A5055817856- Health Policy Implementation Science
- Acute Ischemic Stroke Management
- Primary Care and Health Outcomes
- Health Systems, Economic Evaluations, Quality of Life
- Obstructive Sleep Apnea Research
- Stroke Rehabilitation and Recovery
- Geriatric Care and Nursing Homes
- Interprofessional Education and Collaboration
- Evaluation and Performance Assessment
- Clinical practice guidelines implementation
- Cerebrovascular and Carotid Artery Diseases
- Health Sciences Research and Education
- Musculoskeletal pain and rehabilitation
- Venous Thromboembolism Diagnosis and Management
- Community Health and Development
- Colorectal Cancer Screening and Detection
- Healthcare Systems and Technology
- Neuroscience of respiration and sleep
- Mental Health and Patient Involvement
- Patient Satisfaction in Healthcare
- Cardiovascular and Diving-Related Complications
- Telemedicine and Telehealth Implementation
- Workplace Health and Well-being
- Mycobacterium research and diagnosis
- Educational Assessment and Improvement
Richard L. Roudebush VA Medical Center
2016-2025
Health Services Research & Development
2016-2025
Indiana University School of Medicine
2016-2025
Indiana University – Purdue University Indianapolis
2016-2025
Quality Enhancement Research Initiative
2016-2025
Regenstrief Institute
2015-2024
Indiana University Bloomington
2024
Veterans Health Administration
2016-2024
Indiana University
2014-2024
University School
2023-2024
Implementation of multifaceted interventions typically involves many diverse elements working together in interrelated ways, including intervention components, implementation strategies, and features local context. Given this real-world complexity, researchers may be interested a new mathematical, cross-case method called Coincidence Analysis (CNA) that has been designed explicitly to support causal inference, answer research questions about combinations conditions are minimally necessary or...
Falls are common after stroke; however, circumstances and consequences relatively unknown. Our objectives were to identify the differences between fallers non-fallers among people with chronic stroke, of fall events, examine falls. This is a secondary data analysis; all participants included sustained stroke. Variables demographics, stroke characteristics, comorbidities. collected via self-report, derived from participant description event categorized as appropriate. Among 160 participants,...
Background: The Department of Veterans Affairs (VA) cares for more patients with hepatitis C virus (HCV) than any other US health care system. We tracked the implementation strategies that VA sites used to implement highly effective new treatments HCV aim uncovering how combinations influenced uptake treatment innovation. applied Configurational Comparative Methods (CCMs) uncover causal dependencies and identify difference-making strategy configurations, distinguish higher from lower...
Background Obstructive sleep apnea ( OSA ) is common among patients with acute ischemic stroke and transient attack. We evaluated whether continuous positive airway pressure for recent or attack improved clinical outcomes. Methods Results This randomized controlled trial stroke/transient compared 2 strategies (standard enhanced) the diagnosis treatment of versus usual care over 1 year. Primary outcomes were National Institutes Health Stroke Scale modified Rankin scores. Among 252 (84,...
ACADEMIC EMERGENCY MEDICINE 2011; 18:627–634 © 2011 by the Society for Academic Emergency Medicine Abstract Objectives: The Script Concordance Test (SCT) is a new method of assessing clinical reasoning in face uncertainty. An SCT item consists short vignette followed an additional piece information and asks how this affects learner's decision regarding possible diagnosis, investigational study, or therapy. Scoring based on responses panel experts field. This study attempts to provide...
Chronic pain is prevalent, costly, and associated with profound psychological effects. Although prevalent in returning veterans of the recent military conflicts Afghanistan Iraq (Operation Iraqi Freedom/Operation Enduring New Dawn [OEF/OIF/OND] Veterans), little known about chronic these patients. This study's objective was to ascertain perceptions a multicomponent intervention tested randomized controlled trial for OEF/OIF/OND musculoskeletal (Evaluation Stepped Care Pain...
The Script Concordance test (SCT) measures clinical reasoning in the context of uncertainty by comparing responses examinees and expert clinicians. It uses level agreement with a panel experts to assign credit for examinee's answers.This study describes development validation SCT pre-clinical medical students.Faculty from two US schools developed items domains anatomy, biochemistry, physiology, histology. Scoring procedures utilized data 30 physicians. Validation focused on internal...
<b><i>Background:</i></b> Wake-up stroke (WUS) accounts for a quarter of all ischemic strokes. Its conspicuous occurrence during sleep suggests that WUS may be associated with obstructive apnea (OSA). We investigated the potential association among WUS, OSA, and measures sympathetic hyperactivity. <b><i>Methods:</i></b> This is cross-sectional analysis data from Sleep Apnea in Transient Ischemic Attack Stroke (SLEEP TIGHT) study. patients were...
Introduction to the 3rd Biennial Conference of Society for Implementation Research Collaboration: advancing efficient methodologies through team science and community partnerships Cara Lewis, Doyanne Darnell, Suzanne Kerns, Maria Monroe-DeVita, Sara J. Landes, Aaron R. Lyon, Cameo Stanick, Shannon Dorsey, Jill Locke, Brigid Marriott, Ajeng Puspitasari, Caitlin Karin Hendricks, Andria Pierson, Phil Fizur, Katherine A. Comtois A1: A behavioral economic perspective on adoption, implementation,...
