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At least 19 recordsLinked to original sources
PubMed1994

A collaborative case management program: the Crawford Long Hospital of Emory University model.

At Crawford Long Hospital of Emory University, a new system of patient care delivery, defined as collaborative case management, was developed as the organization struggled with implementation of the Deming management method. At the onset of the change process, an evaluation system was established to measure and document specific outcomes for patients, families, providers of care, and the organization. This article traces the development and implementation of the collaborative case management program and describes the evaluation system. Findings highlighting improved patient care outcomes, changes in patient and provider perceptions of care, and benefits to the organization are summarized.

Georgia↗
PubMed1991

Ileal pouch-anal anastomosis. The Emory University experience.

The ileal pouch-anal anastomosis has become a practical alternative to proctocolectomy for the treatment of ulcerative colitis and polyposis coli. To evaluate its success, the Emory University Affiliated Hospital experience from February 1984 to March 1989 was retrospectively reviewed. There were a total of 50 patients identified; 84 per cent had ulcerative colitis, and 16 per cent had polyposis coli (familial polyposis and Gardner's syndrome). The majority of these patients underwent a two-stage operation, but one-third required a three-stage procedure due to difficulty in mucosal proctectomy or toxic megacolon. J-pouch construction was performed in 72 per cent of patients, S-pouch construction in 14 per cent, straight ileo-anal anastomosis in 8 per cent, and lateral isoperistaltic ileo-anal anastomosis in 6 per cent. Of the 50 patients, 36 (72%) have had closure of the temporary ileostomy. Fourteen patients have not had ileostomy closure due to change in diagnosis to Crohn's disease, operative complications, or ileostomy closure pending. The combined operative morbidity per patient for the ileal pouch-anal anastomosis and the closure of the ileostomy was 32 per cent. This included bowel obstruction, 16 per cent; pelvic abscess, 6 per cent; and ileo-anal separation, 4 per cent. Follow-up on patients with ileostomy closure ranged from 6 months to 4 years (mean, 1.3 years). Stool frequency was 5.9 stools per 24 hours at 6 months and improved with time. During the follow-up period, all patients were eventually completely continent of stool during the day, and most became completely continent of stool at night.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenomatous Polyposis Coli↗
PubMed1996

Emory University Center for Clinical Evaluation Sciences: a model for clinical practice evaluation in the changing environment of the academic health center.

Changes in the health care marketplace have had a profound effect on academic health centers and their traditional missions: teaching, patient care, and research. Many academic health centers have recognized the need to develop a capability for evaluating clinical practices and organizational restructuring. The Center for Clinical Evaluation Sciences at Emory University represents a model for the integration of evaluative capabilities into academic clinical practices.

Academic Medical Centers↗
PubMed2003

Twenty-year survival after coronary artery surgery: an institutional perspective from Emory University.

BACKGROUND: Coronary artery bypass graft (CABG) surgery has been performed frequently for symptomatic coronary atherosclerotic heart disease for more than 30 years. However, uncertainty exists regarding the relationship between long-term survival after CABG and readily available clinical correlates of mortality. METHODS AND RESULTS: We studied outcome at 20 years by age, sex, and other variables in 3939 patients who had CABG surgery from 1973 to 1979 in the Emory University System of Healthcare. Twenty-year survival, freedom from myocardial infarction, and freedom from repeat CABG were 35.6% (95% confidence interval [CI], 33.9% to 37.3%), 66.6% (95% CI, 64.6% to 68.6%), and 59.1% (95% CI, 56.9% to 61.5%). Multivariate correlates of late mortality were age (hazard ratio [HR], 1.46 per 10 years), female sex (HR, 1.21), hypertension (HR, 1.44), angina class (HR, 1.07 per class increase of 1), prior CABG (HR, 1.72), ejection fraction (HR, 1.07 per 10-point decrease), number of vessels diseased (HR, 1.11 per 1-vessel increase), and weight (HR, 1.04 per 10 kg). Twenty-year survival by age was 55%, 38%, 22%, and 11% for age <50, 50 to 59, 60 to 69, and >70 years at the time of initial surgery. Survival at 20 years after surgery with and without hypertension was 27% and 41%, respectively. Similarly, 20-year survival was 37% and 29% for men and women. CONCLUSIONS: Symptomatic coronary atherosclerotic heart disease requiring surgical revascularization is progressive with continuing events and mortality. Clinical correlates of mortality significantly impact survival over time and may help identify long-term benefits after CABG.

