University Hospitals Health System Inc

EMPOWERING WOMEN AND PROVIDERS FOR IMPROVED CARE OF URINARY INCONTINENCE : EMPOWER STUDY - EMPOWERING PATIENTS AND PROVIDERS TO IMPROVE CARE FOR URINARY INCONTINENCE: EMPOWER STUDY URINARY INCONTINENCE (UI) AFFECTS OVER 50% OF WOMEN. NON-SURGICAL TREATMENT, INCLUDING BEHAVIORAL INTERVENTIONS OR PHARMACOTHERAPY, IS USUALLY EFFECTIVE, BUT RECOGNITION AND EVIDENCE-BASED CARE FOR THIS CONDITION REMAINS SUBOPTIMAL. FRONTLINE TREATMENT IN PRIMARY CARE, WITH SYSTEM SUPPORT AND SPECIALTY BACKUP, HAS GREAT POTENTIAL, BUT A VARIETY OF PATIENT-, PROVIDER-, AND SYSTEM-LEVEL BARRIERS RESULT IN UNDER-DIAGNOSIS AND SUBOPTIMAL MANAGEMENT. THEREFORE, USING ESTABLISHED PATIENT-CENTERED OUTCOMES RESEARCH EVIDENCE FOR NONSURGICAL TREATMENTS FOR URINARY INCONTINENCE IN WOMEN, WE PROPOSE AN INTEGRATED, MULTILEVEL (PATIENT, PROVIDE, AND SYSTEM) APPROACH THAT ADDRESSES KEY BARRIERS TO DIAGNOSING AND MANAGING UI IN THE PRIMARY CARE SETTING. IMPLEMENTATION STRATEGIES INCLUDE LARGE-SCALE SCREENING, EMPOWERING PATIENTS TO DISCUSS UI WITH THEIR PROVIDERS, PROVIDER EDUCATION AND TRAINING, PRACTICE FACILITATION THROUGH NURSE NAVIGATION, AND A NOVEL MOBILE PLATFORM “CHATBOT” TO ENGAGE PATIENTS IN SELF-MANAGEMENT OF THEIR UI. A SYSTEM-BASED STRATEGY FOR STREAMLINED REFERRAL AND TREATMENT WILL ALSO BE IMPLEMENTED. THE IMPLEMENTATION PLAN IS FULLY ALIGNED WITH AHRQ'S EVIDENCENOW FRAMEWORK: PRACTICE FACILITATION, EXPERT CONSULTATION, SHARED LEARNING COLLABORATIVE, DATA FEEDBACK AND BENCHMARKING, AND HEALTH-INFORMATION TECHNOLOGY SUPPORT. OVER THE COURSE OF 3 YEARS, WE AIM TO 1) IMPLEMENT THE “EMPOWERMENT FOR IMPROVING UI” PROGRAM ACROSS A LARGE NETWORK OF PRIMARY CARE PRACTICES. THE PROGRAM WILL INVOLVE SYSTEMATIC SCREENING AND IDENTIFICATION OF UI, PATIENT EMPOWERMENT, PROVIDER TRAINING AND EMPOWERMENT, NURSE NAVIGATION, AND SIMPLE AND PRACTICAL EVIDENCE-BASED TECHNOLOGY. WE HYPOTHESIZE THAT THE PROGRAM WILL BE IMPLEMENTED WITH FIDELITY TO ALL PLANNED ELEMENTS AND WITH LOCAL TAILORING IN ALL RECRUITED PRACTICES. 2) CREATE AN EVIDENCE-BASED PATIENT-CENTERED CARE PATHWAY THAT MINIMIZES BURDEN ON PRIMARY CARE WHILE OPTIMIZING HEALTH-INFORMATION SYSTEMS, INCLUDING AN EMBEDDED ELECTRONIC SCREENING TOOL, THAT LEAD TO SUSTAINABLE IMPROVEMENT IN QUALITY OF CARE. 3) ASSESS THE IMPACT OF THE EMPOWERING FOR IMPROVING UI INTERVENTION ON OUTCOMES IMPORTANT TO PATIENTS AND ON PROVIDER KNOWLEDGE AND CONFIDENCE, PRACTICE WORKFLOW AND SATISFACTION AMONG PRACTICE PROVIDERS AND STAFF. THROUGH A SYSTEMIC INTERVENTION THAT IS MULTILEVEL, PATIENT-ORIENTED AND SUPPORTIVE OF PRIMARY CARE PRACTICE, AND A RIGOROUS MIXED METHODS ANALYSIS, THE PROPOSED RESEARCH HAS GREAT POTENTIAL TO IMPROVE PRACTICE AND PATIENT OUTCOMES AND TO GENERATE TRANSPORTABLE NEW KNOWLEDGE TO IMPROVE CARE FOR WOMEN WITH URINARY INCONTINENCE.

