Obstetric Life Support Education for Maternal Cardiac Arrest: A Randomized Clinical Trial.

Importance: Management of maternal cardiac arrest (MCA) requires understanding the unique physiology of pregnancy and modifications to life support. Health care professionals have historically demonstrated inadequate knowledge and skills necessary to treat MCA.

Objective: To evaluate the effect of Obstetric Life Support (OBLS) education on health care professionals' cognitive performance, skills, and self-efficacy in managing MCA.

Will a Programmatic Framework Integrating Food Is Medicine Achieve Value on Investment?

Diet-related chronic diseases account for seven out of the ten leading causes of death in the USA. Food is Medicine (FIM) interventions can be effective adjuncts to standard medical care to address this cost burden. While the Food is Medicine Pyramid recommends some culinary skill development when integrating FIM into healthcare, the emphasis is on medically tailored meals and food provision.

Identifying Asian American lung cancer disparities: A novel analytic approach.

Objective: Asian Americans include heterogeneous subpopulations with unique burden as the only racial group with cancer as the leading cause of death. The purpose of the study was to identify differences in clinical stage and survival of patients with lung cancer between Asian Americans and its subgroups relative to other racial groups.

Methods: Patients with lung cancer from 2016 National Cancer Database were divided into East Asian, Southeast Asian, South Asian subgroups based on geographic origins, and a composite Asian American group with White non-Hispanic, Black, and Hispanic comparison groups.

Single-center pilot study of remote therapeutic monitoring in patients with operative spinal pathologies.

Objectives: Spine pathology affects a significant portion of the population, leading to neck and back pain, impacting quality of life, and potentially requiring surgical intervention. Current pre- and postoperative monitoring methods rely on patient reported outcome (PRO) measures and lack continuous objective data on patients' recoveries. Remote therapeutic monitoring (RTM) using wearable devices offers a promising solution to bridge this gap, providing real-time physical function data.

Large-scale Implementation of a COVID-19 Remote Patient Monitoring Program.

Introduction: We implemented a large-scale remote patient monitoring (RPM) program for patients diagnosed with coronavirus 2019 (COVID-19) at a not-for-profit regional healthcare system. In this retrospective observational study, patients from nine emergency department (ED) sites were provided a pulse oximeter and enrolled onto a monitoring platform upon discharge.

Methods: The RPM team captured oxygen saturation (SpO), heart rate, temperature, and symptom progression data over a 16-day monitoring period, and the team engaged patients via video call, phone call, and chat within the platform.

Validation of a Simulation-Based Resuscitation Curriculum for Maternal Cardiac Arrest.

Objective: To assess the knowledge, skills, and self-efficacy of health care participants completing a simulation-based blended learning training curriculum on managing maternal medical emergencies and maternal cardiac arrest (Obstetric Life Support).

Methods: A formative assessment of the Obstetric Life Support curriculum was performed with a prehospital cohort comprising emergency medical services professionals and a hospital-based cohort comprising health care professionals who work primarily in hospital or urgent care settings and respond to maternal medical emergencies. The training consisted of self-guided precourse work and an instructor-led simulation course using a customized low-fidelity simulator.

HCV universal EHR prompt successfully increases screening, highlights potential disparities.

Background & Objectives: Screening for hepatitis C virus is the first critical decision point for preventing morbidity and mortality from HCV cirrhosis and hepatocellular carcinoma and will ultimately contribute to global elimination of a curable disease. This study aims to portray the changes over time in HCV screening rates and the screened population characteristics following the 2020 implementation of an electronic health record (EHR) alert for universal screening in the outpatient setting in a large healthcare system in the US mid-Atlantic region.

Methods: Data was abstracted from the EHR on all outpatients from 1/1/2017 through 10/31/2021, including individual demographics and their HCV antibody (Ab) screening dates.

Virtual reality for management of cancer pain: Study rationale and design.

Background: Patients with cancer commonly experience acute and/or chronic moderate to severe pain related to disease, treatment, or both. While pain management strategies typically focus on drug therapies, non-pharmacological interventions may prove beneficial without risk of significant clinical side effects or contraindications. One novel strategy, virtual reality, has been shown to improve pain control in addition to usual pharmacological interventions.

Virtual reality for pain management in advanced heart failure: A randomized controlled study.

Background: Hospitalized patients with advanced heart failure often experience acute and/or chronic pain. While virtual reality has been extensively studied across a wide range of clinical settings, no studies have yet evaluated potential impact on pain management on this patient population.

Aim: To investigate the impact of a virtual reality experience on self-reported pain, quality-of-life, general distress, and satisfaction compared to a two-dimensional guided imagery active control.

Addressing fatigue in medical residents with biomathematical fatigue modeling.

