Medicine and Health Sciences Commons^™

No Patient Left Behind: Improving Transition Of Care In Coronary Artery Disease And Heart Failure Patients, Rebecca Schuyler, Gunjan Mundhra, Mubbasher Syed

South Atlantic Division GME Research Day 2025

No abstract provided.

Inpatient Vs. Outpatient Management Outcomes Of Ectopic Pregnancy With Methotrexate, Courtney Smith, Taryn Hoffman, Kavya Davuluri, Ashley Brodrick, Taylor Penny, Robyn Meadows, Martin Wegman

South Atlantic Division GME Research Day 2025

No abstract provided.

Improving Usage Of Low-Dose Chest Ct For Lung Cancer Screening Amongst Tobacco Users That Fall Within Certain Criteria Per Uspstf Recommendations - A Quality Improvement Project, Karissa Charles, Evelyn Ogbomoh, Anthony Shadiack

South Atlantic Division GME Research Day 2025

No abstract provided.

Chaos To Calm: Utilizing Checklists In The Icu To Improve Quality During Intubations, J Dunitz, Matthew Daniel, Will Hickman, Sarah Johnson, Erik Porter

South Atlantic Division GME Research Day 2025

No abstract provided.

Enhancing Patient Safety: The Role Of Interdisciplinary Teams In Reducing Blood Culture Contamination, Fady M. Awad, Austin Patrick-Eisenberg, Brian Watson, Mohamed Faris

South Atlantic Division GME Research Day 2025

No abstract provided.

Generating Real-World Evidence In Early Alzheimer's Disease: Considerations For Applying The Target Trial Emulation Framework To Study The Safety Of Anti-Amyloid Therapies, Xiaojuan Li, Sonal Singh, Bahareh Rasouli, Jennifer Lyons, Noelle M. Cocoros, Richard Platt, Ivan Abi-Elias, Jerry H. Gurwitz

Department of Medicine Faculty Publications

Anti-amyloid beta monoclonal antibodies (anti-Aβ mAbs) have received approval from the US Food and Drug Administration for the treatment of patients with mild cognitive impairment or mild dementia due to Alzheimer's disease (collectively known as early AD) based on evidence from clinical trials. However, whether findings from these trials are generalizable to the real world is uncertain. We need reliable evidence on the real-world safety of these treatments to inform decision making for clinicians, patients, and caregivers. Using lecanemab as an exemplar, we outline the key considerations in designing and implementing an observational study on safety and utilization outcomes using …

A Worker's Struggle, Sakan Binte Imran, Shadman Mahmood Khan Pathan

Electrical & Computer Engineering Faculty Publications

[Introduction] The casualty department at Sir Salimullah Medical College Mitford Hospital was crowded, as it always was. The air smelled of antiseptics, and hurried footsteps echoed through the narrow corridors. It was another day of internship, and I had just finished checking on a patient when a nurse called me over.

“There’s a new case in Trauma. Factory worker. Severe hand injury.”

I hurried over and found a man sitting on the examination table. His face was pale, and his forehead was glistening with sweat. His right hand was wrapped in a blood-soaked cloth. His left hand trembled as he …

Exploring Stress, Fatigue, Burnout, And Resilience Among Healthcare Personnel In Southeast Asia: A Scoping Review, Kelsey Trulik, Vijaya Arun Kumar, Wendy Wu, Muralidhar Varma, Mauli M. Patel, Kajol Manglani, Trini A. Mathew

Global Health Research Collaborative

This study aims to compare methods used to measure burnout, fatigue, stress, and resilience, as well as resilience-building interventions among healthcare personnel (HCP) in Southeast Asia. Even before COVID-19, HCP faced high levels of burnout and stress, exacerbated by the pandemic. Identifying effective resilience-building strategies is essential to supporting a healthier workforce. Studies published from January 2016 to December 2021 focusing on burnout, stress, fatigue, and resilience in HCP in Southeast Asia. A comprehensive literature search of seven databases (Jan 2016-Dec 2021), using terms related to resilience, HCP, and Southeastern Asian countries identified relevant English-language studies. COVIDENCE software was used …

