A5020971681- Space Exploration and Technology
- Planetary Science and Exploration
- Healthcare Policy and Management
- Primary Care and Health Outcomes
- Emergency and Acute Care Studies
- Human-Automation Interaction and Safety
- Space Science and Extraterrestrial Life
- Pharmaceutical Practices and Patient Outcomes
- Patient Safety and Medication Errors
- Health Systems, Economic Evaluations, Quality of Life
- Heart Failure Treatment and Management
- Geriatric Care and Nursing Homes
- Occupational Health and Safety Research
- Electronic Health Records Systems
- Patient Satisfaction in Healthcare
- Spaceflight effects on biology
- Healthcare Quality and Management
- COVID-19 Clinical Research Studies
- Medication Adherence and Compliance
- Neuroendocrine Tumor Research Advances
- Coronary Artery Anomalies
- Systems Engineering Methodologies and Applications
- Pneumonia and Respiratory Infections
- Nursing Roles and Practices
- Medical Coding and Health Information
University of Alabama at Birmingham Hospital
2020
Christiana Care Health System
2014-2019
Iowa City VA Health Care System
2012-2016
Health Services Research & Development
2015
Boston University
2015
VA Boston Healthcare System
2015
Veterans Health Administration
2015
University of Iowa
2004-2012
Iowa City VA Medical Center
2010
Carnegie Mellon University
2006
Chinese translation Background: Reducing length of stay (LOS) has been a priority for hospitals and health care systems. However, there is concern that this reduction may result in increased hospital readmissions. Objective: To determine trends LOS 30-day readmission rates all medical diagnoses combined 5 specific common the Veterans Health Administration. Design: Observational study from 1997 to 2010. Setting: All 129 acute Affairs United States. Patients: 4 124 907 admissions with...
Survey response rate is regarded as a key data-quality indicator, yet not necessarily predictive of nonresponse bias. Our study objective was to use high-response-rate survey assess bias across successive waves. This healthcare leaders utilized web-based, self-report format with an initial invitation and four nonrespondent follow-ups. Across five waves, comparisons were made for demographic facility characteristics, proportion items completed, distribution three question types: factual...
BACKGROUND Advanced practice providers (APPs), including nurse practitioners (NPs) and physician assistants (PAs) are cost‐effective substitutes for physicians, with similar outcomes in primary care surgery. However, little is understood about APP roles inpatient medicine. OBJECTIVE Describe APPs role DESIGN Observational cross‐sectional cohort study. SETTING One hundred twenty‐four Veterans Health Administration (VHA) hospitals. PARTICIPANTS Chiefs of medicine (COMs) managers. MEASUREMENTS...
The Life in the Atacama project investigated regional distribution of life and habitats Desert Chile. We sought to create biogeologic maps through survey traverses across desert using a rover carrying biologic geologic instruments. Elements our science approach were to: Perform ecological transects from relatively wet coastal range arid core desert; use converging evidence instruments reach conclusions about microbial abundance; develop test exploration strategies adapted search scattered...
Scrutiny of hospital readmissions has led to the development and implementation policies targeted at reducing readmission rates.To assess whether historic rates predict risk-adjusted patient measure costs readmission, thus informing reimbursement under consideration by non-Veterans Health Administration payers.Multivariable hospital-fixed effects regression analyses patients admitted 129 Veterans hospitals between 2005 2009 for 3 common conditions, acute myocardial infarction (AMI),...
Despite considerable efforts to improve healthcare quality and patient safety, broad measures of outcomes show little improvement. Many factors, including limited programme evaluations understanding whether improvement (QI) are sustained, potentially contribute the lack widespread improvements in quality. This study examines hospitals participating a Veterans Health Affairs QI collaborative have made then sustained improvements.Separate patient-level risk-adjusted time-series models for two...
To analyze and compare four different methods of detecting medication misadventures in order to determine the optimal system for reporting clinically observed misadventures.Prospective cohort study.Forty-eight-bed general internal medicine inpatient ward at a large academic teaching hospital with decentralized pharmacy system.One hundred twenty-six patients (54% male, mean age 54 yrs) 133 consecutive admissions (mean length stay 7.8 days) over an 8-week period from December 2001-February...
Background Increasing adoption of electronic health records (EHRs) with integrated alerting systems is a key initiative for improving patient safety. Considering the variety dynamically changing clinical information, it remains challenge to design EHR-driven that notify right providers at time while managing alert burden. The objective this study proactively develop and evaluate systematic alert-generating approach as part implementation an Early Warning Score (EWS) hospitals. Methods We...
