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Browsing Abstracts by Author "Allen, John G."
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Item Life Guard Rescues at Seattle Parks’ lake beaches(2014-03) Allen, John G.; Johnson, Leigh; Loewen, Ashlee; Martin, Ashley; Johnson, Valerie; Camp, Kathlene E.; Toale, Ashley; Rice, MargaritaPurpose (a): This purpose of this project is to conduct an exploratory statistical analysis of Water Rescue/Assist Reports for nine fresh water beaches in King County, Washington, for the period 2008 to 2012. The nine beaches covered by the Water Rescue/Assist Report are East Greenlake Beach, Madison Beach, Madrona Beach, Magnuson Beach, Matthews Beach, Mount Baker Beach, Pritchard Beach, Seward Beach, and West Greenlake Beach. The project alternate hypothesis is: By describing and comparing data compiled from the Water Rescue/Assist Reports, public health leaders can make better decisions regarding water safety and can use the information for additional study. Methods (b): A total of 508 Water Rescue/Assist Reports reviewed for this analysis. The data from the reports were entered into and analyzed in Microsoft Excel. We reviewed lifeguard rescue records that collected data on: incident date and time of day; victim gender and age; parent availability during rescues for victims under age 18; victim symptoms after rescue; possible neck/back injuries; disposition to hospital; cause of incident; water depth; water temperature; park rules disobeyed; number of active and passive patrons present at time of rescue. The analysis included: age and gender based descriptive statistics; the ratio of lifeguards to patrons; water temperature correlated with rescue frequency; odds ratios and relative risks based on gender and age and the presence of a parent at the time of rescue. We searched records of the King County Medical Examiners deaths to identify drowning deaths occurring in Seattle Parks. Double entry was completed for each report to maximize data reliability. A data dictionary was developed as a guide for entering data and a blank Water Rescue/Assist Reports and was used as a reference to increase the speed of entering data.The analysis uses coded data to make data inferences using primarily descriptive statistics. Evaluations of non-coded or non-standardized report entries (such as water depth and number of guards on duty) was limited the “Other” category under “Accidents possible causes” in order to determine any possible trends based on information rescuers entered into the form. Results (c): Results: 508 rescues were completely recorded; an average of 11/park/year. Rescues steadily increased from beach opening at 11 AM and peaked at 5-7 PM when beaches closed. Most (65%) involved males; males outnumbered females between the ages of 7-50 years (RR=3.1, p5-10 feet deep; (29%) occurred in waters >10-15 feet deep.Most (65%) involved males; males outnumbered females between the ages of 7-50 years (RR=3.1, p<.05). Most (77%) rescues involved those 7-26 years of age; 55% were < 18 years. The greatest number of rescues involved those 7-10 years. Parents were on site for 90% of children <10 years of age. The most commonly listed causes were “overestimated ability”, “tired”, “waves”, and ”nonswimmer”. Drugs/alcohol were listed in 5% (28/503) of rescues. Half of rescues (51%, 236/ 462) rescues occurred in waters >5-10 feet deep; (29%) occurred in waters >10-15 feet deep. Conclusions (d): This exploratory analysis provides a snapshot of the data from the Water Rescue / Assist Reports filed from 2008-12. The data underscores some key points to be considered, including: most rescued victims were male; rescue frequency positively correlated with increasing levels of parental absence; swimmer overconfidence in their swimming abilities was the most common cause for rescues; more than 70% of rescues occurred in water depth exceeding 5 feet; the relative risk of rescues was twice what is was when there were fewer swimmers in the water as compared to more swimmers in the water. Public health leaders and others can use the information from these reports to better understand the factors involved with rescues and to conduct further study and develop effective policy.Item Minimizing 30-Day Hospital Readmissions and Falls and Improving Quality of Life through the Safe Transitions for the Elderly Patient (STEP) Program(2014-03) Allen, John G.; Johnson, Leigh; Loewen, Ashlee; Martin, Ashley; Johnson, Valerie; Camp, Kathlene E.; Toale, Ashley; Rice, MargaritaBackground: The STEP Program will provide high quality transition of care services for discharged Medicaid eligible elders of Tarrant County that includes a transition of care coordinator and in home medical care team. The in home medical care team comprises a nurse practitioner, physical therapist, social worker and physician. The foundation of the STEP Program was developed by the University of North Texas Health Science Center (UNTHSC) as part of an 1115 Waiver grant proposal