Jonathan Anh Quan Duong

All Publications

• Completeness and quality of text paging for subspecialty consult requests. Postgraduate medical journal Chu, C. D., Tuot, D. S., Harrison, J. D., Duong, J., Luxenberg, A., Khanna, R. R. 2021; 97 (1150): 511-514

  Abstract

  It is unclear whether previously developed frameworks for effective consultation apply to requests initiated by alphanumeric text page. We assessed a random sample of 210 text paged consult requests for communication of previously described 'essential elements' for effective consultation: reason for consult, level of urgency and requester contact information. Overall page quality was evaluated on a 5-point Likert scale. Over 90% of text paged consult requests included contact information and reason for consult; 14% indicated level of urgency. In ordinal logistic regression, reason for consult was most strongly associated with quality (OR 22.4; 95% CI 8.1 to 61.7), followed by callback number (OR 6.2; 95% CI 0.8 to 49.5), caller's name (OR 5.0; 95% CI 1.9 to 13.1) and level of urgency (OR 3.3; 95% CI 1.6 to 6.7). Results suggest that text paged consult requests often include most informational elements, and that urgency, often missing, may not be as 'essential' for text pages as it was once thought to be.

  View details for DOI 10.1136/postgradmedj-2020-137624

  View details for PubMedID 32820085

  View details for PubMedCentralID PMC7895858

• Patient and Family Advisory Councils for Research: Recruiting and Supporting Members From Diverse and Hard-to-Reach Communities. The Journal of nursing administration Harrison, J. D., Anderson, W. G., Fagan, M., Robinson, E., Schnipper, J., Symczak, G., Carnie, M. B., Hanson, C., Banta, J., Chen, S., Duong, J., Wong, C., Auerbach, A. D. 2019; 49 (10): 473-479

  Abstract

  To describe strategies to recruit and support members from hard-to-reach groups on research-focused Patient and Family Advisory Councils (PFACs).Ensuring diverse representation of members of research PFACs is challenging, and few studies have given attention to addressing this problem.A qualitative study was conducted using 8 focus groups and 19 interviews with 80 PFAC members and leaders, hospital leaders, and researchers.Recruitment recommendations were: 1) utilizing existing networks; 2) going out to the community; 3) accessing outpatient clinics; and 4) using social media. Strategies to support inclusion were: 1) culturally appropriate communication methods; 2) building a sense of community between PFAC members; 3) equalizing roles between community members/leaders; 4) having a diverse PFAC leadership team; and 5) setting transparent expectations for PFAC membership.Increasing the diversity of research PFACs is a priority, and it is important to determine how best to engage groups that have been traditionally underrepresented.

  View details for DOI 10.1097/NNA.0000000000000790

  View details for PubMedID 31490796

  View details for PubMedCentralID PMC10985779

• Patient and Family Advisory Councils (PFACs): Identifying Challenges and Solutions to Support Engagement in Research. The patient Harrison, J. D., Anderson, W. G., Fagan, M., Robinson, E., Schnipper, J., Symczak, G., Hanson, C., Carnie, M. B., Banta, J., Chen, S., Duong, J., Wong, C., Auerbach, A. D. 2018; 11 (4): 413-423

  Abstract

  The aim was to describe barriers to patient and family advisory council (PFAC) member engagement in research and strategies to support engagement in this context.We formed a study team comprising patient advisors, researchers, physicians, and nurses. We then undertook a qualitative study using focus groups and interviews. We invited PFAC members, PFAC leaders, hospital leaders, and researchers from nine academic medical centers that are part of a hospital medicine research network to participate. All participants were asked a standard set of questions exploring the study question. We used content analysis to analyze data.Eighty PFAC members and other stakeholders (45 patient/caregiver members of PFACs, 12 PFAC leaders, 12 hospital leaders, 11 researchers) participated in eight focus and 19 individual interviews. We identified ten barriers to PFAC member engagement in research. Codes were organized into three categories: (1) individual PFAC member reluctance; (2) lack of skills and training; and (3) problems connecting with the right person at the right time. We identified ten strategies to support engagement. These were organized into four categories: (1) creating an environment where the PFAC members are making a genuine and unique contribution; (2) building community between PFAC members and researchers; (3) best practice activities for researchers to facilitate engagement; and (4) tools and training.Barriers to engaging PFAC members in research include patients' negative perceptions of research and researchers' lack of training. Building community between PFAC members and researchers is a foundation for partnerships. There are shared training opportunities for PFAC members and researchers to build skills about research and research engagement.