Abstract Background and Objectives To identify the implementation barriers, facilitators, conditions associated with successful outcomes from a clinical demonstration project to reduce potentially avoidable hospitalizations of long-stay nursing facility residents in 19 Indiana homes. Research Design Methods Optimizing Patient Transfers, Impacting Medical quality, Improving Symptoms—Transforming Institutional Care (OPTIMISTIC) is multicomponent intervention that includes enhanced geriatric...
Abstract Background Mailed fecal immunochemical testing (FIT) programs can improve colorectal cancer (CRC) screening rates, but health systems vary how they implement (i.e., adapt) these for their organizations. A insurance plan implemented a mailed FIT program (named BeneFIT), and participating could adapt the program. This multi-method study explored which adaptations might have resulted in higher rates. Methods First, we conducted descriptive analysis of CRC rates by key system...
Abstract Policy implementation is a key component of scaling effective chronic disease prevention and management interventions. can support scale-up by mandating or incentivizing intervention adoption, but enacting policy only the first step. Fully implementing designed to facilitate health interventions often requires range accompanying structures, like IT systems, strategies, training. Decision makers need know what policies adoption how implement those policies, date research on limited...
Despite interest in using electronic health record (EHR) data to assess quality of care, the accuracy such is largely unknown. We sought develop and validate transient ischemic attack minor stroke measures (eQMs) EHR data.A random sample patients with or stroke, cared for Veterans Health Administration facilities (fiscal year 2011), was identified. constructed 31 eQMs based on existing measures. Chart review criterion standard validating eQMs. To evaluate terms eligibility, we calculated...
To compare activities and field descriptions of clinical champions across three levels stroke centers.A cross-sectional qualitative study using quota sampling was conducted. The setting for this 38 acute centers based in US Veterans Affairs Medical Centers with 8 designated as Primary, 24 Limited Hours, 6 Stroke Support Centers. Key informants involved care were interviewed a semi-structured approach. A cross-case synthesis approach used to conduct analysis champions' behaviors...
Abstract Background While the Veterans Health Administration (VHA) MOVE! weight management program is effective in helping patients lose and available at every VHA medical center across United States, reaching to engage them treatment remains a challenge. Facility-based programs vary structures, processes of programming, levels reach, with no single factor explaining variation reach. Configurational analysis, based on Boolean algebra set theory, represents mathematical approach data analysis...
Abstract Background and Aims The Veterans Health Administration (VHA) provides care for more than 80,000 veterans with cirrhosis. This longitudinal, multimethod evaluation of a cirrhosis quality improvement program aimed to (1) identify implementation strategies associated evidence‐based, guideline‐concordant over time, (2) use qualitative interviews operationalize manualized intervention. Approach Results VHA providers were surveyed annually about the 73 improve in fiscal years 2018 (FY18)...
Background: Approximately 1,100 education journals collectively publish more than 20,000 research articles each year. Under current practice, no systematic way exists to move the findings from these studies into hands of millions practitioners and policymakers in United States who might use them. Purpose:To help disseminate findings, we propose that consider adopting a structured abstract, structural innovation focuses on format article itself. The abstract would replace paragraph-style...
Abstract In this study, we explored the relationship between changes in resident health outcomes, practitioner communication patterns, and perceptions of group effectiveness within a quality‐improvement collaborative nursing home clinicians. Survey interview data were collected from clinicians participating collaborative. Quality‐improvement outcomes evaluated using US Federal State minimum dataset measures. Models specified evaluating relationships staff effectiveness. Interview provided...
The timely delivery of guideline-concordant care may reduce the risk recurrent vascular events for patients with transient ischemic attack (TIA) and minor stroke. Although many health organizations measure stroke quality, few evaluate performance TIA or stroke, most include only a limited subset guideline-recommended processes.To assess quality across Veterans Health Administration (VHA) system nationwide.This cohort study included 8201 cared in any VHA emergency department (ED) inpatient...
<h3>Importance</h3> Early evaluation and management of patients with transient ischemic attack (TIA) nonsevere stroke improves outcomes. <h3>Objective</h3> To identify processes care associated reduced risk death or recurrent among TIA stroke. <h3>Design, Setting, Participants</h3> This cohort study included all at Department Veterans Affairs emergency department inpatient settings from October 2010 to September 2011. Multivariable logistic regression was used model associations without-fail...
<h3>PURPOSE</h3> We undertook a study to identify conditions and operational changes linked improvements in smoking blood pressure (BP) outcomes primary care. <h3>METHODS</h3> purposively sampled interviewed practice staff (eg, office managers, clinicians) from subset of 104 practices participating EvidenceNOW—a multisite cardiovascular disease prevention initiative. calculated Clinical Quality Measure improvements, with targets 10-point or greater absolute the proportion patients screening...
Researchers need approaches for analyzing complex phenomena when assessing contingency relationships where specific conditions explain an outcome only combined with other conditions. Using a mixed methods design, we paired configurational and qualitative thematic analysis to model in veteran community reintegration outcomes, identifying combinations of that led success or lack among US military veterans. This pairing allowed modeling at detailed level beyond the capabilities either approach...