Community-based, Hospital-Affiliated Medical Group Becomes a Successful Accountable Care Organization.

Leadership of a multispecialty group practice within a health system recognized in 2015 that population health management requires quality performance improvement and organizational culture change. While blueprints for building successful Accountable Care Organizations (ACOs) exist in the literature, few describe the journey to achieving both shared savings and high quality outcomes achieved by a medical group within an academic health system. Clinician education and engagement, prioritizing prevention and achieving benchmarks, developing supportive roles, more precise documentation of accurate diagnostic coding, and risk stratification constituted the approach.

Saliva as a Potential Specimen to Monitor IL-6, TNF-α and IL-10 in COVID-19 Patients.

The SARS-CoV-2 instigated "cytokine storm" elicited upon infection is known to majorly cause lung injury and even mortality in severe cases. Early clinical prognosis to alleviate the exaggerated release of inflammatory cytokines is thus looked upon. Considering the recent attention and advantages of saliva as a clinical specimen, i.

Anti-inflammatory response of cardamom extract and prediction of therapeutic window in COVID-19 patients by assessing inflammatory markers using RT-PCR.

Introduction: Molecular diagnostics using RT-PCR has now emerged as the new diagnostic method for clinicians with the dawn of SARS-CoV-2. In India, the popularity and awareness of RT-PCR and particularly the increased availability of testing machines across hospitals has now opened up possibilities of diagnostic tests with RT-PCR. In view of the cytokine storm which is the significant reason for morbidity and mortality of COVID-19 patients, we proposed to test the usefulness of a multiplex RT-PCR test kit that simultaneously measured inflammatory markers namely, IL-6, TNF- α and IL-10 (IFM) all in one tube.

Opportunities for single-use plastic reduction in the food service sector during COVID-19.

The COVID-19 pandemic caused a surge in consumption of single-use plastics (SUPs), particularly in the food service sector, due to concerns for public health and safety. To follow public health guidelines, food services have been limited to takeout service and have restricted use of personal reusable items. This study investigated opportunities to reduce increased use of SUPs in Nova Scotia food services sparked by the COVID-19 pandemic using semi-structured interviews and focus groups with stakeholders from the food service sector.

Human Saliva as a Diagnostic Specimen for Early Detection of Inflammatory Biomarkers by Real-Time RT-PCR.

Nowadays human saliva is more frequently studied as a non-invasive, stress-free, and preferable diagnostic material than blood. Supporting evidences acknowledge saliva as a mirror that reflects the body's physical state. Numerous studies have also demonstrated the presence and use of RNA derived from saliva in the early diagnosis of disease by real-time reverse transcriptase polymerase chain reaction (RT-PCR).

Incorporation of grape seed extract towards wound care product development.

Naturally derived ingredients are becoming more prevalent in therapeutic drug formulations due to consumers' concerns about chemical side effects. In the context of wound care, despite the impressive progress in therapeutic product development, drugs dispensed to treat impaired healing challenged by biofilms; excessive inflammation and oxidation are not yet really effective. Thus, the hunts for improved drug formulations preferably using natural ingredients that are cost-effective in accelerating the wound-healing process are of constant demand.

Exploring Cadaver Skin For Standardization Of Rabbit And Porcine Burn Models In Research.

Burn animal models provide substantial insights into burn pathophysiology. Choice of the apt model is important for determining the clinical efficacy of new medicines. Therefore, standardization of burn models is crucial for scientific research.

Prevention is better: the case of the underutilized failure mode effect analysis in patient safety.

Prospective hazard analysis methodologies, like failure modes and effects analysis (FMEA), have been tried and tested in the engineering industry and are more recently gaining momentum in healthcare. Considering FMEA's evidence based successes, this commentary makes the case that healthcare is underutilizing the methodology by relying on retrospective hazard analysis. Healthcare leaders should determine where prospective hazard analysis principles could be better built into care delivery planning and processes that will enhance patient safety.

Reflective Practice: A Tool for Readmission Reduction.

Factors intrinsic to local practice, but not captured by the medical record, contribute to readmissions. Frontline providers familiar with their practice systems can identify these. The objective was to decrease 30-day hospital readmissions.

