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  1. Article ; Online: Emerging principles for health system value improvement programmes.

    Moriates, Christopher / Valencia, Victoria

    BMJ quality & safety

    2019  Volume 28, Issue 6, Page(s) 434–437

    MeSH term(s) Academic Medical Centers ; Accreditation
    Language English
    Publishing date 2019-03-29
    Publishing country England
    Document type Editorial ; Comment
    ZDB-ID 2592912-4
    ISSN 2044-5423 ; 2044-5415
    ISSN (online) 2044-5423
    ISSN 2044-5415
    DOI 10.1136/bmjqs-2019-009427
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Everyday Leadership: A Combined Resident and Faculty Workshop.

    Salib, Sherine / Valencia, Victoria

    Southern medical journal

    2019  Volume 112, Issue 6, Page(s) 301–304

    Abstract: Objectives: Historically, physicians have always been viewed as leaders in the healthcare field. Whether they embrace this role, physicians often find themselves in a leadership role, from the clinical setting to an institutional setting. In most cases, ...

    Abstract Objectives: Historically, physicians have always been viewed as leaders in the healthcare field. Whether they embrace this role, physicians often find themselves in a leadership role, from the clinical setting to an institutional setting. In most cases, this leadership role is taken on without prior training on even the most basic concepts required for effective leadership.
    Methods: We created a combined leadership workshop for both faculty members and residents in training. The topics included an introduction to leadership styles, emotional intelligence, and negotiation skills. The leadership workshop was conducted as an interactive training session for faculty and resident physicians and was embedded during routinely scheduled teaching time for residents.
    Results: We present survey data from two annual workshops, demonstrating a clear improvement in participants' perceived understanding of leadership skills in the areas of leadership style, emotional intelligence, and negotiation skills. We have found that fairly simple measures may be taken to embed this training into the busy schedules of medical faculty and residents in training and that tapping into local expertise was an effective and efficient approach to this.
    Conclusions: We believe the results from our experience can help inform other programs about practical approaches to teaching leadership skills.
    MeSH term(s) Curriculum ; Education ; Faculty, Medical ; Humans ; Internship and Residency ; Leadership ; Professional Competence
    Language English
    Publishing date 2019-06-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 185329-6
    ISSN 1541-8243 ; 0038-4348
    ISSN (online) 1541-8243
    ISSN 0038-4348
    DOI 10.14423/SMJ.0000000000000977
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: What Women Need: a Study of Institutional Factors and Women Faculty's Intent to Remain in Academic Medicine.

    Onumah, Chavon / Wikstrom, Sara / Valencia, Victoria / Cioletti, Anne

    Journal of general internal medicine

    2021  Volume 36, Issue 7, Page(s) 2039–2047

    Abstract: Background: A longstanding gender gap exists in the retention of women in academic medicine. Several strategies have been suggested to promote the retention of women, but there are limited data on impacts of interventions.: Objective: To identify ... ...

    Abstract Background: A longstanding gender gap exists in the retention of women in academic medicine. Several strategies have been suggested to promote the retention of women, but there are limited data on impacts of interventions.
    Objective: To identify what institutional factors, if any, impact women faculty's intent to remain in academic medicine, either at their institutions or elsewhere.
    Design: A survey was designed to evaluate institutional retention-linked factors, programs and interventions, their impact, and women's intent to remain at their institutions and within academic medicine. Survey data were analyzed using non-parametric statistics and regression analyses.
    Participants: Women with faculty appointments within departments of medicine recruited from national organizations and specific social media groups.
    Main measures: Institutional factors that may be associated with women's decision to remain at their current institutions or within academic medicine.
    Key results: Of 410 surveys of women at institutions across the USA, fair and transparent family leave policies and opportunities for work-life integration showed strong associations with intent to remain at one's institution (leave policies: OR 2.22, 95% CI 1.20-4.18, p = 0.01; work-life: OR 4.82, 95% CI 2.50-9.64, p < 0.001) and within academic medicine (leave policies: OR 2.31, 95% CI 1.09-5.03, p = 0.03; work-life: OR 4.66, 95% CI 2.04-11.36, p < 0.001). Other institutional factors associated with intent to remain in academics include peer mentorship (OR 3.16, 95% CI 1.56-6.57, p < 0.01) and women role models (OR 2.21, 95% CI 1.04-4.68, p = 0.04). Institutions helping employees recognize bias, fair compensation and provision of resources, satisfaction with mentorship, peer mentorship, and women role models within the institutions were associated with intent to remain at an institution.
    Conclusions: Our findings suggest that institutional factors such as support for work-life integration, fair and transparent policies, and meaningful mentorship opportunities appear impactful in the retention of women in academic medicine.
    MeSH term(s) Academic Medical Centers ; Career Mobility ; Faculty, Medical ; Female ; Humans ; Job Satisfaction ; Mentors ; Surveys and Questionnaires
    Language English
    Publishing date 2021-05-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639008-0
    ISSN 1525-1497 ; 0884-8734
    ISSN (online) 1525-1497
    ISSN 0884-8734
    DOI 10.1007/s11606-021-06771-z
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Potential Methods to Reduce Unnecessary Use of Laboratory Testing-Reply.