Fatigue in resident physicians has been identified as a factor that contributes to burnout and a decline in overall wellbeing. Fatigue risk exists because of poor sleep habits and demanding work schedules that have only increased due to the COVID-19 pandemic. At this time, it is important not to lose sight of how fatigue can impact residents and how fatigue risk can be mitigated.

A novel application of SMART on FHIR architecture for interoperable and scalable integration of patient-reported outcome data with electronic health records.

Objective: Despite a proliferation of applications (apps) to conveniently collect patient-reported outcomes (PROs) from patients, PRO data are yet to be seamlessly integrated with electronic health records (EHRs) in a way that improves interoperability and scalability. We applied the newly created PRO standards from the Office of the National Coordinator for Health Information Technology to facilitate the collection and integration of standardized PRO data. A novel multitiered architecture was created to enable seamless integration of PRO data via Substitutable Medical Apps and Reusable Technologies on Fast Healthcare Interoperability Resources apps and scaled to different EHR platforms in multiple ambulatory settings.

Biomathematical Modeling Predicts Fatigue Risk in General Surgery Residents.

Objective: To assess resident fatigue risk using objective and predicted sleep data in a biomathematical model of fatigue.

Design: 8-weeks of sleep data and shift schedules from 2019 for 24 surgical residents were assessed with a biomathematical model to predict performance ("effectiveness").

Setting: Greater Washington, DC area hospitals RESULTS: As shift lengths increased, effectiveness scores decreased and the time spent below criterion increased.

Measurement of Trauma Caregiver Stress: Validation of Heart rate variability in a Real-World Surgical Setting.

Background: Acute stress is a potentially modifiable risk-factor that contributes to errors in trauma care. Research on stress mitigation is limited by the lack of a validated objective measure of surgeon stress. We sought to validate HRV in a real-world surgical setting by comparison to the Subjective Units of Distress Score (SUDS), and correlation with self-reported peak stress moments.

Modeling patient-related workload in the emergency department using electronic health record data.

Introduction: Understanding and managing clinician workload is important for clinician (nurses, physicians and advanced practice providers) occupational health as well as patient safety. Efforts have been made to develop strategies for managing clinician workload by improving patient assignment. The goal of the current study is to use electronic health record (EHR) data to predict the amount of work that individual patients contribute to clinician workload (patient-related workload).

Lessons Learned From an Evaluation of Serious Gaming as an Alternative to Mannequin-Based Simulation Technology: Randomized Controlled Trial.

Background: The use of new technology like virtual reality, e-learning, and serious gaming can offer novel, more accessible options that have been demonstrated to improve learning outcomes.

Objective: The aim of this study was to compare the educational effectiveness of serious game-based simulation training to traditional mannequin-based simulation training and to determine the perceptions of physicians and nurses. We used an obstetric use case, namely electronic fetal monitoring interpretation and decision making, for our assessment.

Fatigue in surgical residents an analysis of duty-hours and the effect of hypothetical naps on predicted performance.

Purpose: Sleep loss and fatigue, common in resident physicians, are related to increased medical errors and decreased physician wellbeing. Biomathematical modeling of fatigue can illuminate the relationship between surgical resident fatigue and work scheduling.

Methods: General surgery resident schedules were analyzed using the Sleep, Activity, Fatigue and Task Effectiveness model to predict resident performance during work hours.

Identification of Risk Factors for Testing of Hepatitis C in Non-Birth Cohort Patients: Is Universal Screening Necessary?

Objectives: CDC reported that 45% of Hepatitis C (HCV) infected people denied known risk factors. Electronic health record RF-based, non-Birth Cohort (born outside of years 1945-1965) screening is challenging as risk factors are often input as nonsearchable data. Testing non-Birth Cohort patients solely based on risk factors has the potential to miss a substantial number of HCV infected patients.

A descriptive analysis of an on-demand telehealth approach for remote COVID-19 patient screening.

Introduction: COVID-19 requires methods for screening patients that adhere to physical distancing and other Centers for Disease Control and Prevention guidelines. There is little data on the use of on-demand telehealth to meet this need.

Methods: The functional performance of on-demand telehealth as a COVID-19 remote patient screening approach was conducted by analysing 9270 patient requests.

Notice to comply: A systematic review of clinician compliance with guidelines surrounding acute hospital-based infection management.

Purpose: To identify and characterize studies evaluating clinician compliance with infection-related guidelines, and to explore trends in guideline design and implementation strategies.

Data Sources: PubMed database, April 2017. Followed the PRISMA Statement for systematic reviews.

Design and Evaluation of an Integrated, Patient-Focused Electronic Health Record Display for Emergency Medicine.

Background: Hospital emergency departments (EDs) are dynamic environments, involving coordination and shared decision making by staff who care for multiple patients simultaneously. While computerized information systems have been widely adopted in such clinical environments, serious issues have been raised related to their usability and effectiveness. In particular, there is a need to support clinicians to communicate and maintain awareness of a patient's health status, and progress through the ED plan of care.