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RCS 11-222 – HSR&D Study

Pre-Funded | New | Current | Completed | DRA | DRE | Portfolios/Projects | Centers | Career Development Projects
 
RCS 11-222
Research Career Scientist Award
Sarah L. Krein PhD RN
VA Ann Arbor Healthcare System, Ann Arbor, MI
Ann Arbor, MI
Funding Period: April 2016 - March 2026

BACKGROUND/RATIONALE:
HSR&D Career Scientist awards are intended to support accomplished VA investigators who make exemplary contributions to the VA health services research enterprise, including exercising leadership and mentoring the next generation of VA HSR&D investigators. As such, it is a privilege to have the opportunity to use the skills and expertise I have acquired as a VA health services researcher to not only continue my own research related to patient safety and management of complex, chronic conditions but also support the work of junior investigators and collaborators across VHA to improve the health and health care of Veterans.

OBJECTIVE(S):
The objectives of this award are to use my clinical, content and methodological expertise to: 1) obtain funding, conduct, publish and disseminate high quality research (with two primary areas of focus, patient safety and management of complex chronic conditions); 2) train/mentor early career investigators (particularly in the use of qualitative and mixed-methods and implementation research); 3) work with colleagues and collaborators across the VA; and 4) serve on VA committees and panels (local and national) to support VA research and care delivery.

METHODS:
My research career and focus builds on my clinical background as a nurse, my multidisciplinary health services research training (with concentrations in health economics, research methods and epidemiology) and the interest and expertise I have acquired in the use of qualitative methods and implementation research. Indeed, applying mixed-methods and implementation research techniques to better understand and ultimately improve care delivery with respect to safety, quality and effectiveness has been and continues to be a consistent theme of my research. This includes research designed to reduce risk of harm related to commonly used devices among hospitalized patients, improving infection prevention practices and reducing disease transmission, and improving health care personnel communication. Likewise, I am actively involved in a number of projects focusing on better management of chronic back pain including large-scale implementation work as part of the Improving Pain-Related Outcomes for Veterans (IMPROVE) QUERI program. My mentorship activities similarly focus largely on providing guidance on qualitative, implementation and mixed-methods research across a variety of clinical domains and involve working with both clinician and non-clinician early investigators. I am currently a member of on various VA work groups and committees, locally and nationally, including serving on the leadership council for the VA Ann Arbor Center for Clinical Management Research (CCMR) and as co-director of the CCMR research core, and the VA Ann Arbor Clinical Research Mentorship Program.

FINDINGS/RESULTS:
Not yet available.

IMPACT:
My continuing focus on developing, evaluating and implementing strategies to ensure the safety of hospitalized Veterans has led to tangible improvements in patient care, such as a reduction in rates of catheter-associated urinary tract infection. Moreover, my work related to improving management of Veterans with complex health conditions, such as chronic musculoskeletal pain, continues to play an important role in improving care delivery and health outcomes for Veterans. Finally, my commitment to ensuring the rigorous application of qualitative and mixed-methods and implementation research approaches both in my own work as well as those for whom I serve as a mentor is important in developing and ensuring the application of high-quality evidence to optimize care delivery and outcomes across the VA health care system.

PUBLICATIONS:

Journal Articles

  1. Monsees E, Wirtz AL, Krein S. Stewardship 2.0: Embracing elements of implementation science to enhance everyday antimicrobial Stewardship efforts. Antimicrobial stewardship & healthcare epidemiology : ASHE. 2023 Sep 7; 3(1):e149.
  2. Jones KM, Krein SL, Mantey J, Harrod M, Mody L. Characterizing infection prevention programs and urinary tract infection prevention practices in nursing homes: A mixed-methods study. Infection control and hospital epidemiology. 2024 Jan 1; 45(1):40-47.
  3. Tsao PA, Fann JR, Nevedal AL, Bloor LE, Krein SL, Caram MEV. A Positive Distress Screen…Now What? An Updated Call for Integrated Psychosocial Care. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2023 Nov 1; 41(31):4837-4841.
  4. Claeys KC, Weston LE, Pineles L, Morgan DJ, Krein SL. Implementing diagnostic stewardship to improve diagnosis of urinary tract infections across three medical centers: A qualitative assessment. Infection control and hospital epidemiology. 2023 Jul 10; 1-10.
  5. Amenta E, Grigoryan L, Rajan SS, Ramsey D, Kramer JR, Walder A, Chou A, Van JN, Krein SL, Hysong S, Naik AD, Trautner BW. Quantifying the Implementation and Cost of a Multisite Antibiotic Stewardship Intervention for Asymptomatic Bacteriuria. Antimicrobial stewardship & healthcare epidemiology : ASHE. 2023 Jun 30; 3(1):e115.
  6. Patel M, Berlin H, Rajkumar A, Krein SL, Miller R, DeVito J, Roy J, Punch M, Ellimootti C, Peahl AF. Barriers to Telemedicine Use: Qualitative Analysis of Provider Perspectives During the COVID-19 Pandemic. JMIR human factors. 2023 Jun 26; 10:e39249.
