PHOTOMETRY OF TYPE II CEPHEID CANDIDATES FROM THE NORTHERN PART OF THE ALL SKY AUTOMATED SURVEY

We have obtained VR photometry of 282 Cepheid variable star candidates from the northern part of the All Sky Automated Survey (ASAS). These together with data from the ASAS and the Northern Sky Variability Survey (NSVS) were used to redetermine the periods of the stars. We divided the stars into four groups based on location in a plot of mean color, (V − R), versus period. Two of the groups fell within the region of the diagram containing known type II Cepheids and yielded 14 new highly probable type II Cepheids. The properties of the remaining stars in these two groups are discussed but their nature remains uncertain. Unexplained differences exist between the sample of stars studied here and a previous sample drawn from the NSVS by Akerlof et al. This suggests serious biases in the identification of variables in different surveys. 3 machine-readable text tables are attached as supplemental files

Lessons Learned in Developing and Implementing the ED-PACT Tool: An Innovation Supporting Communication of Care Needs After Emergency Department Visits

Background: Communication failures between providers represent a threat to patient safety. Despite the importance of timely receipt of recommended post-emergency department (ED) care, up to two-thirds of patients discharged from EDs do not receive recommended post-ED care. The ED-PACT tool uses the electronic health record to send messages from Veterans Health Administration ED providers to nurse care managers of patients’ VA Patient-Aligned Care Team (PACT) when patients are discharged home from the ED with an urgent or specific follow-up need. We developed, piloted and formatively evaluated the spread of this tool at VA Greater Los Angeles Healthcare System (VAGLAHS). Methods: Before implementation, we assessed readiness to participate in the innovation with leadership interviews and nurse care manager questionnaires. During deployment, we used audit and feedback to monitor adherence with correct use of the tool. We logged all user feedback, tracked all failures (ie, PACT nurse not acting on message) and their causes, and used run charts to assess for weekly variations in failures. We audited a random sample of 150 messages to capture types of care needs for which messages were sent. We interviewed leaders in three clinics about perceptions of usability and value, and implementation facilitators and barriers. Results: Between November 1, 2015, and May 31, 2016, the ED-PACT tool was used to send 1,350 messages from the VAGLAHS ED to 35 PACT teamlets across 5 primary care clinics. Care needs included: symptom recheck (55%), care coordination (16%), wound care (5%), medication adjustment (5%), laboratory recheck (5%), radiology follow-up (3%), and blood pressure recheck (3%). On average, nurses successfully acted on 91% of messages (weekly range: 72%–100%). Reasons for failure included human error, staffing shortages and technical errors. Interviews with clinic leaders revealed that the ED-PACT tool is perceived to provide substantial benefit for coordinating post-ED care by effectively communicating with patients’ PACT nurses. Leaders also reported nurse training and “buy-in” facilitated implementation, whereas insufficient staff posed a barrier. Conclusion: The ED-PACT tool facilitates communication between providers during a vulnerable care transition. Deployment of similar tools should include attention to the organizational, human and technical factors revealed by our evaluation