Health Services Administration Commons^™

Trends In Gaps Of Care For Patients With Congenital Heart Disease: Implications For Social Determinants Of Health And Child Opportunity Index, Abbas H. Zaidi, Adam Alberts, Devyani Chowdhury, Claude Beaty, Benjamin Brewer, Ming Hui Chen, Sarah D. De Ferranti

Department of Surgery Faculty Papers

BACKGROUND: Lifelong continuity of care is essential for patients with congenital heart disease (CHD) to maximize health outcomes; unfortunately, gaps in care (GIC) are common. Trends in GIC and of social determinants of health factors contributing to GIC are poorly understood.

METHODS AND RESULTS: This retrospective cohort study included patients with CHD, aged 0 to 34 years, who underwent surgery between January 2003 and May 2020, followed up at a pediatric subspeciality hospital. Patients were categorized as having simple, moderate, and complex CHD based on 2018 American Heart Association and American College of Cardiology guidelines. Social determinants of health, such …

Rates Of Reporting And Analyzing Race And Ethnicity In Athlete-Specific Sports Medicine Research: A Systematic Review, John H. Sonnier, Carlo Coladonato, Irfan A. Khan, Gregory Connors, Ryan W. Paul, Anya T. Hall, Emma E. Johnson, Meghan E. Bishop, Fotios P. Tjoumakaris, Kevin B. Freedman

Rothman Institute Papers

BACKGROUND: Race- and ethnicity-based differences in treatment access and outcomes have been reported in the orthopaedic sports medicine literature. However, the rate at which race and ethnicity are reported and incorporated into the statistical analysis of sports medicine studies remains unclear.

PURPOSE: To determine the rate at which race and ethnicity are reported and analyzed in athlete-specific sports medicine literature.

STUDY DESIGN: Systematic review; Level of evidence, 4.

METHODS: Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, articles published by the 3 journals of the American Orthopaedic Society for Sports Medicine between 2017 and 2021 were considered …

Participant Engagement And Preference Study For Clinical Outcomes Associated With Atrial Fibrillation: The Pearl-Af Study, Shelby D. Reed, Josephine L. Harrington, Daniel P. Morin, Samir F. Saba, Jay Alan Montgomery, Robert W. Harrison, Daniel R. Frisch, Thomas Viethen, Miriam Tamm, Jessica Xiao, Hardi Mundl, Rosa Coppolecchia, Jui-Chen Yang, Matthew J. Wallace, Juan Marcos Gonzalez, Manesh R. Patel

Division of Cardiology Faculty Papers

Background: Quantifying patients’ preferences for health outcomes associated with atrial fibrillation (AF) and its treatments offers a replicable approach to considering the patient perspective in regulatory decision-making. Objective: The authors conducted a preference survey to estimate the relative importance of AF-related events for use in clinical trial analyses to estimate net health benefits with anticoagulants. Methods: The survey included nontechnical descriptions of three severities of stroke, systemic embolism, myocardial infarction (MI) with or without subsequent heart failure (HF), major bleeding, clinically relevant nonmajor bleeding, and death. A best-worst scaling question format was used in which patients were shown 10 sets …

Palliative Care And Advance Care Planning Intervention Fidelity Monitoring: Methods And Lessons Learned From Pcori-Funded Large-Scale, Pragmatic Clinical Trials, Manisha Verma, Corita Grudzen, Seiko Izumi, Neil Wenger, Areej El-Jawahri, Deborah Ejem, Rebecca Aslakson

Einstein Health Papers

Over the past decade, the Patient-Centered Outcomes Research Institute (PCORI) funded multiple large-scale, comparative effectiveness clinical trials evaluating palliative care and advance care planning interventions. These are complex multicomponent interventions that need robust but flexible fidelity monitoring. Fidelity is necessary to maintain both internal and external validity within palliative care intervention research and to ultimately evaluate the real-world impact of high-quality interventions. Different trials not only took varying approaches to fidelity monitoring but also uncovered both unique and common challenges and facilitators. This article summarizes 8 of these trials and highlights approaches, adaptations, barriers, and facilitators for intervention fidelity monitoring. …

