scholarly journals 613. Lessons learned from a Rhode Island academic out-patient Lyme and tick-borne disease clinic

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S367-S367
Author(s):  
Meghan L McCarthy ◽  
Rebecca Reece ◽  
Sara E Vargas ◽  
Jennie Johnson ◽  
Jennifer Adelson-Mitty ◽  
...  
Keyword(s):  
Sleep Disturbance ◽  
Rhode Island ◽  
Antibiotic Treatment ◽  
Joint Pain ◽  
Lessons Learned ◽  
Small Subset ◽  
Improvement Project ◽  
Curative Therapy ◽  
Cognitive Difficulty ◽  
Tick Borne Disease

Abstract Background Although the prevalence of tick-borne diseases (TBD) continues to increase, there remains significant confusion regarding treatment for Lyme and other TBDs. We conducted a chart review of all new patients that came to an academic center for Lyme and TBDs. We then initiated a quality improvement project for feedback from a small subset of patients with Post-treatment Lyme disease syndrome (PTLDS). Methods Charts of patients visiting the clinic between March and November 2018 were reviewed. Data abstracted from the electronic health record included demographics, laboratory and clinical data. A small subset of patients who reported a history of Lyme and at least 6 months of symptoms after antibiotic treatment were enrolled in a phone survey to evaluate their experience with treatment for PTLDS. Results Symptoms most commonly seen in 218 new patients included fatigue (66.5%), joint pain (58.2%), cognitive difficulty (32.1%), headache (27.9%) and sleep disturbance (27.5%). 87% had already received tick-borne disease directed antibiotic treatment. Over half (60.5%) of patients report having symptoms for more than 6 months. More than half of patients (54.8%) who had more than 6 months of Lyme-related symptoms had positive serological testing. Common themes identified in the 16 phone surveys of patients with PTLDS conducted so far included significant frustration related to the dismissive attitudes from medical professionals (n=9/16), and many sought alternative or complementary therapies (n=11/16). Six patients reported receiving very long-term antibiotic regimens from other Lyme specialists. Many patients expressed satisfaction with the visit and medical advice even in the absence of curative therapy (n=9/16), although a significant number continued to seek care elsewhere (n=6/16). Conclusion More than half of new patients reported symptoms lasting more than 6 months after targeted antibiotic therapy. Further research is needed to develop interventions for the common symptoms of fatigue, joint pain, cognitive difficulty and sleep disturbance. Treatments to improve sleep, diet, and physical activity and decrease inflammation among patients who suffer from PTLDS are needed. Disclosures All Authors: No reported disclosures

Lessons learned in establishing a quality improvement project to reduce hospital acquired infections in the neonatology ward at a referral hospital in Rwanda

2016 ◽  
Vol 24 (4) ◽  
pp. 341-348 ◽  
Author(s):  
Naasson Gafirimbi ◽  
Rex Wong ◽  
Eva Adomako ◽  
Jeanne Kagwiza
Keyword(s):  
Quality Improvement ◽  
Lessons Learned ◽  
Referral Hospital ◽  
Quality Improvement Project ◽  
Injection Technique ◽  
Improve Quality ◽  
Improvement Project ◽  
Content Type ◽  
Hospital Acquired

Purpose Improving healthcare quality has become a worldwide effort. Strategic problem solving (SPS) is one approach to improve quality in healthcare settings. This case study aims to illustrate the process of applying the SPS approach in implementing a quality improvement project in a referral hospital. Design/methodology/approach A project team was formed to reduce the hospital-acquired infection (HAI) rate in the neonatology unit. A new injection policy was implemented according to the root cause identified. Findings The HAI rate decreased from 6.4 per cent pre-intervention to 4.2 per cent post-intervention. The compliance of performing the aseptic injection technique significantly improved by 60 per cent. Practical implications This case study illustrated the detailed application of the SPS approach in establishing a quality improvement project to address HAI and injection technique compliance, cost-effectively. Other departments or hospitals can apply the same approach to improve quality of care. Originality/value This study helps inform other hospitals in similar settings, the steps to create a quality improvement project using the SPS approach.

