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Journal articles on the topic 'Baystate Medical Center'

Author: Grafiati

Published: 4 June 2021

Last updated: 27 January 2023

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1

Brennan, Maura, and Rebecca Dobert. "Successes and Lessons Learned From Age-Friendly Community Collaborations: Baystate Health GWEP." Innovation in Aging 5, Supplement_1 (December 1, 2021): 494. http://dx.doi.org/10.1093/geroni/igab046.1907.

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Abstract Baystate is the largest health system in Western Massachusetts with 4 hospitals, 3 Community Health Centers (CHCs) and a large primary care network. Baystate Medical Center (BMC) is in Springfield, Massachusetts. BMC and the CHCs were the first health care sites nationally to be recognized by the Institute for Healthcare Improvement as “Committed to Care Excellence” in the age friendly movement. Collaboration with a city-wide coalition of community-based organizations led to simultaneous recognition of Baystate as “age friendly” and recognition of the city as both dementia and age friendly. The 3 awards were presented at a Springfield senior center with media coverage and the participation of the mayor and other political leaders. This collaboration persists and the GWEP and coalition partners continue to participate in multiple joint educational and community outreach projects. As a result, the city coalition has added health care to its initial focus on housing and transportation.

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2

Fitzgerald, Janice, Gary Kanter, and Evan Benjamin. "Case Study: Preventing Surgical Complications at Baystate Medical Center." Joint Commission Journal on Quality and Patient Safety 33, no. 11 (November 2007): 666–71. http://dx.doi.org/10.1016/s1553-7250(07)33076-6.

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3

Earle, David. "Surgical Training and Simulation Laboratory at Baystate Medical Center." Surgical Innovation 13, no. 1 (March 2006): 53–60. http://dx.doi.org/10.1177/155335060601300109.

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4

Proujansky, Alice E. "Birthplace: A Model of Collaborative Care at Baystate Franklin Medical Center." AJN, American Journal of Nursing 110, no. 12 (December 2010): 38–41. http://dx.doi.org/10.1097/01.naj.0000391238.45392.bf.

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5

Gortakowski, Michele, and Chelsea C. Gordner. "Development of Repository From a Pediatric Gender Clinic." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A797. http://dx.doi.org/10.1210/jendso/bvab048.1621.

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Abstract Objectives: With the publication of updated guidelines for care of transgender and gender non-conforming individuals, there has been an increase in the presence of gender diversity in both mainstream media and medical literature. Several gaps currently exist in medical knowledge regarding long term effects of gender-affirming therapies. There is a lack of standardization in study design, patient sampling, and outcome measures, and most studies are retrospective. Here we describe the creation of both a retrospective and prospective repository of patients who presented to the Massachusetts Medical School-Baystate Medical Center (UMass-Baystate) pediatric gender program. Methods: Baystate Medical Center is located in western MA and is a tertiary referral center. A pediatric gender clinic was created in 2014. A repository containing both retrospective and prospective data was approved by the UMass-Baystate IRB to include patients ages 2 to 24 years of age who presented to our gender clinic. Retrospective data was obtained using the McKesson billing database. Sociodemographic, clinical and behavioral health data were collected. We are consenting individuals as they present to the clinic for the prospective component. Those that have consented fill out a survey at each visit. The repository has been approved to follow outcome data for 25 years. Results: To date, we have 218 individuals in the repository, 75 of which are in the prospective component. Age of presentation ranged from 6 yrs to 24 yrs with an average age of 15 yrs. 62% identified as transmale, 31% as transfemale and the remainder as gender fluid or other. 75% have been prescribed gender affirming hormone therapy (56% GnRH agonist therapy, 20% estrogen, 58% testosterone). Of those being followed prospectively, 76% identified as white, 19% Hispanic. 79% were satisfied or very satisfied with their care. Conclusions: Here we describe the demographic and clinical characteristics of patients that have presented to our gender clinic since 2014. The creation of our gender repository will allow us to assess sociodemographic, clinical and behavioral health outcomes of treatment, including metabolic parameters, bone health, and mental health outcomes in our pediatric population. Future projects include assessment of the change in cardiovascular risk in individuals on gender-affirming hormone therapy.

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Gortakowski, Michele, and Chelsea Gordner. "Improving Residents’ Competency in Caring for Transgender Individuals Through Development of a Curriculum." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A799. http://dx.doi.org/10.1210/jendso/bvab048.1625.

