National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 56 Research Studies DisplayedByrnes ME, Varlamos CJ, Rivard SJ
"You're used to being the one that can fix things…": a qualitative snapshot of colorectal surgeons during COVID-19.
This viewpoint article reflects the narratives of 58 colorectal surgeons who engaged in an in-depth qualitative interview during the COVID-19 shutdown of elective surgeries. The goal for reporting these findings is to offer a snapshot of surgeon perspectives on the delays of elective surgeries and to give voice to surgeons who were unable to perform most or all their duties as a surgeon.
AHRQ-funded; HS025365; HS000053.
Citation: Byrnes ME, Varlamos CJ, Rivard SJ .
"You're used to being the one that can fix things…": a qualitative snapshot of colorectal surgeons during COVID-19.
Dis Colon Rectum 2020 Dec;63(12):1575-78. doi: 10.1097/dcr.0000000000001818..
Keywords: Surgery, Provider: Physician, Provider, COVID-19, Public Health, Infectious Diseases
O'Leary KJ, Manojlovich M, Johnson JK
A multisite study of interprofessional teamwork and collaboration on general medical services.
This multisite study of four mid-sized hospitals measured teamwork climate of nurses, nurse assistants, and physicians working on general medical services. Teamwork climate scores for 380 participants (80 hospitalists, 13 resident physicians, 193 nurses, and 94 nurses) were measured using the Safety Attitudes Questionnaire. Hospitalists had the highest median teamwork climate score and nurses had the lowest, but it was not a statistically significant difference. A higher percentage of hospitalists (63.3%) rated the quality of collaboration with nurses as high or very high, but only 48.7% of nurses rated the collaboration with hospitalists as high or very high. There were significant differences in perceptions of teamwork climate across sites and across professional categories.
AHRQ-funded; HS025649.
Citation: O'Leary KJ, Manojlovich M, Johnson JK .
A multisite study of interprofessional teamwork and collaboration on general medical services.
Jt Comm J Qual Patient Saf 2020 Dec;46(12):667-72. doi: 10.1016/j.jcjq.2020.09.009..
Keywords: Teams, Hospitals, Patient Safety, Provider: Clinician, Provider: Physician, Provider: Nurse, Provider
Heinze K, Suwanabol PA, Vitous CA
A survey of patient perspectives on approach to health care: focus on physician competency and compassion.
This study is a cross-sectional survey of 764 patients to gain insight into perceptions of physician qualities of compassion and competence. The participants response rate was 85%, with mean age 52.4, 70.8% female, and 84% identified as white. Predictors of compassion over competence included female gender and whether the respondent had a personal connection to the vignette used. Preferences were found to be influenced by: 1) explicit beliefs regarding the value of physician compassion and competence; 2) impact of emotional and mental health on medical experiences; 3) type and frequency of health care exposure, and; 4) perceived role of the physician in various clinical vignettes.
AHRQ-funded; HS026772.
Citation: Heinze K, Suwanabol PA, Vitous CA .
A survey of patient perspectives on approach to health care: focus on physician competency and compassion.
J Patient Exp 2020 Dec;7(6):1044-53. doi: 10.1177/2374373520968447..
Keywords: Provider: Physician, Provider, Patient Experience, Provider Performance, Quality of Care
Everson J, Cheng AK, Patrick SW
Association of electronic prescribing of controlled substances with opioid prescribing rates.
The purpose of this study was to assess the association between use of electronic prescribing of controlled substances (EPCS) and trends in opioid prescribing. Results suggested that an increased use of EPCS was not associated with decreased opioid prescribing or a decrease in the amount prescribed and may have been associated with a small increase in opioid prescribing. Recommendations included levers to ensure that EPCS is integrated with outside data and that information is actively used to inform prescribing decisions.
AHRQ-funded; HS026395.
Citation: Everson J, Cheng AK, Patrick SW .
Association of electronic prescribing of controlled substances with opioid prescribing rates.
JAMA Netw Open 2020 Dec;3(12):e2027951. doi: 10.1001/jamanetworkopen.2020.27951..
Keywords: Electronic Prescribing (E-Prescribing), Health Information Technology (HIT), Opioids, Medication, Practice Patterns, Provider: Physician, Provider: Clinician, Provider
Dossett LA, Waljee JF, Dimick JB
Ensuring equal access to mentorship and sponsorship for surgeons through structured team-based mentoring.
