The Experts below are selected from a list of 60 Experts worldwide ranked by ideXlab platform

Rachel Maag - One of the best experts on this subject based on the ideXlab platform.

  • correlation of the agency for health care policy and research congestive heart failure admission guideline with mortality Peer Review Organization voluntary hospital association initiative to decrease events provide for congestive heart failure
    Annals of Emergency Medicine, 1999
    Co-Authors: Louis Graff, Yun Wang, Marcia K Petrillo, Jeff Orledge, Martha J Radford, Rachel Maag
    Abstract:

    Study objective: We quantify patient risk as related to the presence or absence of the Agency for Health Care Policy and Research (AHCPR) congestive heart failure (CHF) hospital admission criteria. Methods: This was a retrospective observational cohort study at 12 acute care hospitals examining consecutive patients with the final primary diagnosis of CHF. Trained record abstractors blinded to outcome extracted 386 data elements, including 6 AHCPR admission criteria: (1) pulmonary edema (determined by radiograph) or severe respiratory distress (respiration>40 breaths/min), (2) hypoxia (oxygen saturation Results: Of the 1,674 patients with CHF, 1,340 (80%) were admitted to the hospital. Patients not admitted had a lower mortality rate than admitted patients (30-day mortality rate, 2.1% [95% confidence interval [Cl] 0.6 to 3.6] versus 11.5% [95% Cl 9.8 to 13.2]; odds ratio 0.20 [95% Cl 0.09 to 0.45]). Two of the admission criteria did not correlate with a higher mortality rate: CHF of recent onset and myocardial ischemia. Excluding those 2 criteria, the number of admission criteria present correlated with the patient's probability of hospital admission ( P P =.014), and 30-day mortality rate ( P Conclusion: Selected criteria of the AHCPR CHF admission guideline correlate with mortality rate. Combined with physician clinical judgment, they may be useful in the risk stratification of patients with CHF. Selected low-risk patients with CHF identified by the admission criteria who are presently managed in the acute care hospital may be candidates for outpatient management.

Marcia K Petrillo - One of the best experts on this subject based on the ideXlab platform.

  • a statewide initiative to improve the care of hospitalized pneumonia patients the connecticut pneumonia pathway project
    The American Journal of Medicine, 2001
    Co-Authors: Thomas P Meehan, Scott Weingarten, Eric S Holmboe, Deepak Mathur, Yun Wang, Marcia K Petrillo, George S Tu, Jonathan M Fine
    Abstract:

    Abstract Purpose A statewide quality improvement initiative was conducted in Connecticut to improve process-of-care performance and to decrease length of stay for patients hospitalized with community-acquired pneumonia. Setting and methods Data were collected on 1,242 elderly (≥65 years) pneumonia patients hospitalized at 31 of 32 acute care hospitals between January 16, 1995, and March 15, 1996, and on 1,146 patients hospitalized between January 1, 1997, and June 30, 1997. Interventions included feedback of performance data (Qualidigm, the Connecticut Peer Review Organization), dissemination of an evidence-based pneumonia critical pathway (Connecticut Thoracic Society), and sharing of pathway implementation experiences (hospitals). Process and outcome measures included early antibiotic administration, blood culture collection, oxygenation assessment, length of stay, 30-day mortality, and 30-day readmission rates. Analyses were adjusted for severity of illness and hospital-specific practice patterns. Results After the statewide initiative, improvements were noted in antibiotic administration within 8 hours of hospital arrival (improvement from 83.4% to 88.8%, relative risk [RR] = 1.21; 95% confidence interval [CI]: 1.10 to 1.32), oxygenation assessment within 24 hours of hospital arrival (93.6% to 95.4%; RR=1.23, 95% CI: 1.11 to 1.38), and length of stay (7 days to 5 days, P Conclusions Statewide improvements were demonstrated in the care of hospitalized pneumonia patients concurrent with a multifaceted quality improvement intervention. Further research is needed to separate the effects of the quality improvement interventions from secular trends.