approved by CMS in 2012. The STEP Program was designed to improve the coordination and continuity of care for Medicaid eligible patients 65 years of age and older transitioning from the hospital to the home setting following discharge. The primary goals of the STEP program are to reduce all-cause 30 day hospital readmissions, improve quality of life, and decrease falls among the elderly. These goals were selected because these factors-unnecessary readmissions, excessive falls, and poor quality of life-are often the result of substandard medical coordination and management. Additionally, these factors unnecessarily increase healthcare costs. Methods: The STEP Program will provide care transition services for 750 patients from October 1, 2013, to September 30, 2016, via referrals received from local hospital partners. STEP faculty and staff have developed evidence based protocols and communication strategies aimed at meeting or exceeding performance metrics for reducing hospital readmission, decreasing falls, and improving Quality of Life. The NEXTGEN EMR will be the primary means for gathering data for these metrics and assessing the impact of the evidence based protocols and communication strategies. Plan-Do-Study-Act methodology will be used to regularly evaluate and re-evaluate STEP Program practices to not only meet or exceed performance metrics, but to continuously improve performance. In addition, STEP team members have worked to finalize business agreements with hospital partners (which will serve as patient referral sources) and have begun to market to and partner with community resources that will help meet the social, spiritual, financial, physical, medical and other identified needs of the STEP Program’s target patient population. STEP Team members have met with more than 15 community resources and have hosted outreach events to provide an overview of the STEP Program. Expected Results: The STEP Program must demonstrate a 5% and 10% improvement in federal fiscal years 2015 and 2016, respectively, for reducing hospital readmissions, decreasing falls, and improving Quality of Life among the elderly. Baseline data will be gathered during federal fiscal year 2014. Conclusion: By meeting or exceeding performance metrics for reducing hospital readmission, decreasing falls, and improving Quality of Life, the STEP Program can contribute to improving the quality of and reducing the costs for care transition services. Purpose (a): The STEP Program was designed to improve the coordination and continuity of care for Medicaid eligible patients 65 years of age and older transitioning from the hospital to the home setting following discharge. The primary goals of the STEP program are to reduce all-cause 30 day hospital readmissions, improve quality of life, and decrease falls among the elderly. Methods (b): The STEP Program will provide care transition services for 750 patients from October 1, 2013, to September 30, 2016, via referrals received from local hospital partners. STEP faculty and staff have developed evidence based protocols and communication strategies aimed at meeting or exceeding performance metrics for reducing hospital readmission, decreasing falls, and improving Quality of Life. The NEXTGEN EMR will be the primary means for gathering data for these metrics and assessing the impact of the evidence based protocols and communication strategies. Plan-Do-Study-Act methodology will be used to regularly evaluate and re-evaluate STEP Program practices to not only meet or exceed performance metrics, but to continuously improve performance. In addition, STEP team members have worked to finalize business agreements with hospital partners (which will serve as patient referral sources) and have begun to market to and partner with community resources that will help meet the social, spiritual, financial, physical, medical and other identified needs of the STEP Program’s target patient population. STEP Team members have met with more than 15 community resources and have hosted outreach events to provide an overview of the STEP Program. Results (c): The STEP Program must demonstrate a 5% and 10% improvement in federal fiscal years 2015 and 2016, respectively, for reducing hospital readmissions, decreasing falls, and improving Quality of Life among the elderly. Baseline data will be gathered during federal fiscal year 2014. Conclusions (d): Care transition models are effective in providing a safer and more successful recovery for high risk elderly patients recently discharged from the hospital. Coordination of efficient, interdisciplinary transitional care is believed to be critical for reducing 30-day hospital readmissions, falls, and healthcare costs and increasing quality of life in patients. Data collected during the STEP program is expected to reflect a decrease fall and hospital readmission rates and improve quality of life outcomes. This program will demonstrate a unique transitional care model that may improve health care delivery post-hospitalization.