The Power of Partnerships: Lessons Learned From the C.H.I.L.D., Inc./University of Rhode Island Research Team Partnership

NHSA Dialog ◽  
2002 ◽  
Vol 5 (2-3) ◽  
pp. 213-223
Author(s):  
Julianna C. Golas ◽  
Diane M. Horm-Wingerd ◽  
David A. Caruso ◽  
Lynda Dickinson
Keyword(s):  
Rhode Island ◽  
Research Team ◽  
Lessons Learned

Otolaryngology Resident Reviewer Development Program: Lessons Learned from Cohort 1

2019 ◽  
Vol 160 (3) ◽  
pp. 375-379 ◽  
Author(s):  
Cecelia E. Schmalbach
Keyword(s):  
Peer Review ◽  
Educational Program ◽  
Administrative Support ◽  
Peer Review Process ◽  
Development Program ◽  
Median Number ◽  
Lessons Learned ◽  
Improvement Project ◽  
Minimum Requirement ◽  
Independent Review

Objective To implement a quality improvement project addressing the knowledge gap in the otolaryngology resident and fellow scientific peer review process. Methods The creation of the Resident Reviewer Development Program, cohort 1 outcomes, and subsequent lessons learned from the inaugural class are outlined using the plan-do-study-act model. Interested otolaryngology residents were paired with seasoned reviewers and conducted a minimum of 3 mentored peer reviews followed by an independent review test if competency was determined. Results Twenty-five residents (postgraduate years [PGYs] 2-5) were actively enrolled in cohort 1. At 24 months, 18 (72%) graduated, 6 remained actively enrolled, and 1 did not successfully complete the program. The median number of practice reviews prior to testing was 3 (range, 3-6). The median independent review score was 83 (overall journal mean = 78). Cohort 1 graduates continued on to review 130 articles with a mean score of 85. Five (28%) graduates achieved Star Reviewer status. Discussion The inaugural cohort demonstrated that the PGY-3 and PGY-4 class is ideal for enrollment given that completion of the program could take up to 24 months. Three mentored reviews were identified as the ideal minimum requirement for education. The accelerated achievement of Star Reviewer status (28%) and mean postgraduation score of 85 demonstrate successful and sustainable outcome measures. Implications for Practice With appropriate mentorship and administrative support, scientific peer review can be formally incorporated into an educational program. Lessons learned during the educational program are sustained long term as demonstrated by review scores and Star Reviewer status.

scholarly journals The therapeutic potential of genome editing for β-thalassemia

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 1431 ◽  
Author(s):  
Astrid Glaser ◽  
Bradley McColl ◽  
Jim Vadolas
Keyword(s):  
Gene Therapy ◽  
Genome Editing ◽  
Insertional Mutagenesis ◽  
Therapeutic Potential ◽  
Allogeneic Bone Marrow Transplantation ◽  
Lessons Learned ◽  
Small Subset ◽  
Allogeneic Bone ◽  
Hematopoietic Stem ◽  
Blood Disorder

The rapid advances in the field of genome editing using targeted endonucleases have called considerable attention to the potential of this technology for human gene therapy. Targeted correction of disease-causing mutations could ensure lifelong, tissue-specific expression of the relevant gene, thereby alleviating or resolving a specific disease phenotype. In this review, we aim to explore the potential of this technology for the therapy of β-thalassemia. This blood disorder is caused by mutations in the gene encoding the β-globin chain of hemoglobin, leading to severe anemia in affected patients. Curative allogeneic bone marrow transplantation is available only to a small subset of patients, leaving the majority of patients dependent on regular blood transfusions and iron chelation therapy. The transfer of gene-corrected autologous hematopoietic stem cells could provide a therapeutic alternative, as recent results from gene therapy trials using a lentiviral gene addition approach have demonstrated. Genome editing has the potential to further advance this approach as it eliminates the need for semi-randomly integrating viral vectors and their associated risk of insertional mutagenesis. In the following pages we will highlight the advantages and risks of genome editing compared to standard therapy for β-thalassemia and elaborate on lessons learned from recent gene therapy trials.

Eric H. Shaw: reflections on an improbable academic career

2019 ◽  
Vol 11 (1) ◽  
pp. 12-34 ◽  
Author(s):  
Eric H. Shaw
Keyword(s):  
Student Learning ◽  
Design Methodology ◽  
Academic Career ◽  
Lessons Learned ◽  
Primary Sources ◽  
Field Of Study ◽  
Improvement Project ◽  
Content Type ◽  
Academic Mission ◽  
Teaching Research

