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2. A Public Health Critical Race Praxis Informed Congestive Heart Failure Quality Improvement Initiative on Inpatient General Medicine.

Author

Osuagwu, Chidinma, Khinkar, Roaa M, Zheng, Amy, Wien, Matthew, Decopain, Jennifer, Desai, Sonali, McElrath, Erin, Hinchey, Emily, Mueller, Stephanie K, Schnipper, Jeffrey L, Boxer, Robert, and Shannon, Evan Michael

Subjects
congestive heart failure, health disparities, hospital medicine, quality improvement, social determinants of health, Heart Disease, Cardiovascular, Patient Safety, Clinical Research, Health Services, 8.1 Organisation and delivery of services, Health and social care services research, Clinical Sciences, General & Internal Medicine
Abstract

BackgroundPrior evaluation at our hospital demonstrated that, compared to White patients, Black and Latinx patients with congestive heart failure (CHF) were less likely to be admitted to the cardiology service rather than the general medicine service (GMS). Patients admitted to GMS (compared to cardiology) had inferior rates of cardiology follow-up and 30-day readmission.ObjectiveTo develop and test the feasibility and impacts of using quality improvement (QI) methods, in combination with the Public Health Critical Race Praxis (PHCRP) framework, to engage stakeholders in developing an intervention for ensuring guideline-concordant inpatient CHF care across all patient groups.MethodsWe compared measures for all patients admitted with CHF to GMS between September 2019 and March 2020 (intervention group) to CHF patients admitted to GMS in the previous year (pre-intervention group) and those admitted to cardiology during the pre-intervention and intervention periods (cardiology group). Our primary measures were 30-day readmissions and 14- and 30-day post-discharge cardiology follow-up.ResultsThere were 79 patients admitted with CHF to GMS during the intervention period, all of whom received the intervention. There were similar rates of Black and Latinx patients across the three groups. Compared to pre-intervention, intervention patients had a significantly lower 30-day readmission rate (18.9% vs. 24.8%; p=0.024), though the cardiology group also had a decrease in 30-day readmissions from the pre-intervention to intervention period. Compared to pre-intervention, intervention patients had significantly higher 14-day and 30-day post-discharge follow-up visits scheduled with cardiology (36.7% vs. 24.8%, p=0.005; 55.7% vs. 42.3%, p=0.0029), but no improvement in appointment attendance.ConclusionThis study provides a first test of applying the PHCRP framework within a stakeholder-engaged QI initiative for improving CHF care across races and ethnicities. Our study design cannot evaluate causation. However, the improvements in 30-day readmission, as well as in processes of care that may affect it, provide optimism that inclusion of a racism-conscious framework in QI initiatives is feasible and may enhance QI measures.

Published
2023

5. Patient Safety Indicators During the Initial COVID-19 Pandemic Surge in the United States

Author

Rodriguez, Jorge A., primary, Samal, Lipika, additional, Ganesan, Sandya, additional, Yuan, Nina H., additional, Wien, Matthew, additional, Ng, Kenney, additional, Huang, Hu, additional, Park, Yoonyoung, additional, Rajmane, Amol, additional, Jackson, Gretchen Purcell, additional, Lipsitz, Stuart R., additional, Bates, David W., additional, and Levine, David M., additional

Published
2024
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6. Families as Partners in Hospital Error and Adverse Event Surveillance

