Health Services Research Commons^™

Delivering A “Dose Of Hope”: A Faith-Based Program To Increase Older African Americans’ Participation In Clinical Trials, Paula M. Frew, Saad B. Omer, Kimberly Parker, Marcus Bolton, Jay Schamel, Eve Shapiro, Lauren Owens, Diane Saint-Victor, Sahithi Boggavarapu, Nikia Braxton, Matthew Archibald, Ameeta S. Kalokhe, Takeia Horton, Christin M. Root, Vincent L. Fenimore, Aaron M. Anderson

Environmental & Global Health Faculty Research

Background: Underrepresentation of older-age racial and ethnic minorities in clinical research is a significant barrier to health in the United States, as it impedes medical research advancement of effective preventive and therapeutic strategies. Objective: The objective of the study was to develop and test the feasibility of a community-developed faith-based intervention and evaluate its potential to increase the number of older African Americans in clinical research. Methods: Using a cluster-randomized design, we worked with six matched churches to enroll at least 210 persons. We provided those in the intervention group churches with three educational sessions on the role of clinical …

Health Policy Essentials: Common Health Care Acronyms, National Health Policy Forum

National Health Policy Forum

No abstract provided.

Orientation Virtual Meeting National Advisory Committee For The National Health Security Preparedness Index, Glen P. Mays, Anna Goodman Hoover, Michael Childress

Health Management and Policy Presentations

Refining the measures and methodologies used within the National Health Security Preparedness Index will allow users to make more meaningful comparisons of preparedness levels across U.S. geographic areas and to assess changes in preparedness over time.

Improving Measures Of Public Health Activity At Local And State Levels: The Multi-Network Practice And Outcome Variation Examination Study (Mprove), Glen P. Mays

Health Management and Policy Presentations

Implementation of high-value public health strategies for chronic disease prevention, communicable disease control, and environmental health protection vary widely across U.S. states and communities. The Multi-Network Practice and Outcome Variation Examination Study (MPROVE) supported by the Robert Wood Johnson Foundation creates the measurement and analytic foundation for investigating the causes and consequences of practice variation in public health.

Chhs February 2015 E-Newsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

Assessments Of The Extent To Which Health‐Care Providers Involve Patients In Decision Making: A Systematic Review Of Studies Using The Option Instrument, Nicolas Couët, Sophie Desroches, Hubert Robitaille, Hugues Vaillancourt, Annie Leblanc, Stéphane Turcotte, Glyn Elwyn, France Légaré

Dartmouth Scholarship

Background: We have no clear overview of the extent to which health-care providers involve patients in the decision-making process during consultations. The Observing Patient Involvement in Decision Making instrument (OPTION) was designed to assess this. Objective: To systematically review studies that used the OPTION instrument to observe the extent to which health-care providers involve patients in decision making across a range of clinical contexts, including different health professions and lengths of consultation. We conducted online literature searches in multiple databases (2001-12) and gathered further data through networking.

A Meta-Analysis Of Crew Resource Management/Incident Command Systems Implementation Studies In The Fire And Emergency Services, John C. Griffith, Donna L. Roberts, Ronald T. Wakeham

Aviation / Aeronautics / Aerospace International Research Conference

The presentation will summarize a meta-analysis of studies on Crew Resource Management/Incident Command System implementation in the fire and emergency services. The need for using participative leadership tools such as CRM evolved from an NTSB recommendation that followed United Airlines Flight 173 crash in 1978. NASA, civilian and military aviation communities implemented Crew Resource Management (CRM) training to improve decisionmaking during flight operations. Maintenance Resource Management (MRM) was a variant of CRM and first appeared in a Federal Aviation Administration circular in 2000. CRM was adopted by the medical community in the 1990s, specifically in the surgical and nursing areas, …

Aca Implementation In The South: The Political Economy Of Full Participation In Kentucky, Glen P. Mays

Health Management and Policy Presentations

This analysis, conducted as part of the ACA Implementation Research Network, examines economic and political forces shaping Kentucky's early experience with implementation of the Patient Protection and Affordable Care Act.

Relative Value Units (Rvus), Sally Coberly

National Health Policy Forum

This publication reviews Medicare's relative value units (RVUs), which are assigned to each physician service to represent the resources required to provide the service relative to all other physician services. Three types of resources are included: physician work, that is, the physician time and effort; practice expenses, such as clinical staff and equipment; and professional liability insurance. Each service's RVUs are multiplied by a common dollar conversion factor to determine the Medicare payment.

