Medicine and Health Sciences Commons^™

An Integrated Model Of Palliative Care In The Emergency Department To Improve Referrals, Jennifer L. Schlatter

Doctoral Projects

Introduction: The emergency department plays a critical role in the trajectory of in-hospital patient care. The Center to Advance Palliative Care (CAPC) along with the American College of Emergency Physicians (AECP) recommend early referral to palliative care for patients with life limiting illnesses that present to the emergency department. Research demonstrates that early palliative care consultations result in patient directed goals of care, improved symptom management, decreased length of stay, and reduced direct costs for inpatient hospitalizations.

Objectives: The goal of this project was to implement evidence-based recommendations for early palliative care referrals in an adult emergency department to improve …

Improving Patient Handover From The Pediatric Emergency Department To The Pediatric Intensive Care Unit, Kathryn Devinney

Doctoral Projects

Patient safety can be at risk during registered nurse handover, particularly when transitioning between high risk areas. According to The Joint Commission (2017), a standardized transition process should be implemented during patient handover. The purpose of this paper was to evaluate the effect of a standardized process with a cognitive aid on handover between a pediatric emergency department and an intensive care unit. Objectives of the project were to decrease conversion time in the emergency department, increase standardized process utilization, and improve patient outcomes, registered nurse perception and satisfaction, and patient proxy satisfaction. This evidence-based quality improvement project took place …

Improving Heart Failure Care Plan Coordination Across The Health Care Continuum, Amy Veltkamp

Doctoral Projects

Heart failure costs the United States 31 billion dollars each year, with much of those costs attributed to hospital admissions. Coordinating care across the health care continuum is a critical factor in improving heart failure care and reducing readmissions. An organizational assessment was conducted using the Burke and Litwin Causal Model of Organizational Performance and Change. The quality improvement project implemented a longitudinal plan of care (LPOC) across 10 hospitals and numerous ambulatory care sites at a large Midwestern health organization. Nurse care managers (NCMs) were the focus of this project due to their high-level of involvement in care coordination. …

Abstracts From The 25th Annual Health Care Systems Research Network Conference, April 8–10, 2019, Portland, Oregon

Journal of Patient-Centered Research and Reviews

The Health Care Systems Research Network (HCSRN) is made up of nonprofit health systems with embedded research departments whose scientists are dedicated to public domain research. The network’s annual conference serves as a forum for research teams to disseminate study findings, stimulate new collaborations, and share insights about conducting research in real-world care settings. Abstracts accepted for presentation at HCSRN 2019 are published in this supplement of Journal of Patient-Centered Research and Reviews, the official scientific journal of the conference.

Vaccine Hesitancy In The United States And Switzerland, Anna E. Lunderberg

Independent Study Project (ISP) Collection

Vaccine hesitancy (VH), or the reluctance or refusal to participate in vaccination programs, is a complex phenomenon with far-reaching impacts on society. VH can impact vaccine uptake and facilitate subsequent outbreaks, as seen with the case of measles. Perceptions of vaccination are similar in the United States and Switzerland, and misinformation in each country contributed to VH through impaired parental risk-benefit analysis; parental analysis and subsequent VH is associated with both anti-vaccination messages gaining prominence and a decrease in the public perception of the health risk from vaccine-preventable diseases (VPDs). There are many proposed strategies for addressing VH on both …

Quality Over Quantity: A Comparative Analysis Of The Quality Measures And Performance Between Switzerland And The United States, Lexi Farina

Independent Study Project (ISP) Collection

Even in the best health systems, poor quality of care continues to cause harm to patients and prevent them from receiving the best treatment possible. Thus, it is important to record and report quality of care measures because they can help inform policy changes and improve performance. In this paper, a comparative analysis between the United States and Switzerland is conducted to understand the process for defining and assessing quality indicators in each country as well as compare their quality of care performance results. The methods for this study include a literature review of relevant background information relating to quality …