Radiographic Outcomes And Subsidence Rate In Hyperlordotic Versus Standard Lordotic Interbody Spacers In Patients Undergoing Anterior Cervical Discectomy And Fusion, Rajkishen Narayanan, Nicholas Pohl, Jonathan Dalton, Yunsoo Lee, Anthony Labarbiera, Meryem Guler, Emilie Sawicki, Sebastian Fras, Mark Kurd, John Mangan, I David Kaye, Jose Canseco, Alan Hilibrand, Alex Vaccaro, Christopher Kepler, Gregory Schroeder, Joseph Lee

Rothman Institute Papers

Background: Anterior cervical discectomy and fusion (ACDF) is a common surgery for patients with degenerative cervical disease and current interbody spacers utilized vary based on material composition, structure, and angle of lordosis. Currently, there is a lack of literature comparing subsidence rates or long-term radiographic outcomes with hyperlordotic and standard lordotic spacers. This study compares long-term radiographic outcomes, subsidence rate, and rate of fusion in patients who underwent ACDF with hyperlordotic or standard interbody placement. Materials and Methods: Patients who underwent 1-3-level ACDF with either a standard lordosis or hyperlordotic interbody were included. Standard radiographs were evaluated for C2-7 lordosis …

American Society For Gastrointestinal Endoscopy Best Practice Statements On The Sharing Of Endoscopic Images And Videos On Social Media, Walter Chan, Rashmi Advani, Mohammad Bilal, Aline Charabaty, Karl Kwok, Janese Laster, Alexander Perelman, Shazia Siddique, Judy Trieu, Mfoniso Umoren, Austin Chiang

Division of Gastroenterology and Hepatology Faculty Papers

No abstract provided.

Adaptation Of The Socioecological Model To Address Disparities In Engagement Of Black Men In Prostate Cancer Genetic Testing, Amy Leader, Timothy Rebbeck, William Oh, Alpa Patel, Eric Winer, Leeann Bailey, Leonard Gomella, Crystal Lumpkins, Isla Garraway, Lisa Aiello, Monica Baskin, Heather H Cheng, Kathleen Cooney, Amanda Ganzak, Daniel George, Susan Halabi, Feighanne Hathaway, Claire Healy, Joseph W Kim, Michael Leapman, Stacy Loeb, Kara Maxwell, Christopher Mcnair, Todd Morgan, Breanne Prindeville, Howard R Soule, Whitney Steward, Sakinah Suttiratana, Mary-Ellen Taplin, Kosj Yamoah, Thierry Fortune, Kris Bennett, Joshua Blanding-Godbolt, Laura Gross, Veda Giri

Department of Medical Oncology Faculty Papers

BACKGROUND: Black men consistently have higher rates of prostate cancer (PCA)- related mortality. Advances in PCA treatment, screening, and hereditary cancer assessment center around germline testing (GT). Of concern is the significant under-engagement of Black males in PCA GT, limiting the benefit of precision therapy and tailored cancer screening despite longstanding awareness of these disparities. To address these critical disparities, the Socioecological Model (SEM) was employed to develop comprehensive recommendations to overcome barriers and implement equitable strategies to engage Black males in PCA GT.

METHODS: Clinical/research experts, national organization leaders, and community stakeholders spanning multiple regions in US and Africa …

Design And Implementation Of An Opioid Scorecard For Hospital System-Wide Peer Comparison Of Opioid Prescribing Habits: Observational Study, Benjamin Slovis, Soonyip Huang, Melanie Mcarthur, Cara Martino, Tasia Beers, Meghan Labella, Jeffrey Riggio, Edmund Pribitkin

Jefferson Hospital Staff Papers and Presentations

BACKGROUND: Reductions in opioid prescribing by health care providers can lead to a decreased risk of opioid dependence in patients. Peer comparison has been demonstrated to impact providers' prescribing habits, though its effect on opioid prescribing has predominantly been studied in the emergency department setting.

OBJECTIVE: The purpose of this study is to describe the development of an enterprise-wide opioid scorecard, the architecture of its implementation, and plans for future research on its effects.

METHODS: Using data generated by the author's enterprise vendor-based electronic health record, the enterprise analytics software, and expertise from a dedicated group of informaticists, physicians, and …

Transorbital Alternating Current Stimulation In A Double-Masked Randomized Clinical Trial: Visual Functional Effect And Quality Of Life, Maria De Los Angeles Ramos Cadena, Ashley Sohn, Heather Livengood, Ting-Fang Lee, Batsheva Rubin, Jiyuan Hu, Bernhard A. Sabel, Rachel Matayev, Joseph Panarelli, Gadi Wollstein, Joel S. Schuman

Wills Eye Hospital Papers

PURPOSE: To determine the efficacy and safety of repetitive transorbital alternating current stimulation (rtACS) treatment by assessing vision-related quality of life and visual function outcome in subjects treated with rtACS versus sham-control.