Author

Khan, Alisa, Coffey, Maitreya, Litterer, Katherine P, Baird, Jennifer D, Furtak, Stephannie L, Garcia, Briana M, Ashland, Michele A, Calaman, Sharon, Kuzma, Nicholas C, O’Toole, Jennifer K, Patel, Aarti, Rosenbluth, Glenn, Destino, Lauren A, Everhart, Jennifer L, Good, Brian P, Hepps, Jennifer H, Dalal, Anuj K, Lipsitz, Stuart R, Yoon, Catherine S, Zigmont, Katherine R, Srivastava, Rajendu, Starmer, Amy J, Sectish, Theodore C, Spector, Nancy D, West, Daniel C, Landrigan, Christopher P, Allair, Brenda K, Alminde, Claire, Alvarado-Little, Wilma, Atsatt, Marisa, Aylor, Megan E, Bale, James F, Balmer, Dorene, Barton, Kevin T, Beck, Carolyn, Bismilla, Zia, Blankenberg, Rebecca L, Chandler, Debra, Choudhary, Amanda, Christensen, Eileen, Coghlan-McDonald, Sally, Cole, F Sessions, Corless, Elizabeth, Cray, Sharon, Da Silva, Roxi, Dahale, Devesh, Dreyer, Benard, Growdon, Amanda S, Gubler, LeAnn, Guiot, Amy, Harris, Roben, Haskell, Helen, Kocolas, Irene, Kruvand, Elizabeth, Lane, Michele Marie, Langrish, Kathleen, Ledford, Christy JW, Lewis, Kheyandra, Lopreiato, Joseph O, Maloney, Christopher G, Mangan, Amanda, Markle, Peggy, Mendoza, Fernando, Micalizzi, Dale Ann, Mittal, Vineeta, Obermeyer, Maria, O’Donnell, Katherine A, Ottolini, Mary, Patel, Shilpa J, Pickler, Rita, Rogers, Jayne Elizabeth, Sanders, Lee M, Sauder, Kimberly, Shah, Samir S, Sharma, Meesha, Simpkin, Arabella, Subramony, Anupama, Thompson, E Douglas, Trueman, Laura, Trujillo, Tanner, Turmelle, Michael P, Warnick, Cindy, Welch, Chelsea, White, Andrew J, Wien, Matthew F, Winn, Ariel S, Wintch, Stephanie, Wolf, Michael, Yin, H Shonna, and Yu, Clifton E

Subjects
Clinical Trials and Supportive Activities, Clinical Research, Pediatric, Patient Safety, Good Health and Well Being, Adult, Child, Child, Hospitalized, Cohort Studies, Family, Female, Hospitals, Pediatric, Humans, Male, Medical Errors, Prospective Studies, United States, the Patient and Family Centered I-PASS Study Group, Paediatrics and Reproductive Medicine, Pediatrics
Abstract

ImportanceMedical errors and adverse events (AEs) are common among hospitalized children. While clinician reports are the foundation of operational hospital safety surveillance and a key component of multifaceted research surveillance, patient and family reports are not routinely gathered. We hypothesized that a novel family-reporting mechanism would improve incident detection.ObjectiveTo compare error and AE rates (1) gathered systematically with vs without family reporting, (2) reported by families vs clinicians, and (3) reported by families vs hospital incident reports.Design, setting, and participantsWe conducted a prospective cohort study including the parents/caregivers of 989 hospitalized patients 17 years and younger (total 3902 patient-days) and their clinicians from December 2014 to July 2015 in 4 US pediatric centers. Clinician abstractors identified potential errors and AEs by reviewing medical records, hospital incident reports, and clinician reports as well as weekly and discharge Family Safety Interviews (FSIs). Two physicians reviewed and independently categorized all incidents, rating severity and preventability (agreement, 68%-90%; κ, 0.50-0.68). Discordant categorizations were reconciled. Rates were generated using Poisson regression estimated via generalized estimating equations to account for repeated measures on the same patient.Main outcomes and measuresError and AE rates.ResultsOverall, 746 parents/caregivers consented for the study. Of these, 717 completed FSIs. Their median (interquartile range) age was 32.5 (26-40) years; 380 (53.0%) were nonwhite, 566 (78.9%) were female, 603 (84.1%) were English speaking, and 380 (53.0%) had attended college. Of 717 parents/caregivers completing FSIs, 185 (25.8%) reported a total of 255 incidents, which were classified as 132 safety concerns (51.8%), 102 nonsafety-related quality concerns (40.0%), and 21 other concerns (8.2%). These included 22 preventable AEs (8.6%), 17 nonharmful medical errors (6.7%), and 11 nonpreventable AEs (4.3%) on the study unit. In total, 179 errors and 113 AEs were identified from all sources. Family reports included 8 otherwise unidentified AEs, including 7 preventable AEs. Error rates with family reporting (45.9 per 1000 patient-days) were 1.2-fold (95% CI, 1.1-1.2) higher than rates without family reporting (39.7 per 1000 patient-days). Adverse event rates with family reporting (28.7 per 1000 patient-days) were 1.1-fold (95% CI, 1.0-1.2; P = .006) higher than rates without (26.1 per 1000 patient-days). Families and clinicians reported similar rates of errors (10.0 vs 12.8 per 1000 patient-days; relative rate, 0.8; 95% CI, .5-1.2) and AEs (8.5 vs 6.2 per 1000 patient-days; relative rate, 1.4; 95% CI, 0.8-2.2). Family-reported error rates were 5.0-fold (95% CI, 1.9-13.0) higher and AE rates 2.9-fold (95% CI, 1.2-6.7) higher than hospital incident report rates.Conclusions and relevanceFamilies provide unique information about hospital safety and should be included in hospital safety surveillance in order to facilitate better design and assessment of interventions to improve safety.

