LEAP: Lead, Excel, Achieve, Perform: A Report on the UHC Annual Conference 2011

Cindy White; Julie Cerese; Jake Groenewold; Jim Collins; Susan Dentzer; Timothy H. Dellit; Elizabeth A. McNamara; John B. Lynch; Cathy Rodgers Ward; Edith Matesic; J. Thomas Rosenthal; David J. Cook; Jeffrey E. Thompson; Anantha Kollengode; Thoralf M. Sundt; Catherine Shipp; Phillip J. DeChristopher; Steven B. Edelstein; Jason Kang; Helen Krontiras; Martin J. Heslin; Bettina Berman; William S. Cobb; Bruce A. Snyder; Cindy B. Coffey; Spence M. Taylor; Eugene M. Langan; Kathy Pawlicki; Shane Cerone; Sam Flanders; Rocco J. Perla; Karen Annis; Samuel F. Hohmann; Jodie Black; George V. Russell; Michael Baumann; Gene Beyt; Rich Graffis; Jody Hoffer Gittell; Tom Hartley; Tracy Spitzer; Suzi Tolliver; Cindy Angiulo; Donna Henderson; Katy Folk-Way; Arjun Rao; Joseph Hopkins; Kim Pardini-Keily; Barton L. Sachs; Ellen F. Robinson; Anneliese M. Schleyer; Kevin Middleton; Ken Jarman; Mark Taylor; Mark C. Zaros; Joseph Cuschieri; J. Richard Goss; Glenn K. Geeting; Christopher J. DeFlitch; Kerri Anne Scanlon; Karen Nelson; Sheldon Newman; Kelly Cifu-Tursellino; Susanne Schultz; Bela Patel; Ruth Siska; Tammy Campos; Pratik Doshi; Brandy McKelvy; Khalid Almoosa; Rex Mathew; Andrew Storer; Linda Davis-Moon; Michael Carey; Laura Kneale; Jonathan Stegner; Jenny Lanier; Anika T. Bell-Gray; Kathy Boyle; Pat Tillapaugh; Jeff Pelot; Coletta Danneker; Charles Willson; Gerald Strope; Ronald Perkin; Judy Schueler; Linda May; Tom Gilmore; Joshua Medow; Carin Bouchard; Michael Sheinberg; Francis A. Fullam; Dale Shaller; Gladys J. Epting; Brenda Ohta; Donna L. Kaye; Jeff Strickler; C. Scott Hultman; Lilian Chukwuma; Zachary Mufson; Nathan Levitan; Eric Bieber; Cathy Koppelman; Susan Madden; Dennis Kaldenberg; Richard Siegrist; Madeline Bell; Anna Spraycar; Colleen Swartz; Paul DePriest; Martha J. Radford; Lynn E. Webb; Maureen Slade; Nita Kulkarni; Cahren Cruz; John Brumsted; Randall Messier; Melissa Holman; Carolyn L. Sanders; Lorna Prutzman

