Community Regional Medical Center
Community Regional Medical Center
Rettig S.M.,University of California at San Diego |
Rettig S.M.,Community Regional Medical Center |
Wood Y.,University of California at San Diego |
Wood Y.,Premier Physician Medical Group |
Hirsch J.D.,University of California at San Diego
Journal of the American Pharmacists Association | Year: 2013
Objectives: To compare medication regimen complexity (MRC) for patients with uncontrolled hypertension, uncontrolled diabetes, or both, to examine the contribution of complexity components (dosage form, frequency, additional directions) to total MRC index (MRCI) score, and to explore the relationship of MRC with patient characteristics and medication regimen cost. Methods: This cross-sectional retrospective study used electronic medical record data for patients' most recent visit to a university internal medicine clinic during 2009. MRCI scores (disease specific and patient level [medications for all conditions]) were calculated for adults with uncontrolled hypertension, diabetes, or both (i.e., not at recommended treatment goals). Results: 206 patients (85 with hypertension, 60 with diabetes, and 61 with both) were included. The median (range) disease-specific MRCI was significantly greater for diabetes (8.0 [3-21]) than for hypertension (3.0 [2-11], P < 0.001), though the median number of disease-specific medications was identical (2). The majority of hypertension MRC was the result of dosage frequency (62.1%), while diabetes MRC was distributed among dosage form (38.3%), frequency (39.1%), and additional directions (27.6%). The median patient-level MRCI scores for each group were 11 to 15 points higher than the disease-specific MRCI scores. Higher MRCI scores were associated with higher regimen cost, comorbidity burden, and female gender. Conclusion: The magnitude of MRCI scores varied across the three disease groups, increased dramatically when all medications were considered, and revealed greater complexity than a simple count of prescribed medications. The MRCI may be a useful tool for targeting patients for whom medication therapy management services would be most beneficial and cost effective.
News Article | February 15, 2017
DETROIT, MI--(Marketwired - February 13, 2017) - SmithGroupJJR, one of the nation's leading architecture, engineering and planning firms, is pleased to announce that Tom Butcavage, Sam D'Amico, Mark Kranz and David Varner have been elevated to the American Institute of Architects (AIA) College of Fellows. The recognition reflects their significant contributions to architecture and society and achievement of a standard of excellence in the profession. The four from SmithGroupJJR will be among the 178 new Fellows recognized at an investiture ceremony at the AIA Conference on Architecture 2017, to be held April 27-29 in Orlando, Florida. Tom Butcavage, FAIA, LEED AP BD+C, is a SmithGroupJJR vice president and leader of the Higher Education Studio at the firm's Washington, DC office. He has spent the past 20 years as a pioneer in the programming, planning and design of award-winning and nationally significant higher education facilities across the U.S., ranging from instructional facilities and student centers to libraries and professional schools. Butcavage is widely recognized for his unparalleled expertise in law school design. He has led more than 20 law school projects, each containing a variety of spaces for specialized instruction, research and legal skills development. Among his most recently completed law schools are the University of Utah S.J. Quinney College of Law, American University Washington College of Law, George State University College of Law, and New York Law School - all which exemplify cutting-edge environments for modern legal education. Presently, he is leading the design of a number of new professional education facilities at the University of South Carolina, University of North Carolina at Chapel Hill, and Georgetown University. A frequent presenter at national academic conferences such as the Society for College and University Planning, American Bar Association and Association of College Unions International, Butcavage speaks on topics including the design of student spaces and maximizing student engagement through new facilities. He has served as a critic and lecturer at the Corcoran College of Art + Design and Catholic University of America School of Architecture and Planning. Butcavage is a graduate of Columbia University with a Master of Architecture, preceded by a BA in art history at Swarthmore College. His is a resident of Washington, DC's Shepherd Park neighborhood. Sam D'Amico, FAIA, LEED AP BD+C, is a SmithGroupJJR vice president and design leader for the firm's Health Practice. Based at its San Francisco office, he is now commencing his 35th year practicing architecture throughout the U.S. as well as parts of Asia. D'Amico approaches every project with a specific architectural response that integrates the client's culture, context and place. His design tenets include the integration of daylight, nature and art into the healthcare environment to improve the healing process. D'Amico has designed for world-class teaching institutions and national leaders in healthcare such as the University of California San Francisco Medical Center, Kaiser Permanente, and Barnes Jewish Hospital. Currently, D'Amico is design principal for a new medical office building and bed tower, part of a multi-year expansion program for Community Regional Medical