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Health Care Delivery Publications


What Do We Do After the Pilot Is Done? Implementation of a Hospital Early Warning System at Scale

Adults who deteriorate outside the ICU have high mortality. Most rapid response systems (RRSs) have employed manual detection processes that rapid response teams (RRTs) use to identify patients at risk. This project piloted the use of an automated early w...
Author(s): Paulson SS; Dummett BA; Green J; Scruth E; Reyes V; Escobar GJ

Jt Comm J Qual Patient Saf. 2020 Jan 21.

PubMed abstract

Sounds good: the bright future of clinical alarm management initiatives

Author(s): Ruppel H; Bonafide CP

BMJ Qual Saf. 2020 Feb 21.

PubMed abstract

Association of Mobile Patient Portal Access With Diabetes Medication Adherence and Glycemic Levels Among Adults With Diabetes

Online patient portals support self-management, and mobile devices expand portal access, but whether this translates to improvements in diabetes outcomes is unclear. To examine the association of adding mobile patient portal access with diabetes medicatio...
Author(s): Graetz I; Huang J; Muelly ER; Fireman B; Hsu J; Reed ME

JAMA Netw Open. 2020 Feb 05;3(2):e1921429. Epub 2020-02-05.

PubMed abstract

Association Between Peripheral Blood Oxygen Saturation (SpO2)/Fraction of Inspired Oxygen (FiO2) Ratio Time at Risk and Hospital Mortality in Mechanically Ventilated Patients

Acute respiratory failure requiring mechanical ventilation is a leading cause of mortality in the intensive care unit. Although single peripheral blood oxygen saturation/fraction of inspired oxygen (SpO2/FiO2) ratios of hypoxemia have been evaluated to ri...
Author(s): Adams JY; Rogers AJ; Schuler A; Marelich GP; Fresco JM; Taylor SL; Riedl AW; Baker JM; Escobar GJ; Liu VX

Perm J. 2020;24. Epub 2020-01-31.

PubMed abstract

'No growth to date'? Predicting positive blood cultures in critical illness

Author(s): Liu VX; Wiens J

Intensive Care Med. 2020 Jan 21.

PubMed abstract

Primary Care Practitioners' Perspectives on Burnout and What to Do About It

Author(s): Grant RW; Goitein L

JAMA Intern Med. 2020 Jan 06.

PubMed abstract

Goldilocks, the Three Bears and Intensive Care Unit Utilization: Delivering Enough Intensive Care But Not Too Much. A Narrative Review

Professional societies have developed recommendations for patient triage protocols, but wide variations in triage patterns for many acute conditions exist among hospitals in the United States. Differences in hospitals' triage patterns can be attributed to...
Author(s): Myers LC; Escobar G; Liu VX

Pulm Ther. 2020 Jan 03.

PubMed abstract

The Hospital Readmissions Reduction Program and Readmissions for Chronic Obstructive Pulmonary Disease, 2006-2015.

RATIONALE: In October 2012, the initial phase of the Hospital Readmission Reduction Program (HRRP) imposed financial penalties on hospitals with higher than expected risk-adjusted 30-day readmission rate...
Author(s): Myers, Laura C; Faridi, Mohammad K; Hasegawa, Kohei; Hanania, Nicola A; Camargo, Carlos A

Annals of the American Thoracic Society. 2019 Dec 20;():. Epub 2019-12-20.

PubMed abstract

ICU Utilization for Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease Receiving Noninvasive Ventilation.

OBJECTIVES: We investigated whether patients with chronic obstructive pulmonary disease could safely receive noninvasive ventilation outside of the ICU.

DESIGN: Retr...
Author(s): Myers, Laura C; Faridi, Mohammad Kamal; Currier, Paul; Camargo, Carlos A

Critical care medicine. 2019 05 20;47(5):677-684. Epub 2019-12-20.

