Republished paper: Assessing and improving safety culture throughout an academic medical centre: a prospective cohort study

2011 ◽  
Vol 87 (1028) ◽  
pp. 428-435 ◽  
Author(s):  
L. A. Paine ◽  
B. J. Rosenstein ◽  
J. B. Sexton ◽  
P. Kent ◽  
C. G. Holzmueller ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Safety Culture ◽  
Prospective Cohort ◽  
Medical Centre ◽  
Academic Medical Centre ◽  
Academic Medical

Assessing and improving safety culture throughout an academic medical centre: a prospective cohort study

2010 ◽  
Vol 19 (6) ◽  
pp. 547-554 ◽  
Author(s):  
L. A. Paine ◽  
B. J. Rosenstein ◽  
J. B. Sexton ◽  
P. Kent ◽  
C. G. Holzmueller ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Safety Culture ◽  
Prospective Cohort ◽  
Medical Centre ◽  
Academic Medical Centre ◽  
Academic Medical

scholarly journals Cardiovascular and cerebrovascular health after pre-eclampsia: the Motherhealth prospective cohort study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e043052
Author(s):  
Eliza C Miller ◽  
Andrea Miltiades ◽  
Nicole Pimentel-Soler ◽  
Whitney A Booker ◽  
Ruth Landau-Cahana ◽  
...  
Keyword(s):  
New York ◽  
Cohort Study ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Vascular Function ◽  
Clinical Pathways ◽  
Medical Center ◽  
Cerebrovascular Diseases ◽  
Columbia University ◽  
Academic Medical Centre

IntroductionCardiovascular and cerebrovascular diseases (CCVDs) are the leading cause of maternal mortality in the first year after delivery. Women whose pregnancies were complicated by pre-eclampsia are at particularly high risk for adverse events. In addition, women with a history of pre-eclampsia have higher risk of CCVD later in life. The physiological mechanisms that contribute to increased CCVD risk in these women are not well understood, and the optimal clinical pathways for postpartum CCVD risk reduction are not yet defined.Methods and analysisThe Motherhealth Study (MHS) is a prospective cohort study at Columbia University Irving Medical Center (CUIMC), a quaternary care academic medical centre serving a multiethnic population in New York City. MHS began recruitment on 28 September 2018 and will enrol 60 women diagnosed with pre-eclampsia with severe features in the antepartum or postpartum period, and 40 normotensive pregnant women as a comparison cohort. Clinical data, biospecimens and measures of vascular function will be collected from all participants at the time of enrolment. Women in the pre-eclampsia group will complete an additional three postpartum study visits over 12–24 months. Visits will include additional detailed cardiovascular and cerebrovascular phenotyping. As this is an exploratory, observational pilot study, only descriptive statistics are planned. Data will be used to inform power calculations for future planned interventional studies.Ethics and disseminationThe CUIMC Institutional Review Board approved this study prior to initiation of recruitment. All participants signed informed consent prior to enrolment. Results will be disseminated to the clinical and research community, along with the public, on completion of analyses. Data will be shared on reasonable request.

scholarly journals Effectiveness of a simulation-based mastery learning to train clinicians on a novel cricothyrotomy procedure at an academic medical centre during a pandemic: a quasi-experimental cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e054746
Author(s):  
Nabil Issa ◽  
Whitney E Liddy ◽  
Sandeep Samant ◽  
David B Conley ◽  
Robert C Kern ◽  
...  
Keyword(s):  
Cohort Study ◽  
Mastery Learning ◽  
Tertiary Care ◽  
Medical Centre ◽  
Pretest Score ◽  
Academic Medical Centre ◽  
Academic Medical ◽  
Simulation Based ◽  
Quasi Experimental ◽  
Nose And Throat

ObjectivesTo develop and evaluate a simulation-based mastery learning (SBML) curriculum for cricothyrotomy using wet towels to suppress aerosolisation during a pandemic.DesignQuasi-experimental, pre–post study.SettingTertiary care, academic medical centre in Chicago.ParticipantsEar, nose and throat and general surgery residents, fellows and attendings.InterventionCricothyroidotomy simulation-based mastery learning curriculum.Outcomes measurePretest to posttest simulated cricothyrotomy skills checklist performance.Results37 of 41 eligible surgeons participated in the curriculum. Median pretest score was 72.5 (IQR 55.0–80.0) and 100.0 (IQR 98.8–100.0) for the posttest p<0.001. All participants scored at or above a minimum passing standard (93% checklist items correct) at posttest.ConclusionsUsing SBML is effective to quickly train clinicians to competently perform simulated cricothyrotomy during a pandemic.

scholarly journals Vitamin B12deficiency and hyperhomocysteinaemia in outpatients with stroke or transient ischaemic attack: a cohort study at an academic medical centre

