91 research outputs found
Optimizing Flu Vaccine Planning at NorthShore University HealthSystem
No full textStan Kent, vice president of pharmacy at NorthShore University HealthSystem, is faced with the challenge of seasonal planning for the influenza vaccine. The supply received by the multilocation healthcare system is unreliable in terms of timing and quantity. As part of improved planning, Kent is contemplating a new contract with NorthShore's major supplier of flu vaccines. The options under consideration include fixing either the date of delivery or the quantity delivered. The main decision involved in either option would be how much vaccine to order. The case also provides details about the seasonal influenza epidemic in the United States, illustrates operational complexities of the U.S. flu vaccine supply chain, and provides a brief description of the various channels used to distribute flu vaccine to end consumers.The main objective of the case is to illustrate supply chain decision making when there is an unreliable supply (in contrast to the usual case of uncertain demand). A secondary objective is to make students think about appropriate internal (within sector) and external (other sectors) benchmarks to evaluate the performance of a health commodity supply chain.</jats:p
Image1_Personalized medicine in a community health system: the NorthShore experience.pdf
No full textGenomic and personalized medicine implementation efforts have largely centered on specialty care in tertiary health systems. There are few examples of fully integrated care systems that span the healthcare continuum. In 2014, NorthShore University HealthSystem launched the Center for Personalized Medicine to catalyze the delivery of personalized medicine. Successful implementation required the development of a scalable family history collection tool, the Genetic and Wellness Assessment (GWA) and Breast Health Assessment (BHA) tools; integrated pharmacogenomics programming; educational programming; electronic medical record integration; and robust clinical decision support tools. To date, more than 225,000 patients have been screened for increased hereditary conditions, such as cancer risk, through these tools in primary care. More than 35,000 patients completed clinical genetic testing following GWA or BHA completion. An innovative program trained more than 100 primary care providers in genomic medicine, activated with clinical decision support and access to patient genetic counseling services and digital healthcare tools. The development of a novel bioinformatics platform (FLYPE) enabled the incorporation of genomics data into electronic medical records. To date, over 4,000 patients have been identified to have a pathogenic or likely pathogenic variant in a gene with medical management implications. Over 33,000 patients have clinical pharmacogenomics data incorporated into the electronic health record supported by clinical decision support tools. This manuscript describes the evolution, strategy, and successful multispecialty partnerships aligned with health system leadership that enabled the implementation of a comprehensive personalized medicine program with measurable patient outcomes through a genomics-enabled learning health system model that utilizes implementation science frameworks.</p
Effect of a Type 2 Diabetes–Focused Visit Improvement Initiative on Therapeutic Inertia and Glycemic Control in Primary Care
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This quality improvement (QI) project was conducted in the Department of Family Medicine at NorthShore University HealthSystem, an integrated health system in the Chicago, IL, area with 13 ambulatory family medicine primary care practices caring for ~5,000 adult patients with type 1 or type 2 diabetes. </p
\u3cem\u3eMessner\u3c/em\u3e\u27s Effect on Hospital Consolidation and Anticompetitive Behavior
No full textBy 2021, healthcare spending is expected to reach a whopping twenty percent of gross domestic product. One of the less-publicized causes of the rapid growth in healthcare costs is hospital consolidation, which has allowed hospitals to use their market power to raise prices for private payors.
Attempts to limit abuses of market power in this sector have been insufficient. From the 1980s until the early 1990s, the Federal Trade Commission and the Department of Justice blocked every anticompetitive merger. However, the tides changed in the mid-1990s when the regulators lost five successive cases that challenged hospital mergers. Economists were astounded by these rulings as the defendants relied on unsuitable models to successfully argue that the regulators\u27 definition of their geographic markets was too limited. Empowered by these rulings, hospitals consolidated rapidly. Only recently have better economic models demonstrated that hospital consolidation causes price increases.
The Federal Trade Commission\u27s case against Evanston Northwestern Healthcare Corporation applied these new economic models. In this case, the health network acquired a nearby hospital to form Northshore University HealthSystem. The FTC won its case, and after the administrative action, a class action was filed against Northshore. The district court denied certification, and the plaintiffs appealed. The Seventh Circuit ultimately certified the class in Messner v. Northshore University HealthSystem.