April 2019, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

National Public Health Week

Join in observing National Public Health Week from April 1-7, 2019 and become part of a growing movement to create the healthiest nation in one generation. During the week, we will celebrate the power of prevention, advocate for healthy and fair policies, share strategies for successful partnerships and champion the role of a strong public health system. Each day of NPHW 2019 will focus on a public health topic. Hoping each topic will spark new conversations and engage new participants in the community. Follow along at this link to see daily themes and ways each of …

Emergency Departments And Care For Marginalized Populations, Irvin B. Harrell

Institute for the Humanities Theses

Healthcare providers in emergency departments (EDs) face a daunting daily task: providing health care in a triage setting to a diverse group of patients many with complex medical issues. Many patients rely on ED services out of financial necessity, when their healthcare issues could be better suited for care from a primary care physician. Many of these already vulnerable patients – minorities, those health illiterate, low-income, uninsured and those with language barriers – must also deal with ED overcrowding and staffing conditions. In some cases, patients leave without being seen while others face bed shortages. This study explores healthcare provider …

04-02-19 Hsc Committee Meeting Agenda, Hsc Committee

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

No abstract provided.

04-02-19 Hsc Committee Revised Notice, Hsc Committee

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

No abstract provided.

Ecological Determinants Of Respiratory Health: Examining Associations Between Asthma Emergency Department Visits, Diesel Particulate Matter, And Public Parks And Open Space In Los Angeles, California, Jason A. Douglas, Reginald S. Archer, Serena E. Alexander

Health Sciences and Kinesiology Faculty Articles

Los Angeles County (LAC) low-income communities of color experience uneven asthma rates, evidenced by asthma emergency department visits (AEDV). This has partly been attributed to inequitable exposure to diesel particulate matter (DPM). Promisingly, public parks and open space (PPOS) contribute to DPM mitigation. However, low-income communities of color with limited access to PPOS may be deprived of associated public health benefits. Therefore, this novel study investigates the AEDV, DPM, PPOS nexus to address this public health dilemma and inform public policy in at-risk communities. Optimized Hotspot Analysis was used to examine geographic clustering of AEDVs, DPM, and PPOS at the …

What's Happening: March 25, 2019, Maine Medical Center

What's Happening

No abstract provided.

04-02-19 Hsc Committee Meeting Notice, Hsc Committtee

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

No abstract provided.

Great Save! Old Chapel Pews Find New Homes, Children's Mercy Hospital

Our Story Continues

Discusses the preservation of historical artifacts from Children's Mercy Hospital in Kansas City, specifically the restoration of three chapel pews circa 1917 that have new homes in the hospital's marketing and fund-raising departments, and in the new Children's Research Institute building.

What's Happening: March 18, 2019, Maine Medical Center

What's Happening

No abstract provided.

02-05-19 Hsc Committee Meeting Minutes, Hsc Committee

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

No abstract provided.

Physicians’ Knowledge And Beliefs Regarding Athletic Trainers, Joseph H. Vogler, Lindsey E. Eberman, Zachary K. Winkelmann, M. Seth Smith, James L. Turner, Kenneth E. Games

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

Purpose: The relationship between athletic trainers (ATs) and physicians is a legal obligation and collaboration to improve patient outcomes. The objective of this study was to examine the knowledge of physicians regarding the educational preparation, legal obligations, and scope of practice for ATs and how it relates to previous experiences with ATs. Additionally physicians’ perceptions of Interprofessional Collaboration (IPC) were studied. Methods: 169 physicians medical doctors (MD)=133/169, 78.7%, doctor of osteopathy (DO)=36/169, 21%) completed a 36-question web-based survey, which included a validated IPC scale. Results: Respondents with experience working with an AT scored significantly higher (P < 0.01) on the knowledge assessment, where physicians currently working with an AT scored higher (5.4/8) than those who previously worked with an AT (4.2/8) and those who had never worked with an AT (3.3/8). Additionally, physicians with previous exposure to an AT as an athlete had significantly higher knowledge scores than those without exposure (P < 0.01). Two areas of weakness in IPC from the physician’s perspective included sharing of important information (2.48/4) and importance of work as compared to others on the team (2.38/4). Conclusions: Physicians who have a current working relationship with an AT and those that had access to an AT as an athlete demonstrated significantly higher knowledge about an AT’s academic preparation, legal obligations, and scope of practice. Moreover, physicians currently working with an AT report positive interprofessional collaborations.

