Biomedical subjects

Kimberly J Rask

Publications and source records attributed to Kimberly J Rask.

4 recordsLinked to original sources

PubMed2006

A statewide voluntary patient safety initiative: the Georgia experiene.

BACKGROUND: The Partnership for Health and Accountability (PHA), a voluntary quality improvement and patient safety program, has focused on comprehensive evaluation and feedback. Shared reporting of processes and outcomes is the vehicle for internal quality improvement. PHA provides access to quality and safety tools and benchmarking resources for a diverse group of hospitals, including rural and critical accessfacilities. PARTICIPATION AND OUTCOMES: Hospital participation in PHA-sponsored programs has increased each year, with all eligible hospitals participating in at least one PHA program. Participants in the Safe Medication Use initiative have seen reductions in targeted medication errors, and 97% of the hospitals have reported their performance on Joint Commission on Accreditation of Healthcare Organizations core measures. CASE STUDIES: Athens Regional Medical Center (315 beds) developed the Systematic Assessment of Flow and Error (SAFE) tool, which addresses patient information, clinical decisions, care processes, and patient flow, as a starting point for a wide range of quality improvement initiatives. Since 2004 Habersham County Medical Center, a small (53 beds), rural primary care hospital, has realized a decrease of more than 50% in the postoperative pneumonia rate and a significant decrease in surgical infection rates. DISCUSSION: PHA's challenge is to remain relevant, stable, and integrated and meet the needs of a diverse group of hospitals and yet remain flexible enough to evolve as systems and patient safety priorities change.

Benchmarking↗

PubMed2006

Urban-rural differences in the availability of hospital information technology applications: a survey of Georgia hospitals.

CONTEXT: Information technology (IT) has been identified as a potential tool for improving the safety of health care delivery. PURPOSE: To determine if there are significant differences between urban and rural community hospitals in the availability of selected IT functional applications and technological devices. METHODS: A mailed survey of community hospitals in Georgia assessing the current availability of IT applications (54.6% response rate). FINDINGS: Georgia hospitals reported having 63.6% of 56 possible functional applications computerized but only 52.9% of 41 technological devices. Compared to rural hospitals, urban hospitals had significantly more functional applications computerized (38.0 vs 31.8, P = .031) and technological devices available (23.9 vs 18.2, P = .016). Urban hospitals had significantly (P < .05) more IT applications available in 4 areas: emergency room services (7 of 10), surgical/operating room (8 of 12), laboratory (7 of 12), and radiology (5 of 11). Overall, the availability of IT applications was bimodal in rural hospitals: over 40% of rural hospitals had adopted over 70% of all applications, while approximately 26% of rural hospitals had adopted less than 30%. CONCLUSIONS: Some of the observed urban/rural differences in availability of IT applications may be due to differences in the scope of services provided by rural hospitals, in particular laboratories, radiology departments, emergency rooms, and surgery/operating rooms. Nevertheless, the bimodal distribution of IT applications adopted in rural hospitals raises concerns about the ability of selected rural hospitals to take advantage of regional data-sharing initiatives and maintain quality of patient care in the future.

Georgia↗

PubMed2005

Can an algorithm for appropriate prescribing predict adverse drug events?

OBJECTIVE: To evaluate whether a medication-appropriateness algorithm applied to pharmacy claims data can identify ambulatory patients at risk for experiencing adverse drug events (ADEs) from those medications. STUDY DESIGN: Cohort study. METHODS: We surveyed a random sample of 211 community-dwelling Medicare managed care enrollees over age 65 years who were identified by pharmacy claims as taking a potentially contraindicated medication (exposed enrollees) and a random sample of 195 enrollees who were identified as not taking such a medication (unexposed enrollees). The primary outcome of interest was the prevalence of self-reported events in previous 6 months. RESULTS: Ninety-nine (24.4% of total sample) respondents reported a total of 134 ADEs during the previous 6 months. Exposed enrollees had a significantly higher number of chronic conditions and were taking more prescription and nonprescription medications. However, the higher rate of self-reported ADEs among exposed enrollees was not statistically significant from that of unexposed enrollees (prevalence odds ratio = 1.42; 95% confidence interval [CI] = 0.90, 2.25). Only 1.5% (2/134) of the self-reported ADEs were attributed to a medication from the potentially contraindicated list. Instead, most ADEs were attributed to medications that are commonly used in older patients, including cardiovascular agents (21.6%), anti-inflammatory agents (12.2%), and cholesterol-lowering agents (7.9%). CONCLUSIONS: A medication-appropriateness algorithm using pharmacy claims data was not able to identify a subgroup of enrollees at higher risk of experiencing an ADE from those medications. The vast majority of ADEs were attributable to commonly prescribed medications.

Aged↗

PubMed2004

The impact of reminder-recall interventions on low vaccination coverage in an inner-city population.

BACKGROUND: Reminder-recall interventions have improved immunization rates in numerous studies. OBJECTIVE: To evaluate the impact of large-scale, registry-based reminder-recall interventions on low immunization rates in an inner-city population. DESIGN: Randomized, controlled, effectiveness trial. SETTING: Fulton County, Georgia. PARTICIPANTS: A total of 3050 children (76% black, 14% Hispanic, 7% white, and 3% other or unknown; median age, 9 months; range, 1-14 months) identified in an immunization registry as receiving health care in the public sector. INTERVENTIONS: Each child was randomly assigned to 1 of 4 groups: control (usual care), autodialer (automated telephone or mail reminder recall), outreach (in-person telephone, mail, or home visit recall), and combination (autodialer with outreach backup). Interventions continued until the child reached 24 months of age. MAIN OUTCOME MEASURE: Completion by the age of 24 months of the 4-3-1-3 vaccination series based on intention-to-treat analysis. RESULTS: A total of 260 (34%) of the 763 patients in the control group, 306 (40%) of the 763 in the autodialer group, 284 (37%) of the 760 in the outreach group, and 293 (38%) of 764 in the combination group completed the vaccination series. CONCLUSION: Large-scale, registry-based reminder-recall interventions produced only small improvements in low immunization rates of an inner-city population.

Female↗