ELIZABETH HOWE BRADLEY

..To describe the Hospital Elder Life Program (HELP) across dissemination sites, to detail adaptations, and to summarize advantages across sites...

..This study sought to determine the range and prevalence of practices being implemented by hospitals to reduce 30-day readmissions of patients with heart failure or acute myocardial infarction (AMI)...

..Accordingly, we sought to examine the variation in impact of a health systems strengthening intervention and understand factors that might explain the variation in impact across primary health care units...

..S. hospitals vary 2-fold in their 30-day risk-standardized mortality rates (RSMRs). Nevertheless, information is limited on hospital-level factors that may be associated with RSMRs...

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..Health Services Research, vol. 37, pp. 1221-1242, 2002)...

..Finally, the approach is flexible, as competency areas can be added and removed to be responsive to new research evidence and the changing needs of the field...

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..CONCLUSION: Our findings demonstrate key elements for scaling up and replicating educational initiatives that address management skills essential for long-term health systems strengthening in resource-poor settings...

..To assess the prevalence of advance directives among nursing home residents before and after passage of the Patient Self-Determination Act (PSDA) and to identify factors associated with advance directive completion...

..Although such collaborative efforts are increasingly used to promote improvement, little is known about the types of health care organizations that enroll and their motivations to participate...

..This study examined common challenges faced by hospitals implementing the Hospital Elder Life Program (HELP) and strategies used to address these challenges...

..This is the first study the authors know of that examines the association between hospice enrollment length and subsequent major depressive disorder among surviving caregivers...

..This study presents data on (1) the prevalence of evidence-based strategies in U.S. hospitals that participated in the D2B Alliance and (2) identifies key hospital characteristics associated with their use...

..The effective translation of scientific evidence into clinical practice is paramount to improving the quality and safety of patient care. However, little is known about the patterns of diffusion of evidence-based programmes in healthcare...

..Our findings can be used by hospital management teams as they identify ways to influence and benefit from efforts to improve clinical quality, safety, and the experiences of older adults treated in their hospitals...

..To examine key factors that influence sustainability in the diffusion of the Hospital Elder Life Program (HELP) as an example of an evidence-based, multifaceted, innovative program to improve care for hospitalized older adults...

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..The authors assessed the influences of self-rated knowledge and attitudes on physicians' discussions and referrals for hospice care...

..CONCLUSION: The identification and examination of health care organizations that demonstrate positive deviance provides an opportunity to characterize and disseminate strategies for improving quality...

..5%) and improving social and family relationships (53.0%). The process of establishing and meeting such goals should be explicitly included in the design of future evaluations of outpatient geriatric assessment...

..By reinforcing their current involvement or by identifying potential gaps in their involvement in quality improvement efforts, practitioners may enhance their effectiveness in promoting and sustaining quality in clinical care...

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..We sought to determine the impact of a systems-based approach to improving rural care, the Ethiopian Millennium Rural Initiative, on key healthcare services indicators...

..To examine variations in health service expenditures and social services expenditures across Organisation for Economic Co-operation and Development (OECD) countries and assess their association with five population-level health outcomes...

..The nature of the goal-setting process suggests that explicit discussion of goals for care may be necessary to promote effective patient-family-clinician communication and adequate care planning...

..05) associated with 30-day RSMRs. In conclusion, substantial variation in hospital outcomes for patients with AMI remains unexplained by measurements of hospital characteristics including SES patient profile...

..To describe characteristics, attitudes, and communications of nurses regarding hospice and caring for terminally ill patients...

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..Clinicians should consider factors such as these when targeting caregivers for interventions to alleviate burden...

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..Collaboration with religious support groups or community groups during bereavement could offer an effective mechanism for speeding the process of recovery for some caregivers...

..A taxonomy of the characteristics of the physician quality leader from the perspective of physicians and nonphysicians was developed...

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..Several hospital characteristics were associated with this improvement, but they are weak predictors of hospital-based improvement in the use of beta-blockers...

..The wait time to see a physician in US emergency departments (EDs) is increasing and may differentially affect patients with varied insurance status and racial/ethnic backgrounds...

..Multiple measures that reflect a variety of processes and also outcomes, such as risk-standardized mortality rates, are needed to more fully characterize hospital performance...

..CONCLUSIONS: This study identifies a potential target group of family caregivers, characterized by hospice length of enrollment and several caregiver features, who might be most in need of mental health interventions...

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..Future studies are needed to isolate hospital quality improvement efforts that are associated with superior performance...

..To examine experiences of older persons and their clinicians with shared decision making (SDM) and their willingness to use an SDM instrument...

..We examined family caregiver reports of physician communication about incurable illness, life expectancy, and hospice; the timing of these discussions; and subsequent family understanding of these issues...

..Although many studies have documented problems in communication between physicians and patients, few have focused on discussions regarding prognosis among community dwelling patients with terminal illness...

..This pilot demonstrates that clinical registries may be a cost-effective investment in data infrastructure to support quality improvement in low- and middle-income countries...

..7, 95% CI 3.1, 10.6). This effect persisted after adjusting for patient age, gender, marital status, documented discussions of prognosis, prior hospice use, and type of cancer...

..Therefore, the traditional models of health services use may need to be expanded in order to explain patterns of use among nonwhite populations...

..Despite the many proposed methods for improving quality, little is known about which methods are being applied in practice across the United States or their perceived effectiveness...

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..87, respectively; p for trend <0.001). In conclusion, timely administration of fibrinolytic therapy continues to significantly impact on mortality in the modern era, particularly in patients presenting early after symptom onset...