What's Happening: March 11, 2019, Maine Medical Center

What's Happening

No abstract provided.

Medicaid Work Requirements: State-Based Innovation Or Punitive Policymaking?, Diane Sherwin

Honors Program: Senior Projects (Public)

In March 2017, officials appointed to the Center for Medicare and Medicaid Services by President Donald Trump signaled to state governments their intent to support states who would choose to utilize Medicaid’s Section 1115 waiver provision to alter their state’s Medicaid program by introducing a work requirement. As of October 1, 2018, 13 states have heeded this signal and proposed a work requirement component for their Medicaid programs. The purpose of this paper is to determine if Medicaid work requirements are an innovative policy approach to improve independence among Medicaid enrollees, or if these requirements are a punitive, partisan approach …

Managing Healthcare Data Assets As A Complex Adaptive System, Katie Clifton

Systems Science Friday Noon Seminar Series

A major project is underway to develop a shared platform for data and analytics in a highly federated healthcare delivery organization. In the status quo data environment, analysts have integrated information from various domains — medical records, claims, membership — to produce a multitude of reports and analysis. Duplicative, mis-aligned, and siloed datasets were created as an unintended consequence.

One objective of the project is to produce outcomes (reports, analysis) that are more standardized and efficient than the status quo without sacrificing adaptability. Standards and practices are being intentionally developed as a mechanism for this emerging system to achieve more …

What's Happening: March 4, 2019, Maine Medical Center

What's Happening

No abstract provided.

Estimating Variations In Metabolic Cost Within The Stride Cycle During Level And Uphill Walking, Arash Mohammadzadeh Gonabadi

UNO Student Research and Creative Activity Fair

Indirect calorimetry provides the average cost of a stride cycle and prevents from identifying which part of the gait cycle causes increased metabolic cost in patients, however, recent simulation methods allow estimating the time profile of metabolic cost within the stride cycle. In this study, we compare the estimations of the time profile of the metabolic cost of two simulation methods for level and uphill walking. We used kinematic, kinetic and electromyography data from level and uphill walking (one participant) to estimate the time profiles of metabolic cost using the muscle-level metabolic model of Umberger using electromyography and kinematic data …

Potential Savings From Consumer-Driven Health Plans, Jessica Mcnair, Brittany White, Christopher Miller, William Ferguson, Alberto Coustasse

Management Faculty Research

Consumer Driven Health Plans (CDHPs) have been identified as a high-deductible insurance option that has increased consumer responsibility while health care expenditures have decreased. Anticipated savings through the use of CDHPs have drawn increased interest of employers and policymakers. The increased need to control healthcare costs as well as healthcare utilization have also fostered the development of increased use of CDHPs. As the use of CDHPs have expanded, educated consumers have become more engaged in their healthcare services and have increased demands for transparency of healthcare costs. Healthcare costs, utilization, and moral hazard of this study are further discussed.