Just Compensation: A No-Fault Proposal For Research-Related Injuries, Leslie Meltzer Henry, Megan E. Larkin, Elizabeth R. Pike

Faculty Scholarship

Biomedical research, no matter how well designed and ethically conducted, carries uncertainties and exposes participants to risk of injury. Research injuries can range from the relatively minor to those that result in hospitalization, permanent disability, or even death. Participants might also suffer a range of economic harms related to their injuries. Unlike the vast majority of developed countries, which have implemented no-fault compensation systems, the United States continues to rely on the tort system to compensate injured research participants—an approach that is no longer morally defensible. Despite decades of US advisory panels advocating for no-fault compensation, little progress has been …

Impact Of Condition Specific Camps On Resiliency And Adaptive Behavior In Children With Heart Conditions, Jeanette Fong, Sandra Cushner-Weinstein

GW Research Days 2015

Objectives: Resilience is the ability to adapt in stressful situations and overcome adversity through the use of effective coping strategies. Previous studies have demonstrated that condition-specific camps designed for children with epilepsy can increase adaptive coping skills including social interactions, cooperation, initiative, and communication in participants over a three-year period ^[1,2]. Additionally, research indicates that as a group, individuals who live with chronic health disorders exhibit less hope and have worse health outcomes when compared to their normative peers. The aim of this study was to determine the impact of condition-specific camps on children with heart conditions.

Methods: 39 …

Chhs January 2015 E-Newsletter, Dr. John Bonaguro, Dean, Vashon S. Wells, Editor, Wku College Of Health & Human Services

College of Health & Human Services Publications

No abstract provided.

Is Administrative Discharge An Archaic Or Synchronic Program Practice? The Empirical Side Of The Debate, Izaak Williams

Journal of Health Ethics

No abstract provided.

Relationships Between Activation Level, Knowledge, Self-Efficacy, And Self-Management Behavior In Heart Failure Patients Discharged From Rural Hospitals., Van Do, Lufei Young, Sue Barnason, Hoang Tran

Journal Articles: Health Services Research & Administration

Non-adherence to self-management guidelines accounted for 50% of hospital readmissions in heart failure patients. Evidence showed that patient activation affects self-management behaviors in populations living with chronic conditions. The purpose of this study was to describe patient activation level and its relationship with knowledge, self-efficacy and self-management behaviors in heart failure patients discharged from rural hospitals. Our study populations were recruited from two hospitals in rural areas of Nebraska. We found that two-thirds of the participants reported low activation levels (e.g., taking no action to manage their heart failure condition). In addition, low patient activation levels were associated with inadequate …

Bundled Payments For Care Improvement Initiative – Insights From The Test Pilots Of Payment Reform, Jason M. Sutherland, William B. Borden

Medicine Faculty Publications

Background: The Medicare Bundled Payments for Care Improvement (BPCI) pilot program aims to reward high-value providers by setting a global payment target for particular episodes of care. The representativeness of BPCI participants will influence the ability of this pilot to inform policy decisions. Methods: We linked the Medicare lists of participants in the risk-bearing portion of BPCI Model 2, encompassing acute and post-acute care, to the American Hospital Association resource file and the 2013 Hospital Value-Based Purchasing quality performance data. We classified episode-initiating hospitals by the number of bundles in which they were participating into “narrow”, “medium” and “comprehensive”. The …

The Role Of Occupational Therapy In Primary Care, Priti Patel

Occupational Therapy Doctorate Capstone Projects

The Capstone Project is focused on communicating, influencing and educating other health care professionals regarding the role of occupational therapy in the future model of primary care delivery initiated by the adoption of the Affordable Care Act and the Triple Aim Initiative. Currently, primary care, the largest health care platform in United States, is not inclusive of occupational therapy services. Occupational therapists have the scope, knowledge and understanding to be part of the redesigned team model of primary care. Educating those currently working in primary care about adding occupational therapy services can have a significant impact on the profession of …

Applying The Pharmacists’ Patient Care Process To Immunization Services: A Resource Guide For Pharmacists, Albert Bach, Jeff Goad, Mitchel Rothholz, Brian Wall, Anne Burns, Liza Chapman, Jean-Venable “Kelly” R. Goode, Sheila Seed, Rebecca Snead

Pharmacy Faculty Articles and Research

"This guidance document has been written and formatted to align comprehensive components of a pharmacy-based immunization patient encounter Collect Assess Plan Implement Follow-Up 6 American Pharmacists Association and recommendations from the National Vaccine Advisory Committee (NVAC) the Standards for Adult Immunization Practice with the original framework of the PPCP.5 The colored columns to the right throughout this document are the PPCP steps as they have been published by JCPP, and the main document text describes how to integrate each PPCP step into immunization services."

