peer-Reviewed Original ResearchConceptsTeam-based careVeterans AffairsPatient Aligned Care TeamsEffective team-based careFuture providersMedical home modelOne-year postPrimary care workforcePrimary care educationVA centersCare teamInterprofessional traineesHealth outcomesInterprofessional teamwork trainingClinic efficiencyFaculty providersHealth professionalsInterprofessional careClinical fellowshipHome modelCare educationVA systemCare workforceInterprofessional collaborationInterprofessional training
2013
Veteran Affairs Centers of Excellence in Primary Care Education: Transforming nurse practitioner education
Rugen KW, Watts SA, Janson SL, Angelo LA, Nash M, Zapatka SA, Brienza R, Gilman SC, Bowen JL, Saxe JM. Veteran Affairs Centers of Excellence in Primary Care Education: Transforming nurse practitioner education. Nursing Outlook 2013, 62: 78-88. PMID: 24630678, DOI: 10.1016/j.outlook.2013.11.004.Peer-Reviewed Original ResearchMeSH KeywordsAdultCurriculumDecision MakingDelivery of Health CareEducation, Nursing, GraduateFemaleHumansInternship and ResidencyInterprofessional RelationsLongitudinal StudiesMaleModels, EducationalNurse PractitionersOrganizational ObjectivesPatient-Centered CarePilot ProjectsPrimary Health CareProgram DevelopmentProgram EvaluationQuality ImprovementUnited StatesUnited States Department of Veterans AffairsYoung AdultConceptsNurse practitioner educationPrimary care educationCurricular modelCare educationPractitioner educationHealth care professional learnersInnovative curricular modelLongitudinal learning experiencesDelivery modelVeterans Affairs centersLearning experiencePeer learnersProfessional learnersEducational modelCurricular domainsHealth care trainingInterprofessional learnersNP educationFaculty mentorsEducationInterprofessional collaborationLearnersFoster transformationSustained relationshipsPrimary care delivery models
2002
Alcohol Use Disorders in Primary Care
Brienza RS, Stein MD. Alcohol Use Disorders in Primary Care. Journal Of General Internal Medicine 2002, 17: 387-397. PMID: 12047738, PMCID: PMC1495039, DOI: 10.1046/j.1525-1497.2002.10617.x.Peer-Reviewed Original ResearchMeSH KeywordsFemaleHumansMalePrimary Health CareSex DistributionSocial PerceptionSubstance Abuse DetectionSubstance-Related DisordersWomen's HealthConceptsAlcohol use disorderPrimary care physiciansUse disordersCoronary artery disease mortalityPrevalence of AUDGender-specific differencesCare physiciansPsychiatric comorbidityAccelerated progressionDisease mortalityPrimary careRisk drinkingBreast cancerModerate drinkersAlcohol consumptionAlcohol toxicityHeavy drinkersBrief interventionTreatment programWomenPast historyCommon barriersMenMortalityPhysicians