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It is associated with a significant economic burden, with productivity losses exceeding $40 billion dollars annually in the United States (U.S.) alone. This project focused on the use of a systematic, data-driven approach to improve the screening rate for depression in an academic, metropolitan cancer center located in North Texas. A multidisciplinary team collaboratively applied Lean Six Sigma education, methods, and tools within oncology and psychiatry clinics to address the increased risk of depression among oncology patients. Improving the standardization of screening and follow-up processes, resulted in a 44% sustained increase in the depression screening and follow-up performance rate. This improvement was verified to be statistically significant through the use of control charts toward the end of the project.

The impact of COVID-19, on the health and safety of patients, staff, and healthcare organizations, has yet to be fully uncovered. Patient adverse events, such as hospital-acquired pressure injuries (HAPIs), have been problematic for decades. The introduction of a pandemic to an environment that is potentially at-risk for adverse events may result in unintended patient safety and quality concerns. We use the learning health system framework to motivate our understanding of the impact of the COVID-19 pandemic on the incidence of HAPIs within our health system. Using a retrospective, observational design, we used descriptive statistics to evaluate trends in HAPI from March to July 2020. Hospital-acquired pressure injury numbers have fluctuated from a steady increase from March-May 2020, hitting a peak high of 90 cases in the month of May. However, the trend in the total all stage HAPIs began to decline in June 2020, with a low of 51 in July, the lowest number since March 2020. Patients evaluated in this study from a steady increase from March-May 2020, hitting a peak high of 90 cases in the month of May. However, the trend in the total all stage HAPIs began to decline in June 2020, with a low of 51 in July, the lowest number since March 2020. Patients evaluated in this study did not have a longitudinal increase in HAPIs from March-July 2020 during the COVID-19 pandemic, despite similarities in illness severity between the two time points. Our experience has demonstrated the ability of our organizational leaders to learn quickly during crisis.

Minimally invasive glaucoma surgery (MIGS) is an emerging therapy for glaucoma. The Hydrus Microstent is a MIGS device that stents Schlemm's canal, thereby increasing aqueous drainage and lowering intraocular pressure (IOP). This article describes the use of the microstent in pseudophakic patients with medically refractory glaucoma, a patient population undocumented in the current literature.

We present a retrospective case series of 11 pseudophakic eyes using 3 or more pressure lowering medications daily for open-angle glaucoma who underwent Hydrus Microstent insertion. Patients were followed up at 1, 3, 6, 12, 24, 36, 48, and 60 months postoperatively and assessed for reductions in IOP and medication burden.

At intervals 12 and 24 months, medication burden reduced by 75.6% at both junctures, and IOP reduced by 43.8% and 34.1%. Complications included 4 hyphaemas and 1 corneal epithelial defect, each of which resolved.

This case series demonstrated effective pressure and medication reduction in medically refractory open-angle glaucoma patients using the Hydrus Microstent. Use of this device in this population is thus far undocumented in the literature and may represent an optimal therapeutic modality in the future.

This case series demonstrated effective pressure and medication reduction in medically refractory open-angle glaucoma patients using the Hydrus Microstent. Use of this device in this population is thus far undocumented in the literature and may represent an optimal therapeutic modality in the future.

An Ahmed glaucoma valve (AGV) tube in the ciliary sulcus (CS) is safer for the endothelium. At 4 years of follow-up, there was a significant decrease in endothelial cell count only with anterior chamber (AC) placement.

Corneal endothelium (CE) damage is one of the most feared long-term complications that can result from glaucoma drainage devices. selleck chemical Nonetheless, there is a lack of studies evaluating longitudinal changes in CE cells. This study aims to compare CE changes after AGV implantation in eyes with AC or CS tube placement.

This was a retrospective, nonrandomized, longitudinal study of pseudophakic eyes with open-angle glaucoma and medically uncontrolled intraocular pressure that received an AGV. Eyes with additional glaucoma surgeries performed during follow-up were excluded. The main outcome measure was endothelial cell density (ECD), which was evaluated 1 year±2 months and 4 years±2 months postoperatively. The average endothelial cell size (AS) and the distance from the tube tip to the cornea were also evaluated.

Twenty-six eyes from 26 patients, with a mean age of 73±10 years, were included. The tube was placed in the AC in 15 eyes and in the CS in 11 eyes. The eyes with tube placement in the AC showed a significant AS increase (P=0.007) and ECD decrease (P=0.034), whereas eyes with tube placement in the CS had no significant AS (P=0.575) or ECD (P=0.445) change. In the eyes with tube placement in the AC, there was no correlation between DTC and ECD (P=0.260) or AS (P=0.428) changes.

Tube placement in the AC seems to lead to significant CE cell loss over time, compared with tube placement in the CS.

Tube placement in the AC seems to lead to significant CE cell loss over time, compared with tube placement in the CS.

The FP8 glaucoma valve was demonstrated to be reasonably safe with reliable results in an advanced age patient population.

As life expectancy increases, a growing number of patients with glaucoma are of an advanced age. There are little to no data looking at glaucoma surgical treatment options in patients over the age of 85. Our study describes the safety and efficacy of the FP8 Ahmed glaucoma valve in this patient population.

This was a retrospective study of patients over 85 years of age undergoing FP8 Ahmed glaucoma valve implantation. Preoperative age, sex, intraocular pressure (IOP), and number of glaucoma medications were recorded. Primary outcome variables were IOP and number of medications. Secondary outcome variables included any intraoperative or postoperative complications.

Mean IOP preoperatively was 26 mm Hg on an average of 3 glaucoma medications (n=56). IOP was significantly reduced at all time points in follow-up for an overall reduction of 42% at 1 year and 46% at 2 years. Mean IOP at 1 year follow-up was 15 mm Hg and 14 mm Hg at 2 years follow-up.