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Physician executive

Sophia A Hayes, Dana Zive, Betty Ferrell, Susan W Tolle
BACKGROUND: The Physician Orders for Life-Sustaining Treatment (POLST) Paradigm records advance care planning for patients with advanced illness or frailty as actionable medical records. The National POLST Paradigm Task Force recommends that physicians, advanced practice registered nurses (APRNs), and physician assistants (PAs) be permitted to execute POLST forms. OBJECTIVE: To investigate the percentage of Oregon POLST forms signed by APRNs, and examine the obstacles faced by states attempting to allow APRNs to sign POLST forms...
October 21, 2016: Journal of Palliative Medicine
Gregory A Schmidt, Timothy D Girard, John P Kress, Peter E Morris, Daniel R Ouellette, Waleed Alhazzani, Suzanne M Burns, Scott K Epstein, Andres Esteban, Eddy Fan, Miquel Ferrer, Gilles L Fraser, Michelle Gong, Catherine Hough, Sangeeta Mehta, Rahul Nanchal, Sheena Patel, Amy J Pawlik, Curtis N Sessler, Thomas Strøm, William Schweickert, Kevin C Wilson, Jonathon D Truwit
BACKGROUND: This clinical practice guideline addresses six questions related to liberation from mechanical ventilation in critically ill adults. It is the result of a collaborative effort between the American Thoracic Society (ATS) and American College of Chest Physicians (CHEST). METHODS: A multi-disciplinary panel posed six clinical questions in a Population, Intervention, Comparator and Outcomes (PICO) format. A comprehensive literature search and evidence synthesis was performed for each question, which included appraising the certainty in the evidence (i...
October 20, 2016: American Journal of Respiratory and Critical Care Medicine
Ann Marie Flannery, Mandeep S Tamber, Catherine Mazzola, Paul Klimo, Lissa C Baird, Rachana Tyagi, David F Bauer, Alexandra Beier, Susan Durham, Alexander Y Lin, Catherine McClung-Smith, Laura Mitchell, Dimitrios Nikas
BACKGROUND: Positional plagiocephaly is a common problem seen by pediatricians, pediatric neurologists, and pediatric neurosurgeons. OBJECTIVE: To create evidence-based guidelines for the treatment of pediatric positional plagiocephaly. METHODS: This guideline was prepared by the Plagiocephaly Guideline Task Force, a multidisciplinary team made up of physician volunteers (clinical experts), medical librarians, and clinical guidelines specialists...
November 2016: Neurosurgery
Christoph Gyo, Michael Boll, Dörthe Brüggmann, Doris Klingelhöfer, David Quarcoo, David A Groneberg
BACKGROUND: State-certified occupational physicians who work as civil servants in the Federal Republic of Germany are key players in the German Public Health system. They control i.e. the legal compliance in occupational health and participate in the occupational disease procedures. Despite the role model function of the German Public health system for many developing countries, this area of Public health is debated to have been hampered in the past years by a disregard concerning structural developments...
2016: Journal of Occupational Medicine and Toxicology
Mina S Makary, Summit H Shah, Shantanu Warhadpande, Ivan G Vargas, James Sarbinoff, Joshua D Dowell
PURPOSE: The association of retrievable inferior vena cava filters (IVCFs) with adverse events has led to increased interest in prompt retrieval, particularly in younger patients given the progressive nature of these complications over time. This study takes a design-of-experiments (DOE) approach to investigate methods to best improve filter retrieval rates, with a particular focus on younger (<60 years) patients. METHODS: A DOE approach was executed in which combinations of variables were tested to best improve retrieval rates...
October 12, 2016: Journal of the American College of Radiology: JACR
Donald K Hayes, Candice R Calhoun, Lin Joseph, JoAnn Y Farnsworth, Kimberly B Arakaki
The Hawai'i Maternal and Infant Health Collaborative, founded in 2013, is a public-private partnership committed to improving birth outcomes and reducing infant mortality. The Collaborative was developed in partnership with the Executive Office on Early Learning Action Strategy with help from the Department of Health and National Governor's Association. The Action Strategy provides Hawai'i with a roadmap for an integrated and comprehensive early childhood system, spanning preconception to third grade. The Collaborative helps advance goals within the Action Strategy by focusing on ensuring that children have the best start in life by being healthy and welcomed...