  7. Saint S, Greene MT, Krein SL, Fowler KE, Linder KA, Ratz D, Meddings J. What US hospitals are doing to prevent common device-associated infections during the coronavirus disease 2019 (COVID-19) pandemic: Results from a national survey in the United States. Infection control and hospital epidemiology. 2023 Jun 1; 1-7.
  8. Sheehan JL, Greene-Higgs L, Swanson L, Higgins PDR, Krein SL, Waljee AK, Saini SD, Berinstein JA, Mellinger JL, Piette JD, Resnicow K, Cohen-Mekelburg S. Self-Efficacy and the Impact of Inflammatory Bowel Disease on Patients' Daily Lives. Clinical and translational gastroenterology. 2023 Jun 1; 14(6):e00577.
  9. Murphy SL, Zick SM, Harris RE, Smith SN, Sen A, Alexander NB, Caldararo J, Roman P, Firsht E, Belancourt P, Maciasz R, Perzhinsky J, Mitchinson A, Krein SL. Self-administered acupressure for veterans with chronic back pain: Study design and methodology of a type 1 hybrid effectiveness implementation randomized controlled trial. Contemporary clinical trials. 2023 Jul 1; 130:107232.
  10. Missel AL, Dowker SR, Dzierwa D, Krein SL, Coulter-Thompson EI, Williams M, Trumpower B, Swor R, Hunt N, Friedman CP. Factors Impacting Treatment of Out-of-Hospital Cardiac Arrest: A Qualitative Study of Emergency Responders. Journal of the American Heart Association. 2023 May 16; 12(10):e027756.
  11. Ervin JN, Vitous CA, Wells EE, Krein SL, Friese CR, Ghaferi AA. Rescue Improvement Conference: A Novel Tool for Addressing Failure to Rescue. Annals of surgery. 2023 Feb 1; 277(2):233-237.
  12. Mattocks KM, LaChappelle KM, Krein SL, DeBar LL, Martino S, Edmond S, Ankawi B, MacLean RR, Higgins DM, Murphy JL, Cooper E, Heapy AA. Pre-implementation formative evaluation of cooperative pain education and self-management expanding treatment for real-world access: A pragmatic pain trial. Pain practice : the official journal of World Institute of Pain. 2023 Apr 1; 23(4):338-348.
  13. Secrest KM, Anderson TM, Trumpower B, Harrod M, Krein SL, Guetterman TC, Chan PS, Nallamothu BK. Early changes in hospital resuscitation practices during the COVID-19 pandemic. Resuscitation plus. 2022 Dec 1; 12:100317.
  14. Piette JD, Newman S, Krein SL, Marinec N, Chen J, Williams DA, Edmond SN, Driscoll M, LaChappelle KM, Kerns RD, Maly M, Kim HM, Farris KB, Higgins DM, Buta E, Heapy AA. Patient-Centered Pain Care Using Artificial Intelligence and Mobile Health Tools: A Randomized Comparative Effectiveness Trial. JAMA internal medicine. 2022 Sep 1; 182(9):975-983.
  15. Grigoryan L, Naik AD, Lichtenberger P, Graber CJ, Patel PK, Drekonja DM, Gauthier TP, Shukla B, Sales AE, Krein SL, Van JN, Dillon LM, Hysong SJ, Kramer JR, Walder A, Ramsey D, Trautner BW. Analysis of an Antibiotic Stewardship Program for Asymptomatic Bacteriuria in the Veterans Affairs Health Care System. JAMA Network Open. 2022 Jul 1; 5(7):e2222530.
  16. Maust DT, Takamine L, Wiechers IR, Blow FC, Bohnert ASB, Strominger J, Min L, Krein SL. Strategies Associated With Reducing Benzodiazepine Prescribing to Older Adults: A Mixed Methods Study. Annals of Family Medicine. 2022 Jul 1; 20(4):328-335.
  17. Reuman L, Solar C, MacLean RR, Halat AM, Rajeevan H, Williams DA, Heapy AA, Bair MJ, Krein SL, Kerns RD, Higgins DM. If you personalize it, will they use it?: Self-reported and observed use of a tailored, internet-based pain self-management program. Translational behavioral medicine. 2022 May 26; 12(5):693-701.
  18. Burgess DJ, Hagel Campbell E, Hammett P, Allen KD, Fu SS, Heapy A, Kerns RD, Krein SL, Meis LA, Bangerter A, Cross LJS, Do T, Saenger M, Taylor BC. Taking ACTION to Reduce Pain: a Randomized Clinical Trial of a Walking-Focused, Proactive Coaching Intervention for Black Patients with Chronic Musculoskeletal Pain. Journal of general internal medicine. 2022 Nov 1; 37(14):3585-3593.
  19. Kurlander JE, Helminski D, Lanham M, Henstock JL, Kidwell KM, Krein SL, Saini SD, Richardson CR, De Vries R, Resnicow K, Ruff AL, Wallace DM, Jones EK, Perry LK, Parsons J, Ha N, Alexandris-Souphis T, Dedrick D, Aldridge E, Barnes GD. Development of a multicomponent implementation strategy to reduce upper gastrointestinal bleeding risk in patients using warfarin and antiplatelet therapy, and protocol for a pragmatic multilevel randomized factorial pilot implementation trial. Implementation science communications. 2022 Jan 28; 3(1):8.
