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RCS 97-401 – HSR&D Study

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RCS 97-401
Research Career Scientist Award
Amy K. Rosen PhD
VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA
Boston, MA
Funding Period: October 2006 - September 2025

BACKGROUND/RATIONALE:
This Research Career Scientist Award focuses on the quality and safety of care delivered to the nation's Veterans. My focus over the past year has been on patient safety/quality of care and evaluation of the Veterans Choice Program (VCP), with expansion of community care (CC) due to the VHA MISSION Act. Our focus in the Patient Safety Center of Inquiry (PSCI) was on advancing the measurement of patient safety. Because patient safety events are generally infrequent, and systems have not been readily available to comprehensively examine their prevalence, we developed a Guiding Patient Safety Data Display tool (GPS) that allows facilities to view all the safety measures they currently use into one large picture. From interviews with staff, we learned that facilities are actively using these GPS tools to target safety areas for quality improvement activities in order to improve care. Also, the SAIL report has prompted facilities to pay particular attention to specific measures, such as the AHRQ Patient Safety Indicators (PSIs), which we also report in the GPS. By examining both the SAIL report and the GPS, facilities have gained a better understanding of what areas need the most quality improvement. We have also developed a GPS toolkit that guides facilities in how to use and assess the findings from the GPS data display tool. We have implemented the data display and toolkit at 6 facilities and will be continuing to revise and expand implementation of this in the coming year with additional funds from NCPS.

My other focus this year, evaluation of the VCP, involved a strong collaboration with operational partners from the Office of Community Care and the Partnered Evidence-based Policy Center, as well as co-PIs and staff from VA Palo Alto and VA Salt Lake City (I served as one of three co-PIs along with Drs. Wagner and Vanneman). We developed several datasets that combined several Choice files, along with traditional Fee files in order to examine which Veterans are using care in the community through Choice, the types of services they are using, and whether trends in the use of community care have changed since Choice inception. We also validated some of the data elements included in the Choice files, starting with the "category of care" variable which describes the type of services the Veteran received through Choice. We mapped the category of care variable to other definitions that include provider type and type of services and found that category of care was not very accurate for specialty care or surgical care. We informed our partners of this and we are still working with them to resolve these discrepancies. Through our new SDR project, we continue to work closely with our partners on the Community Care data.

OBJECTIVE(S):
The objectives of this RCS Award are:
1) to become a national expert in measuring and evaluating quality and safety in VA and Community Care (CC)
2) to partner with relevant VA stakeholders and stakeholders groups to develop and implement quality improvement initiatives (e.g., National Center for Patient Safety (NCPS) and the Office of Community Care (OCC))
3) to evaluate and compare the quality and safety of care for Veterans using VA and CC particularly related to surgery and mental health
4) to continue mentoring junior faculty, career development awardees, post-docs, and other investigators in order for them to become successful independent investigators


METHODS:
Methods:


These objectives will be accomplished through continued funding from the National Center for Patient Safety for expansion and revision of the Guiding Patient Safety data display and toolkit as well as continued HSR&D funding through a SDR proposal for the next three years. We have also received start-up funds from QUERI to begin evaluation of the implementation of safety processes in community care by OCC and NCPS and will hopefully get additional funds for another two years to continue this year through 2021.

FINDINGS/RESULTS:
Not yet available.

IMPACT:
Impact:

Our PSCI GPS tools are currently being used by selected VA facilities to identify the important/prevalent safety events that occur at their facility and to target quality improvement activities. We continue to revise and expand the GPS tools which we hope will be housed at NCPS for national use by the end of FY19. We have continued to enlighten the field with our work in Community Care, uncovering important issues related to the community care data. Working with our operational partners this year was helpful in furthering our knowledge, and those of others, in area. We will continue to have an impact in understanding this area through our SDR project.
Additional Information:

Publications (2018):

1.Talutis SD, Chen Q, Wang N, Rosen AK. Comparing Risk Standardized Readmission Rates of Surgical Patients at Safety Net and Non-Safety Net Hospitals. JAMA Surgery. In press (2018).

2.Hachey, K, Morgan R, Rosen AK, Rao SR, McAneny D, Tseng J, Doherty G, Sachs T. Quality Comes with the (Anatomic) Territory: Evaluating the Impact of Surgeon Operative Mix on Patient Outcomes after Pancreaticoduodenectomy. Annals of Surgical Oncology. In press (2018).