This perspective paper describes how Michigan Medicine has developed early- and mid-career mentoring programs for surgeons in the hopes of reducing inequities in access to mentorship and foster a culture of mentorship for women and underrepresented minorities. The university hospital developed a mentoring program with Launch Teams for early career surgeons and Boost Teams for mid-career surgeons. The Launch Teams consist of 5-7 members meeting as a group 4 to 6 times yearly for 3 years. Members are selected jointly by the mentee and a member of the departmental leadership and include a clinical mentor, research mentors (if applicable), one or more external mentors and other members with specific research, administrative, educational, or leadership positions. Mid-career surgeons can elect to join a Boost Team after promotion or making a mid-career institutional transition. The team consists of a larger number of members outside the department or institution than Launch Teams. This team also meets every other month and the goal is to establish a leadership phenotype and long-term goals.
AHRQ-funded; HS026030.
Citation: Dossett LA, Waljee JF, Dimick JB .
Ensuring equal access to mentorship and sponsorship for surgeons through structured team-based mentoring.
Ann Surg 2020 Dec;272(6):939-40. doi: 10.1097/sla.0000000000004500..
Keywords: Provider: Physician, Provider, Surgery
Rutkowski RA, Salwei M, Barton H
Physician perceptions of disposition decision-making for older adults in the emergency department: a preliminary analysis.
Disposition decision-making in the emergency department (ED) is critical to patient safety and quality of care. Disposition decision-making has particularly important implications for older adults who comprise a significant portion of ED visits annually and are vulnerable to suboptimal outcomes throughout ED care transitions. In this study, the investigators conducted a secondary inductive content analysis of interviews with ED physicians to explore their perceptions of who they involve in disposition decision-making and what information they use to make disposition decisions for older adults.
AHRQ-funded; HS026624.
Citation: Rutkowski RA, Salwei M, Barton H .
Physician perceptions of disposition decision-making for older adults in the emergency department: a preliminary analysis.
Proc Hum Factors Ergon Soc Annu Meet 2020 Dec;64(1):648-52. doi: 10.1177/1071181320641148..
Keywords: Elderly, Shared Decision Making, Emergency Department, Provider: Physician
Militello LG, Hurley RW, Cook RL
Primary care clinicians' beliefs and strategies for managing chronic pain in an era of a national opioid epidemic.
Investigators sought a better understanding of primary care clinicians’ approaches to managing patients with chronic pain and explored implications for technological and administrative interventions. They found that primary care clinicians’ beliefs about opioid therapy generally align with the clinical evidence but may have some important gaps, suggesting the potential value of interventions that include improved access to research findings, organizational changes to support spending time with patients to develop rapport, and the need for innovative clinical cognitive support.
AHRQ-funded; HS023306.
Citation: Militello LG, Hurley RW, Cook RL .
Primary care clinicians' beliefs and strategies for managing chronic pain in an era of a national opioid epidemic.
J Gen Intern Med 2020 Dec;35(12):3542-48. doi: 10.1007/s11606-020-06178-2..
Keywords: Primary Care, Opioids, Medication, Pain, Chronic Conditions, Provider: Physician, Provider: Clinician, Provider, Care Management
Benson NM, Myong C, Newhouse JP
Psychiatrist participation in private health insurance markets: paucity in the land of plenty.
Using 2013 Massachusetts licensing data and the All-Payer Claims Database, researchers performed a cross-sectional analysis of licensed psychiatrists in Massachusetts to examine the extent of participation in private insurance. They found that, among Massachusetts psychiatrists, participation in the private insurance market appeared to be limited. Older psychiatrists were more likely to participate, and patients' access to psychiatrists who accept insurance could worsen as these psychiatrists retire.
AHRQ-funded; HS024725.
Citation: Benson NM, Myong C, Newhouse JP .
Psychiatrist participation in private health insurance markets: paucity in the land of plenty.
Psychiatr Serv 2020 Dec;71(12):1232-38. doi: 10.1176/appi.ps.202000022..
Keywords: Health Insurance, Behavioral Health, Access to Care, Provider: Physician, Provider
Ehlers AP, Vitous CA, Sales A
Exploration of factors associated with surgeon deviation from practice guidelines for management of inguinal hernias.
