Factors influencing mothers' decisions regarding obstetrical care in Western Kenya: a mixed-methods study.

Background: Siaya County in Western Kenya has one of the highest maternal mortality rates in Kenya. We sought to elucidate factors that influence mothers' decisions regarding where to seek obstetrical care, to inform interventions that seek to promote effective use of obstetric services and reduce maternal mortalities. To guide our research, we used the "Three Delays Model", focusing on the first delay-seeking care.

Validation of the LACE readmission and mortality prediction model in a large surgical cohort: Comparison of performance at preoperative assessment and discharge time points.

Study Objective: The LACE index (Length of stay, admission Acuity, Charlson comorbidity index, and Emergency department visits within 6 months of current admission) is a practical tool designed to predict the risk of readmission or mortality within 30 days of hospital discharge. We sought to validate and examine its performance in a large surgical population at both the preoperative assessment and discharge time points.

Design: Retrospective cohort study.

The impact of reduction of testing at a Preoperative Evaluation Clinic for elective cases: Value added without adverse outcomes.

Study Objective: Protocol changes at Vanderbilt have been adopted with the intention of reducing unnecessary preoperative testing. We sought to evaluate their success and association with clinical decisions.

Design: Retrospective Observational Study SETTING: Vanderbilt's Preoperative Evaluation Clinic MEASUREMENTS: We reviewed and identified a key interval of change on clinical workup protocols which led to a reduction in preoperative testing.

Does the American College of Surgeons National Surgical Quality Improvement Program pediatric provide actionable quality improvement data for surgical neonates?

Background/purpose: The purpose of this project was to examine the American College of Surgeons National Surgical Quality Improvement Program Pediatric (ACSNSQIP-P) Participant Use File (PUF) to compare risk-adjusted outcomes of neonates versus other pediatric surgical patients.

Methods: In the ACS-NSQIP-P 2012-2013 PUF, patients were classified as preterm neonate, term neonate, or nonneonate at the time of surgery. The primary outcomes were 30-day mortality and composite morbidity.

Use of an electronic decision support tool improves management of simulated in-hospital cardiac arrest.

Introduction: Adherence to advanced cardiac life support (ACLS) guidelines during in-hospital cardiac arrest (IHCA) is associated with improved outcomes, but current evidence shows that sub-optimal care is common. Successful execution of such protocols during IHCA requires rapid patient assessment and the performance of a number of ordered, time-sensitive interventions. Accordingly, we sought to determine whether the use of an electronic decision support tool (DST) improves performance during high-fidelity simulations of IHCA.