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1.
Plast Reconstr Surg ; 146(4): 913-919, 2020 10.
Article in English | MEDLINE | ID: mdl-32970013

ABSTRACT

BACKGROUND: Even before seeing a physician, patients must first gain access to the hospital system. At large hospitals with high patient volumes, access to specialty care can pose a particular challenge. This study examines the effects of specific initiatives to increase clinic capacity, appointment use, and ease of scheduling on both patient satisfaction and hospital revenue. METHODS: In 2017, a task force at a large, multidisciplinary pediatric hospital instituted a number of initiatives to increase patient access to ambulatory specialty clinics. Clinic sessions were standardized to a 4-hour template, and unscheduled, "held" appointment slots were required to be made available ("flipped") 72 hours before the appointment. A patient-centered electronic scheduling platform was also implemented. Patient satisfaction was assessed using Press Ganey scores. Revenue estimates were calculated for increases in "new" and "return" patient appointments. RESULTS: Total new appointment slots increased by over 44 percent, with over 53,000 appointments added annually. The number of held appointment slots declined by 93 percent. A total of 17,996 annual appointments were added in surgical subspecialties, and an additional 14,756 more surgical appointments were completed. Over 2000 appointments were scheduled by means of the online patient portal. Press Ganey "ease-of-scheduling" scores increased from 57 percent to 72 percent over the intervention period. Hospitalwide, these initiatives generated an estimated $8.3 million in revenue opportunity. CONCLUSION: Standardizing clinic sessions and optimizing clinic availability generates new appointment opportunities, improves patient experience, and increases hospital revenue.


Subject(s)
Ambulatory Care Facilities/economics , Ambulatory Care Facilities/organization & administration , Appointments and Schedules , Efficiency, Organizational/economics , Hospitals, Pediatric/economics , Hospitals, Pediatric/organization & administration , Patient Satisfaction/statistics & numerical data , Ambulatory Care Facilities/statistics & numerical data , Child , Health Services Accessibility/organization & administration , Health Services Accessibility/statistics & numerical data , Humans , Retrospective Studies
2.
Org Biomol Chem ; 4(19): 3626-38, 2006 Oct 07.
Article in English | MEDLINE | ID: mdl-16990938

ABSTRACT

Lysostaphin (EC. 3.4.24.75) is a protein secreted by Staphylococcus simulans biovar staphylolyticus and has been shown to be active against methicillin resistant S. aureus (MRSA). The design and synthesis of three internally quenched substrates for lysostaphin based on the peptidoglycan crossbridges of S. aureus, and their use in fluorescence resonance energy transfer (FRET) assays is reported. These substrates enabled the gathering of information about the endopeptidase activity of lysostaphin and the effect that mutations have on its enzymatic ability. Significant problems with the inner filter effect and substrate aggregation were encountered; their minimisation and the subsequent estimation of the kinetic parameters for the interaction of lysostaphin with the substrates is described, as well as a comparison of substrates incorporating two FRET pairs: Abz-EDDnp and DABCYL-EDANS. In addition to this, the points of cleavage caused by lysostaphin in Abz-pentaglycine-EDDnp have been determined by HPLC and mass spectrometry analysis to be between glycines 2 and 3(approximately 60%) and glycines 3 and 4 (approximately 40%).


Subject(s)
Lysostaphin/pharmacology , Peptides/chemistry , Staphylococcus aureus/drug effects , Fluorescence , Kinetics , Lysostaphin/chemistry , Microbial Sensitivity Tests , Peptidoglycan/chemistry , Substrate Specificity/drug effects
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