Mayo Clinic - AuthorCitation

Correction for Evans et al., “Informing Antibiotic Treatment Decisions: Evaluating Rapid Molecular Diagnostics To Identify Susceptibility and Resistance to Carbapenems against Acinetobacter spp. in PRIMERS III”

Hujer, Andrea M. , Jiang, Hongyu , Hill, Carol , Hujer, Kristine M., Mediavilla, José R. , Tran, Thuy Tien T., Higgins, Paul G. , Kreiswirth, Barry N. , Patel, Robin , Chen, Liang , Sampath, Rangarajan , Marzan, Christine, Fowler, Vance G. , Chambers, Henry F. , Evans, Scott , Manca, Claudia , Domitrovic, Tatiana , Seifert, Harald , Kreiswirth, Barry N , Jacobs, Michael R. , Chen, Liang , Hall, Thomas A. , Fowler, Vance G. , Bonomo, Robert A. , Patel, Robin , Evans, Scott R

Journal of Clinical Microbiology | May 23, 2017 | Volume: 55 | Issue: 6 | Pages: 1970-1970

A multidisciplinary approach to reducing alarm fatigue and cost through appropriate use of cardiac telemetry

Alsaad, Ali A. , Alman, Carly R, Thompson, Kristine M., Monteau, Rebecca E. , Park, Shin H, Maniaci, Michael J. , Park, Shin Ho

Postgraduate Medical Journal | April 29, 2017 | Volume: 93 | Issue: 1101 | Pages: 430-435

10.1136/postgradmedj-2016-134764 | PMID 28455284

ABSTRACTBackgroundAlarm fatigue (AF) is a distressing factor for staff and patients in the hospital. Using cardiac telemetry (CT) without clinical indications can create unnecessary alarms, and increase AF and cost of healthcare. We sought to reduce AF and cost associated with CT monitoring.MethodsAfter implementing a new protocol for CT placement, data were collected on telemetry orders, alarms and bed cost for 13 weeks from 1 January 2015 through 31 March 2015. We also retrospectively collected data on the same variables for the 13 weeks prior to the intervention. A survey was administered to nurses to assess past and present perceptions of AF. Interventions included protocol creation and education for participants.ResultsAt baseline, 77% of patients were monitored with CT. A total of 145 (31%) order discrepancies were discovered during data collection, of which 72% had no indication for CT, so CT was discontinued. The other 28% had indications, so orders were placed. A total of 8336 alarms were recorded during 4 weeks of data collection, of which 333 (4%) were classified as true actionable alarms. Postintervention data showed 67% CT assignment with 10% reduction in CT usage, with no increase in mortality (p<0.001 and >0.05, respectively). A 42% cost reduction was achieved after adjusting the patient status. Nurses reported 27% perceived reduction in AF. One-year follow-up revealed that 69% of patients were being monitored by CT, and the rate of order discrepancies due to lack of indication was 9%.ConclusionAll hospital units may benefit from the protocols created during this study. If applied appropriately, these protocols can lead to reduced AF and cost per episode of care.

Development of a Research Agenda to Identify Evidence-Based Strategies to Improve Physician Wellness and Reduce Burnout

Trockel, Mickey , Frank, Erica , Olson, Kristine , Lemaire, Jane B , Swensen, Stephen , Sinsky, Christine A. , Dyrbye, Liselotte N. , Linzer, Mark , Lemaire, Jane, Shanafelt, Tait D.

Annals of Internal Medicine | April 18, 2017 | Volume: 166 | Issue: 10 | Pages: 743-744

10.7326/m16-2956 | PMID 28418518

Hogen, Kristine L., Tindall, D. J., Young, Charles Y.F.

The Japanese Journal of Urology | April 6, 2017 | Volume: 86 | Issue: 3 | Pages: 427

10.5980/jpnjurol.86.427_2

Antigen presenting cell based immunotherapy targeting HER2/Neu positive solid tumors: Results of a phase 1 study of APC8024

Peethambaram, Prema P. , Rinn, Kristine , Jones, Lori , Alberts, Steven R.

