Olena Mazurenko - Academia.edu (original) (raw)

Papers by Olena Mazurenko

The western journal of emergency medicine/Western journal of emergency medicine, May 29, 2024

Healthcare organizations are under increasing pressure from policymakers, payers, and advocates t... more Healthcare organizations are under increasing pressure from policymakers, payers, and advocates to screen for and address patients' health-related social needs (HRSN). The emergency department (ED) presents several challenges to HRSN screening, and patients are frequently not screened for HRSNs. Predictive modeling using machine learning and artificial intelligence, approaches may address some pragmatic HRSN screening challenges in the ED. Because predictive modeling represents a substantial change from current approaches, in this study we explored the acceptability of HRSN predictive modeling in the ED. Methods: Emergency clinicians, ED staff, and patient perspectives on the acceptability and usage of predictive modeling for HRSNs in the ED were obtained through in-depth semi-structured interviews (eight per group, total 24). All participants practiced at or had received care from an urban, Midwest, safety-net hospital system. We analyzed interview transcripts using a modified thematic analysis approach with consensus coding. Results: Emergency clinicians, ED staff, and patients agreed that HRSN predictive modeling must lead to actionable responses and positive patient outcomes. Opinions about using predictive modeling results to initiate automatic referrals to HRSN services were mixed. Emergency clinicians and staff wanted transparency on data inputs and usage, demanded high performance, and expressed concern for unforeseen consequences. While accepting, patients were concerned that prediction models can miss individuals who required services and might perpetuate biases. Conclusion: Emergency clinicians, ED staff, and patients expressed mostly positive views about using predictive modeling for HRSNs. Yet, clinicians, staff, and patients listed several contingent factors impacting the acceptance and implementation of HRSN prediction models in the ED. [West J Emerg Med. 2024;25(4)614-623.]

BMC emergency medicine, Mar 18, 2024

Background Patient health-related social needs (HRSN) complicate care and drive poor outcomes in ... more Background Patient health-related social needs (HRSN) complicate care and drive poor outcomes in emergency department (ED) settings. This study sought to understand what HRSN information is available to ED physicians and staff, and how HRSN-related clinical actions may or may not align with patient expectations. Methods We conducted a qualitative study using in-depth semi-structured interviews guided by HRSN literature, the 5 Rights of Clinical Decision Support (CDS) framework, and the Contextual Information Model. We asked ED providers, ED staff, and ED patients from one health system in the mid-Western United Stated about HRSN information availability during an ED encounter, HRSN data collection, and HRSN data use. Interviews were recorded, transcribed, and analyzed using modified thematic approach. Results We conducted 24 interviews (8 per group: ED providers, ED staff, and ED patients) from December 2022 to May 2023. We identified three themes: (1) Availability: ED providers and staff reported that HRSNs information is inconsistently available. The availability of HRSN data is influenced by patient willingness to disclose it during an encounter. (2) Collection: ED providers and staff preferred and predominantly utilized direct conversation with patients to collect HRSNs, despite other methods being available to them (e.g., chart review, screening questionnaires). Patients' disclosure preferences were based on modality and team member. (3) Use: Patients wanted to be connected to relevant resources to address their HRSNs. Providers and staff altered clinical care to account for or accommodate HRSNs. System-level challenges (e.g., limited resources) limited provider and staff ability to address patients HRSNs. Conclusions In the ED, HRSNs information was inconsistently available, collected, or disclosed. Patients and ED providers and staff differed in their perspectives on how HSRNs should be collected and acted upon. Accounting for such difference in clinical and administrative decisions will be critical for patient acceptance and effective usage of HSRN information.

Health Care Management Review, 2019

The aim of this study was to explore the relationship between managers and clinicians' agreement ... more The aim of this study was to explore the relationship between managers and clinicians' agreement on deeming the patient safety climate as high or low and the patients' satisfaction with those organizations.

