The mobile vaccine equity enhancement program-a model program for enhancing equity in vaccine availability based at a large health care system.

The SARS CoV-2 (COVID-19) pandemic presented unprecedented challenges as communities attempted to respond to the administration of a novel vaccine that faced cold chain logistical requirements and vaccine hesitancy among many, as well as complicated phased rollout plans that changed frequently as availability of the vaccine waxed and waned. The COVID-19 pandemic also disproportionately affected communities of color and communities with barriers to accessing healthcare. In the setting of these difficulties, a program was created specifically to address inequity in vaccine administration with a focus on communities of color and linguistic diversity as well as those who had technological barriers to online sign-up processes common at mass vaccination sites.

Implications of an inpatient warfarin dosing nomogram on safety outcomes post-discharge.

Many hospitals have implemented warfarin dosing nomograms to improve patient safety. To our knowledge, no study has assessed the impact inpatient warfarin initiation has in both medical and surgical patients, on safety outcomes post discharge. To evaluate the impact of a suggested institutional nomogram for the initiation of warfarin, the primary endpoint was the incidence of bleeding throughout follow up.

Measuring Harm in Health Care: Optimizing Adverse Event Review.

Objective: The objective of this study was to identify modifiable factors that improve the reliability of ratings of severity of health care-associated harm in clinical practice improvement and research.

Methods: A diverse group of clinicians rated 8 types of adverse events: blood product, device or medical/surgical supply, fall, health care-associated infection, medication, perinatal, pressure ulcer, surgery. We used a generalizability theory framework to estimate the impact of number of raters, rater experience, and rater provider type on reliability.

Home medication support for childhood cancer: family-centered design and testing.

Purpose: Errors in the use of medications at home by children with cancer are common, and interventions to support correct use are needed. We sought to (1) engage stakeholders in the design and development of an intervention to prevent errors in home medication use, and (2) evaluate the acceptability and usefulness of the intervention.

Methods: We convened a multidisciplinary team of parents, clinicians, technology experts, and researchers to develop an intervention using a two-step user-centered design process.

Composite model for profiling physicians across domains of care.

Physician profiling methods are envisioned as a means of promoting healthcare quality by recognizing the contributions of individual physicians. Developing methods that can reliably distinguish among physicians' performance is challenging because of small sample sizes, incomplete data, and physician panel differences. In this study, we developed a hierarchical, weighted composite model to reliably compare primary care physicians across domains of care, and we demonstrated its use within a clinical system.

The physician quality officer model: 5-year follow-up.

Physician engagement is a key element of health care quality improvement. Challenges include competing demands, inconsistent compensation, knowledge deficits, and lack of mentorship and role modeling. To help address these obstacles, UMass Memorial Medical Center developed a physician quality officer (PQO) program in 2007.

The "physician-led chart audit: " engaging providers in fortifying a culture of safety.

Objectives: Engaging physicians in quality and patient safety initiatives is a well-described challenge. Barriers include time constraints, lack of defined common purpose and leadership support, poorly communicated goals, and scarcity of supporting data (references 1, 2, 3).With reference to strengthening a culture of safety while meeting regulatory and performance standards, health-care systems face a difficult twin objective: educate the medical staff and its trainees and maintain high levels of compliance across inpatient, ambulatory clinic, and procedural areas.

Impact of cardiac telemetry on patient safety and cost.

Background: With the impetus for healthcare reform and the imperative for healthcare organizations to improve efficiency and reduce waste, it is valuable to examine high-volume procedures and practices in order to identify potential overuse. At the same time, organizations must ensure that improved efficiency does not inadvertently reduce patient safety.

Methods: We undertook a multicenter analysis of the use of adult cardiac telemetry outside of the intensive care unit or step-down units at 4 teaching hospitals to determine the percentage of monitoring days that were not justified by an accepted indication and the monetary costs associated with these nonindicated days.

Mortality rates as a measure of quality and safety, "caveat emptor".

The objective of this study was to demonstrate the impact of a single ICD-9 (International Statistical Classification of Diseases and Related Health Problems, Version 9) code on the observed-to-expected mortality ratios for acute care hospitals, calculated using administrative data. The study was a retrospective analysis of mortality data and prospective measurement of the impact of a change in coding on expected mortality rates. Measurement included overall mortality observed-to-expected mortality index for 2 hospitals and rate of use of the palliative care ICD-9 code.

Physician quality officer: a new model for engaging physicians in quality improvement.

The slow progress in health care quality improvement and patient safety in America can be attributed, in part, to the challenge of physician engagement. As multidisciplinary patient-centered care becomes the standard, it is essential to integrate physicians into this process. To this end, the UMass Memorial Medical Center redesigned its Physician Quality Officer (PQO) program in 2007.