Journal of Clinical Oncology | April 5, 2017 | Volume: 22 | Issue: 14_suppl | Pages: 2528-2528

10.1200/jco.2004.22.90140.2528

Looking Under the Streetlight? A Framework for Differentiating Performance Measures by Level of Care in a Value-Based Payment Environment

Naessens, James M. , Such, Monica B. Van, Nesse, Robert E., Dilling, James A., Swensen, Stephen J., Thompson, Kristine M., Orlowski, Janis M., Santrach, Paula J., Such, Monica Van

Academic Medicine | March 28, 2017 | Volume: 92 | Issue: 7 | Pages: 943-950

10.1097/acm.0000000000001654 | PMID 28353502

The majority of quality measures used to assess providers and hospitals are based on easily obtained data, focused on a few dimensions of quality, and developed mainly for primary/community care and population health. While this approach supports efforts focused on addressing the triple aim of health care, many current quality report cards and assessments do not reflect the breadth or complexity of many referral center practices. In this article, the authors highlight the differences between population health efforts and referral care and address issues related to value measurement and performance assessment. They discuss why measures may need to differ across the three levels of care (primary/community care, secondary care, complex care) and illustrate the need for further risk adjustment to eliminate referral bias. With continued movement toward value-based purchasing, performance measures and reimbursement schemes need to reflect the increased level of intensity required to provide complex care. The authors propose a framework to operationalize value measurement and payment for specialty care, and they make specific recommendations to improve performance measurement for complex patients. Implementing such a framework to differentiate performance measures by level of care involves coordinated efforts to change both policy and operational platforms. An essential component of this framework is a new model that defines the characteristics of patients who require complex care and standardizes metrics that incorporate those definitions.

Use of High-Fidelity Simulation to Enhance Interdisciplinary Collaboration and Reduce Patient Falls

Bursiek, April A., Hopkins, Matthew R. , Breitkopf, Daniel M. , Grubbs, Pamela L., Joswiak, M. Ellen , Klipfel, Janee M., Johnson, Kristine M.

Journal of Patient Safety | March 8, 2017 | Volume: 16 | Issue: 3 | Pages: 245-250

10.1097/pts.0000000000000277 | PMID 28272294

Objectives This pilot study aimed to determine the effect of nurse/physician interdisciplinary team training on patient falls. Specifically, we evaluated team training in a simulation center as a method for targeting and minimizing breakdowns in perceptions of respect, collaboration, communication, and role misunderstanding behaviors between care disciplines. Methods Registered nurses (RNs) were randomly assigned to participate. Residents were divided into groups and assigned based on their availability and clinical responsibility. All participants completed a demographic form, the Professional Practice Environment Assessment Scale (PPEAS), and the Mayo High Performance Teamwork Scale (MHPTS) after consenting and before participation in simulation training. The PPEAS and the MHPTS were readministered at 2 and 6 months after the simulation experience. Differences in MHPTS and PPEAS scores between the baseline and 2- and 6-month assessments were analyzed; fall rates over time were evaluated using Cochran-Armitage trend tests. Results After the team training exercises, teamwork as measured by the MHPTS improved significantly at both 2 and 6 months (P = 0.01; P < 0.001) compared with baseline measurement. Practice environment subscores, with the exception of positive organizational characteristics, also increased when measured 6 months after training. The primary outcome, reduction in anticipated patient falls, improved significantly (P = 0.02) over the course of the study. Conclusions Results of this pilot study show that team training exercises result in improvement in both patient safety (anticipated patient falls) and team member perception of their work environment. If validated by other studies, improvement in this patient safety metric would represent an important benefit of simulation and team training.

S0221: Comparison of two schedules of paclitaxel as adjuvant therapy for breast cancer.

Budd, G. Thomas, Hobday, Timothy J. , Stewart, James A. , Salim, Muhammad , Cho, Jonathan K., Rinn, Kristine , Albain, Kathy S. , Chew, Helen K. , Burton, Gary V., Moore, Timothy D., Srkalović, Gordan , Flaherty, Lawrence E. , Livingston, Robert B., Lew, Danika L., Barlow, William E. , Moore, Halle C. F. , Isaacs, Claudine , Salim, Muhammad, McGregor, Bradley A. , Gralow, Julie R. , Hortobágyi, Gabriel N.