A Neural Network Analysis Of Treatment Quality And Efficiency Of Hospitals, Viju Raghupathi, Wullianallur Raghupathi

Publications and Research

Objectives: Due to the escalating healthcare expenditure and the number of hospitalizations, it is becoming increasingly important for healthcare organizations to evaluate the cost and improve the quality and efficiency of treatment.

Method: We deploy neural networks to examine the strategic association between hospitalization experience and treatment results. The healthcare data for the years 2009-2012 are downloaded from the Statewide Planning and Research Cooperative System (SPARCS) of the New York State Department of Health (NYSDOH). We operationalize the hospitalization experience using the indicators facility ID, procedure description, type of admission, patient disposition upon discharge, APR severity of illness, source of …

La Paradoja Hispana Epidemiológica: Investigando Las Preconcepciones Y Generalizaciones, Maya H. Sandalow

CMC Senior Theses

En los Estados Unidos, los latinos suelen tener menos acceso a la educación, el trabajo, y el seguro médico en comparación con los blancos no-latinos, pero aun así el grupo parece superar ciertos obstáculos de la salud. Las estadísticas de la población latina muestran mayor longevidad y otras tasas favorables en comparación con los blancos no-latinos. Los expertos han titulado esta contradicción “La Paradoja Hispana Epidemiológica”.

Desafortunadamente, la investigación de la paradoja está llena de generalizaciones y presuposiciones erróneas sobre la población latina diversa. Esta tesis investiga los participantes que producen generalizaciones sobre la supuesta paradoja para mostrar que estas …

The Impact Of Patient Portals On Release Of Information Requests, April Insco

Applied Research Projects

Patient portals are no longer a thing of the past. The government has issued a mandate that all covered entities who are reimbursed under Medicare payments must implement patient portals as a part of the Meaningful Use initiative or suffer penalties. The objective of this study is to review the data to see if there is a decrease in the number of release of information (ROI) requests at facilities that have implemented patient portals. A survey was conducted to determine if there was any change in the number of ROI requests that facilities received prior to implementation of patient portal …

Managing Copy And Paste Functionality In The Electronic Health Record, Tricia Urquhart-Jones

Applied Research Projects

The increased adoption of Electronic Health Records (EHR) has identified a significant need to develop tools to help providers maximize time spent documenting in the EHR. Copy and paste functionality, also known as carrying forward, cut and paste, and cloning, is one of many tools that can help providers save time and has been around longer than computers. A survey of thirteen Health Information Management (HIM) professionals responsible for HIMS functions within an acute care hospital in North Carolina was conducted. The survey response rate was 53%. The data gathered in this research study will add to HIM body of …

Health Information Exchanges And Patient Portals In Behavioral Health, Christine Peterson

Applied Research Projects

We live in an electronic world. Technology is everywhere, including in our healthcare system. With the advent on the electronic health record and the push to meet Meaningful Use, many healthcare organizations have already started using patient portals and sharing information among providers via health information exchanges. There have been roadblocks to successful implantation of patient portals and health information exchanges, one of which is how to handle behavioral health information and would these new technologies be accepted by patients with mental health diagnoses

The Challenges Of Establishing Partners In Health Information Exchange (Hie), Torian Tate

Applied Research Projects

Health information exchange (HIE) has become a focus of the health care industry. The ability to share information electronically between multiple health care providers is thought to be a key ingredient in the creation of a more efficient global health care system. VA Hospital Memphis has significant challenges in regard to HIE. The Virtual Lifetime Electronic Record (VLER) coordinator at the facility has been charged with establishing an HIE system. This requires the coordinator to identify partners to share health information with electronically, obtain buy-in from patients and providers through education, and to promote/market the VLER program facility-wide. The VA …

Unicondylar Knee Arthroplasty In The Inpatient Vs Outpatient Setting: Impact On Process Time, Quality Outcomes, And Patient Satisfaction, Ibrahim Zeini

Electronic Theses and Dissertations

The implications of rising healthcare expenditures are of great concern nationally and internationally. Performing procedures in the outpatient setting can be one solution to this crisis. However, there is a lack of research on systematic approaches for transitioning procedures to the outpatient setting. Unicondylar knee arthroplasty (UKA) presents an opportunity, as it is already in the early stages of transitioning to the outpatient setting. The key step in facilitating an effective transition to the outpatient setting is comparing outpatient UKAs with inpatient UKAs with a focus on process time, quality outcomes, and patient satisfaction. This study retrospectively compares 400 UKA …

