Sarah L Krein
Biographic Data
| ID | 1726685 |
|---|---|
| NAME | Sarah L Krein |
| GIVEN NAMES | Sarah L |
| FAMILY NAME | Krein |
| SIGNATURE | KREIN S L |
| AFFILIATIONS | University of Michigan |
| ORCID | 0000-0003-2111-8131 |
| VERIFIED | Yes |
| TOTAL WORKS | 17 |
| TOTAL CITATIONS | 3 |
| WORKS AS AUTHOR | 17 |
| WORKS AS EDITOR | 0 |
| FIRST PUBLICATION YEAR | 1995 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 1 |
Recommendations for Improving EHR Transitions
BACKGROUND: Transitions from one electronic health record (EHR) to another are increasingly common yet can be enormously disruptive, affecting patient care and health care worker well-being. Nurses are especially impacted as the largest group of EHR users, and their perspectives are vital for understanding and improving transitions. OBJECTIVE: To identify actionable recommendations for supporting nurses during EHR transitions by learning from nur…
Findings and Recommendations From the State of the Art (Sota) Conference on Nursing Research to Improve Veteran Outcomes
The Veterans Health Administration (VHA), the largest employer of nurses in the United States, has more than 120,000 nursing personnel providing care to over 9 million Veterans across diverse settings. Despite nursing’s central role in delivering and sustaining care, research on strengthening the nursing workforce and optimizing nursing practice has remained underdeveloped in VHA. To address this gap, VHA’s Office of Research and Development, in …
Infection prevention and healthcare epidemiology professionals in low- and middle-income countries
INTRODUCTION: More than 75% of the global population resides in low- and middle-income countries (LMICs), where healthcare-associated infection rates are notably higher than in high-income countries. Little is known about the professional experiences, perceptions and needs of infection prevention and healthcare epidemiology professionals (IPHEP) practising in these countries. METHODS: A voluntary and anonymous online survey of IPHEP in LMICs was …
Use of Preventive Care Services and Hospitalization Among Medicare Beneficiaries in Accountable Care Organizations That Exited the Shared Savings Program
In this cohort study of Medicare beneficiaries, SSP exit was associated with modest declines in clinical quality. These findings were timely given recent SSP changes that could accelerate program exit
Survey Instruments to Assess Patient Experiences With Access and Coordination Across Health Care Settings
BACKGROUND: Improving access can increase the providers a patient sees, and cause coordination challenges. For initiatives that increase care across health care settings, measuring patient experiences with access and care coordination will be crucial. OBJECTIVES: Map existing survey measures of patient experiences with access and care coordination expected to be relevant to patients accessing care across settings. Preliminarily examine whether as…
Unique Factors Rural Veterans’ Affairs Hospitals Face When Implementing Health Care‐Associated Infection Prevention Initiatives
PURPOSE: Health care-associated infection (HAI) is costly to hospitals and potentially life-threatening to patients. Numerous infection prevention programs have been implemented in hospitals across the United States. Yet, little is known about infection prevention practices and implementation in rural hospitals. The purpose of this study was to understand the infection prevention practices used by rural Veterans' Affairs (VA) hospitals and the un…
The influence of organizational context on quality improvement and patient safety efforts in infection prevention
Understanding Variation in the Adoption of a New Technology in Surgery
BACKGROUND: Despite data supporting the superiority of laparoscopy over conventional surgery for donor nephrectomy, prior work reveals that this technology's adoption has been slow. However, the underlying cause for its gradual adoption remains unclear. For this reason, a multilevel analysis was conducted using a population-based cohort to evaluate the amount of variation in laparoscopic donor nephrectomy use attributable to the individual, provi…
Building a Better Quality Measure
BACKGROUND: National performance measures monitor the proportion of diabetic patients with low-density lipoprotein (LDL) levels >/=130 mg/dL, but such simple intermediate outcomes measure poor control, not necessarily poor care. "Tightly linked" quality measures define good quality either by a good intermediate outcome (LDL /=130 mg/dL using the simple intermediate outcome measure, only 13% (148 of 1154) were classified as having substandard qual…
Racial Disparities in Diabetes Care Processes, Outcomes, and Treatment Intensity
BACKGROUND: Black Americans with diabetes have a higher burden of illness and mortality than do white Americans. However, the extent to which differences in medical care processes and treatment intensity contribute to poorer diabetes outcomes is unknown. OBJECTIVE: To assess racial disparities in the quality of diabetes care processes, intermediate outcomes, and treatment intensity. METHODS: We conducted an observational study of 801 white and 11…
Department of Veterans Affairs' Quality Enhancement Research Initiative for Diabetes Mellitus