Journal of Clinical Oncology | February 24, 2017 | Volume: 31 | Issue: 18_suppl | Pages: CRA1008-CRA1008

10.1200/jco.2013.31.18_suppl.cra1008

CRA1008 Background: S0221 is a SWOG-coordinated phase III adjuvant chemotherapy intergroup trial in node-positive and high-risk node-negative operable breast cancer which hypothesized that 1) the weekly AC+G regimen is superior to ddAC x 6 and 2) 12 weeks of weekly paclitaxel (wP) is superior to q 2 week paclitaxel x 6 (ddP). Methods: Between December 2003 and November 2010, 2,716 patients were randomized in a 2 x 2 factorial design to 1) AC+G vs ddAC and 2) P 80 mg/m2/week x 12 vs P 175 mg/m2 q 2 weeks x 6. If there was no significant interaction between the factors, the trial was powered to find a disease-free survival hazard ratio (HR) ≤ 0.82 for weekly vs q 2 week for each factor. At the first interim analysis, the AC randomization was halted for futility, and S0221 was closed to accrual 10 November 2010. S0221 reopened 15 December 2010, after which time all patients received 4 cycles of ddAC and randomization to P weekly x 12 and ddP x 6 continued. Accrual halted at a total of 3,294 in January 2012. Results: By September 7, 2012, 487 events and 340 deaths had occurred, prompting the third planned interim analysis. The Data Safety and Monitoring Committee recommended reporting the results since the futility boundary was crossed. A Cox model adjusting for the AC arms had a HR = 1.08 (95% CI 0.90-1.28; p=0.42), with the 99.5% CI excluding the original alternative hypothesis that the HR=0.82. There was no significant interaction of the two factors. Estimated 5-year progression-free survivals were 82% for weekly P and 81% for ddP. Toxicity data were available for 1,385 patients treated with ddP and 1,367 treated with weekly P. Grade 5 toxicity occurred in 4 patients on ddP and 2 on weekly P. Percent grade 3-4 toxicity per arm are shown in the Table. Conclusions: Either ddPx6 or weekly P x 12 are acceptable schedules of P administration. The differences in leukopenia likely reflect ascertainment bias against weekly P. If this is accepted, weekly P x 12 produces less overall toxicity than 6 cycles of ddP. Support: NCI grants CA32102, CA38926, CA21115, CA21076, CA77597, CA25224, CA77202, CCSRI15469, and Amgen, Inc. Clinical trial information: NCT00070564. [Table: see text]

ASHP Guidelines on Preventing Diversion of Controlled Substances

Brummond, Philip, Chen, David F., Churchill, William, Clark, John Spencer , Dillon, Kevin R., Dumitru, Doina , Eschenbacher, Lynn, Fera, Toni, Fortier, Christopher R., Gullickson, Kristine K., Jurakovich, Kristen, Kent, Stan, Keonavong, Jennifer, Marchese, Christine, Meyer, Tricia A. , Murdaugh, Lee B., Ogden, Richard, O’Neal, Brian, Rough, Steve, Smith, Jacob S., Chen, David F., Saenz, Rafael

American Journal of Health-System Pharmacy | February 17, 2017 | Volume: 74 | Issue: 5 | Pages: 325-348

10.2146/ajhp160919 | PMID 28052859

Choosing Ceftazidime/Avibactam and Ceftolozane/Tazobactam as Empiric Therapies against Pseudomonas aeruginosa (Pa) using Rapid Molecular Diagnostics (RMDs): PRIMERS IV

Tran, Thuy Tien T., Hujer, Andrea M. , Hill, Carol , Hujer, Kristine M., Mediavilla, José R. , Kreiswirth, Barry N , Pérez, Federico , Sampath, Rangarajan , Marzan, Christine, Fowler, Vance G. , Chambers, Henry F. , Evans, Scott , Manca, Claudia , Domitrovic, Tatiana , Patel, Robin , Jacobs, Michael R. , Chen, Liang , Hall, Thomas, Fowler, Vance G. , Bonomo, Robert A.

Open Forum Infectious Diseases | February 1, 2017 | Volume: 3 | Issue: suppl_1 | Pages: No page available

10.1093/ofid/ofw172.1598

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