Medicine and Health Sciences Commons^™

01-08-2019 Hsc Committee Meeting Notice, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

11-06-18 Hsc Committee Meeting Minutes, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Telehealth In Rural Tennessee- Closing The Gap In Care?, Kara L. Bianchini

Applied Research Projects

Telehealth is quickly becoming a tool used in everyday healthcare. Certain areas, such as rural communities in Tennessee, experience health disparities because of their location and distance from health care providers. This gap in care can be diminished through the use of telehealth services. This research project is taking place to gather data from hospitals in Tennessee currently providing telehealth services. I want to determine if telehealth is closing the gap-in-care seen in rural communities. Through research, I have found there are multiple barriers to telehealth, but also significant benefits. I think with additional education and training, telehealth can become …

Impact Information Governance Has On Healthcare Organizations, Nadine N. Ellington

Applied Research Projects

The purpose of this study evaluated the impact of information governance (IG) on healthcare organizations. Objectives and limitations were derived from literature reviews, case studies, and surveys. A methodology of evaluation research with a focus on summative evaluations was conducted. The population study consisted of health information management (HIM) professionals, consultants, data analyst, and other healthcare professionals. The findings from the research provided significant evidence supporting the value IG programs possess along with the benefits healthcare organizations gained with the adoption of the IG initiative.

Design For Success: Identifying A Process For Transitioning To An Intensive Online Course Delivery Model In Health Professions Education., Paige L Mcdonald, Kenneth J Harwood, Joan T Butler, Karen S Schlumpf, Carson W Eschmann, Daniela Drago

Clinical Research and Leadership Faculty Publications

Intensive courses (ICs), or accelerated courses, are gaining popularity in medical and health professions education, particularly as programs adopt e-learning models to negotiate challenges of flexibility, space, cost, and time. In 2014, the Department of Clinical Research and Leadership (CRL) at the George Washington University School of Medicine and Health Sciences began the process of transitioning two online 15-week graduate programs to an IC model. Within a year, a third program also transitioned to this model. A literature review yielded little guidance on the process of transitioning from 15-week, traditional models of delivery to IC models, particularly in online learning …

Which Activities Count? Using Experimental Data To Understand Conceptualizations Of Physical Activity, Rachel Cusatis, Dana Garbarski

Sociology: Faculty Publications and Other Works

US health surveys consistently report that men and those with higher socioeconomic status (SES) engage in more physical activity than women and lower SES counterparts, using questions that ask about physical activity during leisure time. However, social characteristics such as gender and SES shape understandings of and access to leisure-based physical activity as well as other domains where healthy activity is available – namely house work, care work, and paid work. Thus, the physical activity of US adults may look different when what counts as physical activity expands beyond leisure activity.

The current study uses Amazon’s Mechanical Turk platform …

Analyzing Policies Through A Dohad Lens: What Can We Learn?, Julia M. Goodman, Janne Boone-Heinonen, Dawn M. Richardson, Sarah B. Andrea, Lynne C. Messer

OHSU-PSU School of Public Health Faculty Publications and Presentations

Social, health, and environmental policies are critical tools for providing the conditions needed for healthy populations. However, current policy analyses fall short of capturing their full potential impacts across the life course and from generation to generation. We argue that the field of Developmental Origins of Health and Disease (DOHaD), a conceptual and research framework positing that early life experiences significantly affect health trajectories across the lifespan and into future generations, provides an important lens through which to analyze social policies. To illustrate this point, we synthesized evidence related to policies from three domains—family leave, nutrition, and housing—to examine the …

12-04-18 Hsc Committee Meeting Agenda, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Doctoral Dissertation Research Hlt 699, Joanna Burkhardt

Library Impact Statements

No abstract provided.

12.18.2018 Board Of Medical Investigators State Of New Mexico Notice Of General Meeting, Anthony Cervantes

Office of the Medical Investigator Notices and Agendas

No abstract provided.

12-04-18 Hsc Committee Meeting Notice, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

A Program To Treat Hepatitis B In North Korea: A Model Of Antiviral Therapy In A Resource-Poor Setting, Marcia Ann Kilsby, Alice Unah Lee, Heidi Linton, David C. Hilmers

Faculty Publications

Despite the well-proven, safe and effective therapies for hepatitis B infection, delivery of treatment remains a significant challenge in resource-poor settings. Geopolitical and economic restrictions present additional difficulties in providing care in North Korea. However, treatment of patients with chronic hepatitis B remains a top priority for both the North Korean Ministry of Public Health and international agencies working in North Korean hepatitis healthcare facilities. Working in partnership, a path was created to institute this much-needed program. A consortium of United States and Australian humanitarian non-governmental organizations along with generous individual and corporate donors working in concert with local and …

Beyond Continuing Education: Continuing Professional Development And The Cth, Jeff Goad

Pharmacy Faculty Articles and Research

"The CTH exam is taken by physicians, pharmacists and nurses. From country to country and profession to profession, there is a wide variety of travel clinic practice and the training of travel medicine providers. One-time assessments, such as the CTH exam, are important to establishing a standard level of knowledge, but ongoing education that focuses on the knowledge and skills necessary to provide the pre-travel clinic consultation should be a priority."