Design Thinking For Health Environments: Case Study Research On Innovation, Design Leadership, And Healthcare Complexity, Diana S. Nicholas

Antioch University Dissertations & Theses

As healthcare costs are skyrocketing, of the 6,093 hospitals in America, 53% will lose money in the current year (Coleman-Lochner, 2022). Design health innovation centers (DHICs) are formed in Europe and the United States to create efficiencies in healthcare related to budget challenges. DHICs exist in unique contexts both in America and Europe that are not yet well understood. These efforts are difficult to lead due to the lack of understanding of their worth and how their process is valuable to healthcare settings (Bhattacharyya et al., 2022). The specific problem examined here is that little is known about how DHIC …

Icu-Length Of Stay Prediction On Electronic Health Records Using Graph Neural Networks And Homogeneous Similarity Graphs, Ahmad F. Al Musawi, Pratip Rana, Sibtanu Raha, Joshua Braunstein, William C. Sleeman Iv, Rishabh Kapoor, Preetam Ghosh

Computer Science Faculty Publications

Predicting the length of stay (LoS) is important for hospital administration, as it helps allocate proper resources, such as bed management and hospital staffing. Patients' Electronic Health Records (EHRs) contain highly relevant data for LoS prediction; however, their integration and effective use in predictive modeling for accurately estimating LoS remain challenging. To address this, we propose a homogeneous Graph Neural Network (GNN)-based framework for predicting LoS. This method employs a comprehensive data fusion strategy based on the hospital Visit-based Similarity Graph (VSG), which integrates diverse multi-modal clinical features into a coherent, homogeneous graph representation. Next, this VSG is fed into …

The Quick Dash Reformed: Increasing The Holisticity And Occupational Nature Of Upper Extremity Therapeutic Evaluation, Lauren E. Garcia

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: The QuickDASH is one of the most common upper extremity (UE) focused patient-reported outcome measures (PROMs) utilized within current practice. Despite its high utilization rate, there are still many concerns surrounding the QuickDASH, including its applicability to certain populations, difficulty with cross-cultural adaptation, and limited psychosocial evaluation. Purpose: The purpose of this study was to develop and implement a reformed version of the QuickDASH, the OT-DASH, that included modernized and occupation-focused language to achieve increased client applicability and yield more accurate comparisons between client perceptions of dysfunction and their true clinical presentations. Theoretical framework: The Person-Environment-Occupation-Performance model was utilized …

Improving Neuromuscular Blockade Surveillance In Anesthesia Care With Quantitative Train Of Four Monitoring, Carley S. Blair

Graduate Theses, Dissertations, and Problem Reports (ETD)

Problem Statement: Despite the availability of quantitative train of four (TOF) monitoring, anesthesia providers more frequently rely on tactile (qualitative) TOF monitoring, which is associated with underestimation of recovery from muscle relaxation. Inadequate recovery from muscle relaxants results in residual weakness and its associated complications in the postoperative period, including compromised respiratory function (Thilen et al., 2023).

Background: Neuromuscular blockade (NMB) drugs are required to facilitate endotracheal intubation and allow for surgical manipulation. When these drugs are used, train of four (TOF) stimulations are used to monitor and assess the depth and recovery from NMB. TwitchView monitors (quantitative monitoring) is …

Code Blue Narrator Documentation: An Evidence Based Quality Improvement Initiative, Stefanie A. Benvenuto

Graduate Theses, Dissertations, and Problem Reports (ETD)

Background: The code documenter plays a crucial role in ensuring accurate, real-time documentation during Code Blue events, which is critical for patient care and compliance with established guidelines and protocols. However, nurses have reported discomfort with the Code Narrator tool in EPIC, which has hindered effective documentation during these high-pressure situations.

Purpose: The lack of comfort in using the Code Narrator tool has led to inconsistent and inaccurate documentation during Code Blue events, potentially impacting the effectiveness of the response and patient outcomes, such as the achievement of return of spontaneous circulation (ROSC).