Journal of the American Psychiatric Nurses Association

Background High patient activation is associated with a variety of positive health outcomes. Alth... more Background High patient activation is associated with a variety of positive health outcomes. Although increasing patient activation in persons with opioid use disorder (OUD) in intensive outpatient treatment (IOT) programs may increase engagement and improve outcomes, little is known about how patient activation is manifested in these programs. Aims To describe types of instances in which persons play an active role in their IOT or show self-determination in their recovery generally (patient activation) and types of instances in which they play a passive role in their IOT or have recovery directed by others (patient nonactivation). Methods A qualitative descriptive study using data from a larger grounded theory study was conducted. Interviews were completed with 14 persons with OUD who attended an IOT program within a large health care system in the Midwest. Content analysis was used to create a typology of instances of patient activation or nonactivation in participants’ IOT experi...

Journal of Healthcare Management, May 1, 2023

American Journal on Addictions, Mar 6, 2023

Psychiatric Services, Mar 6, 2023

Pharmacoepidemiology and Drug Safety, Dec 12, 2022

Applied Clinical Informatics, May 1, 2022

Objectives The Chronic Pain Treatment Tracker (Tx Tracker) is a prototype decision support tool t... more Objectives The Chronic Pain Treatment Tracker (Tx Tracker) is a prototype decision support tool to aid primary care clinicians when caring for patients with chronic noncancer pain. This study evaluated clinicians' perceived utility of Tx Tracker in meeting information needs and identifying treatment options, and preferences for visual design. Methods We conducted 12 semi-structured interviews with primary care clinicians from four health systems in Indiana. The interviews were conducted in two waves, with prototype and interview guide revisions after the first six interviews. The interviews included exploration of Tx Tracker using a think-aloud approach and a clinical scenario. Clinicians were presented with a patient scenario and asked to use Tx Tracker to make a treatment recommendation. Last, participants answered several evaluation questions. Detailed field notes were collected, coded, and thematically analyzed by four analysts. Results We identified several themes: the need for clinicians to be presented with a comprehensive patient history, the usefulness of Tx Tracker in patient discussions about treatment planning, potential usefulness of Tx Tracker for patients with high uncertainty or risk, potential usefulness of Tx Tracker in aggregating scattered information, variability in expectations about workflows, skepticism about underlying electronic health record data quality, interest in using Tx Tracker to annotate or update information, interest in using Tx Tracker to translate information to clinical action, desire for interface with visual cues for risks, warnings, or treatment options, and desire for interactive functionality. Conclusion Tools like Tx Tracker, by aggregating key information about past, current, and potential future treatments, may help clinicians collaborate with their patients in choosing the best pain treatments. Still, the use and usefulness of Tx Tracker likely relies on continued improvement of its functionality, accurate and complete underlying data, and tailored integration with varying workflows, care team roles, and user preferences.

Drug and Alcohol Dependence, Jul 1, 2022

BMC Health Services Research, Nov 12, 2022

Purpose: This study is a scoping review of the different methods used to measure rurality in the ... more Purpose: This study is a scoping review of the different methods used to measure rurality in the health services research (HSR) literature. Methods: We identified peer-reviewed empirical studies from 2010-2020 from seven leading HSR journals, including the Journal of Rural Health, that used any definition to measure rurality as a part of their analysis. From each study, we identified the geographic unit (e.g., county, zip code) and definition (e.g., Rural Urban Continuum Codes, Rural Urban Commuting Areas) used to classify categories of rurality. We analyzed whether geographic units and definitions used to classify rurality differed by focus area of studies, including costs, quality, and access to care. Lastly, we examined the number of rural categories used by authors to assess rural areas. Findings: In 103 included studies, five different geographic units and 11 definitions were used to measure rurality. The most common geographic units used to measure rurality were county (n = 59, 57%), which was used most frequently in studies examining cost (n = 12, 75%) and access (n = 33, 57.9%). Rural Urban Commuting Area codes were the most common definition used to measure rurality for studies examining access (n = 13, 22.8%) and quality (n = 10, 44%). The majority of included studies made rural versus urban comparisons (n = 82, 80%) as opposed to focusing on rural populations only (n = 21, 20%). Among studies that compared rural and urban populations, most studies used only one category to identify rural locations (n = 49 of 82 studies, 60%). Conclusion: Geographic units and definitions to determine rurality were used inconsistently within and across studies with an HSR focus. This finding may affect how health disparities by rural location are determined and thus how resources and federal funds are allocated. Future research should focus on developing a standardized system to determine under what circumstances researchers should use different geographic units and methods to determine rurality by HSR focus area.