doi:10.1177/1062860611433649

LEAP: Lead, Excel, Achieve, Perform: A Report on the UHC Annual Conference 2011

Cindy White, Julie Cerese, Jake Groenewold, Jim Collins, Susan Dentzer, Timothy H. Dellit, Elizabeth A. McNamara, John B. Lynch, Cathy Rodgers Ward, Edith Matesic, J. Thomas Rosenthal, David J. Cook, Jeffrey E. Thompson, Anantha Kollengode, Thoralf M. Sundt, Catherine Shipp, Phillip J. DeChristopher, Steven B. Edelstein, Jason Kang, Helen KrontirasMartin J. Heslin, Bettina Berman, William S. Cobb, Bruce A. Snyder, Cindy B. Coffey, Spence M. Taylor, Eugene M. Langan, Kathy Pawlicki, Shane Cerone, Sam Flanders, Rocco J. Perla, Karen Annis, Samuel F. Hohmann, Jodie Black, George V. Russell, Michael Baumann, Gene Beyt, Rich Graffis, Jody Hoffer Gittell, Tom Hartley, Tracy Spitzer, Suzi Tolliver, Cindy Angiulo, Donna Henderson, Katy Folk-Way, Arjun Rao, Joseph Hopkins, Kim Pardini-Keily, Barton L. Sachs, Ellen F. Robinson, Anneliese M. Schleyer, Kevin Middleton, Ken Jarman, Mark Taylor, Mark C. Zaros, Joseph Cuschieri, J. Richard Goss, Glenn K. Geeting, Christopher J. DeFlitch, Kerri Anne Scanlon, Karen Nelson, Sheldon Newman, Kelly Cifu-Tursellino, Susanne Schultz, Bela Patel, Ruth Siska, Tammy Campos, Pratik Doshi, Brandy McKelvy, Khalid Almoosa, Rex Mathew, Andrew Storer, Linda Davis-Moon, Michael Carey, Laura Kneale, Jonathan Stegner, Jenny Lanier, Anika T. Bell-Gray, Kathy Boyle, Pat Tillapaugh, Jeff Pelot, Coletta Danneker, Charles Willson, Gerald Strope, Ronald Perkin, Judy Schueler, Linda May, Tom Gilmore, Joshua Medow, Carin Bouchard, Michael Sheinberg, Francis A. Fullam, Dale Shaller, Gladys J. Epting, Brenda Ohta, Donna L. Kaye, Jeff Strickler, C. Scott Hultman, Lilian Chukwuma, Zachary Mufson, Nathan Levitan, Eric Bieber, Cathy Koppelman, Susan Madden, Dennis Kaldenberg, Richard Siegrist, Madeline Bell, Anna Spraycar, Colleen Swartz, Paul DePriest, Martha J. Radford, Lynn E. Webb, Maureen Slade, Nita Kulkarni, Cahren Cruz, John Brumsted, Randall Messier, Melissa Holman, Carolyn L. Sanders, Lorna Prutzman

Department of Emergency Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Background. Ventilator-associated pneumonia (VAP) has been a challenge for our burn, trauma, and neurosurgical population because of their underlying injuries, prolonged mechanical ventilation, need for spinal clearance prior to head-of-bed elevation, and risk for multidrug-resistant organisms, resulting in a total of 266 cases of VAPs in 2007. Intervention detail. We developed a multidisciplinary team, involving critical care, infection control, antimicrobial stewardship, clinical education, and information technology (IT), focused on prevention, diagnosis, and management with detailed surveillance of VAP cases and rates, microbiology, and antimicrobial resistance. Each VAP case is reviewed at the unit level with the multidisciplinary care team for VAP risk factors as well as bundle compliance. IT has facilitated electronic surveillance of bundle compliance in all ventilated patients as well as an automated daily list of all patients on spine precautions and time to head of bed >30°. Results. Improved antimicrobial use along with infection control initiatives such as hand hygiene, active surveillance cultures of all intensive care unit patients for MRSA and carbapenem-resistant Acinetobacter, use of contact precautions, daily chlorhexidine baths, and improved environmental cleaning with monthly audits have led to dramatic reductions in VAP caused by MRSA and Acinetobacter. Changes in local microbiology resulted in modification of empirical antimicrobial therapy and reduced use of imipenem for late-onset VAP (mechanical ventilation or hospitalization >5 days). In addition, active surveillance cultures have a 99% negative predictive value for the development of MRSA VAP, allowing more judicial use of empirical vancomycin. More appropriate use of vancomycin and imipenem are estimated to reduce pharmacy costs by $130 000 per year. These measures have led to a sustained reduction in the number of VAP cases from 266 in 2007 to 98 in 2010, reflecting a 63% reduction in the absolute number of VAP cases, and our management has been improved through appropriate antimicrobial therapy based on local microbiology and resistance patterns.

Original language	English (US)
Pages (from-to)	S3-S33
Journal	American Journal of Medical Quality
Volume	27
Issue number	1 SUPPL.
DOIs	https://doi.org/10.1177/1062860611433649
State	Published - 2012

All Science Journal Classification (ASJC) codes

General Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1177/1062860611433649

Cite this

White, C., Cerese, J., Groenewold, J., Collins, J., Dentzer, S., Dellit, T. H., McNamara, E. A., Lynch, J. B., Ward, C. R., Matesic, E., Rosenthal, J. T., Cook, D. J., Thompson, J. E., Kollengode, A., Sundt, T. M., Shipp, C., DeChristopher, P. J., Edelstein, S. B., Kang, J., ... Prutzman, L. (2012). LEAP: Lead, Excel, Achieve, Perform: A Report on the UHC Annual Conference 2011. American Journal of Medical Quality, 27(1 SUPPL.), S3-S33. https://doi.org/10.1177/1062860611433649