Intervention: An educational competency …

A New Electronic Handoff Tool To Facilitate Patient Transfer From The Or To Sicu: A Quality Improvement Initiative, Kaylan Jean Kerrigan

Graduate Theses, Dissertations, and Problem Reports (ETD)

Introduction/Background: Transfer of care is a vulnerable time for patients. Continuity of care depends on good communication from the transferring team to the receiving team. Communication failures contribute to frustration among medical staff and poor patient outcomes. Purpose: The purose of this project was to improve handoff communication and satisfaction between the anesthesia team in the operating room (OR) and the receiving surgical intensive care unit (SICU) nurses. Intervention: A new electronic handoff tool was developed for the Epic electronic health record (EHR) to provide SICU nurses with patient information (name, age, allergies), procedure and diagnosis, intubation status, reversal status, …

Quality Over Quantity: Doula Perspectives On Equity, Access, And Quality Of Care In Black Maternal Health Outcomes, Terry-Ann E. Lynch

West Chester University Graduate Theses, Dissertations, and Final Projects

Black maternal mortality in the United States is a public health crisis. There are a plethora of reasons as to why maternal and fetal deaths disproportionately impact Black women. From a public health perspective, health disparities are an area of concern in marginalized communities, with Black maternal mortality being a risk factor. “According to the Centers for Disease Control and Prevention (CDC), in 2021, the maternal mortality rate for non-Hispanic Black (subsequently, Black) women was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White (subsequently, White) women (26.6)” Maternal Mortality Rates in the United States, 2021” …

Exploring The Reassessment Of Palliative Home Care Clients: A Mixed Methods Study, Maya Canham

Theses and Dissertations (Comprehensive)

Introduction: The timely reassessment of clients receiving palliative home care (HC) is critical for supporting clinicians with care planning and service delivery. However, there is little information on the frequency of reassessments and factors driving reassessment in palliative HC clients.

Objectives: The objectives of this study were to: (i) determine the proportion of palliative HC clients reassessed with the interRAI Palliative Care (interRAI PC) instrument, (ii) calculate the average interRAI PC reassessment interval, (iii) identify the key factors driving interRAI PC reassessment at various intervals, and (iv) explore the factors that influence palliative HC clinicians to reassess their clients in …

Satisfaction Of Excellent Service Training Participants With The Kirkpatrick Model At Alia Hospital Depok, Nur Fadilah Dewi

Jurnal Vokasi Indonesia

The study aims to improve the quality of human resources and services at Alia Hospital Depok through evaluation of training programs. The approach used is the Donald Kirkpatrick model evaluation which is a common method used in evaluating the effectiveness of training. The main problem faced by Alia Hospital Depok is the lack of evaluation conducted on the training programs that have been held. Therefore, training evaluation needs to be considered to improve the quality of human resources and services provided. The research method used is a survey by distributing questionnaires to service excellent training participants to evaluate their reactions …

Gender Disparities And Burnout Among Emergency Physicians: A Systematic Review By The World Academic Council Of Emergency Medicine-Female Leadership Academy For Medical Excellence., Suman Thakur, Vivek Chauhan, Sagar Galwankar, Fatimah Lateef, Pia Daniel, Zeynep Cakir, Katia M. Lugo, Samjhana Basnet, Busra Bildik, Siham Azahaf, Sevilay Vural, Busra H. Difyeli, Lisa Moreno-Walton

School of Medicine Faculty Publications

Background: The Female Leadership Academy for Medical Excellence, members of the World Academic Council of Emergency Medicine, conducted this systematic review, which explores gender disparities in burnout among emergency physicians (EP) using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Burnout is a critical issue in healthcare, particularly in emergency medicine where high stress and demanding work environments prevail. Methods: Following PRISMA guidelines, we searched PubMed and Epistemonikos for studies using MBI-HSS to measure burnout in EPs. Inclusion criteria encompassed peer-reviewed, English-language articles reporting burnout by sex. Data extraction focused on proportions of burnout and its subcomponents, mean scores, and odds …

Analisis Klaim Pending, Verifikasi Dan Audit Pascaklaim Jaminan Kesehatan Nasional, Anugrah Aulia Ulil Amri, Atik Nurwahyuni

