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O utcomes research examines the effects of medical care interventions and policies on the health outcomes of individuals and society. 1 Investigators conducting outcomes research seek to inform the development of clinical practice guidelines, to evaluate the quality of medical care, and to foster effective interventions to improve the quality of care. 2(More)
BACKGROUND Despite decades of efforts to improve quality of health care, poor performance persists in many aspects of care. Less than 1% of the enormous national investment in medical research is focused on improving health care delivery. Furthermore, when effective innovations in clinical care are discovered, uptake of these innovations is often delayed(More)
BACKGROUND Fewer than half of patients with ST-elevation acute myocardial infarction (STEMI) are treated within guideline-recommended door-to-balloon times; however, little information is available about the approaches used by hospitals that have been successful in improving door-to-balloon times to meet guidelines. We sought to characterize experiences of(More)
OBJECTIVES This study sought to determine the range and prevalence of practices being implemented by hospitals to reduce 30-day readmissions of patients with heart failure or acute myocardial infarction (AMI). BACKGROUND Readmissions of patients with heart failure or AMI are both common and costly; however, evidence on strategies adopted by hospitals to(More)
BACKGROUND Multiple interventions have been launched to improve the quality, access, and utilization of primary health care in rural, low-income settings; however, the success of these interventions varies substantially, even within single studies where the measured impact of interventions differs across sites, centers, and regions. Accordingly, we sought(More)
Breastfeeding (BF) promotion is one of the most cost-effective interventions to advance mother-child health. Evidence-based frameworks and models to promote the effective scale up and sustainability of BF programs are still lacking. A systematic review of peer-reviewed and gray literature reports was conducted to identify key barriers and facilitators for(More)
BACKGROUND Many family health innovations that have been shown to be both efficacious and cost-effective fail to scale up for widespread use particularly in low-income and middle-income countries (LMIC). Although individual cases of successful scale-up, in which widespread take up occurs, have been described, we lack an integrated and practical model of(More)
OBJECTIVE More than half the world's population lives in rural areas; however, we have limited evidence about how to strengthen rural healthcare services. We sought to determine the impact of a systems-based approach to improving rural care, the Ethiopian Millennium Rural Initiative, on key healthcare services indicators. DESIGN We conducted an 18-month(More)
BACKGROUND Although rates of maternal and neonatal mortality have decreased in many countries over the last two decades, they remain unacceptably high, particularly in sub-Saharan Africa. Nevertheless, we know little about the quality of facility-based maternal and newborn care in low-income countries and little about the association between quality of care(More)
UNLABELLED BACKGROUND The emigration of skilled nurses from the Philippines is an ongoing phenomenon that has impacted the quality and quantity of the nursing workforce, while strengthening the domestic economy through remittances. This study examines how the development of brain drain-responsive policies is driven by the effects of nurse migration and(More)