2020
Implementation Evaluation of a Complex Intervention to Improve Timeliness of Care for Veterans with Transient Ischemic Attack
Damush T, Miech E, Rattray N, Homoya B, Penney L, Cheatham A, Baird S, Myers J, Austin C, Myers L, Perkins A, Zhang Y, Giacherio B, Kumar M, Murphy L, Sico J, Bravata D. Implementation Evaluation of a Complex Intervention to Improve Timeliness of Care for Veterans with Transient Ischemic Attack. Journal Of General Internal Medicine 2020, 36: 322-332. PMID: 33145694, PMCID: PMC7878645, DOI: 10.1007/s11606-020-06100-w.Peer-Reviewed Original ResearchConceptsTransient ischemic attackIschemic attackClinical improvementStepped-wedge implementation trialQI teamsGuideline-concordant careTimeliness of careQuality improvement interventionsVA healthcare systemComplex quality improvement interventionsPrimary outcomeTeam activationImplementation strategiesKey implementation strategiesImplementation trialImprovement interventionsClinical staffComplex interventionsConsolidated FrameworkQI programQI planExternal facilitationImplementation researchHealthcare systemPoint improvementAssessment 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
2019
The protocol-guided rapid evaluation of veterans experiencing new transient neurological symptoms (PREVENT) quality improvement program: rationale and methods
Bravata D, Myers L, Homoya B, Miech E, Rattray N, Perkins A, Zhang Y, Ferguson J, Myers J, Cheatham A, Murphy L, Giacherio B, Kumar M, Cheng E, Levine D, Sico J, Ward M, Damush T. The protocol-guided rapid evaluation of veterans experiencing new transient neurological symptoms (PREVENT) quality improvement program: rationale and methods. BMC Neurology 2019, 19: 294. PMID: 31747879, PMCID: PMC6865042, DOI: 10.1186/s12883-019-1517-x.Peer-Reviewed Original ResearchConceptsElectronic health record toolsRecurrent vascular eventsTime-sensitive careProportion of patientsTransient neurological symptomsStepped-wedge trialProcess of careQuality improvement interventionsMulti-component interventionQuality Improvement ProgramElectronic quality measuresQI supportTIA careVascular eventsNeurological symptomsLearning healthcare systemAttack patientsClinical conditionsMedical CenterEffectiveness outcomesHigh riskTimely managementClinical protocolsImprovement interventionsClinical setting
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 riskPatients