Center in Fresno, California. His design of the new Robley Rex Veteran Administration Medical Center, a 1.2 million-square-foot replacement hospital to be constructed in Louisville, Kentucky, led to SmithGroupJJR's award of a prestigious AIA Academy of Architecture National Health Design Award, Unbuilt Category. Another D'Amico design, for the Fuwai Huazhong Cardiovascular and Heart Hospital, Zhenghou, Henan Province, China, was the recipient of an AIA San Francisco Citation Award for unbuilt design. At SmithGroupJJR, D'Amico is a member of the firm's National Design Committee. In 2016, he served as a featured panelist at firm's public forum on design, Perspectives, for a program titled, "The Fusion of Art and Architecture." A graduate from the University of Houston with a Bachelor of Architecture with Honors, the Houston, Texas native now resides in Lafayette, California, where he is on the Board of the city's Improvement Association. Mark Kranz, FAIA, LEED AP BD+C, vice president and design director at SmithGroupJJR, is known for his elegant and synthesized solutions for research and higher education environments across the U.S. As the designer of projects recognized by a total of 27 AIA design awards to-date, he believes that each has the potential for excellence, regardless of budget or constraints. Kranz, who is based at the firm's Phoenix office, is an advocate of pushing the boundaries of innovation and sustainability. He designed the LEED Platinum Energy Systems Integration Facility at the National Renewable Energy Lab in Golden, Colorado, leading a complex team and design vision for a high performance/ultra-low energy building later honored as R&D Magazine's "Lab of the Year." His design of the Defense POW/MIA Accounting Agency Center for Excellence, located at Joint Base Pearl Harbor Hickam, Oahu, Hawaii, was the recipient of the Naval Facilities Engineering Command (NAVFAC) 2015 Commander's Award for Design Excellence. Among Kranz's projects currently underway is the $82 million Engineering Building, now under construction at the University of Texas at Dallas. Scheduled for completion in 2018, the new, 208,000-square-foot building will house the university's rapidly growing mechanical engineering program. He is also serving design principal for the new $60 million San Diego County Crime Laboratory, slated to be completed in 2019. Kranz was elected to the SmithGroupJJR Board of Directors in 2015 and is a member of the firm's National Design Committee and Science & Technology Practice. He is a graduate of the University of Nebraska in Lincoln with a Bachelor of Science in architectural studies, followed by a Master of Architecture from Arizona State University. He now resides in Phoenix. David Varner, FAIA, LEED AP BD+C, is vice president and director of the firm's 200-person office in Washington, DC, located in the 1700 New York Avenue building in the heart of DC's monumental core. Varner is known for his talent in discovering and celebrating hidden environmental, economic and design opportunities in existing buildings. His special expertise and success in creating new value for owners, communities and cities through such building transformation is well demonstrated with the complete transformation of the 2.1 million-square-foot, Constitution Center, a repositioning of a 1960's property into the largest, privately-owned office building in Washington, DC. Certified LEED Gold, the building today is not only highly energy-efficient, but secure, elegant and fully leased. Varner is currently serving as SmithGroupJJR's principal-in-charge for one of the District's most exciting new buildings now under construction: the $60 million, 150,000-square-foot, DC Water Headquarters. When completed in late 2017 along the waterfront of the Anacostia River, the new building will set a new standard for low-energy, high-performance and resilient waterfront development. As a result of his expertise in existing buildings, transformation, planning and mixed-use development, Varner is frequently invited to join interdisciplinary panels of some of the nation's most significant leadership groups. In 2015 he was elected a Trustee of the Federal City Council, a position that catalyzes the collaboration of key business leaders in Washington, DC to solve challenging problems across the city. He is a long-time member of the Urban Land Institute and currently on its exclusive Redevelopment and Reuse Council. Varner has been a member of the SmithGroupJJR Board of Directors since 2011. He is graduate of Rice University with dual degrees: a Bachelor of Arts degree in architecture and art/art history and a Bachelor of Architecture. A native of Houston, Texas, Varner now lives in Arlington, Virginia. The American Institute of Architects Fellowship program was developed to elevate those architects who have made a significant contribution to architecture and society and who have achieved a standard of excellence in the profession. Election to fellowship not only recognizes the achievements of architects as individuals, but also their significant contribution to architecture and society on a national level. SmithGroupJJR (www.smithgroupjjr.com) is an integrated architecture, engineering and planning firm, employing more than 1,100 across 10 offices. In May 2016, SmithGroupJJR was ranked as one of the nation's top architecture firms by Architect magazine's Architect 50. A national leader in sustainable design, SmithGroupJJR has 420 LEED professionals and 160 LEED certified projects.
