Baptist Health, headquartered in Jacksonville, Florida, is a faith-based, non-profit health system comprising six hospitals with 1,168 beds, a cancer center, four satellite emergency departments and more than 200 patient access points of care, including 50 primary care offices located throughout northeast Florida and southeast Georgia. Wolfson Children's Hospital, Baptist Medical Center Jacksonville, Baptist Heart Hospital, Baptist Medical Center Nassau, Baptist Medical Center Beaches, and Baptist Medical Center South]].
The shift from hospital and healthcare leadership to academia is becoming increasingly common among seasoned professionals who seek to extend their impact beyond the clinical and administrative realms. This paper explores the motivations, pathways, challenges and opportunities associated with this career shift. Drawing on the experiences of three healthcare executives who have successfully shifted to academic roles at the University of North Florida (UNF) provides a comprehensive roadmap for practitioners considering a move into academia. It also highlights the unique value that practitioner-scholars bring to health administration education. This shift is not only a career pivot but also a strategic move that allows seasoned professionals to contribute to the academic discourse, influence curriculum development and mentor emerging leaders in health care. As healthcare systems evolve and face unprecedented challenges, the integration of practitioner knowledge into academic settings becomes increasingly vital. Healthcare leaders shifting to academia will encounter a multifaceted journey, exploring personal motivations, institutional pathways and the systemic implications of their move. Understanding the significance of the broader impact on educational quality, student engagement and the alignment between academic programmes and industry needs is crucial for a successful shift. This article is also included in The Business & Management Collection which can be accessed at https://hstalks.com/business/.
Abstract Background and aims Balloon guide catheters (BGC) provide proximal flow arrest during mechanical thrombectomy (MT), potentially improving thrombus retrieval efficiency and reducing distal embolization. However, prospective randomized data comparing BGC versus non-BGC approaches remain limited. We analyzed the impact of BGC use on clinical and angiographic outcomes in the PROST trial. Methods PROST was a multicenter, prospective, randomized trial comparing pRESET versus Solitaire stent retrievers in patients with large vessel occlusion stroke (NCT04102046). In this post-hoc analysis, we compared patients treated with BGC (n=152) versus non-BGC (n=170). The primary outcome was 90-day functional independence (modified Rankin Scale [mRS] 0-2). Secondary outcomes included first-pass effect (FPE; expanded TICI [eTICI] ≥2c), complete reperfusion (eTICI ≥2c), and 90-day mortality. Multivariable logistic regression adjusted for age, sex, baseline NIHSS, comorbidities, IV tPA, and anesthesia type. Results Of 322 patients with BGC data, baseline characteristics were balanced between groups (median age 71vs74 years,p=0.11). BGC use was associated with significantly higher rates of 90-day functional independence (63.2% vs 45.3%; OR2.07, 95% CI1.32-3.24;p=0.002). BGC patients demonstrated superior FPE (51.7%vs36.3%;OR1.87,95%CI1.20-2.93;p=0.007). Mortality at 90 days was significantly lower with BGC (9.2% vs 18.2%;OR 0.45,95%CI0.23-0.89;p=0.024). No difference was observed in symptomatic intracranial hemorrhage or embolization to new territory. After multivariable adjustment, BGC remained independently associated with functional independence (adjusted OR1.74,95%CI1.02-3.06). Conclusions In this post-hoc analysis of the PROST trial, BGC use was associated with significantly improved functional outcomes, higher first-pass and complete reperfusion rates, and reduced mortality compared to non-BGC approaches. Conflict of interest None
Abstract Objective Shunt-dependent hydrocephalus is a common and costly complication of aneurysmal subarachnoid hemorrhage (aSAH), affecting up to 28% of survivors. Existing prediction tools, including the Chronic Hydrocephalus Ensuing from SAH Score (CHESS), have limited discriminative accuracy. We developed the CHECKMATE score, a clinically practical tool to improve prediction of ventriculoperitoneal shunt dependency after aSAH. Methods In this multicenter retrospective cohort of 486 patients with aSAH from Mayo Clinic (January 1, 2006-December 31, 2021), we used multivariable logistic regression and machine learning to identify independent predictors of ventriculoperitoneal shunt placement. The CHECKMATE score was derived from 5 weighted variables: symptomatic hydrocephalus (10 points), intraventricular hemorrhage (5 points), SAH volume greater than 10 mL (3 points), neutrophil-to-lymphocyte ratio greater than 12 (2 points), and 10-year incremental age thresholds starting at older than 60 years (1 point each). Results Of 486 patients (mean age, 56.3 years; 64.6% female), 137 (28.2%) required ventriculoperitoneal shunt placement. The CHECKMATE score achieved an area under the curve of 0.808 (compared to 0.737 for CHESS), with a sensitivity of 0.85, specificity of 0.67, and negative predictive value of 0.92 at the optimal cutoff of 14 points. Conclusions The CHECKMATE score outperforms CHESS for predicting ventriculoperitoneal shunt dependency after aSAH and is easily used at the bedside. Its high negative predictive value helps identify low-risk patients who may benefit from earlier external ventricular drain weaning and shorter hospital stays.
