Health and Medical Administration Commons^™

Standardized Reporting In Pancreatic Protocol Ct: Implementation Across 3 Community Hospitals, Jacob L. Miller, Kevin Carr, James Banks, Nisha Mani

Radiology

No abstract provided.

Improving Team-Based Decision Making Using Data Analytics And Informatics: Protocol For A Collaborative Decision Support Design, Don Roosan, Anandi Law, Mazharul Karim, Moom Roosan

Pharmacy Faculty Articles and Research

Background: According to the September 2015 Institute of Medicine report, Improving Diagnosis in Health Care, each of us is likely to experience one diagnostic error in our lifetime, often with devastating consequences. Traditionally, diagnostic decision making has been the sole responsibility of an individual clinician. However, diagnosis involves an interaction among interprofessional team members with different training, skills, cultures, knowledge, and backgrounds. Moreover, diagnostic error is prevalent in the interruption-prone environment, such as the emergency department, where the loss of information may hinder a correct diagnosis.

Objective: The overall purpose of this protocol is to improve team-based diagnostic …

Is It Fair To Compare? A Patient And Family Experience Of Two Healthcare Systems And Neurosurgical Teams Within A Two-Week Period, Laura Miller Cpxp

Patient Experience Journal

As the mother of a 28-year-old son with cerebral palsy and hydrocephalus, and as a healthcare consultant focused on patient experience and professional development, I have a unique perspective and skill set. Recently he experienced symptoms that included an excruciating headache, neck pain and lethargy. Fearing his ventriculoperitoneal shunt had malfunctioned, he went to the emergency room and was later admitted on the neuro inpatient floor for a three-day hospitalization. His original shunt had been placed in 1991, and he never had an issue with until August 2018. While in the hospital, he was informed that he was no longer …

Measuring Patients’ Perceptions Of Health Care Encounters: Examining The Factor Structure Of The Revised Patient Perception Of Patient-Centeredness (Pppc-R) Questionnaire, Bridget L. Ryan, Judith Belle Brown, Paul F. Tremblay, Moira Stewart

Journal of Patient-Centered Research and Reviews

Purpose: Given the ongoing desire to make health care more patient-centered and growing evidence supporting the provision of patient-centered care, it is important to have valid tools for measuring patient-centered care. The patient-centered clinical method (PCCM) is a conceptual framework for providing patient-centered care. A revision to the PCCM framework led to a corresponding need to enhance the Patient Perception of Patient-Centeredness (PPPC) questionnaire. The original PPPC was aligned with the components of the PCCM conceptual framework and developed to measure patient-centeredness from the patient’s perspective. The purpose of this study was to examine the factor structure of a revised …

Public Health Policy: An Ethical Analysis Of Quarantine, Dina Alqahtani

Electronic Theses and Dissertations

As a public health measure quarantine has both historical and contemporary significance both in the United States and abroad. On the surface it represents a low-cost, low-tech way in which the spread of disease can be mitigated as its core requirement is that those who may have been exposed to an infectious agent are kept away from those who have not been exposed to that agent for enough time to determine whether or not infection has been spread. This has been utilized for centuries with both limited questions and scattered, inconsistent, or impossible to achieve oversight and goals. In understanding …

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.

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 …

How To Translate Self-Management Support Tools Into Clinical Practice, Matthew J. Simpson, Jeanette M. Daly, Douglas H. Fernald, John M. Westfall, Leann C. Michaels, Barcey T. Levy, David L. Hahn, Lyle J. Fagnan, Donald E. Nease Jr.

Journal of Patient-Centered Research and Reviews

Purpose: Patient self-management is an inevitable part of the work of being a patient, and self-management support (SMS) has become increasingly important in chronic disease management. However, the majority of SMS resources available in the Agency for Healthcare Research and Quality SMS Resource Library were developed without explicit collaboration between clinicians and patients.