  • correlation of the agency for health care policy and research congestive heart failure admission guideline with mortality Peer Review Organization voluntary hospital association initiative to decrease events provide for congestive heart failure
    Annals of Emergency Medicine, 1999
    Co-Authors: Louis Graff, Yun Wang, Marcia K Petrillo, Jeff Orledge, Martha J Radford, Rachel Maag
    Abstract:

    Study objective: We quantify patient risk as related to the presence or absence of the Agency for Health Care Policy and Research (AHCPR) congestive heart failure (CHF) hospital admission criteria. Methods: This was a retrospective observational cohort study at 12 acute care hospitals examining consecutive patients with the final primary diagnosis of CHF. Trained record abstractors blinded to outcome extracted 386 data elements, including 6 AHCPR admission criteria: (1) pulmonary edema (determined by radiograph) or severe respiratory distress (respiration>40 breaths/min), (2) hypoxia (oxygen saturation Results: Of the 1,674 patients with CHF, 1,340 (80%) were admitted to the hospital. Patients not admitted had a lower mortality rate than admitted patients (30-day mortality rate, 2.1% [95% confidence interval [Cl] 0.6 to 3.6] versus 11.5% [95% Cl 9.8 to 13.2]; odds ratio 0.20 [95% Cl 0.09 to 0.45]). Two of the admission criteria did not correlate with a higher mortality rate: CHF of recent onset and myocardial ischemia. Excluding those 2 criteria, the number of admission criteria present correlated with the patient's probability of hospital admission ( P P =.014), and 30-day mortality rate ( P Conclusion: Selected criteria of the AHCPR CHF admission guideline correlate with mortality rate. Combined with physician clinical judgment, they may be useful in the risk stratification of patients with CHF. Selected low-risk patients with CHF identified by the admission criteria who are presently managed in the acute care hospital may be candidates for outpatient management.

Yun Wang - One of the best experts on this subject based on the ideXlab platform.

  • a statewide initiative to improve the care of hospitalized pneumonia patients the connecticut pneumonia pathway project
    The American Journal of Medicine, 2001
    Co-Authors: Thomas P Meehan, Scott Weingarten, Eric S Holmboe, Deepak Mathur, Yun Wang, Marcia K Petrillo, George S Tu, Jonathan M Fine
    Abstract:

    Abstract Purpose A statewide quality improvement initiative was conducted in Connecticut to improve process-of-care performance and to decrease length of stay for patients hospitalized with community-acquired pneumonia. Setting and methods Data were collected on 1,242 elderly (≥65 years) pneumonia patients hospitalized at 31 of 32 acute care hospitals between January 16, 1995, and March 15, 1996, and on 1,146 patients hospitalized between January 1, 1997, and June 30, 1997. Interventions included feedback of performance data (Qualidigm, the Connecticut Peer Review Organization), dissemination of an evidence-based pneumonia critical pathway (Connecticut Thoracic Society), and sharing of pathway implementation experiences (hospitals). Process and outcome measures included early antibiotic administration, blood culture collection, oxygenation assessment, length of stay, 30-day mortality, and 30-day readmission rates. Analyses were adjusted for severity of illness and hospital-specific practice patterns. Results After the statewide initiative, improvements were noted in antibiotic administration within 8 hours of hospital arrival (improvement from 83.4% to 88.8%, relative risk [RR] = 1.21; 95% confidence interval [CI]: 1.10 to 1.32), oxygenation assessment within 24 hours of hospital arrival (93.6% to 95.4%; RR=1.23, 95% CI: 1.11 to 1.38), and length of stay (7 days to 5 days, P Conclusions Statewide improvements were demonstrated in the care of hospitalized pneumonia patients concurrent with a multifaceted quality improvement intervention. Further research is needed to separate the effects of the quality improvement interventions from secular trends.

