2022
Implementation of simulation-based health systems science modules for resident physicians
Li L, Ray JM, Bathgate M, Kulp W, Cron J, Huot SJ, Wong AH. Implementation of simulation-based health systems science modules for resident physicians. BMC Medical Education 2022, 22: 584. PMID: 35906583, PMCID: PMC9338604, DOI: 10.1186/s12909-022-03627-w.Peer-Reviewed Original ResearchConceptsResident physiciansImpact care qualityPost-session surveysSimulation-based scenariosCross-cutting domainsResidency training programsMultiple stakeholder perspectivesCare qualityCare deliveryImplementation scienceHealth careEmotional reactionsHands-on practiceEducational moduleIn-personTraining programResidency programsResidency trainingRole-play formatPhysiciansStakeholder perspectivesMedical simulationClinical practiceCareParticipantsThe Stress and Resilience Town Hall: A systems response to support the health workforce during COVID-19 and beyond
Tebes JK, Awad MN, Connors EH, Fineberg SK, Gordon DM, Jordan A, Kravitz R, Li L, Ponce AN, Prabhu M, Rubman S, Silva MA, Steinfeld M, Tate DC, Xu K, Krystal JH. The Stress and Resilience Town Hall: A systems response to support the health workforce during COVID-19 and beyond. General Hospital Psychiatry 2022, 77: 80-87. PMID: 35569322, PMCID: PMC9033303, DOI: 10.1016/j.genhosppsych.2022.04.009.Peer-Reviewed Original ResearchConceptsHealthcare workersHealth systemHealth workforceCOVID-19 pandemicHealth workforce needsMean attendancePost-traumatic stressCOVID-19Traumatic stressorsTypes of stressorsSustainable interventionsRigorous qualitative methodsInterventionPandemicSpecific stressorsStressorsWorkforce needsHospitalWorkersAn Initiative to Improve Performance on a National Transition of Care Measure and to Reduce Readmissions in an Academic Psychiatric Hospital
Li L, Kulp W, Krieg H, Aptaker D, Klink B, Knox D, Pincus HA. An Initiative to Improve Performance on a National Transition of Care Measure and to Reduce Readmissions in an Academic Psychiatric Hospital. The Joint Commission Journal On Quality And Patient Safety 2022, 48: 205-213. PMID: 35193810, DOI: 10.1016/j.jcjq.2022.01.002.Peer-Reviewed Original ResearchConceptsQuality improvement projectReadmission ratesPsychiatric hospitalCompliance rateCause readmission rateDecrease hospital readmissionsClinical decision support toolAcademic psychiatric hospitalAdverse patient outcomesImprovement projectClinical diagnosis dataHospital readmissionPreintervention periodCare measuresPatient outcomesCDS toolProvider complianceReadmissionCDS toolsHospitalOutcome metricsPrimary measureYear 2Year 3Diagnosis data
2021
Shifts in inpatient psychiatry utilization patterns at a U.S. Academic Medical Center during the COVID-19 pandemic
Kulp W, Mitchell TO, Pittman B, Li L. Shifts in inpatient psychiatry utilization patterns at a U.S. Academic Medical Center during the COVID-19 pandemic. Psychiatry Research 2021, 308: 114376. PMID: 34999295, PMCID: PMC8733685, DOI: 10.1016/j.psychres.2021.114376.Peer-Reviewed Original ResearchConceptsInpatient psychiatry serviceU.S. academic medical centersSubstance use disordersAcademic medical centerCOVID-19 pandemicRetrospective cohortInpatient admissionsMedical CenterPsychiatry servicesPsychiatric patientsUse disordersInpatient psychiatryUtilization patternsModest decreasePatientsSignificant changesDiagnostic dataCorresponding monthsEarlier findingsUsing a Patient Safety/Quality Improvement Model to Assess Telehealth for Psychiatry and Behavioral Health Services Among Special Populations During COVID-19 and Beyond