Methods: Translation of SMS tools derived from the library into primary care practices occurred utilizing boot camp translation in four different practice-based research networks (PBRNs). The typical model of boot camp translation was adapted for the purpose of the Implementing Networks’ Self-management Tools Through Engaging Patients and …

Efficacy Of Smart Infusion Pumps From A Nursing Perspective, Kassi B. Zaborowski

Applied Research Projects

In today’s healthcare, intravenous (IV) therapy-related errors have become rampant and are responsible for a substantial portion of hospital injuries and deaths. In the last decade, however, since the development and implementation of “smart” IV pumps, a significant number of these IV medication errors have allegedly been reduced. The purpose of this paper is to discuss research surrounding an evaluation of the efficacy of smart IV pumps from a nursing perspective.

The Hospital Antimicrobial Use Process: From Beginning To End, William R. Truong, Jason Yamaki

Pharmacy Faculty Articles and Research

Hospital antimicrobial stewardship (AMS) programs are responsible for ensuring that all antimicrobials are utilized in the most appropriate and safe manner to improve patient outcomes, prevent adverse drug reactions, and prevent the development of antimicrobial resistance. This Perspectives article outlines the hospital antimicrobial use process (AUP), the foundational system that ensures that all antimicrobials are utilized in the most appropriate and safe manner. The AUP consists of the following steps: antimicrobial ordering, order verification, preparation and delivery, administration, monitoring, and discharge prescribing. AMS programs should determine how each step contributes to how an antimicrobial is used appropriately or inappropriately at …

A Multi-Faceted Intervention To Improve Naloxone Co-Prescription Rates Among Primary Care Providers, Jolane S. Conklin

Evidence-Based Practice Project Reports

It is estimated that 91 Americans die every day due to opioid overdoses, with at least half of those overdoses involving an opioid prescription (CDC, 2016d). To address this issue, the U.S. Department of Health and Human Services (USDHHS) has initiated an opioid initiative, and the Centers for Disease Control and Prevention (CDC) has released a clinical guideline, both of which include a focus on increasing use of naloxone. Despite these recommendations, providers often fail to co-prescribe naloxone to patients at increased risk of opioid overdose. The purpose of this evidence-based practice (EBP) project was to evaluate the effect of …

The Effectiveness Of Interventions And Bundles For Central Line-Associated Bloodstream Infections In The Neonatal Intensive Care Unit, Mohamad Alhamwi

Honors Undergraduate Theses

Introduction: Central Line-Associated Bloodstream Infections (CLABSIs) are a major cause of increased mortality, morbidity and healthcare costs in neonatal intensive care units (NICUs) patients. Despite CDC's efforts to reduce infection rates, patients often suffer consequences. The objective of this study is to perform a systematic review of strategies utilized in the neonatal population and evaluate them with the current CDC's guidelines to assess the effectiveness of bundles in preventing CLABSI in NICUs.

Methods: A systematic literature search was conducted using CINAHL Plus with Text, Cochrane Database of Systematic Reviews and MEDLINE from January 2008 up to 2018. There were multiple …

Implementing Lean Daily Management System To Improve Cvor First Case On-Time Starts, Haley Borchers, Kelly Fehlhafer, Barbara Mueller, Jessica Nichols, Sarah Talken, Mary Hunter, Kenneth Sam

Posters

No abstract provided.

Improving Type And Screen Specimen Collection Prior To Elective Surgery, Nordx Blood Bank Staff, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman

MaineHealth Maine Medical Center

To avoid delays in the availability of compatible blood for elective surgery patients requiring transfusion, a type and screen specimen should be completed at least 24 hours prior to surgery. Baseline metrics in an acute care inpatient blood bank demonstrated a significant number of cases with no type or screen completed.

The objective of this KPI was to prevent any delays in providing compatible blood products to scheduled surgical patients. Several internal and external system issues were identified as a result of a root cause analysis and a number of actions were initiated.

