A5015210707- Healthcare Systems and Technology
- Health Policy Implementation Science
- Primary Care and Health Outcomes
- Electronic Health Records Systems
- Patient Satisfaction in Healthcare
- Quality and Safety in Healthcare
- Occupational Health and Safety Research
- Cardiac Health and Mental Health
- Chronic Disease Management Strategies
- Pharmaceutical Practices and Patient Outcomes
- Geriatric Care and Nursing Homes
- Medication Adherence and Compliance
- Obesity and Health Practices
- Biomedical and Engineering Education
- Blood Pressure and Hypertension Studies
- Health Systems, Economic Evaluations, Quality of Life
- Interprofessional Education and Collaboration
- Complex Systems and Decision Making
- Urinary Tract Infections Management
- Healthcare Operations and Scheduling Optimization
- Behavioral Health and Interventions
- Healthcare Technology and Patient Monitoring
- Clinical practice guidelines implementation
- Chaos, Complexity, and Education
- Pharmacy and Medical Practices
Indiana University Bloomington
2024-2025
University of Wisconsin–Madison
2012-2024
University of Wisconsin Health
2020-2023
National Center for Advancing Translational Sciences
2023
Agency for Healthcare Research and Quality
2023
Madison Area Technical College
2017-2022
Oklahoma State University Center for Health Sciences
2016
ther unnecessary, of low value or wasteful (Institute Medicine, 2013).The third plenary panel brought different perspectives on the enduring and evolving challenges in dissemination evidence evidence-based practices as well opportunities emerging from innovations digital health sector.The sessions were complemented by facilitated lunchtime discussions these topics, additional research priorities, which enabled more in-depth discussions, question answer time, brainstorming future...
Aim: To share insights on Implementation Science (IS) methods, challenges, solutions, and best practices derived from the second National Meeting for Research Community Collaboration toward “Ending HIV Epidemic (EHE) in United States.” Methods: This 2022 hybrid, one-day conference featured presentations 13 projects funded as NIH supplements to CFARs ARCs between 2019 2022. Selected their robust findings, were grouped into four topics: (1) community-based outreach strategies, (2) taking...
Although smoking is a risk factor for cardiovascular and rheumatic disease severity, only 10% of rheumatology visits document cessation counseling. After implementing clinic protocol that increased tobacco quitline referrals 20-fold, we undertook this study to examine patients' barriers facilitators based on prior experiences, solicit reactions the new protocol, identify patient-centered outcomes or signs progress following improved care.We recruited 19 patients who smoke (12 with rheumatoid...
Antibiotic overuse is a significant problem in nursing homes (NHs). Strategies to improve antibiotic prescribing practices NHs are critical need. In this study, we analyzed workflows identify strategies for improving NHs.Qualitative descriptive study using prospective field-based assessment of workflows.Six Wisconsin (n = 3) and Pennsylvania 3).A total 44 interviews with 68 NH professionals, including leadership, nurses, prescribers.During 1-day field visit each NH, conducted semistructured...
Medication list discrepancies between outpatient clinics and pharmacies can lead to medication errors. Within the last decade, a new health information technology (IT), CancelRx, emerged send cancellation message from clinic's electronic record (EHR) pharmacy's software. The objective of this study was measure impact CancelRx on reducing EHR pharmacy dispensing software.CancelRx implemented in October 2017 at an academic system. For 12 months prior, after implementation, data were collected...
Objective Recognizing high blood pressure ( BP ) as the most prevalent cardiovascular risk factor in patients with rheumatic diseases and all adults, experts recommend clinic protocols to improve control. The aim of this study was adapt implement a specialty protocol, “ Connect,” timely primary care follow‐up after measurements rheumatology clinics. Methods We examined Connect 6‐month preimplementation postimplementation quasi‐experimental design 24‐month 3 academic Medical assistants nurses...
Smoking increases cardiopulmonary and rheumatic disease risk, yet tobacco cessation intervention is rare in rheumatology clinics. This study aimed to implement a staff-driven protocol, Quit Connect, increase the rate of electronic referrals (e-referrals) free, state-run quit lines.We conducted quasi-experimental cohort Connect at 3 clinics comparing line from 4 baseline years during 6-month period. Nurses medical assistants were trained use 2 standardized health record (EHR) prompts check...
When patients are seen in an ambulatory outpatient clinic, such as their primary care provider's office, the prescriber often stops or discontinues medications. Although medication discontinuations documented clinic's health record, this information may not be communicated to pharmacy. Within last decade, CancelRx has attempted address issue by sending a message from clinic pharmacy when been discontinued changed. This project studied discontinuation workflows and pharmacists' perspectives...