News Article | December 14, 2016
SmithGroupJJR, one of the nation’s leading architecture, engineering and planning firms, has promoted Ed Burton, Sven Shockey and Cheryl Zuellig to vice president. Ed Burton, RIBA, is promoted to vice president, continuing in his role as director of the firm’s Science & Technology Practice, which provides programming, planning and design of renovation, expansion and new construction projects for academic science, corporate research, technology park, mission critical and forensic clients. A native of England, Burton has more than 25 years of experience in managing large and complex science and technology projects spanning three continents. Among his past clients are the Francis Crick Institute, Eli Lilly, University of Southern California, Alexandria Real Estate Equities, Skolkovo Foundation, Dow Chemical Company, Pfizer, Merck and AstraZeneca. Burton is currently working with several SmithGroupJJR clients, including the University of California San Diego and National Institutes of Health. Educated in the United Kingdom, Burton received an MBA from the prestigious Cranfield University School of Management, Cranfield, and also earned two architecture degrees – a Post Graduate Diploma and Bachelor of Arts – from the Birmingham School of Architecture and Design, Birmingham. He is a Chartered Architect and member of the Royal Institute of British Architects. In the U.S., he is accredited by the U.S. Green Building Council as a LEED Green Associate. Among Burton’s professional memberships is the International Society for Pharmaceutical Engineering. Cheryl Zuellig, RLA, ASLA, is promoted to vice president, continuing in her role of SmithGroupJJR’s Director of Sites. A registered landscape architect, Zuellig recently led the urban design effort in the creation of a long range master plan for Community Regional Medical Center’s campus in downtown Fresno, California. She also served as lead designer for Middlegrounds Metropark, recently opened in downtown Toledo, Ohio along the Maumee River, for which she led the development of an innovative storm water treatment system. Over the past 15 years with SmithGroupJJR, Zuellig has worked with a wide range of the firm’s practices, including Urban Design, Health and Workplace, for clients such as General Motors Corporation, Blue Cross Blue Shield, Olympia Entertainment, Beaumont Health System, the Michigan Department of Natural Resources, and Emory University Hospital. Zuellig earned a Bachelor of Science in Landscape Architecture from Michigan State University, where she remains active as a member of its Landscape Architecture Alumni Advisory Board. Among her professional organizations is the American Society of Landscape Architecture (ASLA.) A resident of Ypsilanti, Michigan, Zuellig currently services as vice chair of the Ypsilanti Planning Committee. She works at the SmithGroupJJR office in Ann Arbor. Sven Shockey, AIA, LEED AP BD+C, is promoted to vice president, retaining his title of Director of Design. With special expertise in design for the workplace sector, among his most significant projects is the new $60 million, 150,000-square foot, DC Water Headquarters building (2017), now under construction along the waterfront of the Anacostia River in Southeast Washington, DC and targeting LEED Platinum. Shockey has also led the design of more than a dozen of the firm’s workplace interior projects for clients like the Advisory Board Company and Evolent Health. In addition to his design of some of SmithGroupJJR’s most significant workplace projects, Shockey has contributed to a variety of mixed-used and institutional projects, including the recently completed Stephen A. Levin Building at the University of Pennsylvania, Philadelphia, which in September 2016 was honored by the Washington, DC Chapter of the American Institute of Architects (AIA). He also leads the design of large-scale, mixed-use development master plans, including the transformative Scotts Run master plan in Tysons Corner, Virginia for SmithGroupJJR client Cityline Partners. Shockey joined SmithGroupJJR in 1998 as a project architect and ascended through the ranks to be elected to the firm’s Board of Directors in 2015. The Vernon, Connecticut native earned a Bachelor of Arts in Cognitive Science from the University of Rochester, followed by a Master of Architecture from Virginia Tech. He is a member of the AIA and Urban Land Institute, and serves as a trustee of the Federal City Council in Washington, DC. Shockey, who both lives and works in Washington, DC, is based at SmithGroupJJR’s office located at 1700 New York Avenue. SmithGroupJJR (http://www.smithgroupjjr.com) is a recognized, integrated architecture, engineering and planning firm ranked Top 10 in the U.S. by Building Design + Construction magazine. The firm’s staff of 1000 spans 10 offices, including its newest office in Shanghai, China. SmithGroupJJR is a national leader in sustainable design with nearly 160 LEED certified projects.