Rural Health Clinic Readiness For Patient-Centered Medical Home Recognition: Preparing For The Evolving Healthcare Marketplace [Working Paper], John A. Gale Ms, Zachariah T. Croll Mph, David Hartley Phd, Mha

Rural Health Clinics

The patient-centered medical home (PCMH) model reaffirms traditional primary care values including continuity of care, connection with an identified personal clinician, provision of same day- and after-hours access, and positions providers to participate in accountable care and other financing and delivery system models. However, little is known about the readiness of the over 4,000 Rural Health Clinics (RHCs) to meet the PCMH Recognition standards established by the National Council for Quality Assurance (NCQA). The authors present findings from a survey of RHCs that examined their capacity to meet the NCQA PCMH requirements, and discuss the implications of the findings for …

Evidence-Based Hospitals, David R. Bardach

Theses and Dissertations--Epidemiology and Biostatistics

In 2011 the University of Kentucky opened the first two inpatient floors of its new hospital. With an estimated cost of over $872 million, the new facility represents a major investment in the future of healthcare in Kentucky. This facility is outfitted with many features that were not present in the old hospital, with the expectation that they would improve the quality and efficiency of patient care. After one year of occupancy, hospital administration questioned the effectiveness of some features. Through focus groups of key stakeholders, surveys of frontline staff, and direct observational data, this dissertation evaluates the effectiveness of …

Respectful Maternity Care Resource Package, Charity Ndwiga, Charlotte E. Warren, Timothy Abuya, Lucy Kanya, Alice Maranga, Christine Ochieng, Mary Wanjala, Beatrice Chelang'at, Anne Njeru, Annie Gituto, George Odhiambo, Faith Mbehero, Lucia Maina, Jeremiah Maina

Reproductive Health

The Respectful Maternity Care Resource Package is a set of manuals, tools, and resources to ensure high-quality, respectful maternal and newborn health services. The resources help program managers, health workers, and technical advisors set up workshops and trainings for facility-based providers and community health workers. The workshops provide practical, low-cost, and easily adaptable strategies to improve respectful care.

The Respectful Maternity Care Resource Package was developed by the Heshima project as part of the USAID Translating Research into Action (TRAction) project.

Training facility-based health providers

• Facilitator’s guide
• Orientation slide deck
• Participant’s guide

Training community health workers

• Facilitator’s guide
• Orientation slide …

Overview Of Aboriginal And Torres Strait Islander Health Status 2015, Australian Indigenous Healthinfonet

Research outputs 2014 to 2021

The main purpose of the Overview is to provide a comprehensive summary of the most recent indicators of the health and current health status of Australia’s Aboriginal and Torres Strait Islanders people. It has been prepared by Australian Indigenous HealthInfoNet staff as part of our contribution to supporting those who work in the Aboriginal and Torres Strait Islander health sector. The Overview is a key element of the HealthInfoNet commitment to authentic and engaged knowledge development and exchange. The initial sections of this Overview provide information about the context of Aboriginal and Torres Strait Islander health, population, and various measures …

A Tale Of Two Diseases: Mental Illness And Hiv/Aids, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

There have been dramatic advances in the treatment of HIV/AIDS. Whereas HIV was once a dire diagnosis, today it is treatable, and individuals who receive early and consistent treatment can expect to live a normal lifespan. Why has the scientific community made the same strides with mental illness? When I was the Legal Director of the National Association of Mental Health in the United Kingdom in the 1980s, major mental illnesses were primarily treated with powerful antipsychotics, such as haloperidol, that carried the debilitating side effects of tardive dyskinesia—involuntary movements of the tongue, lips, face, trunk, and extremities. When I …

Integration Of Rural Community Pharmacies Into A Rural Family Medicine Practice-Based Research Network: A Descriptive Analysis, Nicholas E. Hagemeier, Sarah Blevins, Kyle Hagen, Emily Sorah, Richa Shah, Kelly Ferris

ETSU Faculty Works

Purpose: Practice-based research networks (PBRN) seek to shorten the gap between research and application in primary patient care settings. Inclusion of community pharmacies in primary care PBRNs is relatively unexplored. Such a PBRN model could improve care coordination and community-based research, especially in rural and underserved areas. The objectives of this study were to: 1) evaluate rural Appalachian community pharmacy key informants’ perceptions of PBRNs and practice-based research; 2) explore key informants’ perceptions of perceived applicability of practice-based research domains; and 3) explore pharmacy key informant interest in PBRN participation.

Methods: The sample consisted of community pharmacies within city limits …