October 2016: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
Alexander Seitinger, Andrea Rappelsberger, Harald Leitich, Michael Binder, Klaus-Peter Adlassnig
INTRODUCTION: Clinical decision support systems (CDSSs) are being developed to assist physicians in processing extensive data and new knowledge based on recent scientific advances. Structured medical knowledge in the form of clinical alerts or reminder rules, decision trees or tables, clinical protocols or practice guidelines, score algorithms, and others, constitute the core of CDSSs. Several medical knowledge representation and guideline languages have been developed for the formal computerized definition of such knowledge...
August 12, 2016: Artificial Intelligence in Medicine
Robert S Rudin, Eric C Schneider, Zachary Predmore, Courtney A Gidengil
OBJECTIVES: Complex patients incur a majority of healthcare costs in the United States, in part, because their care is poorly coordinated. We sought to determine the leading edge of health information technology (IT) tools for care coordination of complex patients. STUDY DESIGN: Qualitative discussions and technical expert panels. METHODS: We conducted 35 discussions with clinical leaders, technology and startup executives, government officials, academic researchers, and 2 technical expert panels...
2016: American Journal of Managed Care
Marie Cécile Fevre, Caroline Vincent, Julien Picard, Arnaud Vighetti, Claire Chapuis, Maxime Detavernier, Benoit Allenet, Jean François Payen, Jean Luc Bosson, Pierre Albaladejo
Ultrasound (US) guided needle positioning is safer than anatomical landmark techniques for central venous access. Hand-eye coordination and execution time depend on the professional's ability, previous training and personal skills. Needle Guidance Positioning Systems (GPS) may theoretically reduce execution time and facilitate needle positioning in specific targets, thus improving patient comfort and safety. Three groups of healthcare professionals (41 anaesthesiologists and intensivists, 41 residents in anaesthesiology and intensive care, 39 nurse anaesthetists) were included and required to perform 3 tasks (positioning the tip of a needle in three different targets in a silicon phantom) by using successively a conventional US-guided needle positioning and a needle GPS...
September 19, 2016: Anaesthesia, Critical Care & Pain Medicine
Hyun Ho Han, Byung Yeun Kwon, Sung No Jung, Suk-Ho Moon
Occupational injuries to digits due to hydrofluoric acid (HFA) are frequently encountered. They have distinctive features, including intense pain, progressive tissue necrosis, and possible bone erosion. To minimize tissue damage, it is of great importance to execute prudent preoperative assessment and determine the correct surgical modality to reconstruct and maintain the function of the hand. However, proper protocols for fingers have not been presented in previous studies. Eight cases with HFA burn to digits were presented to the emergency room...
September 17, 2016: Burns: Journal of the International Society for Burn Injuries
Julie Ann Cogin, Ju Li Ng, Ilro Lee
BACKGROUND: We assess how human resource management (HRM) is implemented in Australian hospitals. Drawing on role theory, we consider the influence HRM has on job attitudes of healthcare staff and hospital operational efficiency. METHODS: We adopt a qualitative research design across professional groups (physicians, nurses, and allied health staff) at multiple levels (executive, healthcare managers, and employee). A total of 34 interviews were carried out and analyzed using NVivo...
2016: Human Resources for Health
T Saller, V V Dossow, K Hofmann-Kiefer
BACKGROUND: Delirium is a common complication in critical care. The syndrome is often underestimated due to its potentially no less dangerous course as a hypoactive delirium. Therefore, current guidelines ask for a structured, regular and routine screening in all intensive care units. If delirium is diagnosed, symptomatic therapy should be initiated promptly. OBJECTIVES: The aim of the current study was to evaluate recent German anesthetists' strategies regarding delirium care compared to the German guidelines for sedation and delirium in intensive care...
October 2016: Der Anaesthesist
David A Cook, Christopher M Wittich, Wendlyn L Daniels, Colin P West, Ann M Harris, Timothy J Beebe
BACKGROUND: Most research on how to enhance response rates in physician surveys has been done using paper surveys. Uncertainties remain regarding how to enhance response rates in Internet-based surveys. OBJECTIVE: To evaluate the impact of a low-cost nonmonetary incentive and paper mail reminders (formal letter and postcard) on response rates in Internet-based physician surveys. METHODS: We executed a factorial-design randomized experiment while conducting a nationally representative Internet-based physician survey...
