Journal of General Internal Medicine

https://link.springer.com/journal/11606

List of Papers (Total 3,651)

Ideas from the Frontline: Improvement Opportunities in Federally Qualified Health Centers

Engaging frontline clinicians and staff in quality improvement is a promising bottom-up approach to transforming primary care practices. This may be especially true in federally qualified health centers (FQHCs) and similar safety-net settings where large-scale, top-down transformation efforts are often associated with declining worker morale and increasing burnout. Innovation...

The Changing Medical Publishing Industry: Economics, Expansion, and Equity

Medical journal publishing has changed dramatically over the past decade. The shift from print to electronic distribution altered the industry’s economic model. This was followed by open access mandates from funding organizations and the subsequent imposition of article processing charges on authors. The medical publishing industry is large and while there is variation across...

Effectiveness of a Multi-component Delirium Prevention Program Implemented on General Medicine Hospital Units: an Interrupted Time Series Analysis

Delirium is among the most prevalent harmful events in hospitals that is associated with an elevated risk for severe outcomes such as functional decline, falls, longer length of stay, and increased mortality. To evaluate the impact of the implementation of a multi-component delirium program on the prevalence of delirium and the incidence of falls among patients staying on general...

Barriers to Implementing the Kidney Disease Outcomes Quality Initiative End-Stage Kidney Disease Life Plan Guideline

The updated 2019 National Kidney Foundation Kidney Disease Outcomes Quality Initiative vascular access guidelines recommend patient-centered, multi-disciplinary construction and regular update of an individualized end-stage kidney disease (ESKD) Life-Plan (LP) for each patient, a dramatic shift from previous recommendations and policy. The objective of this study was to examine...

Relief in Sight? Chatbots, In-baskets, and the Overwhelmed Primary Care Clinician

The recent emergence of publically facing artificial intelligence (AI) chatbots has generated vigorous discussion in the lay public around the possibilities, liabilities, and uncertainties of the integration of such technology into everyday life. As primary care clinicians continue to struggle against ever-increasing loads of asynchronous, electronic work, the potential for AI to...

Impact of Recreational Cannabis Legalization on Opioid Prescribing and Opioid-Related Hospital Visits in Colorado: an Observational Study

Cannabis may be a substitute for opioids but previous studies have found conflicting results when using data from more recent years. Most studies have examined the relationship using state-level data, missing important sub-state variation in cannabis access. To examine cannabis legalization on opioid use at the county level, using Colorado as a case study. Colorado allowed...

Advocacy Curricula in Graduate Medical Education: an Updated Systematic Review from 2017 to 2022

Advocacy is an integral component of a physician’s professional responsibilities, yet efforts to teach advocacy skills in a systematic and comprehensive manner have been inconsistent and challenging. There is currently no consensus on the tools and content that should be included in advocacy curricula for graduate medical trainees. To conduct a systematic review of recently...

Applying Kern’s Model to the Development and Evaluation of Medical Student Well-Being Programs

The Liaison Committee on Medical Education (LCME) requires that well-being programs must be “effective.” Yet most medical schools do not robustly assess their well-being programs. Most evaluate their programs using one question on the Association of American Medical College’s annual Graduation Questionnaire (AAMC GQ) survey for fourth-year students on their satisfaction with well...

Current Programs and Incentives to Overcome Rural Physician Shortages in the United States: A Narrative Review

Access to healthcare continues to be a top priority and prominent challenge in rural communities, with 20% of the total U.S. population living in rural areas while only 10% of physicians practice in rural areas. In response to physician shortages, a variety of programs and incentives have been implemented to recruit and retain physicians in rural areas; however, less is known...

Engaging Operational Partners Is Critical for Successful Implementation of Research Products: a Coincidence Analysis of Access-Related Projects in the Veterans Affairs Healthcare System

The Veterans Health Administration (VHA) has prioritized timely access to care and has invested substantially in research aimed at optimizing veteran access. However, implementing research into practice remains challenging. Here, we assessed the implementation status of recent VHA access-related research projects and explored factors associated with successful implementation. We...

Using Nudges to Reduce Missed Appointments in Primary Care and Mental Health: a Pragmatic Trial

Missed appointments (“no-shows”) are a persistent and costly problem in healthcare. Appointment reminders are widely used but usually do not include messages specifically designed to nudge patients to attend appointments. To determine the effect of incorporating nudges into appointment reminder letters on measures of appointment attendance. Cluster randomized controlled pragmatic...

A Sanctioned Encampment as a Strategy for Increasing Homeless Veterans’ Access to Housing and Healthcare During the COVID-19 Pandemic

The COVID-19 pandemic intersected with a housing crisis for unsheltered Veterans experiencing homelessness (VEHs); congregate settings became high risk for viral spread. The VA Greater Los Angeles responded by creating the Care, Treatment, and Rehabilitation Service (CTRS), an outdoor, low-barrier-to-entry transitional housing program on VA grounds. This novel emergency...

Rolling out PRIDE in All Who Served: Barriers and Facilitators for Sites Implementing an LGBTQ+ Health Education Group for Military Veterans

The Veterans Health Administration (VHA) PRIDE in All Who Served health education group (PRIDE) was developed to improve health equity and access to care for military veterans who are lesbian, gay, bisexual, transgender, queer, and/or other sexual/gender-diverse identities (LGBTQ+). This 10-week program rapidly spread to over 30 VHA facilities in 4 years. Veterans receiving PRIDE...