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Abstract Objectives: Several recent publications have described the lack of education in transgender health care among providers across all levels of medical training. Here we describe a QI project that developed and implemented a transgender health care curriculum for the University of Massachusetts Medical School-Baystate Medical Center (UMass-Baystate) pediatric and combined internal medicine-pediatrics residency programs. Methods: We designed a curriculum for the UMass-Baystate pediatric (9 residents/yr) and med-peds (8 residents/yr) residency programs. The curriculum included grand rounds presentations on transgender health care, didactic sessions integrated into the residents’ protected educational time throughout the academic year, and a panel discussion with non-binary and transgender individuals from the community. The didactic sessions included a mixture of lectures, role- playing, and case-based discussion. The curriculum development was guided by a curriculum design specialist and adapted each year based on feedback. Residents’ self- reported comfort and competency level were assessed through a survey at baseline and at the end of each year. Results: Ninety-eight percent (42/43) completed the baseline survey. Forty percent (17/42) had received no formal training in medical school, and 21% (9/42) had never taken care of a transgender patient. At baseline, 62% felt a little less comfortable and 50% felt somewhat competent, 2.4% very competent caring for transgender individuals compared to cisgender individuals. After three years, 25% felt a little less comfortable and 44% felt somewhat competent, 19% felt very competent caring for transgender individuals compared ot cisgender individuals. The community panel was very well received. Free text comments regarding the curriculum included “very helpful,” “loved the panel,” “clinically relevant.” Conclusions: This QI initiative served as the groundwork for the development of a formal curriculum to enhance medical education among residents in caring for transgender individuals. After three years, residents felt more comfortable and competent in caring for transgender individuals as compared to the baseline survey. We will continue to adapt the curriculum as it continues. The curriculum has expanded to include the pediatric nurses and the UMass medical students.

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7

Yu, Cecelia, and Gabriel Cohn. "A comparison of laboratory data in perinatal transfers at Baystate Medical Center and transferring hospitals." Primary Care Update for OB/GYNS 5, no. 4 (July 1998): 184–85. http://dx.doi.org/10.1016/s1068-607x(98)00101-2.

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8

COHEN, LEWIS M. "Shattering the consensus on end-of-life care: Was the Schiavo case palliative medicine's Humpty Dumpty?" Palliative and Supportive Care 4, no. 2 (June 2006): 113–16. http://dx.doi.org/10.1017/s1478951506060159.

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In October of 2005, a two-day conference, “Controversies in End-of-Life Care: Terri Schiavo's Lessons,” was jointly sponsored by Baystate Medical Center and the Smith College School for Social Work. Both the conference and this special issue of the journal are prompted by recognition that the Schiavo case has clearly generated considerable national attention, and it consequently offers palliative medicine, social work, psychiatry, neurology, and allied disciplines a singular opportunity to reflect on our clinical practices and assumptions about the management of catastrophically ill individuals. At the core of the Schiavo case was a bitter family feud, but before it ended, it became a legal battle, a political fight, a disability rights issue, and a macabre media circus. It is heartbreaking that Congress held a midnight session about the health care of one irreparably brain-damaged woman, Terri Schiavo, while ignoring the health crisis of 40 million uninsured Americans (Friedman, 2005).

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9

BREITBART, WILLIAM. "A special issue of Palliative & Supportive Care: The lessons of the Terri Schiavo case." Palliative and Supportive Care 4, no. 2 (June 2006): 111. http://dx.doi.org/10.1017/s1478951506060147.

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This past fall (October 2005), my good friend and colleague Lewis Cohen, M.D., of Baystate Medical Center, helped organize a unique conference (cosponsored by the Smith College of Social Work) that represented an early attempt by psychosocial palliative care clinicians, ethicists, and legal experts to grapple with the issues raised by the Terri Schiavo case, which had so captured the attention of the nation and raised tremendous disagreement and debate. As editor-in-chief of Palliative & Supportive Care, I was, of course, quite thrilled when Dr. Cohen proposed the possibility of our journal publishing the main papers from this unique and timely conference. As the readers of Palliative & Supportive Care will recall, this journal has expressed the opinion that the case of Terri Schiavo represented a watershed event in palliative care practice and research (Breitbart, 2005), and we called for more research into the experience of patients who die of dehydration. Of course, the issues raised by the Schiavo case are so much broader and do, in fact, range from palliative care practice and research to ethics and spiritual issues to legal issues regarding decision making at the end of life.

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10

Johnson, K. G., N. Ravikumar, N. Scuderi, A. Sharma, V. Rastegar, and P. Visintainer. "0604 Comorbidities and Admission Rates in Inpatients Undergoing Sleep Studies." Sleep 43, Supplement_1 (April 2020): A231. http://dx.doi.org/10.1093/sleep/zsaa056.601.