2016: Journal of Medical Internet Research
Manish K Aghi, Clark C Chen, Maria Fleseriu, Steven A Newman, Joshua William Lucas, John S Kuo, Garni Barkhoudarian, Christopher J Farrell, Jason Sheehan, Mateo Ziu, Ian F Dunn
BACKGROUND: Nonfunctioning pituitary adenomas (NFPAs) are the most frequent pituitary tumors. OBJECTIVE: To create evidence-based guidelines for the initial management of NFPAs. METHODS: A multidisciplinary task force composed of physician volunteers and evidence-based medicine-trained methodologists conducted a systematic review of the literature relevant to the management of NFPAs. To ascertain the class of evidence for the posttreatment follow-ups, the task force used the Clinical Assessment evidence-based classification...
October 2016: Neurosurgery
H Drinhaus, T Annecke, J Hinkelbein
Decompression of the chest is a life-saving invasive procedure for tension pneumothorax, trauma-associated cardiopulmonary resuscitation or massive haematopneumothorax that every emergency physician or intensivist must master. Particularly in the preclinical setting, indication must be restricted to urgent cases, but in these cases chest decompression must be executed without delay, even in subpar circumstances. The methods available are needle decompression or thoracentesis via mini-thoracotomy with or without insertion of a chest tube in the midclavicular line of the 2nd/3rd intercostal space (Monaldi-position) or in the anterior to mid-axillary line of the 4th/5th intercostal space (Bülau-position)...
October 2016: Der Anaesthesist
Lawrence P Casalino, Norman Chenven
BACKGROUND: Value-based purchasing (VBP) favors provider organizations large enough to accept financial risk and develop care management infrastructure. Independent Practice Associations (IPAs) are a potential alternative for physicians to becoming employed by a hospital or large medical group. But little is known about IPAs. METHODS: We selected four IPAs that vary in location, structure, and strategy, and conducted interviews with their president and medical director, as well as with a hospital executive and health plan executive familiar with that IPA...
September 8, 2016: Healthcare
William B Weeks, James N Weinstein
PURPOSE: To determine whether several measures of health care expenditures, access, and outcomes for the 25 recently identified "least healthy cities in America" differed from those in the rest of America. METHODS: For 2004 and 2013, we obtained publicly available price-, age-, sex-, and race-adjusted hospital service area per-capita Medicare expenditures; age-, sex-, and race-adjusted Medicare mortality rates; and 2 indicators of primary care access: the proportion of enrollees having at least one ambulatory visit to a primary care clinician and the per-capita discharge rate for ambulatory care sensitive conditions...
September 2, 2016: American Journal of Medicine
Samina Raza Abidi, Jafna Cox, Ashraf Abusharekh, Nima Hashemian, Syed Sibte Raza Abidi
Atrial Fibrillation (AF) is the most common cardiac arrhythmia. Generally, the therapeutic options for managing AF include the use of anticoagulant drugs that prevent the coagulation of blood. New Oral Anticoagulants (NOACs) are not optimally prescribed to patients, despite their efficacy. In Canada, NOAC medications are not directly available to patients who belong to provincial benefits programs, rather a NOAC special authorization process establishes the eligibility of a patient to receive a NOAC and be paid by the provincial Pharmacare program...
2016: Studies in Health Technology and Informatics
Patricia A Carney, Gerald E Crites, Karen H Miller, Michelle Haight, Dimitrios Stefanidis, Eileen Cichoskikelly, David W Price, Modupeola O Akinola, Victoria C Scott, Summers Kalishman
BACKGROUND: Implementation science (IS) is the study of methods that successfully integrate best evidence into practice. Although typically applied in healthcare settings to improve patient care and subsequent outcomes, IS also has immediate and practical applications to medical education toward improving physician training and educational outcomes. The objective of this article is to illustrate how to build a research agenda that focuses on applying IS principles in medical education...
2016: Medical Education Online
John N Galgiani, Neil M Ampel, Janis E Blair, Antonino Catanzaro, Francesca Geertsma, Susan E Hoover, Royce H Johnson, Shimon Kusne, Jeffrey Lisse, Joel D MacDonald, Shari L Meyerson, Patricia B Raksin, John Siever, David A Stevens, Rebecca Sunenshine, Nicholas Theodore
It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. Infectious Diseases Society of America considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.Coccidioidomycosis, also known as San Joaquin Valley fever, is a systemic infection endemic to parts of the southwestern United States and elsewhere in the Western Hemisphere...
September 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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