Mentorship plays a crucial role in the professional development of hospitalists by offering guidance, support, and opportunities for career advancement. Multiple studies have reported that mentorship significantly contributes to improving job performance and cultivating happiness in medicine. Further, mentorship also leads to increased confidence in decision-making, and enhanced work-life balance.
View Article and Find Full Text PDFImportance: Patient experience and patient safety are 2 major domains of health care quality; however empirical data on the association of physician vs nonphysician chief executive officers (CEOs) with public and private quality measures are rare but critical to evaluate as hospitals increasingly seek out physician CEOs.
Objectives: To evaluate whether there is an association of CEO background with hospital quality and to investigate differences in hospital characteristics between hospitals with a physician CEO vs those with a nonphysician CEO.
Design, Setting, And Participants: This cross-sectional study used 2019 data from 3 sources (ie, the American Hospital Association [AHA] Annual Survey, the Hospital Consumer Assessment of Healthcare Providers and Systems [HCAHPS], and the Leapfrog Hospital Safety Grades) to identify statistical differences in hospital characteristics and outcomes.
Pediatr Crit Care Med
February 2021
The Balanced Budget Act of 1997 created a designation for critical access hospitals (CAHs) to sustain care for people living in rural communities who lacked access to care due to hospital closures over the preceding decade. Twenty-five years later, 1350 CAHs serve approximately 18% of the US population and a systematic policy evaluation has yet to be performed. This policy analysis serves to define challenges faced by CAHs through a literature review addressing the four major categories of payment, quality, access to capital, and workforce.
View Article and Find Full Text PDFFront Health Serv Manage
November 2020
The aggregation of Electronic Health Records (EHR) and personalized genetics leads to powerful discoveries relevant to population health. Here we perform genome-wide association studies (GWAS) and accompanying phenome-wide association studies (PheWAS) to validate phenotype-genotype associations of BMI, and to a greater extent, severe Class 2 obesity, using comprehensive diagnostic and clinical data from the EHR database of our cohort. Three GWASs of 500,000 variants on the Illumina platform of 6,645 Healthy Nevada participants identified several published and novel variants that affect BMI and obesity.
View Article and Find Full Text PDFIn this study, we perform a full genome-wide association study (GWAS) to identify statistically significantly associated single nucleotide polymorphisms (SNPs) with three red blood cell (RBC) components and follow it with two independent PheWASs to examine associations between phenotypic data (case-control status of diagnoses or disease), significant SNPs, and RBC component levels. We first identified associations between the three RBC components: mean platelet volume (MPV), mean corpuscular volume (MCV), and platelet counts (PC), and the genotypes of approximately 500,000 SNPs on the Illumina Infimum DNA Human OmniExpress-24 BeadChip using a single cohort of 4,673 Northern Nevadans. Twenty-one SNPs in five major genomic regions were found to be statistically significantly associated with MPV, two regions with MCV, and one region with PC, with p<5x10-8.
View Article and Find Full Text PDFPediatr Crit Care Med
February 2019
J Community Health
June 2018
This study (a) examined the relationships between "top performing" US hospitals and the health status of counties they serve and (b) compared the health status of "top performing" US hospital counties versus that of remaining US counties. Statistical analyses considered US News and World Report Honor Roll ranking data, as a measure of hospital performance, and County Health Rankings (CHR) data, as a measure of county health status. "Top performing" hospital Honor Roll scores were correlated with measures of Clinical Care (p < 0.
View Article and Find Full Text PDFInfect Control Hosp Epidemiol
October 2014
Background: To understand how structural and process elements may affect the risk for surgical site infections (SSIs) in the ambulatory surgery center (ASC) environment, the researchers employed a tool known as socio-technical probabilistic risk assessment (ST-PRA). ST-PRA is particularly helpful for estimating risks in outcomes that are very rare, such as the risk of SSI in ASCs.
Objective: Study objectives were to (1) identify the risk factors associated with SSIs resulting from procedures performed at ASCs and (2) design an intervention to mitigate the likelihood of SSIs for the most common risk factors that were identified by the ST-PRA for a particular surgical procedure.
Background: The Socio-Technical Probabilistic Risk Assessment, a proactive risk assessment tool imported from high-risk industries, was used to identify risks for surgical site infections (SSIs) associated with the ambulatory surgery center setting and to guide improvement efforts.
Objectives: This study had 2 primary objectives: (1) to identify the critical risk factors associated with SSIs resulting from procedures performed at ambulatory surgery centers and (2) to design an intervention to mitigate the probability of SSI for the highest risk factors identified.
Methods: Inputs included quantitative and qualitative data sources from the evidence-based literature and from health care providers.
The residual risk (RR) of transfusion-transmitted infections, including the human immunodeficiency virus and hepatitis B and C viruses, is typically estimated by the incidence[Formula: see text]window period model, which relies on the following restrictive assumptions: Each screening test, with probability 1, (1) detects an infected unit outside of the test's window period; (2) fails to detect an infected unit within the window period; and (3) correctly identifies an infection-free unit. These assumptions need not hold in practice due to random or systemic errors and individual variations in the window period. We develop a probability model that accurately estimates the RR by relaxing these assumptions, and quantify their impact using a published cost-effectiveness study and also within an optimization model.
View Article and Find Full Text PDFObjectives: To examine patient, hospital, and geographic characteristics influencing variation in computed tomography (CT) scan use in inpatients in New York State.
Study Design: Retrospective cohort study.
Methods: We used the 2007 healthcare cost and utilization project's state inpatient database from the agency for healthcare research and quality and applied descriptive univariate statistics and logistic regression models to quantify the influence of each factor on CT scan use.