Published
2017

7. Clinical Decision Support for Hypertension Management in Chronic Kidney Disease: A Randomized Clinical Trial.

Author

Samal, Lipika, Kilgallon, John L., Lipsitz, Stuart, Baer, Heather J., McCoy, Allison, Gannon, Michael, Noonan, Sarah, Dunk, Ryan, Chen, Sarah W., Chay, Weng Ian, Fay, Richard, Garabedian, Pamela M., Wu, Edward, Wien, Matthew, Blecker, Saul, Salmasian, Hojjat, Bonventre, Joseph V., McMahon, Gearoid M., Bates, David W., and Waikar, Sushrut S.

Published
2024
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8. What Went Right? A Mixed-Methods Study of Positive Feedback Data in a Hospital-Wide Mortality Review Survey

Author

Chua, Isaac S., primary, Khinkar, Roaa M., additional, Wien, Matthew, additional, Kerrissey, Michaela, additional, Lipsitz, Stuart, additional, Cheung, Yvonne Y., additional, Mort, Elizabeth A., additional, Desai, Sonali, additional, Morris, Charles A., additional, Pearson, Madelyn, additional, Eappen, Sunil, additional, Rozenblum, Ronen, additional, and Mendu, Mallika, additional

Published
2023
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9. Integrating Research, Quality Improvement, and Medical Education for Better Handoffs and Safer Care: Disseminating, Adapting, and Implementing the I-PASS Program