@article{482f611d4b614e90a93bcb9e40e7d247,

title = "LEAP: Lead, Excel, Achieve, Perform: A Report on the UHC Annual Conference 2011",

abstract = "Background. Ventilator-associated pneumonia (VAP) has been a challenge for our burn, trauma, and neurosurgical population because of their underlying injuries, prolonged mechanical ventilation, need for spinal clearance prior to head-of-bed elevation, and risk for multidrug-resistant organisms, resulting in a total of 266 cases of VAPs in 2007. Intervention detail. We developed a multidisciplinary team, involving critical care, infection control, antimicrobial stewardship, clinical education, and information technology (IT), focused on prevention, diagnosis, and management with detailed surveillance of VAP cases and rates, microbiology, and antimicrobial resistance. Each VAP case is reviewed at the unit level with the multidisciplinary care team for VAP risk factors as well as bundle compliance. IT has facilitated electronic surveillance of bundle compliance in all ventilated patients as well as an automated daily list of all patients on spine precautions and time to head of bed >30°. Results. Improved antimicrobial use along with infection control initiatives such as hand hygiene, active surveillance cultures of all intensive care unit patients for MRSA and carbapenem-resistant Acinetobacter, use of contact precautions, daily chlorhexidine baths, and improved environmental cleaning with monthly audits have led to dramatic reductions in VAP caused by MRSA and Acinetobacter. Changes in local microbiology resulted in modification of empirical antimicrobial therapy and reduced use of imipenem for late-onset VAP (mechanical ventilation or hospitalization >5 days). In addition, active surveillance cultures have a 99% negative predictive value for the development of MRSA VAP, allowing more judicial use of empirical vancomycin. More appropriate use of vancomycin and imipenem are estimated to reduce pharmacy costs by $130 000 per year. These measures have led to a sustained reduction in the number of VAP cases from 266 in 2007 to 98 in 2010, reflecting a 63% reduction in the absolute number of VAP cases, and our management has been improved through appropriate antimicrobial therapy based on local microbiology and resistance patterns.",

author = "Cindy White and Julie Cerese and Jake Groenewold and Jim Collins and Susan Dentzer and Dellit, {Timothy H.} and McNamara, {Elizabeth A.} and Lynch, {John B.} and Ward, {Cathy Rodgers} and Edith Matesic and Rosenthal, {J. Thomas} and Cook, {David J.} and Thompson, {Jeffrey E.} and Anantha Kollengode and Sundt, {Thoralf M.} and Catherine Shipp and DeChristopher, {Phillip J.} and Edelstein, {Steven B.} and Jason Kang and Helen Krontiras and Heslin, {Martin J.} and Bettina Berman and Cobb, {William S.} and Snyder, {Bruce A.} and Coffey, {Cindy B.} and Taylor, {Spence M.} and Langan, {Eugene M.} and Kathy Pawlicki and Shane Cerone and Sam Flanders and Perla, {Rocco J.} and Karen Annis and Hohmann, {Samuel F.} and Jodie Black and Russell, {George V.} and Michael Baumann and Gene Beyt and Rich Graffis and Gittell, {Jody Hoffer} and Tom Hartley and Tracy Spitzer and Suzi Tolliver and Cindy Angiulo and Donna Henderson and Katy Folk-Way and Arjun Rao and Joseph Hopkins and Kim Pardini-Keily and Sachs, {Barton L.} and Robinson, {Ellen F.} and Schleyer, {Anneliese M.} and Kevin Middleton and Ken Jarman and Mark Taylor and Zaros, {Mark C.} and Joseph Cuschieri and Goss, {J. Richard} and Geeting, {Glenn K.} and DeFlitch, {Christopher J.} and Scanlon, {Kerri Anne} and Karen Nelson and Sheldon Newman and Kelly Cifu-Tursellino and Susanne Schultz and Bela Patel and Ruth Siska and Tammy Campos and Pratik Doshi and Brandy McKelvy and Khalid Almoosa and Rex Mathew and Andrew Storer and Linda Davis-Moon and Michael Carey and Laura Kneale and Jonathan Stegner and Jenny Lanier and Bell-Gray, {Anika T.} and Kathy Boyle and Pat Tillapaugh and Jeff Pelot and Coletta Danneker and Charles Willson and Gerald Strope and Ronald Perkin and Judy Schueler and Linda May and Tom Gilmore and Joshua Medow and Carin Bouchard and Michael Sheinberg and Fullam, {Francis A.} and Dale Shaller and Epting, {Gladys J.} and Brenda Ohta and Kaye, {Donna L.} and Jeff Strickler and Hultman, {C. Scott} and Lilian Chukwuma and Zachary Mufson and Nathan Levitan and Eric Bieber and Cathy Koppelman and Susan Madden and Dennis Kaldenberg and Richard Siegrist and Madeline Bell and Anna Spraycar and Colleen Swartz and Paul DePriest and Radford, {Martha J.} and Webb, {Lynn E.} and Maureen Slade and Nita Kulkarni and Cahren Cruz and John Brumsted and Randall Messier and Melissa Holman and Sanders, {Carolyn L.} and Lorna Prutzman",