ADDICTION MEDICINE FELLOWSHIP

CENTER TO IMPROVE CLINICAL DIAGNOSIS - ABSTRACT: DIAGNOSTIC ERRORS ARE COMMON AND FREQUENTLY EXTREMELY SERIOUS. UNFORTUNATELY, STRATEGIES TO IDENTIFY DIAGNOSTIC STANDARDS AND BEST DIAGNOSTIC PRACTICES FOR A VARIETY OF PROBLEMS ARE SCARCE. THE FOCUS OF THE CENTER TO IMPROVE CLINICAL DIAGNOSIS WILL BE TO TACKLE DIAGNOSTIC PROBLEMS USING A DATA AND CONSENSUS DRIVEN APPROACH. THE GOALS OF THE CENTER ARE TO (A) ASSEMBLE A DIVERSE, MULTIDISCIPLINARY TEAM TO PROVIDE FORMAL INPUT ABOUT STANDARDS AND BEST PRACTICES; (B) TO IMPLEMENT A 4-STEP STRATEGY TO DEVELOP RECOMMENDED DIAGNOSTIC PRACTICES; AND (C) TO SUSTAIN THE CENTER BY CREATING A SET OF POLICIES, METHODS, A FUTURE AGENDA, AND PARTNERSHIPS WITHIN AND OUTSIDE OUR ORGANIZATION. OUR CENTER WILL BE FULLY INTEGRATED INTO A LARGER HEALTH SERVICES RESEARCH CENTER WITHIN UNIVERSITY HOSPITALS HEALTH SYSTEM. OUR GENERAL 4-STEP PROCESS TO DEVELOP RECOMMENDED PRACTICES INCLUDES (1) IDENTIFYING PROBLEMS WHICH ARE COMMON, ASSOCIATED WITH HIGH RATES OF DIAGNOSTIC ERROR, AND FOR WHICH GUIDANCE IS LACKING AND IDENTIFY CURRENT DIAGNOSTIC PRACTICE (OR PRACTICES IN RESPONSE TO DIAGNOSTIC INTERVENTIONS) (2) IDENTIFY OUTCOMES OF DIAGNOSTIC PRACTICES; (3) IN COLLABORATION WITH A PANEL OF DIAGNOSTICIANS, REVIEW DATA ABOUT PRACTICE AND OUTCOMES AND FORMULATE RECOMMENDATIONS; (4) IMPLEMENT RECOMMENDATIONS AND MONITOR THEIR IMPACT. WE HAVE CHOSEN THREE PROBLEMS AS DEMONSTRATION PROJECTS BASED ON HOW COMMON AND SERIOUS THEY ARE AND THE EXPERTISE AND EXPERIENCE OF OUR RESEARCH TEAM: (1) THE BEST APPROACH TO IDENTIFYING AND EVALUATING UNINTENTIONAL WEIGHT LOSS IN ADULTS; (2) THE BEST APPROACH TO SCREENING FOR HYPERTENSION IN AFRICAN AMERICAN ADOLESCENTS USING HOME-BP DEVICES; (3) IMPROVED DIAGNOSIS OF SEPSIS IN CHILDREN IN COMMUNITY EMERGENCY DEPARTMENT (ED) SETTINGS, AND ADULTS IN COMMUNITY (ED) AND INPATIENT SETTINGS THROUGH IMPLEMENTATION AND MOST IMPORTANTLY, REFINEMENT OF ELECTRONIC SEPSIS TRIGGER TOOLS. WE BELIEVE OUR SYSTEMATIC APPROACH TO DEVELOPING STANDARDS AND BEST PRACTICES FOR THESE AND FUTURE PROBLEMS WILL PROVIDE A SYSTEM FOR BADLY NEEDED DIAGNOSTIC GUIDANCE THAT IS USEFUL FOR PATIENTS, CLINICIANS, AND HEALTH SYSTEMS.