Author

Landrigan, Christopher P., Spector, Nancy D., Starmer, Amy J., Sectish, Theodore C., Srivastava, Rajendu, West, Daniel C., Menon, Aravind Ajakumar, Ali, Arshia, Allair, Brenda K., Allen, April D., Almaddah, Nureddin, Alminde, Claire, Alvarado-Little, Wilma, Anson, Elizabeth, Ashland, Michele, Atsatt, Marisa, Aylor, Megan, Baird, Jennifer D., Bale, James F., Jr, Balmer, Dorene, Barber, Aisha, Barton, Kevin, Bates, Kimberly, Beck, Carolyn, Berchelmann, Kathleen, Bhan, Renuka, Bismilla, Zia, Blankenburg, Rebecca L., Boa-Hocbo, Aileen, Bordin-Wosk, Talya, Brooks, Michelle, Calaman, Sharon, Campe, Julie, Campos, Maria Lucia, Chandler, Debra, Cheung, Yvonne, Choudhary, Amanda, Christensen, Eileen, Clark, Katherine, Coffey, Maitreya, Coghlan-McDonald, Sally, Cohen, Ellen, Cole, F. Sessions, Corless, Elizabeth, Cray, Sharon, Da Silva, Roxi, Dahale, Devesh, Dalal, Anuj K., Destino, Lauren A., Doroshow, Jonathan, Dreyer, Benard, duPont, Katharine, Eagle, Steven, Edgar-Zarate, Courtney, Etzenhouser, Angie, Everhart, Jennifer L., Feraco, Angela M., Ferrer, Alexandra, Galardy, Paul, Garcia, Briana M., Gaspar-Oishi, Maria, Goldstein, Jenna, Good, Brian P., Graham, Dionne A, Growdon, Amanda S., Gubler, LeAnn, Guiot, Amy, Hanlon, Charin, Hanna-Attisha, Mona, Harris, Roben, Haskell, Helen, Hecht, Melvyn, Hehn, Rebecca S, Held, Justin, Hepps, Jennifer H., Hillier, Debra, Hiraoka, Mark, Howell, Eric, Hrach, Christine, Hughes, Helen, Huskins, Charles, Kaatz, Scott, Kanala, Vishnu, Kantrowitz, Michael, Kaplan, Peter, Kashiwagi, Deanne, Kaul, Rajat, Keohane, Carol A., Kern, Jeremy, Khan, Alisa, Khan, Nazia Naz S., Kitch, Barry, Kocolas, Irene, Kothari, Lara, Kruvand, Elizabeth, Kuzma, Nicholas, Lacy, Mary, Lane, Michele, Langrish, Kate, Ledford, Christy J.W., LeRoux, Laura, Lewis, Kheyandra, Lipsitz, Stuart, Litterer, Katherine P., Lopreiato, Joseph O., Lyons, Aimee, Mack, Avram, Mallouk, Meghan, Maloney, Christopher G., Mangan, Amanda, Mann, Keith, Markle, Peggy, Marrese, Christine, Marseille, David, Maynard, Greg, Mehta, Bijal, Mendoza, Fernando, Mercer, Alexandra N., Micalizzi, Dale, Mims, Lisa, Mittal, Vineeta, Mueller, Stephanie, Ngo, Thuy L., Nolan, Ann, Nyenpan, Christopher, Obermeyer, Maria, O'Donnell, Katherine, O'Toole, Jennifer K., Ottolini, Mary, Owolabi, Mobola, Patel, Aarti, Patel, Rajesh, Patel, Shilpa J., Perron, Catherine, Pickler, Rita, Popa, Alina, Reppert, Patrick, Riss, Robert, Roesch, Justin, Rogers, Jayne E., Rosenbluth, Glenn, Rothschild, Jeffrey M., Sanders, Lee, Sauder, Kimberly, Schnipper, Jeff, Schnock, Kumiko O, Scholtz, Amy, Seltz, Barry, Serra, Theresa, Serwint, Janet, Shah, Samir, Sharma, Meesha, Sheppard, Kathleen, Simpkin, Arabella, Sloan, Karin A, Solan, Lauren G., Southgate, Michael W, Spackman, Jaime Blank, Stevens, Scott M., Stevenson, Adam, Stevenson, Windy, Subramony, Anupama, Surkis, William, Thangarasu, Sudhagar, Thompson, E. Douglas, Toole, Cheryl, Trueman, Laura, Trujillo, Tanner, Tse, Lisa, Turmelle, Michael P., Vaniawala, Vishwas, Wagner, Tamara, Warnick, Cindy, Webster, John, Webster, Mary, Weinerman, Adina, Welch, Chelsea, White, Andrew J., Wien, Matthew F., Winn, Ariel S., Wintch, Stephanie, Yin, H. Shonna, Yoon, Catherine S., Yu, Clifton E., Zampino, Dominick, and Zigmont, Katherine R.

Published
2017
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10. Cost of Inpatient Falls and Cost-Benefit Analysis of Implementation of an Evidence-Based Fall Prevention Program

Author

Dykes, Patricia C., primary, Curtin-Bowen, Mica, additional, Lipsitz, Stuart, additional, Franz, Calvin, additional, Adelman, Jason, additional, Adkison, Lesley, additional, Bogaisky, Michael, additional, Carroll, Diane, additional, Carter, Eileen, additional, Herlihy, Lisa, additional, Lindros, Mary Ellen, additional, Ryan, Virginia, additional, Scanlan, Maureen, additional, Walsh, Mary-Ann, additional, Wien, Matthew, additional, and Bates, David W., additional

Published
2023
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12. Changes in Medical Errors after Implementation of a Handoff Program