Li L, Childs AW. Using a Patient Safety/Quality Improvement Model to Assess Telehealth for Psychiatry and Behavioral Health Services Among Special Populations During COVID-19 and Beyond. Journal Of Psychiatric Practice 2021, 27: 245-253. PMID: 34398574, PMCID: PMC8318385, DOI: 10.1097/pra.0000000000000555.Peer-Reviewed Original ResearchConceptsBehavioral health servicesHealth servicesSpecial populationsPsychiatric care needsMental health needsCoronavirus 2019 (COVID-19) pandemicSustainability of telehealthCritical mental health needsCare needsHealth care landscapeHealth needsTelehealth servicesQuality improvement modelHealth care organizationsTelehealthCare organizationsCOVID-19Care landscapePopulationPandemicYouth populationCareShowing Up Is Half the Battle: The Impact of Telehealth on Psychiatric Appointment Attendance for Hospital-Based Intensive Outpatient Services During COVID-19
Childs AW, Bacon SM, Klingensmith K, Li L, Unger A, Wing AM, Fortunati F. Showing Up Is Half the Battle: The Impact of Telehealth on Psychiatric Appointment Attendance for Hospital-Based Intensive Outpatient Services During COVID-19. Telemedicine Journal And E-Health 2021, 27: 835-842. PMID: 33999738, DOI: 10.1089/tmj.2021.0028.Peer-Reviewed Original ResearchConceptsHigh-risk individualsAppointment attendanceIntensive outpatient programNon-Hispanic white youthRace/ethnicityPsychiatric servicesTreatment programIntensive outpatient servicesOutpatient psychiatric settingsImpact of telehealthHigher clinical acuityChi-square testClinical treatment programsWarrants further investigationNon-Hispanic Black youthAdult patientsIOP groupInsurance typeOutpatient programOutpatient servicesClinical acuityPsychiatric settingsCommercial insuranceClinical programsTelehealth servicesCOVID vaccine use in inpatient psychiatry units—The need is here and now
Li L, Kulp W, Goldman ML, Sernyak M, Petrakis I, Runnels P. COVID vaccine use in inpatient psychiatry units—The need is here and now. General Hospital Psychiatry 2021, 71: 132-133. PMID: 33814221, PMCID: PMC8006511, DOI: 10.1016/j.genhosppsych.2021.03.011.Peer-Reviewed Original ResearchMental Health Staff Perceptions of Improvement Opportunities around COVID-19: A Mixed-Methods Analysis
Bommersbach T, Dube L, Li L. Mental Health Staff Perceptions of Improvement Opportunities around COVID-19: A Mixed-Methods Analysis. Psychiatric Quarterly 2021, 92: 1079-1092. PMID: 33575954, PMCID: PMC7877505, DOI: 10.1007/s11126-021-09890-2.Peer-Reviewed Original ResearchConceptsCOVID-19Mental Health Staff PerceptionsLarge tertiary medical centerHealth staff perceptionsTertiary medical centerBehavioral health servicesBenefits of telehealthHigh community spreadFocus group dataMedical CenterFocus groupsMixed-methods findingsHealth servicesCommunity spreadQualitative focus groupsGroup dataCare transformationHeightened stressStaff perceptionsConvenience surveyService linesTelehealthSurvey responsesMixed-methods analysisThematic analysisEpidemiology, Infection Prevention, Testing Data, and Clinical Outcomes of COVID-19 on Five Inpatient Psychiatric Units in a large Academic Medical Center
Li L, Roberts SC, Kulp W, Wing A, Barnes T, Colandrea N, Klink B, Fortunati F, Martinello R. Epidemiology, Infection Prevention, Testing Data, and Clinical Outcomes of COVID-19 on Five Inpatient Psychiatric Units in a large Academic Medical Center. Psychiatry Research 2021, 298: 113776. PMID: 33571800, PMCID: PMC7987366, DOI: 10.1016/j.psychres.2021.113776.Peer-Reviewed Original ResearchConceptsInpatient psychiatric unitLarge academic medical centerAcademic medical centerPsychiatric unitMedical CenterCOVID-19Retrospective cohort analysisEmergency room visitsInpatient psychiatric facilityLow patientsClinical outcomesRoom visitsHospitalized individualsInfection preventionStudy populationCohort analysisPrevention strategiesAdmission statusTriage protocolDiverse patientsInfection rateMental illnessPsychiatric facilitiesDemographic dataPatientsRacial and Ethnic Differences in Psychiatry Resident Prescribing: a Quality Improvement Education Intervention to Address Health Equity