Outcomes have been positive. Data collection post …

Associations Between Modifiable Health-Risk Behaviors And Personality Types, Jon C. Schommer, Paul D. Tieger, Anthony W. Olson, Lawrence M. Brown

Pharmacy Faculty Articles and Research

Objectives: The first objective for this study was to explore if characteristics of personality type (using the Preferred Communication Style Questionnaire) are associated with the following modifiable health-risk behaviors: smoking, exercise, alcohol consumption, nutrition, sleep, depression-related stress, anxiety-related stress, healthcare professional usage, and self-discipline. The second objective for this study was to explore if characteristics of personality type are associated with (1) the quality of patient-physician relationships, (2) patient-physician communication, and (3) preferred method for receiving information.

Methods: Data were collected from 10,500 adult individuals residing in the United States via an on-line, self-administered survey coordinated by Qualtrics …

Actionable Patient Safety Solution (Apss) #3c: Improve Prevention Of Severe Hypoglycemia, Jerika Lam, Steven Barker, Michael Ramsay, Ariana Longley, Joe Kiani

Pharmacy Faculty Articles and Research

This report presents a plan of action for introducing a "program to reduce errors in the recognition and treatment of [severe hypoglycemia]".

Racial And Ethnic Differences In Receipt Of Immediate Breast Reconstruction Surgery: Do Hospital Characteristics Matter?, Jaya Shankar Khushalani

Theses and Dissertations

Immediate Breast Reconstruction Surgery (IBRS) is associated with better quality of life among women who undergo a mastectomy. Despite insurance coverage for IBRS, utilization of IBRS remains low. Data from publicly available sources for 2010-2012 are used to examine the association between hospital characteristics receipt of IBRS by patients. Minority-serving status, low bed size, for-profit ownership, non-teaching status, high competition, low density of plastic surgeons in the market and non-metropolitan location are associated with lower likelihood of receipt of IBRS.

Racial and ethnic minorities are less likely to receive IBRS. A mixed effects logistic regression model with interactions between Black/Hispanic …

Does The Electronic Health Record Improve The Timeliness Review And Notification Of Medical Laboratory And X-Ray Test Results?, Ruby Estes

Applied Research Projects

The medical community struggles with timeliness issues throughout the different healthcare environments in many areas of patient care. The demands of meeting patient care needs is great everywhere. One area that can lead to extreme adverse outcomes and affects patient safety is failure to review and follow-up on medical test results timely. In addition the lack of timely follow-up and treatment can lead to medico-legal implications for all healthcare professionals involved in the patients care. Some timeliness issues have been attributed to understaffed healthcare institutions, lack of trained staff, and in many instances inefficient and insufficient processes. This is an …

Complexity And Chaos In Surgical Start Times, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In discussing an article investigating the causes for delay of first-case operating room start times included in this issue of the Journal of Patient-Centered Research and Reviews, the editor uses elements of complexity science and chaos theory to explain that such stubborn problems rarely stem from one of a few isolated causes. Taking a whole systems approach that utilizes flexibility, cross training, enhanced communication, common sense and perhaps mathematical models is suggested to effect positive change.

Surveillance, Epidemiological, And Virological Detection Of Highly Pathogenic H5n1 Avian Influenza Viruses In Duck And Poultry From Bangladesh, Wahedul Karim Ansari, Md Safiullah Parvej, Mohamed E. El Zowalaty, Sally Jackson, Stephen A. Bustin, Adel K. Ibrahim, Md Tanvir Rahman, Han Zhang, Mohammad Ferdousur Rahman Khan, Md Mostakin Ahamd, Md. Fasiur Rahman, Marzia Rahman, Khm Nazmul H. Nazir, Sultan Ahmed, Md Liakot Hossenn, Md Abdul Kafi, Mat Yamage, Nitish C. Debnath, Graba Ahmed, Hossam Ashour, Md Masoud, Ayman Noreddin, Md B. Rahman