As Human Factors and Ergonomics (HF/E) practice in health care expands, there is growing recognition of the need to consider design for patient work. Over past several years HF/E practitioners researchers have begun formalize theoretical foundations a work approach. Methodologically, approaches required adaptations existing social science as well development new approaches. This panel will focus on current engaging patients designing interventions multiple settings which performed. Each...
Workflows associated with health care delivery vary between settings, and understanding similarities dissimilarities can inform context-sensitive practice change. Clinical workflows are complex, dynamic, context-dependent, comparing workflow across multiple settings support tailored implementation of practice-change interventions. We propose a methodology for comparative modeling evaluate its use through application to antibiotic prescribing in six nursing homes two states the United States....
Rheumatologists face time pressures similar to primary care but have not generally benefitted from optimized team-based rooming during the waiting room until rheumatologist enters room.The aim of this study was assess current capacity for population management in rheumatology clinics; we aimed measure tasks performed by clinic staff (medical assistants or nurses) rooming.We a cross-sectional time-study and work-system analysis workflows at 3 clinics an academic multispecialty practice...
Background/Objective To address high blood pressure (BP) in rheumatology patients, we previously implemented BP Connect, a brief staff-driven protocol to BP. Although timely follow-up and hypertension rates improved for patients with in-system primary care (PC), many receive PC separate health systems. In this cohort study, compared of across-system maintenance organizations (HMOs) before after Connect implementation. Methods All adult clinic that HMO were eligible. Connect's engaged the...
Approximately 90% of African American patients with newly diagnosed breast cancer have multimorbidity – obesity as one the most common conditions. Obesity is related to negative impacts across all aspects care well more adverse side effects treatment. survivors (BCS) show higher incidences chronic conditions, like obesity, barriers body wellness. Lifestyle interventions can improve survivorship outcomes, but not been adapted BCS needs. The purpose this research explore and honor lived...
<h3>Background</h3> Hypertension (HTN) is the most prevalent cardiovascular disease (CVD) risk factor among adults with rheumatic conditions. However, we found that blood pressures were addressed in <1/3 of rheumatology visits, even when severely elevated (≥160/100 mmHg). At this range, only 11 patients need to be treated for HTN prevent one CVD event. In primary care, protocols executed by nurses (RNs) or medical assistants (MAs) during vital sign assessment have improved control high...
Quit Connect (QC), our specialty clinic smoking cessation intervention, supports staff to check, advise, and connect willing patients a state quit line or class. QC improved tobacco screening referrals 26-fold in predominantly White academic health care system population. Implementing includes education, electronic record (EHR) reminders, periodic audit feedback. This study tested QC's feasibility impact safety-net rheumatology with Black
<h3>PURPOSE</h3> Most patients are escorted to exam rooms (escorted rooming) although directing themselves their room (self-rooming) saves patient and staff time while increasing satisfaction. This study assesses perceptions after pragmatic implementation of self-rooming. <h3>METHODS</h3> In October-December 2020, we surveyed in 25 primary care clinics our institution expanded self-rooming from 4 specially built during the COVID-19 pandemic. Semi-structured surveys asked about rooming...
Theory-based implementation strategies, such as audit and feedback (A&F), can improve the adoption of evidence-based practices. However, few strategies have been developed tested to meet needs specialty clinics. In particular, frontline staff execute cardiovascular disease (CVD) risk reduction protocols, but A&F support them are not well examined. Our objective was develop evaluate a theory-based approach A&F, Interactive Participatory (IPAF).We IPAF informed by two complementary theories,...
In September, 2009, AHRQ and NSF convened a workshop in which experts the fields of industrial systems engineering (ISyE) health care explored critical areas research at intersection both fields. The objectives were to 1) articulate vision for an ideal delivery system, 2) determine why current efforts apply ISyE knowledge have not resulted meaningful change, 3) propose action agenda that should be pursued enable field substantially contribute realization system. This paper presents system...
Abstract Background Prescription opioid misuse is a serious national crisis; in 2018 the top drugs involved prescription overdose deaths included pain medications (opioids), benzodiazepines, and stimulants. Health information technology (health IT) provides means to address this crisis through technologies that streamline prescribing discontinuation process. CancelRx health IT function communicates when medications, such as controlled substances, are discontinued at clinic therefore should...
Patients with rheumatologic conditions are at elevated risk of cardiovascular disease (CVD) due to inflammatory and traditional factors, such as high blood pressure (BP) smoking. However, rheumatology clinics rarely address although they routinely assessed modifiable in primary care. The present study sought (1) characterize clinic staff's work process for addressing BP smoking (2) identify barriers strategies effective management these factors.We conducted 7 focus groups medical assistants,...