Investigators explored factors associated with surgeon choice of approach (minimally invasive vs open) in inguinal hernia repair as a tool to gain an understanding of guideline-discordant care. They found that decision-making for the approach to inguinal hernia repair was largely influenced by surgeon preference and access to resources rather than patient factors. Although a one-size-fits-all approach is not recommended, the operative approach should ideally be informed by patient factors, including hernia characteristics. They recommended addressing surgeon preference and available resources with a clinician-facing decision aid to provide an opportunity to optimize care for patients undergoing inguinal hernia repair.
AHRQ-funded; HS025778.
Citation: Ehlers AP, Vitous CA, Sales A .
Exploration of factors associated with surgeon deviation from practice guidelines for management of inguinal hernias.
JAMA Netw Open 2020 Nov 2;3(11):e2023684. doi: 10.1001/jamanetworkopen.2020.23684..
Keywords: Surgery, Guidelines, Provider: Physician, Provider, Shared Decision Making, Evidence-Based Practice
Lim H, Raffel KE, Harrison JD
Decisions in the dark: an educational intervention to promote reflection and feedback on night float rotations.
An educational intervention was created for medical residents during night float rotations where they admit patients to the hospital. The intervention was designed to provide feedback on their diagnostic and management reasoning using feedback solicitation and chart review. Second- and third-year internal medicine residents on a 1-month night float rotation were recruited. Residents performed chart review of a subset of patients they admitted and completed reflection worksheets detailing patients’ clinical courses. Sixty-eight of 82 eligible residents participated in the intervention. The authors evaluated 248 reflection worksheets using content analysis. Major themes that emerged from chart review included residents’ identification of reasoning gaps and evaluation of resident-provider interactions.
AHRQ-funded; HS026383.
Citation: Lim H, Raffel KE, Harrison JD .
Decisions in the dark: an educational intervention to promote reflection and feedback on night float rotations.
J Gen Intern Med 2020 Nov;35(11):3363-67. doi: 10.1007/s11606-020-05913-z..
Keywords: Provider: Physician, Provider, Education: Continuing Medical Education, Shared Decision Making
Kapoor N, Lacson R, Hammer M
Physician agreement with recommendations contained in a national guideline for the management of incidental pulmonary nodules: a case study.
This survey of physicians was used to determine agreement with recommendations in the national guideline for the management of incidental pulmonary nodules from the 2017 Fleischner Society Guidelines for Management of Incident Pulmonary Nodules (FSG). The FSG contains 18 unique recommendations which were codified into a clinical evidence logic statement (CELS) for this study. The FSG also included ratings for strength of evidence based on the American Society of Chest Physicians grading system. In order to internally grade the strength of evidence behind each recommendation, two medical librarians from the Harvard Library of Evidence analyzed each CELS independently and graded the recommendations based on the supporting clinical studies using the Oxford Centre for Evidence-Based levels of evidence and the US Preventive Service Task Force I-scores. Nine physicians from a single large academic institution were then surveyed via SurveyMonkey to assess agreement with each of the 18 CELS. Agreement on each recommendation ranged from 0 to 100%. This study was meant to be exploratory and to test the hypothesis that guideline nonadherence may be partly affected by lack of physician agreement with guideline component recommendations.
AHRQ-funded; HS024722.
Citation: Kapoor N, Lacson R, Hammer M .
Physician agreement with recommendations contained in a national guideline for the management of incidental pulmonary nodules: a case study.
J Am Coll Radiol 2020 Nov;17(11):1437-42. doi: 10.1016/j.jacr.2020.07.020..
Keywords: U.S. Preventive Services Task Force (USPSTF), Guidelines, Evidence-Based Practice, Respiratory Conditions, Practice Patterns, Provider: Physician, Provider
Shubeck SP, Newman EA, Vitous CA
Hiring practices of US academic surgery departments-challenges and opportunities for more inclusive hiring.
To increase workforce diversity among academic medical centers, the Association of American Medical Colleges recommends multiple inclusive strategies for evaluating and hiring candidates. The objective of this study was to determine (1) usual and inclusive hiring practices used among academic surgery departments and (2) the barriers to utilization of inclusive hiring practices. The investigators concluded that many chairs rely heavily on internal hires or trusted networks, which may limit both demographic and cognitive diversity.
AHRQ-funded; HS026030.
Citation: Shubeck SP, Newman EA, Vitous CA .
Hiring practices of US academic surgery departments-challenges and opportunities for more inclusive hiring.
J Surg Res 2020 Oct;254:23-30. doi: 10.1016/j.jss.2020.03.054..