PubMed abstract

Outcomes of Robotic Hysterectomy for Treatment of Benign Conditions: Influence of Patient Complexity

Robotic hysterectomy may offer advantages for complex cases over the conventional laparoscopic approach. To assess the association of surgical approach (robotic vs conventional) with blood loss, risks of readmission, reoperation, complications, and averag...
Author(s): Herrinton LJ; Raine-Bennett T; Liu L; Alexeeff SE; Ramos W; Suh-Burgmann B

Perm J. 2020;24. Epub 2019-12-18.

PubMed abstract

An Examination of Medical Malpractice Claims Involving Physician Trainees.

PURPOSE: To identify patient-, provider- and claim-related factors of medical malpractice claims in which physician trainees were directly involved in the harm events.

METHOD: The author...
Author(s): Myers, Laura C; Gartland, Rajshri M; Skillings, Jillian; Heard, Lisa; Bittner, Edward A; Einbinder, Jonathan; Metlay, Joshua P; Mort, Elizabeth

Academic medicine : journal of the Association of American Medical Colleges. 2019 Dec 10;47(5):677-684. Epub 2019-12-10.

PubMed abstract

Multiyear Rehospitalization Rates and Hospital Outcomes in an Integrated Health Care System

Since the introduction of the rehospitalization rate as a quality measure, multiple changes have taken place in the US health care delivery system. Interpreting rehospitalization rates without taking a global view of these changes and new data elements fr...
Author(s): Escobar GJ; Plimier C; Greene JD; Liu V; Kipnis P

JAMA Netw Open. 2019 Dec 02;2(12):e1916769. Epub 2019-12-02.

PubMed abstract

Changing Results-Engage and Activate to Enhance Wellness: A Randomized Clinical Trial to Improve Cardiovascular Risk Management

Background Despite the success of current cardiovascular disease (CVD) management programs, many patients do not achieve optimal control of CVD-related risk factors. New strategies are needed to better activate and engage these patients. Methods and Resul...
Author(s): Iturralde E; Sterling SA; Uratsu CS; Mishra P; Ross TB; Grant RW

J Am Heart Assoc. 2019 Dec 03;8(23):e014021. Epub 2019-11-30.

PubMed abstract

Comorbid Diabetes and Severe Mental Illness: Outcomes in an Integrated Health Care Delivery System

Diabetes prevalence is twice as high among people with severe mental illness (SMI) when compared to the general population. Despite high prevalence, care outcomes are not well understood. To compare diabetes health outcomes received by people with and wit...
Author(s): Mangurian C; Schillinger D; Newcomer JW; Vittinghoff E; Essock S; Zhu Z; Dyer W; Young-Wolff KC; Schmittdiel J

J Gen Intern Med. 2019 Nov 08.

PubMed abstract

Enhanced Recovery After Surgery to Change Process Measures and Reduce Opioid Use After Cesarean Delivery: A Quality Improvement Initiative.

OBJECTIVE: To evaluate implementation of an enhanced recovery after surgery (ERAS) program for patients undergoing elective cesarean delivery by comparing opioid exposure, multimodal analgesia use, and other process and ou...
Author(s): Hedderson, Monique M; Lee, Derrick D; Hunt, Eric E; Lee, Kimberly K; Xu, Fei F; Mustille, Alex A; Galin, Jessica J; Campbell, Cynthia C; Quesenberry, Charles C; Reyes, Vivian V; Huang, Mengfei M; Nicol, Barbara B; Paulson, Shirley S; Liu, Vincent V

Obstetrics and gynecology. 2019 Sep ;134(3):511-519. Epub --.

PubMed abstract

More Than We Bargained For: The "Dominating" Cost Effectiveness of Sepsis Quality Improvement?

Author(s): Peltan ID; Liu VX

Crit Care Med. 2019 Oct;47(10):1464-1467.

