Health Services Research Commons^™

Evaluation Of Radiology Request Forms In A Tertiary Care Hospital: An Audit With A Focus On The Impact Of Technological Intervention, Muhammad Danish Barakzai, Zara Za Sheer, Muhammad Azeemuddin, Amna Alvi, Noman Khan, Waseem M. Nizamani, Madiha Beg, Saad Siddiqui

Community Health Sciences

Radiology request forms are the basis of communication between referring physicians and radiologists. These are the sole documents on the basis of which a justification to carry out a radiological procedure is carried out. However, across the globe, there is a problem of inadequately filled radiology request forms. Several interventions like standardization and the use of technology have been proposed worldwide to overcome the shortcomings of inadequately filled radiology request forms. We carried out a two-phase audit assessing the impact of a technological intervention on the quality of radiology requests with the results showing marked improvement in key parameters. A …

Rural Hiv Prevalence And Service Availability In The United States: A Chartbook, Katherine Ahrens Phd, Amanda Burgess Mppm, Louisa Munk, Erika Ziller Phd

Population Health

This chartbook examines 2016 HIV prevalence and the availability of HIV prevention, testing, and treatment services across the rural-urban continuum and by US Census region. Publicly available county-level HIV prevalence data from the CDC and state-produced HIV surveillance reports were used to estimate HIV prevalence across the rural-urban continuum. HIV prevalence data include all diagnoses of HIV infection, with or without a stage 3 (AIDS) diagnosis. Geocoded data on organizations that provide prevention, testing, and treatment services related to HIV were obtained from the National Prevention Information Network.

HIV prevalence is higher in urban counties than rural counties (399 per …

Opioid-Related Visits To Rural Emergency Departments, Erika C. Ziller Phd, Jean A. Talbot Phd, Deborah Thayer Mba, Carly Milkowski Mph

Mental Health / Substance Use Disorders

Increased rates of acute opioid poisoning and related emergency department (ED) visits in the United States have occurred at the same time as rural EDs face a number of resource constraints. Researchers at the Maine Rural Health Research Center conducted this study to gain insight about rural ED visits for acute opioid poisoning and how they compare with urban ED visits. The authors used data from the 2006 and 2013 Nationwide Emergency Department Sample to examine rural and urban opioid-related visits (ORVs) to EDs, including rate change over time, and the outcomes of these ED visits (treatment and release, inpatient …

Knowledge, Attitudes, Practices And Perceived Barriers Of Emergency Health Care Providers Regarding Sepsis And Septic Shock In A Tertiary Care Centre: A Cross-Sectional Study, Madiha Ismail, Umaira Aftab, Kiran Azizi, Badar Afzal Khan

Department of Emergency Medicine

This study aimed to assess knowledge, attitudes, practices, and perceived barriers of emergency healthcare providers regarding the management of sepsis and septic shock. This cross-sectional study was conducted in the Emergency Department of Aga Khan University Hospital, Karachi, Pakistan from August to October 2017. A total of 53 healthcare providers participated in the study. Overall, 42(79%) of the participants demonstrated correct knowledge of the sepsis bundle. The most common barrier reported in the compliance of the sepsis bundle was a shortage of staff (62%), followed by delayed presentation of patients (58%) and overcrowding (42%). Furthermore, better staffing was perceived by …

Building Healthy Communities: Executive Summary - Policy, Systems, And Physical Changes, Core (Center For Outcomes Research & Education)

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No abstract provided.

