Evidence map›Paper›PMID 36849864›Full record

ArticleJournal of general internal medicine2023

A Public Health Critical Race Praxis Informed Congestive Heart Failure Quality Improvement Initiative on Inpatient General Medicine.

Chidinma Osuagwu, Roaa M Khinkar, Amy Zheng, Matthew Wien, Jennifer Decopain, Sonali Desai, Erin McElrath, Emily Hinchey, Stephanie K Mueller, Jeffrey L Schnipper and 2 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of general internal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.7field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 7 institutions in 2 countries.

Chidinma OsuagwuLewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.
Roaa M KhinkarDepartment of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia.
Amy ZhengDepartment of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Matthew WienDivision of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA.
Jennifer DecopainSchool of Nursing, MGH Institute of Health Professions, Charlestown, MA, USA.
Sonali DesaiDivision of Rheumatology, Brigham and Women's Hospital, Boston, MA, USA.
Erin McElrathDepartment of Medicine, Brigham and Woman's Hospital, Boston, MA, USA.
Emily HincheyDepartment of Medicine, Brigham and Woman's Hospital, Boston, MA, USA.
Stephanie K MuellerDivision of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA.
Jeffrey L SchnipperDivision of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA.
Robert BoxerDivision of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA.
Evan Michael ShannonDivision of General Internal Medicine and Health Services Research, University of California, Los Angeles, 1100 Glendon Ave, Suite 850, Room, Los Angeles, CA, 812, USA. emshannon@mednet.ucla.edu.ORCID http://orcid.org/0000-0003-0248-7038
Brigham and Women's Hospital · USWoman's Hospital · USKing Abdulaziz University · SAMassachusetts General Hospital · USMGH Institute of Health Professions · USTemple University · USUniversity of California, Los Angeles · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrior evaluation at our hospital demonstrated that, compared to White patients, Black and Latinx patients with congestive heart failure (CHF) were less likely to be admitted to the cardiology service rather than the general medicine service (GMS). Patients admitted to GMS (compared to cardiology) had inferior rates of cardiology follow-up and 30-day readmission.

objectiveTo develop and test the feasibility and impacts of using quality improvement (QI) methods, in combination with the Public Health Critical Race Praxis (PHCRP) framework, to engage stakeholders in developing an intervention for ensuring guideline-concordant inpatient CHF care across all patient groups.

methodsWe compared measures for all patients admitted with CHF to GMS between September 2019 and March 2020 (intervention group) to CHF patients admitted to GMS in the previous year (pre-intervention group) and those admitted to cardiology during the pre-intervention and intervention periods (cardiology group). Our primary measures were 30-day readmissions and 14- and 30-day post-discharge cardiology follow-up.

resultsThere were 79 patients admitted with CHF to GMS during the intervention period, all of whom received the intervention. There were similar rates of Black and Latinx patients across the three groups. Compared to pre-intervention, intervention patients had a significantly lower 30-day readmission rate (18.9% vs. 24.8%; p=0.024), though the cardiology group also had a decrease in 30-day readmissions from the pre-intervention to intervention period. Compared to pre-intervention, intervention patients had significantly higher 14-day and 30-day post-discharge follow-up visits scheduled with cardiology (36.7% vs. 24.8%, p=0.005; 55.7% vs. 42.3%, p=0.0029), but no improvement in appointment attendance.

conclusionThis study provides a first test of applying the PHCRP framework within a stakeholder-engaged QI initiative for improving CHF care across races and ethnicities. Our study design cannot evaluate causation. However, the improvements in 30-day readmission, as well as in processes of care that may affect it, provide optimism that inclusion of a racism-conscious framework in QI initiatives is feasible and may enhance QI measures.

Indexed as

Heart FailureQuality ImprovementAftercareHumansInpatientsPatient DischargePatient ReadmissionPublic Healthcongestive heart failurehealth disparitieshospital medicinequality improvementsocial determinants of health

Identifiers

PMID36849864
PMCPMC9970115
OpenAlexW4322489649

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.