PubMed abstract

Use and Discontinuation of Insulin Treatment Among Adults Aged 75 to 79 Years With Type 2 Diabetes

Among older individuals with type 2 diabetes, those with poor health have greater risk and derive less benefit from tight glycemic control with insulin. To examine whether insulin treatment is used less frequently and discontinued more often among older i...
Author(s): Weiner JZ; Gopalan A; Mishra P; Lipska KJ; Huang ES; Laiteerapong N; Karter AJ; Grant RW

JAMA Intern Med. 2019 Sep 23.

PubMed abstract

Neonatal Sepsis Evaluation: Facing the Certainty of Uncertainty

Author(s): Puopolo KM; Escobar GJ

JAMA Pediatr. 2019 Sep 03.

PubMed abstract

Portal Use Among Patients With Chronic Conditions: Patient-reported Care Experiences

Personal health records offer patients access to view their own health information and to manage their care online through secure patient portal tools. Little is known about the patient-reported experience in using health portals to manage chronic conditi...
Author(s): Reed ME; Huang J; Millman A; Graetz I; Hsu J; Brand R; Ballard DW; Grant R

Med Care. 2019 Aug 14.

PubMed abstract

Identifying Common Predictors of Multiple Adverse Outcomes Among Elderly Adults With Type-2 Diabetes

As part of a multidisciplinary team managing patients with type-2 diabetes, pharmacists need a consistent approach of identifying and prioritizing patients at highest risk of adverse outcomes. Our objective was to identify which predictors of adverse outc...
Author(s): Kabue S; Liu V; Dyer W; Raebel M; Nichols G; Schmittdiel J

Med Care. 2019 Jul 26.

PubMed abstract

Risk of Cardiovascular Events in Statin-Treated Patients with Type 2 Diabetes and Metabolic Dyslipidemia without Prevalent Atherosclerotic Cardiovascular Disease

The relationship between achieved low-density lipoprotein cholesterol (LDL-C) levels and risk of incident atherosclerotic cardiovascular disease events among patients with diabetes and metabolic dyslipidemia has not been well described. We conducted an ob...
Author(s): Rana JS; Liu JY; Moffet HH; Sanchez RJ; Khan I; Karter AJ

Am J Med. 2019 Jul 22.

PubMed abstract

Assessing clinical heterogeneity in sepsis through treatment patterns and machine learning

To use unsupervised topic modeling to evaluate heterogeneity in sepsis treatment patterns contained within granular data of electronic health records. A multicenter, retrospective cohort study of 29 253 hospitalized adult sepsis patients between 2010 and ...
Author(s): Fohner AE; Greene JD; Lawson BL; Chen JH; Kipnis P; Escobar GJ; Liu VX

J Am Med Inform Assoc. 2019 Jul 17.

PubMed abstract

Patient-Defined Visit Priorities in Primary Care: Psychosocial Versus Medically-Related Concerns

Primary care providers (PCPs) are often challenged to address multiple patient concerns during time-limited visits. The need for PCPs to limit the number of issues addressed may have a negative impact on discussion of patient-defined visit priorities. Usi...
Author(s): Santo EC; Vo MT; Uratsu CS; Grant RW

J Am Board Fam Med. 2019 Jul-Aug;32(4):513-520.

PubMed abstract

Opportunities to encourage mail order pharmacy delivery service use for diabetes prescriptions: a qualitative study

Medication non-adherence is a major contributor to poor outcomes in diabetes. Previous research has shown an association between use of mail order pharmacy delivery and better medication adherence, but little is known about the barriers and facilitators t...
Author(s): Schmittdiel JA; Marshall CJ; Wiley D; Chau CV; Trinacty CM; Wharam JF; Duru OK; Karter AJ; Brown SD

BMC Health Serv Res. 2019 Jun 25;19(1):422. Epub 2019-06-25.

PubMed abstract

Postoperative Opioid Use Before and After Enhanced Recovery After Surgery Program Implementation

Author(s): Liu VX; Eaton A; Lee DC; Reyes VM; Paulson SS; Campbell CI; Avins AL; Parodi SM

Ann Surg. 2019 Jun 20.

PubMed abstract