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McOwen H, Wasserheit JN, Rabinowitz P. US Academic and NGO Engagement in Pandemic Preparedness and Response. Health Secur 2024; 22:167-171. [PMID: 38394310 DOI: 10.1089/hs.2023.0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Affiliation(s)
- Helene McOwen
- Helene L. McOwen, MPH, is a Research Coordinator, Division of Allergy and Infectious Diseases; at the University of Washington, Seattle, WA
| | - Judith N Wasserheit
- Judith N. Wasserheit, MD, MPH, is a Professor, Departments of Global Health, Medicine and Epidemiology; at the University of Washington, Seattle, WA
- Judith N. Wasserheit is Co-Directors, UW Alliance for Pandemic Preparedness, University of Washington, Seattle, WA
| | - Peter Rabinowitz
- Peter M. Rabinowitz, MD, MPH, is a Professor, Departments of Environmental and Occupational Health Sciences, Family Medicine, and Global Health, and Director, University of Washington Center for One Health Research; at the University of Washington, Seattle, WA
- Peter M. Rabinowitz is Co-Directors, UW Alliance for Pandemic Preparedness, University of Washington, Seattle, WA
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Ramirez JL, Matthay ZA, Lancaster E, Smith EJT, Gasper WJ, Zarkowsky DS, Doyle AJ, Patel VI, Schanzer A, Conte MS, Iannuzzi JC. Decreasing prevalence of centers meeting the Society for Vascular Surgery abdominal aortic aneurysm guidelines in the United States. J Vasc Surg 2024; 79:240-249. [PMID: 37774990 DOI: 10.1016/j.jvs.2023.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/14/2023] [Accepted: 09/03/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVE Based on data supporting a volume-outcome relationship in elective aortic aneurysm repair, the Society of Vascular Surgery (SVS) guidelines recommend that endovascular aortic repair (EVAR) be localized to centers that perform ≥10 operations annually and have a perioperative mortality and conversion-to-open rate of ≤2% and that open aortic repair (OAR) be localized to centers that perform ≥10 open aortic operations annually and have a perioperative mortality ≤5%. However, the number and distribution of centers meeting the SVS criteria remains unclear. This study aimed to estimate the temporal trends and geographic distribution of Centers Meeting the SVS Aortic Guidelines (CMAG) in the United States. METHODS The SVS Vascular Quality Initiative was queried for all OAR, aortic bypasses, and EVAR from 2011 to 2019. Annual OAR and EVAR volume, 30-day elective operative mortality for OAR or EVAR, and EVAR conversion-to-open rate for all centers were calculated. The SVS guidelines for OAR and EVAR, individually and combined, were applied to each institution leading to a CMAG designation. The proportion of CMAGs by region (West, Midwest, South, and Northeast) were compared by year using a χ2 test. Temporal trends were estimated using a multivariable logistic regression for CMAG, adjusting by region. RESULTS Overall, 67,865 patients (49,264 EVAR; 11,010 OAR; 7591 aortic bypasses) at 336 institutions were examined. The proportion of EVAR CMAGs increased nationally by 1.7% annually from 51.6% (n = 33/64) in 2011 to 67.1% (n = 190/283) in 2019 (β = .05; 95% confidence interval [CI], 0.01-0.09; P = .02). The proportion of EVAR CMAGs across regions ranged from 27.3% to 66.7% in 2011 to 63.9% to 72.9% in 2019. In contrast, the proportion of OAR CMAGs has decreased nationally by 1.8% annually from 32.8% (n = 21/64) in 2011 to 16.3% (n = 46/283) in 2019 (β = -.14; 95% CI, -0.19 to -0.10; P < .01). Combined EVAR and OAR CMAGs were even less frequent and decreased by 1.5% annually from 26.6% (n = 17/64) in 2011 to 13.1% (n = 37/283) in 2019 (β = -.12; 95% CI, -0.17 to -0.07; P < .01). In 2019, there was no significant difference in regional variation of the proportion of combined EVAR and OAR CMAGs (P = .82). CONCLUSIONS Although an increasing proportion of institutions nationally meet the SVS guidelines for EVAR, a smaller proportion meet them for OAR, with a concerning downward trend. These data question whether we can safely offer OAR at most institutions, have important implications about sufficient OAR exposure for trainees, and support regionalization of OAR.