    Moriates, Christopher / Valencia, Victoria

    JAMA internal medicine

    2018  Volume 178, Issue 5, Page(s) 729–730

    MeSH term(s) Humans ; Unnecessary Procedures
    Language English
    Publishing date 2018-05-22
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 2699338-7
    ISSN 2168-6114 ; 2168-6106
    ISSN (online) 2168-6114
    ISSN 2168-6106
    DOI 10.1001/jamainternmed.2018.1213
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Effectiveness of a simulation-based training for health professionals conducting evaluations of alleged torture and ill-treatment.

    Moreno, Alejandro / Hor, Albert / Valencia, Victoria / Iacopino, Vincent

    Journal of forensic and legal medicine

    2020  Volume 76, Page(s) 102073

    Abstract: Simulation has been used as an effective pedagogical tool for complex, high risk industries, including aviation, merchant marine, military, nuclear energy, and healthcare. Forensic science has also employed a variety of simulation training formats, such ... ...

    Abstract Simulation has been used as an effective pedagogical tool for complex, high risk industries, including aviation, merchant marine, military, nuclear energy, and healthcare. Forensic science has also employed a variety of simulation training formats, such as virtual reality simulators, cadaver farms, objective structured clinical exercises, and mock trials. An evaluation of an alleged torture and ill-treatment victim is one of the most challenging types of evaluations forensic experts may conduct given the complex nature of the abuse and its physical and psychological effect, the status of perpetrators being State Officials, and the critical importance of judicial outcomes for alleged victims. The study presents a simulation-based training curriculum on the effective evaluation of alleged torture and ill treatment according to United Nations standards contained in the Istanbul Protocol and its effectiveness as measured by the participants' perceived gains in knowledge and skills. Of 262 participants, 176 pre-training surveys and 150 post-training surveys were collected for a response rate of 67% and 57%, respectively. Of the 899 end of day course evaluations distributed to the participants, 594 were returned for a response rate of 66%. Participants reported that the course increased their confidence to perform all aspects of the medico-legal evaluation of an alleged victim torture and ill-treatment. Participants' median score for the course content, instructors and course material was 5 using a 5-point Likert scale. The findings of this study demonstrate that a simulation-based course significantly improved the cognitive and technical skills necessary to conduct medico-legal evaluations of alleged victims of torture and ill-treatment in accordance with Istanbul Protocol standards.
    MeSH term(s) Adult ; Attitude of Health Personnel ; Crime Victims ; Curriculum ; Educational Measurement ; Female ; Health Personnel/education ; Humans ; Male ; Medical History Taking ; Simulation Training ; Torture
    Language English
    Publishing date 2020-10-27
    Publishing country England
    Document type Journal Article
    ZDB-ID 2268721-X
    ISSN 1878-7487 ; 1752-928X
    ISSN (online) 1878-7487
    ISSN 1752-928X
    DOI 10.1016/j.jflm.2020.102073
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Attitudes and experiences of health professionals towards clinical evaluations of torture and ill-treatment.

    Moreno, Alejandro / Hor, Albert / Valencia, Victoria / Iacopino, Vincent

    Journal of forensic and legal medicine

    2020  Volume 78, Page(s) 102107

    Abstract: Torture and ill-treatment are crimes practiced systematically in many countries around the world. Little is known about the attitudes and experiences of health professionals who evaluate the victims of these crimes. This study was conducted to assess the ...