  20. Krein SL, Turnwald M, Anderson B, Maust DT. "Sometimes it's not about the money... it's the way you treat people...": A Qualitative Study of Nursing Home Staff Turnover. Journal of The American Medical Directors Association. 2022 Jul 1; 23(7):1178-1184.
  21. Kurlander JE, Helminski D, Kokaly AN, Richardson CR, De Vries R, Saini SD, Krein SL. Barriers to Guideline-Based Use of Proton Pump Inhibitors to Prevent Upper Gastrointestinal Bleeding. Annals of Family Medicine. 2022 Jan 1; 20(1):5-11.
  22. Manojlovich M, Hofer TP, Krein SL. Advancing Patient Safety Through the Clinical Application of a Framework Focused on Communication. Journal of Patient Safety. 2021 Dec 1; 17(8):e732-e737.
  23. Lafferty M, Harrod M, Krein S, Manojlovich M. It's like sending a message in a bottle: A qualitative study of the consequences of one-way communication technologies in hospitals. Journal of the American Medical Informatics Association : JAMIA. 2021 Nov 25; 28(12):2601-2607.
  24. Anderson TM, Secrest K, Krein SL, Schildhouse R, Guetterman TC, Harrod M, Trumpower B, Kronick SL, Pribble J, Chan PS, Nallamothu BK. Best Practices for Education and Training of Resuscitation Teams for In-Hospital Cardiac Arrest. Circulation. Cardiovascular quality and outcomes. 2021 Dec 1; 14(12):e008587.
  25. Hejjaji V, Chakrabarti AK, Nallamothu BK, Iwashyna TJ, Krein SL, Trumpower B, Kennedy M, Chinnakondepalli K, Malik AO, Chan PS. Association Between Hospital Resuscitation Team Leader Credentials and Survival Outcomes for In-hospital Cardiac Arrest. Mayo Clinic proceedings. Innovations, quality & outcomes. 2021 Dec 1; 5(6):1021-1028.
  26. Willis MA, Hu Z, Saran R, Argentina M, Bragg-Gresham J, Krein SL, Gillespie B, Zheng K, Veinot TC. Corrigendum to: Feeling better on hemodialysis:user-centered design requirements for promotingpatient involvement in the prevention of treatmentcomplications. Journal of the American Medical Informatics Association : JAMIA. 2021 Oct 12; 28(11):2547.
  27. Willis MA, Hein LB, Hu Z, Saran R, Argentina M, Bragg-Gresham J, Krein SL, Gillespie B, Zheng K, Veinot TC. Feeling better on hemodialysis: user-centered design requirements for promoting patient involvement in the prevention of treatment complications. Journal of the American Medical Informatics Association : JAMIA. 2021 Jul 30; 28(8):1612-1631.
  28. Mathis MR, Yule S, Wu X, Dias RD, Janda AM, Krein SL, Manojlovich M, Caldwell MD, Stakich-Alpirez K, Zhang M, Corso J, Louis N, Xu T, Wolverton J, Pagani FD, Likosky DS, Video Assessment Cardiac Surgery Quality (VARSITY) Group. Electronic address: https://twitter.com/SurgeryVarsity. The impact of team familiarity on intra and postoperative cardiac surgical outcomes. Surgery. 2021 Oct 1; 170(4):1031-1038.
  29. Solar C, Halat AM, MacLean RR, Rajeevan H, Williams DA, Krein SL, Heapy AA, Bair MJ, Kerns RD, Higgins DM. Predictors of engagement in an internet-based cognitive behavioral therapy program for veterans with chronic low back pain. Translational behavioral medicine. 2021 Jun 17; 11(6):1274-1282.
  30. Willis M, Brand Hein L, Hu Z, Saran R, Argentina M, Bragg-Gresham J, Krein SL, Gillespie B, Zheng K, Veinot TC. Usability Evaluation of a Tablet-Based Intervention to Prevent Intradialytic Hypotension in Dialysis Patients During In-Clinic Dialysis: Mixed Methods Study. JMIR human factors. 2021 Jun 14; 8(2):e26012.
  31. Lei L, Strominger J, Wiechers IR, Kim HM, Blow FC, Bohnert ASB, Min L, Krein SL, Maust DT. Benzodiazepine Prescribing from VA and Medicare to Dually Enrolled Older Veterans: A Retrospective Cohort Study. Journal of general internal medicine. 2021 Dec 1; 36(12):3689-3696.
  32. Weiner DK, Holloway K, Levin E, Keyserling H, Epstein F, Monaco E, Sembrano J, Brega K, Nortman S, Krein SL, Gentili A, Katz JN, Morrow LA, Muluk V, Pugh MJ, Perera S. Identifying biopsychosocial factors that impact decompressive laminectomy outcomes in veterans with lumbar spinal stenosis: a prospective cohort study. Pain. 2021 Mar 1; 162(3):835-845.
  33. Greene MT, Krein SL, Huis A, Hulscher M, Sax H, Sakamoto F, Sakihama T, Tokuda Y, Fowler KE, Saint S. Infection prevention practices in the United States, the Netherlands, Switzerland, and Japan: Results from national surveys. Infection control and hospital epidemiology. 2021 Oct 1; 42(10):1206-1214.
