Medicine and Health Sciences Commons^™

Rethinking Health Systems Responsiveness In Low- And Middle-Income Countries: Validation Study, Meesha Iqbal, Cecilia Ganduglia Cazaban, Robert Morgan, Cici Bauer, Sameen Siddiqi

Faculty, Staff and Student Publications

BACKGROUND: Health systems responsiveness (HSR) is the ability of systems to respond to legitimate non-health expectations of the population. The concept of HSR by the World Health Organization (WHO) includes respect for dignity, individual autonomy, confidentiality, prompt attention to care, availability of basic amenities, choice of provider, access to social support networks, and clarity of communication. The WHO tool is applied globally to assess HSR in low, middle, and high-income countries.

OBJECTIVE: We have revised the conceptual framework of HSR following a rigorous systematic review and made it specific for low- and middle-income countries (L&MICs). This study is designed to …

Assessing Preparedness, Attitudes, And Knowledge Of Knapp-Utrgv Family Medicine Residents On Geriatric Nursing Home Care: Phase 1 - Creation Of Interactive Modules, Maria M. Ferreira Caceres, Miguel A. Alvarez Silva, Juan C. Lopez-Alvarenga

Research Colloquium

Background: Training in geriatrics and nursing home care are a critical element of medical education. This gap in knowledge becomes increasingly significant given the changing demographics and the need to provide adequate care for an aging population. Improving geriatrics curriculum and implementing nursing home rotations are essential to ensure optimal care for the elderly, thereby fulfilling both educational and healthcare imperatives.

Objective: We aim to analyze and assess the influence of geriatrics training through a survey to collect attitudes, skills, and knowledge of UTRGV Knapp Family Medicine residents. Additionally, the goal is to create interactive modules to boost their skills …

10-03-24 Hsc Committee Meeting Notice, Helen Maestas

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

10-03-24 HSC Committee Meeting Notice

Emerging Special Pathogen C4i: Readiness Is Achieved Through Commitment, Collaboration, Coordination, Cooperation, And Innovation, Darrell Ruby, Christa Arguinchona, Lindsey Bandow, David Brett-Major, Barb Dunham, Heather M. Flavell, Jake Lacore, James Lawler, Patti Lord, Brian Rogge, Mark Vazquez, Jana Broadhurst

Conferences

High Consequence Infectious Disease preparedness in Alaska, a partnership. This presentation will detail how civilian and military stakeholders worked together to enhance readiness for management of an emerged special pathogen. Providence, as the Region 10 Emerging Special Pathogen Treatment Center (RESPTC), leveraged regional relationships and partnered with the University of Nebraska Medical Center (UNMC) to integrate frontline special pathogen preparedness training in Alaska with an operational exercise to test interoperability of local high consequence infection prevention and control and case management workflows with the Isolation System for Treatment and Agile Response for High-Risk Infections (ISTARI). Providence led detailed frontline training …

Decreasing Utilization Of Indwelling Urinary Catheters, Stacie Lomibao Fujimoto

Articles, Abstracts, and Reports

Increased utilization and prolonged dwell times of indwelling urinary catheters (IUCs) are directly related to the risk of catheter-associated urinary tract infections (CAUTIs)- the fifth most common type of healthcare associated infection (HAI). The National Health and Safety Network (NHSN) uses the Standardized Utilization Ratio (SUR) metric to measure and compare device utilization in acute care hospitals across the nation. The national target SUR benchmark is 1.0, and a SUR under 1.0 indicates less device usage than NHSN predicts on an inpatient unit. In 2022 a Neuro Med-Surg unit experienced an overall SUR of 1.047 with 2 CAUTIs observed. A …

You Can Drive Cdt Code Changes: Essential Tips For Success, Frank J. Pokorny Ii, Mba, Facd(Hon)

The Journal of the Michigan Dental Association

The American Dental Association (ADA) Code on Dental Procedures and Nomenclature (CDT) undergoes annual updates to reflect evolving dental practices. Building on Mr. Pokorny's April 2024 article, "Dentistry’s CDT Code: Its Origins, Use, and Future," published in the Journal of the Michigan Dental Association1, this article examines the process for requesting changes to the CDT code set. Overseen by the ADA Council on Dental Benefit Programs’ Code Maintenance Committee (CMC), the process provides clear guidelines for submitting change requests. This paper outlines the types of permissible changes and the rationale behind them, offering dentists and other stakeholders the opportunity to …

Customer Service Revisited, Allen Vean Dmd

Metro Denver Dental Society Articulator Magazine

MDDS Co-Editor, Dr. Allen Vean reflects on the importance of excellent customer service in dentistry. The article draws on personal experience and underscores the significance of patient retention, personal touches and creating a welcoming office environment.