Implications Of Upcoding On Medicare, Katrina Cremeans, Samantha Marcum, Carli Followay, Jessica Oldaker, Alberto Coustasse

Management Faculty Research

The complexity of and amount of funds involved in Medicare has led to a significant increase in the incidence of Medicare fraud. A type of Medicare fraud, upcoding, has contributed to excessive and unnecessary health care spending. Upcoding has been an illegal strategy that some providers have used to increase their Medicare reimbursement for certain conditions. This is accomplished by coding a provided service as a more expensive service than what was actually performed. With the proliferation of upcoding, there has been an astonishing $12.5 billion in fraudulent Medicare charges since 2007. The fraudulent strategy of upcoding to increase Medicare …

The Use Of Big Data By Managed Care Organizations, Bojing Wang, Xiaoying Liu, Alberto Coustasse

Management Faculty Research

Big data have become available in all kinds of healthcare organizations. The application of big data analytics in Managed Care Organizations (MCOs) has the potential to improve health care, lower costs, save lives, and help to make better-informed decisions. The study illustrated the implication of big data in MCOs. Big data can help MCOs reduce patients’ relevance, analyze specific diseases such as asthma and diabetes. Big data also could help MCOs to reduce cost after collecting data and determined the specific patients’ situation. The implication of big data has benefited MCOs in reducing costs, improving the quality of healthcare care. …

03-05-2019 Hsc Committee Agenda, Hsc Committee

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

No abstract provided.

March 2019, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

The Bulldog Wellness Committee has 1 standing desk available to be loaned out for a 4 month trial basis. The desk has a two-tiered design with separate keyboard/mouse deck and a spring-assisted lift mechanism that allows for easy access when either sitting or standing. Contact Christina Darras at (580) 774-3159 or email [email protected] to reserve your desk today.

Analisa Pengelolaan Kebutuhan Logistik Farmasi Pada Instalasi Farmasi Rs Mbsd Periode Juli 2017- Juni 2018analisa Pengelolaan Kebutuhan Logistik Farmasi Pada Instalasi Farmasi Rs Mbsd Periode Juli 2017- Juni 2018analisa Pengelolaan Kebutuhan Logistik Farmasi Pada Instalasi Farmasi Rs Mbsd Periode Juli 2017- Juni 2018, Suherman Suherman, Atik Nurwahyuni

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

There is still a vacuum in the availability of medicines on a monthly basis, raising questions about how to manage pharmaceutical logistics in MBSD Hospital Pharmacy Installation. The purpose of this research is to find out how the logistics management system of drug supplies and various problems that occur at each stage of implementation in the MBSD Hospital Pharmacy Installation. This research uses descriptive and analytical methods that are quantitative and qualitative by conducting in-depth interviews, document review, and calculation of ABC drug classifications to then calculate the Economic Order Quantity value and Re Order Point time on drugs classified …

Kajian Kebutuhan Pengembangan Rumah Sakit Pemerintah Daerah Kelas B Di Provinsi Sulawesi Utara, Puput Oktamianti

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The existence of regulations regarding regional referrals established by the central government, encourages the North Sulawesi regional government to provide regional referral hospitals that have service capabilities as class B hospitals. For the development of North Sulawesi Provincial Hospital in the future, basic information on services, facilities, facilities and infrastructure, as well as market coverage that depends on system governance, HR capabilities, physical buildings and equipment and resources. The purpose of this study is to examine the service needs of North Sulawesi Provincial Hospital which includes demographic studies, socio-economic studies, studies of morbidity and mortality, study of policies and regulations, …

Penerapan Metode Abc Indeks Kritis Dalam Pengelolaan Persediaan Obat Di Instalasi Farmasi Rumah Sakit Xyz Pekanbaru, Riau Tahun 2018, Monika Noviera Susanto, Vetty Yulianty Permanasari

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The process of making the XYZ Hospital formulary by the Therapy Pharmacy Team (TFT) has not considered the critical level of a medicine for patients. The failure to carry out the assessment has caused an unplanned purchase of the medicine that needed immediately and affecting patient safety. The ABC method can identify drugs that must always be available and worth a large investment. There is no cost control of drug supplies at XYZ Hospital because data on the value of investment in drugs have not been analyzed. This study uses a qualitative research design by applying the ABC index critical …