Cerdeña I, Holloway T, Cerdeña JP, Wing A, Wasser T, Fortunati F, Rohrbaugh R, Li L. Racial and Ethnic Differences in Psychiatry Resident Prescribing: a Quality Improvement Education Intervention to Address Health Equity. Academic Psychiatry 2021, 45: 13-22. PMID: 33495966, PMCID: PMC9942699, DOI: 10.1007/s40596-021-01397-z.Peer-Reviewed Original ResearchConceptsWhite patientsRace/ethnicityPrescriber profilesLatinx patientsEthnic differencesUnique patient encountersPrescription of antipsychoticsElectronic medical recordsAntidepressant prescriptionsAntipsychotic prescribingAntidepressant prescribingHigher diagnosisPrimary diagnosisMedical recordsDepression diagnosisMedication ordersClinical careLower oddsPatientsPsychotic disordersPatient encountersHealth disparitiesPrescribingConclusionsOur findingsEducation intervention
2020
Nationally Advancing Quality Improvement in Restraint and Seclusion Measures
Li L, Mathis WS. Nationally Advancing Quality Improvement in Restraint and Seclusion Measures. Psychiatric Services 2020, 71: 1322-1323. PMID: 33256532, DOI: 10.1176/appi.ps.202000461.Peer-Reviewed Original ResearchBuilding Psychiatric Quality Programs and Defining Quality Leadership Roles at Four Academic Medical Centers
Li L, Black WE, Cheung EH, Fisher WS, Wells KB. Building Psychiatric Quality Programs and Defining Quality Leadership Roles at Four Academic Medical Centers. Academic Psychiatry 2020, 44: 795-801. PMID: 32944874, PMCID: PMC7498111, DOI: 10.1007/s40596-020-01317-7.Peer-Reviewed Original ResearchAssociation of a Prior Psychiatric Diagnosis With Mortality Among Hospitalized Patients With Coronavirus Disease 2019 (COVID-19) Infection
Li L, Li F, Fortunati F, Krystal JH. Association of a Prior Psychiatric Diagnosis With Mortality Among Hospitalized Patients With Coronavirus Disease 2019 (COVID-19) Infection. JAMA Network Open 2020, 3: e2023282. PMID: 32997123, PMCID: PMC7527869, DOI: 10.1001/jamanetworkopen.2020.23282.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedAged, 80 and overBetacoronavirusCerebrovascular DisordersCohort StudiesComorbidityCoronavirus InfectionsCOVID-19Diabetes MellitusFemaleHeart FailureHIV InfectionsHospitalizationHumansKaplan-Meier EstimateKidney DiseasesLiver DiseasesMaleMental DisordersMiddle AgedMyocardial InfarctionNeoplasmsPandemicsPneumonia, ViralProportional Hazards ModelsRisk FactorsSARS-CoV-2United StatesEmergency conversion to telehealth in hospital-based psychiatric outpatient services: Strategy and early observations
Childs AW, Klingensmith K, Bacon SM, Li L. Emergency conversion to telehealth in hospital-based psychiatric outpatient services: Strategy and early observations. Psychiatry Research 2020, 293: 113425. PMID: 32862066, PMCID: PMC7443337, DOI: 10.1016/j.psychres.2020.113425.Peer-Reviewed Original ResearchConceptsIntensive outpatientAmbulatory servicesComplex patient populationPsychiatric outpatient servicesMental health servicesCritical mental health servicesMental health needsPatient populationEmergency conversionOutpatient servicesPhysical distancing guidelinesClinical protocolsHealth servicesHealth needsClinical settingInfectious spreadGroup-based servicesTelehealthCOVID-19Earlier observationsHelpful toolOutpatientsPatientsWorkforce trainingAction stepsRapid design and deployment of intensive outpatient, group-based psychiatric care using telehealth during coronavirus disease 2019 (COVID-19)