COMMUNITY PROJECT FUNDING/CONGRESSIONALLY DIRECTED SPENDING - CONSTRUCTION

COMMUNITY PROJECT FUNDING/CONGRESSIONALLY DIRECTED SPENDING - CONSTRUCTION

COMMUNITY PROJECT FUNDING/CONGRESSIONALLY DIRECTED SPENDING - CONSTRUCTION - APPLICANT: UNIVERSITY HOSPITALS HEALTH SYSTEM PROJECT LOCATION: UNIVERSITY HOSPITALS PARMA MEDICAL CENTER, 7007 POWERS BOULEVARD, PARMA, OH 44129 PROJECT CONTACT: MARY BETH TALERICO, DIRECTOR, OPERATIONS AND CLINICAL SERVICES, 440-743-4580, MARYBETH.TALERICO@UHHOSPITALS.ORG APPLICANT WEBSITE: HTTPS://WWW.UHHOSPITALS.ORG/ UNIVERSITY HOSPITALS RESPECTFULLY REQUESTS $855,000 OF HRSA FUNDS TOWARDS ESTABLISHING A COMPREHENSIVE BREAST HEALTH CENTER AT UNIVERSITY HOSPITALS PARMA MEDICAL CENTER, A 278-BED FULL SERVICE HOSPITAL THAT HAS SERVED LOCAL RESIDENTS FOR MORE THAN 60 YEARS. DEMAND FOR THESE SERVICES IS HIGH AND INCREASING: BREAST OFFICE VISITS AT UH PARMA DOUBLED FROM 2020 TO 2021 TO 971 VISITS AND THE HOSPITAL ALSO INCREASED THE NUMBER OF BREAST SURGERIES, BIOPSIES AND ULTRASOUNDS. CURRENTLY, BREAST CANCER SERVICES ARE LOCATED IN VARIOUS PLACES ON THE CAMPUS, REQUIRING PATIENTS TO NAVIGATE THE RANGE OF TREATMENTS, COORDINATE WITH A NUMBER OF HEALTH CARE PROFESSIONALS AND VISIT SEVERAL LOCATION POINTS. THE RENOVATED SPACE WILL INCLUDE DIAGNOSTIC TESTING, EXAM ROOMS, AND ADDITIONAL PROVIDER OFFICES. THE HOSPITAL WILL RELOCATE, MODIFY AND UPDATE TWO MAMMOGRAPHY UNITS AND ONE ULTRASOUND MACHINE TO THE SURGEON’S OFFICE. THESE CHANGES WILL RESULT IN MORE EFFICIENT AND ADDITIONAL SERVICES THAT WILL ALLOW FOR STREAMLINED, ACCESSIBLE DIAGNOSIS TO TREATMENT OF BREAST CANCER AND STANDARDIZED HIGH-QUALITY BREAST CARE. THIS FUNDING WILL PURCHASE MOVEABLE-ONLY EQUIPMENT NEEDED FOR THE COMPREHENSIVE BREAST HEALTH CENTER. EQUIPMENT INCLUDES FIVE CRITICAL UNITS FOR BREAST HEALTH AND BREAST CANCER OPERATIONS – A MAMMOGRAM, AN ULTRASOUND, A TRIDENT BREAST TISSUE IMAGING UNIT, A SENTIMAG UNIT, AND A NEOPROBE UNIT. THE FINAL THREE ITEMS WILL BE FOR THE OPERATING ROOM.