Author

Starmer, Amy J., Spector, Nancy D., Srivastava, Rajendu, West, Daniel C., Rosenbluth, Glenn, Allen, April D., Noble, Elizabeth L., Tse, Lisa L., Dalal, Anuj K., Keohane, Carol A., Lipsitz, Stuart R., Rothschild, Jeffrey M., Wien, Matthew F., Yoon, Catherine S., Zigmont, Katherine R., Wilson, Karen M., O’Toole, Jennifer K., Solan, Lauren G., Aylor, Megan, Bismilla, Zia, Coffey, Maitreya, Mahant, Sanjay, Blankenburg, Rebecca L., Destino, Lauren A., Everhart, Jennifer L., Patel, Shilpa J., Bale, James F., Jr., Spackman, Jaime B., Stevenson, Adam T., Calaman, Sharon, Cole, Sessions F., Balmer, Dorene F., Hepps, Jennifer H., Lopreiato, Joseph O., Yu, Clifton E., Sectish, Theodore C., and Landrigan, Christopher P.

Published
2014
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13. Effect of an Online Weight Management Program Integrated With Population Health Management on Weight Change

Author

Baer, Heather J., primary, Rozenblum, Ronen, additional, De La Cruz, Barbara A., additional, Orav, E. John, additional, Wien, Matthew, additional, Nolido, Nyryan V., additional, Metzler, Kristina, additional, McManus, Katherine D., additional, Halperin, Florencia, additional, Aronne, Louis J., additional, Minero, Guadalupe, additional, Block, Jason P., additional, and Bates, David W., additional

Published
2020
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14. Integrating Research, Quality Improvement, and Medical Education for Better Handoffs and Safer Care: Disseminating, Adapting, and Implementing the I-PASS Program

