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"Transitions of care"

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https://www.readbyqxmd.com/read/29318583/geriatric-emergency-department-innovations-transitional-care-nurses-and-hospital-use
#1
Ula Hwang, Scott M Dresden, Mark S Rosenberg, Melissa M Garrido, George Loo, Jeremy Sze, Stephanie Gravenor, D Mark Courtney, Raymond Kang, Carolyn W Zhu, Carmen Vargas-Torres, Corita R Grudzen, Lynne D Richardson
OBJECTIVES: To examine the effect of an emergency department (ED)-based transitional care nurse (TCN) on hospital use. DESIGN: Prospective observational cohort. SETTING: Three U.S. (NY, IL, NJ) EDs from January 1, 2013, to June 30, 2015. PARTICIPANTS: Individuals aged 65 and older in the ED (N = 57,287). INTERVENTION: The intervention was first TCN contact. Controls never saw a TCN during the study period...
January 10, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29313768/from-longshot-to-fantasy-obligations-to-pediatric-patients-and-families-when-last-ditch-medical-efforts-fail
#2
Elliott Mark Weiss, Autumn Fiester
Clinicians at quaternary centers see part of their mission as providing hope when others cannot. They tend to see sicker patients with more complex disease processes. Part of this mission is offering longshot treatment modalities that are unlikely to achieve their stated goal, but conceivably could. When patients embark on such a treatment plan, it may fail. Often treatment toward an initial goal continues beyond the point at which such a goal is feasible. We explore the progression of care from longshot to fantasy using two pediatric cases...
January 2018: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29304857/a-qualitative-exploration-of-the-discharge-process-and-factors-predisposing-to-readmissions-to-the-intensive-care-unit
#3
Uchenna R Ofoma, Yue Dong, Ognjen Gajic, Brian W Pickering
BACKGROUND: Quantitative studies have demonstrated several factors predictive of readmissions to intensive care. Clinical decision tools, derived from these factors have failed to reduce readmission rates. The purpose of this study was to qualitatively explore the experiences and perceptions of physicians and nurses to gain more insight into intensive care readmissions. METHODS: Semi-structured interviews of intensive care unit (ICU) and general medicine care providers explored work routines, understanding and perceptions of the discharge process, and readmissions to intensive care...
January 5, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29298366/getting-it-rite-impact-of-a-dedicated-hospital-medicine-curriculum-for-residents
#4
Doris Lin, Chirayu Shah, Steffanie Campbell, Jeffrey T Bates, Erica Lescinskas
OBJECTIVE: The goal of this study was to improve resident confidence in inpatient care and knowledge in hospital medicine topics with a newly developed rotation and curriculum called the Resident Inpatient Training Experience. METHODS: This study was a prospective observational study completed by postgraduate year-2 (PGY-2) internal medicine residents in two affiliated hospitals. Forty-six PGY-2 residents each rotated on the Resident Inpatient Training Experience service for 1 month and completed a pre- and postrotation confidential online survey...
January 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29298192/helping-older-adults-improve-their-medication-experience-home-by-addressing-medication-regimen-complexity-in-home-healthcare
#5
Orla C Sheehan, Hadi Kharrazi, Kimberly J Carl, Bruce Leff, Jennifer L Wolff, David L Roth, Jennifer Gabbard, Cynthia M Boyd
In skilled home healthcare (SHHC), communication between nurses and physicians is often inadequate for medication reconciliation and needed changes to the medication regimens are rarely made. Fragmentation of electronic health record (EHR) systems, transitions of care, lack of physician-nurse in-person contact, and poor understanding of medications by patients and their families put patients at risk for serious adverse outcomes. The aim of this study was to develop and test the HOME tool, an informatics tool to improve communication about medication regimens, share the insights of home care nurses with physicians, and highlight to physicians and nurses the complexity of medication schedules...
January 2018: Home Healthcare Now
https://www.readbyqxmd.com/read/29288642/improving-staff-communication-and-transitions-of-care-between-obstetric-triage-and-labor-and-delivery
#6
Kathleen O'Rourke, Joseph Teel, Erika Nicholls, Daniel D Lee, Alyssa Covelli Colwill, Sindhu K Srinivas
OBJECTIVE: To improve staff perception of the quality of the patient admission process from obstetric triage to the labor and delivery unit through standardization. DESIGN: Preassessment and postassessment online surveys. SETTING: A 13-bed labor and delivery unit in a quaternary care, Magnet Recognition Program, academic medical center in Pennsylvania. PARTICIPANTS: Preintervention (n = 100), postintervention (n = 52), and 6-month follow-up survey respondents (n = 75) represented secretaries, registered nurses, surgical technicians, certified nurse-midwives, nurse practitioners, maternal-fetal medicine fellows, anesthesiologists, and obstetric and family medicine attending and resident physicians from triage and labor and delivery units...
