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
2023
Ensuring Adequate Preparation for Patient Care Through Interprofessional Team-Based Training and Postgraduate Residencies for Nonphysician Clinicians.
Brienza R. Ensuring Adequate Preparation for Patient Care Through Interprofessional Team-Based Training and Postgraduate Residencies for Nonphysician Clinicians. Annals Of Internal Medicine 2023, 177: 93-94. PMID: 38145568, DOI: 10.7326/m23-3153.Peer-Reviewed Original Research
2022
Twelve Tips for teaching shared decision making
Zegarek M, Brienza R, Quinn N. Twelve Tips for teaching shared decision making. Medical Teacher 2022, 45: 257-263. PMID: 35793200, DOI: 10.1080/0142159x.2022.2093700.Peer-Reviewed Original Research
2021
Virtual Respiratory Urgent Clinics for COVID-19 Symptoms.
Brienza RS, Spelman JF, Hager K, Ruser C. Virtual Respiratory Urgent Clinics for COVID-19 Symptoms. Federal Practitioner 2021, 38: 402-405. PMID: 34737536, PMCID: PMC8562901, DOI: 10.12788/fp.0178.Peer-Reviewed Original ResearchVA Connecticut Healthcare SystemGoals of careCOVID-19 symptomsHealth care provider evaluationsQualitative chart reviewCharacteristics of patientsUrgent care clinicPrimary care sitesSubsequent emergency departmentHealth care workersHigh occupational riskVirtual care modelsCOVID-19 testingChart reviewIsolation precautionsCare clinicsDocumentation ratesEmergency departmentRoutine counselingVirtual careRetrospective analysisUrgent clinicCare sitesCare modelCare workersPeer coaching in an interprofessional academic primary care clinic
Morford K, Milligan T, Brienza R. Peer coaching in an interprofessional academic primary care clinic. Journal Of Interprofessional Education & Practice 2021, 23: 100418. DOI: 10.1016/j.xjep.2021.100418.Peer-Reviewed Original ResearchPrimary care clinicsAcademic primary care clinicCare clinicsMotivational interviewing strategiesDirect clinical observationBrief didactic sessionInternal medicine residentsPeer coachesNurse practitionersClinical observationsChief medical residentsCollaborative communication stylePatient encountersPractice settingsClinic observationsClinicMedicine residentsMedical residentsEvaluation questionnaireInterprofessional learning environmentDidactic sessionsInsight ScaleHealth professionsInterprofessional settingSkill demonstration
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 ResearchConceptsPrimary 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 educationExperiences of Patient-Centered Medical Home Staff Team Members Working in Interprofessional Training Environments
Newell S, O’Brien B, Brienza R, Dulay M, Strewler A, Manuel JK, Tuepker A. Experiences of Patient-Centered Medical Home Staff Team Members Working in Interprofessional Training Environments. Journal Of General Internal Medicine 2020, 35: 2976-2982. PMID: 32728958, PMCID: PMC7573084, DOI: 10.1007/s11606-020-06055-y.Peer-Reviewed Original ResearchConceptsTraining clinicExperiences of staffStaff membersThematic analytic approachSemi-structured interviewsParticipant groupsTraining environmentTeam membersTheme developmentTraineesHome staff membersAnalytic approachLearning initiativesExperienceBenefit providersPsychologyInterprofessional collaborationPositive spillover effectsEducational roleEducational endeavorsTeamStaffSatisfactionEducational effortsLeadershipA 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
Initiative to Minimize Pharmaceutical Risk in Older Veterans (IMPROVE) Polypharmacy Clinic.
Gardner AL, Thomas JM, Mecca MC, Hyson A, Niehoff KM, Jeffery S, Sellinger J, Brienza R. Initiative to Minimize Pharmaceutical Risk in Older Veterans (IMPROVE) Polypharmacy Clinic. Federal Practitioner 2018, 35: 40-47. PMID: 30766331, PMCID: PMC6366595.Peer-Reviewed Original ResearchQualitative 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 residentsTranslating innovation: Exploring dissemination of a unique case conference
King I, Strewler A, Wipf J, Singh M, Painter E, Shunk R, Brienza R, Tivis R, Weppner W, Davidson M, Willis J, Gordon T, Smith C. Translating innovation: Exploring dissemination of a unique case conference. Journal Of Interprofessional Education & Practice 2017, 6: 55-60. DOI: 10.1016/j.xjep.2016.12.004.Peer-Reviewed Original ResearchTranslating innovation: Exploring dissemination of a unique case conference.
King IC, Strewler A, Wipf JE, Singh M, Painter E, Shunk R, Brienza RS, Tivis R, Weppner WG, Davidson M, Willis J, Gordon T, Smith CS. Translating innovation: Exploring dissemination of a unique case conference. Journal of Interprofessional Education & Practice. 2017; 6: 55-60.Peer-Reviewed Original Research
2016
Veterans Affairs Interprofessional Nurse Practitioner Residency in Primary Care: A Competency-based Program
Rugen K, Speroff E, Zapatka S, Brienza R. Veterans Affairs Interprofessional Nurse Practitioner Residency in Primary Care: A Competency-based Program. The Journal For Nurse Practitioners 2016, 12: e267-e273. DOI: 10.1016/j.nurpra.2016.02.023.Peer-Reviewed Original ResearchNurse practitioner transitionNurse practitioner residenciesVeterans Affairs centersInstitute of MedicinePrimary care educationPrimary carePractitioners transitionCompetency-based assessment toolCare educationPractice areaPractice programAssessment toolLack of literatureProgram effectivenessAchievement of competenciesResidencyCareAt a Crossroads
Brienza RS. At a Crossroads. Academic Medicine 2016, 91: 621-623. PMID: 26839946, DOI: 10.1097/acm.0000000000001119.Peer-Reviewed Original ResearchConceptsPrimary 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 toolVeteran Affairs Interprofessional Nurse Practitioner Residency in Primary Care: A Competency Based Program.
Rugen KW, Speroff E, Zapatka S, Brienza RS. Veteran Affairs Interprofessional Nurse Practitioner Residency in Primary Care: A Competency Based Program. Journal for Nurse Practitioners. 2016; 12(6): 267-273.Peer-Reviewed Original Research