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Nadia Awad, Francis J Caputo, Jeffrey P Carpenter, James B Alexander, José L Trani, Joseph V Lombardi
OBJECTIVE: Given the increased pressure from governmental programs to restructure reimbursements to reflect quality metrics achieved by physicians, review of current reimbursement schemes is necessary to ensure sustainability of the physician's performance while maintaining and ultimately improving patient outcomes. This study reviewed the impact of reimbursement incentives on evidence-based care outcomes within a vascular surgical program at an academic tertiary care center. METHODS: Data for patients with a confirmed 30-day follow-up for the vascular surgery subset of our institution's National Surgical Quality Improvement Program submission for the years 2013 and 2014 were reviewed...
November 19, 2016: Journal of Vascular Surgery
Timothy S Nicolello, Forrest Q Pecha, Reed L Omdal, Kurt J Nilsson, Alejandro A Homaechevarria
BACKGROUND: Orthopaedic clinics have acquired a multitude of health professionals to improve clinic efficiency. More recently, athletic trainers (ATs) have been utilized to improve clinical efficiency and patient care because of their extensive background in musculoskeletal injuries and anatomy. Improved clinical efficiency allows for increased patient visits, potentially enhancing patient access and downstream revenue via relative value units (RVUs). HYPOTHESIS: The addition of an AT into a sports medicine physician's clinic will increase total patient throughput and overall RVU production...
October 31, 2016: Sports Health
Daniel Forsberg, Beverly Rosipko, Jeffrey L Sunshine
The workload of US radiologists has increased over the past two decades as measured through total annual relative value units (RVUs). This increase in RVUs generated suggests that radiologists' productivity has increased. However, true productivity (output unit per input unit; RVU per time) is at large unknown since actual time required to interpret and report a case is rarely recorded. In this study, we analyzed how the time to read a case varies between radiologists over a set of different procedure types by retrospectively extracting reading times from PACS usage logs...
October 6, 2016: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
Clay Frank, Dimitriy Kondrashov, S Craig Meyer, Gary Dix, Morgan Lorio, Don Kovalsky, Daniel Cher
BACKGROUND: The evidence base supporting minimally invasive sacroiliac (SI) joint fusion (SIJF) surgery is increasing. The work relative value units (RVUs) associated with minimally invasive SIJF are seemingly low. To date, only one published study describes the relative work intensity associated with minimally invasive SIJF. No study has compared work intensity vs other commonly performed spine surgery procedures. METHODS: Charts of 192 patients at five sites who underwent either minimally invasive SIJF (American Medical Association [AMA] CPT® code 27279) or lumbar microdiscectomy (AMA CPT® code 63030) were reviewed...
2016: ClinicoEconomics and Outcomes Research: CEOR
Sowmya Balasubramanian, Alaina K Kipps, Shea N Smith, Theresa A Tacy, Elif Seda Selamet Tierney
BACKGROUND: Present resource-based relative value unit (RVU) assignment for echocardiography is based on Current Procedural Terminology (CPT) codes, which do not incorporate complexity of diagnosis, time spent for image acquisition, or interpretation of echocardiograms. The objective of this study was to determine whether CPT-based RVU assignment accurately reflects physician effort in performing and interpreting pediatric echocardiographic examinations. METHODS: Cardiac complexity category (CCC) and physician time for study interpretation of 123 echocardiograms (June to September 2013) were prospectively assigned...
July 9, 2016: Journal of the American Society of Echocardiography
Jose Miguel Dora, Felipe Soares Torres, Marcos Gerchman, Flavio S Fogliatto
INTRODUCTION: Demand for CT examinations is continually increasing, with radiologists' reporting times (RRTs) being the major constraint in CT productivity. As CT complexity varies according to the anatomical region, there is a need for methods that normalize radiologist work to address reporting workload. METHODS: All CT orders, from July 2013 to February 2015, from a 850-bed tertiary-care, university-based general hospital in southern Brazil, were studied. Type of examination and RRTs were retrieved from our Radiology Information System/IMPAX...