Food Insecurity Measurement And Prevalence Estimates During The Covid-19 Pandemic In A Repeated Cross-Sectional Survey In Mexico, Pablo Gaitán-Rossi, Mireya Vilar-Compte, Graciela Teruel, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

Objective: To validate the telephone modality of the Latin American and Caribbean Food Security Scale (ELCSA) included in three waves of a phone survey to estimate the monthly household food insecurity prevalence during the COVID-19 pandemic in Mexico. Design: We examined the reliability and internal validity of the ELCSA scale in three repeated waves of cross-sectional surveys with Rasch models. We estimated the monthly prevalence of food insecurity in the general population and in households with and without children and compared them with a national 2018 survey. We tested concurrent validity by testing associations of food insecurity with socio-economic status …

Utility Of Student-Run Free Clinics For Underserved Individuals During Covid-19 Michigan Shelter-In-Place Order, Sara Saymuah, Hailey Heil, Janki Vaghasia, Marla Rojas Thaureaux, Victoria Badia, Paige Baal

Medical Student Research Symposium

Introduction: Cass Clinic, a student-run free clinic (SRFC) affiliated with Wayne State University School of Medicine in Detroit, Michigan, provides free healthcare to predominantly underprivileged populations. Cass Clinic remained open during Governor Whitmer’s shelter-in-place order from March 24, 2020 through June 12, 2020 and throughout the COVID-19 pandemic. The purpose of this study was to assess SRFC’s utility in meeting patient needs during the COVID-19 pandemic.

Methods: A mixed, open and closed-ended quality improvement survey was administered to patients who utilized Cass Clinic between the dates of May 2, 2020 and June 6, 2020. Qualitative analysis included descriptive statistics, while …

Current Community-Based Mental Health Promotion Strategies Among Children And Adolescents: A Literature Review Of Evidence And Feasibility In Indonesia, Ade Sutrimo, Lita Heni Kusumawardani

Journal of Indonesian Health Policy and Administration

Mental disorders impact people's quality of life globally. A quarter of the world's population consists of children and adolescents who are significantly experiencing mental disorders since the age of 14. Community-based mental health strategies are aimed to overcome the challenges of mental health. The purpose of this review was to explore the evidence of children and adolescents' mental health promotion strategies to be potentially implemented in Indonesia. A literature review design was utilized using PRISMA on 20 journals through Science Direct, Proquest, SAGE, Scopus, EBSCO, and Taylor and Francis, in the last five years, within keywords of community-based, children and …

Analysis Of Implementation Of Maternity Planning And Prevention Of Complication (P4k) Program With Stickers In Purwakarta Regency 2017, Yunita Restu Safitri, Pujiyanto Pujiyanto

Journal of Indonesian Health Policy and Administration

. Pregnant women are one of the risk groups that should be considered to receive particular attention. Maternal mortality is caused by direct and indirect causes, which generally can be identified in early pregnancy. The Ministry of Health has launched various programs to reduce maternal mortality. At the community level, since 2007, there has been a birth planning and prevention of complications (P4K) program as a screening tool for pregnant women at risk by using stickers. The main point of this program is the active participation of families and communities to care for pregnant women in their environment. Purwakarta Regency, …

Facilitators And Barriers To Patient-Centered Outcomes Research Partnership Sustainability In The United States, Tristen L. Hall, Charlene Barrientos-Ortiz, Griselda Peña-Jackson, Courtney Fultineer, Kevin Werner, Justine Sunshine

Journal of Patient-Centered Research and Reviews

Purpose: Engaging patients in research can enhance relevance and accelerate implementation of findings. Despite investment in patient-centered outcomes research (PCOR), short-term funding cannot maintain such efforts beyond the program timeframe. Sustained interaction between researchers, practitioners, patients, and other stakeholders is needed to sustain use of evidence-based practices and achieve maximum benefit. While previous literature describes components of public health program sustainability, such factors do not necessarily apply to the partnerships that implement those programs, and facilitators are likely to differ across disciplines. We sought to determine facilitators and barriers to PCOR partnership sustainability from participant experiences with sustainable and unsustainable …

Relationship Between Physician Burnout And Patient’S Perception Of Bedside Time Spent By Physicians, Shannon Leung, Mukta Panda, Georgia Mcintosh, Nargiza Kurbanova, Anna-Carson Rimer Uhelski, Muhammad Mubbashir Sheikh, Rehan Qayyum