10-09-18 Hsc Commmittee Meeting Minutes, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

The Economic Impact Of Potential Closures Of Rural Hospitals In Mississippi, M. Maya Mcdoom, Cyril Chang, John Gnuschke

Delta Directions: Publications

Rural hospitals across the nation are facing a crisis due to ever-changing economic, policy, and population factors. To better understand how the present economic climate and policies are impacting rural hospitals in Mississippi, this report provides a comprehensive assessment of the: health and economic characteristics of hospitals and the communities they serve, factors that impact hospital viability, economic impacts of the “most at-risk” hospitals in Mississippi, and potential innovations and policy considerations to address the challenges facing rural Mississippi hospitals.

11-06-18 Hsc Committee Agenda, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Initiative 427: Nebraska Medicaid Expansion, J. David Aiken

Cornhusker Economics

This article summarizes information regarding Initiative 427–the Medicaid expansion question on the November 6, 2018 ballot. It reprints the actual ballot language and the Nebraska Secretary of State’s summary of arguments for and against Initiative 427.

Background. Originally Medicaid covered the elderly, the disabled, children in low-income families, and low-income pregnant women. In 2010 Medicaid coverage was expanded by Congress to include the working poor. In 2012 the U.S. Supreme Court ruled that the provision of the Affordable Care Act (ACA) requiring states to expand Medicaid was unconstitutional. This made it a state option whether or not to expand Medicaid. …

11-6-18 Hsc Committee Meeting Notice, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Dr. Rand O'Donnell Retires After 25 Years As Ceo, Children's Mercy Hospital

Our Story Continues

Upon his retirement, CEO Dr. O'Donnell looked back on a transformative 25 years of Children's Mercy history and learned that 23rd Street on the hospital's Adele Hall Campus had been renamed O'Donnell way. The attached slide show remembers some moments from his time at Children's Mercy. Also attached: a news story of his retirement celebration, a picture of Rand and Melva receiving a replica street sign, and a picture of the new street sign on the Adele Hall campus of Children's Mercy Kansas City.

Mother Baby Discharge Process, Zander Abbott, Maria Tkacz, Suellen Clark, Justyna Coleman, Dave Cox, Kathy Cyr, Sharon Economides, Jen Johnson, Stacy Lamore, Mary Mcnulty, Joy Moody, Heidi Morin, Cathy Palleschi, Josh Sinkin, Stephen Tyzik, Helen Wild

Maine Medical Center

Problem/Impact Statement: MMC's 32-bed Mother Baby Unit is experiencing backed up flow due to high volume and patients not being discharged quickly enough. The current average discharge time on Mother Baby and the Newborn Nursery is 1:36pm. The Mother baby unit has 32 beds, is staffed by 8-9 nurses, and has average discharge of 91 patients a week.

10-09-18 Hsc Committee Meeting Agenda, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Clinical Documentation Received By Referring Provider, Linda Butler, Julie Plourde, Nate Fuller, Brandy Brown, Roslyn Gerwin, Alyssa Gaudette, Cheryl Wilbur, Rachel Garnsey, Jim Bailinson

Maine Medical Center

Problem statement: At the time of follow up appointments, referring providers do not always have access to the documentation needed for continuum of care.

Patient Visit Efficiency, Brian Roux, Audra Baschagen, Meagan Oberholtzer, Martha Grealey, Lori Kim, Eliza Post, Samantha Byrnes, Victoria Noiles, Monica Russo

Maine Medical Center

By July 15, 2018 we will identify ways to decrease the amount of time our defined patient population spends in the practice for an appointment.

Tobacco Cessation Outcomes: The Case For Milestone-Based Services, Disa L. Cornish, Ki Park, Mitchell Sj Avery

Health, Recreation, and Community Services Faculty Publications

NTRODUCTION This study focuses on a Midwest State's tobacco quitline. The purpose was to understand possible relationships between services provided and cessation rates.

METHODS The data examined in this study came from aggregated intake/treatment data and follow-up interview data. The overall response rate was 22.9%. Measures included quit rate, quit duration, length of services, number of services, stage of change, confidence to quit, and source of referral.