December 2016: Journal of Medical Imaging and Radiation Oncology
Ganiyat O Olatunde, Folake O Henshaw, Michael A Idowu, Keith Tomlins
The effect of pretreatment methods (soaking in water, potassium metabisulphite solution, and blanching) and drying methods (sun and oven) on some quality attributes of flour from ten varieties of sweet potato roots were investigated. The quality attributes determined were chemical composition and functional properties. Data obtained were subjected to descriptive statistics, multivariate analysis of variance, and Pearson's correlation. The range of values for properties of sweet potato flour were: moisture (8...
July 2016: Food Science & Nutrition
Adegoke H Bakare, Oluwatooyin F Osundahunsi, Joseph O Olusanya
The rheological (Pasting, farinograph, and alveograph) properties of wheat flour (WF) replaced with breadfruit four (05-40%) was analyzed. Baking and sensory qualities of the resulting bread were evaluated. Differences in baking properties of loaves produced under laboratory and industrial conditions were analyzed with t-test, whereas ANOVA was used for other analyses. Peak and final viscosities in the composite blends (CB) ranged from 109.20 to 114.06 RVU and 111.86 to 134.40 RVU, respectively. Dough stability decreased from 9...
July 2016: Food Science & Nutrition
Jennifer Lochner, Elizabeth Trowbridge, Sandra Kamnetz, Nancy Pandhi
BACKGROUND AND OBJECTIVES: Primary care physician compensation structures have remained largely volume-based, lagging behind changes in reimbursement that increasingly include population approaches such as capitation, bundled payments, and care management fees. We describe a population health-based physician compensation plan developed for two departmental family medicine faculty groups (residency teaching clinic faculty and community clinic faculty) along with outcomes before and after the plan's implementation...
June 2016: Family Medicine
Sorin T Teich, Renato Roperto, Aurelio A Alonso, Lisa A Lang
A Comprehensive Care Experience Level (CCEL) system that is aligned with Commission on Dental Accreditation (CODA) standards, promotes comprehensive care and prevention, and addresses flaws observed in previous Relative Value Units (RVU)-based programs has been implemented at the School of Dental Medicine, Case Western Reserve University since 2011. The purpose of this article is to report on the design, implementation, and preliminary outcomes of this novel clinical evaluation system. With the development of the CCEL concept, it was decided not to award points for procedures performed on competency exams...
June 2016: Journal of Dental Education
Jennifer L Wiler, Mustafa Ozkaynak, Kelly Bookman, April Koehler, Robert Leeret, Jenny Chua-Tuan, Adit A Ginde, Richard Zane
BACKGROUND: In an urban academic emergency department (ED), a front-end split-flow model, which entailed deployment of an attending-physician intake model, implementation of a 16-bed clinic decision unit, expanded point-of-care (POC) testing, and dedicated ED transportation services, was created. METHODS: A retrospective, observational, pre-post intervention comparison study was conducted at a large academic urban hospital with 74,000 ED annual visits that serves as a Level 2 Trauma Center...
June 2016: Joint Commission Journal on Quality and Patient Safety
Ian C Sando, Adeyiza O Momoh, Kevin C Chung, Jeffrey H Kozlow
Objective The purpose of this study was to evaluate the short-term costs, and financial implications of improvements in operative efficiency of free flap and implant-based breast reconstruction within an academic practice. Methods The billing records of 162 patients who underwent postmastectomy implant-based or free flap breast reconstruction by two newly hired microsurgeons at an academic institution during the 2011, 2012, and 2013 fiscal years were reviewed. Actual data on professional revenue, relative value units (RVUs), and facility costs for the first stage of reconstruction as well as costs of postoperative complications were assessed...
July 2016: Journal of Reconstructive Microsurgery
Harry W Severance
No abstract text is available yet for this article.
January 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Jeffrey D Clinkscales, Francis M Fesmire, Jacob R Hennings, Harry W Severance, David C Seaberg, Nirav Patil
OBJECTIVES: The effect of emergency medicine (EM) residents on the clinical efficiency of attending physicians is controversial. The authors hypothesized that implementing a new EM residency program would result in an increase in relative value units (RVUs) generated per hour by attending physicians and decrease staffing requirements. METHODS: This was a retrospective observational analysis of an emergency department before, during, and after the establishment of a new EM residency program...