STUDY DESIGN: Double masked, randomized, sham-controlled clinical trial (NCT03188042).

SUBJECTS: Sixteen subjects with moderate-to-advanced glaucoma (visual field [VF] mean deviation [MD] ≤-6.00 decibels) randomized into sham (9 subjects) or rtACS intervention (7 subjects) groups.

METHODS: Subjects underwent 10 rtACS sessions over 2 weeks. All subjects had comprehensive ocular examination at baseline, 1-week, and 4-weeks posttreatment.

MAIN OUTCOME MEASURES: Visual acuity (VA), contrast sensitivity (CS), VF MD, number of …

Segregation By Payer In Obstetrics And Gynecology Residency Ambulatory Care Sites, Kavita Vinekar, Neena Qasba, Hannah Reiser, Erika Banks, Kavita Arora, Brownsyne Edmonds, Karen George

Department of Obstetrics and Gynecology Faculty Papers

IMPORTANCE: Many teaching hospitals in the US segregate patients by insurance status, with resident clinics primarily composed of publicly insured or uninsured patients and faculty practices seeing privately insured patients. The prevalence of this model in obstetrics and gynecology residencies is unknown.

OBJECTIVES: To examine the prevalence of payer-based segregation in obstetrics and gynecology residency ambulatory care sites nationally and to compare residents' and program directors' perceptions of differences in quality of care between payer-segregated and integrated sites.

DESIGN, SETTING, AND PARTICIPANTS: This national survey study included all 6060 obstetrics and gynecology residents and 293 obstetrics and gynecology residency program …

Digital Health Research Symposium: Closing Panel Commentary, Judd E. Hollander, Kristin L. Rising, Brian M. Dougan

Department of Emergency Medicine Faculty Papers

No abstract provided.

Challenges In Traumatic Spinal Cord Injury Care In Developing Countries - A Scoping Review, Mohammad Hosein Ranjbar Hameghavandi, Elaheh Khodadoust, Mahgol Sadat Hassan Zadeh Tabatabaei, Farzin Farahbakhsh, Zahra Ghodsi, Sabra Rostamkhani, Shahryar Ghashghaie, Mahkame Abbaszade, Arash Arbabi, Seyedeh Maede Hossieni, Mohsen Sadeghi-Naini, Rasha Atlasi, Samuel Berchi Kankam, Alexander Vaccaro, James Guest, Michael Fehlings, Vafa Rahimi-Movaghar

Department of Neurosurgery Faculty Papers

OBJECTIVE: To evaluate the leading challenges in developing countries' traumatic spinal cord injury (TSCI) care.

METHODS: We conducted a systematic search in electronic databases of PubMed, SCOPUS, Web of Science, EMBASE, and Cochrane Library on 16 April 2023. Studies that investigated challenges associated with the management of TSCI in developing countries were eligible for review. We extracted related outcomes and categorized them into four distinct parts: injury prevention, pre-hospital care, in-hospital care, and post-hospital care.

RESULTS: We identified 82 articles that met the eligibility criteria including 13 studies on injury prevention, 25 on pre-hospital care, 32 on in-hospital care, and …

Setting Up An Ambulatory Gi Endoscopy Suite In The Usa-Anesthesia And Sedation Challenges, Basavana Goudra

Department of Anesthesiology Faculty Papers

Gastrointestinal endoscopy units, both freestanding and associated with ambulatory surgical centers, are on the increase, and the trend is likely to continue. The concept is relatively new, and there are insufficient guidelines and a general dearth of information for prospective planners and physicians. Debate continues in areas such as the selection of patients, appropriateness of procedures, and access to tertiary care. Leaders often scramble to address both critical and non-critical issues, often after the center has opened to the public. They often encounter issues which were not anticipated. In this review, we have provided comprehensive and concise information on the …

Equity In Access For Veterans In The Va Community Care Program, Baligh R. Yehia, Said A. Ibrahim

Department of Medicine Faculty Papers

No abstract provided.

