The Pittsburgh Regional Healthcare Initiative (PRHI) is an innovative model for health system change based on regionwide shared learning. By linking patient outcomes data with processes of care and sharing that information widely, PRHI supports measurable improvements in regionwide clinical practice and patient safety. In addition, through the redesign of problem solving at the front lines of care, PRHI helps health care organizations to evolve toward becoming sustainable systems of perfect patient care. This paper describes PRHI's design for change, reviews the progress and limitations of the shared learning model, and offers a set of broader policy considerations.
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http://dx.doi.org/10.1377/hlthaff.22.5.157 | DOI Listing |
Urology
December 2024
Department of Urology, University of Michigan, Ann Arbor, MI.
Objectives: To determine how many cores should be collected per region of interest in magnetic resonance imaging (MRI)-guided fusion prostate biopsy. MRI-guided targeted prostate biopsy has led to improved detection of clinically significant prostate cancer (csPC); however, data is limited regarding the optimal number of biopsy cores that should be taken. An ideal number of cores maximizes clinically significant cancer detection while minimizing cost, discomfort, and procedure time.
View Article and Find Full Text PDFJAMA Netw Open
December 2024
Influenza Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, Georgia.
Importance: Increasing the understanding of vaccine effectiveness (VE) against levels of severe influenza in children could help increase uptake of influenza vaccination and strengthen vaccine policies globally.
Objective: To investigate VE in children by severity of influenza illness.
Design, Setting, And Participants: This case-control study with a test-negative design used data from 8 participating medical centers located in geographically different US states in the New Vaccine Surveillance Network from November 6, 2015, through April 8, 2020.
Arch Osteoporos
December 2024
Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Unlabelled: This study examines how power training affects estimated bone strength, revealing that females benefit more than males, especially in the upper limbs (radius). These findings highlight the importance of designing sex-specific exercise programs to enhance bone health. Further research is needed to optimize training duration and address site-specific differences.
View Article and Find Full Text PDFToxins (Basel)
December 2024
Poison Control Center, The University of Arizona College of Pharmacy, Tucson, AZ 85724, USA.
The onset, progression, and severity of pain following rattlesnake envenomation are highly variable between patients. Pain can be severe and persistent, seemingly refractory to opioid analgesics. The ability of antivenom to directly relieve pain has not been well studied.
View Article and Find Full Text PDFGeriatrics (Basel)
December 2024
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA.
Background: Hand dexterity is affected by normal aging and neuroinflammatory processes in the brain. Understanding the relationship between hand dexterity and brain structure in neurotypical older adults may be informative about prodromal pathological processes, thus providing an opportunity for earlier diagnosis and intervention to improve functional outcomes.
Methods: this study investigates the associations between hand dexterity and brain measures in neurotypical older adults (≥65 years) using the Nine-Hole Peg Test (9HPT) and magnetic resonance imaging (MRI).
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