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Improving Care for Veterans with Traumatic Brain Injury Across the Lifespan
This report presents findings from a study designed to identify the long-term outcomes of traumatic brain injury for veterans, the future needs of this population, effective treatments, and the availability of community-based resources.
Personalizing Antiseptic Treatment of Schizophrenia
Despite the availability of efficacious antipsychotic drugs, the pharmacological management of schizophrenia remains a challenge, and it largely follows a trial-and-error paradigm. With notoriously high rates of poor antipsychotic drug adherence and limited means to detect it, prescribers are often uncertain whether a lack of treatment response is due to poor adherence or true lack of effect. Moreover, when encountering a patient with intolerable side effects, prescribers do not know whether to switch to another drug or merely reduce the dose. This uncertainty results in unnecessarily high rates of unwarranted treatment changes and antipsychotic polypharmacy, loss of adherence and disease co...
Recommended Standards for Delivering High-Quality Care to Veterans with Invisible Wounds
Traumatic brain injuries and psychological health problems such as posttraumatic stress disorder, depression, and substance use, often referred to as invisible wounds, are common among U.S. military veterans who served in the era after September 11, 2001. Although there are effective treatments for these conditions, it has been challenging to identify places that provide such care, as there has not been a shared definition of what makes care high quality. In a previous study, high-quality care for invisible wounds was defined as care that is veteran-centered, accessible, and evidence-based and that includes outcome monitoring. Identifying standards to operationalize this definition is essent...
COVID-19 Testing in K-12 Schools
In this report, we share insights from a national scan and more than 80 interviews with early adopters of COVID-19 testing in K-12 schools as of December 2020. We describe the characteristics of early adopter schools and districts and their varied approaches to testing. We provide concrete examples of key facilitators of feasible, acceptable, and effective COVID-19 testing. Through ten detailed profiles of schools, districts, and states that have implemented COVID-19 testing in the K-12 setting, we illustrate how these facilitators enabled schools to establish their testing programs. The experiences of early adopters of COVID-19 testing during the fall 2020 semester show that, despite the ab...
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Identifying and Coordinating Care for Complex Patients
"In the United States, a relatively small proportion of complex patients--defined as having multiple comorbidities, high risk for poor outcomes, and high cost--incur most of the nation's health care costs. Improved care coordination and management of complex patients could reduce costs while increasing quality of care. However, care coordination efforts face multiple challenges, such as segmenting populations of complex patients to better match their needs with the design of specific interventions, understanding how to reduce spending, and integrating care coordination programs into providers' care delivery processes. Innovative uses of analytics and health information technology (HIT) may address these challenges. Rudin and colleagues at RAND completed a literature review and held discussions with subject matter experts, reaching the conclusion that analytics and HIT are being used in innovative ways to coordinate care for complex patients but that the capabilities are limited, evidence of their effectiveness is lacking, and challenges are substantial, and important foundational work is still needed"--Publisher's description.
