A5065997616- Geriatric Care and Nursing Homes
- Primary Care and Health Outcomes
- Frailty in Older Adults
- Palliative Care and End-of-Life Issues
- Telemedicine and Telehealth Implementation
- Health Systems, Economic Evaluations, Quality of Life
- Healthcare Systems and Technology
- Dementia and Cognitive Impairment Research
- Healthcare cost, quality, practices
- Healthcare Policy and Management
- Health Policy Implementation Science
- Healthcare Operations and Scheduling Optimization
- Evaluation and Performance Assessment
- Electronic Health Records Systems
- Global Health Workforce Issues
- Patient Satisfaction in Healthcare
- Interprofessional Education and Collaboration
- Health Sciences Research and Education
Center for Innovation
2019-2025
VA Eastern Colorado Health Care System
2020-2024
Veterans Health Administration
2022
United States Department of Veterans Affairs
2022
Denver VA Medical Center
2019
<i>Pressure exists in health services research for teams to collect and synthesize qualitative data rapidly. Lacking is a standard process aid team-based debriefings during the early stages of collection real time. We propose systematic template use phase studies demonstrate utility approach using Veteran’s Administration evaluation study. Guided Team Discussion (GTD) can improve efficiency team debriefing through facilitated that standardizes discussion format sharing learnings...
Virtual Integrated Multi-Site Patient Aligned Care Team (V-IMPACT) was a Veterans Health Administration (VHA) initiative created to increase access primary care for through Clinical Video Telehealth (CVT) appointments. Between January and August 2019, we conducted 48 semi-structured qualitative interviews with who had V-IMPACT appointment. Many participants shared feelings of skepticism before their first appointments but some, opinions changed. talked about how opinion video changed the...
ABSTRACT Introduction The Veterans Health Administration’s (VHA) history of enhancing Veterans’ healthcare access continued in 2016 with the launch ChooseVA (née: MyVA Access). This initiative was designed to transform VHA and rapidly increase Veteran’s care across all facilities. Relevant this article include mandates improve patient-centered scheduling. In prioritizing scheduling, other large systems have paradoxical task providing health that meets not only needs individual patients but...
Electronic consultation (e-consultation) is increasingly being adopted to expand access specialty care and reduce health costs. Little known about clinicians' perceptions of using e-consultations, which may be associated with program adoption.To identify primary clinicians in the US Veterans Health Administration (VHA) system e-consultation workload.A qualitative study semistructured interviews was conducted from September 2017 through March 2018 a national sample VHA clinics US....
Decisions about postacute care are increasingly important as the United States population ages, its use becomes common, and payment reforms target care. However, little is known how to improve these decisions.To understand whether cognitive biases play an role in patient clinician decision-making regarding skilled nursing facilities (SNFs) identify most impactful biases.Secondary analysis of 105 semistructured interviews with patients, caregivers, clinicians.Three hospitals three SNFs a...
Background Understanding adaptations supports iterative refinement of the implementation process and informs scale out programs. Systematic documentation across life course programs is not routinely done, efficient capture in real world studies well understood. Methods We used a multi-method longitudinal approach to systematically document during pre-implementation, implementation, sustainment for Veteran Health Administration (VA) Advanced Care Coordination program. This included...
Background Despite the increased focus on improving patient’s postacute care outcomes, best practices for reducing readmissions from skilled nursing facilities (SNFs) are unclear. The objective of this study was to observe processes used prepare patients in SNFs, and explore differences between hospital-SNF pairs with high or low 30-day readmission rates. Design We a rapid ethnographic approach intensive multiday observations key informant interviews at high-performing low-performing...
BACKGROUND: Decisions about postacute care are increasingly important as the United States population ages, its use becomes common, and payment reforms target care. However, little is known how to improve these decisions. OBJECTIVE: To understand whether cognitive biases play an role in patient clinician decision-making regarding skilled nursing facilities (SNFs) identify most impactful biases. DESIGN: Secondary analysis of 105 semistructured interviews with patients, caregivers, clinicians....
Abstract Background Veterans who need post-acute home health care (HHC) are at risk for adverse outcomes and unmet social needs. Veterans’ needs could be identified met by community-based HHC clinicians due to their unique perspective from the environment, acuity of they serve, access receiving community care. To understand these needs, we explored clinician, Veteran, partner perspectives during transition hospital with skilled HHC. Methods Qualitative data were collected through individual...
Abstract Improving hospital discharge processes and reducing adverse outcomes post has become a topic of national importance, especially for older patients transitioning to skilled nursing facilities (SNFs). The substantial variation in rehospitalization suggests contextual factors may play role performance. We conducted rapid ethnography with opportunistic interviews (148 hours observations, 30 clinicians) at hospitals that were high (n=2) or low (n=2)- performing terms their readmission...
Abstract Despite the increasing national focus on improving post-acute care outcomes, best practices for reducing readmissions from skilled nursing facilities (SNFs) are unclear. The objective of this rapid ethnographic study was to observe processes used prepare older patients in SNFs, and explore differences between hospital-SNF pairs with high or low thirty-day readmission rates. We stratified hospitals according rates SNF convenience sampling identify two performing sites associated SNFs...