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Affiliation(s)
- Joel L Ramirez
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA; Chan Zuckerberg Biohub, San Francisco, CA
| | - Zachary A Matthay
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA
| | - Elizabeth Lancaster
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA
| | - Eric J T Smith
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA
| | - Warren J Gasper
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA
| | - Devin S Zarkowsky
- Division of Vascular Surgery, Department of Surgery, Scripps Clinic, La Jolla, CA
| | - Adam J Doyle
- Division of Vascular Surgery, Department of Surgery, University of Rochester Medical Center, Rochester, NY
| | - Virendra I Patel
- Division of Vascular Surgery, Department of Surgery, Columbia University Irving Medical Center, New York, NY
| | - Andres Schanzer
- UMassMemorial Center for Complex Aortic Disease, University of Massachusetts Medical School, Worcester, MA
| | - Michael S Conte
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA
| | - James C Iannuzzi
- Division of Vascular and Endovascular Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA.
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Sandhu RK, Seiler A, Johnson CJ, Bunch TJ, Deering TF, Deneke T, Kirchhof P, Natale A, Piccini JP, Russo AM, Hills MT, Varosy PD, Araia A, Smith AM, Freeman J. Heart Rhythm Society Atrial Fibrillation Centers of Excellence Study: A survey analysis of stakeholder practices, needs, and barriers. Heart Rhythm 2022; 19:1039-1048. [PMID: 35428582 DOI: 10.1016/j.hrthm.2022.02.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/31/2022] [Accepted: 02/17/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND An integrated, coordinated, and patient-centered approach to atrial fibrillation (AF) care delivery may improve outcomes and reduce cost. OBJECTIVE The purpose of this study was to gain a better understanding from key stakeholder groups on current practices, needs, and potential barriers to implementing optimal integrated AF care. METHODS A series of comprehensive questionnaires were designed by the Heart Rhythm Society Atrial Fibrillation Centers of Excellence (CoE) Task Force to conduct surveys with physicians, advanced practice professionals, patients, and hospital administrators. Data collected focused on the following areas: access to care, stroke prevention, education, AF quality improvement, and AF CoE needs and barriers. Survey responses were collated and analyzed by the Task Force. RESULTS The surveys identified 5 major unmet needs: (1) Standardized protocols, order sets, or care pathways in the emergency department or inpatient setting were uncommon (36%-42%). (2) All stakeholders agreed stroke prevention was a top priority; however, prior bleeding or risk of bleeding was the most frequent barrier for initiation. (3) Patients indicated that education on modifiable causes, AF-related complications, and lowering stroke risk is most important. (4) Less than half (43%) of the health care systems track patients with AF or treatment status. Patients reported that stroke and heart failure prevention and access to procedures were priority areas for an AF CoE. The most common barriers to implementing AF CoE identified by clinicians were administrative support (69%) and cost (52%); administrators reported physical space (43%). CONCLUSION On the basis of the findings of this study, the Task Force identified high priority areas to develop initiatives to aid the implementation of AF CoE.
