University of Pittsburgh Medical Center Home Transitions Multidisciplinary Care Coordination Reduces Readmissions for Older Adults

2018 ◽  
Author(s):  
Johanna E. Bellon ◽  
Andrew Bilderback ◽  
Namita S. Ahuja‐Yende ◽  
Cindy Wilson ◽  
Stefanie C. Altieri Dunn ◽  
...  
Keyword(s):  
Older Adults ◽  
Care Coordination ◽  
Medical Center ◽  
Multidisciplinary Care ◽  
University Of Pittsburgh ◽  
Pittsburgh Medical

Implementation of the Acute Care Nurse Practitioner Role

1994 ◽  
Vol 5 (3) ◽  
pp. 404-407
Author(s):  
Lynn A. Kelso ◽  
Lori M. Massaro
Keyword(s):  
Acute Care ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Medical Center ◽  
Care Nurse ◽  
University Of Pittsburgh ◽  
Acute Care Nurse Practitioner ◽  
The University ◽  
Pittsburgh Medical ◽  
Practitioner Role

In this article, the experiences of two new acute care nurse practitioners working at the University of Pittsburgh Medical Center arc described. Included are the experiences they encountered in initiating the role and some of the responsibilities they assumed.

scholarly journals The evolution of a clinical registry during 25 years of experience with Gamma Knife radiosurgery in Pittsburgh

2013 ◽  
Vol 34 (1) ◽  
pp. E4 ◽  
Author(s):  
Oren Berkowitz ◽  
Douglas Kondziolka ◽  
David Bissonette ◽  
Ajay Niranjan ◽  
Hideyuki Kano ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Patient Outcomes ◽  
Medical Center ◽  
Gamma Knife Radiosurgery ◽  
Study Patient ◽  
Anatomical Site ◽  
University Of Pittsburgh ◽  
Database Technology ◽  
The University ◽  
Pittsburgh Medical

Object The first North American 201 cobalt-60 source Gamma Knife surgery (GKS) device was introduced at the University of Pittsburgh Medical Center in 1987. The introduction of this innovative and largely untested surgical procedure prompted the desire to study patient outcomes and evaluate the effectiveness of this technique. The parallel advances in computer software and database technology led to the development of a registry to track patient outcomes at this center. The purpose of this study was to describe the registry's evolution and to evaluate its usefulness. Methods A team was created to develop a software database and tracking system to organize and retain information on the usage of GKS. All patients undergoing GKS were systematically entered into this database by a clinician familiar with the technology and the clinical indications. Information included patient demographics and diagnosis as well as the anatomical site of the target and details of the procedure. Results There are currently 11,738 patients in the database, which began to be used in August 1987. The University of Pittsburgh Medical Center has pioneered the evaluation and publication of the GKS technique and outcomes. Data derived from this computer database have facilitated the publication of more than 400 peer-reviewed manuscripts, more than 200 book chapters, 8 books, and more than 300 published abstracts and scientific presentations. The use of GKS has become a well-established surgical technique that has been performed more than 700,000 times around the world. Conclusions The development of a patient registry to track and analyze the use of GKS has given investigators the ability to study patient procedures and outcomes. The future of clinical medical research will rely on the ability of clinical centers to store and to share information.

Digital Applications in Cytopathology: Problems, Rationalizations, and Alternative Approaches

2017 ◽  
Vol 62 (1) ◽  
pp. 68-76 ◽  
Author(s):  
Nikolaos Chantziantoniou ◽  
Maheswari Mukherjee ◽  
Amber D. Donnelly ◽  
Liron Pantanowitz ◽  
R. Marshall Austin
Keyword(s):  
Diagnostic Criteria ◽  
Medical Center ◽  
Robotic Cell ◽  
University Of Pittsburgh ◽  
Video Clips ◽  
Medical City ◽  
Alternative Approaches ◽  
2D And 3D ◽  
Intraepithelial Lesions ◽  
Pittsburgh Medical

