Richard Mularski

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Palliative care aims to prevent and relieve suffering by controlling symptoms and to provide other support to patients and families in order to maintain and improve their quality of living. Although originally conceived and practiced as end-of-life care, palliative care may be applied to all stages of illness, whether terminal or not. Because its members(More)
Dyspnea is a cardinal symptom of chronic obstructive pulmonary disease (COPD), and its severity and magnitude increases as the disease progresses, leading to significant disability and a negative effect on quality of life. Refractory dyspnea is a common and difficult symptom to treat in patients with advanced COPD. There are many questions concerning(More)
OBJECTIVES To systematically identify quality measures and the evidence for them-to support quality assessment and improvement in the palliative care of patients with cancer in the areas of pain, dyspnea, depression, and advance care planning (ACP), and to identify important gaps in related research. DATA SOURCES MEDLINE, CINAHL, and PsycINFO in English(More)
In 2009, the American Thoracic Society (ATS) funded an assembly project, Palliative Management of Dyspnea Crisis, to focus on identification, management, and optimal resource utilization for effective palliation of acute episodes of dyspnea. We conducted a comprehensive search of the medical literature and evaluated available evidence from systematic(More)
BACKGROUND Extended smoking cessation follow-up after hospital discharge significantly increases abstinence. Hospital smoke-free policies create a period of 'forced abstinence' for smokers, thus providing an opportunity to integrate tobacco dependence treatment, and to support post-discharge maintenance of hospital-acquired abstinence. This study is funded(More)
BACKGROUND The Patient Reported Outcomes Measurement Information System 43-item short form (PROMIS-43) and the five-level EQ-5D (EQ-5D-5L) are recently developed measures of health-related quality of life (HRQL) that have potentially broad application in evaluating treatments and capturing burden of respiratory-related diseases. The aims of this study were:(More)
RATIONALE Pay-for-performance is a model for health care financing that seeks to link reimbursement to quality. The American Thoracic Society and its members have a significant stake in the development of pay-for-performance programs. OBJECTIVES To develop an official ATS policy statement addressing the role of pay-for-performance in pulmonary, critical(More)
Electronic medical records (EMRs) hold the promise of making routine comprehensive measurement of care quality a reality. However, there are many informatics challenges that stand in the way of this goal. Guidelines are rarely stated in precise enough language for automated measurement of clinical practices and the data necessary for that measurement often(More)
Mission: The Permanente Journal advances knowledge in scientific research, clinical medicine, and innovative health care delivery. Circulation: 25,000 print readers per quarter, and accessed by 700,000 unique Web readers in the last 12 months from 164 countries. ON THE COVER " Yosemite Winter Scene " by Gary Larsen taken in Yosemite National Park during the(More)