This Note explores whether the Seventh Circuit\u27s decision in Messner will deter hospitals\u27 anticompetitive conduct in light of the Court\u27s Daubert ruling and trends in antitrust class actions and finds that it will ultimately be in the hands of the regulators to police hospitals\u27 monopolistic practices
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An operationally implementable model for predicting the effects of an infectious disease on a comprehensive regional healthcare system
No full textAn operationally implementable predictive model has been developed to forecast the number of COVID-19 infections in the patient population, hospital floor and ICU censuses, ventilator and related supply chain demand. The model is intended for clinical, operational, financial and supply chain leaders and executives of a comprehensive healthcare system responsible for making decisions that depend on epidemiological contingencies. This paper describes the model that was implemented at NorthShore University HealthSystem and is applicable to any communicable disease whose risk of reinfection for the duration of the pandemic is negligible.</p
NeuroQOL Clinical Validation Study (aka Wave II)
No full textFrom January 15, 2009 to January 30, 2010 Wave II short form testing in
clinical samples was conducted to increase the sample size for some of the instrument calibration analyses and to conduct validation studies. Wave II participants were recruited from Cleveland Clinic Foundation, Dartmouth-Hitchcock Medical Center, NorthShore University HealthSystem, Northwestern University Feinberg School of Medicine, Rehabilitation Institute of Chicago, University of Chicago, University of Puerto Rico, and the University of Texas Health Science Center. Validation results will be discussed in subsequent publications. The sampling plan facilitated obtaining item calibrations for the different domain areas, estimating profile scores for varied subgroups, confirming factor structure, and conducting item and bank analyses. Given the large number of items (>500), we knew that participants could not be asked to respond to the full item pool. It was estimated that participants would respond to four questions per minute, with the maximum number of items administered for each respondent approximately 150
NeuroQOL Clinical Validation Study (aka Wave II)
No full textFrom January 15, 2009 to January 30, 2010 Wave II short form testing in
clinical samples was conducted to increase the sample size for some of the instrument calibration analyses and to conduct validation studies. Wave II participants were recruited from Cleveland Clinic Foundation, Dartmouth-Hitchcock Medical Center, NorthShore University HealthSystem, Northwestern University Feinberg School of Medicine, Rehabilitation Institute of Chicago, University of Chicago, University of Puerto Rico, and the University of Texas Health Science Center. Validation results will be discussed in subsequent publications. The sampling plan facilitated obtaining item calibrations for the different domain areas, estimating profile scores for varied subgroups, confirming factor structure, and conducting item and bank analyses. Given the large number of items (>500), we knew that participants could not be asked to respond to the full item pool. It was estimated that participants would respond to four questions per minute, with the maximum number of items administered for each respondent approximately 150
Hospitalizations for vaccine preventable pneumonias in patients with inflammatory bowel disease: a 6-year analysis of the Nationwide Inpatient Sample
No full textDerrick J Stobaugh,1,2 Parakkal Deepak,1,2 Eli D Ehrenpreis1,21Center for the Study of Complex Diseases, Research Institute, NorthShore University HealthSystem, Evanston, IL, USA; 2Gastroenterology Department, NorthShore University HealthSystem, Highland Park, IL, USABackground: Pneumonias are among the most common causes of hospitalization among inflammatory bowel disease (IBD) patients. Guidelines published in 2004 advocate vaccination against Streptococcus pneumoniae and influenza virus. We sought to examine trends in hospitalizations for vaccine preventable pneumonias among IBD patients since the availability of published guidelines, and to identify whether Haemophilus influenzae is a causative organism for pneumonia hospitalizations among IBD patients.Methods: This cross-sectional study on the Nationwide Inpatient Sample was used to identify admissions for pneumonias in patients with IBD between 2004 and 2009. A multivariate logistic regression analysis was performed comparing IBD patients to controls, accounting for potential confounders.Results: There were more admissions for S. pneumoniae pneumonia than influenza virus or H. influenzae (787, 393, and 183 respectively). Crohn’s disease (CD) as well as ulcerative colitis (UC) patients did not demonstrate increased adjusted odds of hospitalization for S. pneumoniae pneumonia (1.08; confidence interval [CI] 0.99–1.17 compared to 0.93; CI 0.82–1.06 respectively). Increased adjusted odds for hospitalization for pneumonias due to influenza virus were seen among UC patients in the bottom quartile of income (1.86; CI 1.46–2.37). Adjusted odds for H. influenzae pneumonia admission in patients with UC and CD patients were increased compared to controls (1.42; CI 1.13–1.79 and 1.28; CI 1.06–1.54, respectively).Conclusion: The study identified lowest income UC patients as having higher adjusted odds, and these patients should be targeted for influenza virus vaccination. Additionally, H. influenzae may be another vaccine preventable cause for pneumonia among IBD patients.Keywords: infection, Crohn’s disease, colitis, ulcerative, vaccination, pneumoni
Dr. Kenneth P. Anderson, D.O., M.S., CPE, Chief Operating Officer for the Health Research & Educational Trust
No full textThe guest in this episode of The Health Leader Forge is Dr. Kenneth Anderson, DO, the Chief Operating Officer for the Health Research and Educational Trust, a subsidiary of the American Hospital Association in Chicago, Illinois. In this podcast, we trace Ken’s career in medicine, from his training in both family practice and internal medicine, then as nephrologist and kidney transplant specialist, followed by his movement into the physician executive ranks, specializing in quality and data management as the Chief Medical Quality Officer for the NorthShore University HealthSystem before his current position as COO of HRET. As the COO of HRET he helps to influence health policy at the national level through research and educational programs.
ADDENDUM: Since the recording of this podcast, Dr. Anderson has been promoted to Acting President of HRET and Acting Senior Executive for Health Improvement for the AHA (American Hospital Association)
Risk of Second Seizure in Pediatric Patients With Idiopathic Autism
No full textPurpose:Epilepsy is a comorbidity of idiopathic autism spectrum disorder. The aim was to characterize the risk and time of second seizure in children with idiopathic autism spectrum disorder.Methods:A retrospective review was performed at the University of Chicago and NorthShore University HealthSystem. Patients with idiopathic autism spectrum disorder, ≥1 seizure, and age 2 to 23 years were included.Results:153 patients were included; 141 (92%) had a second seizure. The average age at first seizure was 7.14 years (median: 5.08 years) and 8.12 years (median: 7.3 years) at second seizure. Average time between first and second seizure was 7.68 months.Discussion:A high risk of seizure recurrence was found in this population. There was a short time to second seizure, with most having a recurrence within 1 year. These findings may be used to guide therapy in children with autism spectrum disorder and epilepsy.</jats:sec
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