note = "Funding Information: Pathology, diology and neapolis, Minnesota and the St. Paul and the University of supported by The Saint Paul Foundation, Minneapolis and The Mayo Foundation, Rochester. Dr. Brooks S. Edwards is supported by Institutes of Health, Bethesda, Manuscript received February June 29, 1987, accepted July 14, 1987.",

year = "2012",

doi = "10.1177/1062860611433649",

language = "English (US)",

volume = "27",

pages = "S3--S33",

journal = "American Journal of Medical Quality",

issn = "1062-8606",

publisher = "Wolters Kluwer Health",

number = "1 SUPPL.",

}

White, C, Cerese, J, Groenewold, J, Collins, J, Dentzer, S, Dellit, TH, McNamara, EA, Lynch, JB, Ward, CR, Matesic, E, Rosenthal, JT, Cook, DJ, Thompson, JE, Kollengode, A, Sundt, TM, Shipp, C, DeChristopher, PJ, Edelstein, SB, Kang, J, Krontiras, H, Heslin, MJ, Berman, B, Cobb, WS, Snyder, BA, Coffey, CB, Taylor, SM, Langan, EM, Pawlicki, K, Cerone, S, Flanders, S, Perla, RJ, Annis, K, Hohmann, SF, Black, J, Russell, GV, Baumann, M, Beyt, G, Graffis, R, Gittell, JH, Hartley, T, Spitzer, T, Tolliver, S, Angiulo, C, Henderson, D, Folk-Way, K, Rao, A, Hopkins, J, Pardini-Keily, K, Sachs, BL, Robinson, EF, Schleyer, AM, Middleton, K, Jarman, K, Taylor, M, Zaros, MC, Cuschieri, J, Goss, JR, Geeting, GK, DeFlitch, CJ, Scanlon, KA, Nelson, K, Newman, S, Cifu-Tursellino, K, Schultz, S, Patel, B, Siska, R, Campos, T, Doshi, P, McKelvy, B, Almoosa, K, Mathew, R, Storer, A, Davis-Moon, L, Carey, M, Kneale, L, Stegner, J, Lanier, J, Bell-Gray, AT, Boyle, K, Tillapaugh, P, Pelot, J, Danneker, C, Willson, C, Strope, G, Perkin, R, Schueler, J, May, L, Gilmore, T, Medow, J, Bouchard, C, Sheinberg, M, Fullam, FA, Shaller, D, Epting, GJ, Ohta, B, Kaye, DL, Strickler, J, Hultman, CS, Chukwuma, L, Mufson, Z, Levitan, N, Bieber, E, Koppelman, C, Madden, S, Kaldenberg, D, Siegrist, R, Bell, M, Spraycar, A, Swartz, C, DePriest, P, Radford, MJ, Webb, LE, Slade, M, Kulkarni, N, Cruz, C, Brumsted, J, Messier, R, Holman, M, Sanders, CL & Prutzman, L 2012, 'LEAP: Lead, Excel, Achieve, Perform: A Report on the UHC Annual Conference 2011', American Journal of Medical Quality, vol. 27, no. 1 SUPPL., pp. S3-S33. https://doi.org/10.1177/1062860611433649

TY - JOUR

T1 - LEAP

T2 - Lead, Excel, Achieve, Perform: A Report on the UHC Annual Conference 2011

AU - White, Cindy

AU - Cerese, Julie

AU - Groenewold, Jake

AU - Collins, Jim

AU - Dentzer, Susan

AU - Dellit, Timothy H.

