Publications by authors named "Fred Rubin"
Background/objectives: To describe the Mobility Action Group (MACT), an innovative process to enhance implementation of hospital mobility programs and create a culture of mobility in acute care.
Design: Continuous quality improvement intervention with episodic data review.
Setting: Inpatient units including medical, surgical, and intensive care settings.
Objectives: To compare rates of 30-day readmission between hospital units with a Hospital Elder Life Program (HELP) and control units without HELP.
Design: Retrospective cohort study.
Setting: The study took place from July 1, 2013, to June 30, 2014, at the University of Pittsburgh Medical Center Shadyside, a 520-bed community teaching hospital that has used HELP since 2002.
The Hospital Elder Life Program (HELP), an effective intervention to prevent delirium in older hospitalized adults, has been successfully replicated in a community teaching hospital as a quality improvement project. This article reports on successfully sustaining the program over 7 years and expanding its scale from one to six inpatient units at the same hospital. The program currently serves more than 7,000 older patients annually and is accepted as the standard of care throughout the hospital.
View Article and Find Full Text PDFNursing home residents' quality of life (QoL) is directly related to the quality improvement (QI) processes mandated by federal law. This article describes a 3-year longitudinal study of QI process innovations in two nursing homes and highlights details of a successful 6-month initiative. The initial QI initiatives were based on the principles of staff empowerment, enhanced ability through training, and financial incentives.
View Article and Find Full Text PDFPurpose: Several studies have previously documented the existence of a perception gap-the extent to which quality-of-life ratings provided by nursing home residents and caregivers diverge. In this study we use Helson's adaptation-level theory to investigate three types of antecedents: (a) focal factors, (b) background factors, and (c) residual factors.
Design And Methods: We calculated the perception gap for 11 quality-of-life domains.
Objectives: To evaluate a replication of the Hospital Elder Life Program (HELP), a quality-improvement model, in a community hospital without a research infrastructure, using administrative data.
Design: A pretest/posttest quality-improvement study.
Setting: A 500-bed community teaching hospital in western Pennsylvania.
Objective: To determine if educating nursing home staff about pressure ulcer prevention reduces the differential risk of pressure ulcer development in black and white nursing home residents.
Design: Subanalysis of a study designed to monitor the emergence of all pressure ulcers in nursing home residents during 12-week baseline and intervention periods.
Participants: All residents and staff of a not-for-profit, 136-bed nursing home in urban western Pennsylvania.
Objective: Quality improvement (QI) processes in nursing homes are highly variable and often ineffective. This study evaluated an innovative QI process to reduce pressure ulcers (PUs) in a nursing home with a high rate of PUs.
Design: This was a 48-week, longitudinal study comparing the incidence of PUs during 12-week baseline and intervention and post-intervention periods.
Background: Residents covering attendings' patients must decide when to call the attending and when to evaluate patients at the bedside for new clinical events. Conflicts arise when residents and attendings disagree about these decisions.
Purpose: Our purpose was to determine differences in expectations between attendings and residents concerning the need for phone communication about, and bedside evaluation of, new patient problems in hospitalized patients.