News Article | November 21, 2016
In what is considered a victory for patient safety, hospitals across the U.S. have reduced deadly, but highly preventable, central-line bloodstream infections by 50 percent since 2008. In a new investigation of nearly 2,000 hospitals, Consumer Reports looks at the five-year track record of teaching hospitals to see which have successfully reduced these infections, and which have not. The report, available in the January issue of Consumer Reports and online at CR.org, identifies 31 U.S. teaching hospitals on its lowest-performing “zero tolerance” list and 32 on its list of top performers. The story and Ratings are free, in addition to an interactive look-up tool showing hospitals in your area and their five-year track record (go to CR.org/central-line-infections for the tool). “Because teaching hospitals are teaching our next generation of physicians, we think it’s critical to monitor them closely. Our review of their performance on controlling central-line infections is very sobering,” says Doris Peter, Ph.D., director of the Consumer Reports Health Ratings Center. “Central-line infections are highly preventable and there are no excuses for poor performance on this metric. It’s unfortunate to see so many well-known hospitals, some who tout their top rankings and awards, sitting on the sidelines of one of the biggest triumphs in patient safety.” Central-line infections derive from the intravenous lines used to supply medication, nutrients, and fluids to patients who need them the most. When not handled properly, central lines can become host to bacteria, pumping germs straight into the bloodstream of the patient. Once there, the bacteria – including deadly strains such as MRSA that aren’t easily managed with antibiotics – can spread to the heart and other organs. About 650,000 people develop infections after they are admitted to hospitals each year, and 75,000 patients die, according to the latest data from the Centers for Disease Control and Prevention. That makes hospital acquired infections the eighth leading cause of death, just behind diabetes. Central-line infections account for roughly 5 percent of all hospital infections, but are considered a critical subset because: While other hospital infections have stayed steady or declined only slightly in recent years, those linked to central lines were cut in half between 2008 and 2014, according to the CDC. “It’s one of the nation’s greatest patient safety success stories ever,” says Arjun Srinivasan, M.D., associate director for Healthcare Associated Infection Prevention Programs at the CDC. “Hospitals are moving in the right direction, but progress is slowing and too many hospitals have not adequately addressed the problem over the past five years,” says Consumer Reports’ Peter. What Can Be Done Consumer Reports’ nine-page investigation outlines the Pronovost principles developed 15 years ago to prevent central-line infections. It also includes profiles of two hospitals, Shore Medical Center in New Jersey and Mount Sinai St. Luke’s-Roosevelt in New York, that give insight into how they successfully battled this infection, and how they continue to be vigilant and improve. The story also includes 15 steps that consumers can take to stay safe in the hospital (see sidebar). From a policy standpoint, CR has worked successfully at the state level to get laws passed that require hospitals to publicly report hospital infections for more than a decade. And while President Barack Obama’s Affordable Care Act included a provision that lowered Medicare payments to hospitals that had too many infections, more can be done at the federal government to give the public more timely and actionable information, says Lisa McGiffert, director of Consumer Reports’ Safe Patient Project (SafePatientProject.org). “We think there are many requirements that could keep patients safe. For example, the federal government should require hospitals to immediately report infection outbreaks or infection-control breaches to patients, healthcare providers, state and federal agencies, and the public. In essence, we’re saying that when there is an outbreak, if the hospital knows, then everyone should know,” says McGiffert. Complete hospital lists and Ratings are available in the magazine story and online. The list below reveals the 31 lowest scoring U.S. teaching hospitals at preventing central-line infections in intensive care units from January 1, 2011 to December 31, 2015. Hospitals appear in alphabetical order. Atlanta Medical Center (Atlanta, GA) Banner- University Medical Center Tucson (Tucson, AZ) Brooklyn Hospital Center (Brooklyn, NY) Community Regional