A5084063732- Palliative Care and End-of-Life Issues
- Pain Management and Opioid Use
- Interprofessional Education and Collaboration
- Patient Dignity and Privacy
- Family and Patient Care in Intensive Care Units
- Primary Care and Health Outcomes
- Musculoskeletal pain and rehabilitation
- Patient-Provider Communication in Healthcare
- Opioid Use Disorder Treatment
- Geriatric Care and Nursing Homes
- Health Systems, Economic Evaluations, Quality of Life
- Childhood Cancer Survivors' Quality of Life
- Pediatric Pain Management Techniques
- Pain Management and Placebo Effect
- Complementary and Alternative Medicine Studies
- Grief, Bereavement, and Mental Health
- Health Policy Implementation Science
- Acupuncture Treatment Research Studies
- Ethics in medical practice
- Cancer survivorship and care
- Empathy and Medical Education
- Healthcare professionals’ stress and burnout
- COVID-19 and Mental Health
- Pharmaceutical Practices and Patient Outcomes
- Mental Health and Patient Involvement
VA Palo Alto Health Care System
2016-2025
Stanford University
2018-2025
Center for Innovation
2016-2025
Health Services Research & Development
2019-2024
Primary Health Care
2020-2024
United States Department of Veterans Affairs
2021-2024
Veterans Health Administration
2024
Olive View-UCLA Medical Center
2024
Cornell University
2024
University of Colorado Anschutz Medical Campus
2024
Palliative care has the potential to improve for patients and families undergoing high-risk surgery.To characterize use of perioperative palliative its association with family-reported end-of-life experiences who died within 90 days a surgical operation.This secondary analysis administrative data from retrospective cross-sectional patient cohort was conducted in Department Veterans Affairs (VA) Healthcare System. Patients underwent any 227 operations between January 1, 2012, December 31,...
Facilitating appropriate and safe prescribing of opioid medications for chronic pain management in primary care is a pressing public health concern. Interdisciplinary team-based models are exploring the expansion clinical pharmacist roles to support disease conditions, e.g. pain. Our study aims 1) identify pharmacists can assume team based processes 2) understand barriers assuming these expanded roles. Setting: Veterans Health Administration (VA) has implemented an interdisciplinary model...
Opioid prescribing for chronic pain, including the potential over-reliance and misuse, is a public health concern.In context of Veterans Administration (VA) primary care team-based pain management, we aimed to understand providers' perceptions barriers reducing opioid use improving nonpharmacologic management therapies (NPTs) pain.A semistructured interview elucidated provider experiences with assessing managing pain. Emergent themes were mapped known dimensions VA access.Informants included...
Introduction Prescribing long-term opioid therapy is a nuanced clinical decision requiring careful consideration of risks versus benefits. Our goal to understand patient, provider and context factors that impact the prescribe opioids in patients with cancer. Methods We conducted secondary analysis raw semistructured interview data gathered from 42 prescribers who participated one two aligned concurrent qualitative studies USA Australia. two-part interview: first identifying all influencing...
Pain and opioid management are core ambulatory palliative care skills. Existing literature on how to manage misuse/use disorder excludes patients found in settings, such as individuals with serious illness or those at the end of life.
Objectives: Veterans Health Administration (VHA) launched a national initiative to train providers in specific, protocolized auricular acupuncture treatment (also called Battlefield Acupuncture or BFA) as nonpharmacological approach pain management. This evaluation assessed the real-world effectiveness of BFA on immediate relief and identified subgroups patients for whom is most effective. Research Design: In cross-sectional cohort study, electronic medical record data 11,406 treated with at...
Purpose To determine the feasibility of mapping interdisciplinary role ownership over actionable practices identified from qualitative comments in Veterans Affairs Bereaved Family Survey (BFS). Methods We polled two providers each 14 disciplines as to whether an practice that improved end-of-life care quality sits within their scope practice. grouped by having greatest, middle, and fewest number claimed then characterized what roles were shared. Major Findings Medicine, nursing, social work,...
The AUA convened a 2021-2022 Quality Improvement Summit to bring together interdisciplinary providers inform the current state and discuss potential strategies for integrating primary palliative care into urology practice. We hypothesized that findings would scalable model urology.
Background Effective implementation strategies might facilitate patient-centered medical home (PCMH) uptake and spread by targeting barriers to change. Evidence-based quality improvement (EBQI) is a multi-faceted strategy that based on clinical-researcher partnership. It promotes organizational change fostering innovation the of those innovations are successful. Previous studies demonstrated EBQI accelerated PCMH adoption within Veterans Health Administration primary care practices, compared...
Although numerous scholars have emphasized the need for effective communication between members of interprofessional teams, few studies provide a clear understanding what constitutes team in primary care settings, specifically where patient-centered medical home (PCMH) teams been implemented. This paper describes elements as perceived by PCMH and identifies that persisted over time. Using transcribed text from 75 semi-structured interviews, we applied grounded theory method constant...
Objective Pain is experienced by most patients with cancer and opioids are a cornerstone of management. Our objectives were (1) to identify patterns or trajectories long-term opioid therapy (LTOT) their correlates among without (2) assess the association between risk for overdose, considering potential moderating role cancer. Methods analysis We conducted retrospective cohort study individuals in US Veterans Health Administration database incident LTOT (N=44 351; N=285 772, respectively)...
Pain is a longstanding and growing concern among US military veterans. Although many individuals rely on medications, body of literature supports the use complementary non-pharmacologic approaches when treating pain. Our objective to characterize veteran experiences with barriers accessing alternatives medication (e.g., treatments or approaches) for pain in primary care. Data this qualitative analysis were collected as part Effective Screening (ESP) study (2012–2017), national randomized...