A5054717222- Assisted Reproductive Technology and Twin Pregnancy
- Ovarian function and disorders
- Reproductive Health and Technologies
- Reproductive Biology and Fertility
- Health Policy Implementation Science
- Electronic Health Records Systems
- Pharmaceutical Practices and Patient Outcomes
- Atrial Fibrillation Management and Outcomes
- Healthcare Systems and Technology
- Clinical practice guidelines implementation
- Venous Thromboembolism Diagnosis and Management
- Gestational Diabetes Research and Management
- Healthcare Technology and Patient Monitoring
- Uterine Myomas and Treatments
- Antiplatelet Therapy and Cardiovascular Diseases
- Blood Pressure and Hypertension Studies
- Simulation Techniques and Applications
- Circadian rhythm and melatonin
- Sleep and related disorders
- Urinary Tract Infections Management
- Pelvic floor disorders treatments
- Reproductive Health and Contraception
- Patient Satisfaction in Healthcare
- Endometriosis Research and Treatment
- Pharmaceutical industry and healthcare
University of Michigan
2015-2025
Michigan United
2025
Michigan Medicine
2012-2024
Menlo School
2022
Ann Arbor Center for Independent Living
2018
Women's Hospital
2016
BackgroundThe implementation of the Accreditation Council for Graduate Medical Education (ACGME) Milestones in field obstetrics and gynecology has arrived with Level One defined as level expected an incoming first-year resident.PurposeWe designed, implemented, evaluated a 4-week elective fourth-year medical school students, which utilized multimodal approach to teaching assessing competencies.MethodsThe 78-hour curriculum traditional didactic lectures, flipped classroom active learning...
ObjectiveTo evaluate the feasibility of a brief, intensive weight loss intervention (IWL) to improve reproductive outcomes in obese subfertile women.DesignPilot study IWL versus standard-of-care nutrition counseling (SCN).SettingSingle-site, academic institution.Patient(s)Obese women (body mass index, 35–45 kg/m2) with anovulatory subfertility.Intervention(s)Women were rigorously prescreened rule out secondary causes subfertility. Eligible randomized or SCN. consisted 12 weeks...
Abstract Background Home-based care for patients diagnosed in emergency departments (EDs) with low-risk pulmonary embolism (PE) is an evidence-based, guideline-recommended practice that not widely adopted the US. Few studies demonstrate how this pathway can be implemented effectively or test whether implementation strategies address known barriers. Further, prior have lacked diversity population and health system type did integrate theory-informed frameworks. Although essential establishing...
Abstract Many patients receiving anticoagulants take antiplatelet medications unnecessarily and without gastroprotection, increasing the risk of gastrointestinal bleeding. To evaluate effectiveness a multicomponent intervention—clinician notification with nurse facilitation (CNNF)—in reducing high-risk use in taking warfarin proton pump inhibitor (PPI). For CNNF group, nurses sent electronic messages to clinicians identifying use, recommending consideration either discontinuation or PPI...
Facilitating appropriate care delivery using electronic health record (digital health) tools is increasing. However, frequently used determinants frameworks seldom address key barriers for technology-associated implementation.Semi-structured interviews were conducted in two contexts: the national Veterans Health Affairs (VA) following implementation of an dashboard, a population tool, and Michigan Anticoagulation Quality Improvement Initiative (MAQI2) prior to similar dashboard. The...
Abstract Background Use of direct oral anticoagulants (DOAC) is rapidly growing for treatment atrial fibrillation and venous thromboembolism. However, incorrect dosing these medications common puts patients at risk adverse drug events. One way to improve safe prescribing the use population health tools, including interactive dashboards built into electronic record (EHR). As such tools become more common, exploring ways understand which aspects are effective in specific settings how...
Direct oral anticoagulant medications are commonly used to treat or prevent thrombotic conditions, such as pulmonary embolism, deep vein thrombosis, and atrial fibrillation. However, up 10-15% of patients receiving these get unsafe doses based on a patient's kidney liver function, potential interactions with other medications, indication for taking the medication. Alert systems may be beneficial improving evidence-based prescribing, but can burdensome not currently able provide monitoring...
Overuse of antiplatelet therapy and underuse gastroprotection contribute to preventable bleeding in patients taking anticoagulants. (1) Determine the feasibility a factorial trial testing patient activation clinician outreach reduce gastrointestinal (GI) risk prescribed warfarin-antiplatelet without proton pump inhibitor (2) assess intervention acceptability. Pragmatic 2 × cluster-randomized controlled pilot comparing booklet vs usual care notification plus nurse facilitation was performed....
Abstract Background The concomitant use of anticoagulant and antiplatelet medications increases the risk upper gastrointestinal (GI) bleeding. Two underused evidence-based practices (EBPs) can reduce risk: de-prescribe unnecessary therapy or initiate a proton pump inhibitor. We describe development multicomponent intervention to increase these EBPs in patients treated with warfarin followed by an anticoagulation monitoring service (AMS), design pilot pragmatic implementation trial. Methods A...
Direct Oral Anticoagulants (DOACs) are beneficial blood-thinning medications that frequently misprescribed. Clinical decision support systems can be effective in reducing these prescription errors through well-designed medication alerts. The effectiveness of alerts improved a User Centered Design (UCD) process. We describe the multi-stage UCD process used to (1) produce initial draft alerts, (2) refine designs, and (3) validate designs findings. resulting prototype DOAC prescribing alert...
The aim of this study was to determine if preoperative medication administration is associated with postoperative urinary retention (PUR) after urogynecologic procedures and identify intraoperative factors that are predictive PUR.A retrospective review patients who underwent prolapse and/or incontinence surgery performed. primary outcome PUR, defined as retrograde void trial postvoid residuals greater than 100 mL. Bivariate analysis performed compare demographics characteristics women...