cne is responsible for a greater global burden of disease than psoriasis, cellulitis, and melanoma. [1][2][3] Not only can acne be associated with physical disfigurement, such as permanent scarring, but its emotional impact can lead to social isolation, depression, and suicidality. In fact, treatment of acne is associated with reduced symptoms of depression. [4][5][6] Given the profound association of acne with quality of life, several qualitative studies [7][8][9][10][11] have sought to understand the lived experience of acne among adolescents. These studies [7][8][9][10][11] have highlighted that acne can have important effects on social and emotional functioning, relationships, school, and work. 12 However, few studies have specifically explored the lived experience of acne in adult populations, and these studies 13,14 have been limited by small sample sizes. Because acne often persists into adulthood in women, understanding their perspectives on acne and its treatment is important to guide clinical management in this population. 15 The purpose of this study was to examine the lived experience of acne and its treatment among a large cohort of adult women. Methods Study ParticipantsFemale patients 18 to 40 years of age with moderate to severe acne were recruited from clinics at the University of Pennsylvania Health System and Dermatologists of Southwest Ohio (a INTRODUCTION Acne often persists into adulthood in women. However, few studies have specifically explored the lived experience of acne in adult populations.OBJECTIVE To examine the lived experience of acne and its treatment among a cohort of adult women. DESIGN, SETTING, AND PARTICIPANTSA qualitative analysis was conducted from free listing and open-ended, semistructured interviews of patients at a large academic health care system (University of Pennsylvania Health System) and a private practice (Dermatologists of Southwest Ohio). Fifty women 18 to 40 years of age with moderate to severe acne participated in interviews conducted between August 30, 2019, and December 31, 2020. MAIN OUTCOMES AND MEASURESFree-listing data from interviews were used to calculate the Smith S, a measure of saliency for each list item. Semistructured interviews were examined to detect themes about patient perspectives regarding their acne and its treatment.RESULTS Fifty participants (mean [SD] age, 28 [5.38] years; 24 [48%] White) described acne-related concerns about their appearance that affected their social, professional, and personal lives, with many altering their behavior because of their acne. Depression, anxiety, and social isolation were commonly reported. Participants described successful treatment as having completely clear skin over time or a manageable number of blemishes. Many participants described frustration with finding a dermatologist with whom they were comfortable and with identifying effective treatments for their acne. CONCLUSIONS AND RELEVANCEThe results of this qualitative study suggest that women with acne have strong concerns about appearance and exp...

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METHODS: This multicenter qualitative study took place in the context of the Eliminating Monitor Overuse (EMO) SpO2 study, a cross-sectional study to establish rates of cSpO2 in bronchiolitis. We conducted semistructured interviews, informed by the Consolidated Framework for Implementation Research, with a purposive sample of stakeholders at sites with high and low cSpO2 use rates to identify barriers and facilitators to addressing cSpO2 overuse. Interviews were audio recorded and transcribed. Analyses were conducted using an integrated approach. RESULTS: Participants (n = 56) included EMO study site principal investigators (n = 12), hospital administrators (n = 8), physicians (n = 15), nurses (n = 12), and respiratory therapists (n = 9) from 12 hospitals. Results suggest that leadership buy-in, clear authoritative guidelines for SpO2 use incorporated into electronic order sets, regular education about cSpO2 in bronchiolitis, and visual reminders may be needed to reduce cSpO2 utilization. Parental perceptions and individual clinician comfort affect cSpO2 practice. CONCLUSION: We identified barriers and facilitators to deimplementation of cSpO2 for stable patients with bronchiolitis across children’s hospitals with high- and low-cSpO2 use. Based on these data, future deimplementation efforts should focus on clear protocols for cSpO2, EHR changes, and education for hospital staff on bronchiolitis features and rationale for reducing cSpO2. Journal of Hospital Medicine 2020;15:XXX-XXX. © 2020 Society of Hospital Medicine

OBJECTIVES Clinical event debriefing (CED) can improve patient care and outcomes, but little is known about CED across inpatient settings, and participant experiences have not been well described. In this qualitative study, we sought to characterize and compare staff experiences with CED in 2 hospital units, with a goal of generating recommendations for a hospital-wide debriefing program. METHODS We conducted 32 semistructured interviews with clinical staff who attended a CED in the previous week. We explored experiences with CED, with a focus on barriers and facilitators. We used content analysis with constant comparative coding to understand priorities identified by participants. We used inductive reasoning to develop a set of CED practice recommendations to match participant priorities. RESULTS Three primary themes emerged related to CED barriers and facilitators. (1) Factors affecting attendance: most respondents voiced a need for frontline staff inclusion in CED, but they also cited competing clinical duties and scheduling conflicts as barriers. (2) Factors affecting participant engagement: respondents described factors that influence participant engagement in reflective discussion. They described that the CED leader must cultivate a psychologically safe environment in which participants feel empowered to speak up, free from judgment. (3) Factors affecting learning and systems improvement: respondents emphasized that the CED group should generate a plan for improvement with accountable stakeholders. Collectively, these priorities propose several recommendations for CED practice, including frontline staff inclusion. CONCLUSIONS In this study, we propose recommendations for CED that are derived from first-hand participant experiences. Future study will explore implementation of CED practice recommendations.