    Abstract Torture and ill-treatment are crimes practiced systematically in many countries around the world. Little is known about the attitudes and experiences of health professionals who evaluate the victims of these crimes. This study was conducted to assess the attitudes and experiences of health professionals who conduct clinical evaluations of alleged torture and ill-treatment and identify common needs and challenges. Two surveys were administered to health professionals who attended a series of Istanbul Protocol (IP) trainings in various countries of Central Asia, Middle East/North Africa and Latin-America. The findings indicate that participants documented a significant number of torture and ill-treatment cases during a three-year period preceding the survey and that they were interested in conducting evaluations in accordance with the IP, but expressed concern about the impact of such evaluations on their workload and the effects of secondary trauma. Participants indicated support for a wide range of professional development and self-regulatory measures. The study also indicates the need for additional training and other measures to ensure effective documentation practices as 13% of participants failed to understand one of the most basic IP concepts - that the absence of physical and/or psychological evidence does not rule out the possibility that torture and/or ill-treatment occurred.
    MeSH term(s) Adult ; Attitude of Health Personnel ; Crime Victims ; Documentation/standards ; Female ; Guidelines as Topic ; Health Personnel/education ; Health Personnel/psychology ; Humans ; Male ; Middle Aged ; Physical Examination/standards ; Psychological Tests/standards ; Surveys and Questionnaires ; Torture
    Language English
    Publishing date 2020-12-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 2268721-X
    ISSN 1878-7487 ; 1752-928X
    ISSN (online) 1878-7487
    ISSN 1752-928X
    DOI 10.1016/j.jflm.2020.102107
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Factors Associated With the Cost of Care for the Most Common Atraumatic Painful Upper Extremity Conditions.

    Crijns, Tom J / Ring, David / Valencia, Victoria

    The Journal of hand surgery

    2019  Volume 44, Issue 11, Page(s) 989.e1–989.e18

    Abstract: Purpose: To help strategize efforts to optimize value (relative improvement in health for resources invested), we analyzed the factors associated with the cost of care and use of resources for painful, nontraumatic conditions of the upper extremity.: ... ...

    Abstract Purpose: To help strategize efforts to optimize value (relative improvement in health for resources invested), we analyzed the factors associated with the cost of care and use of resources for painful, nontraumatic conditions of the upper extremity.
    Methods: The following were the most common upper extremity diagnoses in the Truven Health MarketScan database: shoulder pain and rotator cuff tendinopathy, shoulder stiffness, shoulder arthritis, lateral epicondylitis, hand arthritis, trigger finger, wrist pain, and hand pain. Multivariable generalized linear regression models were constructed accounting for sex, age, employment status, enrollment year, payer type, emergency room visit, joint injection, magnetic resonance imaging (MRI), physical or occupational therapy, outpatient and inpatient surgery, and insurance type. In addition, we assessed the use of the following 4 diagnostic and treatment interventions: joint injection, surgery, MRI, and physical or occupational therapy.
    Results: Inpatient and outpatient surgery are the largest contributors to the total amount paid for most diagnoses. Older patients had more injections for the majority of conditions.
    Conclusions: Efforts to improve the value of care for nontraumatic upper extremity pain can focus on the relative benefits of surgery compared with other treatments and interventions to lower the costs of surgery (eg, office surgery and limited draping for minor hand surgery).
    Type of study/level of evidence: Economic II.
    MeSH term(s) Adult ; Arm Injuries/epidemiology ; Arm Injuries/physiopathology ; Arm Injuries/surgery ; Chronic Pain/diagnosis ; Chronic Pain/economics ; Chronic Pain/therapy ; Cohort Studies ; Combined Modality Therapy ; Cost of Illness ; Cost-Benefit Analysis/economics ; Databases, Factual ; Female ; Humans ; Logistic Models ; Male ; Medicare/statistics & numerical data ; Middle Aged ; Multivariate Analysis ; Musculoskeletal Diseases/diagnosis ; Musculoskeletal Diseases/economics ; Musculoskeletal Diseases/epidemiology ; Musculoskeletal Diseases/therapy ; Outcome Assessment, Health Care ; Pain Measurement ; Retrospective Studies ; Severity of Illness Index ; Shoulder Pain/diagnosis ; Shoulder Pain/economics ; Shoulder Pain/epidemiology ; Shoulder Pain/therapy ; United States ; Upper Extremity/physiopathology ; Upper Extremity/surgery
    Language English
    Publishing date 2019-02-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605716-0
    ISSN 1531-6564 ; 0363-5023
    ISSN (online) 1531-6564
    ISSN 0363-5023
    DOI 10.1016/j.jhsa.2019.01.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Regional variation in human papillomavirus vaccination uptake and completion among adolescents 13-17 in the state of Texas.

    Conrey, Reghan / Valencia, Victoria / Cioletti, Anne / Williams-Brown, M Yvette

    Vaccine

    2020  Volume 38, Issue 25, Page(s) 4119–4124

    Abstract: Background: HPV vaccination rates remain low in the United States despite efforts to increase them, although rates vary geographically both at the state and regional level within the United States. This study examines differences in teen HPV vaccination ...