  34. Fowler KE, Krein SL, Ratz D, Zawol D, Saint S. Sustainability of a program to reduce unnecessary urethral catheter use at a Veterans Affairs hospital. Infection control and hospital epidemiology. 2021 Dec 1; 42(12):1497-1499.
  35. Tanner WD, Leecaster MK, Zhang Y, Stratford KM, Mayer J, Visnovsky LD, Alhmidi H, Cadnum JL, Jencson AL, Koganti S, Bennett CP, Donskey CJ, Noble-Wang J, Reddy SC, Rose LJ, Watson L, Ide E, Wipperfurth T, Safdar N, Arasim M, Macke C, Roman P, Krein SL, Loc-Carrillo C, Samore MH. Environmental Contamination of Contact Precaution and Non-Contact Precaution Patient Rooms in Six Acute Care Facilities. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2021 Jan 29; 72(Suppl 1):S8-S16.
  36. Mody L, Akinboyo IC, Babcock HM, Bischoff WE, Cheng VC, Chiotos K, Claeys KC, Coffey KC, Diekema DJ, Donskey CJ, Ellingson KD, Gilmartin HM, Gohil SK, Harris AD, Keller SC, Klein EY, Krein SL, Kwon JH, Lauring AS, Livorsi DJ, Lofgren ET, Merrill K, Milstone AM, Monsees EA, Morgan DJ, Perri LP, Pfeiffer CD, Rock C, Saint S, Sickbert-Bennett E, Skelton F, Suda KJ, Talbot TR, Vaughn VM, Weber DJ, Wiemken TL, Yassin MH, Ziegler MJ, Anderson DJ, SHEA Research Committee. Coronavirus disease 2019 (COVID-19) research agenda for healthcare epidemiology. Infection control and hospital epidemiology. 2022 Feb 1; 43(2):156-166.
  37. Heapy AA, Tankha H, Higgins DM, Driscoll M, LaChappelle KM, Goulet JL, Buta E, Piette JD, Kerns RD, Krein SL. Incorporating walking into cognitive behavioral therapy for chronic pain: safety and effectiveness of a personalized walking intervention. Journal of behavioral medicine. 2021 Apr 1; 44(2):260-269.
  38. Krein SL, Harrod M, Weston LE, Garlick BR, Quinn M, Fletcher KE, Chopra V. Comparing peripherally inserted central catheter-related practices across hospitals with different insertion models: a multisite qualitative study. BMJ quality & safety. 2021 Aug 1; 30(8):628-638.
  39. Heapy AA, Driscoll MA, Buta E, LaChappelle KM, Edmond S, Krein SL, Piette JD, Mattocks K, Murphy JL, DeBar L, MacLean RR, Ankawi B, Kawecki T, Martino S, Wagner T, Higgins DM. Co-Operative Pain Education and Self-management (COPES) Expanding Treatment for Real-World Access (ExTRA): Pragmatic Trial Protocol. Pain medicine (Malden, Mass.). 2020 Dec 12; 21(12 Suppl 2):S21-S28.
  40. Malik AO, Nallamothu BK, Trumpower B, Kennedy M, Krein SL, Chinnakondepalli KM, Hejjaji V, Chan PS. Association Between Hospital Debriefing Practices With Adherence to Resuscitation Process Measures and Outcomes for In-Hospital Cardiac Arrest. Circulation. Cardiovascular quality and outcomes. 2020 Nov 17; 13(11):e006695.
  41. Manojlovich M, Harrod M, Hofer T, Lafferty M, McBratnie M, Krein SL. Factors influencing physician responsiveness to nurse-initiated communication: a qualitative study. BMJ quality & safety. 2021 Sep 1; 30(9):747-754.
  42. Cohen-Mekelburg S, Saini SD, Krein SL, Hofer TP, Wallace BI, Hollingsworth JM, Bynum JPW, Wiitala W, Burns J, Higgins PDR, Waljee AK. Association of Continuity of Care With Outcomes in US Veterans With Inflammatory Bowel Disease. JAMA Network Open. 2020 Sep 1; 3(9):e2015899.
  43. Cohen-Mekelburg S, Yu X, Costa D, Hofer TP, Krein S, Hollingsworth J, Wiitala W, Saini S, Zhu J, Waljee A. Variation in Provider Connectedness Associates With Outcomes of Inflammatory Bowel Diseases in an Analysis of Data From a National Health System. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 2021 Nov 1; 19(11):2302-2311.e1.
  44. Kurlander JE, Rubenstein JH, Richardson CR, Krein SL, De Vries R, Zikmund-Fisher BJ, Yang YX, Laine L, Weissman A, Saini SD. Physicians' Perceptions of Proton Pump Inhibitor Risks and Recommendations to Discontinue: A National Survey. The American journal of gastroenterology. 2020 May 1; 115(5):689-696.
  45. Vaughn VM, Saint S, Greene MT, Ratz D, Fowler KE, Patel PK, Krein SL. Trends in Health Care-Associated Infection Prevention Practices in US Veterans Affairs Hospitals From 2005 to 2017. JAMA Network Open. 2020 Feb 5; 3(2):e1920464.