The Patient Experience: A Roadmap To Success, Amanda Jozsa Dds

Metro Denver Dental Society Articulator Magazine

This article outlines a ten-step system designed to enhance patient experience in the dental practice. The author emphasizes the importance of exceptional customer service, team collaboration and attention to detail in all steps of the patient journey. By focusing on the steps outlined the author believes dental practices can foster patient loyalty, reduce marketing costs, boost team morale and lead to practice growth and success.

September 2024, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

Preventing Childhood Obesity

In Oklahoma, 20.4% of youth ages 10 to 17 have obesity...

Supervised Classification Modeling On Louisiana Medicaid Data: A Comparative Study, Yead Rahman

Master's Theses

This thesis systematically optimizes and compares state-of-the-art supervised classification models for Louisiana Medicaid data targeting clinical services, COVID-19 infection, and tobacco use. These target variables are critically important as they represent key health outcomes and behaviors among Medicaid enrollees in Louisiana, a population often characterized by poverty and limited access to education. This study applies advanced machine learning techniques to identify the best model for multinomial and binary classification tasks. These include models such as Logistic Regression, XGBoost, AdaBoost, Random Forest, Decision Tree, Artificial Neural Networks, and Naïve Bayes. Extensive tuning of the hyperparameters and optimization of each classifier were …

Preventive Effects Of Quercetin On The Leaky Gut By Suppression Of Il-1beta-Induced Transcription Factors Involved In An Inflammatory Pathway In Colonic Epithelial Cells, Wannaporn Chayalak, Sumpun Thammacharoen, Chatsri Deachapunya, Sutthasinee Poonyachoti

The Thai Journal of Veterinary Medicine

Flavonol quercetin (Q), found in vegetables and fruits, demonstrates the most potent anti-inflammatory effect. The preventive effect and cellular mechanisms of Q (Q1, Q10, and Q100 µM) on IL-1β induced leaky gut via the signaling molecules of inflammatory pathway, NF-κB p65-iκB/or p38/ERK1/2/MLCK/phospho(p)-MLC were investigated in Caco-2 cells. The cytotoxic effect of Q was initially determined by MTT assay. Transepithelial electrical resistance (TER) and apical-to-basolateral fluorescein isothiocyanate-labeled dextran (FD-4) flux were used to determine paracellular permeability. The protein expression of signaling molecules was examined by Western blot analysis, and their target MLCK mRNA expression was determined using real-time PCR. All Q …

A Systematic Review Of Racial Disparities In Emergency Department Pain Evaluation And Treatment In The United States, Cyrus Wolff

Theses and Graduate Projects

Background: Providers working in emergency departments (ED) must balance the need to relieve patients’ pain with the dangers of overprescribing opioids. Lack of standardization of pain evaluation and treatment may contribute to inequities in the management of pain in emergency departments. Evaluating differences in how different populations receive care in emergency departments can help to identify problems and areas where improvements need to occur.

