Try a new search

Format these results:

Searched for:

person:cmp277

in-biosketch:true

Total Results:

42


Understanding patient preference for physician attire in ambulatory clinics: a cross-sectional observational study

Zollinger, Marc; Houchens, Nathan; Chopra, Vineet; Clack, Lauren; Schreiber, Peter Werner; Kuhn, Latoya; Snyder, Ashley; Saint, Sanjay; Petrilli, Christopher M; Sax, Hugo
OBJECTIVES/OBJECTIVE:We explored patient perceptions regarding physician attire in different clinical contexts and resultant effects on the physician-patient relationship. SETTING/METHODS:The 900-bed University Hospital Zurich, Switzerland. PARTICIPANTS/METHODS:A convenience sample of patients receiving care in dermatology, infectious diseases and neurology ambulatory clinics of the University Hospital Zurich participated in a paper-based survey. PRIMARY AND SECONDARY OUTCOME MEASURES/UNASSIGNED:The survey instrument was randomised and showed photographs of male or female physicians wearing various forms of attire. On the basis of the respondents' ratings of how the physician's attire affected perceptions across five domains (knowledgeable, trustworthy, caring, approachable and comfort with the physician), a composite preference score for attire was calculated as the primary outcome. Secondary outcomes included variation in preferences by respondent characteristics and context in which care was provided. RESULTS:Of 834 patient respondents (140 in dermatology, 422 in infectious diseases and 272 in neurology), 298 (36%) agreed that physician attire was important. When compared with all available choices, the combination of white scrubs with white coat was rated highest while a business suit ranked lowest. Variation in preferences and opinions for attire were noted relative to respondent demographics and the clinical setting in which the survey was administered. For example, compared with younger patients, respondents ≥65 years of age more often reported that physician dress was both important to them and influenced how happy they were with their care (p=0.047 and p=0.001, respectively). CONCLUSIONS:Outpatients at a large Swiss University hospital prefer their physicians to be dressed in white scrubs with white coat. Substantial variation among respondents based on demographics, type of physician and clinical setting were observed. Healthcare systems should consider context of care when defining policies related to dress code.
PMID: 31072853
ISSN: 2044-6055
CID: 3900902

Patient Preferences for Physician Attire in Ophthalmology Practices

De Lott, Lindsey B; Panarelli, Joseph F; Samimi, David; Petrilli, Christopher; Snyder, Ashley; Kuhn, Latoya; Saint, Sanjay; Chopra, Vineet; Whipple, Katherine M
Importance/UNASSIGNED:Interest is growing in targeting physician attire to improve the patient experience. Few studies in ophthalmology have examined patient preferences for physician attire. Objective/UNASSIGNED:To understand patient preferences for physician attire in ophthalmology practices in the United States. Design/UNASSIGNED:Survey-based, cohort study. Setting/UNASSIGNED:Two private and two academic ophthalmology practices. Participants/UNASSIGNED:A convenience sample of patients receiving ophthalmic care between June 1, 2015 and October 31, 2016. Methods/UNASSIGNED:A questionnaire containing 22 questions and photographs of a male and female physician in seven forms of attire were presented to patients; 14 unique questionnaires were randomly distributed. Patient preference for physician attire was the primary outcome determined by summing ratings of how knowledgeable, trustworthy, caring, approachable, and comfortable the pictured physician made the respondent feel. One-way ANOVA assessed differences in mean composite scores. Comparisons between respondent demographics, practice type, and attire preferences were assessed by chi-square tests. Patient satisfaction was assessed by agreement with questions about importance of physician attire and whether this influences happiness with care. Results/UNASSIGNED:< 0.05). Preferences for attire varied by clinical setting: patients preferred surgeons (45.2%) and physicians in emergency rooms (41.7%) in scrubs rather than formal attire with white coat. Conclusions/UNASSIGNED:Physician attire is important to patients receiving ophthalmic care. Policies aimed at physician attire in ophthalmology practices should be considered.
PMCID:6716523
PMID: 31475243
ISSN: 2475-4757
CID: 4068932

