Medicine and Health Sciences Commons^™

Sedation Minimization And Early Mobility To Prevent Intensive Care Unit Delirium, Alana M. Kugelard

Lynchburg Journal of Medical Science

The purpose of this paper is to synthesize current evidence on sedation minimization, early mobility, and multicomponent care bundles for the prevention of intensive care unit (ICU) delirium in critically ill adults. ICU delirium is a common and serious complication associated with increased mortality, prolonged mechanical ventilation, extended ICU and hospital length of stay, and long-term cognitive impairment, making it a significant safety and quality-of-care concern. A literature review was conducted using PubMed and the Cochrane Library, with search terms including “ICU delirium,” “sedation minimization,” “light sedation,” “early mobilization,” and “ABCDEF bundle.” Filters included adult populations, peer-reviewed studies, randomized controlled …

Key Drivers Of Revisit Intention In Dental And Oral Teaching Hospital, Mega Denada Aldila, Wahyu Sulistiadi

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Digital transformation in dental and oral teaching hospitals demands strategies that not only ensure clinical quality but also sustain patient loyalty. This study examines the effects of digital storytelling and service quality on outpatient revisit intention at the Dental and Oral Hospital of Universitas Jenderal Soedirman (RSGMP Unsoed), with brand image and patient satisfaction as mediating variables. A quantitative cross-sectional design was applied to 115 outpatients aged ≥18 years who had completed one full episode of dental treatment. After exposure to a standardized digital storytelling video about RSGMP Unsoed, respondents completed a structured Likert-scale questionnaire. Data were analyzed using Partial …

Kepuasan Pasien Terhadap Pelayanan Di Rumah Sakit Pemerintah Dan Rumah Sakit Swasta: Tinjauan Literatur, Bahar Syah, Mardiati Nadjib

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Patient satisfaction is an important indicator for assessing the quality and performance of hospital services as it reflects patients’ experiences through the healthcare delivery process; this study explore how patient satisfaction toward hospital services in public and private hospitals by analyzing 23 selected scientific articles published between 2015 and 2024 and gathered from ProQuest, Scopus, PubMed, and ScienceDirect databases from an initial total of 176 articles founded based on inclusion and exclusion criteria, and the findings indicate that service quality has a significant impact toward patient satisfaction in both types of hospitals, with private hospitals generally demonstrating higher satisfaction levels …

Evaluasi Penerapan Rekam Medis Elektronik Terhadap Kinerja Perawat Di Unit Rawat Inap Rs Grha Permata Ibu Kota Depok Tahun 2025, Ratna Dian Andriani, Dicky Yulius Pangkey, Ahdun Trigono

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Electronic Medical Records (EMR) adoption aims to improve documentation efficiency and nurses’ performance; however, system instability and limited continuous training remain obstacles. This study examined the effects of EMR features and functionality, technical support and training, and users’ perceptions and attitudes on nurses’ performance at Grha Permata Ibu Hospital. This study employed an analytic observational design with a cross-sectional approach, using a quantitative survey conducted among 74 inpatient nurses through a Likert-scale questionnaire. Descriptive analysis, Spearman correlations, and multiple linear regression were employed. Results indicate that features and functionality (X1) have a strong positive association with performance (p = 0.652; …

Efektivitas Implementasi Raspro Terhadap Pola Resistensi Dan Biaya Antibiotik Di Rsud Kabupaten Bekasi, Irmawati Hasan, Helen Andriani

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The increasing use of antibiotics over recent decades has significantly affected global public health, primarily through the emergence of antimicrobial resistance (AMR), which contributes to higher morbidity, mortality, and economic burden. As a regional referral hospital, Bekasi Regency General Hospital faces substantial challenges related to high resistance rates, with multidrug-resistant organisms (MDROs) showing MRSA at 22.22% and ESBL at 40% in 2024. This study evaluated the implementation of the Prospective System Antimicrobial Regulation Program (RASPRO) in relation to resistance patterns, antibiotic cost efficiency, and supporting roles of governance, human resources, and monitoring systems. A quantitative prospective cohort design was applied, …

Kualitas Hidup Pasien Penyakit Gagal Ginjal Kronik Dan Kepuasan Pelayanan Di Unit Hemodialisis Rumah Sakit Alia Depok: Studi Mixed-Methods, Bimo Kusumo, Vetty Yulianty Permanasari