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Affiliation(s)
- Roopinder K Sandhu
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
| | | | - Colleen J Johnson
- Southeast Louisiana Veterans Healthcare System, Tulane University, New Orleans, Louisiana
| | - T Jared Bunch
- University of Utah School of Medicine, Salt Lake City, Utah
| | | | | | - Paulus Kirchhof
- University Heart and Vascular Center UKE Hamburg, Hamburg, Germany
| | | | | | - Andrea M Russo
- Cooper Medical School at Rowan University, Camden, New Jersey
| | | | - Paul D Varosy
- VA Eastern Colorado Health Care Systems, Aurora, Colorado; University of Colorado, Aurora, Colorado
| | - Almaz Araia
- Heart Rhythm Society, Washington, District of Columbia
| | | | - James Freeman
- Yale University School of Medicine, New Haven, Connecticut
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Yamamoto-Furusho JK, Andrade D, Barahona J, Bautista S, Bosques-Padilla F, de Paula J, Galiano MT, Iade B, Juliao-Baños F, Otoya G, Steinwurz F, Torres E, Veitia G, Barreiro-de Acosta M. Latin American consensus on the quality indicators for comprehensive care clinics for patients with inflammatory bowel disease: PANCCO-GETECCU. Rev Gastroenterol Mex (Engl Ed) 2022; 87:89-102. [PMID: 34866040 DOI: 10.1016/j.rgmxen.2021.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 05/18/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Inflammatory bowel disease (IBD) is a chronic and incurable entity. The aim of the Pan American Crohn's and Colitis Organisation (PANCCO) is to create awareness of IBD, with special emphasis on Latin America, and the primary objective of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis (GETECCU, the Spanish acronym) is to obtain the accreditation of the clinical and therapeutic criteria for the diagnosis and treatment of IBD. AIM To carry out a consensus for evaluating the approval criteria that a Comprehensive Care Clinic for Latin American IBD patients must meet, to be considered a center of excellence. MATERIALS AND METHODS Fourteen clinical experts participated in the consensus. They were made up of specialists in gastroenterology, with broad clinical experience, spanning several years, in managing the care of a large number of patients with IBD, as well as advanced specialists in IBD. Thirteen of the participants came from 11 Latin American countries (Argentina, Brazil, Colombia, Dominican Republic, Ecuador, Guatemala, Mexico, Peru, Puerto Rico, Uruguay, and Venezuela) that have IBD clinics. An expert from Spain, representing the GETECCU, provided the methodologic support. The consensus consisted of 52 statements divided into three sections: 1) Structure indicators, 2) Process indicators, and 3) Result indicators. The Delphi panel method was applied. RESULTS The present Latin American consensus describes the quality indicators that a Comprehensive Care Clinic for IBD patients must meet, to be considered a center of excellence, taking into account the needs of our region. CONCLUSIONS This is the first Latin American consensus, jointly carried out by the PANCCO and GETECCU, to present accreditation standards for centers of excellence in the care of patients with IBD.
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Affiliation(s)
- J K Yamamoto-Furusho
- Inflammatory Bowel Disease Clinic, Gastroenterology Department, National Institute of Medical Science and Nutrition Salvador Zubirán, Mexico City, Mexico.
| | - D Andrade
- Servicio de Gastroenterología y Endoscopía Digestiva, Unidad de Intestino Clínica de Enfermedad Inflamatoria Intestinal, Hospital José Carrasco Arteaga, Instituto Ecuatoriano de Seguridad Social, Cuenca, Ecuador
| | - J Barahona
- Enfermedades Digestivas de Guatemala, Ciudad de Guatemala, Guatemala
| | - S Bautista
- CEDIMAT Gastroenterology Center, Santo Domingo, Dominican Republic
| | - F Bosques-Padilla
- Department of Gastroenterology, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, Mexico
| | - J de Paula
- Gastroenterology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - B Iade
- Unidad de Enfermedad Inflamatoria Intestinal, Hospital Maciel ASSE, CASMU y COSEM, Montevideo, Uruguay
| | - F Juliao-Baños
- Inflammatory Bowel Disease Clinic, Gastroenterology Unit, Hospital Pablo Tobón Uribe, Medellín, Colombia
| | - G Otoya
- Private Practice, Lima, Peru
| | - F Steinwurz
- Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - E Torres
- University of Puerto Rico, San Juan, Puerto Rico
| | - G Veitia
- Gastroenterology Service, Hospital Vargas de Caracas, Caracas, Venezuela
| | - M Barreiro-de Acosta
- Gastroenterology Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
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Del Forno B, Ascione G, De Bonis M. Advances in Mitral Valve Repair for Degenerative Mitral Regurgitation: Philosophy, Technical Details, and Long-Term Results. Cardiol Clin 2021; 39:175-184. [PMID: 33894931 DOI: 10.1016/j.ccl.2021.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Degenerative mitral valve disease represents the most common cause of mitral regurgitation in industrialized countries. When left untreated, patients with severe degenerative mitral regurgitation show a poor clinical outcome. Conversely, a timely and appropriate correction provides a restored life expectancy and a good quality of life. Therefore, in this scenario, surgical mitral valve repair represents the gold standard of treatment. This review aims to analyze the indications, timing, and contemporary surgical techniques of mitral valve repair for degenerative mitral regurgitation. Moreover, the value of heart team approach and centers of excellence for mitral valve repair are also deeply discussed.
