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Papers by Richard Liebowitz

Research paper thumbnail of Putting patients first. Helping patients make care decisions through education

Research paper thumbnail of The AHCPR Unstable Angina Algorithm in Practice

JAMA: The Journal of the American Medical Association, 1997

The AHCPR Unstable Angina Algorithm in Practice To the Editor.\p=m-\DrKatz and colleagues1 compar... more The AHCPR Unstable Angina Algorithm in Practice To the Editor.\p=m-\DrKatz and colleagues1 compare theactual disposition of patients with a diagnosis of unstable angina in emergency departments (EDs) with recommendations based on a national guideline from the Agency for Health ...

Research paper thumbnail of Deep Venous Thrombosis

Archives of Internal Medicine, 1998

Research paper thumbnail of 2011 John M. Eisenberg Patient Safety and Quality Awards. The effect of a novel Housestaff Quality Council on quality and patient safety. Innovation in patient safety and quality at the local level

Joint Commission Journal on Quality and Patient Safety Joint Commission Resources, Jul 1, 2012

BACKGROUND: In 2008 New York-Presbyterian Hospital (NYP)/Weill Cornell Medical Center, New York C... more BACKGROUND: In 2008 New York-Presbyterian Hospital (NYP)/Weill Cornell Medical Center, New York City, the largest not-for-profit, nonsectarian hospital in the United States, created and implemented a novel approach--the Housestaff Quality Council (HQC)--to engaging house-staff in quality and patient safety activities.METHODS: The HQC represented an innovative collaboration between the housestaff, the Department of Anesthesiology, the Division of Quality and Patient Safety, the Office of Graduate Medical Education, and senior leadership. As key managers of patient care, the housestaff sought to become involved in the quality and patient safety decision- and policy-making processes at the hospital. Its members were determined to decrease or minimize adverse events by facilitating multimodal communication, ensuring smart work flow, and measuring outcomes to determine best practices. The HQC, which also included frontline hospital staff or managers from areas such as nursing, pharmacy, and information technology, aligned its initiatives with those of the division of quality and patient safety and embarked on two projects--medication reconciliation and use of the electronic medical record. More than three years later, the resulting improvements have been sustained and three new projects--hand hygiene, central line-associated bloodstream infections, and patient handoffs--have been initiated.CONCLUSIONS: The HQC model is highly replicable at other teaching institutions as a complementary approach to their other quality and patient safety initiatives. However, the ability to sustain positive momentum is dependent on the ability of residents to invest time and effort in the face of a demanding residency training schedule and focus on specialty-specific clinical and research activities.

Research paper thumbnail of The Effect of a Novel Housestaff Quality Council on Quality and Patient Safety

Joint Commission journal on quality and patient safety / Joint Commission Resources

ABSTRACT

Research paper thumbnail of 2011 John M. Eisenberg Patient Safety and Quality Awards. Mentored implementation: building leaders and achieving results through a collaborative improvement model. Innovation in patient safety and quality at the national level

Joint Commission journal on quality and patient safety / Joint Commission Resources, 2012

The Society of Hospital Medicine (SHM) created "Mentored Implementation" (MI) programs ... more The Society of Hospital Medicine (SHM) created "Mentored Implementation" (MI) programs with the dual aims of educating and mentoring hospitalists and their quality improvement (QI) teams and accelerating improvement in the inpatient setting in three signature programs: Venous Thromboembolism (VTE) Prevention, Glycemic Control, and Project BOOST (Better Outcomes for Older adults through Safe Transitions). More than 300 hospital improvement teams were enrolled in SHM MI programs in a series of cohorts. Hospitalist mentors worked with individual hospitals/health systems to guide local teams through the life cycle of a QI project. Implementation Guides and comprehensive Web-based "Resource…

Research paper thumbnail of Lavender (Lavandula angustifolia Miller)

Journal of Herbal Pharmacotherapy, 2004

Research paper thumbnail of Reversible Systolic Dysfunction in an Elite Athlete

Research paper thumbnail of The Oldest Patient to Undergo Aortic Valve Replacement

Cardiology, 1999

As the American population ages, more elderly patients will present with significant heart diseas... more As the American population ages, more elderly patients will present with significant heart disease. This group has an increase in morbidity and mortality with heart surgery as compared to a younger population. Severe aortic stenosis has a grave prognosis, and therefore surgical options should be considered even in the most elderly patient with this condition. We present the oldest reported