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The prevalence of chronic kidney disease (CKD) in Indonesia remains a high-incidence condition and most of it underwent hemodialysis in Hospital. This study aims to analyze the quality of life of patients with chronic kidney disease and satisfaction with services in the hemodialysis unit. This study is a mixed-methods study with a quantitative study using the World Health Organization Quality of Life (WHOQOL-BREF) and Service Quality (SERVQUAL) questionnaires, and a qualitative study with in-depth interviews related to hospital services from both service providers (healthcare professionals) and service recipients (patients). The study found predominantly moderate scores on the WHOQOL-BREF and poor …

Persepsi Dokter Terhadap Kompetensi Perawat Di Rsud Siti Aisyah Lubuklinggau: Analisis Domain Komunikasi, Profesionalisme, Dan Kolaborasi Tim, Novita Purnamasari, Wiku Bakti Bawono Adisasmito

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

This study analyzes doctors' perceptions of nurses' competencies at Siti Aisyah Regional Hospital in Lubuklinggau across three domains: communication, professionalism, and team collaboration. Doctors' perceptions are important for supporting interprofessional collaboration, quality of patient care, and patient outcomes. The study results are expected to identify competency gaps and provide an evidence-based foundation for developing measurable and effective nurse training programs. The study used a quantitative descriptive design with a cross-sectional approach, with a sample of 24 doctors who evaluated nurses' overall competencies in their work units. Data were collected through a structured questionnaire containing 11 Likert-scale items and were analyzed …

Practical Implementation Of An Osteoarthritis Treatment Program In A Radiation Oncology Center Within Md Anderson’S Cancer Network, Aaron Shaykevich, Adam Grippin, Warren Floyd, Brady Cripe, Alexander Augustyn, Shalin Shah, Samantha Buszek

Advances in Cancer Education and Quality Improvement

Background: Low-dose radiation therapy (LDRT) for symptomatic osteoarthritis (OA) can add to the workload of radiation oncology services, particularly in small centers with limited capacity and staff. After we launched an OA LDRT program in December 2024, referrals grew rapidly at our rural, single-linac radiation oncology practice at UT MD Anderson’s Cancer Network Partner site (Community Health Network in Indianapolis, IN), leading to long wait times and workflow strain.

Methods: We used load leveling to reserve capacity for cancer care and make OA scheduling predictable. Five 15-minute benign consult slots were set aside each week. Patients then went on a …

From Burnout To Belonging: A Faculty Well-Being Director's Perspective On Leadership, Workplace Culture, Organizational Efficiency, And The Broader Role Of Physician Well-Being, Ajit K. Bisen

Advances in Cancer Education and Quality Improvement

Burnout remains a major challenge in health care, despite increasing investments in physician well-being initiatives. As the faculty well-being director for my department, my perspective on physician well-being has shifted from focusing primarily on individual resilience, mindfulness, and wellness initiatives to recognizing the important roles of leadership, workplace culture, and organizational efficiency. Physician well-being is an essential foundation for high-quality patient care, stronger teams, patient safety, quality improvement, and healthier organizations. Here, I discuss the 3 key shifts in thinking that have influenced my approach as faculty well-being director.

Towards Upstate Well Center: Lessons Learned In Organizational Well-Being Over The Last Decade, Nayla M. Khoury, Asalim Thabet, Kerryanna M. Elhage, Jarrod L. Bagatell, Kaushal Nanavati, Leslie J. Kohman

Advances in Cancer Education and Quality Improvement

Background: Upstate Well has evolved over more than 10 years through the integration of multiple partners, programs, and initiatives. The scope and complexity have increased alongside stronger relationships, shared ownership, and supportive infrastructure.

Methods: This report analyzes implementation lessons learned through program development and impact assessment over 5 years.

Results: Upstate has a growing number of wellness champions across the institution, collaboration among multiple wellness programs, and lessons learned from select programs. Themes include (1) supportive infrastructure, including new full-time equivalent positions to support Upstate Well; (2) active collaboration between stakeholders, and appointed wellness champions in each department; (3) improved …

From Career Alignment To Action: Strengthening Academic Mentoring Through Structured Reflection, Fanni Farago, Julie Izzo, Courtney L. Holladay, Diane C. Bodurka, Michelle Hildebrandt, Suezen Salinas

Advances in Cancer Education and Quality Improvement

Background: As faculty roles and responsibilities become increasingly complex and demanding in contemporary academic medicine, fostering and sustaining faculty well-being has emerged as a critical organizational priority. In response to this need, this brief report describes early insights from the first year of implementation of the Academic Mentoring Program (AMP), a formal and expanding faculty mentoring initiative at UT MD Anderson. Our findings highlight the potential value of incorporating a structured career development assessment (CDA) tool into the mentee intake and engagement effort, evaluating development alignment, professional activities, and organizational expectations.