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Affiliation(s)
- Benedetto Del Forno
- Department of Cardiac Surgery, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan 20132, Italy.
| | - Guido Ascione
- Department of Cardiac Surgery, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan 20132, Italy
| | - Michele De Bonis
- Department of Cardiac Surgery, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Via Olgettina 60, Milan 20132, Italy
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Damari B, Kamrava SK, Kazemi-Asl S, Rostamigooran N. Iranian centers of excellence in medical sciences: A qualitative study to analyze the current state and design of a future roadmap. Med J Islam Repub Iran 2021; 34:143. [PMID: 33437739 PMCID: PMC7787043 DOI: 10.34171/mjiri.34.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Indexed: 11/25/2022] Open
Abstract
Background: Due to the law for the fifth development plan and Iran’s 20- year economic perspective, Centers of Excellence (COEs) were expected to upgrade the level of research and education besides improving infrastructures in Iran. This study is aimed to analyze the current state of national centers of excellence and designing a future roadmap.
Methods: In this qualitative study, data was gathered by reviewing relevant national & international literature and upstream documents, interview with experts, and focused group discussions with stakeholders. Finally, a roadmap was prepared for approval.
Results: Lack of common understanding of the COEs definition, lack of clear professional orientation for each center, lack of mandate and commitment in using COEs in the health system and community health promotion, weakness in enticing elites, and unresponsive to basic needs of the country were five major challenges COEs encountered. The consensus prospective vision for centers of excellence was developed based on the establishment and management of special institutions of thought and technology in centers of excellence to advise health policymakers and provide the highest level of the regional and global position.
Conclusion: Despite over a decade of development of medical COEs, their goals have not been reached yet. Enactment of designed roadmap and its subprojects in the Supreme Council of Centers is the primary steps for functional improvement of COEs.
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Affiliation(s)
- Behzad Damari
- Governance and Health Department, Neuroscience Institue, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Kamran Kamrava
- Head and Neck Research Center, Hazrat Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Siamak Kazemi-Asl
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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Swords DS, Skarda DE, Sause WT, Gawlick U, Cannon GM, Lewis MA, Scaife CL, Gygi JA, Tae Kim H. Surgeon-Level Variation in Utilization of Local Staging and Neoadjuvant Therapy for Stage II-III Rectal Adenocarcinoma. J Gastrointest Surg 2019; 23:659-669. [PMID: 30706375 DOI: 10.1007/s11605-019-04107-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 01/04/2019] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Neoadjuvant therapy (NT) is the standard of care for clinical stage II-III rectal adenocarcinoma, but utilization remains suboptimal. We aimed to determine the underlying reasons for omission of local staging and NT. METHODS We conducted a retrospective study of patients with clinical stage II-III or undocumented clinical stage/pathologic stage II-III rectal adenocarcinoma who were treated in 2010-2016 in one of nine Intermountain Healthcare hospitals. The outcomes of omission of local staging and NT were examined with multivariable models. Risk- and reliability-adjusted rates of local staging and NT were calculated for surgeons who treated ≥ 3 patients. Pathologic and long-term outcomes were examined after excluding patients who were not resected or who underwent local excision (N = 11). RESULTS Local staging was omitted in 43/240 (17.9%) patients and NT was omitted in 41/240 (17.1%). The strongest risk factors for local staging and NT omission were upper rectal tumors and surgeons who treated ≤ 3 cases/year. Thirty-six of 41 (87.8%) cases of omitted NT had local staging omitted. Adjusted surgeon-specific local staging rates varied 1.6-fold (56.3-92.4%) and NT rates varied 2.8-fold (34.1-97.1%). Surgeon local staging and NT rates were strongly correlated (r = 0.92). NT was associated with lower rates of positive circumferential radial margins (7.9 vs. 20.0%; P = 0.02), node positivity (33.3 vs. 55.0%; P = 0.01), and local recurrences (7.6 vs. 14.9% at 5 years; P = 0.0176). CONCLUSIONS NT omission should be understood as a consequence of surgeon failure to perform local staging in most cases. Quality improvement efforts should focus on improving utilization of local staging.