Adult↗
PubMed1981

Chronic pain as a learned experience: Emory University Pain Control Center.

Chronic pain is often a conditioned socioeconomic disease. A majority of chronic pain patients show pain behavior in excess of biomedical findings and disability ratings out of proportion to their actual physical impairment. Biomedical data and pain behavior are independent variables, as the latter is heavily controlled by socioeconomic factors. The diagnosis of chronic pain patients requires evaluation and matching of both variables. When disability claims are present, a comprehensive vocational evaluation should be performed and matched with biomedical and behavioral findings. The Emory Pain Estimate Model for diagnosis of chronic pain states is discussed briefly and techniques of vocational evaluation are presented also. The structure of the Emory Pain Control Program and data from treatment outcome are presented and discussed.

Conditioning, Operant↗
PubMed2000

Novel Ruthenium Building Blocks for the Efficient Modular Construction of Heterobimetallic Molecular Squares of Porphyrins This work was supported by the Italian MURST. We thank Prof. L. G. Marzilli (Emory University, Atlanta, USA) for helpful discussions, and Johnson Matthey for a loan of RuCl(3) small middle dotx H(2)O. The CNR staff at ELETTRA is acknoweldged for help in the use of the facility supported by CNR and Elettra Scientific Division.

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Journal Article↗
PubMed1987

Restenosis after percutaneous transluminal coronary angioplasty: the Emory University Hospital experience.

Restenosis after coronary angioplasty, a gradual encroachment of the dilated arterial lumen by overgrowth of neointimal cells, occurs in a minority (25% to 30%) of patients. Clinical and anatomic descriptors of those patients who develop restenosis have been identified and suggest a complex, multifactorial etiology. Optimal initial enlargement of the diameter probably reduces the chance of restenosis on geometric grounds alone. The independent predictive value of a low final translesional pressure gradient indicates that adequate blood flow may reduce platelet adhesion and thrombus formation. The importance of the latter factor remains uncertain. Individual proliferative responses to the intimal and medial injury caused by balloon dilatation appear to be modulated by both lesion-specific and patient factors. Lesion-specific factors appear most important and relate to vessel site, tortuosity and branching. These factors are also thought to influence native atherogenesis but the relation between restenosis and atherogenesis remains obscure. Patient risk factors for coronary artery disease also appear to influence restenosis. Procedural factors and risk factor modification may partially modify the restenosis response; however, prevention of restenosis will depend on finding agents that block either stimulation or proliferation of smooth muscle cells.

Angioplasty, Balloon↗
PubMed1987

Emory University Project on Children of Disturbed Parents.

Young children (from birth to 5 years of age) of schizophrenic, depressed, and well mothers were studied to assess their intellectual, social, and neuropsychiatric functioning. The sample derived from predominantly black, low-income, single-parent families. An extensive battery of laboratory and home-based tests was administered three times, each 1 year apart, to test the stability of findings. Schizophrenic offspring, as a group, had more problems than others. They showed more deficits on social competence, had lower IQ's (the youngest children only), and were overrepresented in the group of children with multiple negative indices. However, both schizophrenic offspring and depressive offspring sometimes performed more poorly than children with well mothers (presence of symptoms of psychiatric disorder and certain categories of social behavior). In certain instances, the children of depressed mothers were worse off than either other group (small for age and showing less social competence at home). Deficits were found in the child-rearing environment provided by the disturbed mothers. Both schizophrenic and depressed mothers were rated as less affectively involved and less responsive than well mothers. Schizophrenic mothers were rated as providing the poorest overall environment: less play stimulation, fewer learning experiences, and less emotional and verbal involvement. The following possible protective factors were identified in the mothers: lesser severity of illness, older age, higher education, higher IQ, work experience, and presence of spouse, boyfriend, or other relative to help in child care.

Child↗