Reducing Unnecessary Vitamin D Screening in an Academic Health System: What Works and When

Petrilli, Christopher M; Henderson, James; Keedy, Jenna; Dibble, Emily; Wei, Melissa Y; Prussack, Julie K; Greenberg, Grant; Kerr, Eve
PMID: 30063888
ISSN: 1555-7162
CID: 3235892

Web Exclusive. Annals for Hospitalists Inpatient Notes - Clinical Pearls-A Middle-Aged Man With Pneumonia and Elevated High-Sensitivity Troponin Levels

Petrilli, Christopher M; Giacherio, Donald A
PMID: 30326100
ISSN: 1539-3704
CID: 3368372

Large-Scale Variability of Inpatient Tacrolimus Therapeutic Drug Monitoring at an Academic Transplant Center: a Retrospective Study

Strohbehn, Garth W; Pan, Warren W; Petrilli, Christopher M; Heidemann, Lauren; Larson, Sophia; Aaronson, Keith D; Johnson, Matt; Ellies, Tammy; Heung, Michael
BACKGROUND:Inpatient tacrolimus therapeutic drug monitoring (TDM) lacks standardized guidelines. In this study, the authors analyzed variability in the pre-analytical phase of the inpatient tacrolimus TDM process at their institution. METHODS:Patients receiving tacrolimus (twice-daily formulation) and tacrolimus laboratory analysis were included in the study. Times of tacrolimus administration and laboratory study collection were extracted and time distribution plots for each step in the inpatient TDM process were generated. RESULTS:Trough levels were drawn appropriately in 25.9% of the cases. Timing between doses was consistent, with 91.9% of the following dose administrations occurring 12 +/- 2 hours after the previous dose. Only 38.1% of the drug administrations occurred within one hour of laboratory study collection. Tacrolimus-related patient safety events were reported at a rate of 1.9 events per month while incorrect timing of TDM sample collection occurred approximately 200 times per month. Root cause analysis identified a TDM process marked by a lack of communication and coordination of drug administration and TDM sample collection. Extrapolating findings nationwide, we estimate $22 million in laboratory costs wasted annually. CONCLUSIONS:Based on this large single-center study, the authors concluded that the inpatient TDM process is prone to timing errors, thus is financially wasteful, and at its worst harmful to patients due to clinical decisions being made on the basis of unreliable data. Further work is needed on systems solutions to better align the laboratory study collection and drug administration processes.
PMID: 29750738
ISSN: 1536-3694
CID: 3150592

Eliminating Inappropriate Telemetry Monitoring: An Evidence-Based Implementation Guide

Yeow, Raymond Y; Strohbehn, Garth W; Kagan, Calvin M; Petrilli, Christopher M; Krishnan, Jamuna K; Edholm, Karli; Sussman, L Scott; Blanck, Jaime F; Popa, Remus I; Pahwa, Amit K
In-hospital continuous electrocardiographic monitoring, commonly referred to as telemetry, has allowed for rapid recognition of life-threatening conditions, including complex arrhythmias and myocardial ischemia. However, inappropriate use can lead to unnecessary downstream testing from "false alarms," which in turn affects clinician efficiency and increases health care costs without benefiting patients. For these reasons, the Society of Hospital Medicine's Choosing Wisely campaign recommended use of a protocol-driven discontinuation of telemetry. The American Heart Association (AHA) developed a set of Practice Standards for the appropriate use of telemetry monitoring in 2004, which they updated in 2017. Unfortunately, the AHA Practice Standards have not been widely adopted-with as many as 43% of monitored patients lacking a recommended indication for monitoring. Thus, we created an overview discussing the safety and efficacy of incorporating the AHA Practice Standards and a review of studies highlighting their successful incorporation within patient care workflow. We conclude by outlining an "implementation blueprint" for health system professionals and administrators seeking to change their institution's culture of telemetry use. As the health care landscape continues to shift, enacting high-value initiatives that improve patient safety and efficiency of care will be critical.
PMID: 29868894
ISSN: 2168-6114
CID: 3154482