RESULTS The dataset included 1452 cases; 77% enrolled in services only once, 17% enrolled twice and 6% enrolled three or more times. Use of medication was higher among those who quit [chi(2)(1)=7.1, p=0.009, …

Coordination Of Inpatient And Outpatient Care For Neurology Patients Undergoing Epilepsy Monitoring, Sara Schrock, Michelle Beane, Kathryn Cope, Mark Parker, Suneela Nayak, Ruth Hanselman, Stephen Tyzik, Amy Sparks, Brendan Lilley

Operations Transformation

ORGANIZING A SYSTEM TO CONSOLIDATE EPILEPSY REFERRALS TO AN OUTPATIENT NEUROLOGY PRACTICE

An outpatient neurology practice was experiencing delayed or lost referrals for epilepsy monitoring. This delay was leading many patients to suffer unnecessary and unmanaged seizures and, in some cases, frequent trips to the emergency department.

As a result, a team consisting of the neurology practice and neuro-navigators used baseline metrics to demonstrate the current state of the problem and conducted a root cause analysis that outlined several causes. A number of countermeasures were initiated with the goal of decreasing referral misses.

Post the initiation of two KPIs, a …

Reducing O Negative Blood Product Usage In A Tertiary Care Academic Medical Center, Wendy Weiler, Tracy Cook, Mmc Blood Bank, Mark Parker, Stephen Tyzik, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operations Transformation

MANAGEMENT OF O NEGATIVE BLOOD USE

O registered blood cells are the universal donor but it comprises only 7% of the blood supply. As a result, inappropriate use can result in shortages.

At an academic tertiary care medical center, a performance improvement goal was established that O negative blood cells would make up less than 12% of all blood type transfused by the end of their fiscal year.

A root cause analysis established reasons for the use of O negative blood cells. A number of countermeasures were initiated using the plan, do, study, act (PDSA) problem solving model. Using newly …

Implementing Strategies To Reduce Central Line-Associated Blood Stream Infections On An Inpatient Pediatric Unit, Sherryann St. Pierre, Nicole Manchester, Jessica Howe, Melanie Lord, Mark Parker, Suneela Nayak, Ruth Hanselman, Stephen Tyzik, Amy Sparks, Barbara Bush Children's Hospital

Operations Transformation

STRATEGIES TO REDUCE CENTRAL LINE ASSOCIATED BLOODSTREAM INFECTIONS

Every central line associated bloodstream infection (CLABSI) leads to poor outcomes, increased mortality and increased healthcare costs. A pediatric care team in an academic tertiary medical center set a goal to reduce the number of these infections on their unit.

The team’s research showed that daily bathing greatly decreases CLABSI. Their baseline metrics demonstrated an unacceptable level of those with central lines being bathed. A root cause analysis revealed that patient and family refusal was the leading cause for those who did not bathe.

A performance improvement plan was initiated that consisted …

Increasing Bedside Medication Safety In An Intensive Care Setting, Natasha Stankiewicz, Jonathan Archibald, Scu 2, Mark Parker, Stephen Tyzik, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operations Transformation

A PERFORMANCE IMPROVEMENT PROJECT FOR INCREASED BEDSIDE MEDICATION SAFETY

The convenience of having certain medications directly available at bedside has long been a priority for a medical intensive care nursing team in an academic tertiary medical center.

However, it was apparent to new staff and leadership that there was a lack of awareness and interest in securing medications within the department. This posed a risk to patients, families, visitors and colleagues.

Baseline metrics on patient safety were collected and a root cause analysis was conducted. Countermeasures included increased education of medication safety as well as a instituting a KPI which …

Improving Revenue Capture And Patient Safety In An Icu Setting, Natasha Stankiewicz, Laura Lewis, Jonathan Archibald, Mark Parker, Suneela Nayak, Stephen Tyzik, Ruth Hanselman, Amy Sparks

Operations Transformation

IMPROVING REVENUE CAPTURE AND PATIENT SAEFTY IN AN INTENSIVE CARE SETTING

Materials management department is responsible for restocking chargeable supplies in an intensive care unit (ICU) at an academic tertiary medical center. Staff confusion as to what items were considered chargeable often led to low supply par levels resulting in delays of critical patient care.

Using baseline metrics, a team of caregivers created several performance improvement goals to increase nursing compliance with appropriate supply charging. The results of a root cause analysis spearheaded the development of a KPI that encompassed staff education, lost charge tracking and charge supply labeling.

Post …

Strategies To Improve Timeliness For Cleaning Inpatient Rooms Following Patient Discharge, Lora Dixon, Mark Parker, Ruth Hanselman, Suneela Nayak, Amy Sparks

Operations Transformation

STRATEGIES TO IMPROVE THE TIME FRAME FOR CLEANING INPATIENT ROOMS BY ENVIRONMENTAL SERVICES

In an inpatient rehab hospital, it was noted that Environmental Services (EVS) was delayed in cleaning rooms between patient discharges and admissions. This resulted in the frequent use of a “stat clean” order that allows only 50% of the normal cleaning time , forcing patients to wait and impacting patient flow.

A root cause analysis demonstrated lack of communication between the rehab hospital and the contracted cleaning services. A number of counter measures were initiated with the goal that cleaning would be started within 20 minutes of …