The science goals of the Life in Atacama (LITA) robotic field experiment are to understand habitat and seek out life Desert, Chile, as an analog future missions Mars. To those ends, we present a new data analysis tool, LITA Data Scoring System (DSS), which (1) integrates rover orbital relevant environmental habitability detection, (2) provides standard metric, or “score” evaluate (a) potential habitability, (b) strength evidence for at all locales along rover's traverse. Designed tested...
In the decade since release of Institute Medicine (IOM) report To Err Is Human: Building a Safer Health System, health care field has steadily increased its understanding adverse drug events (ADEs).1 Initially, research in area focused on determining rate hospitalized patients.2 An important question throughout this initial stage was to determine best method for collecting information about ADEs. One particular focus whether various reporting methods detected different types The explored...
Background: Hospital-based palliative care consultation is consistently associated with reduced hospitalization costs and more importantly improved patient quality of life. As healthcare systems move toward value-based purchasing rather than fee-for-service models, understanding how metrics can provide evidence for expanded health system support a greater presence. Aim: To understand impacts rates readmission hospital-acquired infections metrics. Design: Retrospective propensity-matched...
The Life in the Atacama project examined six different sites Desert (Chile) over 3 years an attempt to remotely detect presence of life with a rover. remote science team, using only orbital and rover data sets, identified areas high potential for as targets further inspection by Orbital visible/near infrared (VNIR) thermal (TIR) were used examine mineralogy, geomorphology, chlorophyll field sites. Field instruments included two spectrometers (VNIR reflectance TIR emission) neutron detector:...
Robotic exploration is an excellent method for obtaining information about sites too dangerous people to explore. The operator's understanding of the environment depends on rover returning useful information. mission bandwidth frequently constrained, limiting amount can return. This paper explores tradeoff between and based two years observations during a robotic astrobiology field study. developed theory begins by analyzing search task conducted robot operators. analysis leads optimization...
Recent studies have documented that a significant increase in the use of observation stays along with extensive variation patterns across hospitals. The objective this longitudinal observational study was to examine extent which patient, hospital, and local health system characteristics explain stay rates Veterans Health Administration (VHA) Our data came from years 2005 2012 nationwide VHA Medical SAS inpatient enrollment files, American Hospital Association Survey, Area Resource File. We...
To determine the extent to which 30- and 90-day hospital readmission mortality rates differ as a function of whether chest pain patient is placed in observation status or admitted for short-stay (<48 h). Using 114,043 stays admissions at Veterans Health Administration hospitals between 2005 2013, we estimated event-level logistic regression models using generalized estimating equation framework predict 30 readmissions had an stay admission. We also adjusted variety characteristics unobserved...
During two weeks of study in September and October 2004, a science team directed rover explored the arid Atacama Desert Chile. The objective mission was to search for life. Over course gained experience with became more reliable autonomous. As result, rover/operator system effective. Several factors likely contributed improvement effectiveness including increased experience, effective strategies, different composition, site locations, changes operational capabilities, operation interface....
The scientific success of a remote exploration rover mission depends on the right combination technology, teamwork and insight. In order to quantitatively evaluate field trial, it is necessary assess accuracy interpretations made during test. This work compares three structured approaches assessing ground truth findings from science team conducting investigation locale using an autonomous rover. For first approach, independent assessment, daily summaries were analyzed reduced series 1082...
Observation stays are an outpatient service used to diagnose and treat patients for extended periods of time while a decision is made regarding inpatient admission or discharge. Although the use observation increasing, little known about which observed admitted similar as inpatients. The aim was identify patient characteristics associated with being rather than short stay (<48 hours) within Veterans Health Administration (VHA). In our longitudinal analysis, we logistic regression...
Humans are often blamed for errors in complex systems. A number of taxonomies exist classifying human errors, but recent doubts have been raised as to whether these actually or simply processes involved both correct and incorrect decisions. field test was designed address some issues. During the test, three geologists made assessments about past environment based on robotically collected data. The decisions were classified previous error taxonomy. Each conclusion then checked accuracy. From...
Robotic exploration of remote planetary environments requires scientists and robots to interact effectively in order generate accurate scientific conclusions. Optimizing the quality reliability these interpretations increases effectiveness productivity missions. During 2004 Life Atacama (LITA) field test, Pittsburgh, PA interacted with a rover Chile exploring Desert for signs life. Recordings scientists' actions conversations revealed patterns meriting further study. For example,...
Measuring the error introduced by machine and human in a man-machine system is an important step understanding improving system. Two experiments assessed from total length measurements shape classification. A separate analysis calculated introduce camera. The average for was 2.33 pixels with standard deviation of 2.399. edge location camera 5-10 pixels. This indicates that humans generally are good at measuring lengths, but have difficulty near threshold resolution. Results classification...