2023 Inaugural Healthcare Delivery Science: Innovation and Partnerships for Health Equity Research (DESCIPHER) Symposium.

Introduction: This article provides an overview of presentations and discussions from the inaugural Healthcare Delivery Science: Innovation and Partnerships for Health Equity Research (DESCIPHER) Symposium.

Methods: The symposium brought together esteemed experts from various disciplines to explore models for translating evidence-based interventions into practice.

Results: The symposium highlighted the importance of disruptive innovation in healthcare, the need for multi-stakeholder engagement, and the significance of family and community involvement in healthcare interventions.

Transitioning from the Emergency Department to a General Internist Outpatient Clinic for Paracentesis: A Qualitative Inquiry.

Background: Repeated paracentesis for ascites can place significant demands on the emergency department (ED). A new general internist-led outpatient procedure clinic to alleviate this demand required ED staff and patients to accept this transition of care.

Aim: This qualitative study evaluates barriers and facilitators to implementing the FLuid ASPiration (FLASP) clinic in a safety net hospital.

A Mixed-Methods Exploration of Competencies and Professional Development Needs Among Chief Certified Registered Nurse Anesthetists.

This project sought to explore the experiences, self-perceived preparation, professional development needs, and preferred learning methods of certified registered nurse anesthetists (CRNAs) in a management role. A sample of 10 current chief CRNAs responded to a demographics survey and participated in one-on-one interviews using a 14-question, semi-structured interview framework modified from a previous study. Interview responses were deidentified and qualitatively analyzed for common themes by two content experts and one qualitative analysis expert.

Disparities in Care for Low-Income Patients with Cirrhosis: Implementing an Innovative Outpatient Clinic for Refractory Ascites in a Safety Net Hospital.

Background: Disparities in life-saving interventions for low-income patients with cirrhosis necessitate innovative models of care.

Aim: To implement a novel generalist-led FLuid ASPiration (FLASP) clinic to reduce emergency department (ED) care for refractory ascites.

Setting: A large safety net hospital in Los Angeles.

Partners in vaccination: A community-based intervention to promote COVID-19 vaccination among low-income homebound and disabled adults.

Background: Care managers (CM) for low-income disabled clients may address COVID-19 vaccine hesitancy with specific training.

Objective: To assess the Partners in Vaccination (PIV) that trained CMs of a homecare program for disabled adults to promote COVID-19 vaccination.

Methods: We randomized 78 CMs to PIV intervention (N = 38) or control (N = 40).

Transitioning from the Emergency Department to a General Internist Outpatient Clinic for Paracentesis: A Qualitative.

Background: Repeated paracentesis for ascites can place significant demands on the emergency department (ED). A new general internist-led outpatient procedure clinic to alleviate this demand required ED staff and patients to accept this transition of care.

Aim: This qualitative study evaluates barriers and facilitators to implementing the FLuid ASPiration (FLASP) clinic in a safety net hospital.

Wellness Tour for Tribal Communities During the COVID-19 Pandemic: Uniting Sacred Space with Western Medicine to Prevent Substance Use.

Substance use disorders (SUD) and overdose deaths worsened further during the Covid-19 pandemic in American Indian and Alaska Native (AIAN) communities. The Native Dad's Network (NDN) delivered the Wellness Tour, offering cultural activities and SUD prevention education, from March 2021 to June 2022, to 11 AIAN tribal communities across California. The in-person program created a "sacred space" through culturally congruent song, dance, and prayer.

Implicit Racial Bias Attitudes and Mitigation in Neonatal Nurse Practitioners: A Quality Improvement Project.

Purpose: to assess the impact of education using the implicit bias recognition and management (IBRM) teaching approach.

Design: longitudinal quasi-experimental design. Surveys at baseline, immediate postimplementation, and 4-week postimplementation using the modified version of the Attitudes Toward Implicit Bias Instrument (ATIBI).

Effectiveness of a Modified Nurse-Led COUGH Bundle for Obese Patients After Bariatric Surgery.

Background: Obesity commonly affects postsurgical pulmonary outcomes and is associated with increased oxygen usage, length of recovery and hospital stay, discharge to high levels of care, cost, morbidity, and mortality.

Local Problem: No standardized pulmonary care bundle for obese patients after bariatric surgery was available in the postanesthesia care unit (PACU) at a hospital in Singapore.

Methods: This quality improvement project was a prospective, single-cohort, pre- and posttest intervention design with 151 patients recruited.

American Indian and Alaska Native substance use treatment: Barriers and facilitators according to an implementation framework.

Introduction: Substance use disorder (SUD) and overdose deaths are higher in the American Indian and Alaska Native (AIAN) population than in other racial/ethnic groups. Multi-level gaps hinder SUD treatment for AIAN patients. Few studies have engaged front-line clinicians and administrators of SUD treatment programs serving AIAN patients to identify barriers and facilitators to improve the implementation of effective treatment.

Prevention of Hepatocellular Carcinoma (HCC). White Paper of the Texas Collaborative Center for Hepatocellular Cancer (TeCH) Multi-stakeholder Conference.

Background & Aims: Texas has the highest age-adjusted incidence rate of hepatocellular carcinoma (HCC) in the United States. The Cancer Prevention and Research Institute of Texas has funded the Texas Collaborative Center for Hepatocellular Cancer (TeCH) to facilitate HCC research, education, and advocacy activities with the overall goal of reducing HCC mortality in Texas through coordination, collaboration, and advocacy.