3.Mull HJ, Itani KMF, Pizer SD, Charns M, Rivard P, McIntosh N, Hawn MT, Rosen AK. Development of an Adverse Event Surveillance Model for Outpatient Surgery in the Veterans Health Administration. Health Services Research. In press (2018).

4.Titan A, Graham L, Rosen AK, Itani K, Copeland LA, Mull HJ, Burns E, Richman J, Kertesz S, Wahl T, Morris M, Whittle J, Telford G, Wilson M, Hawn M. Homeless status, post discharge healthcare utilization and readmission after surgery. Medical Care. In press (2018).

5.Sullivan JL, Shin MH, Engle RL, Yaksic E, VanDeusen Lukas C, Paasche-Orlow MK, Starr LM, Restuccia JD, Holmes S, Rosen AK. Evaluating the Implementation of Project Re-Engineered Discharge (RED) in Veterans Health Administration (VA) Hospitals. The Joint Commission Journal on Quality and Patient Safety. In press (2018).

6.Mull HJ, Itani KMF, MacDonald S, Charns MP, Pizer SD, Hawn MT, Rosen AK. The Nature and Severity of Adverse Events in Select Outpatient Surgeries in the Veterans Health Administration. Quality Management in Health Care. 2018 July/Sep; 27 (3):136-144.

7.Borzecki AM, Chen Q, O'Brien W, Shwartz M, Najjar PA, Rosen AK. The Patient Safety Indicator Perioperative Pulmonary Embolism or Deep Vein Thrombosis: Is There Associated Surveillance Bias in the Veterans Health Administration? American Journal of Surgery. 2018 Jul 4. pii: S0002-9610(17)31603-3.

8.Wahl TS, Graham LA, Morris MS, Richman JS, Hollis RH, Jones CE, Itani KM, Wagner TH, Mull HJ, Whittle JC, Telford GL, Rosen AK, Copeland LA, Burns EA, Hawn MT. Association Between Preoperative Proteinuria and Postoperative Acute Kidney Injury and Readmission. JAMA Surgery; 2018 July 3: e182009.

9.Chen L, Chan JA, Alligood E, Rosen AK, Borzecki AM. Does Surveillance Bias Influence the Validity of Measures of Inpatient Complications? A Systematic Review. American Journal of Medical Quality; 2018 May/Jun;33(3):291-302.

10.Mull HJ, Graham LA, Morris MS, Rosen AK, Richman JS, Whittle J, Burns E, Wagner TH, Copeland LA, Wahl T, Jones C, Hollis RH, Itani KMF, Hawn MT. A Consensus Process to Identify Postoperative Readmission Codes Related to Surgical Quality. JAMA Surgery 2018 April 18.

11.Sterbling H, Rosen AK, Hachey K, Vellanki N, Hewes P, Rao S, Pinjic E, Fernando H, Litle V. Caprini Risk Model Decreases Venous Thromboembolism Rates in Thoracic Surgery Cancer Patients. The Annals of Thoracic Surgery; 2018 Mar;105(3):879-885.

12.Chen Q, Rosen AK, Amirfarzan H, Rochman A, Itani K. Improving Detection of Intraoperative Medical Errors (iMEs) and Adverse Events (iAEs) and their Contribution with Postoperative Outcomes. American Journal of Surgery. 2018 Mar 6. pii: S0002-9610(17)31222-9.

13.Shin MH, Rivard PE, Shwartz M, Borzecki A, Yaksic E, Stolzmann K, Lisa Zubkoff L, Rosen AK. Tailoring an Educational Program on the AHRQ Patient Safety Indicators to Meet Stakeholder Needs: Lessons Learned in the VA. BMC Health Services Research; 2018 Feb 14;18(1):114.

14.Mull H, Rosen AK, O'Brien W, McIntosh N, Legler A, Hawn M, Itani K, Pizer S. Factors Associated with Hospital Admission after Outpatient Surgery in the Veterans Health Administration. Health Services Research. 2018; Jan 23.


1. Mull H, Rosen, AK, O'Brien W, McIntosh N, Legler A, Hawn M, Itani K, Pizer S. Factors Associated with Hospital Admission after Outpatient Surgery in the Veterans Health Administration. HSR. In press (2017).

2. Sterbling H, Rosen AK, Hachey K, Vellanki N, Hewes P, Rao S, Pinjic E, Fernando H, Litle V. Caprini Risk Model Decreases Venous Thromboembolism Rates in Thoracic Surgery Cancer Patients. The Annals of Thoracic Surgery. In Press (2017).

