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  1. Article: Major Bleeding After Paracentesis Associated With Apixaban Use: Two Case Reports.

    Kuperman, Ethan / Hobbs, Ryan A

    Hospital pharmacy

    2022  Volume 58, Issue 1, Page(s) 34–37

    Abstract: We report 2 patients with compensated cirrhosis and moderate renal impairment who experienced severe bleeding complications from paracentesis during concurrent therapy with apixaban. While paracentesis has traditionally been considered a low bleeding- ... ...

    Abstract We report 2 patients with compensated cirrhosis and moderate renal impairment who experienced severe bleeding complications from paracentesis during concurrent therapy with apixaban. While paracentesis has traditionally been considered a low bleeding-risk procedure and safe to perform without interruption of therapeutic anticoagulation, the increased concentrations observed in patients with impaired liver function may place these patients at unexpectedly high bleeding risk. Further investigation into the safety of paracentesis in patients with cirrhosis on apixaban may be warranted, as well as additional understanding of the clinical safety of this drug in Child-Pugh B cirrhosis.
    Language English
    Publishing date 2022-07-28
    Publishing country United States
    Document type Case Reports
    ZDB-ID 1468893-1
    ISSN 0018-5787
    ISSN 0018-5787
    DOI 10.1177/00185787221111741
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  2. Article ; Online: Using Telehealth as a Tool for Rural Hospitals in the COVID-19 Pandemic Response.

    Gutierrez, Jeydith / Kuperman, Ethan / Kaboli, Peter J

    The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association

    2020  Volume 37, Issue 1, Page(s) 161–164

    MeSH term(s) COVID-19/epidemiology ; Consultants ; Cooperative Behavior ; Credentialing/organization & administration ; Hospitals, Rural/organization & administration ; Humans ; Inservice Training ; Internet/standards ; Pandemics ; SARS-CoV-2 ; Telemedicine/organization & administration ; United States/epidemiology
    Keywords covid19
    Language English
    Publishing date 2020-06-01
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 639160-6
    ISSN 1748-0361 ; 0890-765X
    ISSN (online) 1748-0361
    ISSN 0890-765X
    DOI 10.1111/jrh.12443
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  3. Article ; Online: A systematic review of telehealth applications in hospital medicine.

    Gutierrez, Jeydith / Rewerts, Kelby / CarlLee, Sheena / Kuperman, Ethan / Anderson, Melver L / Kaboli, Peter J

    Journal of hospital medicine

    2022  Volume 17, Issue 4, Page(s) 291–302

    Abstract: Background: Despite the proliferation of telehealth, uptake for acute inpatient services has been slower. Hospitalist shortages in rural and critical access hospitals as well as the COVID-19 pandemic have led to a renewed interest in telehealth to ... ...

    Abstract Background: Despite the proliferation of telehealth, uptake for acute inpatient services has been slower. Hospitalist shortages in rural and critical access hospitals as well as the COVID-19 pandemic have led to a renewed interest in telehealth to deliver acute inpatient services. Understanding current evidence is crucial for promoting uptake and developing evidence-based practices.
    Objective: To conduct a systematic review of telehealth applications in acute inpatient general medicine and pediatric hospital wards and synthesize available evidence.
    Data sources: A search of five databases (PubMed, CINAHL, Embase, Scopus, and ProQuest Theses, and Dissertations) using a combination of search terms including telemedicine and hospital medicine/inpatient care keywords yielded 17,015 citations.
    Study selection and data extraction: Two independent coders determined eligibility based on inclusion and exclusion criteria. Data were extracted and organized into main categories based on findings: (1) feasibility and planning, (2) implementation and technology, and (3) telehealth application process and outcome measures.
    Results: Of the 20 publications included, three were feasibility and planning studies describing the creation of the program, services provided, and potential cost implications. Five studies described implementation and technology used, including training, education, and evaluation methods. Finally, twelve discussed process and outcome measures, including patient and provider satisfaction and costs.
    Conclusion: Telehealth services for hospital medicine were found to be effective, well received, and initial cost estimates appear favorable. A variety of services were described across programs with considerable benefit appreciated by rural and smaller hospitals. Additional work is needed to evaluate clinical outcomes and overall program costs.
    MeSH term(s) COVID-19 ; Child ; Hospital Medicine ; Humans ; Pandemics ; Rural Population ; Telemedicine
    Language English
    Publishing date 2022-03-06
    Publishing country United States
    Document type Journal Article ; Review ; Systematic Review ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 2233783-0
    ISSN 1553-5606 ; 1553-5592
    ISSN (online) 1553-5606
    ISSN 1553-5592
    DOI 10.1002/jhm.12801
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  5. Article ; Online: Using Telehealth as a Tool for Rural Hospitals in the COVID‐19 Pandemic Response

    Gutierrez, Jeydith / Kuperman, Ethan / Kaboli, Peter J.