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Abstract Introduction Uncontrolled sleep-disordered breathing (SDB) and hypoventilation, which are common in COPD, CHF and obesity hypoventilation patients can lead to death and readmissions. It is unknown whether inpatient sleep studies to diagnose and optimize treatment improve care and prevent readmissions. Methods All patients > 18 years old with sleep studies while inpatient at Baystate Medical Center between October 2015 and September 2017 were included. Patient characteristics, comorbidities, sleep study diagnoses, and treatment recommendations were evaluated. Admission (inpatient or observation) and death rates were determined for 1-year before admit date and 1-year after discharge date of index admission. Results 326 adult inpatients had 120 portable and 304 in-laboratory tests performed. Average age was 62.9±14.4, mean BMI was 37.2±12.3 and 56% were male. Principal diagnoses were CHF (50%), COPD (39%), both COPD and CHF (20%) and obesity hypoventilation (27%). 31 used PAP and 71 used oxygen prior to admission. Sleep diagnoses included OSA (73%), central sleep apnea (CSA) (29%), treatment emergent CSA (8%), hypoxia (48%), hypoventilation (41%), and normal or non-diagnostic (6%). Treatment recommendations included CPAP (25%), BiPAP (18%), BiPAP ST (3%), ASV (4%), iVAPS (22%), oxygen only (5%) and further titration (20%). The average length of stay was 11.6 ± 9.6 days. There was no difference in the percentage of patients who had an admission before or after their sleep study (53% vs 56%, respectively). In addition, no difference was seen in the median number of admissions before and after the sleep study (median=1.0, IQI=0-2, p=0.77). 90-day readmission rate was 19%. 14% died. Conclusion SDB, hypoxia and hypoventilation were common in inpatients evaluated with sleep studies with PAP therapy recommended in most patients. Further research is needed to determine whether inpatient testing and subsequent treatment can result in decreased readmissions and death. Support None

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11

Chen, E. Alexandra, Gregory A. Carlson, Bret F. Coughlin, William P. Reed, Jane L. Garb, and James L. Frank. "Routine Chest Roentgenography Is Unnecessary in the Work-Up of Stage I and II Breast Cancer." Journal of Clinical Oncology 18, no. 20 (October 20, 2000): 3503–6. http://dx.doi.org/10.1200/jco.2000.18.20.3503.

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PURPOSE: Clinical practice guidelines of many professional societies call for routine staging chest x-rays (SCXR) for all patients with invasive cancer. Given the estimated 157,000 patients annually for whom this recommendation pertains, this screening examination represents a considerable health care expenditure. If it were shown that SCXR rarely changed the management of low-risk subsets of this population, it might be possible to selectively omit this practice from the care of these patients with substantial resultant cost savings. PATIENTS AND METHODS: All patients with clinical stage I and II breast cancer presenting to the Baystate Medical Center from 1989 through 1997 were identified through the Tumor Registry. Their hospital records were reviewed for clinical presentation and documentation of SCXR. RESULTS: One thousand four hundred ninety-four patients were identified with clinical stage I and II disease. SCXR were available for review on 1,003 patients. Only one asymptomatic patient was upstaged to stage IV based on a SCXR. Two patients with primary lung tumors were also identified. These data demonstrate an asymptomatic pulmonary metastasis detection rate of 0.099% (95% confidence interval, 0.0% to 0.6%). The total charges of SCXR for this group approached $180,000. CONCLUSION: These data demonstrate the low diagnostic yield and high cost of routine SCXR in the management of asymptomatic patients with clinical stage I and stage II breast cancer. Because other studies have shown that SCXR changes neither quality of life nor overall survival, SCXR should be limited to symptomatic patients in whom metastatic disease is suspected.

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12

Rodriguez, Julieta, Nicholas Karr, Grzegorz Danielczok, Donna J. Fisher, and Ingrid Y. Camelo. "471. Descriptive Analysis of Multiinflammatory Syndrome in Children (MIS-C) Secondary to COVID 19 Infection in a Predominantly Latino Population in Western Massachusetts." Open Forum Infectious Diseases 8, Supplement_1 (November 1, 2021): S337. http://dx.doi.org/10.1093/ofid/ofab466.670.