Methods: We conducted descriptive statistical analysis and qualitative thematic …

Feasibility And Pilot Study Of Implementing Mindfulness-Based Attention Training In A Pediatric Health Care Setting, Thomas B. Ayres, Seth Sonnevile, Angela Myers

Advances in Cancer Education and Quality Improvement

We present herein our preliminary evidence from a pilot study of the feasibility of implementing Mindfulness-Based Attention Training (MBAT) in a pediatric health care institution. MBAT has been implemented primarily in military settings, representing another high-stress work environment. Furthermore, MBAT has had favorable evaluations from being implemented with medical students. Mindfulness-based interventions have received increasing attention in health care environments. This interest from health care institutions and the focus on developing attention-based resources through MBAT created a use case for implementing MBAT. We had 5 health care workers with a variety of job roles in our institution complete a train-the-trainer …

Pebbles In The Shoe: A Multidisciplinary Program To Identify And Resolve Workplace Inefficiencies In A Pediatric Oncology Division, Reeja Raj, Kate Gazouleas, Pavilia Francis, Nancy Gordon, Vidya Gopalakrishnan, Amy Heaton, Ishwaria Subbiah, Priti Tewari, Harjeet Singh, Aaron Walton, Shehla Razvi, Martha Askins, Lisa Triche, Karen Moody

Advances in Cancer Education and Quality Improvement

Introduction: Occupational burnout is a significant concern among pediatric oncology faculty and multidisciplinary staff, characterized by emotional depletion, detachment from work, or a diminished sense of professional achievement. Inefficient work processes can be important contributors to burnout. This report describes the implementation and outcomes of Pebbles in the Shoe (also referred to as Pebbles), a pediatric division–wide initiative designed to address workplace concerns and inefficiencies.

Methods: The Pebbles program was developed and led by our pediatric division's wellness task force. Division members were invited to anonymously submit work-related concerns and irritations through a QR code–accessible electronic form. Five discipline-based work …

Aligning Trainee Leave Policies Across Surgical Fellowships: Development Of A Division-Wide Framework For Leave And Program Completion, Helen M. Johnson, Mara B. Antonoff, Kelly K. Bree, Maxwell G. Lewis, Heather A. Lillemoe, Margaret S. Roubaud

Advances in Cancer Education and Quality Improvement

Background: Surgical fellows and program leaders face difficulties navigating parental, caregiver, medical, and personal leave due to variation in policies. A Division of Surgery (DoS) Trainee Leave and Parental Support Task Force was convened at The University of Texas MD Anderson Cancer Center to review existing requirements and develop a harmonized framework for trainee leave and fellowship program completion.

Methods: The Task Force conducted a comprehensive review of policies relevant to surgical fellow leave and graduation requirements, identified best practices, and drafted a DoS policy. The policy was refined iteratively through engagement with key stakeholders, including program directors, department chairs, …

Creating A Culture Of Well-Being By Removing Barriers To Participation In A Multi-Campus Cancer Center, Adam Siegman, Miranda M. Phillips, Jennifer Bickel

Advances in Cancer Education and Quality Improvement

Background: Healthcare professionals in geographically distributed cancer care settings may face barriers to accessing workforce well-being resources due to geographic distance, staffing constraints, and operational demands. Disconnect & Refresh was developed to improve access to restorative wellness opportunities across community-based cancer care sites.

