An Innovative Cost-Effective Model of Using Advanced Care Practitioners (ACPs) in Improving Glycemic Control and LOS in a Large Hospital System

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1322-P ◽  
Author(s):  
RENU JOSHI ◽  
AMY HELMUTH
Keyword(s):  
Glycemic Control ◽  
Cost Effective ◽  
Effective Model ◽  
Large Hospital ◽  
Hospital System

scholarly journals Assessment of vitamin B12 deficiency and B12 screening trends for patients on metformin: a retrospective cohort case review

2021 ◽  
pp. bmjnph-2020-000193
Author(s):  
Darby Martin ◽  
Jeet Thaker ◽  
Maria Shreve ◽  
Lois Lamerato ◽  
Kartazyna Budzynska
Keyword(s):  
Retrospective Cohort ◽  
Protective Factor ◽  
Vitamin B12 Deficiency ◽  
Older Age ◽  
Secondary Outcome ◽  
Vitamin B ◽  
Case Review ◽  
Large Hospital ◽  
Hospital System ◽  
B12 Deficiency

ObjectivesOur study investigated the use of vitamin B12 testing in a large cohort of patients on metformin and assesses appropriateness and benefits of screening recommendations for vitamin B12 deficiency.DesignThis retrospective cohort study included insured adult patients who had more than 1 year of metformin use between 1 January 2010 and 1 October 2016 and who filled at least two consecutive prescriptions of metformin to establish compliance. The comparison group was not exposed to metformin. Primary outcome was incidence of B12 deficiency diagnosed in patients on metformin. Secondary outcome was occurrence of B12 testing in the patient population on metformin. Records dated through 31 December 2018 were analysed.SettingLarge hospital system consisting of inpatient and outpatient data base.ParticipantsA diverse, adult, insured population of patients who had more than 1 year of metformin use between 1 January 2010 and 1 October 2016 and who filled at least two consecutive prescriptions of metformin.ResultsOf 13 489 patients on metformin, 6051 (44.9%) were tested for vitamin B12 deficiency, of which 202 (3.3%) tested positive (vs 2.2% of comparisons). Average time to test was 990 days. Average time to test positive for deficiency was 1926 days. Factors associated with testing were linked to sex (female, 47.8%), older age (62.79% in patients over 80 years old), race (48.98% white) and causes of malabsorption (7.11%). Multivariable logistic regression showed older age as the only factor associated with vitamin B12 deficiency, whereas African-American ethnicity approached significance as a protective factor.ConclusionsBased on our study’s findings of vitamin B12 deficiency in patients on metformin who are greater than 65 years old and have been using it for over 5 years, we recommend that physicians consider screening in these populations.

scholarly journals The Albufera Initiative for Biodiversity: a cost effective model for integrating science and volunteer participation in coastal protected area management

2014 ◽  
Vol 14 (2) ◽  
pp. 267-288 ◽  
Author(s):  
Nick J. Riddiford ◽  
Jeroen A. Veraart ◽  
Inmaculada Férriz ◽  
Nick W. Owens ◽  
Laura Royo ◽  
...  
Keyword(s):  
Protected Area ◽  
Cost Effective ◽  
Protected Area Management ◽  
Effective Model ◽  
Volunteer Participation ◽  
Area Management

Resourcing Popular Music for Relevant Themes in Music Therapy with Perinatal Loss

2021 ◽  
Author(s):  
John Mondanaro
Keyword(s):  
Music Therapy ◽  
Popular Music ◽  
Belief Systems ◽  
Perinatal Loss ◽  
Anticipatory Grief ◽  
Large Hospital ◽  
Hospital System ◽  
Perinatal Bereavement ◽  
Art Form ◽  
Grief Responses

Abstract Perinatal loss poses unique challenges to grief work because of the complexity of dynamics it carries. Historically shrouded in socially and culturally based belief systems often impeding normal grief responses, the barriers to healthy processing have been surmounted in recent decades. The emergence of music therapy in partnership with social work is one such approach to addressing both anticipatory grief and bereavement of parents enduring the death of their infant prenatally. This retrospective article highlights the resourcing of popular music within a clinical music therapy approach to the curation of a perinatal bereavement event within a large hospital system in a metropolitan area. Popular music as a ubiquitous art form lends tangibility and relevance to the complicated themes of perinatal loss in a manner that invites bereft parents into a forum of acceptance and acknowledgment of a loss that for too long has remained in the shadows.