Proceedings - Academy of Management, Aug 1, 2022

Medical Care Research and Review, Nov 10, 2021

Health insurers use narrow and tiered networks to lower costs by contracting with, or favoring, s... more Health insurers use narrow and tiered networks to lower costs by contracting with, or favoring, selected providers. Little is known about the contemporary effects of narrow or tiered networks on key metrics. The purpose of this systematic review was to synthesize the evidence on how narrow and tiered networks impact cost, access, quality, and patient steering. We searched PubMed, MEDLINE, and Cochrane Central Register of Controlled Trials databases for articles published from January 2000 to June 2020. Both narrow and tiered networks are associated with reduced overall health care costs for most cost-related measures. Evidence pertaining to access to care and quality measures were more limited to a narrow set of outcomes or were weak in internal validity, but generally concluded no systematic adverse effects on narrow or tiered networks. Narrow and tiered networks appear to reduce costs without affecting some quality measures. More research on quality outcomes is warranted.

JAMIA Open

Objective To evaluate primary care provider (PCP) experiences using a clinical decision support (... more Objective To evaluate primary care provider (PCP) experiences using a clinical decision support (CDS) tool over 16 months following a user-centered design process and implementation. Materials and Methods We conducted a qualitative evaluation of the Chronic Pain OneSheet (OneSheet), a chronic pain CDS tool. OneSheet provides pain- and opioid-related risks, benefits, and treatment information for patients with chronic pain to PCPs. Using the 5 Rights of CDS framework, we conducted and analyzed semi-structured interviews with 19 PCPs across 2 academic health systems. Results PCPs stated that OneSheet mostly contained the right information required to treat patients with chronic pain and was correctly located in the electronic health record. PCPs used OneSheet for distinct subgroups of patients with chronic pain, including patients prescribed opioids, with poorly controlled pain, or new to a provider or clinic. PCPs reported variable workflow integration and selective use of certain On...

Journal of Medical Systems

Background While person-centered care (PCC) includes multiple domains, residential SUD treatment ... more Background While person-centered care (PCC) includes multiple domains, residential SUD treatment clients may value certain domains over others. We sought to identify the PCC domains most valued by former residential SUD treatment clients. Methods We distributed an online survey via social media to a national convenience sample of former residential SUD treatment clients. Respondents were presented with ten PCC domains in an online survey: (a) access to evidence-based care; (b) integration of care; (c) diversity/respect for other cultures; (d) individualization of care; (e) emotional support; (f) family involvement in treatment; (g) transitional services; (h) aftercare; (i) physical comfort; and (j) information provision. Respondents were asked to select up to two domains they deemed most important to their residential SUD treatment experience. We used descriptive statistics to identify response frequencies and logistic regression to predict relationships between selected domains and...

International Nursing Review, Sep 3, 2014

A comparison of the education and work experiences of immigrant and the United States of America-... more A comparison of the education and work experiences of immigrant and the United States of America-trained nurses. International Nursing Review 61, 472-478 Aim: This study examined the education and work experience of immigrant and American-trained registered nurses from 1988 to 2008. Background: The USA increasingly relies on immigrant nurses to fill a significant nursing shortage. These nurses receive their training overseas, but can obtain licenses to practice in different countries. Introduction: Although immigrant nurses have been in the USA workforce for several decades, little is known about how their education and work experience compares with USA-trained nurses. Yet much is presumed by policy makers and administrators who perpetuate the stereotype that immigrant nurses are not as qualified. Methods: We analysed the National Sample Survey of Registered Nurses datasets from 1988 to 2008 using the Cochran-Armitage trend tests. Results: Our findings showed similar work experience and upward trends in education among both groups of nurses. However, American-trained nurses were more likely to further advance their education, whereas immigrant nurses were more likely to have more work experience and practice in a wider range of healthcare settings. Discussion: Although we discovered differences between nurses trained in the USA and abroad, we theorize that these differences even out, as education and work experience each have their own distinct caregiving advantages. Conclusion: Immigrant nurses are not less qualified than their American-trained counterparts. However, healthcare providers should encourage them to further pursue their education and certifications. Implications for nursing and health policy: Even though immigrant nurses' education and work experience are comparable with their American counterparts, workforce development policies may be particularly beneficial for this group.