December 27, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/29288620/assessing-emergency-department-utilization-in-the-era-of-population-health
#7
EDITORIAL
Jesse D Schold, Jayme E Locke
Population health has been broadly defined as "health outcomes of a group of individuals, including the distribution of such outcomes within the group." (1) Increasingly, population health has gained prominence and impact with emergence of Accountable Care Organizations that serve populations across transitions of care and different providers (often extended to communities). Population health has also been a focus of healthcare reform and development of policies and interventions aimed at simultaneously improving quality and reducing costs...
December 30, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29279267/academy-of-nutrition-and-dietetics-revised-2017-standards-of-practice-in-nutrition-care-and-standards-of-professional-performance-for-nutrition-and-dietetics-technicians-registered
#8
(no author information available yet)
Nutrition and dietetics technicians, registered (NDTRs) face complex situations every day. Competently addressing the unique needs of each situation and applying standards appropriately are essential to providing safe, timely patient-/client-/customer-centered quality nutrition and dietetics care and services. The Academy of Nutrition and Dietetics (Academy) leads the profession by developing standards that can be used by NDTRs (who are credentialed by the Commission on Dietetic Registration) for self-evaluation to assess quality of practice and performance...
December 23, 2017: Journal of the Academy of Nutrition and Dietetics
https://www.readbyqxmd.com/read/29276301/impact-of-inpatient-automatic-therapeutic-substitutions-on-postdischarge-medication-prescribing
#9
Pooja J Shah, Jennifer L Cruz, Ashley L Pappas, Kayla M Waldron, Scott W Savage
Background: Automatic therapeutic substitution (ATS) is the act of therapeutic interchange, in which patients are transitioned from a nonformulary preadmission medication to an equivalent formulary medication upon admission. ATS protocols are able to provide several benefits; however, if medications are unreconciled at the time of discharge, then use may lead to duplication or omission resulting in adverse outcomes. The objective was to assess the impact of preidentified ATS protocol use during admission on duplication and omission postdischarge...
October 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29276282/pharmacy-transitions-of-care-and-culture
#10
EDITORIAL
Dana H Manning, Judith L Kristeller
No abstract text is available yet for this article.
September 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29273612/interprofessional-care-collaboration-for-patients-with-heart-failure
#11
Amanda Boykin, Danielle Wright, Lydia Stevens, Lauren Gardner
PURPOSE: An innovative collaborative care model to improve transitions of care (TOC) for patients with heart failure (HF) is described. SUMMARY: As part of a broad effort by New Hanover Regional Medical Center (NHRMC) to reduce avoidable 30-day hospital readmissions and decrease associated healthcare costs through a team-centered, value-based approach to patient care, an interprofessional team was formed to help reduce hospital readmissions among discharged patients with HF...
January 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29251766/handing-off-the-older-patient-improved-documentation-of-geriatric-assessment-in-transitions-of-care
#12
Ben A Blomberg, Rebekah C Mulligan, Stephen J Staub, Laura C Hanson, Margaret A Drickamer, Maureen C Dale
OBJECTIVES: To improve assessment and documentation of function, cognition, and advance care planning (ACP) in admission and discharge notes on an Acute Care of the Elderly (ACE) unit. DESIGN: Continuous quality improvement intervention with episodic data review. SETTING: ACE unit of an 866-bed academic tertiary hospital. PARTICIPANTS: Housestaff physicians rotating on the ACE unit (N = 31). INTERVENTION: Introduction of templated notes, housestaff education, leadership outreach, and posted reminders...
December 18, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29248987/healthcare-professionals-agreement-on-clinical-relevance-of-drug-related-problems-among-elderly-patients
#13
Christine Flagstad Bech, Tine Frederiksen, Christine Tilsted Villesen, Jette Højsted, Per Rotbøll Nielsen, Lene Juel Kjeldsen, Lotte Stig Nørgaard, Lona Louring Christrup
Background Disagreement among healthcare professionals on the clinical relevance of drug-related problems can lead to suboptimal treatment and increased healthcare costs. Elderly patients with chronic non-cancer pain and comorbidity are at increased risk of drug related problems compared to other patient groups due to complex medication regimes and transition of care. Objective To investigate the agreement among healthcare professionals on their classification of clinical relevance of drug-related problems in elderly patients with chronic non-cancer pain and comorbidity...
December 16, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29248079/preliminary-findings-from-a-student-pharmacist-operated-transitions-of-care-pilot-service
#14
Kari Vavra, Matthew Paluzzi, Margaret de Voest, Sarah Raguckas, Martha Slot
BACKGROUND AND PURPOSE: Student pharmacists are well equipped to complete transitions of care (TOC) activities. This communication describes the implementation of a student-operated TOC pilot service at a community hospital and explores the clinical and educational findings of such a service. EDUCATIONAL ACTIVITY AND SETTING: Patients admitted to the hospital were included in the service if they had a primary care provider from an affiliated ambulatory care office...