Jurnal Ekonomi Kesehatan Indonesia

The implementation of Indonesia’s National Health Insurance (JKN) poses new challenges for hospitals as service providers. Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan, the program’s administrator, now routinely conducts post-claim verifications and audits after claims have been paid. This often results in claim adjustments or even full reversals of previously reimbursed amounts. This case study examines JKN claim management at a Type D General Hospital in 2022, focusing on pending claims, verification, and post-claim audits, using a systems theory framework. Key issues in pending claims include incomplete medical records (29%), insufficient supporting documents (24%), and coding errors (21%). Post-claim problems primarily …

The Role Of Social Health Insurance In Achieving Universal Health Coverage In Asia: A Systematic Review, Afaf Jauhar, Mardiati Nadjib

Jurnal Ekonomi Kesehatan Indonesia

Universal Health Coverage (UHC) aims to ensure that all individuals have access to essential health services without financial hardship. Social Health Insurance (SHI) is critical in achieving this goal, especially in low- and middle-income countries. This systematic review explores the role of SHI systems in advancing UHC across 14 Asian countries, focusing on healthcare access, financial protection, and equity. A comprehensive search across PubMed, Scopus, and ScienceDirect identified 768 articles, and 37 studies were selected after screening, following the PRISMA guidelines. The chosen studies cover countries with varying SHI models across Asia. The findings reveal that high-income countries such as …

Letter To "Early Do-Not-Attempt Resuscitation Orders And Neurological Outcomes In Older Out-Of-Hospital Cardiac Arrest Patient: A Multicenter Observational Study", Benjamin Tangkamolsuk, Quang La, David F Lo

Rowan-Virtua School of Osteopathic Medicine Departmental Research

We enjoyed reading the article by Kohri et al., titled “Early do‐not‐attempt resuscitation orders and neurological outcomes in older out‐of‐hospital cardiac arrest patients: A multicenter observational study” and would like to offer additional commentary on the article. We hope these perspectives may provide insight into areas that may require further research and improvement.

Ethical Aspects Of Utilising Artificial Intelligence In Clinical Settings, Jeffrey Byrnes, Michael Robinson

Philosophy Faculty Articles and Research

In response to recent proposals to utilize artificial intelligence (AI) to automate ethics consultations in healthcare, we raise two main problems for the prospect of having healthcare professionals rely on AI-driven programs to provide ethical guidance in clinical matters. The first cause for concern is that, because these programs would effectively function like black boxes, this approach seems to preclude the kind of transparency that would allow clinical staff to explain and justify treatment decisions to patients, fellow caregivers, and those tasked with providing oversight. The other main problem is that the kind of authority that would need to be …

Transparency And Authority Concerns With Using Ai To Make Ethical Recommendations In Clinical Settings, Jeffrey Byrnes, Michael Robinson

Philosophy Faculty Articles and Research

In response to recent proposals to utilize artificial intelligence (AI) to automate ethics consultations in healthcare, we raise two main problems for the prospect of having healthcare professionals rely on AI-driven programs to provide ethical guidance in clinical matters. The first cause for concern is that, because these programs would effectively function like black boxes, this approach seems to preclude the kind of transparency that would allow clinical staff to explain and justify treatment decisions to patients, fellow caregivers, and those tasked with providing oversight. The other main problem is that the kind of authority that would need to be …

Priorities To Care Within The Military Health System: A Mixed Methods Study On Military Spouse Access To Care During Covid-19 On Okinawa, Elayne L. Wilson

Theses & Dissertations

Military spouses in Okinawa experienced denial of care at military treatment facilities and off base Japanese healthcare facilities during the COVID-19 pandemic. Over two years of travel restrictions further contributed to difficulties accessing healthcare while stationed on the island with their active-duty spouse. This study examined the implications of a priority-based access system through the TRICARE program implemented due to limited resources during COVID-19 and its impact on military spouses in a scarce medical resource environment. This concurrent mixed-methods research used a survey tool developed by Community First Hawaii to quantify access to healthcare and in-depth interviews to further explore …

