Publications by authors named "Shamuel Yagudayev"

3 Publications

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SARS-CoV-2 Seroprevalence Among Healthcare Workers by Job Function and Work Location in a New York Inner-City Hospital.

J Hosp Med 2021 May;16(5):282-289

Department of Family Medicine, Bronx-Care Health System Bronx, NY.

Objective: To describe the seroprevalence and risk for SARS-CoV-2 among healthcare workers (HCWs) by job function and work location following the pandemic's first wave in New York City (NYC).

Methods: A cross-sectional study conducted between May 18 and June 26, 2020, during which HCWs at a large inner-city teaching hospital in NYC received voluntary antibody testing. The main outcome was presence of SARS-CoV-2 antibodies indicating previous infection. Seroprevalence and adjusted odds ratios (aORs) for seropositivity by type and location of work were calculated using logistic regression analyses.

Results: Of 2,749 HCWs tested, 831 tested positive, yielding a crude seroprevalence of 30.2% (95% CI, 29%-32%). Seroprevalence ranged from 11.1% for pharmacy staff to 44.0% for nonclinical HCWs comprised of patient transporters and housekeeping and security staff, with 37.5% for nurses and 20.9% for administrative staff. Compared to administrative staff, aORs (95% CIs) for seropositivity were 2.54 (1.64-3.94) for nurses; 2.51 (1.42-4.43) for nonclinical HCWs; between 1.70 and 1.83 for allied HCWs such as patient care technicians, social workers, registration clerks and therapists; and 0.80 (0.50-1.29) for physicians. Compared to office locations, aORs for the emergency department and inpatient units were 2.27 (1.53-3.37) and 1.48 (1.14-1.92), respectively.

Conclusion: One-third of hospital-based HCWs were seropositive for SARS-CoV-2 by the end of the first wave in NYC. Seroprevalence differed by job function and work location, with the highest estimated risk for nurses and the emergency department, respectively. These findings support current nationwide policy prioritizing HCWs for receipt of newly authorized COVID-19 vaccines.
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May 2021

Tele-transitions of care. A 12-month, parallel-group, superiority randomized controlled trial protocol, evaluating the use of telehealth versus standard transitions of care in the prevention of avoidable hospital readmissions.

Contemp Clin Trials Commun 2018 Dec 17;12:9-16. Epub 2018 Aug 17.

Stony Brook Medicine, Department of Family, Population and Preventive Medicine, Stony Brook, NY, 11794, USA.

Introduction: Comprehensive transitions of care, reduce dangerous hospital readmissions. Telehealth offers promise, however few guidelines aid clinicians in introducing it in a feasible way while addressing the needs of a multi-comorbid population. Physician adoptability remains a significant barrier to the use of Telehealth due to data overload, concerns for disruptive workflows and uncertain practices. The methods proposed aid clinicians in implementing Telehealth training and research with limited resources to reach patients who need clinical surveillance most. This study introduces a new workflow for addressing tele-transitions of care, using risk stratification, remote patient monitoring, and patient-centered virtual visits. We propose a new communication tool which facilitates adoption. We take a clinically meaningful approach in assessing avoidable hospital readmissions, which can lead to further quality improvements and improved patient care.

Methods: This study design is a parallel-group, superiority, randomized controlled trial in which 180 patients are enrolled in the standard of care or Telehealth arms and evaluated for 30-days post hospitalization. The Telehealth group receives daily vitals surveillance with a "teledoc", a senior resident physician, who performs weekly virtual visits. The endpoint is 30-day hospital readmission. Patient data is collected on hospital utilization, patient self-management, physician and patient experience.

Discussion: Our protocol introduces a novel study design with existing clinical trainees, to provide comprehensive tele-transitions of care to reduce avoidable readmissions.
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December 2018

Institutions with accredited residencies in New York State with an interest in developing new residencies or expanding existing ones.

Acad Med 2013 Sep;88(9):1287-92

Stony Brook University, Stony Brook, NY 11794-8036, USA.

Purpose: In view of the looming physician shortage, especially in primary care specialties, there have been calls for increasing graduate medical education (GME). However, the capacity for increases of GME in institutions accredited by the Accreditation Council for Graduate Medical Education (ACGME) has not been determined.

Method: In 2009, the authors surveyed the 48 designated institutional officials supervising ACGME-accredited residencies in New York State that were eligible for their study, to determine interest in and capacity for development of new core residencies and expansion of existing ones if additional funds were made available at current Medicare rates.

Results: Thirty-six (75%) responded; 39% would add new programs and 47% would expand current programs with additional funding. The major interest in adding new programs was in emergency medicine (35%). Notably, only 11% would add family medicine. The major interest in program expansion was internal medicine (48%), urology (42%), diagnostic radiology (35%), obstetrics-gynecology (26%), and emergency medicine (25%).

Conclusions: Fewer than 50% of current training institutions are interested in or have the capacity for expansion of core residencies. The interest in establishing or expanding primary care is especially problematic. Because 70% of internal medicine residents become subspecialists, additional funds for GME at current rates would largely encourage the training of additional hospital-based and hospital-intensive specialists, with little impact on those who would practice adult primary care medicine. Significantly increasing the physician training for adult primary care medicine will require more substantial institutional incentives.
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September 2013