Methods: Disconnect & Refresh was implemented at The University of Texas MD Anderson Cancer Center across 4 Houston area locations. The initiative included BeWell Paws, virtual reality meditation, chair yoga, and creative wellness activities delivered during the workday. Participation was voluntary and tracked through employee badge scans. Participants were invited to complete an anonymous post-event survey, and …

Faculty Growth Through Academic Career Development Committees, China Crowder, Rebekah Filson, Elizabeth Grubbs, Carin Hagberg, Anne Tsao

Advances in Cancer Education and Quality Improvement

Academic medical centers face ongoing challenges in providing structured, career -stage-–specific faculty development, mentorship, and leadership opportunities that effectively engage faculty throughout their academic careers. The Academic Career Development Committees at The University of Texas MD Anderson Cancer Center represent a structured, faculty-driven model designed to promote professional growth, mentorship, and leadership engagement across all career stages. Grounded in established principles of faculty development and mentorship in academic medicine, the Academic Career Development Committees foster cross-level collaboration, inclusive participation, and intentional skill-building. Outcomes were measured through participant evaluations, attendance and participation trends, mentorship engagement indicators, and qualitative feedback gathered from …

Leadforward: A Department-Based Leadership Development Program To Support Workforce Well-Being, Leisa A. Bryant, Denise Marshall, Loreal Williams, Miranda M. Phillips

Advances in Cancer Education and Quality Improvement

Introduction: Leadership development is increasingly recognized as an important strategy for supporting workforce engagement, professional growth, and succession planning in healthcare settings. To address leadership development needs within Food, Nutrition, and Patient Transportation (FNPT) departments, a structured leadership development program, LeadForward, was developed for emerging and midlevel leaders.

Project Description: LeadForward was implemented within the FNPT departments at a comprehensive cancer center. Ten participants completed the inaugural cohort. The curriculum was organized into 6 instructional modules designed to develop leadership competencies among emerging and midlevel leaders. Leadership outcomes were assessed using pre- and postprogram self-assessments across 14 leadership competency …

Standardized Preprocedure Protocolling Of Stereotactic Breast Biopsies Enables Device-Level Supply Chain Forecasting: A Multisite Quality Improvement Analysis, Megan Kalambo, Mike Everding, Maria Montemayor, Falguni Patel, Mohit Nath

Advances in Cancer Education and Quality Improvement

Background: Breast imaging depends on single-use, vendor-proprietary consumables produced by a concentrated set of manufacturers. During supply shortages in 2026, healthcare organizations faced urgent pressure to shift from reactive to proactive inventory management. Stereotactic breast biopsy needle shortages revealed that traditional forecasting based on procedure volume lacks the granularity needed for device-specific demand. We aimed to enable device-level forecasting through standardized preprocedure protocolling.

Methods: In a retrospective analysis of 1,456 stereotactic biopsies across 4 breast imaging sites (June 2025 to June 2026), compliance with a standardized electronic protocolling tool that captured lesion count and needle size (standard vs. petite) was …

Critical Daily Dose Warning Optimization In An Electronic Health Record At A Tertiary Cancer Center, Mckenzie Erwin, Sadika Eslaminejad, David Perez, Jesni Mathew

Advances in Cancer Education and Quality Improvement

Objectives: Clinical decision support is a form of health information technology utilized by electronic health records (EHRs) to reduce prescribing errors. The challenge of incorporating clinical decision support into medication workflows is balancing alert fatigue with clinical appropriateness. At our 777-bed tertiary cancer center, one form of interruptive clinical decision support is critical dose warnings that appear when the ordered dose deviates by a defined threshold from the maximum dose. Our tertiary cancer center relies on a third-party data vendor to provide maximum dose limits that are integrated into the EHR medication ordering process. At the time of project initiation, …

Implementation Of A Low-Cost Tobacco-Free Intervention In A Permanent Supportive Housing Program To Address Cancer Disparities Among People Who Have Experienced Homelessness, Ammar D. Siddiqi, Phoebe Wong, Cathy Crouch, Lorraine R. Reitzel

Advances in Cancer Education and Quality Improvement

Objectives: Permanent supportive housing residents who have experienced homelessness use tobacco products at elevated rates, contributing to higher cancer risk. Agencies that provide wraparound support services to this group are committed to rebuilding their stability by improving their health. Yet, their delivery of tobacco screening and cessation care is limited, as is information about their clients’ tobacco use behaviors. Here, we evaluated a low-cost intervention for an Albert Schweitzer Fellowship project conducted in a permanent supportive housing program with 650 adults who had experienced homelessness in Houston, Texas.