3. Chen L, Chan JA, Alligood E, Rosen AK, Borzecki AM. Does Surveillance Bias Influence the Validity of Measures of Inpatient Complications? A Systematic Review. American Journal of Medical Quality; September 2017; https://doi.org/10.1177/1062860617730900.

4. Chen Q, Oriel B, Rosen AK, Greenan M, Amirfarzan H, Mull HJ, Fisichella P, Itani K. Detection and Potential Consequences of Intraoperative Adverse Events (IAEs): A Pilot Study in the Veterans Health Administration. American Journal of Surgery; In press (2017).

5. Copeland L, Graham L, Richman J, Rosen AK, Mull H, Burns E, Whittle J, Itani K, Hawn M. A Study to Reduce Readmissions after Surgery in the Veterans Health Administration: Design and Methodology. BMC Health Services Research; In press (2017).

6. Rosen AK, O'Brien W, Chen Q, Shwartz M, Itani K, Gunnar W. Trends in the Purchase of Surgical Care in the Community by the Veterans Health Administration. Medical Care. 2017 March 17. Doi: 10.1097/MLR. 0000000000000707. [Epub ahead of print]

7. Hollis RJ, Graham L, Richman J, Morris M, Mull H, Wahl T, Burns E, Copeland C, Telford G, Rosen AK, Itani K, Whittle J, Wagner T, Hawn, M. Hospital Readmissions after Surgery: How Important are Hospital and Specialty Factors? Journal of the American College of Surgery; In press (2017).

8. Mull HJ, Rivard P, Legler A, Pizer S, Hawn M, Itani KMF, Rosen AK. Comparing Definitions of Outpatient Surgery: Implications for Quality Measurement. American Journal of Surgery 2017; Epub ahead of print. https://www.americanjournalofsurgery.com/article/S0002-9610(16)31059-5/abstract

From 2016:
1.Chen Qi, Rosen AK, Borzecki A, Shwartz M. Using Harm-based Weights for the AHRQ Patient Safety Indicators Composite (PSI-90): Does it Affect Assessment of Hospital Performance and Financial Penalties in the Veterans Health Administration Hospitals? HSR; In press (2016).

2.Hanchate AD, Stolzmann K, Rosen AK, Fink AS, Shwartz M, Ash A, Abdulkerim H, Pugh MJ, Shokeen P, Borzecki A. Does Adding Clinical Data to Administrative Data Improve Agreement among Hospital Quality Measures? Healthcare; In press (2016).

3.Brady MT, Patts G, Rosen AK, Kasotakis G, Siracuse J, Sachs T, Kuhnen A, Kunitake H. Postoperative Venous Thromboembolism in Patients Undergoing Abdominal Surgery for IBD: A Common but Rarely Addressed Problem. Diseases of the Colon and Rectum; In press (2016).

4.Mull HJ, Rosen AK, Rivard P, Itani K. Defining Outpatient Surgery: Perspectives of Surgical Staff in the Veterans' Health Administration (VA). American Surgeon. In press (2016).

5.Morris MS, Graham LA, Richman JS, Hollis RH, Jones CE, Wahl T, Itani KM, Mull HJ, Rosen AK, Copeland L, Burns E, Telford G, Whittle J, Wilson M, Knight SJ, Hawn MT. Postoperative 30-day Readmission: Time to Focus on What Happens Outside the Hospital. Annals of Surgery. 2016 Oct;264(4):621-31. doi: 10.1097/SLA.0000000000001855.

6.Mull HJ, Rosen AK, Pizer S, Itani K. Association between Postoperative Admission and Location of Hernia Surgery: A Matched Case-Control Study in the Veterans Administration. JAMA Surgery, 2016 Sep 28. doi: 10.1001/jamasurg.2016.3113. [Epub ahead of print]

7.Rosen AK, Chen Q. Measuring Patient Safety Events: Opportunities and Challenges. In: National Quality Measures Clearinghouse (NQMC) [Website]. Rockville (MD): Agency for Healthcare Research and Quality (AHRQ); [2016 June 13]. Available: http://www.qualitymeasures.ahrq.gov.

8.Borzecki A, Chen Q, Mull, HJ, Shwartz M, Bhatt D, Hanchate A, Rosen AK. Do AMI and HF Readmissions Flagged as Potentially Preventable by the 3MTM PPR Software Have More Process of Care Problems? Circulation Cardiovascular Quality and Outcomes. 2016 Sep;9(5):532-41. doi: 10.1161/CIRCOUTCOMES.115.002509. Epub 2016 Sep 6.