January 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Tara Garber, Charles G T Ledonio, David W Polly
BACKGROUND: Minimally invasive sacroiliac joint fusion is increasing significantly. Starting January 1, 2015, it has a category I CPT code. The current RVU for this procedure is not equal to the amount of work involved. There is not a published RUC validated survey to establish the work effort of MI SI fusion. Our hospital system has been doing this procedure for 4 years and has been tracking surgeon time through a commercial tracking system (Navicare). Our study looks at time utilization for performance of MI SI joint fusion and a comparator of primary lumbar discectomy (PLD), presumably similar in time and work effort...
2015: International Journal of Spine Surgery
K Ashwath Kumar, G K Sharma, M A Khan, T Govindaraj, A D Semwal
Four different Multigrain Premixes (MGPs) namely MGP I, MGP II, MGP III, MGP IV were developed to select the best premix for preparation of biscuits based on nutritional value and biscuit quality. The MGPs were prepared using cereals (barley, sorghum, maize, oats), pulses (chickpea dhal, green gram, peas, soya flour), millets (pearl millet, finger millet) and wheat germ each at 20 % level. The MGPs developed had 22.91-27.84 % protein, 16.82-18.72 % dietary fiber and 3.11-3.46 % minerals. The wheat flour was replaced with MGPs separately at different levels of 10, 20, 30, 40 and 50 %...
December 2015: Journal of Food Science and Technology
Amanjit Baadh, Yuri Peterkin, Melanie Wegener, Jonathan Flug, Douglas Katz, Jason C Hoffmann
The relative value unit (RVU) is an important measuring tool for the work performed by physicians, and is currently used in the United States to calculate physician reimbursement. An understanding of radiology RVUs and current procedural terminology codes is important for radiologists, trainees, radiology managers, and administrators, as this knowledge would help them to understand better their current productivity and reimbursement, as well as controversies regarding reimbursement, and permit them to adapt to reimbursement changes that may occur in the future...
March 2016: Current Problems in Diagnostic Radiology
Brittany L Vieira, David J Hernandez, Charles Qin, Stephanie S Smith, John Y S Kim, Jose C Dutra
OBJECTIVES/HYPOTHESIS: Intraoperative experience is an essential element of surgical training, but has the potential to impact patient outcomes. The purpose of this study was two-fold: 1) to evaluate the effect of resident involvement on morbidity and mortality following otolaryngology procedures and 2) to examine the influence of resident training level on the same outcomes. STUDY DESIGN: Retrospective cohort study. METHODS: This study reviewed 2,320,920 patients captured in the 2005 to 2012 National Surgical Quality Improvement Program databases to identify surgical otolaryngology cases...
March 2016: Laryngoscope
Tarek N Hanna, Thomas Loehfelm, Faisal Khosa, Saurabh Rohatgi, Jamlik-Omari Johnson
The aims of the study are to identify factors contributing to preliminary interpretive discrepancies on overnight radiology resident shifts and apply this data in the context of known literature to draw parallels to attending overnight shift work schedules. Residents in one university-based training program provided preliminary interpretations of 18,488 overnight (11 pm–8 am) studies at a level 1 trauma center between July 1, 2013 and December 31, 2014. As part of their normal workflow and feedback, attendings scored the reports as major discrepancy, minor discrepancy, agree, and agree--good job...
February 2016: Emergency Radiology
Wei-li Wu, Hua Shen, Kai Liao, Hong-bo Yu, He-tong Zhou, Hong-fei Wu
OBJECTIVE: To identify the correlation of the volume of residual urine (VRU) with the severity of bladder outlet obstruction (BOO) and detrusor contractility in patients with benign prostatic hyperplasia (BPH). METHODS: A total of 152 patients with clinically diagnosed BPH underwent ultrasonography for measurement of the prostate volume and RVU, free uroflowmetry, and urodynamic examination for the severity of BOO and detrusor contractility. Using the software SPSS20...
August 2015: Zhonghua Nan Ke Xue, National Journal of Andrology
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