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Objective. There is limited theory regarding the real-world implementation of mental health care in the primary care setting: a type of organizational coordination intervention. The purpose of this study was to develop a theory to conceptualize the potential causes of barriers and facilitators to how local sites responded to this mandated intervention to(More)
The objective of our study was to compare the in vitro release kinetics of a sustained-release injectable microsphere formulation of the polypeptide drug, calcitonin (CT), to optimize the characteristics of drug release from poly-(lactide-co-glycolide) (PLGA) copolymer biodegradable microspheres. A modified solvent evaporation and double emulsion technique(More)
OBJECTIVES Despite recognition that implementation of evidence-based clinical practices (EBPs) usually depends on the structure and processes of the larger health care organizational context, the dynamics of implementation are not well understood. This project's aim was to deepen that understanding by implementing and evaluating an organizational model(More)
BACKGROUND The goal of the Pursuing Perfection (P2) program was to encourage organizations to push quality improvement to new levels of excellence. As part of an evaluation of P2, we surveyed employees at the 7 participating P2 organizations to (1) assess their perceptions of patient care quality and improvement progress and (2) examine perceived(More)
PURPOSE The objective of this study was to test and revise a staff assessment of person-centered care (PCC) within the Veterans Health Administration (VA) Community Living Center (CLC) setting. DESIGN AND METHODS Starting with measures of PCC initially developed through the Better Jobs Better Care (BJBC) study, we conducted cognitive interviews with CLC(More)
OBJECTIVE To examine variation in culture change to a person-centered care (PCC) model, and the association between culture change and a composite measure of quality in 107 Department of Veterans Affairs nursing homes. METHODS We examined the relationship between a composite quality measure calculated from 24 quality indicators (QIs) from the Minimum Data(More)
BACKGROUND Racial and ethnic differences in lung cancer care have been previously documented. These differences may be related to access to care, cultural differences, or fewer patients presenting with operable lung cancer. The relationship between race and pathologic stage of patients who undergo lung cancer resection has not been defined. This study(More)
OBJECTIVE The purpose of this study was to direct attention to mental health issues that may occur around discharge of patients hospitalized for general medical issues. This study provides a methodology and tested whether postdischarge mental health care moderates the effect of the length of the medical inpatient stay on costs one year later. METHODS(More)
BACKGROUND The lack of a tool for categorizing and differentiating hospitals according to their high reliability organization (HRO)-related characteristics has hindered progress toward implementing and sustaining evidence-based HRO practices. Hospitals would benefit both from an understanding of the organizational characteristics that support HRO practices(More)