Objectives: Right ventricular failure remains a major cause of perioperative morbidity and early mortality after left ventricular assist device implantation. We evaluated whether a novel and readily available echocardiographic-hemodynamic surrogate of right ventricular pulmonary vascular coupling predicts right ventricular assist device requirement and survival after magnetically levitated centrifugal flow left ventricular assist device. Methods: We performed a multicenter retrospective study of 202 HeartMate 3 recipients with preoperative right ventricular dysfunction. The tricuspid annular plane systolic excursion and pulmonary vascular resistance index ratio was derived. The primary end point was assessing its capacity to prognosticate the right ventricular assist device need in comparison with other established indices of right ventricular dysfunction. Multivariable logistic regression, calibration analysis, bootstrap validation, cross-validation, incremental-value modeling, and sensitivity analyses excluding venoarterial extracorporeal membrane oxygenation and mechanically ventilated patients were performed. Survival was assessed using Kaplan–Meier and Cox analyses. Results: The tricuspid annular plane systolic excursion and pulmonary vascular resistance index ratio demonstrated strong discrimination for right ventricular assist device requirement and outperformed conventional predictors. Bootstrap validation confirmed model stability, and cross-validation demonstrated consistent discrimination. Sensitivity analysis showed that discrimination remained robust after excluding venoarterial extracorporeal membrane oxygenation and mechanically ventilated patients. Multivariable logistic regression showed that the tricuspid annular plane systolic excursion and pulmonary vascular resistance index ratio remained independently associated with overall 1-year survival age, body mass index, chronic kidney disease, and diabetes. Discrimination remained robust after excluding venoarterial extracorporeal membrane oxygenation and venoarterial extracorporeal membrane oxygenation placement before the left ventricular assist device. A tricuspid annular plane systolic excursion and pulmonary vascular resistance index ratio threshold of 0.9 was able to stratify patient survival at 30 days, 100 days, and 1 year after left ventricular assist device placement. Conclusions: The tricuspid annular plane systolic excursion and pulmonary vascular resistance index ratio improves prediction of right ventricular assist device requirement and survival after HeartMate 3 implantation and may enhance perioperative right ventricular risk stratification.
Our study has two objectives: (1) to evaluate the incidence and severity of food retention observed during esophagogastroduodenoscopies (EGDs) in patients with and without history of glucagon-like peptide-1 receptor agonist (GLP-1 RA) use and (2) to create a grading scale to standardize the language regarding food retention. GLP-1 RAs have gained attention for treating obesity and type 2 diabetes (T2DM), largely due to their ability to reduce gastric motility. We aim to evaluate if this reduction leads to increased gastric food retention, raising the risk of aspiration. A retrospective cross-sectional study was performed on patients who underwent an EGD from 2022 to 2024. The chi-square test was used to evaluate associations between categorical variables, including sex, gastroparesis diagnosis, T2DM diagnosis, and the presence of retained gastric contents (categorized by grade). Fisher’s exact test was employed in cases where expected cell counts were less than five. The study consisted of 150 patients, with 73 GLP-1 RA users in the experimental group and 77 non-users in the control group. Most patients in both groups had no significant gastric retention at the time of EGD. When retention grades were grouped into a binary classification (None/A vs. B/C/D), there was no significant association between GLP-1 RA use and gastric retention (p = 0.67). Patients in the experimental group were significantly more likely to have a documented diagnosis of gastroparesis (p < 0.001) and T2DM (p < 0.001) as compared to the control group. Our initial data suggest that GLP-1 RA use does not lead to substantial gastric food retention as observed in EGDs. We propose using this study’s grading scale as the standard for quantifying gastric food retention. By defining stages from no residue to severe obstruction, it enhances study comparisons and procedure planning while promoting a shared understanding among providers.