Methods: On September 17, 2022, TeCH co-sponsored a multi-stakeholder conference on HCC with the Baker Institute Center for Health and Biosciences.

The integration of primary care and childhood cancer survivorship care: a scoping review.

Purpose: This scoping review describes existing care models that integrate primary care and childhood cancer survivorship care, examines the effectiveness of these models, and characterizes barriers and facilitators to their integration.

Methods: A systematic search (PubMed®, CINAHL®, Embase®) was conducted to identify citations which were evaluated against inclusion criteria using the PICOTTS framework. The PRISMA-ScR extension for scoping reviews was used to report review findings (protocol https://osf.

Evidence-Based Quality Improvement: a Scoping Review of the Literature.

Background: Quality improvement (QI) initiatives often reflect approaches based on anecdotal evidence, but it is unclear how initiatives can best incorporate scientific literature and methods into the QI process. Review of studies of QI initiatives that aim to systematically incorporate evidence review (termed evidence-based quality improvement (EBQI)) may provide a basis for further methodological development.

Methods: In this scoping review (registration: https://osf.

Implementing a Clinical Decision Tool to Improve Oncologic Venous Thromboembolism Management.

Background: Cancer patients with venous thromboembolic (VTE) disease are complex, and many factors must be considered when initiating anticoagulation management. Clinical decision support systems can aid in decision-making by utilizing guidelines at the point of care.

Objectives: The purpose of our project was to develop, implement, and evaluate an electronic clinical decision tool (CDT) utilizing evidence-based guidelines to aid in decision-making for adult oncologic patients who present with new VTE to symptom care clinics.

Integrating primary care and childhood cancer survivorship care: a scoping review protocol.

Introduction: Improved treatment regimens have led to increased survival rates among childhood cancer survivors (CCS), and more than 84% of all children diagnosed with cancer will experience long-term survival or cure. Survivors are susceptible to late effects of cancer treatment often requiring lifelong follow-up care, as many of these conditions can be prevented or mitigated with surveillance. Integrating primary care (PC) and childhood cancer survivorship care can improve follow-up for survivors, however, little integrative research exists.

Integrating Management of Hepatitis C Infection into Primary Care: the Key to Hepatitis C Elimination Efforts.

Elimination of hepatitis C virus (HCV), a leading cause of liver disease in the USA and globally, has been made possible with the advent of highly efficacious direct acting antivirals (DAAs). DAA regimens offer cure of HCV with 8-12 weeks of a well-tolerated once daily therapy. With increasingly straightforward diagnostic and treatment algorithms, HCV infection can be managed not only by specialists, but also by primary care providers.

Association of nonpharmacologic chronic pain management with function in a low-income population: Evidence from a survey of a sample of Latinos from five states.

Background: Low-income minority populations often confront barriers to professional nonpharmacologic management of chronic pain and, without this care, may have poorer daily function.

Objective: To examine the association of professional nonpharmacologic chronic pain management in the past year categorized as physical interventions or mind-body interventions with current functional status.

Design: Online, population-based survey.

Genetic Diversity of L. (Hydrocharitaceae) Stands across Europe.

Intense land use and river regulations have led to the destruction of wetland habitats in the past 150 years. One plant that is affected by the reduction in appropriate habitats is the macrophyte which has become rare in several areas. The preservation of genetic diversity within a species is a prerequisite for survival under changing environmental conditions.

Improving Efficiency Using Electronic Medical Record Rounding Report & Sign-Out Report.

Introduction: Standardized rounding and sign-out reports can improve provider efficiency and satisfaction. The purpose of this quality improvement project was to evaluate implementing an electronic medical record-integrated neonatal intensive care unit-specific rounding report and sign-out report on provider efficiency and satisfaction.

Method: A pre- and post-quality improvement project was implemented to evaluate the effectiveness of standardized electronic rounding and sign-out reports on a 48-bed level-4 neonatal intensive care unit staffed daily by two neonatologists and four advanced practice providers.

Assessing Insomnia in Active-Duty Service Members in a Military Primary Care Clinic.

Background: Insomnia is a significant problem in the U.S. military, affecting the health, resiliency, and readiness of service members (Seelig et al.

Buddy Care, a Peer-to-Peer Intervention: A Pilot Quality Improvement Project to Decrease Occupational Stress Among an Overseas Military Population.

Introduction: Occupational stress can have a direct influence on worker safety and health. Navy medical professionals are known to neglect self-care, putting them at risk for deteriorations in psychological health that can lead to adverse patient outcomes. To support medical professionals, a peer-to-peer intervention called Buddy Care, embedded in Navy Medicine's Caregiver Occupational Stress Control (CgOSC) program, was evaluated.

Educating Primary Care Providers and Associate Care Providers About Hepatitis C Screening of Baby Boomers: a Multi-practice Study.

Chronic hepatitis C virus (HCV) increases the risk for hepatocellular carcinoma. Despite higher prevalence of HCV in persons born 1945-1965 (baby boomer), screening has not been widely adopted. Both primary care providers (PCPs) and associate care providers (ACPs) need to be educated about the rationale and methods to screen for HCV.