Mia Lei Karamatsu

All Publications

• From Why to How in Physician Well-Being: Aligning Strategies for Sustainable Cultural Change in Healthcare. Rhode Island medical journal (2013) Alvarez, A., Winkel, M., Karamatsu, M. L. 2025; 108 (3): 11-15

  Abstract

  The evolution from the Triple Aim to the Quintuple Aim has highlighted physician well-being as crucial for healthcare delivery. While evidence- based interventions exist, implementing sustainable well- being initiatives remains challenging for healthcare organizations.This report demonstrates how three established business frameworks - McKinsey 7S Framework, Kotter's 8-Step Change Model, and PESTEL analysis - can be adapted to implement physician well-being initiatives in healthcare settings.These frameworks analyzed three initiatives: promoting break-taking behaviors (McKinsey 7S), transitioning from a sick-call to a back-up call system (Kotter's model), and updating Work-Family-Career Guidelines (PESTEL). Each framework provided unique insights: 7S enabled systematic organizational alignment, Kotter's model facilitated change management, and PESTEL assessed external factors influencing implementation.Adapting business frameworks to healthcare settings provides structured approaches for implementing physician well-being initiatives, demonstrating how cross-sector tools can advance the Quintuple Aim while addressing systemic drivers of burnout.

  View details for PubMedID 40009094

• Changes in community-associated methicillin-resistant Staphylococcus aureus skin and soft tissue infections presenting to the pediatric emergency department: comparing 2003 to 2008. Pediatric emergency care Karamatsu, M. L., Thorp, A. W., Brown, L. 2012; 28 (2): 131-5

  Abstract

  This study aimed to compare the differences in the type and location of skin infections, organisms cultured, and antibiotic resistance patterns presenting to the same pediatric emergency department from 2003 to 2008 with specific focus on community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections.We performed a retrospective chart review of children younger than 18 years who presented to the pediatric emergency department with a skin or soft tissue infection from January 1 to December 31, 2008, and compared these data to a similar data set collected at the same institution from January 1 to December 31, 2003.From 2003 to 2008, the proportion of abscesses among all skin or soft tissue infections increased from 14% (95% confidence interval [CI], 8.4%-21.2%) to 65% (95% CI, 58.4%-70.6%). Cultures positive for MRSA increased from 21% (95% CI, 14.3%-29.0%) in 2003 to 42% (95% CI, 35.2%-47.8%) in 2008 (z score = -3.98, P < 0.001). Similar to 2003, all MRSA culture-positive abscesses were sensitive to trimethoprim-sulfamethoxazole and vancomycin in 2008. The most common anatomic location for MRSA abscesses in 2003 and 2008 was the buttocks, with a wider variation of anatomic sites in 2008 to include head/neck, trunk, and extremities.The prevalence of CA-MRSA skin infections, specifically abscesses, has significantly increased at our institution from 2003 to 2008. The antibiotic resistance patterns have not significantly changed. The most common anatomic location for CA-MRSA abscesses continues to be the buttocks, but more children are presenting with multiple abscesses in a wider variety of anatomic locations.

  View details for DOI 10.1097/PEC.0b013e318243fa36

  View details for PubMedID 22270497

• Inhibition of intra-abdominal adhesions: a comparison of hemaseel APR and cryoprecipitate fibrin glue. Journal of investigative surgery : the official journal of the Academy of Surgical Research Meek, K., de Virgilio, C., Murrell, Z., Karamatsu, M., Stabile, B., Amin, S., Sandoval, M., French, S., Pierre, K. 2001; 14 (4): 227-33

  Abstract

  Our previous studies demonstrated fibrin glue (FG) prepared from cryoprecipitate (cryo) inhibits intra-abdominal adhesions in rats. A new FG, Hemaseel APR, is Food and Drug Administration (FDA) approved for hemostasis during cardiac surgery and splenic trauma. This study was undertaken to determine if Hemaseel FG prevents intra-abdominal adhesions, and to compare it to cryo FG. Forty-five rats underwent laparotomy. Bilateral peritoneal-muscular defects were created. Polypropylene mesh was sewn into each defect with a running silk suture. The bowel was abraded with gauze. The rats were then randomized to mesh covered with Hemaseel FG, cryo FG, or control. On postoperative day 7, the severity of adhesions were graded by percentage of mesh covered by adhesion (0-100%) and degree of adhesion (0-3). The mean percentage of mesh covered by adhesion was 9% for Hemaseel FG, 43% for cryo FG (p = .005), and 65% for the controls (p < .0001). The mean density adhesion score was 0.5 for Hemaseel FG, 1.2 for cryo FG (p = .04), and 2.1 for the controls (p < .0001). In the Hemaseel FG group, 77% of patches had no adhesions, compared with 37% in the cryo FG group (p = .004) and 13% in the controls (p < .0001). Thus, Hemaseel FG significantly decreases intra-abdominal adhesions, and is more effective than cryo FG.

  View details for DOI 10.1080/089419301750420269

  View details for PubMedID 11680533