Keywords: Surgery, Provider: Physician, Provider, Workforce, Hospitals
Varban OA, Thumma JR, Carlin AM
Peer assessment of operative videos with sleeve gastrectomy to determine optimal operative technique.
Global assessments of technical skill have been associated with surgical outcomes. More detailed understanding of which specific aspects of technique combine to make the "optimal" sleeve gastrectomy are necessary to help surgeons improve their practice. In this article, the investigators described their study in which the review of de-identified videos of practicing bariatric surgeons was conducted by a minimum of 10 peer surgeons. The videos were assessed on the technical quality of 9 operative maneuvers (ie mobilization of the fundus, stapler location, and sleeve width).
AHRQ-funded; HS017765.
Citation: Varban OA, Thumma JR, Carlin AM .
Peer assessment of operative videos with sleeve gastrectomy to determine optimal operative technique.
J Am Coll Surg 2020 Oct;231(4):470-77. doi: 10.1016/j.jamcollsurg.2020.06.016..
Keywords: Surgery, Obesity: Weight Management, Obesity, Adverse Events, Provider: Physician, Provider
Isbell LM, Boudreaux ED, Chimowitz H
What do emergency department physicians and nurses feel? A qualitative study of emotions, triggers, regulation strategies, and effects on patient care.
Despite calls to study how healthcare providers' emotions may impact patient safety, little research has addressed this topic. The current study aimed to develop a comprehensive understanding of emergency department (ED) providers' emotional experiences, including what triggers their emotions, the perceived effects of emotions on clinical decision making and patient care, and strategies providers use to manage their emotions to reduce patient safety risks.
AHRQ-funded; HS025752.
Citation: Isbell LM, Boudreaux ED, Chimowitz H .
What do emergency department physicians and nurses feel? A qualitative study of emotions, triggers, regulation strategies, and effects on patient care.
BMJ Qual Saf 2020 Oct;29(10):1-2. doi: 10.1136/bmjqs-2019-010179..
Keywords: Emergency Department, Provider: Nurse, Provider: Physician, Patient Safety
Vitous CA, Jafri SM, Seven C
Exploration of surgeon motivations in management of abdominal wall hernias: a qualitative study.
Although evidence-based guidelines designed to minimize health care variation and promote effective care are widely accepted, creating guidelines alone does not often lead to the desired practice change. Such knowledge-to-practice gaps are well-recognized in the management of patients with abdominal wall hernia. The purpose of this study was to evaluate the systematic application of the Theoretical Domains Framework (TDF) to explore motivations and behaviors associated with surgical decision-making in abdominal wall hernia practice to help inform the future design of theory-based interventions for desired practice and behavior change.
AHRQ-funded; HS025778.
Citation: Vitous CA, Jafri SM, Seven C .
Exploration of surgeon motivations in management of abdominal wall hernias: a qualitative study.
JAMA Netw Open 2020 Sep;3(9):e2015916. doi: 10.1001/jamanetworkopen.2020.15916..
Keywords: Surgery, Digestive Disease and Health, Provider: Physician, Provider
Lozada MJ, Raji MA, Goodwin JS
Opioid prescribing by primary care providers: a cross-sectional analysis of nurse practitioner, physician assistant, and physician prescribing patterns.
The purpose of this study was to identify prescription opioid over-prescribers by comparing prescribing patterns of primary care physicians (MDs), nurse practitioners (NPs), and physician assistants (PAs). Participants were a national sample of 2015 Medicare Part D enrollees. Findings showed that most NPs/PAs prescribed opioids in a pattern similar to MDs, but NPs/PAs had more outliers who prescribed high-frequency, high-dose opioids than did MDs. Recommendations included efforts to reduce opioid overprescribing including targeted provider education, risk stratification, and state legislation.
AHRQ-funded; HS020642.
Citation: Lozada MJ, Raji MA, Goodwin JS .
Opioid prescribing by primary care providers: a cross-sectional analysis of nurse practitioner, physician assistant, and physician prescribing patterns.
J Gen Intern Med 2020 Sep;35(9):2584-92. doi: 10.1007/s11606-020-05823-0..
Keywords: Opioids, Medication, Primary Care, Practice Patterns, Medication: Safety, Provider: Nurse, Provider: Physician, Provider: Physician Assistant, Provider
Blackley SV, Schubert VD, Goss FR
Physician use of speech recognition versus typing in clinical documentation: a controlled observational study.