Childs AW, Unger A, Li L. Rapid design and deployment of intensive outpatient, group-based psychiatric care using telehealth during coronavirus disease 2019 (COVID-19). Journal Of The American Medical Informatics Association 2020, 27: 1420-1424. PMID: 32687151, PMCID: PMC7454574, DOI: 10.1093/jamia/ocaa138.Peer-Reviewed Original ResearchConceptsPsychiatric careHigh-risk psychiatric patientsHigh-risk individualsOutpatient psychiatric servicesProvider-patient interactionsAdolescent treatment programsCOVID-19Telehealth service deliveryGroup-based interventionPsychiatric interventionPsychiatric servicesPsychiatric patientsPhysical distancing guidelinesTreatment programTelehealth policyTelehealthInfectious spreadService deliveryCOVID-19 outbreakTelehealth infrastructureFeasibility testingCareInterventionDeliveryGroup supportEmerging Need and Early Experiences With a COVID-Specific Psychiatric Unit
Li L, Stanley R, Fortunati F. Emerging Need and Early Experiences With a COVID-Specific Psychiatric Unit. Psychiatric Services 2020, 71: 873-873. PMID: 32741335, DOI: 10.1176/appi.ps.71803.Peer-Reviewed Original ResearchChallenges and Priorities in Responding to COVID-19 in Inpatient Psychiatry
Li L. Challenges and Priorities in Responding to COVID-19 in Inpatient Psychiatry. Psychiatric Services 2020, 71: 624-626. PMID: 32321388, DOI: 10.1176/appi.ps.202000166.Peer-Reviewed Original Research
2019
Substance Use Disorders in Later Life: A Review and Synthesis of the Literature of an Emerging Public Health Concern
Yarnell S, Li L, MacGrory B, Trevisan L, Kirwin P. Substance Use Disorders in Later Life: A Review and Synthesis of the Literature of an Emerging Public Health Concern. American Journal Of Geriatric Psychiatry 2019, 28: 226-236. PMID: 31340887, DOI: 10.1016/j.jagp.2019.06.005.Peer-Reviewed Original ResearchConceptsSubstance use disordersPublic health concernOlder individualsUse disordersDrug useOlder personsHealth concernGeriatric psychiatryComprehensive care modelLater lifeIllicit drugsField of geriatricsTreatment modalitiesGeriatric cohortCurrent treatment modelsCare modelMeeting criteriaHealth problemsPsychiatric conditionsSubstance abuseDrug dependencyIllicit substancesDrug abuseDrug habitsPrevious cohortA Qualitative Study of Implementation Challenges of Mental Health Clubhouse Rehabilitation Services in China’s Hunan Province
Li L, Deng M, Liu Z, Rohrbaugh R. A Qualitative Study of Implementation Challenges of Mental Health Clubhouse Rehabilitation Services in China’s Hunan Province. Psychiatric Services 2019, 70: 674-680. PMID: 31035893, DOI: 10.1176/appi.ps.201800549.Peer-Reviewed Original ResearchConceptsMental health rehabilitation servicesPsychosocial rehabilitation servicesHealth rehabilitation servicesRehabilitation servicesMental illnessPsychosocial rehabilitationPublic health prioritySerious mental illnessRecovery-oriented servicesMiddle-income countriesEvidence-based practiceHealth priorityEarly identificationStandard qualitative methodsHospital leadersIllnessStandard evaluationRehabilitationFocus groupsQualitative studyInterview transcriptsStrong government commitmentStigmaImplementation challengesChina’s Hunan ProvinceRisk of Readmission After Discharge From Skilled Nursing Facilities Following Heart Failure Hospitalization: A Retrospective Cohort Study
Weerahandi H, Li L, Bao H, Herrin J, Dharmarajan K, Ross JS, Kim KL, Jones S, Horwitz LI. Risk of Readmission After Discharge From Skilled Nursing Facilities Following Heart Failure Hospitalization: A Retrospective Cohort Study. Journal Of The American Medical Directors Association 2019, 20: 432-437. PMID: 30954133, PMCID: PMC6486375, DOI: 10.1016/j.jamda.2019.01.135.Peer-Reviewed Original ResearchConceptsSkilled nursing facilitiesSNF dischargeRetrospective cohort studySNF lengthHeart failureHF hospitalizationComposite outcomeCohort studyNursing facilitiesService beneficiaries 65Heart failure hospitalizationRisk of readmissionHazard rate ratiosFailure hospitalizationUnplanned readmissionHF diagnosisHospital dischargePostdischarge outcomesSNF stayMedicare patientsMedicare feeHome transitionPatientsReadmissionDay 3