2020
Assessment of the Protocol-Guided Rapid Evaluation of Veterans Experiencing New Transient Neurological Symptoms (PREVENT) Program for Improving Quality of Care for Transient Ischemic Attack
Bravata DM, Myers LJ, Perkins AJ, Zhang Y, Miech EJ, Rattray NA, Penney LS, Levine D, Sico JJ, Cheng EM, Damush TM. Assessment of the Protocol-Guided Rapid Evaluation of Veterans Experiencing New Transient Neurological Symptoms (PREVENT) Program for Improving Quality of Care for Transient Ischemic Attack. JAMA Network Open 2020, 3: e2015920. PMID: 32897372, PMCID: PMC7489850, DOI: 10.1001/jamanetworkopen.2020.15920.Peer-Reviewed Original ResearchConceptsTransient ischemic attackQuality of careIschemic attackElectronic health record toolsRecurrent vascular eventsDiverse medical centersGuideline-recommended processesQuality improvement interventionsProportion of veteransHealth care systemImplementation periodIntervention associationsQI supportVascular eventsMost patientsPrimary outcomeMean ageCare existIntervention periodSymptom interventionMedical CenterQI interventionsMAIN OUTCOMEHigh riskTimely management
2018
Uncertainty as a Key Influence in the Decision To Admit Patients with Transient Ischemic Attack
Homoya BJ, Damush TM, Sico JJ, Miech EJ, Arling GW, Myers LJ, Ferguson JB, Phipps MS, Cheng EM, Bravata DM. Uncertainty as a Key Influence in the Decision To Admit Patients with Transient Ischemic Attack. Journal Of General Internal Medicine 2018, 34: 1715-1723. PMID: 30484102, PMCID: PMC6712185, DOI: 10.1007/s11606-018-4735-9.Peer-Reviewed Original ResearchConceptsTransient ischemic attackVA Medical CenterTIA patientsChart review dataAdmission ratesTIA admissionsTIA careABCD2 scoreIschemic attackChart reviewAdministrative dataSubsequent vascular eventsSecondary prevention strategiesSubset of patientsQuality improvement interventionsHigher admission ratesQuality of careKey ResultsProvidersTimely workupVascular eventsEmergency departmentInpatient settingMedical CenterHigh riskPatientsQuality of Care for Veterans With Transient Ischemic Attack and Minor Stroke
Bravata DM, Myers LJ, Arling G, Miech EJ, Damush T, Sico JJ, Phipps MS, Zillich AJ, Yu Z, Reeves M, Williams LS, Johanning J, Chaturvedi S, Baye F, Ofner S, Austin C, Ferguson J, Graham GD, Rhude R, Kessler CS, Higgins DS, Cheng E. Quality of Care for Veterans With Transient Ischemic Attack and Minor Stroke. JAMA Neurology 2018, 75: 419-427. PMID: 29404578, PMCID: PMC5885264, DOI: 10.1001/jamaneurol.2017.4648.Peer-Reviewed Original ResearchConceptsTransient ischemic attackMinor strokeEmergency departmentElements of careDay 2Ischemic attackDay 7Federal fiscal year 2014Intensive care unit stayDeep vein thrombosis prophylaxisVeterans Health Administration systemCare qualityReceipt of thrombolysisRecurrent vascular eventsStroke care qualityVHA emergency departmentGuideline-concordant careLength of stayGuideline-recommended processesProcess of careHealth Administration systemQuality of careHemoglobin A1c measurementsElectronic quality measuresHealth care system
2017
Development and Validation of Electronic Quality Measures to Assess Care for Patients With Transient Ischemic Attack and Minor Ischemic Stroke
Bravata DM, Myers LJ, Cheng E, Reeves M, Baye F, Yu Z, Damush T, Miech EJ, Sico J, Phipps M, Zillich A, Johanning J, Chaturvedi S, Austin C, Ferguson J, Maryfield B, Snow K, Ofner S, Graham G, Rhude R, Williams LS, Arling G. Development and Validation of Electronic Quality Measures to Assess Care for Patients With Transient Ischemic Attack and Minor Ischemic Stroke. Circulation Cardiovascular Quality And Outcomes 2017, 10: e003157. PMID: 28912200, DOI: 10.1161/circoutcomes.116.003157.Peer-Reviewed Original ResearchConceptsTransient ischemic attackElectronic quality measuresMinor ischemic strokeProportion of patientsIschemic attackIschemic strokeEHR dataDeep vein thrombosis prophylaxisVeterans Health Administration facilitiesCoronary risk assessmentInternational normalized ratioElectronic health record dataIschemic stroke careHealth record dataQuality of careSubstance abuse referralAntihypertensive classesMedication intensificationThrombosis prophylaxisLipid managementChart reviewStroke careAtrial fibrillationNeurology consultationNormalized ratio