Z-Coding for Social Contributors to Health in Colorado Federally Qualified Health Centers.

Background: Federally Qualified Health Centers (FQHC) provide services to individuals facing systemic barriers to health equity and are disproportionately affected by adverse social determinants of health. To better align healthcare services with the needs of those individuals experiencing health inequities, it is essential to screen for and document problematic social contributors to health in electronic health records, which health systems have been mandated to document by 2026.

Objectives: The aims of this study were to 1) determine the prevalence of documented social contributors to health Z-codes among patients receiving care through Colorado nurse-led FQHCs across urban, rural, and frontier settings; and 2) estimate healthcare utilization and expenditures associated with the presence of documented social contributors to health Z-codes compared to a matched sample of patients without that Z-code documentation.

Universal Depression Screen of Ambulatory Heart Transplant Recipients With Referral for Mental Health Intervention: A Quality Improvement Project.

Background: Patients with a heart transplant and depression have higher rates of graft failure and noncompliance.

Local Problem: The heart transplant clinic had no standardized approach to assess for depression.

Methods: The heart transplant clinic implemented routine use of the Patient Health Questionnaire (PHQ).

Subsequent Fracture Prevention in Patients 50 Years and Older With Fragility Fractures: A Quality Improvement Initiative.

Because of osteoporosis, patients older than 50 years with fragility fractures are at risk of further fractures. We developed a quality improvement initiative based on an evidence-based Fracture Liaison Service (FLS) model of care to help prevent subsequent fractures. Previous to the implemented FLS model, less than 13% of patients with fragility fractures were assessed for osteoporosis at our institution.

Failure to fail: the institutional perspective.

Purpose: To determine institutional barriers to placing failing students on probation, dismissing students.

Methods: An online survey study was distributed to Student Affairs Deans or the equivalent at allopathic (MD) and osteopathic (DO) medical schools, and physician assistant (PA) and nurse practitioner (NP) schools across the United States. Nineteen (40%) of the 48 schools responded: six MD, four DO, five PA and four NP.

Inpatient Falls: Defining the Problem and Identifying Possible Solutions. Part II: Application of Quality Improvement Principles to Hospital Falls.

In this 2 part series, analysis of the risk stratification tools that are available and definition of the scope of the problem and potential solutions through a review of the literature is presented. A systematic review was used to identify articles for risk stratification and interventions. Three risk stratification systems are discussed, STRATIFY, Morse Fall Scale, and the Hendrich Fall Risk Model (HFRM).

Inpatient falls: defining the problem and identifying possible solutions. Part I: an evidence-based review.

In this 2 part series, analysis of the risk stratification tools that are available, definition for the scope of the problem, and potential solutions through a review of the literature are presented. A systematic review was used to identify articles for risk stratification and interventions. Three risk stratification systems are discussed, St Thomas's Risk Assessment Tool in Falling Elderly Inpatients, Morse Fall Scale, and the Hendrich Fall Risk Model.