Analysis Of Public Opinion Polls About Covid-19 Vaccines: Theoretical And Policy Implications For Vaccine Communication And Campaigns To Address Vaccine Hesitancy, Muhammad Ittefaq, Hong Tien Vu, Ali Zain, Tayyeb Ramazan, Gary L. Kreps

School of Communication Studies - Faculty Scholarship

This study analyzed 1432 questions asked in 19 surveys (N = 43,014) on COVID-19 vaccines between January 2020 and August 2022 using dimensions including (1) information sources about COVID-19 vaccine, (2) information about the access, effectiveness, and side effects of COVID-19 vaccine, (3) COVID-19 vaccine hesitancy (i.e. false perception, skepticism, and vaccine refusal), (4) motivations to get the COVID-19 vaccine (i.e. to perform routine activities, convenience, incentives, influences, and travel requirement), (5) false perceptions caused vaccine refusal, and (6) intentions to get vaccinated. Our results show that vaccine refusal was rampant throughout the pandemic and mostly attributed to the …

Does Physician-Hospital Vertical Integration Affect Hospital Output?, Soumya Upadhyay, Neeraj Bhandari

Healthcare Administration and Policy Faculty Research

Background: Physician-hospital vertical integration is gaining steam but it is unclear how they affect hospital output.

Objective: To examine the direct impact of vertical integration on hospital output.

Design: A pooled design with 6-year data using linear regressions was used. Then, panel data design with hospital fixed effects was used.

Methods: We linked American Hospital Association data (2016-2021) with AHRQ Comparative Health System Performance Initiative’s Compendium (2018, 2020, 2021; 34 987 hospital-year observations) to develop new measures of vertical integration and assess its relationship with several measures of hospital output including annualized total admissions, total number of inpatients days, …

Advanced Practice Clinician Outcomes: Pre/Post Implementation Of An Advanced Practice Clinician Council, Jeannine M. Moss

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Improving access to quality, affordable, and timely healthcare is a national priority. Health systems across the United States are utilizing Advanced Practice Clinicians (APCs) to fill the void in healthcare delivery. As provider shortages continue and the demand for APCs increases, organizations must develop robust structures to support APC engagement, retention, job satisfaction, and professional growth. Currently, 44% of the provider workforce within a large urban health system are APCs, yet despite substantial APC provider labor pool representation, the organization had little infrastructure to support APC professional growth and no mechanism for organizational involvement. This quality improvement (QI) project aimed …

Reducing No-Shows In A Behavioral Health Setting: A Program Evaluation, Meagan Evans

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Mental healthcare in America faces many significant challenges; this is especially true in rural regions like Southwest Virginia. When patients miss their scheduled appointments, it represents a lost opportunity to deliver the critical mental health services that other individuals in need could have benefited from. A significant access issue presents itself when patients are not able to get the mental health support they need. The lack of outpatient access leads to patients utilizing emergency rooms inappropriately for what could have been routine care visits. A multitude of factors can contribute to patients failing to attend their scheduled appointments, including transportation …

The Living Document: Medical Records As A Malleable Presence, Camilla Lyckblad

Proceedings from the Document Academy

Understanding why individuals might safeguard information or keep secrets in working documents such as medical records is essential for the development of good quality care, fostering an environment where both patients and staff feel secure to part with sensitive information, encouraging more honest and open communication as well as improved quality of care. This ongoing research aims to deepen comprehension of information behavior in clinical contexts, where the contemporary medical record, with its increasing properties such as open record access for patients, can be viewed as an entity that both listens and influences. This examination sheds light on the complex …

Venous Thromboembolism Prophylaxis In Orthopedic Surgery: A Narrative Review, Jacob Lahti, Sarah Gallitto, Thomas C. Varkey

Annual Research Symposium

This poster highlights current and updated guidelines for chemical and mechanical prophylaxis for venous thromboembolism in patients undergoing major and minor orthopedic surgery. Existing and new potential therapies were reviewed, as well as an analysis into the lack of high-quality risk-prediction score calculators to improve personalization of prophylaxis regimens. Alongside a summary of existing and potential new prophylaxis protocols, a call to action to improve validity of said risk score calculators so as to improve patient outcomes and personalized medicine is made.