    The Journal of Rural Health ; ISSN 0890-765X 1748-0361

    2020  

    Keywords Public Health, Environmental and Occupational Health ; covid19
    Language English
    Publisher Wiley
    Publishing country us
    Document type Article ; Online
    DOI 10.1111/jrh.12443
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Implementation of Clinical Practice Guidelines for Hospitalized Patients With COVID-19 in Academic Medical Centers.

    Berger, Amy Chang / Simchoni, Noa / Auerbach, Andrew / Brode, W Michael / Kuperman, Ethan / Raffel, Katie / Kubey, Alan

    JAMA network open

    2022  Volume 5, Issue 4, Page(s) e225657

    MeSH term(s) Academic Medical Centers ; COVID-19 ; Humans ; Patients ; Practice Guidelines as Topic
    Language English
    Publishing date 2022-04-01
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S. ; Research Support, Non-U.S. Gov't
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2022.5657
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  7. Article ; Online: Outcomes of a home telemonitoring program for SARS-CoV-2 viral infection at a large academic medical center.

    Bryant, Andrew D / Robinson, Tommy J / Gutierrez-Perez, Jeydith T / Manning, Bradley L / Glenn, Kevin / Imborek, Katherine L / Kuperman, Ethan F

    Journal of telemedicine and telecare

    2022  Volume 30, Issue 4, Page(s) 675–680

    Abstract: Introduction: Telemedicine serves as a viable option during the COVID-19 pandemic to provide in-home care, maintain home isolation precautions, reduce unnecessary healthcare exposures, and de-burden hospitals.: Methods: We created a novel ... ...

    Abstract Introduction: Telemedicine serves as a viable option during the COVID-19 pandemic to provide in-home care, maintain home isolation precautions, reduce unnecessary healthcare exposures, and de-burden hospitals.
    Methods: We created a novel telemedicine program to closely monitor patients infected with SARS-CoV-2 (COVID-19) at home. Adult patients with COVID-19 were enrolled in the program at the time of documented infection. Patients were followed by a team of providers via telephone or video visits at frequent intervals until resolution of their acute illness. Additionally, patients were stratified into high-risk and low-risk categories based on demographics and underlying comorbidities. The primary outcome was hospitalization after enrollment in the home monitoring program, including 30 days after discharge from the program.
    Results: Over a 3.5-month period, 1128 patients met criteria for enrollment in the home monitoring program. 30.7% were risk stratified as high risk for poor outcomes based on their comorbidities and age. Of the 1128 patients, 6.2% required hospitalization and 1.2% required ICU admission during the outcome period. Hospitalization was more frequent in patients identified as high risk (14.2% vs 2.7%,
    Discussion: Enrollment in a home monitoring program appears to be an effective and sustainable modality for the ambulatory management of COVID-19.
    MeSH term(s) Adult ; Humans ; COVID-19 ; SARS-CoV-2 ; Pandemics ; Telemedicine ; Academic Medical Centers
    Language English
    Publishing date 2022-03-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 1340281-x
    ISSN 1758-1109 ; 1357-633X
    ISSN (online) 1758-1109
    ISSN 1357-633X
    DOI 10.1177/1357633X221086067
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    Zs.A 4525: Show issues Location:
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  8. Article ; Online: Impact of adding additional providers to resident workload and the resident experience on a medical consultation rotation.

    Fang, Michele / Linson, Eric / Suneja, Manish / Kuperman, Ethan F

    BMC medical education

    2017  Volume 17, Issue 1, Page(s) 44

    Abstract: Background: Excellence in Graduate Medical Education requires the right clinical environment with an appropriate workload where residents have enough patients to gain proficiency in medicine with optimal time for reflection. The Accreditation Council ... ...

