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  1. Article ; Online: Characterizing the Utilization of the Problem List for Pediatric Trauma Care.

    Durojaiye, Ashimiyu B / McGerorge, Nicolette / Kristen, Webster / Oruc, Cagla / Fackler, James C / Gurses, Ayse P

    AMIA ... Annual Symposium proceedings. AMIA Symposium

    2018  Volume 2018, Page(s) 404–412

    Abstract: The EHR problem list has the potential to support care coordination among the multidisciplinary care team that cares for pediatric trauma patients. To realize this potential, the need exists to ensure appropriate utilization by formulating acceptable ... ...

    Abstract The EHR problem list has the potential to support care coordination among the multidisciplinary care team that cares for pediatric trauma patients. To realize this potential, the need exists to ensure appropriate utilization by formulating acceptable usage and management policy. In this regard, understanding the prevailing utilization pattern is pivotal. To this end, we analyzed EHR in tandem with trauma registry data at a Level I pediatric trauma center. Almost all (97.8%) of the actions executed on the problem list were addition of items. Among the 517 patient encounters in the cohort, 263 (48.9%) encounters involving sicker patients had at least one problem list item added, mostly within the first 4 hours of arrival, while in the emergency department, and by providers in the service of record. This represents a foundation to build upon. Subsequent research will explore completeness, accuracy, and the impact of the utilization on patient outcomes.
    MeSH term(s) Child ; Child, Preschool ; Electronic Health Records ; Emergency Service, Hospital ; Female ; Humans ; Male ; Medical Records, Problem-Oriented ; Pediatrics/organization & administration ; Registries ; Trauma Centers ; Traumatology/organization & administration
    Language English
    Publishing date 2018-12-05
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, P.H.S.
    ISSN 1942-597X
    ISSN (online) 1942-597X
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: A model for an institutional response to the opioid crisis.

    Hanna, Marie N / Chambers, Chester / Punyala, Ananth / Iqbal, Asniya / Singh, Bhuchitra / Oruc, Cagla / Prakash, Priyamvadha / Prajapati, Yash / Wang, Yidong / Amery Ai, Zeyu / Shechter, Ronen / Speed, Traci J / Koch, Colleen G / Williams, Kayode

    Journal of opioid management

    2020  Volume 16, Issue 1, Page(s) 73–83

    Abstract: The use of opioid analgesics for pain management has increased dramatically over the past decade, with corresponding increases in negative sequelae including overdose and death. Physicians, policymakers, and researchers are focused on finding ways to ... ...

    Abstract The use of opioid analgesics for pain management has increased dramatically over the past decade, with corresponding increases in negative sequelae including overdose and death. Physicians, policymakers, and researchers are focused on finding ways to decrease opioid use and overdose. This crisis calls for a coordinated response that includes the entire healthcare sector. In this work, the authors lay out a blueprint for such a response at the level of the academic medical center. The proposed model is a comprehensive opioid overdose prevention, response, and education program to evaluate, monitor, and address prescription opioid-related adverse events and addiction among all patients within a healthcare system. The approach includes three inter-related elements: (1) creation of an organizational structure that is subdivided into subcommittees to facilitate cross-functional collaboration and implementation. These subcommittees will focus on Research and Design, Implementation, Advisory, and Compliance with the recommendation. (2) Development of an effective communication plan throughout the institution to enable the organization to function seamlessly and efficiently as a single unit, (3) development of a data tracking and reporting system that intended to have a 360° view of all aspects of opioid prescription and downstream patient outcomes. The most effective response system will require an organizational structure that facilitates the ad hoc constitution of cross-functional teams with members drawn from all levels of the organizational hierarchy (executive leadership to frontline staff). Such a structure provides the teams with immediate solutions as developed by the frontline staff and authority to remove institutional barriers that may delay or limit the successful implementation. The model described was developed in our institution by a cross-functional team that included members from the Johns Hopkins School of Medicine and Johns Hopkins University Carey Business School, Department of Operations Management. The multidisciplinary nature of collaboration allowed us to develop a model for an immediate institution-wide response to the opioid crisis, and one that other healthcare organizations could adopt with local modification as a template for execution. The model also meant to serve as a template for an institutional rapid-response that can be seamlessly implemented during any future drug-related crisis or epidemic.
    MeSH term(s) Academic Medical Centers/standards ; Analgesics, Opioid/adverse effects ; Drug Overdose/prevention & control ; Humans ; Models, Organizational ; Opioid Epidemic ; Opioid-Related Disorders/prevention & control ; Pain Management
    Chemical Substances Analgesics, Opioid
    Language English
    Publishing date 2020-02-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2397614-7
    ISSN 1551-7489
    ISSN 1551-7489
    DOI 10.5055/jom.2020.0553
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Targeted gown and glove use to prevent

    Lydecker, Alison D / Osei, Patience A / Pineles, Lisa / Johnson, J Kristie / Meisel, Jacquelyn / Stine, O Colin / Magder, Laurence / Gurses, Ayse P / Hebden, Joan / Oruc, Cagla / Mody, Lona / Jacobs Slifka, Kara / Stone, Nimalie D / Roghmann, Mary-Claire

    Infection control and hospital epidemiology

    2020  Volume 42, Issue 4, Page(s) 448–454

    Abstract: Objective: To test the feasibility of targeted gown and glove use by healthcare personnel caring for high-risk nursing-home residents to prevent Staphylococcus aureus acquisition in short-stay residents.: Design: Uncontrolled clinical trial.: ... ...

    Abstract Objective: To test the feasibility of targeted gown and glove use by healthcare personnel caring for high-risk nursing-home residents to prevent Staphylococcus aureus acquisition in short-stay residents.
    Design: Uncontrolled clinical trial.
    Setting: This study was conducted in 2 community-based nursing homes in Maryland.
    Participants: The study included 322 residents on mixed short- and long-stay units.
    Methods: During a 2-month baseline period, all residents had nose and inguinal fold swabs taken to estimate S. aureus acquisition. The intervention was iteratively developed using a participatory human factors engineering approach. During a 2-month intervention period, healthcare personnel wore gowns and gloves for high-risk care activities while caring for residents with wounds or medical devices, and S. aureus acquisition was measured again. Whole-genome sequencing was used to assess whether the acquisition represented resident-to-resident transmission.
    Results: Among short-stay residents, the methicillin-resistant S. aureus acquisition rate decreased from 11.9% during the baseline period to 3.6% during the intervention period (odds ratio [OR], 0.28; 95% CI, 0.08-0.92; P = .026). The methicillin-susceptible S. aureus acquisition rate went from 9.1% during the baseline period to 4.0% during the intervention period (OR, 0.41; 95% CI, 0.12-1.42; P = .15). The S. aureus resident-to-resident transmission rate decreased from 5.9% during the baseline period to 0.8% during the intervention period.
    Conclusions: Targeted gown and glove use by healthcare personnel for high-risk care activities while caring for residents with wounds or medical devices, regardless of their S. aureus colonization status, is feasible and potentially decreases S. aureus acquisition and transmission in short-stay community-based nursing-home residents.
    MeSH term(s) Cross Infection/prevention & control ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Nursing Homes ; Pilot Projects ; Staphylococcal Infections/prevention & control ; Staphylococcus aureus
    Language English
    Publishing date 2020-10-20
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 639378-0
    ISSN 1559-6834 ; 0195-9417 ; 0899-823X
    ISSN (online) 1559-6834
    ISSN 0195-9417 ; 0899-823X
    DOI 10.1017/ice.2020.1219
    Database MEDical Literature Analysis and Retrieval System OnLINE

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