Purpose The purpose of this paper is to describe the author’s serendipitous career and provide some lessons that might be of value to those pursuing the academic mission: teaching, research and service. Design/methodology/approach The method involves primary sources; mainly the author’s CV to jog recall of events and dates, some of his articles and the teachings and writings of many others that influenced or inspired various aspects of the author’s career. Findings The author’s experiences affirm that to achieve any degree of success in the professoriate, in addition to having some talent it is also helpful to be lucky. There is a lot to navigate at a university. Opportunities exist at every turn, some noticed some missed. When recognized, be prepared. Being a professor is not what you do, it is who you are. Preparation for an academic career involves becoming a self-improvement project (essentially, a life-long student learning lessons). It requires developing expertise (preferably excellence) in some field of study, as well as resourcefulness, resilience and perseverance. Originality/value Each individual’s story is unique. The author’s path seems to have included more twists and turns than most. Consequently, he tried to highlight the experiences with lessons learned in most sections, some obvious some less so, which he expects (at least hopes) will prove valuable to future educators.

Lessons learned from the institution of the Surgical Care Improvement Project at a teaching medical center

2009 ◽  
Vol 198 (6) ◽  
pp. 881-888 ◽  
Author(s):  
Bruce Potenza ◽  
Michelle Deligencia ◽  
Brenda Estigoy ◽  
Eema Faraday ◽  
Andrea Snyder ◽  
...  
Keyword(s):  
Medical Center ◽  
Surgical Care ◽  
Lessons Learned ◽  
Improvement Project ◽  
Surgical Care Improvement Project ◽  
Care Improvement

scholarly journals Partnering with State Health Departments to Address Injection-Related Infections during the Opioid Epidemic: Experience at a Safety Net Hospital

2021 ◽  
Author(s):  
Rebecca H Burns ◽  
Cassandra M Pierre ◽  
Jai G Marathe ◽  
Glorimar Ruiz-Mercado ◽  
Jessica L Taylor ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Medical Center ◽  
Safety Net ◽  
Opioid Use Disorder ◽  
Lessons Learned ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Persons Who Inject Drugs ◽  
Curative Therapy ◽  
Safety Net Hospital

Abstract Massachusetts is one of the epicenters of the opioid epidemic and has been severely impacted by injection-related viral and bacterial infections. A recent increase in newly diagnosed human immunodeficiency virus (HIV) infections among persons who inject drugs in the state highlights the urgent need to address and bridge the overlapping epidemics of opioid use disorder (OUD) and injection-related infections. Building on an established relationship between the Massachusetts Department of Public Health (MDPH) and Boston Medical Center (BMC), the Infectious Diseases section has contributed to the development and implementation of a cohesive response involving ambulatory, inpatient, emergency department and community-based services. We describe this comprehensive approach including the rapid delivery of antimicrobials for the prevention and treatment of HIV, sexually transmitted diseases, systemic infections such as endocarditis, bone and joint infections, as well as curative therapy for chronic hepatitis C virus (HCV) in a manner that is accessible to patients on the addiction-recovery continuum. We also provide an overview of programs that provide access to medications for opioid use disorder (MOUD), harm reduction services including overdose education and distribution of naloxone. Finally, we outline lessons learned to inform initiatives in other settings.

scholarly journals The OASI care bundle quality improvement project: lessons learned and future direction

2021 ◽  
Author(s):  
Magdalena Jurczuk ◽  
Posy Bidwell ◽  
Ipek Gurol-Urganci ◽  
Jan van der Meulen ◽  
Nick Sevdalis ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Royal College ◽  
Lessons Learned ◽  
Care Bundle ◽  
Sphincter Injury ◽  
Improvement Project ◽  
Mediolateral Episiotomy ◽  
Anal Sphincter Injury ◽  
Manual Perineal Protection ◽  
Future Direction

AbstractRising rates of obstetric anal sphincter injury (OASI) led to a collaborative effort by the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives (RCM) to develop and evaluate the OASI Care Bundle (OASI-CB). The OASI-CB comprises four practices (antenatal discussion about OASI, manual perineal protection, mediolateral episiotomy at 60° from the midline, and systematic examination of the perineum, vagina and ano-rectum after vaginal birth) and was initially implemented as part of a quality improvement (QI) project—“OASI1”—in 16 maternity units across Great Britain. Evaluation of the OASI1 project found that the care bundle reduced OASI rates and identified several barriers and enablers to implementation. This paper summarises the key findings, including strengths, limitations and lessons learned from the OASI1 QI project, and provides rationale for further evaluation of the OASI-CB.

Sign in / Sign up

Export Citation Format

Share Document