Implementation of a pilot teleretinal screening protocol for hydroxychloroquine retinopathy in a Los Angeles County safety net clinic

2021 ◽  
pp. 1357633X2110181
Author(s):  
Betty A Situ ◽  
Hong-Uyen Hua ◽  
Abdul-Hadi Kaakour ◽  
Lauren Patty Daskivich ◽  
Stavros Savvas ◽  
...  
Keyword(s):  
Los Angeles ◽  
Los Angeles County ◽  
Medical Center ◽  
Wait Time ◽  
Safety Net ◽  
Screening Guidelines ◽  
Face To Face ◽  
Efficiency Measures ◽  
Clinic Efficiency ◽  
Hydroxychloroquine Retinopathy

Introduction This study aimed to determine whether teleretinal screening for hydroxychloroquine retinopathy (HCQR) improves clinical efficiency and adherence to recommended screening guidelines compared to face-to-face screening among patients in a large safety net medical system. Methods In this retrospective cohort study of a consecutive sample of 590 adult patients with active HCQ prescriptions seen in the outpatient ophthalmology clinic at Los Angeles County + University of Southern California Medical Center from 1 September 2018 to 25 November 2019, 203 patients underwent technician-only tele-HCQR screening (THRS), and 387 patients underwent screening with traditional face-to-face visits (F2FV) with an eye-care provider. Data on clinic efficiency measures (appointment wait time and encounter duration) and adherence to recommended screening guidelines were collected and compared between the two cohorts. Results Compared to F2FV, the THRS cohort experienced significantly shorter median (interquartile range) time to appointment (2.5 (1.5–4.6) vs. 5.1 (2.9–8.4) months; p < 0.0001), shorter median encounter duration (1 (0.8–1.4) vs. 3.7 (2.5–5.2) hours; p < 0.0001) and higher proportion of complete baseline screening (102/104 (98.1%) vs. 68/141 (48.2%); p < 0.001) and complete chronic screening (98/99 (99%) vs. 144/246 (58.5%); p < 0.001). Discussion A pilot THRS protocol was successfully implemented at a major safety net eye clinic in Los Angeles County, resulting in a 50.9% reduction in wait times for screening, 72.9% reduction in encounter duration and 49.9% and 40.5% increases in proportions of complete baseline and chronic screening, respectively. Tele-HCQ retinal screening protocols may improve timeliness to care and screening adherence for HCQR in the safety net setting.

scholarly journals Impact of COVID-19 infection among cancer patients treated at the Los Angeles County Medical Center

2021 ◽  
Vol 26 ◽  
pp. 100273
Author(s):  
Lauren Antrim ◽  
Stephen Capone ◽  
Stephen Dong ◽  
David Chung ◽  
Sonia Lin ◽  
...  
Keyword(s):  
Los Angeles ◽  
Cancer Patients ◽  
Los Angeles County ◽  
Medical Center

Development of neurosurgery in Southern California and the Los Angeles County/University of Southern California Medical Center

1993 ◽  
Vol 79 (1) ◽  
pp. 145-148
Author(s):  
John H. Schneider ◽  
Martin H. Weiss ◽  
William T. Couldwell
Keyword(s):  
Los Angeles ◽  
Los Angeles County ◽  
Southern California ◽  
Medical Center ◽  
University Of Southern California ◽  
Content Type ◽  
School Of Medicine ◽  
Integral Role ◽  
Southern California School ◽  
The University

✓ The Los Angeles County General Hospital has played an integral role in the development of medicine and neurosurgery in Southern California. From its fledgling beginnings, the University of Southern California School of Medicine has been closely affiliated with the hospital, providing the predominant source of clinicians to care for and to utilize as a teaching resource the immense and varied patient population it serves.