AU - McNamara, Elizabeth A.

AU - Lynch, John B.

AU - Ward, Cathy Rodgers

AU - Matesic, Edith

AU - Rosenthal, J. Thomas

AU - Cook, David J.

AU - Thompson, Jeffrey E.

AU - Kollengode, Anantha

AU - Sundt, Thoralf M.

AU - Shipp, Catherine

AU - DeChristopher, Phillip J.

AU - Edelstein, Steven B.

AU - Kang, Jason

AU - Krontiras, Helen

AU - Heslin, Martin J.

AU - Berman, Bettina

AU - Cobb, William S.

AU - Snyder, Bruce A.

AU - Coffey, Cindy B.

AU - Taylor, Spence M.

AU - Langan, Eugene M.

AU - Pawlicki, Kathy

AU - Cerone, Shane

AU - Flanders, Sam

AU - Perla, Rocco J.

AU - Annis, Karen

AU - Hohmann, Samuel F.

AU - Black, Jodie

AU - Russell, George V.

AU - Baumann, Michael

AU - Beyt, Gene

AU - Graffis, Rich

AU - Gittell, Jody Hoffer

AU - Hartley, Tom

AU - Spitzer, Tracy

AU - Tolliver, Suzi

AU - Angiulo, Cindy

AU - Henderson, Donna

AU - Folk-Way, Katy

AU - Rao, Arjun

AU - Hopkins, Joseph

AU - Pardini-Keily, Kim

AU - Sachs, Barton L.

AU - Robinson, Ellen F.

AU - Schleyer, Anneliese M.

AU - Middleton, Kevin

AU - Jarman, Ken

AU - Taylor, Mark

AU - Zaros, Mark C.

AU - Cuschieri, Joseph

AU - Goss, J. Richard

AU - Geeting, Glenn K.

AU - DeFlitch, Christopher J.

AU - Scanlon, Kerri Anne

AU - Nelson, Karen

AU - Newman, Sheldon

AU - Cifu-Tursellino, Kelly

AU - Schultz, Susanne

AU - Patel, Bela

AU - Siska, Ruth

AU - Campos, Tammy

AU - Doshi, Pratik

AU - McKelvy, Brandy

AU - Almoosa, Khalid

AU - Mathew, Rex

AU - Storer, Andrew

AU - Davis-Moon, Linda

AU - Carey, Michael

AU - Kneale, Laura

AU - Stegner, Jonathan

AU - Lanier, Jenny

AU - Bell-Gray, Anika T.

AU - Boyle, Kathy

AU - Tillapaugh, Pat

AU - Pelot, Jeff

AU - Danneker, Coletta

AU - Willson, Charles

AU - Strope, Gerald

AU - Perkin, Ronald

AU - Schueler, Judy

AU - May, Linda

AU - Gilmore, Tom

AU - Medow, Joshua

AU - Bouchard, Carin

AU - Sheinberg, Michael

AU - Fullam, Francis A.

AU - Shaller, Dale

AU - Epting, Gladys J.

AU - Ohta, Brenda

AU - Kaye, Donna L.

AU - Strickler, Jeff

AU - Hultman, C. Scott

AU - Chukwuma, Lilian

AU - Mufson, Zachary

AU - Levitan, Nathan

AU - Bieber, Eric

AU - Koppelman, Cathy

AU - Madden, Susan

AU - Kaldenberg, Dennis

AU - Siegrist, Richard

AU - Bell, Madeline

AU - Spraycar, Anna

AU - Swartz, Colleen

AU - DePriest, Paul

AU - Radford, Martha J.

AU - Webb, Lynn E.

AU - Slade, Maureen

AU - Kulkarni, Nita

AU - Cruz, Cahren

AU - Brumsted, John

AU - Messier, Randall

AU - Holman, Melissa

AU - Sanders, Carolyn L.

AU - Prutzman, Lorna

N1 - Funding Information: Pathology, diology and neapolis, Minnesota and the St. Paul and the University of supported by The Saint Paul Foundation, Minneapolis and The Mayo Foundation, Rochester. Dr. Brooks S. Edwards is supported by Institutes of Health, Bethesda, Manuscript received February June 29, 1987, accepted July 14, 1987.