Medical Center (Fresno, CA) Cooper University Health Care (Camden, NJ) Dartmouth – Hitchcock Medical Center (Lebanon, NH) Emory University Hospital Midtown (Atlanta, GA) Eskenazi Health (Indianapolis, IN) George Washington University Hospital (Washington, DC) Grady Memorial Hospital (Atlanta, GA) Holy Cross Hospital (Silver Spring, MD) Howard University Hospital (Washington, D.C.) Hurley Medical Center (Flint, MI) Indiana University Health University Hospital (Indianapolis, IN) Interim LSU Public Hospital (New Orleans, LA) Long Beach Memorial Medical Center (Long Beach, CA) MacNeal Hospital (Berwyn, IL) Maine Medical Center (Portland, ME) Maricopa Integrated Health System (Phoenix, AZ) Nebraska Medicine - Nebraska Medical Center (Omaha, NE) Palmetto Health Richland (Columbia, SC) Robert Wood Johnson University Hospital (New Brunswick, NJ) Ronald Reagan UCLA Medical Center (Los Angeles, CA) SUNY Downstate Medical Center University Hospital (Brooklyn, NY) Truman Medical Center - Hospital Hill (Kansas City, MO) Tulane Medical Center (New Orleans, LA) UC San Diego Health (San Diego, CA) UF Health Jacksonville (Jacksonville, FL) University Hospital (Newark, NJ) University Medical Center of El Paso (El Paso, TX) University of Iowa Hospitals and Clinics (Iowa City, IA) About Consumer Reports Consumer Reports is the world’s largest and most trusted nonprofit consumer organization, working to improve the lives of consumers by driving marketplace change. Founded in 1936, Consumer Reports has achieved substantial gains for consumers on food and product safety, financial reform, health reform, and many other issues. The organization has advanced important policies to prohibit predatory lending practices, combat dangerous toxins in food, and cut hospital-acquired infections. Consumer Reports tests and rates thousands of products and services in its 50-plus labs, state-of-the-art auto test center, and consumer research center. It also works to enact pro-consumer laws and regulations in Washington, D.C., in statehouses, and in the marketplace. An independent nonprofit, Consumer Reports accepts no advertising, payment, or other support from the companies that create the products it evaluates. _______________ JANUARY 2017 © 2016 Consumer Reports. The material above is intended for legitimate news entities only; it may not be used for advertising or promotional purposes. Consumer Reports® is an expert, independent nonprofit organization whose mission is to work for a fair, just, and safe marketplace for all consumers and to empower consumers to protect themselves. We accept no advertising and pay for all the products we test. We are not beholden to any commercial interest. Our income is derived from the sale of Consumer Reports®, ConsumerReports.org® and our other publications and information products, services, fees, and noncommercial contributions and grants. Our Ratings and reports are intended solely for the use of our readers. Neither the Ratings nor the reports may be used in advertising or for any other commercial purpose without our permission. Consumer Reports will take all steps open to it to prevent commercial use of its materials, its name, or the name of Consumer Reports®.
Balasubramanian V.,Community Regional Medical Center |
Naing S.,University of California at San Francisco
Current Opinion in Pulmonary Medicine | Year: 2012
PURPOSE OF REVIEW: This review summarizes the literature on hypogonadism in men with chronic obstructive pulmonary disease (COPD). RECENT FINDINGS: COPD is a systemic disease with effects beyond the lungs. Many prior studies have shown that middle-aged and elderly COPD patients may develop hypogonadism. Prevalence of hypogonadism in men with COPD can range from 22 to 69% and has been associated with several other systemic manifestations including osteoporosis, depression, and muscle weakness. Recent studies have revealed conflicting results with regards to these previous perceptions. The discrepancies in the findings can be mainly attributed to small sample size, differences in patient selection, and inconsistent findings. Testosterone replacement therapy may result in modest improvements in fat-free mass and limb muscle strength but its therapeutic efficacy in COPD patients still remains controversial. SUMMARY: The relationship between hypogonadism and COPD still remains poorly understood. The current literature is at best circumstantial. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Afsari A.,Loma Linda University |
Liporace F.,North Jersey Orthopaedic Institute |
Lindvall E.,Community Regional Medical Center |
Infante Jr. A.,Florida Orthopedic Institute |
And 2 more authors.