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MESH Headings
- Adenocarcinoma/mortality
- Adenocarcinoma/pathology
- Adenocarcinoma/therapy
- Adult
- Aged
- Aged, 80 and over
- Chemoradiotherapy, Adjuvant/standards
- Chemoradiotherapy, Adjuvant/statistics & numerical data
- Female
- Follow-Up Studies
- Healthcare Disparities/statistics & numerical data
- Humans
- Male
- Margins of Excision
- Middle Aged
- Neoadjuvant Therapy/standards
- Neoadjuvant Therapy/statistics & numerical data
- Neoplasm Recurrence, Local/epidemiology
- Neoplasm Recurrence, Local/etiology
- Neoplasm Recurrence, Local/prevention & control
- Neoplasm Staging
- Practice Patterns, Physicians'/standards
- Practice Patterns, Physicians'/statistics & numerical data
- Procedures and Techniques Utilization/standards
- Procedures and Techniques Utilization/statistics & numerical data
- Proctectomy
- Quality Assurance, Health Care
- Quality Indicators, Health Care/statistics & numerical data
- Rectal Neoplasms/mortality
- Rectal Neoplasms/pathology
- Rectal Neoplasms/therapy
- Reproducibility of Results
- Retrospective Studies
- Surgeons/standards
- Surgeons/statistics & numerical data
- Treatment Outcome
- United States/epidemiology
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Affiliation(s)
- Douglas S Swords
- Surgical Services Clinical Program, Intermountain Healthcare, Salt Lake City, UT, USA.
- Department of Surgery, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA.
| | - David E Skarda
- Surgical Services Clinical Program, Intermountain Healthcare, Salt Lake City, UT, USA
- Department of Surgery, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA
| | - William T Sause
- Oncology Services Clinical Program, Intermountain Healthcare, Salt Lake City, UT, USA
| | - Ute Gawlick
- Surgical Services Clinical Program, Intermountain Healthcare, Salt Lake City, UT, USA
| | - George M Cannon
- Oncology Services Clinical Program, Intermountain Healthcare, Salt Lake City, UT, USA
| | - Mark A Lewis
- Oncology Services Clinical Program, Intermountain Healthcare, Salt Lake City, UT, USA
| | - Courtney L Scaife
- Department of Surgery, University of Utah, 30 North 1900 East, Salt Lake City, UT, 84132, USA
| | - Jesse A Gygi
- Oncology Services Clinical Program, Intermountain Healthcare, Salt Lake City, UT, USA
| | - H Tae Kim
- Surgical Services Clinical Program, Intermountain Healthcare, Salt Lake City, UT, USA
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Telem DA, Jones DB, Schauer PR, Brethauer SA, Rosenthal RJ, Provost D, Jones SB. Updated panel report: best practices for the surgical treatment of obesity. Surg Endosc 2018; 32:4158-64. [PMID: 29602992 DOI: 10.1007/s00464-018-6160-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 03/21/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND During the 2004 annual meeting of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), a panel of experts convened to provide updated information on best practices in bariatric surgery. The rapid evolution of endoluminal technologies, surgical indications, and training in bariatric surgery since 2004 has led to new questions and concerns about optimal treatment algorithms, patient selection, and the preparation of our current and future bariatric workforce. METHODS An expert panel was convened at the SAGES 2017 annual meeting to provide a summative update on current practice patterns, techniques, and training in bariatric surgery in order to review and establish best practices. This was a joint effort by SAGES, International Society for the Perioperative Care of the Obese Patient, and the American Society for Metabolic and Bariatric Surgery. RESULTS On March 23, 2017, seven expert faculty convened to address current areas of controversy in bariatric surgery and provide updated guidelines and practice recommendations. Areas addressed included the expanded indications for use of metabolic surgery in the treatment of diabetes, the safety and efficacy of new and investigational endoluminal procedures, updates on new guidelines for the management of airway and sleep apnea in the obese patient, the development of clinical pathways to reduce variation in the management of the bariatric patient, and new guidelines for training, credentialing, and bariatric program accreditation. The following article is a summary of this panel. CONCLUSION Bariatric surgery is a field that continues to evolve. A timely, systematic approach, such as described here, that coalesces data and establishes best practices on the current body of available evidence is imperative for optimal patient care and to inform provider, insurer, and policy decisions.