Purpose: The purpose of this literature review is to evaluate what current research states about the prevalence and causes of racial disparities in pain evaluation and treatment in United States emergency departments and determine what gaps …

Personalized Nutrition: Tailoring Dietary Recommendations Through Genetic Insights, Saiful Singar, Ravinder Nagpal, Bahram H. Arjmandi, Neda S. Akhavan

Kinesiology and Nutrition Sciences Faculty Research

Personalized nutrition (PN) represents a transformative approach in dietary science, where individual genetic profiles guide tailored dietary recommendations, thereby optimizing health outcomes and managing chronic diseases more effectively. This review synthesizes key aspects of PN, emphasizing the genetic basis of dietary responses, contemporary research, and practical applications. We explore how individual genetic differences influence dietary metabolisms, thus underscoring the importance of nutrigenomics in developing personalized dietary guidelines. Current research in PN highlights significant gene–diet interactions that affect various conditions, including obesity and diabetes, suggesting that dietary interventions could be more precise and beneficial if they are customized to genetic profiles. …

Digital Scribes: A Possible Solution For Provider Burnout By Reducing Provider Workload, Shannon Storley

Theses and Graduate Projects

Background: Provider burnout is continuing to be a massive problem for our healthcare industry. One major contributor to provider burnout is burdensome administrative tasks associated with documentation of electronic medical records (EMR). This review aims to uncover the applications for artificially intelligent digital scribes as a solution to reduce EMR documentation burden. Purpose: Provider burnout has shown to increase the incidence of major mistakes and decreased patient safety grades. Digital scribes could be a solution in reducing provider burnout by reducing the administrative burden of EMR documentation. Methods: A comprehensive literature review was conducted using articles from PubMed using search …

Barriers Primary Care Physician Assistants Face In Referring Patients To Palliative Care Services Early In The Disease Process, Claire Petersen

Theses and Graduate Projects

Background: Medical specialties such as hospice and palliative care have been proven to improve quality of life for patients facing end-of-life and chronic illness. Though increasing awareness of these specialties has resulted in greater availability, it is essential to investigate the barriers clinicians, such as Physician Assistants, face in making these referrals in order to provide quality healthcare to those who need it. Physician Assistants specifically are an essential clinician group to evaluate, as they continue to become more prevalent in the healthcare system.

Purpose: To determine barriers primary care Physician Assistants face when identifying candidates for and referring to …

Central Tracking And Billing System For Insurance Bills, Kehinde Alabi

Harrisburg University Dissertations and Theses

In this article, we introduce a new centralized billing platform designed for insurance bills including auto insurance, health insurance, home insurance, life insurance, etc. This system consolidates all bills for individual users eliminating the need for them to manage and pay bills separately. Users stand to benefit from significant time and effort savings each month, reducing the likelihood of missed payments and associated late fees. Insurance billing organizations and banks can also capitalize on timely payments and reduced physical mailings, leading to cost savings and environmental benefits. The proposed system offers users the ability to track and review their historical …

Foundational Patient Experience: Analyzing 10 Years Of Patient Experience Research, Geoffrey A. Silvera Phd, Mha, Courtney Haun Phd, Mph, Varun Natarajan

Patient Experience Journal

In this study, we seek to provide a critical examination of the field of Patient Experience (PX) by using citation analysis to determine the foundational keystones of the PX knowledge base. This study will employ a systematic citation analysis to evaluate the articles published in the Patient Experience Journal (PXJ), focusing on citation frequency as evidence of impact on the field. To achieve this, we examine the entire corpus of article citations published in the PXJ from 2014–2023 (Volumes 1–10). By examining a corpus consisting of 515 independent articles (N=515) that include over 12,000 references (n=12,712) over the course of …

Accompanying People Affected By Cancer In Their Return To Life After Treatment: A Report On An Experiment Conducted In Canada, Christine Arsenault, Saskia Hazout, John Calogerinis, Françoise Poirier, Louise Normandin, Cécile Vialaron, Monica Iliescu Nelea, Marie-Pascale Pomey

Patient Experience Journal

This study aims to assess family doctors' perceived needs for improved patient follow-up post-acute treatment in oncology departments, specifically focusing on the Patient Oriented Discharge Summary (PODS) for individuals living with cancer. A cross-sectional quantitative survey targeted family doctors, and a before/after exploratory study was conducted with patients to measure their needs pre- and post-PODS implementation. Twenty-one out of 42 family doctors participated in the survey (50%). Patient data was collected at three points in time: prior to PODS implementation (T1, n = 20/30; 77%), one month later (T2, n = 20/26; 77%), and six months later (T3, n = …