9.Mull HJ, Rosen AK, Charns M, Itani KMF, Rivard P. Identifying Risks and Opportunities in Outpatient Surgical Patient Safety: A Qualitative Analysis of Veterans Health Administration Staff Perceptions. Journal of Patient Safety; In press (2016).

10.Shimada S, Allison J, Rosen AK, Feng H, Houston T. Sustained Use of Patient Portal Features and Improvements in Diabetes Physiologic Measures. Journal of Medical Internet Research; 2016; 18(6):e179. Doi:10.2196/jmir.5663.

11.Sullivan J, Rivard P, Shin M, Rosen AK. Applying the High-Reliability Health Care Maturity Model to Assess Hospital Performance: A VA Case Study. Joint Commission Journal on Quality and Patient Safety; September 2016: Volume 42 (9), 389-399.

12.Elwy AR, Itani KFM, Bokhour B, Mueller N, Glickman M, Zhao S, Rosen AK, Lynge, Perkal M, Brotschi E, Sanchez V, Gallagher T. Surgeons' Disclosures of Clinical Adverse Events. JAMA Surgery; 2016 Jul 20. doi: 10.1001/jamasurg.2016.1787. [Epub ahead of print]

13.Macht R, Rosen AK, Horn G, Carmine B, Hess D. An exploration of system-level factors and geographic variation in bariatric surgery utilization. Obesity Surgery; 2016 Jul;26(7):1635-8. doi: 10.1007/s11695-016-2164-6.

14.Hatoun J, Chan JA, Yaksic E, Greenan MA, Borzecki AM, Shwartz M, Rosen AK. A systematic review of patient safety measures in adult primary care. American Journal of Medical Quality. 2016 Apr 26. pii: 1062860616644328. [Epub ahead of print]

15.Rosen AK, Chen Q, Shwartz M, Pilver C, Mull HJ, Itani K, Borzecki A. Does Use of a Hospital-wide Readmission Measure versus Condition-Specific Readmission Measures Make a Difference for Hospital Profiling and Payment Penalties? Medical Care; 2016(54:2): 155-161.

Other Publications (2016):

Wagner TH, Gehlert E, Rosen AK, Valenstein M. Updating the Psychiatric Case Mix System (PsyCMS) Mental Health and Substance use Grouper for ICD-10CM. Technical Report 31. Menlo Park, CA. VA Palo Alto, Health Economics Resource Center; August 2016.

Conference Presentations (2017)
:Strymish J, Jones M, Evans M, Branch-Elliman W, Robillard E, Chan J, Rosen AK, Gupta K.
Electronic Detection of MRSA Infections in a National VA Population Augments Current Manual Process. Infectious Diseases Society of America (ID)Week, October 4-8, 2017, San Diego, CA.

George J, Parker V,A, Greenan A,, Chan JA, Sullivan JL, Shin MH, Chen Q, Shwartz M, Rosen AK. How do VA Hospitals Determine their Patient Safety Priorities? Assessing Hospital Practices from an Organizational Learning Framework. AcademyHealth Annual Research meeting, June 2017.

Chen Q, Rochman A, Amirfarzan H, Rosen AK, Itani K. Can A Surgical Debriefing Process Be Used in Addition to Traditional Incident Reporting to Improve Detection of Intraoperative Adverse Events (IAEs)? A Case Study in the Veterans Health Administration. AcademyHealth Annual Research Meeting, June 2017.

Chen Q, Rochman A, Amirfarzan H, Rosen AK, Itani K. Can A Surgical Debriefing Process Be Used in Addition to Traditional Incident Reporting to Improve Detection of Intraoperative Adverse Events (IAEs)? A Case Study in the Veterans Health Administration. Association of VA Surgeons Annual Meeting. May 2017.

Rosen AK, O'Brien W, Chen Q, Shwartz M, Itani K, Gunnar W. Trends in the Purchase of Surgical Care in the Community by the Veterans Health Administration. VA National Research Week, VA Boston Healthcare System, May 2017, Boston, MA.

Sterbling HM, Rosen AK, Hachey KJ, Vellanki NS, Hewes PD, Rao SR, Pinjic E, FernandoH.C., Litle V.R.. Caprini Risk Assessment Model Implementation Decreases VTE Rates in Thoracic Surgery Cancer Patients. Podium presentation at the Society of Thoracic Surgeons (STS) 53rd Annual Meeting, Houston, TX. January 23, 2017.