Author

Starmer, Amy J., primary, Spector, Nancy D., additional, West, Daniel C., additional, Srivastava, Rajendu, additional, Sectish, Theodore C., additional, Landrigan, Christopher P., additional, Starmer, Amy J., additional, Menon, Aravind Ajakumar, additional, Ali, Arshia, additional, Allair, Brenda K., additional, Allen, April D., additional, Almaddah, Nureddin, additional, Alminde, Claire, additional, Alvarado-Little, Wilma, additional, Anson, Elizabeth, additional, Ashland, Michele, additional, Atsatt, Marisa, additional, Aylor, Megan, additional, Baird, Jennifer D., additional, Bale, James F., additional, Balmer, Dorene, additional, Barber, Aisha, additional, Barton, Kevin, additional, Bates, Kimberly, additional, Beck, Carolyn, additional, Berchelmann, Kathleen, additional, Bhan, Renuka, additional, Bismilla, Zia, additional, Blankenburg, Rebecca L., additional, Boa-Hocbo, Aileen, additional, Bordin-Wosk, Talya, additional, Brooks, Michelle, additional, Calaman, Sharon, additional, Campe, Julie, additional, Campos, Maria Lucia, additional, Chandler, Debra, additional, Cheung, Yvonne, additional, Choudhary, Amanda, additional, Christensen, Eileen, additional, Clark, Katherine, additional, Coffey, Maitreya, additional, Coghlan-McDonald, Sally, additional, Cohen, Ellen, additional, Cole, F. Sessions, additional, Corless, Elizabeth, additional, Cray, Sharon, additional, Da Silva, Roxi, additional, Dahale, Devesh, additional, Dalal, Anuj K., additional, Destino, Lauren A., additional, Doroshow, Jonathan, additional, Dreyer, Benard, additional, duPont, Katharine, additional, Eagle, Steven, additional, Edgar-Zarate, Courtney, additional, Etzenhouser, Angie, additional, Everhart, Jennifer L., additional, Feraco, Angela M., additional, Ferrer, Alexandra, additional, Galardy, Paul, additional, Garcia, Briana M., additional, Gaspar-Oishi, Maria, additional, Goldstein, Jenna, additional, Good, Brian P., additional, Graham, Dionne A, additional, Growdon, Amanda S., additional, Gubler, LeAnn, additional, Guiot, Amy, additional, Hanlon, Charin, additional, Hanna-Attisha, Mona, additional, Harris, Roben, additional, Haskell, Helen, additional, Hecht, Melvyn, additional, Hehn, Rebecca S, additional, Held, Justin, additional, Hepps, Jennifer H., additional, Hillier, Debra, additional, Hiraoka, Mark, additional, Howell, Eric, additional, Hrach, Christine, additional, Hughes, Helen, additional, Huskins, Charles, additional, Kaatz, Scott, additional, Kanala, Vishnu, additional, Kantrowitz, Michael, additional, Kaplan, Peter, additional, Kashiwagi, Deanne, additional, Kaul, Rajat, additional, Keohane, Carol A., additional, Kern, Jeremy, additional, Khan, Alisa, additional, Khan, Nazia Naz S., additional, Kitch, Barry, additional, Kocolas, Irene, additional, Kothari, Lara, additional, Kruvand, Elizabeth, additional, Kuzma, Nicholas, additional, Lacy, Mary, additional, Lane, Michele, additional, Langrish, Kate, additional, Ledford, Christy J.W., additional, LeRoux, Laura, additional, Lewis, Kheyandra, additional, Lipsitz, Stuart, additional, Litterer, Katherine P., additional, Lopreiato, Joseph O., additional, Lyons, Aimee, additional, Mack, Avram, additional, Mallouk, Meghan, additional, Maloney, Christopher G., additional, Mangan, Amanda, additional, Mann, Keith, additional, Markle, Peggy, additional, Marrese, Christine, additional, Marseille, David, additional, Maynard, Greg, additional, Mehta, Bijal, additional, Mendoza, Fernando, additional, Mercer, Alexandra N., additional, Micalizzi, Dale, additional, Mims, Lisa, additional, Mittal, Vineeta, additional, Mueller, Stephanie, additional, Ngo, Thuy L., additional, Nolan, Ann, additional, Nyenpan, Christopher, additional, Obermeyer, Maria, additional, O'Donnell, Katherine, additional, O'Toole, Jennifer K., additional, Ottolini, Mary, additional, Owolabi, Mobola, additional, Patel, Aarti, additional, Patel, Rajesh, additional, Patel, Shilpa J., additional, Perron, Catherine, additional, Pickler, Rita, additional, Popa, Alina, additional, Reppert, Patrick, additional, Riss, Robert, additional, Roesch, Justin, additional, Rogers, Jayne E., additional, Rosenbluth, Glenn, additional, Rothschild, Jeffrey M., additional, Sanders, Lee, additional, Sauder, Kimberly, additional, Schnipper, Jeff, additional, Schnock, Kumiko O, additional, Scholtz, Amy, additional, Seltz, Barry, additional, Serra, Theresa, additional, Serwint, Janet, additional, Shah, Samir, additional, Sharma, Meesha, additional, Sheppard, Kathleen, additional, Simpkin, Arabella, additional, Sloan, Karin A, additional, Solan, Lauren G., additional, Southgate, Michael W, additional, Spackman, Jaime Blank, additional, Stevens, Scott M., additional, Stevenson, Adam, additional, Stevenson, Windy, additional, Subramony, Anupama, additional, Surkis, William, additional, Thangarasu, Sudhagar, additional, Thompson, E. Douglas, additional, Toole, Cheryl, additional, Trueman, Laura, additional, Trujillo, Tanner, additional, Tse, Lisa, additional, Turmelle, Michael P., additional, Vaniawala, Vishwas, additional, Wagner, Tamara, additional, Warnick, Cindy, additional, Webster, John, additional, Webster, Mary, additional, Weinerman, Adina, additional, Welch, Chelsea, additional, White, Andrew J., additional, Wien, Matthew F., additional, Winn, Ariel S., additional, Wintch, Stephanie, additional, Yin, H. Shonna, additional, Yoon, Catherine S., additional, Yu, Clifton E., additional, Zampino, Dominick, additional, and Zigmont, Katherine R., additional

Published
2017
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15. Patient Characteristics Associated With Reactions to Mrgprx2-Activating Drugs in an Electronic Health Record–Linked Biobank

Author

Foer, Dinah, Wien, Matthew, Karlson, Elizabeth W., Song, Wenyu, Boyce, Joshua A., and Brennan, Patrick J.

Abstract

Mas-related G protein-couple receptor x2 (Mrgprx2) activation underlies many common non–IgE-mediated adverse drug reactions (ADRs), yet the features of patients with reactions to Mrgprx2-activating drugs are unknown.

Published
2023
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