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..The impact of quality campaigns also depends on contextual factors, including the nature of the innovation itself, external environmental incentives, and features of adopting organizations...

..By distilling the complex and diverse experiences of organizational change into its essential components, this study provides a foundation for future efforts to elevate clinical performance in the hospital setting...

..As the industry develops a substantial for-profit presence, it is critical for clinicians and other healthcare professionals to be alert to the potential impact of profit status on the care their patients receive...

..The objective of this study was to assess whether recurrent involuntary job loss among US workers nearing retirement resulted in increasingly less severe changes in depressive symptoms with successive job losses...

..In case reports, transfers in the care of patients among health care providers have been linked to adverse events. However, little is known about the nature and frequency of these transfer-related problems...

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..However, little work has been done to elicit from patients themselves the aspects of treatment decision-making most important to them when making end-of-life treatment decisions...

..Previous studies have not examined hospital-level performance on ED wait time and visit length in the United States. The purpose of this study is to describe hospital-level performance on ED wait time and visit length...

..Hospices are now mandated to perform routine quality assessment under the final Medicare Hospice Conditions of Participation, creating an opportunity to explore standardized approaches to monitoring hospice quality...

..However, there have been limited data on the costs and cost effectiveness of such programs...

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..To examine the association between physician race/ ethnicity, workplace discrimination, and physician job turnover...

..Understanding how top-performing hospitals recognize and respond to setbacks can help senior management promote organizational resiliency, leading to an environment in which learning, growth, and quality improvement can be sustained...

..This study examines expert opinion regarding what constitutes informed consent...

..Although the uninsured comprise a range of income levels, little attention has been directed at higher-income uninsured adults and their patterns of care...

..To determine predictors of recommendation adherence and goal attainment of family caregivers of patients at a geriatric assessment center...

..National quality campaigns often sponsor online communities; however, little is known about whether and how organisations use these communities, and the impact of their use...

..To examine the adequacy of caregiver-patient communication in serious illness and its relationship to caregiver burden...

..The purpose of this study was to develop a patient-centered measure of treatment preference applicable across a range of diseases and treatment decisions...

..Honoring patients' treatment preferences is a key component of high-quality end-of-life care...

..Mortality rates for patients with acute myocardial infarction (AMI) vary substantially across hospitals, even when adjusted for patient severity; however, little is known about hospital factors that may influence this variation...

..The purpose of this study was to investigate the association between involuntary job loss among workers nearing retirement and long-term changes in depressive symptoms...

..The aim of this study was to develop and to assess the validity and reliability of two brief questionnaires for assessing patient experiences with hospital and outpatient care in a low-income setting...

..To examine agreement between patients, caregivers, and clinicians regarding prognosis communication and to examine patients' and caregivers' desire for prognostic information...

..Although studies have examined how well surrogates agree with patients' preferences for specific treatment interventions, agreement regarding the valuation of health states as treatment outcomes is unknown...

..The questions patients are asked about their preferences with regard to life-sustaining treatment usually focus on specific interventions, but the outcomes of treatment and their likelihood affect patients' preferences...

..These are grouped under the following actions: 1) enhance public education; 2) offer better professional provider education and support; and 3) augment services. The recommendations are illustrated with quotations from the focus groups...

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..This study sought to identify and classify the range of work-related ethical conflicts experienced by medical house officers...

..The objective of this study was to estimate the risk of myocardial infarction (MI) and stroke associated with involuntary job loss among workers nearing retirement in the United States...

..However, the factors associated with death in an inpatient hospice have not been examined in previous studies...

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..Examine the association between poverty and preventive care use among older working adults...

..However, insight into the professional experiences of minority physicians is limited. This knowledge is fundamental to developing effective strategies to recruit, retain, and support a diverse physician workforce...

..Recent developments in the methodology and standards for outcomes measurement have laid the groundwork for incorporating outcomes into performance monitoring efforts for these conditions...

..We examine the implications of these findings for the millions of vulnerable Americans who rely on safety-net hospitals for their care...

..Little is known about current attitudes and practices among residents and nurses regarding error reporting. A survey was conducted to suggest differing needs for training and other interventions to enhance reporting...

..To understand potential patient barriers to discussions about implantable cardioverter defibrillator (ICD) deactivation in patients with advanced illness...

..The partnership-mentoring model promotes sustainability and may provide other countries with approaches for improving the quality of hospital care through improved hospital management...

..Targeted outreach and provider education are needed to ensure individuals with intellectual disability receive appropriate counseling and testing...

..We investigated physician perspectives on how patients' SES influences care...

..To enhance participation, we sought to understand how older adults consider and discuss their life and health goals during the clinical encounter...

..To examine changes in patients' and caregivers' understanding of prognosis with progression of the patient's illness...

..Relevance in lay language: We will generate knowledge about the influence of for-profit hospice ownership on the experiences of patients with cancer and their families. ..

..Relevance in lay language: We will generate knowledge about the influence of for-profit hospice ownership on the experiences of patients with cancer and their families. ..

..We will work on dissemination strategies with CMS, JCAHO, American College of Cardiology (ACC), American Health Association (AHA), the Veteran's Administration (VA), and the VHA. ..

..We will work on dissemination strategies with CMS, JCAHO, American College of Cardiology (ACC), American Health Association (AHA), the Veteran's Administration (VA), and the VHA. ..

..We will work on dissemination strategies with CMS, JCAHO, American College of Cardiology (ACC), American Health Association (AHA), the Veteran's Administration (VA), and the VHA. ..