(Presentations 2016):
Rosen AK, Chen Qi, Elwy R, Barnett P, O'Brien W, Itani KFM, Shwartz M. Preliminary Findings on Veterans' Use of Community Care (CC) for Surgery: Pre- and Post-Choice. Care in the Community Conference, August 2016, Arlington VA.

Rosen AK, Chen Q, Borzecki A, Shwartz M. Using Harm-Based Weights for the AHRQ Patient Safety for Selected Indicators Composite (PSI-90): Does it Affect Assessment of Hospital Performance and Financial Penalties in Veterans Administration Hospitals? AcademyHealth Annual Research Meeting, June, 2016.

Mull HJ, Rosen AK, Charns M, Itani K, Rivard P. Identifying Risks and Opportunities in Outpatient Surgical Patient Safety: A Qualitative Analysis of Surgical Staff Perceptions in the Veterans Health Administration. AcademyHealth Annual Research Meeting, June, 2016, Boston, MA.

Mull HJ, Rosen AK, Hawn M, Itani K, Pizer S. Predictors of Hospitalization after Outpatient Surgery in the Veterans Health Administration. AcademyHealth Annual Research Meeting, June, 2016, Boston, MA.

Shin M, Rivard P, Shwartz M, Borzecki A, Yaksic E, Stolzmann K, Rosen AK. Educating Hospital Managers about the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicators (PSIs): Lessons Learned in the VA. AcademyHealth Annual Research Meeting, June, 2016, Boston, MA.

Greenan MA, Chen Q, Sullivan J, Shwartz M, Shin M, Yaksic E, Chan J, Rosen AK. Development and Implementation of a Tool to Guide Patient Safety in the Veterans Health Administration (VA). AcademyHealth Annual Research Meeting, June, 2016, Boston, MA.

Yaksic E, Sullivan J, Chan J, Shwartz M, Shin M, Borzecki A, Greenan MA, George J, Coronel V, Quigly P, Rosen AK. Lessons Learned from Developing an Innovative Data Display to Assist Fall Prevention in the Veterans Health Administration (VA): A Pilot Study at One VA Hospital. AcademyHealth Annual Research Meeting, June, 2016, Boston, MA.

Borzecki A, Rao S, Rosen AK, Shwartz M. Assessing the Performance of an Existing Automated Model Identifying Heart Failure Patients at Risk for 30-day Readmission in the VA. AcademyHealth Annual Research Meeting, June, 2016, Boston, MA.

Chan J, Shwartz M, Restuccia J, Rosen AK. Improving Performance on Hospital Readmission Rates in the Veterans Health Administration (VA): Organizational FIT and Measure-Based Quality Improvement. AcademyHealth Annual Research Meeting, June, 2016, Boston, MA.

Chen Q, Oriel B, Greenan MA, Shapiro M, Amirfarzan H, Mull H, Fisichella P, Itani K, Rosen AK. A Pilot Study to Detect Intraoperative Adverse Events (IAE) and Assess Their Contribution to Postoperative Outcomes. AcademyHealth Annual Research Meeting, June, 2016, Boston, MA.

Chan, J, Hatoun J, Yaksic E, Greenan MA, Borzecki A, Shwartz, M, Rosen AK. A Systematic Review of Patient Safety Measures in Adult Primary Care. AcademyHealth Annual Research Meeting, June, 2016, Boston, MA.

Mull HJ, Rosen AK, Hawn M, Itani K, Pizer S. Predictors of Hospitalization after Outpatient Surgery in the Veterans Health Administration. 25th Grasberger Research Symposium, May 20, 2016, Boston, MA.

Mull HJ, Rosen AK, Rivard P, Pizer S, Itani K. What is the Relationship Between Postoperative Admission and Ambulatory Surgical Center Care Following Hernia Surgery? A matched case control study in the Veterans Health Administration. Association of VA Surgeons, April 9, 2016, Virginia Beach, VA.

Mull HJ, Rosen AK, Hawn M, Itani K, Pizer S. Predictors of Hospitalization after Outpatient Surgery in the Veterans Health Administration. Association of VA Surgeons, April 9, 2016, Virginia Beach, VA.

Chen Q, Oriel B, Greenan M, Amirfarzan H, Mull H, Fisichella P, Rosen AK, Itani K. Finding Intraoperative Adverse Events and Assessing Their Contribution to Postoperative Outcomes. Association of VA Surgeons, April 9, 2016, Virginia Beach, VA.






