A5009590841- Maternal and Perinatal Health Interventions
- Reproductive Health and Contraception
- Primary Care and Health Outcomes
- Maternal Mental Health During Pregnancy and Postpartum
- Telemedicine and Telehealth Implementation
- Maternal and fetal healthcare
- Patient Satisfaction in Healthcare
- Healthcare Policy and Management
- Global Maternal and Child Health
- Health Policy Implementation Science
- Patient-Provider Communication in Healthcare
- Pregnancy-related medical research
- Health Systems, Economic Evaluations, Quality of Life
- COVID-19 and healthcare impacts
- Interprofessional Education and Collaboration
- Healthcare Systems and Technology
- Chronic Disease Management Strategies
- Empathy and Medical Education
- Gestational Diabetes Research and Management
- Healthcare cost, quality, practices
- Diabetes Management and Education
- Innovations in Medical Education
- COVID-19 and Mental Health
- Diversity and Career in Medicine
- Pregnancy and preeclampsia studies
Stanford University
2016-2025
Community Partners
2023-2025
Center for Innovation
2014-2024
VA Palo Alto Health Care System
2014-2024
Royal Devon & Exeter NHS Foundation Trust
2023
Primary Health Care
2022
Stanford Health Care
2021-2022
Roots Community Health Center
2021
Stanford Medicine
2013-2020
Palo Alto University
2020
Abstract Introduction The Consolidated Framework for Implementation Research (CFIR) is a commonly used implementation science framework to facilitate design, evaluation, and of evidence‐based interventions. Its comprehensiveness an asset considering facilitators barriers also makes the cumbersome use. We describe adaptations we made CFIR simplify its pragmatic application, use in learning health system context, evaluation complex patient‐centered care transformation. Methods conducted...
To evaluate the association between antenatal posttraumatic stress disorder (PTSD) and spontaneous preterm delivery.We identified PTSD status delivery in a retrospective cohort of 16,334 deliveries covered by Veterans Health Administration from 2000 to 2012. We divided mothers with into those diagnoses present year before (active PTSD) only earlier (historical PTSD). birth potential confounders including age, race, military deployment, twins, hypertension, substance use, depression, results...
Objective: The purpose of this study was to evaluate the impact objective isolation and loneliness on Medicare spending outcomes. Method: We linked Health Retirement Study data claims analyze (scaled composite social contacts network) (positive response three-item scale) as predictors subsequent spending. In multivariable regression adjusting for health demographics, we determined marginal differences in expenditures. Secondary outcomes included by setting, mortality. Results: Objective...
<h3>Importance</h3> Many organizations are adopting intensive outpatient care programs for high-need patients, yet little is known about their effectiveness in integrated systems with established patient-centered medical homes. <h3>Objective</h3> To evaluate how augmenting the Veterans Affairs (VA) home (Patient Aligned Care Teams [PACT]) an Intensive Management program (ImPACT) influences patients' costs, health utilization, and experience. <h3>Design, Setting, Participants</h3> Randomized...
Prior work shows that Post-traumatic Stress Disorder (PTSD) predicts an increased risk of preterm birth, but the causal pathway(s) are uncertain. We evaluate associations between PTSD and antepartum complications to explore how PTSD's pathophysiology impacts pregnancy.This retrospective cohort analysis all Veterans Health Administration (VA)-covered deliveries from 2000-12 used data VA clinical administration. Mothers with current were identified using ICD-9 diagnostic codes (i.e. code...
Telemedicine has been used for decades. Despite its many advantages, uptake and rigorous evaluation of feasibility across neurology's ambulatory subspecialties sparse. However, the COVID-19 pandemic prompted health care systems worldwide to reconsider traditional delivery. To safeguard workers patients, quickly transitioned telemedicine, including neurology subspecialties, providing a new opportunity evaluate this modality care.
Abstract Background Current evaluation methods are mismatched with the speed of health care innovation and needs delivery partners. We introduce a qualitative approach called lightning report method its specific product—the “Lightning Report.” compare implementation results across four projects to explore sensitivity potential depth breadth findings. Methods The was refined over 2.5 years projects: team‐based primary care, cancer center transformation, precision in national life‐sustaining...
To determine the prevalence of gestational diabetes (GDM) and hypertensive disorders pregnancy (HDP) among women Veterans using Department Affairs (VA) maternity benefits previously deployed in service Operation Enduring Freedom/Operation Iraqi New Dawn (OEF/OIF/OND), whether complications were associated with VA use following delivery.We identified study population through linkage Defense roster administrative clinical data. GDM HDP by International Classification Diseases, Ninth Revision...
Abstract Background COVID-19 studies are primarily from the inpatient setting, skewing towards severe disease. Race and comorbidities predict hospitalization, however, ambulatory presentation of milder disease characteristics associated with progression to is not well-understood. Methods We conducted a retrospective chart review including all positive cases Stanford Health Care (SHC) in March 2020 assess demographics, symptoms relationship to: 1) their access point testing (outpatient,...
Objective We sought to investigate the concept and practices of ‘clinician presence’, exploring how physicians professionals create connection, engage in interpersonal interaction, build trust with individuals across different circumstances contexts. Design In 2017–2018, we conducted qualitative semistructured interviews 10 30 non-medical from fields protective services, business, management, education, art/design/entertainment, social legal/personal services. Setting Physicians were...
The SARS-CoV-2 (COVID-19) pandemic has rapidly moved telemedicine from discretionary to necessary. Here, we describe how the Stanford Neurology Department (1) adapted COVID-19 pandemic, resulting in over 1,000 video visits within 4 weeks, and (2) accelerated an existing quality improvement plan of a tiered roll out for ambulatory neurology full-scale out. Key issues encountered addressed were related equipment/software, provider engagement, workflow/triage, training. On reflection, key...
<sec> <title>UNSTRUCTURED</title> Given rising demand for Emergency Department (ED) services and coupled with a scarcity of specialty care availability, there is urgency to design system appropriate, effective, timely ED-to-specialty outpatient referrals. Efficient transitions are important patient outcomes experience require cross-specialty cooperation. Here we describe collaboration between Stanford’s Medicine Neurology & Neurological Sciences departments that designed implemented an...
Background: Human milk-feeding benefits infants and parents. Exclusive human milk (EHM) feeding is recommended for younger than 6 months; however, many U.S. do not receive this recommendation. Documented disparities exist between White historically marginalized populations, including Hispanic/Latino Quality Improvement Needs Assessment Aims: To explore Hispanic birthing parents’ experiences with lactation support as part of a quality improvement needs assessment project, identifying barriers...
Importance Leveraging technology to prompt team-based care might improve ambulatory hypertension care. Objective To assess whether an electronic medical record (EMR) high blood pressure (BP) advisory improves control. Design, Setting, and Participants This quality improvement study assessed control in patients presenting primary office visits from March 2018 February 2020. Data were included 28 clinics (8 contributed data toward the objective secondary objectives) a single academic health...
Medical school is a critical time for physicians in training to learn the professional norms of interacting with pharmaceutical industry, yet little known about how students' attitudes vary during course training. This study sought determine opinions industry interactions medical students and whether these differ between preclinical clinical students.The authors surveyed at Harvard School (HMS) from November 2003 through January 2004 using six-question survey. The then analyzed responses...