Journal of Bone and Joint Surgery - Series A | Year: 2010
BACKGROUND: Subtrochanteric fractures can be a treatment challenge. The substantial forces that this region experiences and the fact that the proximal fragment is frequently displaced make accurate reduction and internal fixation difficult. The purpose of this study was to evaluate a series of patients who had undergone clamp-assisted reduction and intramedullary nail fixation to determine the impact of this technique on fracture union rates and reduction quality. METHODS: Between December 2003 and January 2007, fifty-five consecutive patients with a displaced high subtrochanteric femoral fracture were treated with clamp-assisted reduction and intramedullary nail fixation at two level-I trauma centers. Two patients died, and nine were lost to follow-up. The remaining forty-four patients were followed until union or a minimum of six months. There were twenty-seven male and seventeen female patients with a mean age of fifty-five years. All were treated with an antegrade statically locked nail implanted with a reaming technique as well as the assistance of a reduction clamp placed through a small lateral incision. Nine patients were treated with a single supplemental cerclage cable. Radiographs were evaluated for the quality of the reduction and fracture union. RESULTS: Forty-three of the forty-four fractures united. All reductions were within 5° of the anatomic position in both the frontal and the sagittal plane. Thirty-eight (86%) of the forty-four reductions were anatomic. Six fractures had a minor varus deformity of the proximal fragment (between 2° and 5°). There were no complications. DISCUSSION: Surgical treatment of subtrochanteric femoral fractures with clamp-assisted reduction and intramedullary nail fixation techniques with judicious use of a cerclage cable can result in excellent reductions and a high union rate. Careful attention to detail is important to perform these maneuvers with minimal additional soft-tissue disruption. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence. Copyright © 2010 by The Journal of Bone and Joint Surgery, Incorporated.
News Article | November 17, 2016
The International Association of HealthCare Professionals is pleased to welcome Israel K. Brown Brantuoh, DO, OB/GYN Physician, to their prestigious organization with his upcoming publication in The Leading Physicians of the World. He is a highly trained and qualified OB/GYN physician with a vast expertise in all facets of his work. Dr. Brantuoh has been in practice for more than six years and is currently serving patients at MFA Gateway in Merced, California. Furthermore, he holds hospital privileges at the Community Regional Medical Center in Fresno, California. Dr. Brantuoh graduated with his Doctorate of Osteopathic Medicine at Kansas City University of Medicine and Biosciences in 2006. He then went on to complete his internship at The Philadelphia College of Osteopathic Medicine, followed by his residency at Wyckoff Heights Medical Center in Brooklyn, New York. Dr. Brantuoh is certified by the American Board of Obstetrics and Gynecology, and keeps up to date with the latest advances in his field through his professional memberships with the American Osteopathic Association and the American Congress of Obstetricians and Gynecologists. Dr. Brantuoh attributes his success to his passion for women’s health, and when he is not assisting patients, dedicates his spare time to hiking, tennis, soccer, watching movies, and musicals. Learn more about Dr. Brantuoh by reading his upcoming publication in The Leading Physicians of the World. FindaTopDoc.com is a hub for all things medicine, featuring detailed descriptions of medical professionals across all areas of expertise, and information on thousands of healthcare topics. Each month, millions of patients use FindaTopDoc to find a doctor nearby and instantly book an appointment online or create a review. FindaTopDoc.com features each doctor’s full professional biography highlighting their achievements, experience, patient reviews and areas of expertise. A leading provider of valuable health information that helps empower patient and doctor alike, FindaTopDoc enables readers to live a happier and healthier life. For more information about FindaTopDoc, visit:http://www.findatopdoc.com