    Abstract Background: HPV vaccination rates remain low in the United States despite efforts to increase them, although rates vary geographically both at the state and regional level within the United States. This study examines differences in teen HPV vaccination rates and associated sociodemographic factors among six regions in Texas to understand potential variation insmaller regions. These differences may inform planning of local public health interventions aimed at increasing vaccination uptake in teens.
    Methods: We analyzed sociodemographic and vaccination data for a total of 2256 teens 13-17 years old from six regions in Texas using the 2017 National Immunization Survey--Teen (NIS-Teen). We used survey-weighted chi-squared tests to compare demographic characteristics and HPV vaccination initiation and series completion across regions and multivariable robust Poisson regression models to examine the association between region of residence and HPV vaccination outcomes.
    Results: Rates of initiation and completion of the HPV vaccine series varied significantly between six regions in Texas and were both highest in El Paso County and lowest in Dallas County (initiation 82.8% vs52.5%, P < 0.001; completion 51.3% vs 30.2%, P < 0.001). Adjusted multivariable log binomial regression models demonstrated that teens in Dallas county were significantly less likely to initiate the HPV vaccine series than teens in Travis county (RR = 0.79, 95% CI: (0.65, 0.95), P = 0.01).
    Discussion: HPV vaccination uptake varied significantly between six regions in Texas, highlighting the importance of closely examining local regions in public health planning efforts. Intervention efforts should consider the variation in sociodemographic characteristics as well as policy at the regional level to best improve vaccination rates in communities across the nation.
    MeSH term(s) Adolescent ; Alphapapillomavirus ; Humans ; Immunization ; Papillomavirus Infections/prevention & control ; Papillomavirus Vaccines ; Texas ; United States ; Vaccination
    Chemical Substances Papillomavirus Vaccines
    Language English
    Publishing date 2020-04-27
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 605674-x
    ISSN 1873-2518 ; 0264-410X
    ISSN (online) 1873-2518
    ISSN 0264-410X
    DOI 10.1016/j.vaccine.2020.03.059
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Hospital Buprenorphine Program for Opioid Use Disorder Is Associated With Increased Inpatient and Outpatient Addiction Treatment.

    Christian, Nicholaus / Bottner, Richard / Baysinger, Amber / Boulton, Alanna / Walker, Blair / Valencia, Victoria / Moriates, Christopher

    Journal of hospital medicine

    2021  Volume 16, Issue 6, Page(s) 345–348

    Abstract: Despite evidence that medications for patients with opioid use disorder (OUD) reduce mortality and improve engagement in outpatient addiction treatment, these life-saving medications are underutilized in the hospital setting. This study reports the ... ...

    Abstract Despite evidence that medications for patients with opioid use disorder (OUD) reduce mortality and improve engagement in outpatient addiction treatment, these life-saving medications are underutilized in the hospital setting. This study reports the outcomes of the B-Team (Buprenorphine-Team), a hospitalist-led interprofessional program created to identify hospitalized patients with OUD, initiate buprenorphine in the inpatient setting, and provide bridge prescription and access to outpatient treatment programs. During the first 2 years of the program, the B-Team administered buprenorphine therapy to 132 patients in the inpatient setting; 110 (83%) of these patients were bridged to an outpatient program. Of these patients, 65 patients (59%) were seen at their first outpatient appointment; 42 (38%) attended at least one subsequent appointment 1 to 3 months after discharge from the hospital; 29 (26%) attended at least one subsequent appointment between 3 and 6 months after discharge; and 24 (22%) attended at least one subsequent appointment after 6 months. This model is potentially replicable at other hospitals because it does not require dedicated addiction medicine expertise.
    MeSH term(s) Buprenorphine/therapeutic use ; Hospitals ; Humans ; Inpatients ; Opioid-Related Disorders/drug therapy ; Outpatients
    Chemical Substances Buprenorphine (40D3SCR4GZ)
    Language English
    Publishing date 2021-06-15
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2233783-0
    ISSN 1553-5606 ; 1553-5592
    ISSN (online) 1553-5606
    ISSN 1553-5592
    DOI 10.12788/jhm.3591
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Improving Healthcare Value: Effectiveness of a Program to Reduce Laboratory Testing for Non-Critically-Ill Patients With COVID-19.

    Abdul-Moheeth, Mustafa / Valencia, Victoria / Schaefer, Stewart / Brode, W Michael / Nieto, Kirsten / Moriates, Christopher

    Journal of hospital medicine

    2021  Volume 16, Issue 8, Page(s) 495–498

    Abstract: Avoiding routine, repetitive inpatient laboratory testing is a Choosing ... ...

    Abstract Avoiding routine, repetitive inpatient laboratory testing is a Choosing Wisely
    MeSH term(s) COVID-19 ; Delivery of Health Care ; Humans ; Pandemics ; SARS-CoV-2
    Language English
    Publishing date 2021-10-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2233783-0
    ISSN 1553-5606 ; 1553-5592
    ISSN (online) 1553-5606
    ISSN 1553-5592
    DOI 10.12788/jhm.3649
    Database MEDical Literature Analysis and Retrieval System OnLINE

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