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e026564 ◽  
Author(s):  
Shamon Ahmed ◽  
Chrysi Bogiatzi ◽  
Daniel G Hackam ◽  
Angela C Rutledge ◽  
Luciano A Sposato ◽  
...  
Keyword(s):  
Cohort Study ◽  
Transient Ischaemic Attack ◽  
Small Vessel Disease ◽  
Medical Centre ◽  
Large Artery ◽  
Stroke Subtype ◽  
Academic Medical Centre ◽  
Academic Medical ◽  
Ischaemic Attack ◽  
Total Homocysteine

ObjectiveWe sought to assess the current magnitude of the opportunity for secondary stroke prevention with B vitamins.DesignA cohort study.SettingThe Urgent TIA (Transient Ischaemic Attack) Clinic at an academic medical centre.Main outcome measuresWe assessed the prevalence of biochemical vitamin B12deficiency (B12Def, serum B12<156 pmol/L), hyperhomocysteinaemia (HHcy; plasma total homocysteine [tHcy] >14 µmol/L) and metabolic B12deficiency (MetB12Def, serum B12<258 pmol/L and HHcy) between 2002 and 2017, by age group and by stroke subtype.ResultsData were available in 4055 patients. B12Def was present in 8.2% of patients overall; it declined from 10.9% of patients referred before 2009 to 5.4% thereafter (p=0.0001). MetB12Def was present in 10.6% of patients, and HHcy was present in 19.1% of patients. Among the patients aged ≥80 years, MetB12Def was present in 18.1% and HHcy in 35%. Among the 3410 patients whose stroke subtype was determined, HHcy was present in 18.4% of patients: 23.3% of large artery atherosclerosis, 18.1% of cardioembolic, 16.3% of small vessel disease, 10.8% of other unusual aetiologies and 13.6% of undetermined subtypes (p=0.0001).ConclusionsDespite a decline in our referral area since 2009, B12Def, MetB12Def and HHcy remain common in patients with stroke/TIA. Because these conditions are easily treated and have serious consequences, all patients with stroke/TIA should have their serum B12and tHcy measured.

scholarly journals Risk factors and reasons for cancellation within 24 h of scheduled elective surgery in an academic medical centre: A cohort study

2019 ◽  
Vol 66 ◽  
pp. 72-78 ◽  
Author(s):  
Aidan L. Tan ◽  
Calvin J. Chiew ◽  
Sijia Wang ◽  
Hairil Rizal Abdullah ◽  
Sean SW. Lam ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Elective Surgery ◽  
Medical Centre ◽  
Academic Medical Centre ◽  
Academic Medical

scholarly journals Cohort study of impact on length of stay of individual enhanced recovery after surgery protocol components

2021 ◽  
Vol 3 (1) ◽  
pp. e000087
Author(s):  
Rachel C. Sisodia ◽  
Dan Ellis ◽  
Michael Hidrue ◽  
Pamela Linov ◽  
Elena Cavallo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Length Of Stay ◽  
Minimally Invasive ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Fluid Administration ◽  
Medical Centre ◽  
Academic Medical Centre ◽  
Process Measure ◽  
Academic Medical

ObjectiveThe goal of this study was to explore which enhanced recovery after surgery (ERAS) bundle items were most associated with decreased length of stay after surgery, most likely associated with decreased length of stay after surgery.DesignA cohort study.SettingLarge tertiary academic medical centre.ParticipantsThe study included 1318 women undergoing hysterectomy as part of our ERAS pathway between 1 February 2018 and 30 January 2020 and a matched historical cohort of all hysterectomies performed at our institution between 3 October 2016 and 30 January 2018 (n=1063).InterventionThe addition of ERAS to perioperative care.This is a cohort study of all patients undergoing hysterectomy at an academic medical centre after ERAS implementation on 1 February 2018. Compliance and outcomes after ERAS roll out were monitored and managed by a centralised team. Descriptive statistics, multivariate regression, interrupted time series analysis were used as indicated.Main outcome measuresImpact of ERAS process measure adherence on length of stay.ResultsAfter initiation of ERAS pathway, 1318 women underwent hysterectomy. There were more open surgeries after ERAS implementation, but cohorts were otherwise balanced. The impact of process measure adherence on length of stay varied based on surgical approach (minimally invasive vs open). For open surgery, compliance with intraoperative antiemetics (−30%, 95% CI −18% to 40%) and decreased postoperative fluid administration (−12%, 95% CI −1% to 21%) were significantly associated with reduced length of stay. For minimally invasive surgery, ambulation within 8 hours of surgery was associated with reduced length of stay (−53%, 95% CI −55% to 52%).ConclusionsWhile adherence to overall ERAS protocols decreases length of stay, the specific components of the bundle most significantly impacting this outcome remain elusive. Our data identify early ambulation, use of antiemetics and decreasing postoperative fluid administration to be associated with decreased length of stay.

Organizational Justice and Health of Employees: Prospective Cohort Study.

2013 ◽  
Author(s):  
Mika Kivimaki ◽  
Marko Elovainio ◽  
Jussi Vahtera ◽  
Marianna Virtanen ◽  
Jane E. Ferrie
Keyword(s):  
Cohort Study ◽  
Organizational Justice ◽  
Prospective Cohort Study ◽  
Prospective Cohort
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