Assessing Blood Administering Practices

1999 ◽  
Vol 123 (7) ◽  
pp. 595-598 ◽  
Author(s):  
Ira A. Shulman ◽  
Sunita Saxena ◽  
Lois Ramer
Keyword(s):  
Health Care ◽  
Los Angeles ◽  
Los Angeles County ◽  
Medical Center ◽  
Health Care Financing ◽  
Vital Signs ◽  
Data Driven ◽  
Blood Component ◽  
University Of Southern California ◽  
Health Care Financing Administration

Abstract The risk that a red blood cell unit will be associated with an ABO-incompatible transfusion is currently slightly greater than the aggregate risk of acquiring human immunodeficiency virus, human T-cell lymphotropic virus, hepatitis B virus, or hepatitis C virus by transfusion. Since the most common cause for ABO-incompatible transfusion is the failure of transfusionists to properly identify a patient or a blood component before a transfusion, transfusion services are encouraged to evaluate and monitor the processes of dispensing and administering blood. In addition, a proposal of the Health Care Financing Administration of the Department of Health and Human Services would require hospitals to use a data-driven quality assessment and performance improvement program that evaluates the dispensing and administering of blood and that ensures that each blood product and each intended recipient is positively identified before transfusion. The Los Angeles County+University of Southern California Medical Center assesses the blood dispensing and administering process as proposed by the Health Care Financing Administration. During the fourth quarter of 1997, 85 blood transfusions were assessed for compliance with the Los Angeles County+University of Southern California Medical Center policies and procedures: 55 transfusion episodes had no variance from institutional protocol and 30 had one or more variances. Of the transfusions with at least one variance, 16 had one or more variances involving the identification of the patient, the component, or the paperwork. The remaining 14 transfusions had one or more variances involving other criteria (nonidentification items). The most frequent variance was the failure to document vital signs during the first 15 minutes after a transfusion was started or after 50 mL of a component had been transfused. No variances in patient or blood component identification were noted in nursing units whose staff routinely performed self-assessment of blood administering practices. Based on these findings, a corrective action plan was implemented. Follow-up assessments (n = 63) were conducted after 3 months (during the second quarter of 1998). The compliance with the pretransfusion identification protocol improved from 81% to 95%. The most common reason for noncompliance continued to be a lack of checking vital signs. This report demonstrates the value of using a data-driven program that assesses blood administering practices.

Clinical Pharmacy Case Studies

1974 ◽  
Vol 8 (4) ◽  
pp. 166-166
Author(s):  
Margaret M. McCarhon
Keyword(s):  
Los Angeles ◽  
Laboratory Test ◽  
Continuing Education ◽  
Case Studies ◽  
Clinical Education ◽  
Clinical Pharmacy ◽  
Los Angeles County ◽  
Medical Center ◽  
Medical Material ◽  
Normal Laboratory

This series of case studies has been prepared by the faculty of the Department of Clinical Education and Services at U.S.C. School of Pharmacy as a continuing education course for pharmacists. The cases are meant to be studied in sequence; concepts and laboratory test evaluations presented in one case will be used in subsequent cases. All normal laboratory test values will be those used at the Los Angeles County/U.S.C. Medical Center; values may differ at other hospitals depending on the method used. Medical material is presented to give the pharmacist an understanding of the case, it is not meant to teach the pharmacist diagnosis. The cases have been altered for teaching purposes so that they do not represent actual cases.

Clinical Pharmacy Case Studies

1974 ◽  
Vol 8 (1) ◽  
pp. 16-16
Author(s):  
Margaret M. McCarron
Keyword(s):  
Los Angeles ◽  
Laboratory Test ◽  
Continuing Education ◽  
Case Studies ◽  
Clinical Education ◽  
Clinical Pharmacy ◽  
Los Angeles County ◽  
Medical Center ◽  
Medical Material ◽  
Normal Laboratory

This series of case studies has been prepared by the faculty of the Department of Clinical Education and Services at U.S.C. School of Pharmacy as a continuing education course for pharmacists. The cases are meant to be studied in sequence; concepts and laboratory test evaluations presented in one case will be used in subsequent cases. All normal laboratory test values will be those used at the Los Angeles County/U.S.C. Medical Center; values may differ at other hospitals depending on the method used. Medical material is presented to give the pharmacist an understanding of the case, it is not meant to teach' the pharmacist diagnosis. The cases have been altered for teaching purposes so that they do not represent actual cases.