Objective: The aim of this work was to raise awareness of problems using digital applications for examining, teaching, and applying telecytology at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia; University of Nebraska Medical Center (UNMC), Omaha, NE, USA; and University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA, USA. The objective was to rationalize problems and propose alternative digital approaches. Study Design: We sought to identify solutions to improve the following: (a) interpretive examination scores at KAMC for complex cytological templates (i.e., high-grade squamous intraepithelial lesions [HSIL]) when using static digital images (SDI) of cells in regions of interest (ROI); (b) visualization of cells in 3D clusters when teaching at UNMC using 2D and 3D whole-slide imaging (WSI); and (c) visualization of cells through streaming telecytology at UPMC. Results: Composite SDI (CSDI) improved test scores for complex interpretations (i.e., HSIL) by converging diagnostic criteria from multiple ROI. Multiplane focusing through z-stacked WSI facilitated the teaching of cytological entities characterized by 3D cell clusters and consultative telecytology through robotic cell analysis. Conclusions: Adequately visualized cytomorphology and multiplane focusing are essential for virtual cytopathology examinations, teaching, or consultative telecytology. Visualization of diagnostic criteria through 2D or 3D imaging is critical. Panoptiq panoramic WSI with integrated z-stacked video clips enables optimal applied telecytology.

Adjuvant High Dose Rate Brachytherapy Combined with Vacuum-Assisted Closure for Soft Tissue Sarcomas: The University of Pittsburgh Medical Center Experience

Brachytherapy ◽  
2018 ◽  
Vol 17 (4) ◽  
pp. S44
Author(s):  
Joshua L. Rodríguez-López ◽  
Steven A. Burton ◽  
Kurt R. Weiss ◽  
Richard L. McGough ◽  
Mark A. Goodman ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Dose Rate ◽  
Medical Center ◽  
Soft Tissue Sarcomas ◽  
High Dose Rate ◽  
High Dose ◽  
Vacuum Assisted Closure ◽  
University Of Pittsburgh ◽  
The University ◽  
Pittsburgh Medical

scholarly journals 1987. Impact of Updated IDSA Clostridium difficile Guidelines on the use of Fidaxomicin in a Large Health System

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S666-S666 ◽  
Author(s):  
J Ryan Bariola ◽  
Tina Khadem
Keyword(s):  
Medical Center ◽  
System Level ◽  
Hospital Level ◽  
University Of Pittsburgh ◽  
Clostridioides Difficile ◽  
Days Of Therapy ◽  
Clostridioides Difficile Infection ◽  
First Recurrence ◽  
New Guidelines ◽  
Pittsburgh Medical

Abstract Background Fidaxomicin (fidax) is approved for treatment of Clostridioides difficile infection. In February 2018 IDSA/SHEA released updated guidelines suggesting expanded use of fidax, recommending it or oral vancomycin (po vanc) in severe or non-severe initial episodes or for most recurrences. In April 2018, University of Pittsburgh Medical Center (UPMC) relaxed system-wide guidelines to allow for fidax use in the first recurrence of C. difficile or later, with earlier use allowed by ID or GI specialists or with local Pharmacy and Therapeutics Chair approval. Hospitals could continue to be more restrictive if desired. We reviewed changes in fidax, po vanc, and IV/PO metronidazole (metro) use at UPMC hospitals after guideline changes. Methods For the reviewed antibiotics, hospital-level usage was evaluated at 15 UPMC hospitals before/after system-level changes. Usage was measured as days of therapy per 1,000 patient-days (DOT/1,000 PD). Sites were further grouped by the level of restrictions: Standard (following new system guidelines) or more restrictive (additional restrictions remained in place locally). Hospitals were also grouped by type of local stewardship programs (ASP): Robust (included an Infectious Diseases trained clinical pharmacist or ID physician with specific time dedicated to antibiotic review) or Non-Robust. Results Figure 1 shows before/after changes in usage at all hospitals. Figure 2 shows changes in Standard vs. More Restrictive hospitals, and Figure 3 shows changes in Robust vs. Non-Robust hospitals. Conclusion Fidax use remained low, but an increase was seen after the release of the guidelines and relaxation of system restrictions, mainly in hospitals without additional restrictions in place. PO vanc also increased across the system, possibly indicating better adherence to updated guidelines regarding less metro use for C. difficile treatment. Although minimal decrease, if any, was seen with metro itself. This could have been compounded by the recent fluid shortage as well as other common uses for metro. Dissemination of new guidelines to providers should be a key function of ASPs as well as monitoring for changes in usage after implementation of local changes. Further studies are needed to define any differences in practice patterns and clinical outcomes related to changes in guidelines. Disclosures All authors: No reported disclosures.

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