Journal of Patient-Centered Research and Reviews

Although the adverse effect of burnout on physicians has been widely documented, studies have shown an inconsistent relationship between burnout and the quality of patient care. We hypothesized that physician burnout will have an inverse relationship with the time spent at the bedside by physicians. In a cross-sectional study, we surveyed patients on their perception of the time spent by their physician on the day of the survey (4 categories: 0–5, 6–10, 11–15, > 15 minutes). Oldenburg Burnout Inventory was used to assess physician burnout; burnout was defined as high levels of both exhaustion (≥ 2.25) and disengagement (≥ 2.10). Among …

A Watched Pot Never Boils: Attentive Care Needs No Timer, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

In this issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews comments on the premise that length of patient consultation time is less important than what patients perceive happened during that time. Regardless of the time allotted to a clinical visit, health care providers should make efforts to address the emotional and psychosocial needs of their patients. As always, taking a little time to express empathy can make a big difference in patient satisfaction.

Patient Recommendations For Providers To Avoid Stigmatizing Weight In Rural-Based Women With Low Income, Declan Watson, Katherine Hughes, Emma Robinson, Jacqueline Billette, Andrea E. Bombak

Journal of Patient-Centered Research and Reviews

Purpose: Weight stigma has become widespread within health care and disproportionately affects women, who are under greater appearance-based scrutiny than men. It is also well established that rural-based individuals with low incomes suffer greater health disparities compared with urban, higher-income counterparts, yet studies examining recommendations for nonstigmatizing health care among higher-weight women from low-income rural settings are lacking. This study examined the experiences and recommendations of higher-weight, low-income, rural women, with the aim of improving health care for similar populations.

Methods: In-depth, semi-structured interviews were conducted in a rural region of the Midwestern United States to explore participants’ recommendations for …

Assessment Of Stakeholder Engagement In A Down Syndrome Research Study, Jeanhee Chung, Ashwini Sarathy, Yichuan Grace Hsieh, Greg Estey, Amy Torres, Vasiliki Patsiogiannis, Karen Donelan, Brian G. Skotko

Journal of Patient-Centered Research and Reviews

There is growing recognition of the importance of engaging patients early in the design of research studies. For studies involving patients with intellectual and cognitive disabilities, researchers may consider engaging with family caregivers, health professionals, community advocates, and/or subject matter experts to provide a more multifaceted, surrogate perspective. Evaluating the engagement of these stakeholder groups in research is nascent, and tools are limited. Research studies involving these individuals provide the opportunity to test new methods of measurement of stakeholder engagement in research. We conducted a 3-year research study implementing and evaluating Down Syndrome Clinic to You, an online platform for …

Comprehensive Echocardiographic Findings In Critically Ill Covid-19 Patients With Or Without Prior Cardiac Disease, Renuka Jain, Pedro D. Salinas, Stacie Kroboth, Abigail Kaminski, Sarah Roemer, Ana Cristina Perez Moreno, Bijoy K Khandheria

Journal of Patient-Centered Research and Reviews

Purpose: Coronavirus disease 2019 (COVID-19) presents with a spectrum of disease severity, the most serious cases requiring intensive care. Echocardiography is a front-line tool in evaluating cardiovascular complications of COVID-19 in the intensive care unit (ICU); we analyzed transthoracic echocardiograms obtained from this patient population with state-of-the-art ultrasound technology.

Methods: All patients with COVID-19 requiring ICU admission on whom a transthoracic echocardiogram was obtained were included in the study. Focused transthoracic protocols were performed by experienced sonographers. Echocardiographic variables, including speckle-tracking echocardiography, were collected and analyzed. Clinical information was obtained from the electronic medical record. Patients were followed until discharge. …

Using Mobile Phones To Improve Young People Sexual And Reproductive Health In Low And Middle-Income Countries: A Systematic Review To Identify Barriers, Facilitators, And Range Of Mhealth Solutions, Anam Shahil Feroz, Naureen Akber Ali, Adeel Khoja, Armish Asad, Sarah Saleem