Research paper thumbnail of Ten Years After the IOM Report: Engaging Residents in Quality and Patient Safety by Creating a House Staff Quality Council

American Journal of Medical Quality, 2011

Ten years after the 1999 Institute of Medicine report, it is clear that despite significant progr... more Ten years after the 1999 Institute of Medicine report, it is clear that despite significant progress, much remains to be done to improve quality and patient safety (QPS). Recognizing the critical role of postgraduate trainees, an innovative approach was developed at New York-Presbyterian Hospital, Weill Cornell Medical Center to engage residents in QPS by creating a Housestaff Quality Council (HQC). HQC leaders and representatives from each clinical department communicate and partner regularly with hospital administration and other key departments to address interdisciplinary quality improvement (QI). In support of the mission to improve patient care and safety, QI initiatives included attaining greater than 90% compliance with medication reconciliation and reduction in the use of paper laboratory orders by more than 70%. A patient safety awareness campaign is expected to evolve into a transparent environment where house staff can openly discuss patient safety issues to improve the quality of care.

Research paper thumbnail of The Role of Housestaff in Implementing Medication Reconciliation on Admission at an Academic Medical Center

American Journal of Medical Quality, 2011

Since 2006, the Joint Commission has required all hospitals to have a process in place for medica... more Since 2006, the Joint Commission has required all hospitals to have a process in place for medication reconciliation (MR). Although it has been shown that MR decreases medical errors, achieving compliance has proven difficult for many health care institutions. This article describes a housestaff-championed intervention of a "hard stop" for on-admission MR orders that led to a statistically significant increase in compliance that was sustained at 6 months after intervention. Academic medical centers, which comprise large numbers of housestaff, can improve compliance with on-admission MR by engaging housestaff in the development of solutions and in communication to their peers, leading to sustained results.

Research paper thumbnail of Complementary and alternative medicine in cardiovascular disease: a review of biologically based approaches

American Heart Journal, 2004

Research paper thumbnail of A multidimensional integrative medicine intervention to improve cardiovascular risk

Journal of General Internal Medicine, 2006

Research paper thumbnail of Putting patients first. Helping patients make care decisions through education

Research paper thumbnail of The AHCPR Unstable Angina Algorithm in Practice

JAMA: The Journal of the American Medical Association, 1997

The AHCPR Unstable Angina Algorithm in Practice To the Editor.\p=m-\DrKatz and colleagues1 compar... more The AHCPR Unstable Angina Algorithm in Practice To the Editor.\p=m-\DrKatz and colleagues1 compare theactual disposition of patients with a diagnosis of unstable angina in emergency departments (EDs) with recommendations based on a national guideline from the Agency for Health ...

Research paper thumbnail of Deep Venous Thrombosis

Archives of Internal Medicine, 1998

Research paper thumbnail of 2011 John M. Eisenberg Patient Safety and Quality Awards. The effect of a novel Housestaff Quality Council on quality and patient safety. Innovation in patient safety and quality at the local level

Joint Commission Journal on Quality and Patient Safety Joint Commission Resources, Jul 1, 2012

BACKGROUND: In 2008 New York-Presbyterian Hospital (NYP)/Weill Cornell Medical Center, New York C... more BACKGROUND: In 2008 New York-Presbyterian Hospital (NYP)/Weill Cornell Medical Center, New York City, the largest not-for-profit, nonsectarian hospital in the United States, created and implemented a novel approach--the Housestaff Quality Council (HQC)--to engaging house-staff in quality and patient safety activities.METHODS: The HQC represented an innovative collaboration between the housestaff, the Department of Anesthesiology, the Division of Quality and Patient Safety, the Office of Graduate Medical Education, and senior leadership. As key managers of patient care, the housestaff sought to become involved in the quality and patient safety decision- and policy-making processes at the hospital. Its members were determined to decrease or minimize adverse events by facilitating multimodal communication, ensuring smart work flow, and measuring outcomes to determine best practices. The HQC, which also included frontline hospital staff or managers from areas such as nursing, pharmacy, and information technology, aligned its initiatives with those of the division of quality and patient safety and embarked on two projects--medication reconciliation and use of the electronic medical record. More than three years later, the resulting improvements have been sustained and three new projects--hand hygiene, central line-associated bloodstream infections, and patient handoffs--have been initiated.CONCLUSIONS: The HQC model is highly replicable at other teaching institutions as a complementary approach to their other quality and patient safety initiatives. However, the ability to sustain positive momentum is dependent on the ability of residents to invest time and effort in the face of a demanding residency training schedule and focus on specialty-specific clinical and research activities.

