Select 2023 Publications

Davis TL, Schäfer WLA, Blake SC, Close S, Balbale SN, Perry JE, Zarate RP, Ingram M, Strople J, Johnson JK, Holl JL, Raval MV

Enhanced recovery protocols (ERPs) for gastrointestinal surgery result in shorter lengths of stay, shortened time to regular diet, and fewer opioids. This study evaluates ERP implementation at 18 US hospitals with pediatric surgery services. We conducted semi-structured interviews with 48 pediatric surgeons, anesthesiologists, gastroenterologists, nurses, and physician assistants. Facilitators for effective practices included standardized protocols and organizational support, while barriers included a lack of compliance. Facilitators for effective implementation were checklists, protected time to oversee ERPs, and electronic medical record order sets; barriers included having no formal ERP team. Facilitators for enabling context were having a multidisciplinary team and patient/family engagement, and a barrier was having limited team buy-in. ERP implementation in pediatric surgery needs team-based support for change management and protocols for developing an ERP implementation team.

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Chrenka EA, Roblin DW, Gander JC, Powers JH 3rd, Cromwell L, Kodthala P, Whiting TS, Sesay MM, Segall MF, Deneal AN, Truitt AR, Sour EU, Martinson BC

InFLUenza Patient-reported Outcome (FLU-PRO Plus) is a 34-item patient-reported outcome instrument designed to capture the intensity and frequency of viral respiratory symptoms. We evaluated whether FLU-PRO Plus responses could discriminate between symptoms of COVID-19 and influenza-like illness with no COVID diagnosis across three integrated health care systems. FLU-PRO Plus was administered daily for 14 days, and 314 patients completed Day 1. Three symptom clusters (general body, tracheal/bronchial, and nasopharyngeal) identified from FLU-PRO Plus responses successfully discriminated patients with COVID-19 from non-COVID influenza-like illness and were associated with QoL and predicted symptom duration.

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Owen-Smith AA, McDonald B, Sesay MM, Simon GE, McCracken CE

This study examined how chronic noncancer pain (CNCP) impacts the initiation of depression treatment. We performed a retrospective cohort study of KPGA adult members who received a diagnosis of depression and classified them by the presence or absence of comorbid CNCP. Outcomes included fulfillment of a new antidepressant medication and a follow-up mental health encounter. Over 27% of the 22,996 members meeting the inclusion criteria had a diagnosis of CNCP. Results demonstrated that there was no difference in time to a new antidepressant fill among members with and without CNCP. Members with CNCP were less likely to have a follow-up mental health encounter.

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