  46. Vaughn VM, Greene MT, Ratz D, Fowler KE, Krein SL, Flanders SA, Dubberke ER, Saint S, Patel PK. Antibiotic stewardship teams and practices in United States hospitals: A national survey in The Joint Commission antibiotic stewardship standard era. Infection control and hospital epidemiology. 2020 Feb 1; 41(2):143-148.
  47. Higgins DM, Buta E, Williams DA, Halat A, Bair MJ, Heapy AA, Krein SL, Rajeevan H, Rosen MI, Kerns RD. Internet-Based Pain Self-Management for Veterans: Feasibility and Preliminary Efficacy of the Pain EASE Program. Pain practice : the official journal of World Institute of Pain. 2020 Apr 1; 20(4):357-370.
  48. Van T, Annis AM, Yosef M, Robinson CH, Duffy SA, Li YF, Taylor BA, Krein S, Sullivan SC, Sales A. Nurse staffing and healthcare-associated infections in a national healthcare system that implemented a nurse staffing directive: Multi-level interrupted time series analyses. International journal of nursing studies. 2020 Apr 1; 104:103531.
  49. Caverly TJ, Robinson CH, Krein SL, Forman J, Quinn M, Skurla SE, Damschroder L. Using Democratic Deliberation to Engage Veterans in Complex Policy Making for the Veterans Health Administration. Federal practitioner : for the health care professionals of the VA, DoD, and PHS. 2020 Jan 1; 37(1):24-32.
  50. Quinn M, Ameling JM, Forman J, Krein SL, Manojlovich M, Fowler KE, King EA, Meddings J. Persistent Barriers to Timely Catheter Removal Identified from Clinical Observations and Interviews. Joint Commission Journal on Quality and Patient Safety. 2020 Feb 1; 46(2):99-108.
  51. Manojlovich M, Harrod M, Hofer TP, Lafferty M, McBratnie M, Krein SL. Using Qualitative Methods to Explore Communication Practices in the Context of Patient Care Rounds on General Care Units. Journal of general internal medicine. 2020 Mar 1; 35(3):839-845.
  52. Krein SL, Kuhn L, Ratz D, Chopra V. Use of Designated Nurse PICC Teams and CLABSI Prevention Practices Among U.S. Hospitals: A Survey-Based Study. Journal of Patient Safety. 2019 Dec 1; 15(4):293-295.
  53. Krein SL, Kronick SL, Chopra V, Shever LL, Weston LE, Gregory L, Harrod M. Comparing inpatient versus emergency department clinician perceptions of personal protective equipment for different isolation precautions. American journal of infection control. 2020 Feb 1; 48(2):224-226.
  54. Kumar J, Eilertson B, Cadnum JL, Whitlow CS, Jencson AL, Safdar N, Krein SL, Tanner WD, Mayer J, Samore MH, Donskey CJ. Environmental Contamination with Species in Multiple Hospitals Including a Tertiary Care Hospital with a Outbreak. Pathogens & immunity. 2019 Oct 28; 4(2):260-270.
  55. Dukes K, Bunch JL, Chan PS, Guetterman TC, Lehrich JL, Trumpower B, Harrod M, Krein SL, Kellenberg JE, Reisinger HS, Kronick SL, Iwashyna TJ, Nallamothu BK, Girotra S. Assessment of Rapid Response Teams at Top-Performing Hospitals for In-Hospital Cardiac Arrest. JAMA internal medicine. 2019 Oct 1; 179(10):1398-1405.
  56. Harrod M, Petersen L, Weston LE, Gregory L, Mayer J, Samore MH, Drews FA, Krein SL. Understanding Workflow and Personal Protective Equipment Challenges Across Different Healthcare Personnel Roles. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2019 Sep 13; 69(Supplement_3):S185-S191.
  57. Quinn M, Forman J, Harrod M, Winter S, Fowler KE, Krein SL, Gupta A, Saint S, Singh H, Chopra V. Electronic health records, communication, and data sharing: challenges and opportunities for improving the diagnostic process. Diagnosis (Berlin, Germany). 2019 Aug 27; 6(3):241-248.
  58. Guetterman TC, Kellenberg JE, Krein SL, Harrod M, Lehrich JL, Iwashyna TJ, Kronick SL, Girotra S, Chan PS, Nallamothu BK. Nursing roles for in-hospital cardiac arrest response: higher versus lower performing hospitals. BMJ quality & safety. 2019 Nov 1; 28(11):916-924.
  59. Trautner BW, Saint S, Fowler KE, Van J, Rosen T, Colozzi J, Chopra V, Lescinskas E, Krein SL. What do patients say about their experience with urinary catheters and peripherally inserted central catheters?. American journal of infection control. 2019 Sep 1; 47(9):1130-1134.
  60. Gregory L, Weston LE, Harrod M, Meddings J, Krein SL. Understanding nurses' workflow: Batching care and potential opportunities for transmission of infectious organisms, a pilot study. American journal of infection control. 2019 Oct 1; 47(10):1213-1218.