Pharmacy Faculty Articles and Research

Avian influenza viruses (AIVs) continue to pose a global threat. Waterfowl are the main reservoir and are responsible for the spillover of AIVs to other hosts. This study was conducted as part of routine surveillance activities in Bangladesh and it reports on the serological and molecular detection of H5N1 AIV subtype. A total of 2169 cloacal and 2191 oropharyngeal swabs as well as 1725 sera samples were collected from live birds including duck and chicken in different locations in Bangladesh between the years of 2013 and 2014. Samples were tested using virus isolation, serological tests and molecular methods of RT-PCR. …

Impact Of Emergency Department Sepsis Policy, Lynette Rayman

Evidence-Based Practice Project Reports

Sepsis is a serious concern of key healthcare stakeholders due to high incidence, mortality, and cost. The objectives of this evidence-based project were to 1) identify potential sepsis patients early during the emergency department (ED) triage process and 2) implement Sepsis Order Sets. Kotter’s change model and the Stetler model of evidence-based practice guided this project. An extensive literature search was undertaken to find best practice evidence regarding care of sepsis patients. Recommended care includes a protocolized format utilizing a screening tool and point of care lactate levels for early identification of sepsis, and early treatment with antibiotics and fluid …

Actionable Patient Safety Solution (Apss) #3b: Improve Prevention Of Severe Hypoglycemia, Ron Jordan, Jerika Lam, Laura Batz Townsend, Steven Barker, Thomas Corlett, Paul Jansen, Chris Jerry, Ariana Longley, Steve Mullenix, Robert Nickell, Rachael Raynes, Rochelle Sandell, Jason Yamaki

Pharmacy Faculty Articles and Research

"Severe hypoglycemia (SH) causes significant morbidity and occasional mortality in hospitalized patients. The establishment of an effective program to reduce errors in the recognition and treatment of SH requires an implementation plan that includes the following actionable steps[.]"

An Analysis Of Women’S Access To Acute Opioid Detoxification Services In Maine: Identifying The Barriers To Treatment, Karen E. Conley

Muskie School Capstones and Dissertations

The lack of treatment facilities and services for opioid use disorder in Maine, combined with an increased prevalence of addiction, creates a potential for health inequity between men and women that may be intensified by barriers in access to care. This capstone study utilized detoxification screening inquiry forms and data obtained from the Milestone Foundation’s acute opioid detoxification program to assess and categorize barriers to access by gender. A barriers model was developed based on existing literature and was to identify potential associations among and between the known barriers to accessing treatment. Barriers were described as internally or externally based, …

Identifying Venous Thromboembolism In Cancer Patients Using Veterans Affairs Administrative Data, Noah Ravenborg, Najeebah A. Bade, Dalia Abdelaziz Mobarek

GW Research Days 2016 - 2020

Identifying Venous Thromboembolism in Cancer Patients Using Veterans Affairs Administrative Data

Noah Ravenborg1, Najeebah A. Bade, M.D.2, Dalia Abdelaziz Mobarek, M.D.1, 2, 3

1 George Washington University School of Medicine and Health Sciences, Washington, D.C. 2 Department of Medicine, Section of Hematology, Veterans Affairs Medical Center, Washington, D.C., 3 Department of Medicine, Section of Hematology & Medical Oncology, George Washington University Medical Center, Washington, D.C. Noah Ravenborg Cell phone: (310)-804-0848, Email: [email protected], MS2

IMPORTANCE: The validity of administrative data in identifying diagnoses within the Veterans Affairs (VA) database, including viral hepatitis, cirrhosis, H. pylori, and cancer metastasis has been reported. …

Realizing Improved Patient Care Through Human-Centered Design In The Operating Room, Volume 2, Clemson Center For Health Facilities Design & Testing

Center for Health Facilities Design and Testing

This 4-year grant from the Agency for Healthcare Research and Quality supports the development of a learning lab focused on designing a safer, more ergonomic operating room. Sponsor: Agency for Healthcare Research Quality Project period: 9/1/15 to 8/31/19 Project Description: The overarching goal of the learning lab titled, “Realizing Improved Patient Care through Human-Centered Design in the Operating Room (RIPCHD.OR) is to develop an evidence-based framework and methodology for the design and operation of operating rooms such that it impacts improved perioperative outcomes including surgical site infections, surgical errors and staff injuries.

