Characterizing barriers to closing cross-institutional referral loops: Workflow and information flow analysis.

The specialty referral process consists of primary care clinicians referring patients to specialty consultants. This care transition requires effective care coordination and health information exchange between care teams; however, breakdowns in workflow and information flow impede "closing the referral loop" and delay or prevent referrers from receiving the consultant's "visit notes," particularly in cross-institutional referrals. This study aimed to describe and map the referral process as it occurs in clinics and identify and characterize work system barriers affecting its performance.

Measurement of Nontechnical Skills During Robotic-Assisted Surgery Using Sensor-Based Communication and Proximity Metrics.

This cohort study uses sensor-based communication and proximity metrics to assess surgeon nontechnical skills during robotic-assisted surgery.

Characterizing robotic surgical expertise: An exploratory study of neural activation during mental imagery of robotic suturing.

Background: Mental imagery (MI) aids skill acquisition, however, it is unclear to what extend MI is used by experienced surgeons. The purpose of this study was to assess differences in MI of participants with varying surgical expertise in robotic surgery.

Methods: Students, residents, and surgeons completed the Mental Imagery Questionnaire to assess MI for robotic suturing.

Surgeon stress negatively affects their non-technical skills in the operating room.

Background: Poor surgeons' non-technical skills (NTS) and excessive stress and workload are known contributors to surgical errors. Our aim was to examine the relationship between surgeons' stress and workload, and their observed NTS intraoperatively.

Methods: Surgeon's NTS were rated in the operating room (OR) by trained observers.

Using a Semi-Markov Model to Estimate Medicaid Cost Savings due to Minnesota's Return to Community Initiative.

Objectives: To provide an estimate and level of uncertainty for Medicaid cost savings due to Minnesota's Return to Community Initiative (RTCI).

Design: Medicaid cost savings are estimated using a semi-Markov model and simulation approach.

Setting And Participants: RTCI is a statewide program that assists private paying nursing home residents with discharge to the community.

Correction to: Does 24-h Activity Cycle Influence Plasma PCSK9 Concentration? A Systematic Review and Meta-Analysis.

Due to typesetting mistake, an unknown image was accidentally captured as graphical abstract. This should be removed.

Does 24-h Activity Cycle Influence Plasma PCSK9 Concentration? A Systematic Review and Meta-Analysis.

Purpose Of Review: Higher plasma proprotein convertase subtilisin/kexin type 9 (PCSK9) concentration has been associated with a higher risk of atherosclerotic cardiovascular disease (ASCVD). Animal and human studies have examined the relationship between 24-h activity cycles (24-HAC) and PCSK9, but conflicting results exist. Therefore, this review aimed to examine the relationship between 24-HAC and plasma PCSK9 concentration in animals and humans.

Workflow characterization in a busy urban primary care clinic.

We are examining the workflow processes within a large, urban general internal medicine practice in order to understand task inefficiencies that can lead to medical errors. We are performing a time-motion study looking at task management of check-in, check-out clerks, nurses, nurse's aides and physicians. Our pilot data suggests that there is significant variability in the task burden at different times of the day due to several factors, including patient-show rates, time allotted to late arrivals, multi-tasking by check-in clerks and inefficient intra-clinic communication processes.