Researchers studied the usability and quality of documentation with speech recognition (SR) versus typing; participants were ten physicians at Brigham and Women's Hospital, Boston, who had used SR for at least six months. The researchers found that participants felt that SR saved them time, increased their efficiency, and allowed them to quickly document more relevant details. Quality analysis supported the perception that SR allowed for more detailed notes, but whether dictation was objectively faster than typing remains unclear, and participants described some scenarios where typing was still preferred. They concluded that dictation can be effective for creating comprehensive documentation, especially when physicians like and feel comfortable using SR.
AHRQ-funded; HS024264.
Citation: Blackley SV, Schubert VD, Goss FR .
Physician use of speech recognition versus typing in clinical documentation: a controlled observational study.
Int J Med Inform 2020 Sep;141:104178. doi: 10.1016/j.ijmedinf.2020.104178.
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Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Physician, Provider
Shechter A, Diaz F, Moise N
Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the COVID-19 pandemic.
The mental health toll of COVID-19 on healthcare workers (HCW) is not yet fully described. In this study the authors, using a cross-sectional web survey, characterized distress, coping, and preferences for support among NYC HCWs during the COVID-19 pandemic. They concluded that NYC HCWs, especially nurses and advanced practice providers, were experiencing COVID-19-related psychological distress.
AHRQ-funded; HS024262.
Citation: Shechter A, Diaz F, Moise N .
Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the COVID-19 pandemic.
Gen Hosp Psychiatry 2020 Sep-Oct;66:1-8. doi: 10.1016/j.genhosppsych.2020.06.007..
Keywords: COVID-19, Stress, Provider: Clinician, Provider: Physician, Provider: Nurse, Provider: Health Personnel, Behavioral Health
Cotter JM, Tyler A, Reese J
Steroid variability in pediatric inpatient asthmatics: survey on provider preferences of dexamethasone versus prednisone.
This study looked at pediatric emergency department (ED) inpatient use of dexamethasone versus prednisone by providers for asthma treatment. A survey was distributed to providers who care for inpatient asthmatics. Ninety-two providers completed the survey. When patients received dexamethasone in the ED, 44% continued dexamethasone, 14% switched to prednisone, 2% stopped steroid use, and 40% said it depended on the circumstances. Hospitalists were significantly more likely to continue dexamethasone than pulmonologists (61% versus 15%). Switching to prednisone included factors such as severity of exacerbation (73%) and asthma history (47%). Just over half of providers (5f1%) felt uncomfortable using dexamethasone because of “minimal data to support [its] use inpatient.”
AHRQ-funded; HS026512.
Citation: Cotter JM, Tyler A, Reese J .
Steroid variability in pediatric inpatient asthmatics: survey on provider preferences of dexamethasone versus prednisone.
J Asthma 2020 Sep;57(9):942-48. doi: 10.1080/02770903.2019.1622713..
Keywords: Children/Adolescents, Asthma, Respiratory Conditions, Medication, Inpatient Care, Care Management, Hospitalization, Emergency Department, Practice Patterns, Provider: Physician, Provider
Thomas GW, Long S, Tatum M
A vision for using simulation & virtual coaching to improve the community practice of orthopedic trauma surgery.
In this paper, a vision is presented to elevate community orthopedic practice and improve patient safety by advancing the use of simulators for training and assessing surgical skills. Key elements of this vision included 1) methods for the objective and rigorous assessment of the performance of practicing surgeons now exist, 2) simulators are sufficiently mature and sophisticated that practicing surgeons will use them, and 3) practicing surgeons can improve their performance with appropriate feedback and coaching.
AHRQ-funded; HS022077; HS025353.
Citation: Thomas GW, Long S, Tatum M .
A vision for using simulation & virtual coaching to improve the community practice of orthopedic trauma surgery.
Iowa Orthop J 2020;40(1):25-34..
Keywords: Orthopedics, Surgery, Simulation, Training, Provider: Physician, Provider
Rhee TG, Olfson M, Nierenberg AA
20-year trends in the pharmacologic treatment of bipolar disorder by psychiatrists in outpatient care settings.
Pharmacological options for treating bipolar disorder have increased over the past 20 years, with several second-generation antipsychotics receiving regulatory approval in the 1990s. In this study the authors describe trends in use of pharmacological agents in the outpatient management of bipolar disorder. The authors concluded that substantial changes occurred in the treatment of bipolar disorder over the past 20 years, with second-generation antipsychotics in large measure supplanting traditional mood stabilizers.
