Implementation of a multicomponent medication adherence promotion system is associated with a decrease in late T-cell-mediated rejection.

Poor immunosuppression adherence in pediatric recipients of liver transplant (LT) contributes to late T-cell-mediated rejection (TCMR) in ~90% of cases and increases the risk of mortality. A medication adherence promotion system (MAPS) was found to reduce late rejection in pediatric recipients of kidney transplants. Using quality improvement methodology, we adapted and implemented the MAPS in our LT clinic.

Distinct effects of racial and socioeconomic disparities on biliary atresia diagnosis and outcome.

Objectives: To identify and distinguish between racial and socioeconomic disparities in age at hepatology care, diagnosis, access to surgical therapy, and liver transplant-free survival in patients with biliary atresia (BA).

Methods: Single-center retrospective cohort study of 69 BA patients from 2010 to 2021. Patients were grouped into White and non-White cohorts.

Paradoxical pulmonary artery systolic pressure response with catheter-directed therapies for pulmonary embolism.

Background: Early data on use of catheter-directed therapies (CDT) for treatment of Intermediate or High-Risk pulmonary embolism (PE) show improvement in pulmonary artery systolic pressures (PAsP) and RV/LV ratios. Occasionally a paradoxical rise in PAsP was observed with CDT utilizing ultrasound-assisted thrombolysis (USAT). It is unclear whether this pattern is seen with CDT utilizing mechanical aspiration.

Using Gamification to Engage Clinical Nurses in Quality Improvement.

Engaging clinical nurses in quality improvement is essential to achieve improved patient outcomes. By using gamification, nursing professional development specialists can increase motivation and improve attitudes toward quality improvement. This project was designed to create and implement a virtual escape room to engage clinical nurses in nursing-sensitive quality improvement.