  61. Saint S, Greene MT, Fowler KE, Ratz D, Patel PK, Meddings J, Krein SL. What US hospitals are currently doing to prevent common device-associated infections: results from a national survey. BMJ quality & safety. 2019 Sep 1; 28(9):741-749.
  62. Umberfield E, Ghaferi AA, Krein SL, Manojlovich M. Using Incident Reports to Assess Communication Failures and Patient Outcomes. Joint Commission Journal on Quality and Patient Safety. 2019 Jun 1; 45(6):406-413.
  63. Forman JH, Robinson CH, Krein SL. Striving toward team-based continuity: provision of same-day access and continuity in academic primary care clinics. BMC health services research. 2019 Mar 4; 19(1):145.
  64. Kurlander JE, Kennedy JK, Rubenstein JH, Richardson CR, Krein SL, De Vries R, Saini SD. Patients' Perceptions of Proton Pump Inhibitor Risks and Attempts at Discontinuation: A National Survey. The American journal of gastroenterology. 2019 Feb 1; 114(2):244-249.
  65. Likosky DS, Harrington SD, Cabrera L, DeLucia A, Chenoweth CE, Krein SL, Thibault D, Zhang M, Matsouaka RA, Strobel RJ, Prager RL. Collaborative Quality Improvement Reduces Postoperative Pneumonia After Isolated Coronary Artery Bypass Grafting Surgery. Circulation. Cardiovascular quality and outcomes. 2018 Nov 1; 11(11):e004756.
  66. Smith ME, Wells EE, Friese CR, Krein SL, Ghaferi AA. Interpersonal And Organizational Dynamics Are Key Drivers Of Failure To Rescue. Health affairs (Project Hope). 2018 Nov 1; 37(11):1870-1876.
  67. Krein SL, Mayer J, Harrod M, Weston LE, Gregory L, Petersen L, Samore MH, Drews FA. Identification and Characterization of Failures in Infectious Agent Transmission Precaution Practices in Hospitals: A Qualitative Study. JAMA internal medicine. 2018 Aug 1; 178(8):1016-1057.
  68. Saint S, Trautner BW, Fowler KE, Colozzi J, Ratz D, Lescinskas E, Hollingsworth JM, Krein SL. A Multicenter Study of Patient-Reported Infectious and Noninfectious Complications Associated With Indwelling Urethral Catheters. JAMA internal medicine. 2018 Aug 1; 178(8):1078-1085.
  69. Vaughn VM, Saint S, Krein SL, Forman JH, Meddings J, Ameling J, Winter S, Townsend W, Chopra V. Characteristics of healthcare organisations struggling to improve quality: results from a systematic review of qualitative studies. BMJ quality & safety. 2019 Jan 1; 28(1):74-84.
  70. Manojlovich M, Frankel RM, Harrod M, Heshmati A, Hofer T, Umberfield E, Krein S. Formative evaluation of the video reflexive ethnography method, as applied to the physician-nurse dyad. BMJ quality & safety. 2019 Feb 1; 28(2):160-166.
  71. Nallamothu BK, Guetterman TC, Harrod M, Kellenberg JE, Lehrich JL, Kronick SL, Krein SL, Iwashyna TJ, Saint S, Chan PS. How Do Resuscitation Teams at Top-Performing Hospitals for In-Hospital Cardiac Arrest Succeed? A Qualitative Study. Circulation. 2018 Jul 10; 138(2):154-163.
  72. Annis AM, Harris M, Kim HM, Rosland AM, Krein SL. Trends in primary care encounters across professional roles in PCMH. The American journal of managed care. 2018 Jul 1; 24(7):e222-e229.
  73. Clack L, Zingg W, Saint S, Casillas A, Touveneau S, da Liberdade Jantarada F, Willi U, van der Kooi T, Damschroder LJ, Forman JH, Harrod M, Krein S, Pittet D, Sax H, PROHIBIT Consortium. Implementing infection prevention practices across European hospitals: an in-depth qualitative assessment. BMJ quality & safety. 2018 Oct 1; 27(10):771-780.
  74. Greene MT, Fowler KE, Ratz D, Krein SL, Bradley SF, Saint S. Changes in Influenza Vaccination Requirements for Health Care Personnel in US Hospitals. JAMA Network Open. 2018 Jun 1; 1(2):e180143.
  75. Krein SL, Greene MT, King B, Welsh D, Fowler KE, Trautner BW, Ratz D, Saint S, Roselle G, Clifton M, Kralovic SM, Martin T, Mody L. Assessing a National Collaborative Program To Prevent Catheter-Associated Urinary Tract Infection in a Veterans Health Administration Nursing Home Cohort. Infection control and hospital epidemiology. 2018 Jul 1; 39(7):820-825.
  76. Becker WC, DeBar LL, Heapy AA, Higgins D, Krein SL, Lisi A, Makris UE, Allen KD. A Research Agenda for Advancing Non-pharmacological Management of Chronic Musculoskeletal Pain: Findings from a VHA State-of-the-art Conference. Journal of general internal medicine. 2018 May 1; 33(Suppl 1):11-15.