AHRQ-funded; HS023000.
Citation: Rhee TG, Olfson M, Nierenberg AA .
20-year trends in the pharmacologic treatment of bipolar disorder by psychiatrists in outpatient care settings.
Am J Psychiatry 2020 Aug;177(8):706-15. doi: 10.1176/appi.ajp.2020.19091000..
Keywords: Behavioral Health, Medication, Practice Patterns, Ambulatory Care and Surgery, Provider: Physician, Provider
Zetts RM, Stoesz A, Garcia AM
Primary care physicians' attitudes and perceptions towards antibiotic resistance and outpatient antibiotic stewardship in the USA: a qualitative study.
Outpatient antibiotic stewardship is needed to improve prescribing and address the threat of antibiotic resistance. A better understanding of primary care physicians (PCPs) attitudes towards antibiotic prescribing and outpatient antibiotic stewardship is needed to identify barriers to stewardship implementation and help tailor stewardship strategies. The aim of this study was to assess PCPs current attitudes towards antibiotic resistance, inappropriate antibiotic prescribing and the feasibility of outpatient stewardship efforts.
AHRQ-funded; HS026506; HS024930; 233201500020I.
Citation: Zetts RM, Stoesz A, Garcia AM .
Primary care physicians' attitudes and perceptions towards antibiotic resistance and outpatient antibiotic stewardship in the USA: a qualitative study.
BMJ Open 2020 Jul 14;10(7):e034983. doi: 10.1136/bmjopen-2019-034983..
Keywords: Primary Care, Antimicrobial Stewardship, Antibiotics, Medication, Provider: Physician, Provider
Rhee TG, Wilkinson ST
Exploring the psychiatrist-industry financial relationship: insight from the open payment data of Centers for Medicare and Medicaid Services.
The Physician Payments Sunshine Act (PPSA) requires reporting of financial payments by pharmaceutical and medical device companies to teaching hospitals and individual physicians in the United States. In this study, industry payments made to psychiatrists were quantified. The investigators found that over half of active psychiatrists (55.7%) received some form of payments from pharmaceutical manufacturers.
AHRQ-funded; HS023000.
Citation: Rhee TG, Wilkinson ST .
Exploring the psychiatrist-industry financial relationship: insight from the open payment data of Centers for Medicare and Medicaid Services.
Adm Policy Ment Health 2020 Jul;47(4):526-30. doi: 10.1007/s10488-020-01009-2.
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Keywords: Provider: Physician, Provider, Behavioral Health, Payment, Policy
Bansal P, Bingemann TA, Greenhawt M
Clinician wellness during the COVID-19 pandemic: extraordinary times and unusual challenges for the allergist/immunologist.
This article describes current challenges for the allergy/immunology community due to the COVID-19 pandemic. The need for social distancing adds to complexity of care and can create isolation and anxiety. The authors suggests that tools such as the Strength-Focused and Meaning-Oriented Approach to Resilience and Transformation approach, wellness apps, mindfulness and gratitude can be used to help reduce issues contributing to burnout, depression, anxiety, substance abuse, and posttraumatic stress disorder.
AHRQ-funded; HS024599.
Citation: Bansal P, Bingemann TA, Greenhawt M .
Clinician wellness during the COVID-19 pandemic: extraordinary times and unusual challenges for the allergist/immunologist.
J Allergy Clin Immunol Pract 2020 Jun;8(6):1781-90.e3. doi: 10.1016/j.jaip.2020.04.001..
Keywords: COVID-19, Burnout, Stress, Provider: Clinician, Provider: Physician
Pruitt LCC, Skarda DE, Barnhart DC
Impact of consolidation of cases on post-operative outcomes for index pediatric surgery cases.
The effect of the consolidation of neonatal pediatric surgical cases to limited surgeons within a hospital is unknown. In this retrospective cohort study, the authors elected to model the distribution of complex neonatal procedures using an economic measure of market concentration, the Herfindahl-Hirschmann Index (HHI), and study its effect on outcomes of index pediatric surgical operations.
AHRQ-funded; HS025776.
Citation: Pruitt LCC, Skarda DE, Barnhart DC .
Impact of consolidation of cases on post-operative outcomes for index pediatric surgery cases.
J Pediatr Surg 2020 Jun;55(6):1048-52. doi: 10.1016/j.jpedsurg.2020.02.044..
Keywords: Newborns/Infants, Surgery, Hospitals, Provider: Physician, Provider