PY - 2012

Y1 - 2012

N2 - Background. Ventilator-associated pneumonia (VAP) has been a challenge for our burn, trauma, and neurosurgical population because of their underlying injuries, prolonged mechanical ventilation, need for spinal clearance prior to head-of-bed elevation, and risk for multidrug-resistant organisms, resulting in a total of 266 cases of VAPs in 2007. Intervention detail. We developed a multidisciplinary team, involving critical care, infection control, antimicrobial stewardship, clinical education, and information technology (IT), focused on prevention, diagnosis, and management with detailed surveillance of VAP cases and rates, microbiology, and antimicrobial resistance. Each VAP case is reviewed at the unit level with the multidisciplinary care team for VAP risk factors as well as bundle compliance. IT has facilitated electronic surveillance of bundle compliance in all ventilated patients as well as an automated daily list of all patients on spine precautions and time to head of bed >30°. Results. Improved antimicrobial use along with infection control initiatives such as hand hygiene, active surveillance cultures of all intensive care unit patients for MRSA and carbapenem-resistant Acinetobacter, use of contact precautions, daily chlorhexidine baths, and improved environmental cleaning with monthly audits have led to dramatic reductions in VAP caused by MRSA and Acinetobacter. Changes in local microbiology resulted in modification of empirical antimicrobial therapy and reduced use of imipenem for late-onset VAP (mechanical ventilation or hospitalization >5 days). In addition, active surveillance cultures have a 99% negative predictive value for the development of MRSA VAP, allowing more judicial use of empirical vancomycin. More appropriate use of vancomycin and imipenem are estimated to reduce pharmacy costs by $130 000 per year. These measures have led to a sustained reduction in the number of VAP cases from 266 in 2007 to 98 in 2010, reflecting a 63% reduction in the absolute number of VAP cases, and our management has been improved through appropriate antimicrobial therapy based on local microbiology and resistance patterns.

AB - Background. Ventilator-associated pneumonia (VAP) has been a challenge for our burn, trauma, and neurosurgical population because of their underlying injuries, prolonged mechanical ventilation, need for spinal clearance prior to head-of-bed elevation, and risk for multidrug-resistant organisms, resulting in a total of 266 cases of VAPs in 2007. Intervention detail. We developed a multidisciplinary team, involving critical care, infection control, antimicrobial stewardship, clinical education, and information technology (IT), focused on prevention, diagnosis, and management with detailed surveillance of VAP cases and rates, microbiology, and antimicrobial resistance. Each VAP case is reviewed at the unit level with the multidisciplinary care team for VAP risk factors as well as bundle compliance. IT has facilitated electronic surveillance of bundle compliance in all ventilated patients as well as an automated daily list of all patients on spine precautions and time to head of bed >30°. Results. Improved antimicrobial use along with infection control initiatives such as hand hygiene, active surveillance cultures of all intensive care unit patients for MRSA and carbapenem-resistant Acinetobacter, use of contact precautions, daily chlorhexidine baths, and improved environmental cleaning with monthly audits have led to dramatic reductions in VAP caused by MRSA and Acinetobacter. Changes in local microbiology resulted in modification of empirical antimicrobial therapy and reduced use of imipenem for late-onset VAP (mechanical ventilation or hospitalization >5 days). In addition, active surveillance cultures have a 99% negative predictive value for the development of MRSA VAP, allowing more judicial use of empirical vancomycin. More appropriate use of vancomycin and imipenem are estimated to reduce pharmacy costs by $130 000 per year. These measures have led to a sustained reduction in the number of VAP cases from 266 in 2007 to 98 in 2010, reflecting a 63% reduction in the absolute number of VAP cases, and our management has been improved through appropriate antimicrobial therapy based on local microbiology and resistance patterns.

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UR - http://www.scopus.com/inward/citedby.url?scp=84890928626&partnerID=8YFLogxK

U2 - 10.1177/1062860611433649

DO - 10.1177/1062860611433649

M3 - Article

C2 - 22446888

AN - SCOPUS:84890928626

SN - 1062-8606

VL - 27

SP - S3-S33

JO - American Journal of Medical Quality

JF - American Journal of Medical Quality

IS - 1 SUPPL.

ER -

LEAP: Lead, Excel, Achieve, Perform: A Report on the UHC Annual Conference 2011

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