Ethnicity & Disease, Jul 20, 2016

Health disparities associated with race and insurance status are widely documented. A 2003 Instit... more Health disparities associated with race and insurance status are widely documented. A 2003 Institute of Medicine report states that racial/ethnic minorities and low-income groups are disproportionately affected by medical care disparities in the United States, even after controlling for income and access to care. 1 This report suggests that, "the sources of these disparities are complex and rooted in historic and contemporary inequalities, and involve many participants at several levels, including health systems, healthcare managers, medical professionals and patients". Previous research indicates that minority patients are more likely to receive lower quality of care across a range of conditions and care processes, and have higher morbidity and mortality rates including some patient safety indicators on selected outcomes. 2-13 Patient safety indicators (PSIs), developed by the Agency for Healthcare Research and Quality (AHRQ), are a set of indicators providing information on potential in-hospital complications and adverse events following surgeries, procedures, and childbirth. The PSIs were developed after a comprehensive literature review, analysis of ICD-9-CM codes, review by a clinician panel, implementation of risk adjustment, and empirical analyses. The PSIs provide the opportunity to assess the incidence of adverse events and in-hospital complications us

International nursing review en español: revista oficial del Consejo Internacional de Enfermeras, 2014

Objet ivo: Este estudio examino la formacion y la experiencia laboral de enfermeras inmigrantes y... more Objet ivo: Este estudio examino la formacion y la experiencia laboral de enfermeras inmigrantes y enfermeras registradas formadas en los Estados Unidos desde 1988 hasta 2008. Antecedentes: Los EE.UU. dependen cada vez mas de enfermeras inmigrantes para cubrir una significativa escasez de enfermeras. Estas enfermeras reciben su formacion en el extranjero, pero pueden obtener licencias para ejercer en diferentes paises. Introduccion: Aunque las enfermeras inmigrantes han sido parte estado de la fuerza laboral de los EE.UU. desde hace varias decadas, poco se sabe de su formacion y experiencia laboral en comparacion con enfermeras formadas en los EE.UU. Sin embargo, muchas instancias normativas y administradores suponen que las enfermeras emigrantes no estan calificadas y perpetuan este estereotipo. Metodos: Analizamos los conjuntos de datos de la Encuesta de la Muestra Nacional de Enfermeras Registradas de 1988 a 2008 utilizando los tests de tendencia de Cochran-Armitage. Resultados: Nuestros resultados mostraron experiencia laboral similar y tendencias ascendentes en la formacion de los dos grupos de enfermeras. Sin embargo, las enfermeras formadas en los EE.UU. tenian mas probabilidades de seguir avanzando en su formacion, mientras que las enfermeras inmigrantes tenian mas probabilidades de tener mas experiencia y practica laboral en una mayor variedad de entornos de atencion sanitaria. Discusion: Aunque revelamos diferencias entre enfermeras formadas en los EE.UU. y en el extranjero, teorizamos que estas diferencias se igualan, en la medida que la formacion y la experiencia laboral tiene cada una sus propias ventajas diferenciadas de prestacion de atencion. Conclusion: Las enfermeras inmigrantes no estan menos cualificadas que sus homologas formadas en los EE.UU. Sin embargo, los proveedores de atencion sanitaria deben estimularlas a proseguir su formacion y certificaciones. Implicaciones para la Enfermeria y la Politica Sanitaria: Aunque la formacion y la experiencia laboral de las enfermeras inmigrantes sean equivalentes a sus homologas estadounidenses, las politicas de desarrollo de la fuerza laboral pueden que quiza sean particularmente beneficiosas para este grupo.