  77. Chopra V, Harrod M, Winter S, Forman J, Quinn M, Krein S, Fowler KE, Singh H, Saint S. Focused Ethnography of Diagnosis in Academic Medical Centers. Journal of hospital medicine. 2018 Oct 1; 13(10):668-672.
  78. Kurlander JE, Barnes GD, Anderson MA, Haymart B, Kline-Rogers E, Kaatz S, Saini SD, Krein SL, Richardson CR, Froehlich JB. Mind the gap: results of a multispecialty survey on coordination of care for peri-procedural anticoagulation. Journal of Thrombosis and Thrombolysis. 2018 Apr 1; 45(3):403-409.
  79. Hutton DW, Krein SL, Saint S, Graves N, Kolli A, Lynem R, Mody L. Economic Evaluation of a Catheter-Associated Urinary Tract Infection Prevention Program in Nursing Homes. Journal of the American Geriatrics Society. 2018 Apr 1; 66(4):742-747.
  80. Trautner BW, Prasad P, Grigoryan L, Hysong SJ, Kramer JR, Rajan S, Petersen NJ, Rosen T, Drekonja DM, Graber C, Patel P, Lichtenberger P, Gauthier TP, Wiseman S, Jones M, Sales A, Krein S, Naik AD, Less is More Study Group. Protocol to disseminate a hospital-site controlled intervention using audit and feedback to implement guidelines concerning inappropriate treatment of asymptomatic bacteriuria. Implementation science : IS. 2018 Jan 19; 13(1):16.
  81. Annis AM, Robinson CH, Yankey N, Krein SL, Duffy SA, Taylor B, Sales A. Factors Associated With the Implementation of a Nurse Staffing Directive. The Journal of nursing administration. 2017 Dec 1; 47(12):636-644.
  82. Adams MA, Prenovost KM, Dominitz JA, Holleman RG, Kerr EA, Krein SL, Saini SD, Rubenstein JH. Predictors of Use of Monitored Anesthesia Care for Outpatient Gastrointestinal Endoscopy in a Capitated Payment System. Gastroenterology. 2017 Dec 1; 153(6):1496-1503.e1.
  83. Krein SL, Harrod M, Collier S, Davis KK, Rolle AJ, Fowler KE, Mody L. A national collaborative approach to reduce catheter-associated urinary tract infections in nursing homes: A qualitative assessment. American journal of infection control. 2017 Dec 1; 45(12):1342-1348.
  84. Mody L, Greene MT, Meddings J, Krein SL, McNamara SE, Trautner BW, Ratz D, Stone ND, Min L, Schweon SJ, Rolle AJ, Olmsted RN, Burwen DR, Battles J, Edson B, Saint S. A National Implementation Project to Prevent Catheter-Associated Urinary Tract Infection in Nursing Home Residents. JAMA internal medicine. 2017 Aug 1; 177(8):1154-1162.
  85. Gundlapalli AV, Divita G, Redd A, Carter ME, Ko D, Rubin M, Samore M, Strymish J, Krein S, Gupta K, Sales A, Trautner BW. Detecting the presence of an indwelling urinary catheter and urinary symptoms in hospitalized patients using natural language processing. Journal of Biomedical Informatics. 2017 Jul 1; 71S:S39-S45.
  86. Heapy AA, Higgins DM, Goulet JL, LaChappelle KM, Driscoll MA, Czlapinski RA, Buta E, Piette JD, Krein SL, Kerns RD. Interactive Voice Response-Based Self-management for Chronic Back Pain: The COPES Noninferiority Randomized Trial. JAMA internal medicine. 2017 Jun 1; 177(6):765-773.
  87. Sharpe E, Kuhn L, Ratz D, Krein SL, Chopra V. Neonatal Peripherally Inserted Central Catheter Practices and Providers: Results From the Neonatal PICC1 Survey. Advances in neonatal care : official journal of the National Association of Neonatal Nurses. 2017 Jun 1; 17(3):209-221.
  88. Chopra V, Kuhn L, Ratz D, Winter S, Carr PJ, Paje D, Krein SL. Variation in use of technology among vascular access specialists: an analysis of the PICC1 survey. The journal of vascular access. 2017 May 15; 18(3):243-249.
  89. Krein SL, Greene MT, Apisarnthanarak A, Sakamoto F, Tokuda Y, Sakihama T, Fowler KE, Ratz D, Saint S. Infection Prevention Practices in Japan, Thailand, and the United States: Results From National Surveys. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2017 May 15; 64(suppl_2):S105-S111.
  90. Meddings J, Saint S, Krein SL, Gaies E, Reichert H, Hickner A, McNamara S, Mann JD, Mody L. Systematic Review of Interventions to Reduce Urinary Tract Infection in Nursing Home Residents. Journal of hospital medicine. 2017 May 1; 12(5):356-368.
  91. Skelton F, Campbell B, Horwitz D, Krein S, Sales A, Gundlapalli A, Trautner BW. Developing a user-friendly report for electronically assisted surveillance of catheter-associated urinary tract infection. American journal of infection control. 2017 May 1; 45(5):572-574.