  • correlation of the agency for health care policy and research congestive heart failure admission guideline with mortality Peer Review Organization voluntary hospital association initiative to decrease events provide for congestive heart failure
    Annals of Emergency Medicine, 1999
    Co-Authors: Louis Graff, Yun Wang, Marcia K Petrillo, Jeff Orledge, Martha J Radford, Rachel Maag
    Abstract:

    Study objective: We quantify patient risk as related to the presence or absence of the Agency for Health Care Policy and Research (AHCPR) congestive heart failure (CHF) hospital admission criteria. Methods: This was a retrospective observational cohort study at 12 acute care hospitals examining consecutive patients with the final primary diagnosis of CHF. Trained record abstractors blinded to outcome extracted 386 data elements, including 6 AHCPR admission criteria: (1) pulmonary edema (determined by radiograph) or severe respiratory distress (respiration>40 breaths/min), (2) hypoxia (oxygen saturation Results: Of the 1,674 patients with CHF, 1,340 (80%) were admitted to the hospital. Patients not admitted had a lower mortality rate than admitted patients (30-day mortality rate, 2.1% [95% confidence interval [Cl] 0.6 to 3.6] versus 11.5% [95% Cl 9.8 to 13.2]; odds ratio 0.20 [95% Cl 0.09 to 0.45]). Two of the admission criteria did not correlate with a higher mortality rate: CHF of recent onset and myocardial ischemia. Excluding those 2 criteria, the number of admission criteria present correlated with the patient's probability of hospital admission ( P P =.014), and 30-day mortality rate ( P Conclusion: Selected criteria of the AHCPR CHF admission guideline correlate with mortality rate. Combined with physician clinical judgment, they may be useful in the risk stratification of patients with CHF. Selected low-risk patients with CHF identified by the admission criteria who are presently managed in the acute care hospital may be candidates for outpatient management.

Louis Graff - One of the best experts on this subject based on the ideXlab platform.

  • correlation of the agency for health care policy and research congestive heart failure admission guideline with mortality Peer Review Organization voluntary hospital association initiative to decrease events provide for congestive heart failure
    Annals of Emergency Medicine, 1999
    Co-Authors: Louis Graff, Yun Wang, Marcia K Petrillo, Jeff Orledge, Martha J Radford, Rachel Maag
    Abstract:

    Study objective: We quantify patient risk as related to the presence or absence of the Agency for Health Care Policy and Research (AHCPR) congestive heart failure (CHF) hospital admission criteria. Methods: This was a retrospective observational cohort study at 12 acute care hospitals examining consecutive patients with the final primary diagnosis of CHF. Trained record abstractors blinded to outcome extracted 386 data elements, including 6 AHCPR admission criteria: (1) pulmonary edema (determined by radiograph) or severe respiratory distress (respiration>40 breaths/min), (2) hypoxia (oxygen saturation Results: Of the 1,674 patients with CHF, 1,340 (80%) were admitted to the hospital. Patients not admitted had a lower mortality rate than admitted patients (30-day mortality rate, 2.1% [95% confidence interval [Cl] 0.6 to 3.6] versus 11.5% [95% Cl 9.8 to 13.2]; odds ratio 0.20 [95% Cl 0.09 to 0.45]). Two of the admission criteria did not correlate with a higher mortality rate: CHF of recent onset and myocardial ischemia. Excluding those 2 criteria, the number of admission criteria present correlated with the patient's probability of hospital admission ( P P =.014), and 30-day mortality rate ( P Conclusion: Selected criteria of the AHCPR CHF admission guideline correlate with mortality rate. Combined with physician clinical judgment, they may be useful in the risk stratification of patients with CHF. Selected low-risk patients with CHF identified by the admission criteria who are presently managed in the acute care hospital may be candidates for outpatient management.

Cynthia Weinmann - One of the best experts on this subject based on the ideXlab platform.

  • quality improvement in health care a brief history of the medicare Peer Review Organization pro initiative
    Evaluation & the Health Professions, 1998
    Co-Authors: Cynthia Weinmann
    Abstract:

    The Medicare Peer Review Organization (PRO) program began in the mid 1980s in response to concerns with medical necessity and quality of care of services delivered to the elderly and disabled, and paid for by the federal Medicare program. As part of their legislated oversight, PROs Reviewed a random sample of hospital medical records. Using locally developed and maintained clinical criteria, PRO nurse and physician Reviewers made determinations about the medical necessity of the inpatient stay and services, and identified issues with the quality of care delivered. Within 10 years of its initiation, however, criticisms of the PRO program, based in the reliability and validity of Review findings, combined with national interest in quality improvement, led HCFA to refocus the program. PROs currently emphasize clinical and process quality improvement, through collaborative working relationships with providers and consumers.