Counting CD4(+) and CD8(+) T cells in the spleen: a novel in vivo method for assessing biomaterial immunotoxicity.

As immunotoxicity assessments of newly developed biomaterials are often restricted to use in assessment of local tissue response at the implantation site, they do not always show an immune response acceptable to qualify them for clinical use. We tested a new method to assess systemic toxicity: counting the CD4(+) and CD8(+) cells in the spleen. Three different biomaterials were subcutaneously implanted in three groups of rats for the same time period.

Creating a Patient-Centered Health Care Delivery System: A Systematic Review of Health Care Quality From the Patient Perspective.

Patient experience is one of key domains of value-based purchasing that can serve as a measure of quality and be used to improve the delivery of health services. The aims of this study are to explore patient perceptions of quality of health care and to understand how perceptions may differ by settings and condition. A systematic review of multiple databases was conducted for studies targeting patient perceptions of quality of care.

Clinical decision support improves quality of telephone triage documentation--an analysis of triage documentation before and after computerized clinical decision support.

Background: Clinical decision support (CDS) has been shown to be effective in improving medical safety and quality but there is little information on how telephone triage benefits from CDS. The aim of our study was to compare triage documentation quality associated with the use of a clinical decision support tool, ExpertRN©.

Methods: We examined 50 triage documents before and after a CDS tool was used in nursing triage.

Physician satisfaction and burnout at different career stages.

Objective: To explore the work lives, professional satisfaction, and burnout of US physicians by career stage and differences across sexes, specialties, and practice setting.

Participants And Methods: We conducted a cross-sectional study that involved a large sample of US physicians from all specialty disciplines in June 2011. The survey included the Maslach Burnout Inventory and items that explored professional life and career satisfaction.

Mentoring programs for physicians in academic medicine: a systematic review.

Purpose: Mentoring is vital to professional development in the field of medicine, influencing career choice and faculty retention; thus, the authors reviewed mentoring programs for physicians and aimed to identify key components that contribute to these programs' success.

Method: The authors searched the MEDLINE, EMBASE, and Scopus databases for articles from January 2000 through May 2011 that described mentoring programs for practicing physicians. The authors reviewed 16 articles, describing 18 programs, extracting program objectives, components, and outcomes.

Clinical audit on "evaluation of special issues in adolescents with cancer treated in an adult cancer setting": an Indian experience.

Background: Adolescents with cancer form a distinct group with special care needs. These patients are often cared in an adult supportive care setting where the special needs of adolescents are not met.

Aim: To identify special issues in adolescents with cancer and to determine whether special needs of adolescents are met in an adult cancer setting

Materials And Methods: 10 adolescents with cancer were randomly chosen and retrospectively studied for physical, psychoscocial and emotional issues using an internally validated tool.

Protective eyewear selection for interventional fluoroscopy.

Three protective eyewear models were evaluated to determine effectiveness in reducing radiation dose to a fluoroscopist's eyes. The performance of the protective eyewear was measured using radiation dosimeters in a fluoroscopy suite. An Eyewear Protection Factor was determined for each model in each of three exposure orientations.

Nutrition in the hospitalized patient.

Almost 50% of patients are malnourished on admission; many others develop malnutrition during admission. Malnutrition contributes to hospital morbidity, mortality, costs, and readmissions. The Joint Commission requires malnutrition risk screening on admission.

A clinical deterioration prediction tool for internal medicine patients.

Many early warning models for hospitalized patients use variables measured on admission to the hospital ward; few have been rigorously derived and validated. The objective was to create and validate a clinical deterioration prediction tool using routinely collected clinical and nursing measurements. Multivariate regression analysis was used to determine clinical variables statistically associated with clinical deterioration; subsequently, the model tool was retrospectively validated using a different cohort of medical inpatients.

The positive impact of a facilitated peer mentoring program on academic skills of women faculty.

Background: In academic medicine, women physicians lag behind their male counterparts in advancement and promotion to leadership positions. Lack of mentoring, among other factors, has been reported to contribute to this disparity. Peer mentoring has been reported as a successful alternative to the dyadic mentoring model for women interested in improving their academic productivity.