PUBLICATIONS:

Journal Articles

  1. Shimada SL, Allison JJ, Rosen AK, Feng H, Houston TK. Sustained Use of Patient Portal Features and Improvements in Diabetes Physiological Measures. Journal of medical Internet research. 2016 Jul 1; 18(7):e179.
  2. Singer SJ, Rivard PE, Hayes JE, Shokeen P, Gaba D, Rosen A. Improving patient care through leadership engagement with frontline staff: a Department of Veterans Affairs case study. Joint Commission Journal on Quality and Patient Safety. 2013 Aug 1; 39(8):349-60.
  3. Borzecki AM, Cevasco M, Chen Q, Shin M, Itani KM, Rosen AK. Improving identification of postoperative respiratory failure missed by the patient safety indicator algorithm. American journal of medical quality : the official journal of the American College of Medical Quality. 2013 Jul 1; 28(4):315-23.
  4. Luther SL, Neumayer L, Henderson WG, Foulis P, Richardson M, Haun J, Mikelonis M, Rosen A. The use of breast-conserving surgery for women treated for breast cancer in the Department of Veterans Affairs. American journal of surgery. 2013 Jul 1; 206(1):72-9.
  5. Borzecki AM, Cevasco M, Mull H, Shin M, Itani K, Rosen AK. Improving the identification of postoperative wound dehiscence missed by the Patient Safety Indicator algorithm. American journal of surgery. 2013 Jun 1; 205(6):674-80.
  6. Mull HJ, Borzecki AM, Hickson K, Itani KM, Rosen AK. Development and testing of tools to detect ambulatory surgical adverse events. Journal of Patient Safety. 2013 Jun 1; 9(2):96-102.
  7. Chen Q, Borzecki AM, Cevasco M, Shin MH, Shwartz M, Itani KM, Rosen AK. Examining the relationship between processes of care and selected AHRQ patient safety indicators postoperative wound dehiscence and accidental puncture or laceration using the VA electronic medical record. American journal of medical quality : the official journal of the American College of Medical Quality. 2013 May 1; 28(3):206-13.
  8. Navathe AS, Silber JH, Small DS, Rosen AK, Romano PS, Even-Shoshan O, Wang Y, Zhu J, Halenar MJ, Volpp KG. Teaching hospital financial status and patient outcomes following ACGME duty hour reform. Health services research. 2013 Apr 1; 48(2 Pt 1):476-98.
  9. Rivard PE, Parker VA, Rosen AK. Quality improvement for patient safety: project-level versus program-level learning. Health care management review. 2013 Jan 1; 38(1):40-50.
Center Products

  1. Rosen AK. Overview of the Agency for Healthcare Research and Quality Patient Safety Indicators. 2014 Jul 8.
Conference Presentations

  1. Rosen AK, Chen Q, Borzecki AM, Shin M, Itani K, Shwartz M. Using Estimated True Safety Event Rates vs. Flagged Safety Event Rates: Does it Change Hospital Profiling and Payment? Presented at: American Statistical Association Joint Statistical Annual Meeting; 2014 Aug 3; Boston, MA.
  2. Rosen AK, Branch-Elliman W, Strymish J, Kudesia V, Gupta K. Electronic Surveillance of Hospital Acquired Infections: Implementation of an Electronic Algorithm to Detect Catheter-associated Urinary Tract Infections in the Veterans Health Administration. Presented at: AcademyHealth Annual Research Meeting; 2014 Jun 9; San Diego, CA.
  3. Chen Q, Mull HJ, O'Brien W, Itani K, Rosen AK. Examining Potentially Preventable Readmissions after Surgical Procedures in the Veteran Health Administration. Poster session presented at: AcademyHealth Annual Research Meeting; 2013 Jun 26; Baltimore, MD.
  4. Chen Q, Borzecki A, O'Brien W, Mull HJ, Restuccia J, Rosen AK. Validating the 3M™ Potentially Preventable Readmissions Software in a Cohort of Veterans with Pneumonia. Poster session presented at: AcademyHealth Annual Research Meeting; 2013 Jun 24; Baltimore, MD.
  5. Volpp KG, Silber J, Wang Y, Even-Shoshan O, Halenar M, Bellini L, Romano P, Zhu J, Press M, Rosen A, Itani K, Loveland S, Hanchate HD, Borzecki A. The impact of resident duty hour reform on hospital readmission rates. Paper presented at: Society of General Internal Medicine Annual Meeting; 2010 Apr 28; Minneapolis, MN.


DRA: Health Systems
DRE: none
Keywords: Career Development
MeSH Terms: none