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Abstract Background COVID-19 infection is usually mild in children. Progression to severe disease with multiple organ systems compromise described as Multi Inflammatory Syndrome in Children (MIS-C) is a rare occurrence believed to be immunologically mediated. Previous reports describe a possible link between children of Latino origin and high incidence of MIS-C in the US. 40% of the total population in Western Massachusetts is of Latino origin. Methods Retrospective chart review of 30 children admitted to Baystate Medical Center in Springfield, Massachusetts from April 2020-June 2021 meeting Centers for Disease Control and Prevention (CDC) criteria for MIS-C. Demographics, laboratory data, and clinical outcomes including progression to Macrophage Activation Syndrome (MAS) were analyzed. Results 60% of children were Hispanic. Mean age (9.1 yrs). Range (3m-20 yrs). COVID PCR positive (78%) and COVID Antibody positive (68%). The most common symptom was fever (96.8%) followed by gastrointestinal symptoms (84%). Respiratory symptoms (29%), dermatological manifestations (39%). Most common comorbidity, asthma (19%) followed by obesity (17%). Leukocytosis (47%), lymphopenia (45%), Anemia (55%), thrombocytopenia (20%), high CRP (90%), ferritinemia (57%), acute kidney injury (20%), elevated liver enzymes (53%), 52% children had electrocardiogram (EKG) abnormalities, 34% had abnormal echocardiograms, none displayed coronary artery dilation. Progression to MAS (20%). All patients were treated with intravenous immunoglobulin G, steroids, aspirin, and anakinra (IL1 receptor antagonist) if progression to MAS. All patients survived. Conclusion In our population, gastrointestinal symptoms were predominant despite a high prevalence of asthma and obesity, previous reports of children with MIS-C describe predominance of respiratory manifestations. We did not encounter any coronary aneurysms during admission. Most children had positive PCR or Antibodies for COVID 19 and showed important abnormalities in multiple cell lines and inflammatory markers. More research is needed to fully understand ethnical risk factors associated with disease severity especially the risk of progression to MAS from MIS-C in children of Latino origin diagnosed with COVID 19 infection. Disclosures All Authors: No reported disclosures

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13

"Peripheral IV bacteremia: Relationship to prehospital and emergency room insertions M. Schulte, RN, MA, CIC,* J. Luff, RNC, A. Corl, RN, CIC, D. Cipriani, S. Calderone, MS, R. Brown, MD. Baystate Medical Center, Springfield, MA." American Journal of Infection Control 23, no. 2 (April 1995): 123. http://dx.doi.org/10.1016/0196-6553(95)90202-3.

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14

"Surgical wound infection data collection, validation and reporting system M. Schulte, RN, MA, CIC,* A. Corl, RN, CIC, S. Calderone, MS, D. Cipriani, RN, BSN, CIC, J. Luff, RNC, R. Brown, MD. Baystate Medical Center, Springfield, MA." American Journal of Infection Control 23, no. 2 (April 1995): 102. http://dx.doi.org/10.1016/0196-6553(95)90127-2.

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15

"Myocardial salvage by fatty acid binding protein *1Birendra N. Srimani, Arabinda Samanta, Richard M. Engelman, Randall Jones and Dipak K. Das. Cardiovascular Division, Department of Surgery, University of Connecticut School of Medicine, Farmington, CT 06032, and Department of Surgery, Baystate Medical Center, Springfield, MA 01199." Journal of Molecular and Cellular Cardiology 21 (April 1989): S131. http://dx.doi.org/10.1016/0022-2828(89)91893-2.

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16

"Cardioprotective role of ceruloplasmin, a major copper containing human serum protein Jaisimha Iyengar, Yutaka Kimura, Richard M. Engelman, Randall M. Jones, John A. Rousou and Dipak K. Das, University of Connecticut School of Medicine, Farmington, CT, 06032 and Baystate Medical Center, Springfield, MA, 01199, U.S.A." Journal of Molecular and Cellular Cardiology 22 (July 1990): 5. http://dx.doi.org/10.1016/0022-2828(90)90140-w.

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17

"Reduced free radical generation during reperfusion of hypothermically arrested heart M. Renuka Prasad, John A. Rousou, Richard M. Engelman, Xuekun Liu, Devarshi Nath and Dipak K. Das. University of Connecticut School of Medicine, Farmington, CT, 06032 and Baystate Medical Center, Springfield, MA, 01199, U.S.A." Journal of Molecular and Cellular Cardiology 22 (July 1990): 7. http://dx.doi.org/10.1016/0022-2828(90)90145-r.

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18

"Direct scavenging of free radicals by captopril, an angiotensin converting enzyme inhibitor *1Randall Jones, M. Renuka Prasad, Richard M. Engelman and Dipak K. Das. Cardiovascular Division, Department of Surgery, University of Connecticut School of Medicine, Farmington, CT and Department of Surgery, Baystate Medical Center, Springfield, MA." Journal of Molecular and Cellular Cardiology 21 (April 1989): S130. http://dx.doi.org/10.1016/0022-2828(89)91892-0.