Diabetes is a common disease, which frequently leads to serious, high-cost complications. Estimates show that in fiscal year 1994 (FY94), 12.5% of outpatients in the Veterans Health Administration (VHA) received diabetes-specific medications, accounted for almost 25% of all VHA pharmacy costs, had a hospitalization rate 1.6 times that of veterans without diabetes, and made 3.6 million outpatient visits to VA clinics. Research demonstrates that mu…
Research on Managed Care Organizations in Rural Communities
North Med HMO
NorthMed HMO is viewed by its owners as an important vehicle for integrating rural providers in northern Michigan. Through the HMO, rural providers hope to be able to contract with government programs, while retaining private‐sector patients through employer contracts. For most rural providers, NorthMed HMO does not yet represent a major source of revenues. However, the HMO is about to embark on an expansion that, if successful, will increase its…
Rural Radiology
The purpose of this study is to identify the local availability and trends in local availability of imaging technology and interpretation services in rural hospitals in the northwestern United States during the period between 1991 to 1994. Another objective is to describe hospital and community factors associated with the diffusion of image production and interpretation services. The information for this study was gathered through telephone surve…
The Employment and Use of Nurse Practitioners and Physician Assistants by Rural Hospitals
Nurse practitioners and physician assistants are both important resources for the delivery of health care services in rural areas. Nevertheless, little is known about the demand for their services by rural employers. The purpose of this study was: (1) to describe and compare the employment and use of nurse practitioners and physician assistants by rural hospitals in an eight‐state region in the northwestern United States (Minnesota, North Dakota,…
The Composition of Rural Hospital Medical Staffs
The local supply of physicians has a strong influence on the availability and the quality of services provided by rural hospitals. Nevertheless, there are no published studies that describe the composition of rural hospital medical staffs and, in particular, the availability of specialists on these staffs. This study uses 1991 and 1994 survey data from rural hospitals located in eight states to describe the specialty composition and factors that …
Availability of Rural Minnesota Obstetric Services
In the late 1980s several published articles predicted a crisis in the availability of obstetric care due to declining numbers of rural obstetrical providers. Several state and national studies documented the adverse impact of malpractice and time demands on both urban and rural physicians. But only limited information is available to document current trends in rural obstetrical practice and assess whether or not the predicted crisis occurred. Th…
Availability of Rural Minnesota Obstetric Services
In the late 1980s several published articles predicted a crisis in the availability of obstetric care due to declining numbers of rural obstetrical providers. Several state and national studies documented the adverse impact of malpractice and time demands on both urban and rural physicians. But only limited information is available to document current trends in rural obstetrical practice and assess whether or not the predicted crisis occurred. Th…
Rural Radiology
The purpose of this study is to identify the local availability and trends in local availability of imaging technology and interpretation services in rural hospitals in the northwestern United States during the period between 1991 to 1994. Another objective is to describe hospital and community factors associated with the diffusion of image production and interpretation services. The information for this study was gathered through telephone surve…
The Employment and Use of Nurse Practitioners and Physician Assistants by Rural Hospitals
Nurse practitioners and physician assistants are both important resources for the delivery of health care services in rural areas. Nevertheless, little is known about the demand for their services by rural employers. The purpose of this study was: (1) to describe and compare the employment and use of nurse practitioners and physician assistants by rural hospitals in an eight‐state region in the northwestern United States (Minnesota, North Dakota,…
The Composition of Rural Hospital Medical Staffs
The local supply of physicians has a strong influence on the availability and the quality of services provided by rural hospitals. Nevertheless, there are no published studies that describe the composition of rural hospital medical staffs and, in particular, the availability of specialists on these staffs. This study uses 1991 and 1994 survey data from rural hospitals located in eight states to describe the specialty composition and factors that …
Research on Managed Care Organizations in Rural Communities
North Med HMO
NorthMed HMO is viewed by its owners as an important vehicle for integrating rural providers in northern Michigan. Through the HMO, rural providers hope to be able to contract with government programs, while retaining private‐sector patients through employer contracts. For most rural providers, NorthMed HMO does not yet represent a major source of revenues. However, the HMO is about to embark on an expansion that, if successful, will increase its…
Department of Veterans Affairs' Quality Enhancement Research Initiative for Diabetes Mellitus
