Ochsner Medical Center

About: Ochsner Medical Center is a healthcare organization based out in New Orleans, Louisiana, United States. It is known for research contribution in the topics: Population & Heart failure. The organization has 980 authors who have published 1159 publications receiving 49961 citations. The organization is also known as: Ochsner Hospital & Ochsner Foundation Hospital.

Web-based patient portal access in an orthopedic adult reconstruction patient population.

Abstract: Background We surveyed patients in an adult reconstruction practice as to their use of the Web-based portal provided by our electronic health record, seeking to reveal patterns of use and helpfulness. Methods A total of 150 completed surveys were received. The survey queried demographics, the number of clinic visits, Internet access, portal activation, portal use frequency, and portal information questions and how patients answered them. Helpfulness was rated from 1 (not helpful) to 5 (very helpful). Statistical analysis included bivariate analysis and logistic regression, with odds ratio (OR) and 95% confidence interval (CI) reported. Results The mean age was 67.6 years. Most were females (n = 97, 65.1%). Most (68.7%) patients used the portal. Younger age (OR, 0.94; CI, 0.90-0.99) and access to Internet (OR, 31.8; CI, 8.5-119.4) predicted portal use (P .373). Of all, 47.5% of patients were unclear about online chart information. Older age indicated being unclear of portal information (68.5 vs 66, P = .0002). Of those who clarified doubts regarding information (n = 67), 23 used the Internet (34.3%), 32 (47.7%) called the physician, and 12 (17.9%) asked a friend and/or family member. Most (90.3%) patients felt the portal was helpful in gathering health information. Conclusions Age and Internet access affected portal usage; ability to understand chart information decreased with age. Most patients used the Internet or a family member to clarify doubts regarding portal information. The use of portal data resulted in 32 extra communications to the physician.

Rapid Response System Restructure: Focus on Prevention and Early Intervention.

Abstract: This article describes the staged restructure of the rapid response program into a dedicated 24/7 proactive rapid response system in a quaternary academic medical center in the southern United States. Rapid response nurses (RRNs) completed clinical leadership training on artificial intelligence, electronic risk stratification alerts, expert nurse rounding, emergency response, teamwork, closed-loop communication, and outcome measurement. The program goal was to reduce preventable deaths and resuscitation events outside the intensive care unit (ICU). Program outcomes between 2017 and 2019 included a 65% decrease in cardiac arrests outside the ICU, a 27% decrease of cardiac arrests inside the ICU, a 4.7% decrease in patients admitted to the ICU from inpatient beds, and a 27% reduction in the risk-adjusted mortality index for patients with expert proactive rounding encounters. Hospital peer group ranking on the Hospital Survey of Patient Safety improved in the areas of events reported, actions promoting patient safety, and continuous improvement suggesting a positive cultural shift. Implementation of a dedicated 24/7 RRN model of care integrating proactive rounding, technology, and ART can improve outcomes for patients and staff.

Outcomes of unselected recipients of sirolimus-eluting stents: the Cypher stent U.S. post-marketing surveillance registry.

Abstract: Objective. To examine the 1-year safety and clinical outcomes associated with the post-marketing early unselected use of sirolimus-eluting stents (SES) in the United States. Background. The safety and effectiveness of SES has been assessed in selected patients enrolled in pivotal randomized trials. This PMS registry was initiated to examine the safety and effectiveness of SES in an unselected population. Methods. Consecutive patients who underwent implantation of ≥1 SES at 38 participating U.S. centers were enrolled in this registry. Results were compared according to "off-" versus "on-label" use of SES. Multi-variate regression analyses were carried out in search of predictors of 1-year MACE and stent thrombosis. Results. The mean age of the 2,067 patients (3,367 treated lesions) was 63.7 years. The 12-month follow up was completed by 1,964 patients (95%). SES were implanted for "off-label" indications in 1,173 patients (57%). The 12-month rates of MACE and TLR in that subgroup were 9.2% and 6.2% (p < 0.001 vs. "on-label" indications). Rate of definite/probable stent thrombosis was 1.6% ("off-label") vs. 0.6% ("on-label"), p = 0.026. The rates of MACE, TLR and stent thrombosis in 640 diabetics (31 %) were 9.4%, 5.8% and 1.3% (p = 0.021, NS and NS vs. non-diabetics, respectively). Number of lesions, insulin-dependent diabetes and unstable angina were predictors of stent thrombosis. Conclusions. The "off-label" use of SES was associated with higher 1-year cumulative rates of MACE than "on-label" indications, although rates were similar to those seen in historical pre-marketing randomized trials. None of the "off-label" indications were independent predictors of MACE or stent thrombosis.

Status of Diabetes Care: New Challenges, New Concepts, New Measures--Focusing on the Future!

Abstract: With the release of this issue, our editorial team is now at the 3.5-year mark in our tenure of overseeing the scientific aspects of Diabetes Care . During this time, we have done our best to keep you up to date on all changes, innovations, progress, and successes of the journal. We realize that with each issue we are responsible for providing new information to help health care professionals care for people with diabetes and to stimulate the research community in its quest for new discoveries and new treatment paradigms. At this time last year, our editorial on the status of Diabetes Care was titled “It Just Doesn’t Get Any Better … or Does It?” (1). We also questioned whether in another 12 months we would “still be asking, ‘Can it possibly get any better than this?’” With this report, we feel that question has clearly been answered in the affirmative. A new norm for excellence has been established at Diabetes Care . Over the last year, the number of new submissions reached record levels and the quality of the published articles (our primary metric) has never been higher. Moreover, the range of topics our journal covers is unlike that of any other. In the last year, we presented reports on new medications, new combinations of medications, critical reviews of safety of commercially available agents, extended outcomes of bariatric surgery, new data on the microbiome, latest developments in the artificial pancreas, staggering data on economic costs and analysis, emerging ideas on the pathogenesis of type 2 diabetes, functional imaging studies, cognitive outcomes, and corneal nerve morphology, just to name a few—the list goes on and on! The journal also disseminates Scientific Statements, Consensus Reports, and Position Statements carefully prepared by the American Diabetes Association (ADA) (see Table 1 for highlighted …

A case report of intraoperative endoscopic ultrasound during robotic assisted Heller myotomy for severe esophageal achalasia.

Abstract: Esophageal achalasia is the best described primary esophageal motility disorder. Endoscopic ultrasound (EUS) is considered a useful adjunct for grading and establishing the prognosis of these patients. Recent experience using Da Vinci robotic assisted myotomy has demonstrated that this is a safe and effective approach of treatment. The benefit of magnification and three dimensional imaging helps prevent esophageal perforation and identify residual circular muscle fibers. This paper reports the relative efficacy and safety of intraoperative ultrasound during robotic assisted myotomy in a patient with severe achalasia. Intraoperative esophageal endoscopic ultrasound is a safe technique that may improve the success rate of surgery by confirming the adequacy of myotomy, thereby decreasing the likelihood of recurrent symptoms.