Changing the research landscape: the New York City Clinical Data Research Network.

The New York City Clinical Data Research Network (NYC-CDRN), funded by the Patient-Centered Outcomes Research Institute (PCORI), brings together 22 organizations including seven independent health systems to enable patient-centered clinical research, support a national network, and facilitate learning healthcare systems. The NYC-CDRN includes a robust, collaborative governance and organizational infrastructure, which takes advantage of its participants' experience, expertise, and history of collaboration. The technical design will employ an information model to document and manage the collection and transformation of clinical data, local institutional staging areas to transform and validate data, a centralized data processing facility to aggregate and share data, and use of common standards and tools.

Pay for performance improves quality across demographic groups.

Objective: To evaluate quality and the effect of pay for performance among minority patient groups, during a pay-for-performance program in 22 primary care practice sites.

Methods: Data were collected on 26 standardized measures of care for 2 measurement cycles. Proportions of recommended care received across 5 composite quality domains were analyzed by demographic group.

Standardizing race, ethnicity, and preferred language data collection in hospital information systems: results and implications for healthcare delivery and policy.

The Institute of Medicine has identified the need for healthcare organizations to collect standardized demographic data as a step toward reducing healthcare disparities. This observational study of patients discharged from a large academic medical center between 2005 and 2009, evaluates an organizational effort to standardize demographic data collection, characterizes limitations of the implementation, and assesses its utility in quality improvement and disparity reduction efforts. Primary measures include percentages of inpatient discharges with unknown race, ethnicity, and language data.

Investigation of inpatient probiotic use at an academic medical center.

Objectives: Despite the widespread use of probiotics, there are limited data regarding their safety. The aims of this study were to characterize inpatient probiotic use and to determine the incidence of probiotic-related bloodstream infections due to Lactobacillus acidophilus/Lactobacillus bulgaricus.

Methods: This study was a two-part retrospective study conducted at a large academic medical center.

Improving primary percutaneous coronary intervention performance in an urban minority population using a quality improvement approach.

It has been well established that there are racial and ethnic disparities in cardiovascular care. Quality improvement initiatives have been recommended to proactively address these disparities. An initiative was implemented to improve timeliness of and access to primary percutaneous coronary intervention (PCI) procedures among myocardial infarction patients at an academic medical center serving a predominantly minority population.

The incidence of infectious complications of central venous catheters at the subclavian, internal jugular, and femoral sites in an intensive care unit population.

Objective: The objective was to assess the risk of central venous catheter infection with respect to the site of insertion in an intensive care unit population. The subclavian, internal jugular, and femoral sites were studied.

Design: An epidemiologic, prospective, observational study.

Improving the rates of inpatient pneumococcal vaccination: impact of standing orders versus computerized reminders to physicians.

Objective: To determine the impact of interventions using standing orders and computerized reminders to physicians on inpatient pneumococcal vaccination rates relative to a control group.

Design: Open trial of the following approaches, each on a different ward: (1) standing orders for vaccination of eligible consenting patients, (2) computerized reminders to physicians, and (3) usual practice.

Setting And Patients: Four hundred twenty-four patients were admitted to three 30-bed inpatient medical wards during a 4-month period in 1999 at one hospital.

Evidence for biliary excretion of vancomycin into stool during intravenous therapy: potential implications for rectal colonization with vancomycin-resistant enterococci.

Sixty-three stool samples and five bile samples were prospectively collected from 33 patients receiving intravenous vancomycin therapy and were quantitatively analyzed for vancomycin by a competitive immunoassay. Vancomycin was excreted via bile into the stools of almost all patients at concentrations of 3.3 to 94.