Beaumont Health

About: Beaumont Health is a nonprofit organization based out in Royal Oak, Michigan, United States. It is known for research contribution in the topics: Medicine & Population. The organization has 1483 authors who have published 1448 publications receiving 15407 citations. The organization is also known as: William Beaumont Health System & Beaumont Hospitals.

Impact of Early Educational Intervention on Coding for First-year Emergency Medicine Residents.

Abstract: Objectives Coding of a medical visit is based on provider documentation in the medical record; the documentation should reflect the level of care that was provided. To maximize coding and subsequent billing, providers must complete various components of the record to best convey the complexity of the case. Little education is provided to resident physicians regarding appropriate documentation practices, and studies suggest a need for improved education in this area. The primary goal of this study is to determine if implementing an early educational intervention will improve billing and coding. Methods This was a randomized, prospective controlled study in an academic Level I emergency department (ED). Interns without prior experience in billing and coding were eligible participants. Participants in the intervention group each received an interactive lecture on coding, evaluation and management (E/M) levels, and documentation macros, prior to their first ED rotation at the base hospital. A pocket card with E/M level requirements was given as a resource. Biweekly feedback was given to the residents to address any patterns of mistakes. The number of charts for each E/M level was collected from both groups, which were converted to relative value units (RVUs). A multivariate analysis using multivariate linear regressions controlling for age, sex of patient, admission rate, and month of encounter was used to statistically evaluate billing outcomes. Results The mean RVUs per hour and encounter in the intervention group were, respectively, 3.52 and 3.84 while in the control group they were, respectively, 3.36 and 3.72 (p = 0.0112). Intervention group encounters had 27% greater odds (odds ratio = 1.27) of having a level 5 chart compared to the control group (p = 0.0025). Conclusion The focused longitudinal educational interventions resulted in improved billing performances, reflected by better documentation, in the intervention group versus the control group.

Monthly Progression of Emergency Medicine Resident Efficiency: What Can We Expect of Our Residents Throughout Training?

Abstract: Background Developing the capacity for efficient patient care is essential during emergency medicine (EM) residency training. Previous studies have demonstrated that resident efficiency improves during each year of training. Objectives This study assessed the progression of EM resident efficiency monthly and sought to develop a model that describes this progression in terms of patients per hour (pts/h) weighted by month of training. Methods We performed a retrospective review of EM resident efficiency as determined by pts/h using EM resident monthly patient logs from a postgraduate year (PGY) 1–3 EM training program. Mean pts/h and standard deviation (SDs) were calculated based on month of training. One-way analysis of variance compared year-to-year training. We formulated several linear regression models to describe this progression. Results We analyzed 51 consecutive months of patient logs from 110 residents. The mean pts/h for PGY1 was 1.201 (n = 85, SD = 0.241), for PGY2 was 1.497 (n = 82, SD = 0.218), and for PGY3 was 1.676 (n = 80, SD = 0.224). Linear regression was used to describe patients seen per hour by the month of training. A significant regression was found with an R2 of 0.437 and p Conclusions EM resident efficiency increases monthly, with most improvement occurring in the PGY1 year. Understanding this improvement may aid in resident performance evaluation and the understanding of predicted resident workflow.

Physician Burnout and Wellness

Abstract: Physician stress and burnout are common in the practice of medicine and were once thought to be occupational hazards due to hard-driving personality traits. As a result, research focused on ways to help physicians cope with stress. Following decades of study, however, researchers believe that a significant portion of physician burnout is due to potentially modifiable workplace factors. While interventions still include teaching physicians ways to cope with stressful work, more attention is being given to how to change the healthcare workplace, not only to decrease physician burnout but also in order to improve patient quality and safety initiatives. This chapter defines burnout and outlines the historical context of its study and controversy over measurement. The chapter describes studies of physician burnout across the developmental spectrum and discusses the correlates. Finally, the chapter reviews effective intervention strategies and the movement to shift from burnout to physician wellness promotion.

Effects of Resistance Training on Vascular and Hemodynamic Responses in Patients With Coronary Artery Disease

Abstract: Purpose: The purpose of this study was to determine the impact of adjunctive resistance training (RT) in aerobically trained patients with coronary artery disease on systolic blood pressure (SBP), heart rate (HR), rating of perceived exertion (RPE; using the traditional 6-to-20 scale), and rate-pressure product (RPP) responses to lifting fixed submaximal workloads. Additionally, pretest and posttest RT measures of brachial artery reactivity were obtained. Method: Fifteen patients with coronary artery disease (Mage = 66.1 ± 5.1 years) who were already performing regular aerobic exercise completed an adjunctive 12-week progressive RT program. Prior to and immediately after the training period, hemodynamic responses and RPE were obtained while participants performed one set of exercises including the bicep curl (BC), shoulder press (SP), and leg press (LP) at individually determined fixed submaximal loads, using ~ 60% to 80% of estimated maximal voluntary contraction. Vascular function was assessed b...

Getting Back to Normal: A Grounded Theory Study of Function in Post-hospitalized Older Adults.

Abstract: Background and objectives The literature on transitions after hospitalization is based on a medicalized model focusing primarily on medication management and readmission, but little is known about the process older adults engage in to maintain their normal life posthealth event or how older adults define what the transition is. This grounded theory study aimed to describe how older adults understand and define a transition process, what actions they take based on their understanding, and what consequences they experience as they transition. Research design and methods Adults aged 65 and older discharged from a large Midwestern teaching hospital (N = 14) were interviewed using in-depth one-on-one interviews. Data were analyzed using open, axial, and selective coding. Results All participants described the process of transition as moving from a state of normal function to loss, and then working back to a normal state. A conceptual model was developed to illustrate the complexity of movement related to how older adults understand and manage the transition. All participants described starting out being normal until they experienced a major health event (acute or chronic illness). Losing normal involved experiencing a lower level of function both inside and outside the home. Working back to normal was accomplished by two different pathways: those "working to regain" focused on getting back to the level they were at prior to the major health event, whereas those "working to maintain" often involved redefining a new normal. The consequences of the two pathways were quite different, with those working to maintain describing several negative consequences. Discussion and implications This study provides a detailed understanding of how older adults transition and the complexity of that transition. Findings provide a foundation for broadening our understanding of function beyond typical activities of daily living and reveal a more complex transition process that can span months to years.