Abstract WP455: Memorial Hermann Hospital System Stroke Coordinators: Working as One

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Sandi G Shaw ◽  
Isabel Gonzales ◽  
Hari Indupuru ◽  
Nicole Harrison ◽  
Sean Savitz ◽  
...  
Keyword(s):  
Best Practice ◽  
Quality Care ◽  
High Volume ◽  
Work Load ◽  
Joint Commission ◽  
Large Hospital ◽  
Hospital System ◽  
Primary Stroke Center ◽  
Stroke Center ◽  
The Joint Commission

Background: Many hospital stroke programs fail to meet or maintain the certification requirements of The Joint Commission (TJC) as a Primary Stroke Center (PSC) or Comprehensive Stroke Center (CSC). The most common reason is the absence of a dedicated stroke program coordinator. There are opportunities for improvement to promote stroke coordinator growth and retention. Purpose: We created The Memorial Hermann Hospital System Stroke Coordinator Alliance to combine resources, reduce workload, and support stroke coordinators in order to promote adherence to best practice and maintain TJC stroke certification. Methods: The Memorial Hermann Hospital System Stroke Coordinator Alliance was developed in 2015. It includes 14 nurses who represent 11 acute care hospitals within a large hospital system in Houston (Figure1). Four of the hospitals are CSCs, five are PSCs, and two are not certified. Monthly meetings are conducted to create standardized access to resources, stroke coordinator orientation, education, medical power plans, process improvement, and data development. Coordinator work groups, a central email and shared drive, biweekly data meetings, and a buddy system were created to reduce work load, improve electronic communication, and streamline data review procedures. A partnership was created to onboard new coordinators and to prepare for mock and real time survey visits. In 2018 data abstraction was standardized across hospitals with use of a homegrown database Stroke Program Registry (REGIS). Results: Of the 14 Stroke Coordinators in place during fiscal years 2015 - 2019, retention was 100%. A total of 19 stroke surveys were completed and recognized as successful by The Joint Commission. A total of 17,148 stroke patients were received with PSC measures averaging greater than 95% and CSC measures above 90%. Conclusion: Implementing program development support for stroke coordinators improves retention and quality care in a high volume stroke system.

scholarly journals Independent Correlates of Hospitalization in 2040 Patients with COVID-19 at a Large Hospital System in Michigan, United States

2020 ◽  
Vol 35 (8) ◽  
pp. 2516-2517 ◽  
Author(s):  
Zaid Imam ◽  
Fadi Odish ◽  
Justin Armstrong ◽  
Heba Elassar ◽  
Jonathan Dokter ◽  
...  
Keyword(s):  
United States ◽  
Large Hospital ◽  
Hospital System

scholarly journals Advance Service Reservations with Heterogeneous Customers

2020 ◽  
Vol 66 (7) ◽  
pp. 2929-2950 ◽  
Author(s):  
Clifford Stein ◽  
Van-Anh Truong ◽  
Xinshang Wang
Keyword(s):  
New York ◽  
New York City ◽  
Online Advertising ◽  
Capacity Utilization ◽  
Freight Transportation ◽  
Real Data ◽  
Large Hospital ◽  
Data Set ◽  
Hospital System ◽  
Specific Amount

We study a fundamental model of resource allocation in which a finite number of resources must be assigned in an online manner to a heterogeneous stream of customers. The customers arrive randomly over time according to known stochastic processes. Each customer requires a specific amount of capacity and has a specific preference for each of the resources with some resources being feasible for the customer and some not. The system must find a feasible assignment of each customer to a resource or must reject the customer. The aim is to maximize the total expected capacity utilization of the resources over the horizon. This model has application in services, freight transportation, and online advertising. We present online algorithms with bounded competitive ratios relative to an optimal off-line algorithm that knows all stochastic information. Our algorithms perform extremely well compared with common heuristics as demonstrated on a real data set from a large hospital system in New York City. This paper was accepted by Yinyu Ye, optimization.

scholarly journals The business of integrative medicine in a large hospital system

2014 ◽  
Vol 3 (3) ◽  
pp. 52 ◽  
Author(s):  
Thomas Lanni ◽  
Gail Elliott Patricolo
Keyword(s):  
Healthcare System ◽  
Integrative Medicine ◽  
Medical Specialty ◽  
Large Hospital ◽  
Hospital System ◽  
Alternative Medicines ◽  
Naturopathic Medicine ◽  
Successful Program ◽  
Number Of Patients ◽  
Integrative Medicine Program

The number of patients seeking complementary and alternative medicines combined with conventional treatments has grown considerably over the past decade. To meet the growing demand, a dedicated oncology integrative medicine program was initiated in the Beaumont Health System to address the needs of this patient population. Due to its resounding success and patient satisfaction, as evidenced by patient utilization and testimonials and physician referrals, the program was expanded across the healthcare system to every medical specialty. This study outlines how the program was implemented and its business model. A number of methods were used to evaluate the feasibility of starting the program and determine the services required. Financial analyses were developed to understand the costs associated with starting the program without financial assistance. In 2006, an Integrative Medicine program was launched in the Beaumont Cancer Institute (Royal Oak, MI). The initial offering for patients was clinical massage; however, the program rapidly expanded. Currently, services include clinical massage, a clinical massage training program, Reiki, guided imagery, acupuncture, and naturopathic medicine. Patients and physicians expressed satisfaction with the increasing number of complementary services offered at the institution, and the services are heavily utilized. In 2012, the program had more than 18,000 patient visits, of which, 10,191 were for clinical massage, 6,515 for acupuncture, and 1,030 for naturopathic medicine. In this study of developing and implementing an Integrative Medicine program in a large healthcare system, it is shown that a successful program could be initiated with the appropriate planning and support from administration. The program is shown to be financially viable, as the Integrative Medicine (IM) department has become self-sufficient and no longer requires financial support from other hospital departments, and the numerous testimonials indicate that the program has been rewarding for practitioners, staff, and patients. 

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