Practical Guidance On Establishing A Molecular Testing Pathway For Alterations In Homologous Recombination Repair Genes In Clinical Practice For Patients With Metastatic Prostate Cancer, Martin Schostak, Angela Bradbury, Alberto Briganti, David Gonzalez, Leonard Gomella, Joaquin Mateo, Frédérique Penault-Llorca, Albrecht Stenzinger, Alexander Wyatt, Anders Bjartell

Department of Urology Faculty Papers

CONTEXT: Prostate cancer is a molecularly heterogeneous disease that is amenable to diagnostic testing to identify patients potentially eligible for personalised treatments inform familial risk and provide relevant information about potential prognosis. Several guidelines support the integration of genomic testing in a shared decision-making framework so that both health care professionals (HCPs) and patients are involved in determining the best treatment approach.

OBJECTIVE: To review current guidelines on molecular diagnostic testing for homologous recombination repair (HRR) gene alterations in patients with metastatic prostate cancer, with the aim of providing practical considerations for effective guideline implementation and establishment of an appropriate …

The Iris Registry: A Novel Approach To Clinical Registry Development In Ophthalmology, John C. Lin, Leslie Hyman, Ingrid U. Scott

Wills Eye Hospital Papers

No abstract provided.

Did A Physician-Targeted Intervention That Reduced Potentially Inappropriate Prescribing To Elderly Patients Also Reduce Related Hospitalizations?, Jacquelyn Mcrae, Pharmd, Sarah E. Hegarty, Pharmd, M. Alcusky, A. Vegesna, S. Varga, S. W. Keith, S. Del Canale, M. Lombardi, Vittorio Maio, Pharmd, Msph

College of Population Health Posters

Objectives:

To determine whether a general practitioner focused intervention aimed at decreasing PIM prescribing in the elderly can decrease the risk of PIM-related hospitalizations.

Poster presented at 2016 ISPOR conference in Washington DC.

Patient Engagement: The Missing Measure In The Patient-Centered Medical Home, Manisha Verma Md, Mph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Teaching Us Healthcare Organization And Delivery: Two Models Of Instruction, Juan Leon Phd, Laura T. Pizzi Pharmd, Mph, Deon Steele Mph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

The Use Of Interpreters To Improve The Quality And Safety Of Healthcare Through Better Communication In Obstetrical Patients: Effect On Primary Cesarean Delivery Rate, Stephen A. Pearlman, Md

Master of Science in Healthcare Quality and Safety Capstone Presentations

Patients with limited English proficiency have poorer healthcare outcomes. An assessment of the cultural and linguistic competency of Christiana Care Health Systems revealed that our language services were not sufficiently robust and this was affecting care. Therefore, the purpose of this quality improvement study was to improve healthcare outcomes, specifically the rate of primary cesarean delivery, through improved language assistance, to patients with limited English proficiency presenting to labor and delivery. The methods employed included use of the TeamSTEPPS program to educate the staff on how to improve safety for patients with limited English proficiency, adding a live Spanish interpreter …

Insights From "Creating The Healthcare Workforce For The 21(St) Century" Conference., Amanda R Solis

College of Population Health Faculty Papers

No abstract provided.

Thomas Jefferson University-Annual Report-2008, Robert L. Barchi, Md, Phd, Brian G. Harrison

Thomas Jefferson University Administrative Documents and Reports

No abstract provided.

Jefferson Medical College Annual Report, 2007, Thomas J. Nasca

Jefferson Medical College Administrative Documents and Reports

No abstract provided.

Not Again!, David B. Nash

Selected Works of David B. Nash, MD, MBA

No abstract provided.

Insights From The 2007 Disease Management Colloquium., David B Nash, Tine Hansen-Turton, Tracey Moorhead, Harry Leider, Donald F Wilson

College of Population Health Faculty Papers

No abstract provided.

Redefining Healthcare Education: Perspectives And Accomplishments, Brian G. Harrison, Robert L. Barchi

Thomas Jefferson University Administrative Documents and Reports

2007 Annual report of Thomas Jefferson University.

Consumer Engagement, David B. Nash

Selected Works of David B. Nash, MD, MBA

No abstract provided.

Healthcast 2020, David B. Nash

Selected Works of David B. Nash, MD, MBA

No abstract provided.

Medicare And P4p, David B. Nash

Selected Works of David B. Nash, MD, MBA

No abstract provided.

Focus On The Future Of Clinical Care, Brian G. Harrison, Robert L. Barchi

Thomas Jefferson University Administrative Documents and Reports

2006 Annual report of Thomas Jefferson University