Research paper thumbnail of The Effect of a Novel Housestaff Quality Council on Quality and Patient Safety

Joint Commission journal on quality and patient safety / Joint Commission Resources

ABSTRACT

Research paper thumbnail of 2011 John M. Eisenberg Patient Safety and Quality Awards. Mentored implementation: building leaders and achieving results through a collaborative improvement model. Innovation in patient safety and quality at the national level

Joint Commission journal on quality and patient safety / Joint Commission Resources, 2012

The Society of Hospital Medicine (SHM) created "Mentored Implementation" (MI) programs ... more The Society of Hospital Medicine (SHM) created "Mentored Implementation" (MI) programs with the dual aims of educating and mentoring hospitalists and their quality improvement (QI) teams and accelerating improvement in the inpatient setting in three signature programs: Venous Thromboembolism (VTE) Prevention, Glycemic Control, and Project BOOST (Better Outcomes for Older adults through Safe Transitions). More than 300 hospital improvement teams were enrolled in SHM MI programs in a series of cohorts. Hospitalist mentors worked with individual hospitals/health systems to guide local teams through the life cycle of a QI project. Implementation Guides and comprehensive Web-based "Resource…

Research paper thumbnail of Lavender (Lavandula angustifolia Miller)

Journal of Herbal Pharmacotherapy, 2004

Research paper thumbnail of Reversible Systolic Dysfunction in an Elite Athlete

Research paper thumbnail of The Oldest Patient to Undergo Aortic Valve Replacement

Cardiology, 1999

As the American population ages, more elderly patients will present with significant heart diseas... more As the American population ages, more elderly patients will present with significant heart disease. This group has an increase in morbidity and mortality with heart surgery as compared to a younger population. Severe aortic stenosis has a grave prognosis, and therefore surgical options should be considered even in the most elderly patient with this condition. We present the oldest reported

Research paper thumbnail of Ten Years After the IOM Report: Engaging Residents in Quality and Patient Safety by Creating a House Staff Quality Council

American Journal of Medical Quality, 2011

Ten years after the 1999 Institute of Medicine report, it is clear that despite significant progr... more Ten years after the 1999 Institute of Medicine report, it is clear that despite significant progress, much remains to be done to improve quality and patient safety (QPS). Recognizing the critical role of postgraduate trainees, an innovative approach was developed at New York-Presbyterian Hospital, Weill Cornell Medical Center to engage residents in QPS by creating a Housestaff Quality Council (HQC). HQC leaders and representatives from each clinical department communicate and partner regularly with hospital administration and other key departments to address interdisciplinary quality improvement (QI). In support of the mission to improve patient care and safety, QI initiatives included attaining greater than 90% compliance with medication reconciliation and reduction in the use of paper laboratory orders by more than 70%. A patient safety awareness campaign is expected to evolve into a transparent environment where house staff can openly discuss patient safety issues to improve the quality of care.

Research paper thumbnail of The Role of Housestaff in Implementing Medication Reconciliation on Admission at an Academic Medical Center

American Journal of Medical Quality, 2011

Since 2006, the Joint Commission has required all hospitals to have a process in place for medica... more Since 2006, the Joint Commission has required all hospitals to have a process in place for medication reconciliation (MR). Although it has been shown that MR decreases medical errors, achieving compliance has proven difficult for many health care institutions. This article describes a housestaff-championed intervention of a "hard stop" for on-admission MR orders that led to a statistically significant increase in compliance that was sustained at 6 months after intervention. Academic medical centers, which comprise large numbers of housestaff, can improve compliance with on-admission MR by engaging housestaff in the development of solutions and in communication to their peers, leading to sustained results.

Research paper thumbnail of Complementary and alternative medicine in cardiovascular disease: a review of biologically based approaches

American Heart Journal, 2004

Research paper thumbnail of A multidimensional integrative medicine intervention to improve cardiovascular risk

Journal of General Internal Medicine, 2006