Medical Publications
We pride our work on real results from reliable sources. The studies below describe actual use of the Domain Model (SDMM) within clinical processes and in research methodologies. We are honored that several of the articles have received Continuing Medical Education (CME) status, indicating their importance for the journal’s readership. Three studies specifically show improved patient outcomes after implementing the Siebens Domain Management Model. Our work has also been published in some prominent medical, nursing, and geriatric textbooks. Most recently our work was integral to care management for individuals with Parkinson’s. The approach used is applicable to individuals with any enduring, or chronic, condition in any health care setting and in the home.
PARKINSON DISEASE – NURSE-LED CARE MANAGEMENT INTERVENTION ADDRESSED CURRENT DAY CHALLENGES OF CARE MANAGEMENT IN PARKINSON’S
Setting: Outpatient
Connor KI, Siebens HC, Mittman BS, Ganz DA, Barry F, McNeese-Smith DK, Cheng EM, Vickrey BG. Implementation fidelity of a nurse-led RCT-tested complex intervention, care coordination for health promotion and activities in Parkinson’s disease (CHAPS) in meeting challenges in care management. BMC Neurology 2022;22: 36 (15 pages) Open Access
January 2022
Significance: CHAPS, a nurse-led proactive Parkinson’s care management program, improved care quality when tested in a randomized controlled trial. CHAPS is designed to be reproducible and supportive to clinicians. Findings in this paper indicated CHAPS Model fidelity occurred to the Chronic Care Model. Fidelity to implementation of the CHAPS components was also demonstrated. In other words, protocols were followed. Current Parkinson’s care management challenges, identified in a literature review, were met through CHAPS activities. Thus, dissemination of CHAPS merits consideration by those responsible for implementing changes in clinical practice and reaching people in need.
PARKINSON DISEASE – THE SIEBENS DOMAIN MANAGEMENT MODEL AND THE SIEBENS HEALTH CARE NOTEBOOK IN NURSE-LED CARE MANAGEMENT
Setting: Outpatient
Connor KI, Siebens HC, Mittman BS, McNeese-Smith DK, Ganz DA, Barry F, Edwards LK, McGowan MG, Cheng EM, Vickrey BG. Stakeholder perceptions of components of a Parkinson disease care management intervention, care coordination for health promotion and activities in Parkinson’s disease (CHAPS). BMC Neurology 2020;20: 437 (13 pages) Open Access
December 2020
Significance: Stakeholder (patient participants, nurse care managers, and Parkinson disease specialists) perceptions of the successful proactive nurse-led CHAPS care management intervention were overall positive. Participant feedback on their personalized Notebook for Wellbeing & Health Care (formerly called Siebens Health Care Notebook) indicated its helpfulness. Shared attributes regarding the Siebens Domain Management Model and Notebook usability, reported by the CHAPS nurse care managers, were user-friendly, person/patient-centered, and organized. Some challenges to their use were identified. This study demonstrates the value the SDMM and the Notebooks bring to the care of individuals with enduring medical conditions.
PARKINSON DISEASE – THE SIEBENS DOMAIN MANAGEMENT MODEL AND THE Notebook for Wellbeing & Health Care IN NURSE-LED CARE MANAGEMENT
Setting: Outpatient
Connor KI, Siebens HC, Mittman BS, Ganz DA, Barry F, Ernst EJ, Edwards LK, McGowan MG, McNeese-Smith DK, Cheng EM, Vickrey BG. Quality and extent of implementation of a nurse-led care management intervention: care coordination for health promotion and activities in Parkinson’s disease (CHAPS). BMC Health Services Research 2020:20:732 (17 pages). Open Access
August 2020
Significance: The details of the CHAPS implementation components confirmed multiple CHAPS nurse care manager activities including Initial Assessments on 31 CHAPS standard problems/topics, customized education, coaching, and care coordination. Results also confirm the 4 domains of the Siebens Domain Management Model were used to organize almost all (97.7%, n=4870) of the CHAPS problems/topics in documentation. These were distributed in I Medical/Surgical Issues 38.8%, II Mental Status/Emotions/Coping 27.5%, III Physical Function 14.3%, and Living Environment 19.4%. Details about the customized Siebens Health Care Notebooks indicated participants interacted with their Notebooks.
Thus, results demonstrate the Siebens Domain Management Model can be integrated into care management providing a whole person perspective. The Notebook for Wellbeing & Health Care (formerly called Siebens Health Care Notebook) can be personalized, depending on individuals’ health conditions, and serve as a self-care tool.
BREAST CANCER – USE OF THE SIEBENS HEALTH CARE NOTEBOOK (now called Notebook for Wellbeing & Health Care)
Setting: Outpatient
Moyo P, Walters D, Siebens HC, Myers J, Baynes R, Cook-Wiens G, Jo MY, Asher A. Perceptions of a health care notebook from female breast cancer survivors with cognitive impairment. Journal of Cancer Education, 4 May 2020.