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19

"Diltiazem and trifluoperazine alone or in combination for myocardial preservation during cardiac surgery Yutaka Kimura, Jaisimha Iyengar, Richard M. Engelman, John A. Rousou, Joseph Flack and Dipak K. Das. University of Connecticut School of Medicine, Farmington, CT 06032 and Baystate Medical Center, Springfield, MA 01199, USA." Journal of Molecular and Cellular Cardiology 22 (July 1990): 2. http://dx.doi.org/10.1016/0022-2828(90)90130-t.

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20

Ogunneye, Owolabi, Michael Rothberg, Jennifer Friderici, Mara Slawsky, Reva Kleppel, Stephanie Calcasola, Taraka V. Gadiraju, and Mihaela Stefan. "Abstract 225B: Nursing Home Care Quality and 30-Day Readmission Rates for patients with Heart Failure." Circulation: Cardiovascular Quality and Outcomes 5, suppl_1 (April 2012). http://dx.doi.org/10.1161/circoutcomes.5.suppl_1.a225b.

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Background: Acute decompensated heart failure (ADHF) is one of the most frequent cause for hospitalization in the United States but little is known about how the quality of care provided by the skilled nursing facilities (SNFs) influences readmission rates. Objectives: 1)To determine the association between care quality reported on Medicare's Nursing Home Compare website and 30-day risk-adjusted readmission rate (RAR) for ADHF. 2) To assess the correlation of processes of care and characteristics of SNFs with 30-day RAR. Methods: Retrospective cohort study at Baystate Medical Center, a 659-bed tertiary care hospital. Subjects: Patients aged ≥18 years discharged to 17 local SNFs after hospitalization for ADHF from November 2008 to October 2011. SNF quality of care was assessed based on the quality rating (health inspection, quality measures and staff rating) obtained from www.medicare.gov/NHCompare (range 1 to 5 stars). Based on the distribution of quality ratings, SNFs with only 1 star were considered lower quality. A telephone survey about SNF characteristics (e.g. physician hours, number of beds, licensed nurse's minutes) and processes of care (e.g. telemonitoring capability, onsite IV lasix, Heart failure (HF) treatment protocol) was completed by each director of nursing. RAR's were calculated using a mixed-effects logistic regression model adjusting for demographics, comorbidities and clinical characteristics of the patients. Results: Of the 605 discharges (491 patients), 121 were readmitted within 30-days, 57 were ADHF related; 64% were female, 86% white and median age was 84 years (interquartile range 13). Nearly all (99%) patients had Medicare or Medicaid. At discharge, 37% had ejection fraction <40% and 60% had at least one high-risk comorbidity (e.g. coronary artery disease, hypertension, atrial fibrillation). Higher quality SNFs (58%) were more likely to be non-profit and had more beds. The 30-day all-cause RAR was 19% (95% CI 14 -23) and 22% (95% CI 17 - 26) and the 30-day ADHF RAR was 9% (95% CI 6 -11.6) and 10% (95% CI 7 - 12.9) for higher and lower quality SNF's respectively. Both all-cause and ADHF RARs declined significantly between 2008- 2011 (P=0.02, χ2 test of trend). Although RAR were slightly lower in higher quality SNFs, these differences were not statistically significant in either adjusted or unadjusted models. Higher SNF staff ratings was marginally correlated with lower readmission rates (Spearmean R = - 0.39, p = 0.05). Self-reported processes of care (e.g. telemonitoring capability, weight graph), as well as SNF care structure (e.g. physician hours) did not correlate with RAR. Conclusions: Overall Quality rating reported on www.medicare.gov/NHCompare, as well as processes of care performed by SNFs were not associated with RARs for patients with Heart failure. Higher staff ratings correlated with lower RAR.

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21

"The role of the institutional review board in quality improvement: a survey of quality officers, institutional review board chairs, and journal editors. Lindenauer PK,**Peter K. Lindenauer, MD, MSc, Division of Healthcare Quality, Baystate Medical Center, 759 Chestnut Street, P-5928, Springfield, MA 01199, USA; e-mail: Peter.Lindenauer\@bhs.orgBenjamin EM, Naglieri-Prescad D, Fitzgerald J, Pekow P. Am J Med 2002;113:575–579." American Journal of Ophthalmology 135, no. 5 (May 2003): 753–54. http://dx.doi.org/10.1016/s0002-9394(03)00138-7.

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