Ralph Gonzales

Examining Disparities in Pediatric Asthma, Pneumonia, and Bronchiolitis Care in General Hospitals

Adria K. Bowles, Jonathan Rodean, Elana J. Siegel, Sarah Gray et autres

BACKGROUND/OBJECTIVE: Prior disparity research has focused on evaluating patient outcomes in freestanding children's hospitals, rather than identifying potential drivers of these disparities. Our objective was to evaluate drivers of disparities in respiratory illness care quality and outcomes in a national sample of …

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Agreement Between Telehealth and In-Person Evaluations of Patients with Acute Respiratory Infections

Joshua P. Metlay, Ralph Gonzales, Timothy J. Judson, Pierre Borczuk et autres

How the absence of a physical examination in telehealth visits influences clinical decision-making in telehealth visits is not known. The aim of this study was to examine whether provision of patient self-collected vital signs influences telehealth management decisions for acute respiratory tract …

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Barriers, Facilitators, and Time Costs of Implementing a Pediatric Clinical Pathway Intervention

Kathleen Bonsmith, Ralph Gonzales, Andrew D. Auerbach, Angela Douglas et autres

OBJECTIVES: Clinical pathways can improve care and outcomes for children with respiratory illnesses. The Simultaneously Implementing Pathways for Improving Asthma, Pneumonia, and Bronchiolitis Care for Hospitalized Children (SIP) trial is a multicenter, randomized trial of a high-efficiency pathway intervention in general and …

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Assessing the Utilization of Electronic Consultations in Genetics: Seven-Year Retrospective Study

Sawona Biswas, Joyce So, Robert J. Wallerstein, Ralph Gonzales et autres

Background: Patient and health care provider access to genetic subspecialists is challenging owing to limited number of genetics experts across the United States. The University of California San Francisco (UCSF) Genetics electronic consultation (e-Consult) service was implemented along with the usual referral …

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Readiness of General Hospitals That Participate in Pediatric Quality Improvement Initiatives

Jordan H. Vaughan, Yeelen Edwards, Jonathan Rodean, Charles E. McCulloch et autres

BACKGROUND AND OBJECTIVE: General hospitals care for more than 70% of hospitalized children nationally but face challenges in pediatric quality improvement (QI). Feasibility and organizational readiness to change assessments can help inform effective QI. Our objective was to assess readiness to implement …

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Accuracy of Patient-Collected Vital Signs

Joshua P. Metlay, Ralph Gonzales, Timothy J. Judson, Yuchiao Chang et autres

Introduction: Telehealth has emerged as an important clinical setting for managing acute respiratory tract infections (ARIs), potentially reducing emergency department and urgent care overcrowding, and reducing nosocomial transmission. Many current algorithms for ARI management incorporate information on patient vital signs. However, the …

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Simultaneously implementing pathways for improving asthma, pneumonia, and bronchiolitis care for hospitalized children: Protocol for a hybrid effectiveness‐implementation, cluster‐randomized trial

Yeelen Edwards, Nancy Yang, Andrew David Auerbach, Ralph Gonzales et autres

BACKGROUND: Asthma, pneumonia, and bronchiolitis are the top causes of childhood hospitalization in the United States, leading to over 350,000 hospitalizations and ≈$2 billion in costs annually. The majority of these hospitalizations occur in general/community hospitals. Poor guideline adoption by clinicians contributes …

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eConsultation for Deprescribing Among Older Adults: Clinician Perspectives on Implementation Barriers and Facilitators

Matthew E. Growdon, Lauren J. Hunt, Matthew J Miller, Madina Halim et autres

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A Seven-Year Retrospective Assessment Evaluating the Effectiveness of Electronic Consultation (e-Consult) Service in Genetics (Preprint)

Sawona Biswas, Joyce So, Robert J. Wallerstein, Ralph Gonzales et autres

UNSTRUCTURED Electronic consultation (e-Consult) programs serve as a conduit between healthcare providers and specialized genetic experts. This retrospective chart review and summary report presents the experience of implementing a Genetics e-Consult Service at the University of California San Francisco (UCSF) from 2016 …

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A Seven-Year Retrospective Assessment Evaluating the Effectiveness of Electronic Consultation (e-Consult) Service in Genetics

Sawona Biswas, Joyce So, Robert J. Wallerstein, Ralph Gonzales et autres

ABSTRACT Electronic consultation (e-Consult) programs serve as a conduit between healthcare providers and specialized genetic experts. This retrospective chart review and summary report presents the experience of implementing a Genetics e-Consult Service at the University of California San Francisco (UCSF) from 2016 …

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Engaging GME Learners in Health System-Aligned Improvement Work in the Clinical Learning Environment

Glenn Rosenbluth, Lei Choi, Christy Boscardin, Ralph Gonzales et autres

Alignment between graduate medical education (GME) and health system priorities is foundational to meaningful engagement of residents and fellows in systems improvement work within the clinical learning environment. The Residents and Fellows Leading Interprofessional Continuous Improvement Teams program at the University of …

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188 A Qualitative Investigation of Black Patient Perspectives on Racism and Emergency Care

Anish Kumar Agarwal, Ralph Gonzales, Christine Sagan, Sally Nijim et autres

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