Community Health Sciences

Background: Globally, reproductive health programs have used mHealth to provide sexual and reproductive health (SRH) education and services to young people, through diverse communication channels. However, few attempts have been made to systematically review the mHealth programs targeted to improve young people SRH in low-and-middle-income countries (LMICs). This review aims to identify a range of different mHealth solutions that can be used for improving young people SRH in LMICs and highlight facilitators and barriers for adopting mHealth interventions designed to target SRH of young people.
Methods: Databases including PubMed, CINAHL Plus, Science Direct, Cochrane Central, and grey literature were searched …

Frontiers In Human Factors: Embedding Specialists In Multi-Disciplinary Efforts To Improve Healthcare., Ken Catchpole, Paul Bowie, Sarah Fouquet, Joy Rivera, Sue Hignett

Manuscripts, Articles, Book Chapters and Other Papers

Despite the application of a huge range of human factors (HF) principles in a growing range of care contexts, there is much more that could be done to realize this expertise for patient benefit, staff well-being and organizational performance. Healthcare has struggled to embrace system safety approaches, misapplied or misinterpreted others, and has stuck to a range of outdated and potentially counter-productive myths even has safety science has developed. One consequence of these persistent misunderstandings is that few opportunities exist in clinical settings for qualified HF professionals. Instead, HF has been applied by clinicians and others, to highly variable degrees-sometimes …

Improving Evidence-Based Grouping Of Transitional Care Strategies In Hospital Implementation Using Statistical Tools And Expert Review, Jing Li, Gaixin Du, Jessica Miller Clouser, Arnold J. Stromberg, Glen Mays, Joann Sorra, Jane Brock, Terry Davis, Suzanne Mitchell, Huong Q. Nguyen, Mark V. Williams

Center for Health Services Research Faculty Publications

BACKGROUND: As health systems transition to value-based care, improving transitional care (TC) remains a priority. Hospitals implementing evidence-based TC models often adapt them to local contexts. However, limited research has evaluated which groups of TC strategies, or transitional care activities, commonly implemented by hospitals correspond with improved patient outcomes. In order to identify TC strategy groups for evaluation, we applied a data-driven approach informed by literature review and expert opinion.

METHODS: Based on a review of evidence-based TC models and the literature, focus groups with patients and family caregivers identifying what matters most to them during care transitions, and expert …

Trends In Diagnoses Of Neonatal Abstinence Syndrome At Newborn Hospitalization In Maine, 2009-2018, Emily C. Bauer Mph, Katherine Ahrens Phd, Jenny L. Carwile Mph, Scd

Journal of Maine Medical Center

Introduction: Incidence rates of neonatal abstinence syndrome (NAS) have increased in Maine, but whether this increase can be explained by use of different diagnosis codes over time is unknown. Our objective was to estimate trends in diagnoses of NAS at newborn hospitalization in Maine using different NAS case definitions.

Methods: We used International Classification of Diseases (ICD) diagnosis codes to identify newborns diagnosed with NAS in Maine between 2009 and 2018 using state-level hospital discharge data (n = 123 519). First, we considered only ICD-9 and ICD-10 codes used for confirmed NAS. Then we used an expanded ICD-10 NAS case …

What Are The Life Experiences Of Health Care Professionals Working During The Covid Pandemic?, Laniece Mcgee

Public Health Education, MPH

Since the end of December 2019, a virus named Coronavirus disease 2019 (COVID-19) has spread rapidly worldwide. First originated in Wuhan China, COVID-19 was declared an international public health emergency by the World Health Organization on January 30, 2020. On March 11, 2020, the COVID-19 outbreak was declared a pandemic. Approximately, there were 792,000 deaths attributed to COVID 19 as of August 21, 2020. Photovoice is a highly recommended participatory research method first introduced by Wang and Burris in the early 90s. The main purpose of photovoice was to give people a way to reflect, talk, learn, share, and make …