Three LDI Senior Fellows Win Top AcademyHealth Awards
Development Of Persistent Opioid Use After Cardiac Surgery
Chase R. Brown, Zehang Chen, Fabliha Khurshan, Peter W. Groeneveld, Nimesh D. Desai
Abstract [from journal]
Importance The overuse of opioids for acute pain management has led to an epidemic of persistent opioid use.
Objective To determine the proportion of opioid-naive patients who develop persistent opioid use after cardiac surgery and investigate the association between the initial amount of opioids prescribed at discharge and the likelihood of developing new persistent opioid use.
Design, Setting, and Participants This retrospective cohort study used data from a national...
A Targeted Program In An Academic Rheumatology Practice To Improve Compliance With Opioid Prescribing Guidelines For The Treatment Of Chronic Pain
Eric J. Wang, Rebecca Helgesen, Chadwick R. Johr, Hannah S. Lacko, Michael A. Ashburn, Peter A. Merkel
Abstract [from journal]
Objective: The Centers for Disease Control and Prevention (CDC) and many state governments have issued guidelines for opioid prescribing for the treatment of chronic non-cancer-associated pain. We sought to decrease practice variation and increase adherence to these guidelines in a tertiary academic Rheumatology practice by developing an interdisciplinary Opioid Working Group and using Electronic Health Record (EHR)-integrated data feedback.
Methods: Division leadership and providers
...Phenotyping Physician Practice Patterns And Associations With Response To A Nudge In The Electronic Health Record For Influenza Vaccination: A Quasi-Experimental Study
Sujatha Changolkar, Jeffrey Rewley, Mohan Balachandran, Charles A L Rareshide, Christopher K Snider, Susan C Day, Mitesh S Patel
Abstract [from journal]
Background: Health systems routinely implement changes to the design of electronic health records (EHRs). Physician behavior may vary in response and methods to identify this variation could help to inform future interventions. The objective of this study was to phenotype primary care physician practice patterns and evaluate associations with response to an EHR nudge for influenza vaccination.
Methods and findings: During the 2016-2017 influenza season, 3 primary care practices at Penn Medicine...
Coronavirus Disease 2019 (COVID-19) Information for Cardiologists - Systematic Literature Review and Additional Analysis
Tadafumi Sugimoto, Atsushi Mizuno, Takuya Kishi, Naoya Ito, Chisa Matsumoto, Memori Fukuda, Nobuyuki Kagiyama, Tatsuhiro Shibata, Takashi Ohmori, Shogo Oishi, Jun Fuse, Keisuke Kida, Fujimi Kawai, Mari Ishida, Shoji Sanada, Issei Komuro, Koichi Node
Abstract [from journal]
Background: Despite the rapidly increasing attention being given to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, more commonly known as coronavirus disease 2019 (COVID-19), the relationship between cardiovascular disease and COVID-19 has not been fully described.Methods and Results:A systematic review was undertaken to summarize the important aspects of COVID-19 for cardiologists. Protection both for patients and healthcare providers, indication for treatments, collaboration with other departments and
...Observational Study of Clinician Attentional Reserves (OSCAR): Acuity-Based Rounds Help Preserve Clinicians' Attention
Merrick Miles, Dorothee Mueller, Daniel Gay-Betton, Sarah H. Baum Miller, Scott Massa, Yaping Shi, Matthew S. Shotwell, Meghan Lane-Fall, Joseph J. Schlesinger
Abstract [from journal]
Objectives: Team rounding in the ICU can tax clinicians' finite attentional resources. We hypothesized that a novel approach to rounding, where patients are seen in a decreasing order of acuity, would decrease attentional attrition.
