376 results match your criteria: "Center for Health Services and Outcomes Research[Affiliation]"
BMC Prim Care
July 2024
Center for Health Information and Communication, Department of Veterans Affairs, Health Services Research and Development Service, Veterans Health Administration, Richard L. Roudebush VA Medical Center, CIN 13 416, Indianapolis, IN, USA.
Background: Electronic health records (EHRs) can accelerate documentation and may enhance details of notes, or complicate documentation and introduce errors. Comprehensive assessment of documentation quality requires comparing documentation to what transpires during the clinical encounter itself. We assessed outpatient primary care notes and corresponding recorded encounters to determine accuracy, thoroughness, and several additional key measures of documentation quality.
View Article and Find Full Text PDFAnn Vasc Surg
December 2024
Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Yale University School of Medicine, New Haven, CT.
Background: Inferior vena cava (IVC) filter tilt is associated with technical difficulties at the time of retrieval. However, the degree of tilt that predisposes patients to undergo complex or failed retrieval has not been defined.
Methods: The electronic charts of patients undergoing IVC filter removal between 2010 and 2019 at a single tertiary center were reviewed.
Am J Phys Med Rehabil
November 2024
From the Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, Illinois (MW, PS, FMW, CTE); Parkinson School of Health Sciences and Public Health, Loyola University Chicago, Maywood, Illinois (FMW); Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania (KJS); Department of Medicine, Center for Research on Healthcare, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (KJS); Spinal Cord Injury/Disorders Service, VA Puget Sound Healthcare System, Seattle, Washington (SPB); Department of Physical Medicine and Rehabilitation, University of Washington School of Medicine, Seattle, Washington (SPB); Department of Medicine, Division of Infectious Diseases, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin (NS); Department of Medicine, Division of Infectious Diseases, William S. Middleton VA Hospital, Madison, Wisconsin (NS); College of Nursing, University of Illinois Chicago, Chicago, Illinois (EC); Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine, Chicago, Illinois (CTE); Center of Innovation for Veteran-Centered and Value-Driven Care, Rocky Mountain Regional VA Medical Center, Aurora, Colorado (MAF); and Department of Medicine, Division of Infectious Diseases, University of Colorado Anschutz Medical Campus, Aurora, Colorado (MAF).
Inappropriate urinary tract infection diagnosis in patients with neurogenic bladder may result from ambiguous symptoms experienced by these patients and contributes to antibiotic overuse. Characterization of patient-reported signs and symptoms may help providers more appropriately diagnose urinary tract infections. A previous study collected signs and symptoms recorded in electronic medical records of patients with neurogenic bladder due to spinal cord injury/disorder, multiple sclerosis, and Parkinson's disease with at least one urinary tract infection diagnosis between 2017-2018 at four medical centers.
View Article and Find Full Text PDFJ Hosp Med
December 2024
Department of Medicine, Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Background: Malnutrition in hospitalized patients is associated increased length of stay, cost, readmission, and death. No recent studies have examined trends in prevalence or outcomes of hospitalized patients with a diagnosis of malnutrition.
Objectives: To study the prevalence of malnutrition diagnostic codes and associated hospital outcomes in the United States between 2016 and 2019.
Crit Care Explor
July 2024
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Northwestern University, Chicago, IL.
Objectives: Interhospital transfer of patients with acute respiratory failure (ARF) is relevant in the current landscape of critical care delivery. However, current transfer practices for patients with ARF are highly variable, poorly formalized, and lack evidence. We aim to synthesize the existing evidence, identify knowledge gaps, and highlight persisting questions related to interhospital transfer of patients with ARF.
View Article and Find Full Text PDFPLoS One
June 2024
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America.
Ther Adv Respir Dis
June 2024
Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Kenilworth, NJ, USA.
Background: Chronic cough (CC) affects about 10% of adults, but opioid use in CC is not well understood.
Objectives: To determine the use of opioid-containing cough suppressant (OCCS) prescriptions in patients with CC using electronic health records.
Design: Retrospective cohort study.
Sci Rep
June 2024
Vascular Biology and Therapeutics Program, Yale School of Medicine, New Haven, CT, USA.
Clinical outcomes of arteriovenous fistulae (AVF) for hemodialysis remain inadequate since biological mechanisms of AVF maturation and failure are still poorly understood. Aortocaval fistula creation (AVF group) or a sham operation (sham group) was performed in C57BL/6 mice. Venous limbs were collected on postoperative day 7 and total RNA was extracted for high throughput RNA sequencing and bioinformatic analysis.