The Disease Burden And The Extent Of Drug Therapy Problems In An Underserved Minority Population Receiving Medication Therapy Management At An Ambulatory Care Free Clinic, D. N. Ombengi, F. A. Ndemo, Ayman M. Noreddin, W. T. Harris

Pharmacy Faculty Articles and Research

Objective: To determine the common medical conditions, medications, and associated drug therapy problems in an underserved minority population receiving medication therapy management services at a large Community Free Clinic compared to the findings of the Minnesota Pharmaceutical Care Project.

Methods: Retrospective cohort study of a random sample of 60 minority patients referred for medication therapy management service at a Community Free Clinic from January 2012 to January 2014. Patient data including demographics, medication experience, past medical and medication history, medical conditions, active medications, allergies, immunization history and drug therapy was systematically evaluated to determine the most common conditions, …

Reducing Overutilization Of Testing For Clostridium Difficile Infection In A Pediatric Hospital System: A Quality Improvement Initiative., J Michael Klatte, Rangaraj Selvarangan, Mary Anne Jackson, Angela Myers

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: Study objectives included addressing overuse of Clostridium difficile laboratory testing by decreasing submission rates of nondiarrheal stool specimens and specimens from children ≤12 months of age and determining resultant patient and laboratory cost savings associated with decreased testing.

METHODS: A multifaceted initiative was developed, and components included multiple provider education methods, computerized order entry modifications, and automatic declination from laboratory on testing stool specimens of nondiarrheal consistency and from children ≤12 months old. A run chart, demonstrating numbers of nondiarrheal plus infant stool specimens submitted over time, was developed to analyze the initiative's impact on clinicians' test-ordering practices. A …

Preparedness Of Hospitals In The Republic Of Ireland For An Influenza Pandemic, An Infection Control Perspective, Mary Reidy, Fiona Ryan, Dervla Hogan, Seán Lacey, Claire Buckley

Department of Mathematics Publications

When an influenza pandemic occurs most of the population is susceptible and attack rates can range as high as 40–50 %. The most important failure in pandemic planning is the lack of standards or guidelines regarding what it means to be ‘prepared’. The aim of this study was to assess the preparedness of acute hospitals in the Republic of Ireland for an influenza pandemic from an infection control perspective.

Compliance To The Consort Statement On Participant Flow Diagrams In Infectious Disease Randomized Clinical Trials, Onyeka P. Godwin, Brandon Dyson, Paul S. Lee, Soon Park, Euni Lee

Pharmacy Faculty Articles and Research

Background: The Consolidated Standard of Reporting Trials (CONSORT) Guidelines were developed to support adequate reporting of randomized controlled trials (RCTs).

Method: A systematic review was conducted including RCTs of infectious diseases published in the top general medical and infectious disease journals in 2010. The level of compliance to flow diagram and its association with the CONSORT endorsement by the journals were evaluated.

Results: A total of 67 studies were included in the analysis and a half of the studies were HIV/AIDS RCTs. About 78% of the studies included the flow diagram and 66% of the studies described …

Cancer Survivorship Care: An Emphasis On Rehabilitation Needs In Maine, Miranda Carlson, Nicole Christine, Charles Dowd, Cassandra Dawley, Irina Fedulow, Lisa Gerhardt, Erin Pike, Kaitlin Powers, Angela Serrani

Disease Prevention and Health Promotion Papers

The first section of this report addresses the evidence of causation concerning impairments developed as a result of a cancer diagnosis and cancer treatment. The second section investigates the evidence regarding rehabilitation and physical activity as an effective intervention in the prevention and treatment of impairments from cancer diagnosis and cancer treatment. The third section discusses the underlying behavioral change theory for incorporation of our Cancer Survivorship Rehabilitation Algorithm (Appendix 1), which details our proposed use of rehabilitation and wellness services in the continuum of cancer care and includes an outline for a survivorship care plan. This section also discusses …