Investigating The Perceived Impact Of Surgeons' Burnout On Surgical Physician Associates' Wellness In United States Ambulatory Surgery Centers, Rhionna J. Smith, Lihua Dishman, John W. Fick, Kathleen M. Thomas

Patient Experience Journal

Surgeons are the de facto leaders of surgical teams with surgical physician associates (SPAs) as integral members who function in all areas of the peri-operative environment. Surgeons often supervise SPAs. Ambulatory surgery centers (ASCs) provide patients with same-day diagnostic and preventive procedures as more convenient alternatives to hospital-based outpatient procedures. This qualitative, national, and cross-sectional study explored the perceived impact of surgeons' burnout on SPAs' wellness in U.S. ASCs during global health crises. Primary demographic and qualitative data were collected using a self-developed, three-section survey instrument: (1) information regarding informed consent; (2) 10 short demographic questions; and (3) two open-ended …

Is Timing Everything?: The Role Of Time On The Relationship Between Patient-Centered Communication And Provider Empathy, Shanequa S. Roscoe-Nelson, Geoffrey A. Silvera Phd, Mha

Patient Experience Journal

Several studies have indicated that providers that successfully implement patient-centered communication (PCC) practices related to health literacy and exemplify higher levels of empathy improve patient health outcomes. Time is frequently noted as a barrier when implementing PCC practices. The purpose of this study was to examine the role of time on the relationship between PCC and provider empathy. A cross-sectional study design was employed utilizing data from the 2019 Medical Expenditure Panel Survey-Household Component (MEPS-HC) and a supplemental survey, Self-Administered Questionnaire (SAQ), including a total of 6,459 patient respondents (N = 6,459). Structural Equation Modeling (SEM) was utilized for the …

Primary Care Productivity And Patient Satisfaction Community Practice: What Is The Relationship?, Thomas G. Howell Jr.

Patient Experience Journal

Research has shown a consistent positive association between patient and provider experience and improved patient outcomes and safety. There is a belief that patient satisfaction and physician productivity are competing interests. The relationship for primary care physicians, in a Midwest Health system was evaluated as part of this project. Data from Press Ganey patient satisfaction surveys on likelihood of recommending the practice and the physician were compared between primary care physicians in the top quartile of average monthly patient visits and those that were in the three lower quartiles. A secondary analysis of patient satisfaction scores related to continuous years …

The Perceived Usefulness Of Patient Narrative Feedback In Primary Care Settings, Sasmira Matta, Yuna S.H. Lee, Rachel Grob, Mark Schlesinger, Ingrid Nembhard

Patient Experience Journal

Research suggests that insights from patient narratives – stories about care experiences in patients' own words – contain information that can be used to improve care. However, assessments of narratives reported by clinical personnel have been mixed. This is the first study, to our knowledge, to systematically measure how useful personnel in primary care perceive patient narratives to be. We surveyed 276 clinical and administrative personnel in nine primary care clinics in a large health system in the United States. We found that perceived usefulness of patient narratives is generally high, but varies by individual characteristics such as level of …

A Commitment To Experience Must Reach Across The Continuum Of Care, Jason A. Wolf Phd

Patient Experience Journal

A conversation on patient experience is not restricted to one care setting, nor should it be. People's healthcare journeys are not singular instances, but most often a series of encounters that while perhaps separate operationally from the delivery side of care, all weave together to frame one experience for a patient, their family members and care partners. This special issue purposefully takes us outside the traditional conversation space for experience, looking at segments of the care continuum including primary care, ambulatory care, free clinics and even dental care and the use of non-traditional care methods such as telehealth and app-based …

08-08-2024 Hsc Committee Minutes, Helen Maestas

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

08-08-2024 HSC Committee Minutes

Health For All: Evaluating The Impact Of Equity-Centered Approaches On U.S. Healthcare Delivery, A Review Of Literature, Angela Leung

Master's Projects and Capstones

This literature review examines the impact of equity-centered approaches on issues affecting U.S. healthcare delivery—multiple databases to identify relevant literature that discussed equity-centered care, associated health disparities, and implementation strategies. Of the 490 search results, ten articles remained after refining the search results to include papers published between 2014-2024 and fit the specific inclusion and exclusion criteria. The key findings highlight the benefits of equity-centered approaches in improving the quality and accessibility issues affecting the U.S. healthcare system. Presently, the status of equity work is siloed between healthcare systems in the U.S., creating an unprecedented roadblock. Nonetheless, the findings suggest …

Decreasing Incivility And Bullying Through The Development Of A Healthy, Respectful Work Culture, Bridgette Wilson

Master's Projects and Capstones

Abstract

Problem: Incidents of bullying and incivility, including verbal aggression and exclusionary practices within the Telemetry department.

