Objective To develop expeditiously a pragmatic, modular, and extensible software framework for understanding and improving healthcare value (costs relative to outcomes).Materials and methods In 2012, a multidisciplinary team was assembled by the leadership of the University of Utah Health Sciences Center and charged with rapidly developing a pragmatic and actionable analytics framework for understanding and enhancing healthcare value. Based on an analysis of relevant prior work, a value analytics framework known as Value Driven Outcomes (VDO) was developed using an agile methodology. Evaluation consisted of measurement against project objectives, including implementation timeliness, system performance, completeness, accuracy, extensibility, adoption, satisfaction, and the ability to support value improvement.Results A modular, extensible framework was developed to allocate clinical care costs to individual patient encounters. For example, labor costs in a hospital unit are allocated to patients based on the hours they spent in the unit; actual medication acquisition costs are allocated to patients based on utilization; and radiology costs are allocated based on the minutes required for study performance. Relevant process and outcome measures are also available. A visualization layer facilitates the identification of value improvement opportunities, such as high-volume, high-cost case types with high variability in costs across providers. Initial implementation was completed within 6 months, and all project objectives were fulfilled. The framework has been improved iteratively and is now a foundational tool for delivering high-value care.Conclusions The framework described can be expeditiously implemented to provide a pragmatic, modular, and extensible approach to understanding and improving healthcare value.

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a unique case study for examining the specific considerations for mass violence events in senior living facilities. A variety of factors, including reduced sensory perception, reduced mobility, and cognitive decline, may increase the vulnerability of the populations of senior living facilities during mass violence events. Management of response aspects such as evacuation, relocation, and reunification also require special consideration in the context of mass violence at senior living facilities. Better awareness of these vulnerabilities and response considerations can assist facility administrators and emergency managers when preparing for potential mass violence events at senior living facilities. (Disaster Med Public Health Preparedness. 2017;11:150-152)

A significant decrease in patient volume was seen at the AL1TC with the initiation of the PL2TC in close proximity. Orthopaedic patient volume did not recuperate after the removal of the PL2TC status.

Missed injuries in trauma patients are a significant source of preventable morbidity. The tertiary survey is a head-to-toe physical exam performed within 24 hours of admission to identify any injuries which may have been missed during initial assessment and resuscitation. The Physician Assist Trauma Software (PATS) is an electronic program designed to guide users through a thorough tertiary survey and document the results. This thesis project was designed to study the impact of implementing this novel mobile device based electronic tertiary survey program on missed injuries. The first phase of this study involved quantifying and characterizing the missed injury rate at two distinct pilot sites. The second phase compared missed injury rates before and after implementation of the PATS program. Completion rates before and after implementation were also compared as a measure of feasibility. The implementation of the PATS program significantly decreased missed injury rates and improved documentation compliance at both sites. The third phase focused on user-level feasibility by surveying the pre-and post-PATS practitioners responsible for completing the tertiary survey. Overall, users found the PATS program useful, time-saving, and effective. The PATS program appears to be an effective and feasible way to reduce missed injuries and improve documentation in trauma.