  92. Gilliam M, Krein SL, Belanger K, Fowler KE, Dimcheff DE, Solomon G. Novel combined patient instruction and discharge summary tool improves timeliness of documentation and outpatient provider satisfaction. SAGE open medicine. 2017 Mar 29; 5:2050312117701053.
  93. Krein SL, Kuhn L, Ratz D, Winter S, Vaughn VM, Chopra V. The relationship between perceived role and appropriate use of peripherally inserted central catheters: A survey of vascular access nurses in the United States. International journal of nursing studies. 2017 Jun 1; 71:28-33.
  94. Adams MA, Prenovost KM, Dominitz JA, Kerr EA, Krein SL, Saini SD, Rubenstein JH. National Trends in Use of Monitored Anesthesia Care for Outpatient Gastrointestinal Endoscopy in the Veterans Health Administration. JAMA internal medicine. 2017 Mar 1; 177(3):436-438.
  95. Chopra V, Kuhn L, Ratz D, Shader S, Vaughn VM, Saint S, Krein SL. Vascular Access Specialist Training, Experience, and Practice in the United States: Results From the National PICC1 Survey. Journal of infusion nursing : the official publication of the Infusion Nurses Society. 2017 Jan 1; 40(1):15-25.
  96. Manojlovich M, Ratz D, Miller MA, Krein SL. Use of Daily Interruption of Sedation and Early Mobility in US Hospitals. Journal of nursing care quality. 2017 Jan 1; 32(1):71-76.
  97. Mody L, Greene MT, Saint S, Meddings J, Trautner BW, Wald HL, Crnich C, Banaszak-Holl J, McNamara SE, King BJ, Hogikyan R, Edson BS, Krein SL. Comparing Catheter-Associated Urinary Tract Infection Prevention Programs Between Veterans Affairs Nursing Homes and Non-Veterans Affairs Nursing Homes. Infection control and hospital epidemiology. 2017 Mar 1; 38(3):287-293.
  98. Zubkoff L, Neily J, King BJ, Dellefield ME, Krein S, Young-Xu Y, Boar S, Mills PD. Virtual Breakthrough Series, Part 1: Preventing Catheter-Associated Urinary Tract Infection and Hospital-Acquired Pressure Ulcers in the Veterans Health Administration. Joint Commission Journal on Quality and Patient Safety. 2016 Nov 9; 42(11):485-AP2.
  99. Trautner BW, Greene MT, Krein SL, Wald HL, Saint S, Rolle AJ, McNamara S, Edson BS, Mody L. Infection Prevention and Antimicrobial Stewardship Knowledge for Selected Infections Among Nursing Home Personnel. Infection control and hospital epidemiology. 2017 Jan 1; 38(1):83-88.
  100. Heapy AA, Higgins DM, LaChappelle KM, Kirlin J, Goulet JL, Czlapinski RA, Buta E, Piette JD, Krein SL, Richardson CR, Kerns RD. Cooperative pain education and self-management (COPES): study design and protocol of a randomized non-inferiority trial of an interactive voice response-based self-management intervention for chronic low back pain. BMC musculoskeletal disorders. 2016 Feb 16; 17:85.
Journal Other

  1. Hejjaji V, Chakrabarti AK, Nallamothu BK, Iwashyna TJ, Krein SL, Trumpower B, Kennedy M, Chinnakondepalli K, Malik AO, Chan PS. Corrigendum to 'Association Between Hospital Resuscitation Team Leader Credentials and Survival Outcomes for In-Hospital Cardiac Arrest' [Mayo Clinic Proceedings Innovation Quality Outcomes, 2021, Vol 5, Issue 6, Pages 1021-1028, Article Number: doi: 10.1016/j.mayocpiqo.2021.06.002]. Mayo Clinic proceedings. Innovations, quality & outcomes. 2022 Dec 1; 6(6):636.
  2. Manojlovich M, Krein SL. We don't talk about communication: why technology alone cannot save clinically deteriorating patients. [Editorial]. BMJ quality & safety. 2022 Jul 22.
  3. Evans CT, Jump RL, Krein SL, Bradley SF, Crnich CJ, Gupta K, Perencevich EN, Vander Weg MW, Morgan DJ. Setting a Research Agenda in Prevention of Healthcare-Associated Infections (HAIs) and Multidrug-Resistant Organisms (MDROs) Outside of Acute Care Settings. Infection control and hospital epidemiology. 2018 Feb 1; 39(2):210-213.
  4. Quinn M, Robinson C, Forman J, Krein SL, Rosland AM. Survey Instruments to Assess Patient Experiences With Access and Coordination Across Health Care Settings: Available and Needed Measures. Medical care. 2017 Jul 1; 55 Suppl 7 Suppl 1:S84-S91.
VA Cyberseminars

  1. Krein SL. Notes to Your Future Self: Data Documentation and Data Planning Throughout the Research. Planning for Data: Early, Often and Ongoing [Cyberseminar]. AcademyHealth 2017 Annual Research Meeting. 2017 Jun 25.
  2. Saint SK, Krein SL, Meddings J. Enhancing Patient Safety by Preventing Device-Associated Harm. [Cyberseminar]. 2017 Jan 12.


DRA: Health Systems
DRE: none
Keywords: Capacity Building
MeSH Terms: none

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