Initiating a Standard Venous Thromboembolism Prophylaxis Order Set Designed to Improve Patient Outcomes at Los Angeles County + University of Southern California

2016 ◽  
Vol 82 (10) ◽  
pp. 1000-1004 ◽  
Author(s):  
Daniel Gardner ◽  
Andrew Liman ◽  
Victoria Autelli ◽  
Casey O'Connell ◽  
Nicholas Testa ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Los Angeles ◽  
Patient Outcomes ◽  
Los Angeles County ◽  
Southern California ◽  
Safety Net ◽  
University Of Southern California ◽  
Vte Prophylaxis ◽  
Safety Net Hospital ◽  
Order Sets

Improving patient safety is vital for all hospitals due to increasing public reporting and pay-for-performance reimbursement. Venous thromboembolism (VTE) remains a leading cause of preventable mortality accounting for 5 per cent of inpatient deaths. The purpose of this study was to outline the process of implementing standard VTE prophylactic order sets in a 600-bed academic safety net hospital and assess the resulting change in patient outcomes. Outcomes were assessed by comparing the rate that eligible inpatients receive VTE prophylaxis and the rate of preventable VTE's compared with total VTE's. From 2011 to 2015, random samples of 60 Los Angeles County+University of Southern California inpatients were generated monthly to examine compliance rates by comparing ICD-9 diagnostic codes to ordered VTE prophylaxis. All inpatient VTE's are retrospectively analyzed. Baseline-ordered VTE prophylaxis was 37 per cent in 2010. The target of 85 per cent was exceeded by the second quarter of 2012 to 2013 when compliance reached 88 per cent, a 51 per cent increase from baseline ( P < 0.01). These results suggest VTE protocols are effective though standardization across service lines is often difficult. Despite these challenges, after implementing standard order sets, we saw compliance increase significantly. Ongoing analysis to determine whether VTE rates have significantly decreased is presently underway.

ChemoPalRx: Development and implementation of a chemotherapy mobile provider order entry system in a safety net hospital.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18071-e18071
Author(s):  
Kin Wai (Tony) Hung ◽  
Natasha Banerjee
Keyword(s):  
Los Angeles ◽  
Mobile Application ◽  
Medical Center ◽  
Hospital Setting ◽  
Safety Net ◽  
Quality Improvement Initiative ◽  
Order Entry ◽  
Development Environment ◽  
Safety Net Hospital ◽  
Safety Parameters

e18071 Background: Computerized provider order entry (CPOE) systems have been shown to enhance the safety and efficiency of prescribing chemotherapy over the handwritten ordering process. However, many institutions lack the financial ability, technological capability, or operational flexibility to invest in and implement such a system. In particular, Olive View-UCLA Medical Center (OVMC), a Los Angeles County safety net hospital, is among these institutions with unique restrictions that preclude the use of chemotherapy CPOE and mandate handwritten orders. Methods: In an effort to bridge the gap for safe chemotherapy prescribing, we aimed to develop and implement an effective, scalable, and sustainable chemotherapy provider order entry solution that was operationally sensitive to institutions without a chemotherapy CPOE. The solution was designed as a mobile application using Xcode, the integrative development environment of Apple Inc., with the Swift programing language. Results: On September 5th, 2018, we launched a free, chemotherapy provider order entry solution on the worldwide Apple App Store – ChemoPalRx. Using ChemoPalRx, providers can search, customize, and print common chemotherapy regimens in prescription format. Along with a reference library of over 120 order set and 450 medications, ChemoPalRx is equipped with the functions to automate dosage calculation, suggest pre-medications and safety parameters, and trigger alerts for missing prescribing information. As a quality improvement initiative, we implemented ChemoPalRx at OVMC. Implementation stages include obtaining administrative buy-in, consulting with multidisciplinary staffs, investing $100 USD for a prescription printer, and encouraging providers to download ChemoPalRx on their own mobile devices. An ongoing prospective cohort study is being conducted to determine ChemoPalRx effectiveness in reducing errors compared to handwritten orders. Conclusions: ChemoPalRx is developed to enhance the safety and efficiency of chemotherapy prescribing. Implementation of this mobile application is feasible in the safety-net hospital setting and has the potential to transform oncology practices globally.

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