Understanding patient preference for physician attire: a cross-sectional observational study of 10 academic medical centres in the USA

Petrilli, Christopher M; Saint, Sanjay; Jennings, Joseph J; Caruso, Andrew; Kuhn, Latoya; Snyder, Ashley; Chopra, Vineet
OBJECTIVE:Several large studies have shown that improving the patient experience is associated with higher reported patient satisfaction, increased adherence to treatment and clinical outcomes. Whether physician attire can affect the patient experience-and how this influences satisfaction-is unknown. Therefore, we performed a national, cross-sectional study to examine patient perceptions, expectations and preferences regarding physicians dress. SETTING/METHODS:10 academic hospitals in the USA. PARTICIPANTS/METHODS:Convenience sample of 4062 patients recruited from 1 June 2015 to 31 October 2016. PRIMARY AND SECONDARY OUTCOMES MEASURES/UNASSIGNED:We conducted a questionnaire-based study of patients across 10 academic hospitals in the USA. The questionnaire included photographs of a male and female physician dressed in seven different forms of attire. Patients were asked to rate the provider pictured in various clinical settings. Preference for attire was calculated as the composite of responses across five domains (knowledgeable, trustworthy, caring, approachable and comfortable) via a standardised instrument. Secondary outcome measures included variation in preferences by respondent characteristics (eg, gender), context of care (eg, inpatient vs outpatient) and geographical region. RESULTS:Of 4062 patient responses, 53% indicated that physician attire was important to them during care. Over one-third agreed that it influenced their satisfaction with care. Compared with all other forms of attire, formal attire with a white coat was most highly rated (p=0.001 vs scrubs with white coat; p<0.001 all other comparisons). Important differences in preferences for attire by clinical context and respondent characteristics were noted. For example, respondents≥65 years preferred formal attire with white coats (p<0.001) while scrubs were most preferred for surgeons. CONCLUSIONS:Patients have important expectations and perceptions for physician dress that vary by context and region. Nuanced policies addressing physician dress code to improve patient satisfaction appear important.
PMCID:5988098
PMID: 29844101
ISSN: 2044-6055
CID: 3154472

Evidence-Based Guidelines to Eliminate Repetitive Laboratory Testing

Eaton, Kevin P; Levy, Kathryn; Soong, Christine; Pahwa, Amit K; Petrilli, Christopher; Ziemba, Justin B; Cho, Hyung J; Alban, Rodrigo; Blanck, Jaime F; Parsons, Andrew S
Routine daily laboratory testing of hospitalized patients reflects a wasteful clinical practice that threatens the value of health care. Choosing Wisely initiatives from numerous professional societies have identified repetitive laboratory testing in the face of clinical stability as low value care. Although laboratory expenditure often represents less than 5% of most hospital budgets, the impact is far-reaching given that laboratory tests influence nearly 60% to 70% of all medical decisions. Excessive phlebotomy can lead to hospital-acquired anemia, increased costs, and unnecessary downstream testing and procedures. Efforts to reduce the frequency of laboratory orders can improve patient satisfaction and reduce cost without negatively affecting patient outcomes. To date, numerous interventions have been deployed across multiple institutions without a standardized approach. Health care professionals and administrative leaders should carefully strategize and optimize efforts to reduce daily laboratory testing. This review presents an evidence-based implementation blueprint to guide teams aimed at improving appropriate routine laboratory testing among hospitalized patients.
PMID: 29049500
ISSN: 2168-6114
CID: 3085092

Innovating Toward High-Value Cardiovascular Care [Editorial]

Alyesh, Daniel; Petrilli, Christopher; Obi, Andrea
PMID: 28982508
ISSN: 1558-3597
CID: 3154462

Inpatient Thrombophilia Testing: At What Expense?

Heidemann, Lauren A; Petrilli, Christopher M; Barnes, Geoffrey D
PMID: 28914288
ISSN: 1553-5606
CID: 3076712