May 2020
Significance: This study involved women with thinking difficulties after treatment for their breast cancer. These difficulties likely would make managing their own health care difficult. All study participants, 100%, endorsed the Siebens Health Care Notebook as useful in tracking their health information. They said they all would recommend it to others.
STROKE – SIEBENS DOMAIN MANAGEMENT MODEL IN TEAM CONFERENCE
Setting: Inpatient Stroke Rehabilitation
Kushner DS and Strasser DC. Stroke inpatient rehabilitation team conferences: leadership and structure improve patient outcomes. Journal of Stroke and Cerebrovascular Diseases, 2020; 29: 104622
April 2020
Significance: This review noted essential components for improving team effectiveness - structure and leadership - were addressed through the SDMM, as a patient-centered clinical model, in Dr. Kushner’s studies. (1) Managerial practices allowed any team member to contribute to the discussion of the SDMM’s four domains addressing all major components of care. (2) The teams’ professional network improved as different disciplines recognized the collaborative work required to address discharge barriers. (3) Team leadership broadened through a shared structure including the physician and the case manager. The authors also note that the principles leading to improved team function should apply across health care services beyond rehabilitation. This has already occurred as the SDMM is one component of an outpatient nurse-led care management program for individuals with Parkinson’s.
PARKINSON DISEASE – THE SIEBENS DOMAIN MANAGEMENT MODEL AND THE SIEBENS HEALTH CARE NOTEBOOK IN NURSE-LED CARE MANAGEMENT
Setting: Outpatient
Connor KI, Cheng EM, Barry F, Siebens HC, Lee ML, Ganz DA, Mittman BS, Connor MK, Edwards LK, McGowan MG, Vickrey BG. Randomized trial of care management to improve Parkinson disease care quality. Neurology 2019; 92(16): e1831-e1842. Free PMC article.
April 2019
Significance: The nurse-led proactive care management intervention, Care Coordination for Health Promotion and Activities in Parkinson’s Disease (CHAPS) substantially increased adherence to PD quality of care indicators. This was a complex intervention with multiple components including use of the Siebens Domain Management Model to organize the CHAPS Assessment, 31 CHAPS standard problems/topics, follow-up notes, and patient notebooks (the Siebens Health Care Notebook). This is the first study to demonstrate the application of the SDMM in the outpatient setting and use of the Notebook in outpatient self-management.
STROKE – SIEBENS DOMAIN MANAGEMENT MODEL IN TEAM CONFERENCE
Setting: inpatient rehabilitation facility
Kushner DS, Peters K, Johnson-Greene D. Evaluating use of the Siebens Domain Management Model during inpatient rehabilitation to increase functional independence and discharge rate to home in stroke patients. PMR 2015;7:354-364. CME Status
April 2015
Significance: This is the first study to show that the use of SDMM leads to improved clinical outcomes using fewer resources. The SDMM was implemented as a guide to inpatient rehabilitation weekly team conference discussions. In addition, discussion had to focus on barriers to community discharge. Improved outcomes included better functional levels, shorter lengths of stay, and more patients discharged to home. Importantly, there were fewer discharges back to the acute hospital.
HIP FRACTURE - REHABILITATION RESEARCH
Setting: Inpatient rehabilitation hospitals and skilled nursing facilities
Siebens H, Sharkey P, Aronow HU, Deutscher D, Roberts P, Munin MC, Radnay C, Horn SD. Variation in rehabilitation treatment patterns for hip fracture treated with arthroplasty. PM&R 2016; 8:191-207. CME designated status.
March 2016
Significance: In this descriptive study, the rehabilitation therapy activity treatments by physical therapy (PT) and occupational therapy (OT) were organized using the four SDMM domains (see Table 3). When this approach was initiated, feedback by therapists studying traumatic brain injury was positive. Those activities that were not domain-specific were categorized under Care Processes (e.g. assessment).
While the four domains have been used by clinical therapists (PT, OT) in rehabilitation hospital team conferences for several years; this is the first study to do this with research data. This application supports the interdisciplinary design of the SDMM.
Patients’ characteristics at admission (Table 1) and discharge (Table 4) were also organized by the four domains as were the recommended discharge treatments (Table 4).
PARKINSON’S DISEASE – NURSE-LED CARE COORDINATION AND CARE MANAGEMENT
Setting: Outpatient
Connor K, Cheng E, Siebens HC, Lee ML, Mittman BS, Ganz DA, Vickrey B. Study protocol of “CHAPS”: a randomized controlled trial of Care Coordination for Health Promotion and Activities in Parkinson’s Disease to improve the quality of care for individuals with Parkinson’s disease. BMC Neurology; 2015: 15:258 Open Access
December 2015
Significance: This study is unique in that the SDMM concept is being used, as designed, with both providers and patients. In addition, this care coordination program is the first outpatient clinical program to use the SDMM to guide steps of care. A comprehensive patient assessment, the priority problem list, and nurse clinical manager documentation are organized consistently using the four domains. The domains are extended to patients through use of the Siebens Health Care Notebook, customized for each patient. An ongoing research study funded through a nursing research initiative in the Veterans Affairs Health Services Research and Development is evaluating outcomes.