View Article and Find Full Text PDFInfect Control Hosp Epidemiol
May 2024
National Infectious Diseases Service, Specialty Care Services, Veterans Health Administration, US Department of Veterans Affairs, Washington, DC, USA.
Objective: Develop and implement a system in the Veterans Health Administration (VA) to alert local medical center personnel in real time when an acute- or long-term care patient/resident is admitted to their facility with a history of colonization or infection with a multidrug-resistant organism (MDRO) previously identified at any VA facility across the nation.
Methods: An algorithm was developed to extract clinical microbiology and local facility census data from the VA Corporate Data Warehouse initially targeting carbapenem-resistant (CRE) and methicillin-resistant (MRSA). The algorithm was validated with chart review of CRE cases from 2010-2018, trialed and refined in 24 VA healthcare systems over two years, expanded to other MDROs and implemented nationwide on 4/2022 as "VA Bug Alert" (VABA).
Antimicrob Steward Healthc Epidemiol
May 2024
Center of Innovation for Complex Chronic Healthcare (CINCCH), Hines Jr. Veterans Affairs Hospital, Hines, IL, USA.
Decreasing the time to contact precautions (CP) is critical to carbapenem-resistant Enterobacterales (CRE) prevention. Identifying factors associated with delayed CP can decrease the spread from patients with CRE. In this study, a shorter length of stay was associated with being placed in CP within 3 days.
View Article and Find Full Text PDFAntimicrob Steward Healthc Epidemiol
April 2024
Center for Health Services and Outcomes Research, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Objective: To describe utilization of at-home coronavirus disease 2019 (COVID-19) testing among healthcare workers (HCW).
Design: Serial cross-sectional study.
Setting And Participants: HCWs in the Chicago area.
J Bone Joint Surg Am
September 2024
Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Background: Recent evidence showing that computer-assisted total knee arthroplasty (TKA) is associated with better outcomes compared with conventional TKA for patients with end-stage knee osteoarthritis has not been included in economic evaluations of computer-assisted TKA, which are needed to support coverage decisions. This study evaluated the cost-effectiveness of computer-assisted TKA from a payer's perspective, incorporating recent evidence.
Methods: We compared computer-assisted TKA with conventional TKA with regard to costs (in 2022 U.
IISE Trans Healthc Syst Eng
April 2023
Biological Sciences Division, University of Chicago, Chicago, Illinois, United States of America.
Evidence suggests system-level norms and care processes influence individual patients' medical decisions, including end-of-life decisions for patients with critical illnesses like acute respiratory failure. Yet, little is known about how these processes unfold over the course of a patient's critical illness in the intensive care unit (ICU). Our objective was to map current-state ICU care delivery processes for patients with acute respiratory failure and to identify opportunities to improve the process.
View Article and Find Full Text PDFCureus
March 2024
Headache Centers of Excellence (HCoE) Research & Evaluation Center, Veterans Health Administration, Department of Veterans Affairs, Orange, USA.
Background Since headache specialists cannot treat all the patients with headache disorders, multidisciplinary teams that include health psychologists are becoming more prevalent. Health psychologists mainly use a form of cognitive-behavioral therapy (CBT), along with biofeedback on occasion, to effectively address patients' pain and headache disorders. The Veterans Health Administration (VHA) is one setting that routinely includes a health psychologist with advanced training in pain disorders in their pain care to its veterans.
View Article and Find Full Text PDFInfect Control Hosp Epidemiol
April 2024
Center for Access & Delivery Research and Evaluation, Iowa City Veterans Affairs Health Care System, Iowa City, IA, USA.
Acad Emerg Med
August 2024
Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Background: Persons living with dementia (PLWD) experience frequent and costly emergency department (ED) visits, with poor outcomes attributed to suboptimal care and postdischarge care transitions. Yet, patient-centered data on ED care experiences and postdischarge needs are lacking. The objective of this study was to examine the facilitators and barriers to successful ED care and care transitions after discharge, according to PLWD and their caregivers.
View Article and Find Full Text PDFJ Public Health Dent
June 2024
College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois, USA.