Materials and Methods: Between August 2024 and February 2025, client-facing staff members …

Evaluation Of Shortened Irinotecan Infusion Times And Adverse Effects Incidence For Gastrointestinal Medical Oncology Patients, Rachel N. Ochs, Daniel J. Donovan, Neha A. Betrabet, Wendy M. Covert

Advances in Cancer Education and Quality Improvement

Background: Irinotecan, a topoisomerase I inhibitor, is commonly used to treat gastrointestinal cancers. The infusion time of irinotecan is usually over 90 minutes; however, studies support the safety and feasibility of 30-minute infusions. A shortened infusion duration may improve patient quality of life, optimize infusion chair utilization, and reduce wait times. Faster infusion rates may increase the risk of acute cholinergic side effects, reported in up to 50% of patients (all grades). Current institutional practice in the gastrointestinal medical oncology (GIMO) clinic involves administering irinotecan over 90 minutes and using atropine as needed for reversing cholinergic symptoms. For patients who …

Unlocking Faculty Potential: A Quasi-Experimental Study Of Coaching And Academic Performance In Health Care Settings, Amanda Woods Herron, Katelyn J. Cavanaugh, Michelle Figliuolo Deveau, Courtney L. Holladay

Advances in Cancer Education and Quality Improvement

As faculty in academic medicine face mounting demands to excel in clinical care, research, teaching, and administrative responsibilities, interventions that support professional sustainability are increasingly critical. Coaching has emerged as a promising developmental strategy within health care leadership, yet its impact on research and clinical outcomes in academic medical centers remains underexplored. This quasi-experimental study evaluated the effectiveness of a coaching program using intentional change theory (ICT) as a conceptual framework. ICT emphasizes sustainable personal transformation through alignment between the ideal self and professional goals. We examined a sample of 189 coached clinical faculty and 200 matched peers who had …

Why Should A Data-Driven Cancer Center Prioritize Well-Being?, Peter Pisters

Advances in Cancer Education and Quality Improvement

No abstract provided.

The Future Of Wellness In Health Care, Jennifer Bickel

Advances in Cancer Education and Quality Improvement

No abstract provided.

Actualizing Leaders To Inspire A Group Network (Align): Feasibility And Pilot Of Implementing A Commensality Group Program For Leaders In A Pediatric Healthcare Setting, Thomas B. Ayres, Kristin Ray, Angela Myers

Advances in Cancer Education and Quality Improvement

Background: Leadership behaviors in pediatric health care settings are strongly linked to leader burnout, professional fulfillment, and self-care in addition to influencing their teams. Despite their pivotal role, leaders often face substantial emotional burdens associated with their roles. Commensality groups, defined as small, recurring gatherings centered around shared meals and structured discussions, have emerged as a promising approach to enhancing connection, community, and resilience among health care professionals. A gap in the literature regarding commensality groups is understanding the mechanism of this well-being intervention. Our hypothesis is that commensality groups act as resource caravans and provide psychosocial resources to health …

Narrative Medicine: Essays On Health And Care Vol 2, Robert B. Hackey, Will Toner, Megan Lessard, Jessica A. Smith, Glorimar De Los Santos Mejia, Jillian M. Spinali, Paige M. Daly, Brianna De La Fuente, Julia M. Renzelmann, Clare C. Diffin

Narrative Medicine: Essays on Health and Care

No abstract provided.

Editor's Note, Robert Hackey

Narrative Medicine: Essays on Health and Care

No abstract provided.

Listening To Patients, Michael Stout Md

Narrative Medicine: Essays on Health and Care

No abstract provided.

Paralyzed, Paige M. Daly

Narrative Medicine: Essays on Health and Care

This essay was written for Dr. Simal’s Intermediate Spanish for Health Professions course at Providence College, which invited students to reflect on personal experiences with healthcare. Students shared their narratives in English and Spanish to reach a broader audience and highlight the importance of empathy and listening in healthcare. About the course: Intermediate Spanish for Health Professions aims not only to develop the language skills and medical vocabulary necessary to facilitate communication between future health professionals and the Spanish-speaking communities in the United States, but also to explore the historical, cultural, and ethical dimensions of healthcare in Latin America and …

Just A Stomachache, Jillian M. Spinali

Narrative Medicine: Essays on Health and Care

This essay was written for Dr. Simal’s Intermediate Spanish for Health Professions course at Providence College, which invited students to reflect on personal experiences with healthcare. Students shared their narratives in English and Spanish to reach a broader audience and highlight the importance of empathy and listening in healthcare. About the course: Intermediate Spanish for Health Professions aims not only to develop the language skills and medical vocabulary necessary to facilitate communication between future health professionals and the Spanish-speaking communities in the United States, but also to explore the historical, cultural, and ethical dimensions of healthcare in Latin America and …