    Abstract Background: Excellence in Graduate Medical Education requires the right clinical environment with an appropriate workload where residents have enough patients to gain proficiency in medicine with optimal time for reflection. The Accreditation Council for Graduate Medical Education (ACGME) has focused more on work hours rather than workload; however, high resident workload has been associated with lower resident participation in education and fatigue-related errors. Recognizing the potential risks associated with high resident workload and being mindful of the costs of reducing resident workload, we sought to reduce residents' workload by adding an advanced practice provider (APP) to the surgical comanagement service (SCM) and study its effect on resident satisfaction and perceived educational value of the rotation.
    Methods: In Fiscal Year (FY) 2014 and 2015, an additional faculty member was added to the SCM rotation. In FY 2014, the faculty member was a staff physician, and in FY 2015, the faculty member was an APP.. Resident workload was assessed using billing data. We measured residents' perceptions of the rotation using an anonymous electronic survey tool. We compared FY2014-2015 data to the baseline FY2013.
    Results: The number of patients seen per resident per day decreased from 8.0(SD 3.3) in FY2013 to 5.0(SD 1.9) in FY2014 (p < 0.001) and 5.7(SD 2.0) in FY2015 (p < 0.001). A higher proportion of residents reported "just right" patient volume (64.4%, 91.7%, 96.7% in FY2013, 2014, 2015 respectively p < 0.001), meeting curricular goals (79.9%, 95.0%, 97.2%, in FY2013, 2014 and 2015 respectively p < 0.001), and overall educational value of the rotation (40.0%, 72.2%, 72.6% in FY2013, 2014, 2015 respectively, p < 0.001).
    Conclusions: Decreasing resident workload through adding clinical faculty (both staff physician and APPs) was associated with improvements on resident perceived educational value and clinical experience of a medical consultation rotation.
    MeSH term(s) Accreditation ; Attitude of Health Personnel ; Clinical Competence/standards ; Education, Medical, Graduate/standards ; Fatigue ; Humans ; Internship and Residency ; Iowa ; Job Satisfaction ; Personal Satisfaction ; Personnel Staffing and Scheduling ; Quality of Health Care/standards ; Work Schedule Tolerance/psychology ; Workload/psychology ; Workload/statistics & numerical data
    Language English
    Publishing date 2017-02-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 2044473-4
    ISSN 1472-6920 ; 1472-6920
    ISSN (online) 1472-6920
    ISSN 1472-6920
    DOI 10.1186/s12909-017-0874-7
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  9. Article ; Online: The Development and Evaluation of a Novel Instrument Assessing Residents' Discharge Summaries.

    Hommos, Musab S / Kuperman, Ethan F / Kamath, Aparna / Kreiter, Clarence D

    Academic medicine : journal of the Association of American Medical Colleges

    2017  Volume 92, Issue 4, Page(s) 550–555

    Abstract: Purpose: To develop and determine the reliability of a novel measurement instrument assessing the quality of residents' discharge summaries.: Method: In 2014, the authors created a discharge summary evaluation instrument based on consensus ... ...

    Abstract Purpose: To develop and determine the reliability of a novel measurement instrument assessing the quality of residents' discharge summaries.
    Method: In 2014, the authors created a discharge summary evaluation instrument based on consensus recommendations from national regulatory bodies and input from primary care providers at their institution. After a brief pilot, they used the instrument to evaluate discharge summaries written by first-year internal medicine residents (n = 24) at a single U.S. teaching hospital during the 2013-2014 academic year. They conducted a generalizability study to determine the reliability of the instrument and a series of decision studies to determine the number of discharge summaries and raters needed to achieve a reliable evaluation score.
    Results: The generalizability study demonstrated that 37% of the variance reflected residents' ability to generate an adequate discharge summary (true score variance). The decision studies estimated that the mean score from six discharge summary reviews completed by a unique rater for each review would yield a reliability coefficient of 0.75. Because of high interrater reliability, multiple raters per discharge summary would not significantly enhance the reliability of the mean rating.
    Conclusions: This evaluation instrument reliably measured residents' performance writing discharge summaries. A single rating of six discharge summaries can achieve a reliable mean evaluation score. Using this instrument is feasible even for programs with a limited number of inpatient encounters and a small pool of faculty preceptors.
    MeSH term(s) Clinical Competence ; Educational Measurement/methods ; Hospitals, Teaching ; Humans ; Internal Medicine/education ; Internship and Residency ; Patient Discharge Summaries/standards ; Pilot Projects ; Reproducibility of Results ; Retrospective Studies ; United States
    Language English
    Publishing date 2017-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 96192-9
    ISSN 1938-808X ; 1040-2446
    ISSN (online) 1938-808X
    ISSN 1040-2446
    DOI 10.1097/ACM.0000000000001450
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  10. Article: The Association between the Electronic Health Record and Patient-Reported Receipt of Tobacco Cessation Care in Hospitalized Veterans.

    Kuperman, Ethan F / Chapin, Jennifer / Grant, Kathleen M / Vander Weg, Mark W / Katz, David A

    Joint Commission journal on quality and patient safety

    2018  Volume 44, Issue 5, Page(s) 304–306

    MeSH term(s) Aged ; Electronic Health Records/standards ; Electronic Health Records/statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Patient Reported Outcome Measures ; Quality Improvement/standards ; Retrospective Studies ; Self Report/standards ; Self Report/statistics & numerical data ; Tobacco Use Cessation/methods ; United States ; United States Department of Veterans Affairs ; Veterans
    Language English
    Publishing date 2018-05-11
    Publishing country Netherlands
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 1189890-2
    ISSN 1938-131X ; 1549-425X ; 1553-7250 ; 1070-3241 ; 1549-3741
    ISSN (online) 1938-131X ; 1549-425X
    ISSN 1553-7250 ; 1070-3241 ; 1549-3741
    DOI 10.1016/j.jcjq.2017.11.004
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