Design: Prospective interventional internal-control cohort study in which stop signal task testing was used as a proxy for attentional reserves. Stop signal task is a measure of cognitive control and response inhibition in addition to performance monitoring, all reflective of
...Burnout and Joy in the Profession of Critical Care Medicine
Meeta Prasad Kerlin, Joanne McPeake, Mark E. Mikkelsen
Abstract [from journal]
The intensive care unit (ICU) can be a stressful environment for patients and families, with well-established long-term consequences. The impact that this unique environment can have on healthcare professionals is being increasingly recognized. Challenging ethical situations, exposure to high patient mortality and difficult daily workloads can lead to excessive stress for those caring for critically ill patients. A growing body of literature suggests that this excessive stress and resultant moral distress can lead to burnout syndrome.
...Quantifying Gender Disparity in Physician Authorship Among Commentary Articles in Three High-Impact Medical Journals: An Observational Study
Mira Mamtani, Frances Shofer, Anita Mudan, Utsha Khatri, Rachael Walker, Jeanmarie Perrone, Jaya Aysola
Abstract [from journal]
Background: Scholarship plays a direct role in career advancement, promotion and authoritative recognition, and women physicians remain under-represented as authors of original research articles.
Objective: We sought to determine if women physician authors are similarly under-represented in commentary articles within high-impact journals.
Design/Setting/Participants: In this observational study, we abstracted and analysed author information (gender and degree) and authorship position
...Private Equity Investment in Physician Practices
Private equity acquisition of physician medical groups has come under increasing scrutiny for its potential role in expanding the use of “surprise” medical bills. Due to limited data availability, empirical study of private equity acquisition has been challenging, with most existing evidence coming from industry reports and a growing chorus of opinion articles in academic journals.
Testing a Theory of Strategic Implementation Leadership, Implementation Climate, and Clinicians' Use of Evidence-Based Practice: A 5-Year Panel Analysis
Nathaniel J. Williams, Courtney Benjamin Wolk, Emily M. Becker-Haimes, Rinad S. Beidas
Abstract [from journal]
Background: Implementation theory suggests that first-level leaders, sometimes referred to as middle managers, can increase clinicians' use of evidence-based practice (EBP) in healthcare settings by enacting specific leadership behaviors (i.e., proactive, knowledgeable, supportive, perseverant with regard to implementation) that develop an EBP implementation climate within the organization; however, longitudinal and quasi-experimental studies are needed to test this hypothesis.
Methods: Using data
Impact of a Multidisciplinary, Endocrinologist-Led Shared Medical Appointment Model on Diabetes-Related Outcomes in an Underserved Population
Valerie S. Ganetsky, Judith A. Long, Nandita Mitra, Krisda H. Chaiyachati, Steven T. Kaufman
Abstract [from journal]
A multidisciplinary endocrinologist-led shared medical appointment (SMA) model showed statistically significant reductions in A1C from baseline over 3 years that were not significantly different from appointments with endocrinologists or primary care providers alone within a resource-poor population. Similarly, the SMA model achieved clinical outcomes on par with endocrinologist-only visits with the added benefit of improving endocrine provider productivity and specialty access for patients. Greater patient engagement with the SMA model was associated
...Better Prescribing for Bad Backs
Low back pain is a major cause of disability among adults and a top reason patients are prescribed opioids. However, a recent study in the Journal of the American Board of Family Medicine finds that patients with new low back pain are receiving opioids less frequently, though prescribing rates remain uneven across the country.
Report From National Clinician Scholars Program's Annual Meeting, 2019
Dissatisfaction with Medical and Surgical Residency Training Is Consistently Higher for Women than for Men
C. Jessica Dine, Manqing Liu, David A. Asch, Lisa M. Bellini, Karl Y. Bilimoria, Sanjay V. Desai, Judy A. Shea
Abstract [from journal]
In an attempt to balance service and education, there is a renewed focus on trainee work experiences and job satisfaction. Overall measures of dissatisfaction likely disguise differences across defined subgroups, particularly men and women, known to experience job satisfaction and burnout differently across professions. A previous study showed gender differences in satisfaction during surgical residency training. The objective of this study was to determine gender differences in dissatisfaction with specific aspects of the institutional environment and with...