Context: This quality improvement project addresses workplace incivility, bullying, and harassment. The project aims to develop and implement a Compact Agreement of Unit Norms to foster a healthier work environment.

Interventions: Interventions included leadership education on bullying and conflict resolution, team awareness was heightened through workshops defining bullying and incivility, and a collaborative Compact Agreement of Unit Norms was developed and implemented.

Measures: An analysis of reported incidents for the first quarter of 2024 through the Electronic Reposting System (ERRF) on the Telemetry …

Post Anesthesia Care Unit Comprehension Safety Program Quality Improvement Project On De-Escalation Of Patients, Mary M. Gaukler Giannavola, Basil George Verghese, Deborah Maier

Advances in Clinical Medical Research and Healthcare Delivery

Background:

Violence within the healthcare setting has risen significantly, and has crossed into areas where staff are less prepared to manage and deescalate challenging patient encounters. This lack of preparedness and confidence has led to increased staff stress, burn out, and can potentiate poor patient outcomes.

Methods:

A pre/post-simulation quality improvement project was performed within a tertiary hospital Post-Anesthesia Care Unit in Upstate New York to evaluate the effect of simulation on feelings of confidence and preparedness in patient de-escalation with PACU nurses and patient care technicians. The project evaluation included the Thackrey’s Clinician Confidence in Coping with Patient Aggression …

Improving Utilization Of Interqual Among Case Managers/Patient Care Coordinators At Santa Clara Medical Center, Czar Binuya Viesca

Master's Projects and Capstones

Problem: The utilization management department at Santa Clara Medical Center had low compliance with InterQual criteria, at 35%. This resulted in inconsistent care decisions, poor resource allocation, and regulatory penalties, affecting patient care and performance.

Context: The project aimed to enhance InterQual utilization, aligning with Santa Clara Medical Center's goals of evidence-based, patient-centered care. The initiative was guided by Jesuit values and ANA ethical standards, focusing on service, justice, excellence, patient advocacy, and professional responsibility.

Interventions: The project implemented three main interventions: comprehensive training programs, regular audits, and performance recognition. These interventions aimed to address gaps and ensure the …

Utilizing The 4ms Framework To Create A Structure And Process To Support Voluntary Health Assessments In Affordable Housing, Elyse Perweiler, Jennifer Degennaro, Sherry Pomerantz, Marilyn Mock, Margaret Avallone, Aaron Truchil, Stephen Singer

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: A growing number of older adults live in senior affordable housing, many with limited support systems and representing underserved or disadvantaged populations. Staff in these buildings are in a unique position to identify and address the healthcare and biopsychosocial needs of their residents and link them to services and supports.

METHODS: Staff in four affordable housing sites received training on the 4Ms approach to caring for older adults and conducting resident health assessments. They learned to collect comprehensive health information using a 4Ms Resident Health Risk Assessment (4Ms-RHRA) and results are entered into a customized electronic database. Embedded flags …

Sustainable Waste-To-Bioproducts Engineering Center Laboratory Safety Project, Claudine Mock

All Graduate Reports and Creative Projects, Fall 2023 to Present

Laboratory accidents are common in teaching and research labs; these accidents can be injurious or even fatal. The consequences of each type of laboratory accident are different based on the activities performed and the hazardous materials used in each facility. However, the most common issue related to laboratory accidents is the lack of proper safety measures (e.g., poor handling of hazardous materials, not reporting incidents immediately, etc.). This project aimed to establish and strengthen best practices and procedures to ensure laboratory safety at the Utah State University Sustainable Waste-to-Bioproducts Engineering Center. To achieve this goal, different practices and measures were …