Diabetes is a common disease, which frequently leads to serious, high-cost complications. Estimates show that in fiscal year 1994 (FY94), 12.5% of outpatients in the Veterans Health Administration (VHA) received diabetes-specific medications, accounted for almost 25% of all VHA pharmacy costs, had a hospitalization rate 1.6 times that of veterans without diabetes, and made 3.6 million outpatient visits to VA clinics. Research demonstrates that mu…
Building a Better Quality Measure
BACKGROUND: National performance measures monitor the proportion of diabetic patients with low-density lipoprotein (LDL) levels >/=130 mg/dL, but such simple intermediate outcomes measure poor control, not necessarily poor care. "Tightly linked" quality measures define good quality either by a good intermediate outcome (LDL /=130 mg/dL using the simple intermediate outcome measure, only 13% (148 of 1154) were classified as having substandard qual…
Racial Disparities in Diabetes Care Processes, Outcomes, and Treatment Intensity
BACKGROUND: Black Americans with diabetes have a higher burden of illness and mortality than do white Americans. However, the extent to which differences in medical care processes and treatment intensity contribute to poorer diabetes outcomes is unknown. OBJECTIVE: To assess racial disparities in the quality of diabetes care processes, intermediate outcomes, and treatment intensity. METHODS: We conducted an observational study of 801 white and 11…
Understanding Variation in the Adoption of a New Technology in Surgery
BACKGROUND: Despite data supporting the superiority of laparoscopy over conventional surgery for donor nephrectomy, prior work reveals that this technology's adoption has been slow. However, the underlying cause for its gradual adoption remains unclear. For this reason, a multilevel analysis was conducted using a population-based cohort to evaluate the amount of variation in laparoscopic donor nephrectomy use attributable to the individual, provi…
The influence of organizational context on quality improvement and patient safety efforts in infection prevention
Unique Factors Rural Veterans’ Affairs Hospitals Face When Implementing Health Care‐Associated Infection Prevention Initiatives
PURPOSE: Health care-associated infection (HAI) is costly to hospitals and potentially life-threatening to patients. Numerous infection prevention programs have been implemented in hospitals across the United States. Yet, little is known about infection prevention practices and implementation in rural hospitals. The purpose of this study was to understand the infection prevention practices used by rural Veterans' Affairs (VA) hospitals and the un…
Survey Instruments to Assess Patient Experiences With Access and Coordination Across Health Care Settings
BACKGROUND: Improving access can increase the providers a patient sees, and cause coordination challenges. For initiatives that increase care across health care settings, measuring patient experiences with access and care coordination will be crucial. OBJECTIVES: Map existing survey measures of patient experiences with access and care coordination expected to be relevant to patients accessing care across settings. Preliminarily examine whether as…
Use of Preventive Care Services and Hospitalization Among Medicare Beneficiaries in Accountable Care Organizations That Exited the Shared Savings Program
In this cohort study of Medicare beneficiaries, SSP exit was associated with modest declines in clinical quality. These findings were timely given recent SSP changes that could accelerate program exit
Infection prevention and healthcare epidemiology professionals in low- and middle-income countries
INTRODUCTION: More than 75% of the global population resides in low- and middle-income countries (LMICs), where healthcare-associated infection rates are notably higher than in high-income countries. Little is known about the professional experiences, perceptions and needs of infection prevention and healthcare epidemiology professionals (IPHEP) practising in these countries. METHODS: A voluntary and anonymous online survey of IPHEP in LMICs was …
Recommendations for Improving EHR Transitions
BACKGROUND: Transitions from one electronic health record (EHR) to another are increasingly common yet can be enormously disruptive, affecting patient care and health care worker well-being. Nurses are especially impacted as the largest group of EHR users, and their perspectives are vital for understanding and improving transitions. OBJECTIVE: To identify actionable recommendations for supporting nurses during EHR transitions by learning from nur…
Findings and Recommendations From the State of the Art (Sota) Conference on Nursing Research to Improve Veteran Outcomes
The Veterans Health Administration (VHA), the largest employer of nurses in the United States, has more than 120,000 nursing personnel providing care to over 9 million Veterans across diverse settings. Despite nursing’s central role in delivering and sustaining care, research on strengthening the nursing workforce and optimizing nursing practice has remained underdeveloped in VHA. To address this gap, VHA’s Office of Research and Development, in …
Medicine (13 works) · Health care (10 works) · Family medicine (8 works) · Primary Care and Health Outcomes (7 works) · Nursing (6 works) · Global Health Workforce Issues (5 works) · Healthcare Policy and Management (5 works) · Political science (5 works) · Rural area (4 works) · Business (3 works)