Objectives: While factors contributing to dental antibiotic overprescribing have previously been described, previous work has lacked any theoretical behavior change framework that could guide future intervention development. The purpose of this study was to use an evidence-based conceptual model to identify barriers and facilitators of appropriate antibiotic prescribing by dentists as a guide for future interventions aimed at modifying antibiotic prescribing.
Methods: Semi-structured interviews were conducted with dentists from the National Dental Practice Based Research Network (PBRN) exploring patient and practice factors perceived to impact antibiotic prescribing.
BMC Health Serv Res
March 2024
Center of Innovation for Complex Chronic Healthcare, Department of Veterans Affairs, Edward Hines, Jr. VA Hospital, 5000 South 5th Ave., Hines, IL, 60141, USA.
Background: Chronic pain is a leading cause of disability and negatively impacts biological/physical, psychological, and social aspects of life resulting in significant pain interference or disability. This project was part of a longitudinal mixed-methods implementation evaluation of the TelePain-Empower Veterans Program (EVP), a non-pharmacological chronic pain intervention. The purpose of this quality management project was to examine electronic patient-reported outcome measures (ePROs) including primary pain-related (intensity, interference, catastrophizing, kinesiophobia) and secondary outcomes (physical, psychological, acceptance, social) to determine TelePain-EVP effectiveness.
View Article and Find Full Text PDFSpinal Cord
May 2024
Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. VA Hospital, Hines, IL, USA.
Study Design: Qualitative study.
Objectives: To explore how knowledge, perceptions, and beliefs about urinary tract infections (UTIs) among persons with neurogenic bladder (NB) may impact health behaviors and provider management and enhance person-centeredness of interventions to improve UTI management.
Setting: Three Veterans Affairs (VA) medical centers.
Med Care
April 2024
Center for Health Services and Outcomes Research, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Background: Evidence of higher hospital volume being associated with improved outcomes for patients undergoing total knee replacement (TKR) is mostly based on arbitrary distribution-based thresholds.
Objective: We aimed to define outcome-based volume thresholds using data from a national database.
Methods: We used the MedPAR Limited Data Set inpatient data from 2010-2015 to identify patients who had undergone primary TKR.
J Community Genet
April 2024
Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Clinical chatbots are increasingly used to help integrate genetic testing into clinical contexts, but no chatbot exists for Apolipoprotein L1 (APOL1) genetic testing of living kidney donor (LKD) candidates of African ancestry. Our study aimed to culturally adapt and assess perceptions of the Gia® chatbot to help integrate APOL1 testing into LKD evaluation. Ten focus groups and post-focus group surveys were conducted with 54 LKDs, community members, and kidney transplant recipients of African ancestry.
View Article and Find Full Text PDFJ Pain
July 2024
Research and Development Service, James A. Haley Veterans' Hospital, Tampa, Florida; Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, Utah.
In response to the opioid epidemic and high rates of chronic pain among the veteran population, the U.S. Department of Veterans Affairs implemented the TelePain-Empower Veterans Program (EVP), a nonpharmacological pain management program for veterans.
View Article and Find Full Text PDFSpec Care Dentist
July 2024
Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, U.S. Department of Veterans Affairs, Pittsburgh, Pennsylvania, USA.
Introduction: Dry socket and infection are complications of tooth extractions. The objective was to determine risk factors for post-extraction complications in patients without antibiotic prophylaxis stratified by early- and late-complications and complication type (oral infection and dry socket).
Methods: Retrospective, case (with complications)-control (without complications) study of patients (n = 708) who had ≥1 extraction performed at any Veterans Health Administration facility between 2015-2019 and were not prescribed an antibiotic 30 days pre-extraction.
Ophthalmic Epidemiol
October 2024
Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Purpose: To investigate the association between visual impairment and employment status due to disability, utilizing data from the 2022 National Health Interview Survey (NHIS).
Methods: Adults 18 years of age and older were extracted from the 2022 NHIS dataset. A multivariable logistic regression model was created to evaluate the odds of unemployment ("laid off" and "looking for work").
Front Pharmacol
January 2024
Center for Health Equity Research and Promotion, VA Pittsburgh Health Care System, Pittsburgh, PA, United States.
Antibiotics prescribed as infection prophylaxis prior to dental procedures have the potential for serious adverse drug events (ADEs). However, the extent to which guideline concordance and different dental settings are associated with ADEs from antibiotic prophylaxis is unknown. The purpose was to assess guideline concordance and antibiotic-associated ADEs and whether it differs by VA and non-VA settings.
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