  View details for DOI 10.1007/s40271-018-0298-4

  View details for PubMedID 29392529

  View details for PubMedCentralID PMC11034744

• Exploring Physician Perspectives of Residency Holdover Handoffs: A Qualitative Study to Understand an Increasingly Important Type of Handoff. Journal of general internal medicine Duong, J. A., Jensen, T. P., Morduchowicz, S., Mourad, M., Harrison, J. D., Ranji, S. R. 2017; 32 (6): 654-659

  Abstract

  The term "holdover admissions" refers to patients admitted by an overnight physician and whose care is then transferred to a new primary team the next morning. Descriptions of the holdover process in internal medicine are sparse.To identify important factors affecting the quality of holdover handoffs at an internal medicine (IM) residency program and to compare them to previously identified factors for other handoffs.We undertook a qualitative study using structured focus groups and interviews. We analyzed data using qualitative content analysis.IM residents, IM program directors, and hospitalists at a large academic medical center.A nine-question open-ended interview guide.We identified 13 factors describing holdover handoffs. Five factors-physical space, standardization, task accountability, closed-loop verification, and resilience-were similar to those described in prior handoff literature in other specialties. Eight factors were new concepts that may uniquely affect the quality of the holdover handoff in IM. These included electronic health record access, redundancy, unwritten thoughts, different clinician needs, diagnostic uncertainty, anchoring, teaching, and feedback. These factors were organized into five overarching themes: physical environment, information transfer, responsibility, clinical reasoning, and education.The holdover handoff in IM is complex and has unique considerations for achieving high quality. Further exploration of safe, efficient, and educational holdover handoff practices is necessary.

  View details for DOI 10.1007/s11606-017-4009-y

  View details for PubMedID 28194689

  View details for PubMedCentralID PMC5442018

• It All Just Clicks: Development of an Inpatient E-Consult Program. Journal of hospital medicine Najafi, N., Harrison, J. D., Duong, J., Greenberg, A., Cheng, H. Q. 2017; 12 (5): 332-334

  Abstract

  Although the use of electronic consultations (e-consults) in the outpatient setting is commonplace, there is little evidence of their use in the inpatient setting. Often, the only choice hospitalists have is between requesting a time-consuming in-person consultation or requesting an informal, undocumented "curbside" consultation. For a new, remote hospital in our healthcare system, we developed an e-consult protocol that can be used to address simple consultation questions. In the first year of the program, 143 e-consults occurred; the top 5 consultants were infectious disease, hematology, endocrinology, nephrology, and cardiology. Over the first 4 months, no safety issues were identified in chart review audits; to date, no safety issues have been identified through the hospital's incident reporting system. In surveys, hospitalists were universally pleased with the quality of e-consult recommendations, though only 43% of consultantsagreed. With appropriate care for patient selection, e-consults can be used to safely and efficiently provide subspecialty expertise to a remote inpatient site Journal of Hospital Medicine 2017;12:332-334.

  View details for DOI 10.12788/jhm.2740

  View details for PubMedID 28459902

• Effect of insulin versus triple oral therapy on the progression of hepatic steatosis in type 2 diabetes. Journal of investigative medicine : the official publication of the American Federation for Clinical Research Lingvay, I., Roe, E. D., Duong, J., Leonard, D., Szczepaniak, L. S. 2012; 60 (7): 1059-63

  Abstract

  Hyperinsulinemia has been associated with hepatic fat deposition and ensuing insulin resistance. It is unknown if treatment with exogenous insulin in patients with type 2 diabetes, who are most prone to hepatic fat accumulation, would promote the occurrence or worsening of nonalcoholic fatty liver disease.Patients with treatment-naive type 2 diabetes (N = 16) were treated with insulin and metformin for a 3-month lead-in period, then assigned triple oral therapy (metformin, glyburide, and pioglitazone) or continued treatment with insulin and metformin. Hepatic triglyceride content (HTC)-measured by magnetic resonance spectroscopy, serum lipids, glucose, liver function tests, and inflammatory and thrombotic biomarkers were followed for a median of 31 months.The 45% decline in HTC during the lead-in period persisted through the follow-up period with no difference between treatment groups at the end of the study (5.26 ± 4.21% in the triple oral therapy vs 7.47 ± 7.40% for insulin/metformin), whereas glycemic control was comparable.Improvements in HTC with initial insulin/metformin therapy persisted through the median 31-month follow-up period regardless of the treatment. More importantly, insulin-based treatment did not appear to promote or worsen nonalcoholic fatty liver disease.

  View details for DOI 10.2310/JIM.0b013e3182621c5f

  View details for PubMedID 22801247

  View details for PubMedCentralID PMC3448864