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Kola LA, Hrouda DR, Boyle PE, Kubek P. The Center for Evidence Based Practices at the Jack, Joseph and Morton Mandel School of Applied Social Sciences and the Department of Psychiatry, Case Western Reserve University. J Evid Inf Soc Work 2017; 14:368-378. [PMID: 28786759 DOI: 10.1080/23761407.2017.1357515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The Center for Evidence-Based Practices (CEBP), a multidisciplinary center located at the Mandel School of Applied Social Sciences (MSASS), has been in operation for the past 17 years. It is a joint project of MSASS and the Department of Psychiatry, School of Medicine, Case Western Reserve University, and funded primarily through the Ohio Department of Mental Health and Addiction Services, as well as a variety of contractual agreements with agencies throughout the state and the country. The CEBP provides technical assistance for service innovations that improve quality of life and other outcomes for people with mental illness or co-occurring mental illness and substance use disorders. Clinical and programmatic consultation, as well as training, are provided to both public and private agencies to help them build capacity to implement and sustain research-supported interventions practices. CEBP staff also provide instruction to students in the classroom and field experiences.
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Affiliation(s)
- Lenore A Kola
- a Center for Evidence Based Practices , Case Western Reserve University , Cleveland , Ohio , USA
| | - Debra R Hrouda
- a Center for Evidence Based Practices , Case Western Reserve University , Cleveland , Ohio , USA
| | - Patrick E Boyle
- a Center for Evidence Based Practices , Case Western Reserve University , Cleveland , Ohio , USA
| | - Paul Kubek
- a Center for Evidence Based Practices , Case Western Reserve University , Cleveland , Ohio , USA
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Santos-Moreno P, Castañeda O, Garro B, Flores D, Sánchez G, Castro C. From the model of integral attention to the creation of centers of excellence in rheumatoid arthritis. Clin Rheumatol 2015; 34 Suppl 1:S71-7. [PMID: 26208443 PMCID: PMC4617853 DOI: 10.1007/s10067-015-3017-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Revised: 04/19/2015] [Accepted: 05/17/2015] [Indexed: 11/28/2022]
Abstract
For the Pan American Health Organization (PAHO), the care of patients with chronic diseases currently experiences fragmentation in attention, generating poor performance of health services. Thus, comprehensive health care strategies arise to mitigate these problems; one of them are Centers of Excellence (CoEs), which aim to obtain high quality results in health from the adequate and minimum use of resources. The objective of this study was to describe the history and current context of the CoE in comprehensive care in patients with rheumatoid arthritis (RA). A systematic search of the literature terms (MeSH) was performed. The bases used were PubMed, Ebsco Host, Lilacs, Science Direct, Ovid, and Google (gray literature). The source of the information was evaluated to determine its quality. International standards focus the CoEs starting from comprehensive management of patients with RA and patient volume, continuous improvement, and quality of health care, constituting an interdisciplinary team. The REAL-PANLAR group suggested that the inclusion of the strategy "Treat to Target", and patient education improves patient conditions and understanding of the disease. RA is a prevalent and costly disease. The creation of comprehensive care centers of the CoE type is an initiative that improves the prognosis of RA. This document aims to encourage rheumatologists and scientific societies to structure CoE in an interdisciplinary endeavor.
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Affiliation(s)
| | | | - Boris Garro
- Clinica Ricardo Palma and Osteoporosis Center, Lima, Peru.
| | - Dennis Flores
- Salvadorean Social Security Institute, San Salvador, El Salvador.
| | | | - Carlos Castro
- SIIES research and education in health, Bogotá, Colombia.
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