January 2018: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29233434/assessing-students-knowledge-regarding-the-roles-and-responsibilities-of-a-pharmacist-with-focus-on-care-transitions-through-simulation
#15
Erini S Serag-Bolos, Aimon C Miranda, Shyam R Gelot, Sheetal P Dharia, Kristy M Shaeer
BACKGROUND AND PURPOSE: To evaluate the impact of a pharmacist-focused transitions of care (TOC) simulation on students' perceptions and knowledge of pharmacist roles in the healthcare continuum. Educational Activity and Setting: Two simulations, highlighting pharmacist roles in various practice settings, were conducted within the Pharmaceutical Skills courses in the third-year doctor of pharmacy curriculum. Patient cases were built utilizing electronic medical records (EMR). Students' knowledge was assessed before and after the simulations regarding pharmacist involvement in medication reconciliation, reduction in patient readmissions, reduction of inappropriate medication use, roles and communication on an interprofessional team, and involvement with health information technology (HIT) during care transitions...
July 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29233313/pharmacy-student-involvement-in-a-transition-of-care-program
#16
Raquel Hertig, Rina Ackerman, Brenda Zagar, Serina Tart
BACKGROUND AND PURPOSE: Cape Fear Valley Medical Center (CFVMC) implemented a Community Paramedic Program (CPP) to improve the transition of hospitalized patients to the home setting. In this program, paramedics conduct home visits for 30 days after qualifying patients are discharged. This article describes pharmacy services provided to CPP patients by fourth-year pharmacy students on Advanced Pharmacy Practice Experiences (APPE) that assisted with home visits. EDUCATIONAL ACTIVITY AND SETTING: Students were oriented to the CPP and patient interview technique was assessed through a role-play scenario...
September 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29230400/perspectives-of-post-acute-transition-of-care-for-cardiac-surgery-patients
#17
REVIEW
Nicoleta Stoicea, Tian You, Andrew Eiterman, Clifton Hartwell, Victor Davila, Stephen Marjoribanks, Cristina Florescu, Sergio Daniel Bergese, Barbara Rogers
Post-acute care (PAC) facilities improve patient recovery, as measured by activities of daily living, rehabilitation, hospital readmission, and survival rates. Seamless transitions between discharge and PAC settings continue to be challenges that hamper patient outcomes, specifically problems with effective communication and coordination between hospitals and PAC facilities at patient discharge, patient adherence and access to cardiac rehabilitation (CR) services, caregiver burden, and the financial impact of care...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29209996/understanding-ownership-of-patient-care-a%C3%A2-dual-site-qualitative-study-of-faculty-and-residents-from-medicine-and-psychiatry
#18
Deborah S Cowley, Jesse D Markman, Jennifer A Best, Erica L Greenberg, Michael J Grodesky, Suzanne B Murray, Kelli A Corning, Mitchell R Levy, William E Greenberg
INTRODUCTION: With changes in duty hours and supervision requirements, educators have raised concerns about erosion of patient care ownership by resident physicians. However, the definition of ownership is unclear. This qualitative study investigated definitions of ownership in medicine and psychiatry faculty and residents. METHODS: The authors distributed an anonymous online survey regarding definitions of ownership to faculty and residents at the psychiatry and internal medicine residency programs at the University of Washington and the Harvard Longwood psychiatry residency and conducted a qualitative analysis of free-text responses to identify emergent themes...
December 5, 2017: Perspectives on Medical Education
https://www.readbyqxmd.com/read/29200089/designing-a-new-model-for-clinical-education-an-innovative-approach
#19
Kathryn Shaffer, Beth Ann Swan, Mary Bouchaud
To keep pace with the ever-changing health care delivery system, it is important to transform the way future nurses are educated, both in classroom and in clinical settings, to care for people along the life and care continuum, not only in acute-care settings. The purpose of this article is to describe a new approach to educating baccalaureate nursing students using immersion practicums that expose students to population health, transitions of care, care coordination, and the multiple roles a nurse engages in along the continuum...
December 1, 2017: Nurse Educator
https://www.readbyqxmd.com/read/29194176/racial-disparities-in-outpatient-mental-health-service-use-among-children-hospitalized-for-traumatic-brain-injury
#20
Megan Moore, Nathalia Jimenez, Janessa M Graves, Tessa Rue, Jesse R Fann, Frederick P Rivara, Monica S Vavilala
OBJECTIVE: To examine racial differences in mental health service utilization after hospitalization for traumatic brain injury (TBI) among children with Medicaid insurance. DESIGN AND MAIN MEASURES: Retrospective analysis of the MarketScan Multi-State Medicaid database from 2007 to 2012 was performed. Outpatient mental health service utilization (psychiatric and psychological individual and group services) was compared at TBI hospitalization, from discharge to 3 months and from 4 to 12 months after discharge, between children of non-Hispanic white (NHW), non-Hispanic black (NHB), Hispanic, and "Other" racial groups...
November 29, 2017: Journal of Head Trauma Rehabilitation
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