RYAN WHITE HIV/AIDS PROGRAM PART C EIS COVID-19 RESPONSE

TELEMEDICINE PREPARATION FOR OLDER ADULTS WITH TYPE 2 DIABETES - DURING THE COVID-19 PANDEMIC, MANY PRIMARY CARE APPOINTMENTS WERE CONVERTED TO TELEMEDICINE. TELEMEDICINE APPOINTMENTS MAY BE ESPECIALLY BENEFICIAL FOR PATIENTS WHO ARE AT HIGH RISK FOR COVID MORTALITY, SUCH AS OLDER ADULTS, AFRICAN AMERICANS, AND PATIENTS WITH TYPE 2 DIABETES. NUMEROUS STUDIES HAVE FOUND TELEMEDICINE CAN BE AN EFFECTIVE VENUE FOR DIABETES CARE. UNFORTUNATELY, SUCH INTERVENTIONS OFTEN ASSUME THAT PATIENTS ALREADY HAVE INTERNET-CAPABLE DEVICES, RELIABLE INTERNET SERVICE, AND BASIC DIGITAL SKILLS. MANY PATIENTS, ESPECIALLY OLDER PATIENTS AND AFRICAN AMERICANS, LACK THE DIGITAL SKILLS NEEDED FOR TELEMEDICINE. UNFORTUNATELY, THE NET RESULT IS THAT THOSE AT HIGHEST RISK FOR CHRONIC DISEASES AND THEIR COMPLICATIONS ARE OFTEN LEAST ABLE TO TAKE ADVANTAGE OF TELEMEDICINE. WE PROPOSE A DIGITAL SKILLS TRAINING INTERVENTION COMPRISING ESSENTIAL BASIC SKILLS TO PARTICIPATE IN A TELEMEDICINE APPOINTMENT FOR OLDER (AGE 50-70 YEARS) MOSTLY AFRICAN AMERICAN PRIMARY CARE PATIENTS WITH TYPE 2 DIABETES WHO ALREADY OWN AN INTERNET-CAPABLE DEVICE BUT HAVE NEVER HAD A TELEMEDICINE APPOINTMENT. THE INTERVENTION'S GOAL IS TO PREPARE PATIENTS TO HAVE A SUCCESSFUL TELEMEDICINE APPOINTMENT. PATIENTS WILL FIRST BE ASSESSED FOR SKILLS AND THEN RECEIVE CUSTOMIZED DIGITAL SKILLS TRAINING THROUGH A COMMUNITY-BASED ORGANIZATION. PARTICIPANTS WILL ALSO BE SCHEDULED TO HAVE A VIRTUAL DIABETES MANAGEMENT APPOINTMENT WITHIN 6 MONTHS. FOR SPECIFIC AIM # 1, WE WILL MEASURE WHETHER OR NOT PATIENTS REFERRED TO THE TELEMEDICINE TRAINING INTERVENTION COMPLETE A TELEMEDICINE APPOINTMENT WITHIN 6 MONTHS. IN SPECIFIC AIM # 2, WE WILL INTERVIEW PATIENTS AND ANALYZE INTERVIEW TRANSCRIPTS TO ASSESS THEIR EXPERIENCE WITH TELEMEDICINE. PATIENTS WHO SUCCESSFULLY COMPLETED A TELEMEDICINE APPOINTMENT WILL BE ASKED ABOUT THEIR SATISFACTION WITH BOTH THE TELEMEDICINE TRAINING INTERVENTION AND THEIR TELEMEDICINE APPOINTMENT. PATIENTS WHO ENROLLED IN THE TELEMEDICINE TRAINING INTERVENTION BUT EITHER DID NOT COMPLETE A TELEMEDICINE APPOINTMENT AND/OR DID NOT COMPLETE TELEMEDICINE TRAINING WILL BE ASKED ABOUT THEIR BARRIERS AND HOW THE TELEMEDICINE TRAINING INTERVENTION COULD BETTER MEET THEIR NEEDS.

TELEMEDICINE GRANT

THE AFFORDABLE CONNECTIVITY OUTREACH GRANT PROGRAM PROVIDES ELIGIBLE GOVERNMENTAL AND NON-GOVERNMENTAL ENTITIES WITH THE FUNDING AND RESOURCES NEEDED TO INCREASE AWARENESS OF AND PARTICIPATION IN THE AFFORDABLE CONNECTIVITY PROGRAM AMONG THOSE ELIGIBLE HOUSEHOLDS MOST IN NEED OF AFFORDABLE CONNECTIVITY.

RYAN WHITE HIV/AIDS PROGRAM PART D WICY COVID-19 RESPONSE

DLT OPIOID GRANTS