Browsing by Author "Sawin, Gregory"

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    Glucose control in hospitalized patients.
    (American family physician, 2010-05) Sawin, Gregory; Shaughnessy, Allen F
    Evidence indicates that hospitalized patients with hyperglycemia do not benefit from tight blood glucose control. Maintaining a blood glucose level of less than 180 mg per dL (9.99 mmol per L) will minimize symptoms of hyperglycemia and hypoglycemia without adversely affecting patient-oriented health outcomes. In the absence of modifying factors, physicians should continue patients' at-home diabetes mellitus medications and randomly check glucose levels once daily. Sulfonylureas should be withheld to avoid hypoglycemia in patients with limited caloric intake. Patients with cardiovascular conditions may benefit from temporarily stopping treatment with thiazolidinediones to avoid precipitating heart failure. Metformin should be temporarily withheld in patients who have worsening renal function or who will undergo an imaging study that uses contrast. When patients need to be treated with insulin in the short term, using a long-acting basal insulin combined with a short-acting insulin before meals (with the goal of keeping blood glucose less than 180 mg per dL) better approximates normal physiology and uses fewer nursing resources than sliding-scale insulin approaches. Most studies have found that infusion with glucose, insulin, and potassium does not improve mortality in patients with acute myocardial infarction. Patients admitted with acute myocardial infarction should have moderate control of blood glucose using home regimens or basal insulin with correctional doses.
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    Partnerships to Care for Our Patients and Communities During COVID-19
    (The Journal of the American Board of Family Medicine, 2021-09) Viera, Anthony J; Barnett, Jacqueline; Case, Matthew; Epling, Carol; Halstater, Brian; Lyn, Michelle; Martinez-Bianchi, Viviana; Ragsdale, John; Railey, Kenyon; Said, Kristen; Sawin, Gregory; Spotts, Hunter; Vaughn, John; Weigle, Nancy; Michener, J Lloyd
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    Perceived Benefits of Training Clinicians in Community Engagement for a Leadership Development Program.
    (Family medicine, 2022-02) Simpson, Courtney; Silberberg, Mina; Hibbard, Susan T; Lyn, Michelle J; Sawin, Gregory

    Background and objectives

    Community engagement (CE), including community-engaged research, is a critical tool for improving the health of patients and communities, but is not taught in most medical curricula, and is even rarer in leadership training for practicing clinicians. With the growth of value-based care and increasing concern for health equity, we need to turn our attention to the benefits of working with communities to improve health and health care. The objective of this brief report is to increase understanding of the perceived benefits of CE training for primary care clinicians, specifically those already working.

    Methods

    We assessed perceived benefits of CE training for primary care clinicians participating in health care transformation leadership training through analysis of learner reflection papers.

    Results

    Clinicians (n=12) reported transformational learning and critical shifts of perspective. Not only did they come to value and understand CE, but the training changed their perception of their roles as clinicians and leaders.

    Conclusions

    Educating primary care clinicians in CE as a foundational principle can orient them to the criticality of stakeholder engagement for daily practice, practice transformation, and population health improvement, and provides them with a new understanding of their roles as clinicians and leaders.
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    Primary Care Transformation.
    (Primary care, 2019-12) Sawin, Gregory; O'Connor, Nicole
    Primary care transformation will usher in a new era of advanced team-based care with extensive roles beyond the physician to build authentic healing relationships with patients. Smart technology will support these relationships, empower and engage patients, and build confidence that their health care team will take excellent care of them. Investments need to shift from catastrophic hospital-based care to proactive prevention and wellness, pushing us to think of health beyond health care. Systems need to build a culture of continuous improvement, supported by data-driven improvement science, and keep a sharp focus on the patient experience of care.
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    Scoping Review of Restorative Justice in Academics and Medicine: A Powerful Tool for Justice Equity Diversity and Inclusion
    (Health Equity, 2023-09-01) Sawin, Gregory; Klasson, Christopher L; Kaplan, Samantha; Larson Sawin, Jennifer; Brown, Ann; Thadaney Israni, Sonoo; Schonberg, Jessica; Gregory, Ada