Read by QxMD icon Read

Patient centered rounds

Pierre Antoine Brown, Swapnil Hiremath, Edward G Clark, Edmund S H Kwok, Christopher McCudden, Ayub Akbari
BACKGROUND: Morbidity and Mortality Conferences (M&MCs) have for generations been part of the education of physicians, yet their effectiveness remains questionable. The Ottawa M&M Model (OM3) was developed to provide a structured approach to M&MCs in order to maximize the quality improvement impact of such rounds. STUDY DESIGN: We conducted a retrospective assessment of the impact of implementing nephrology-specific M&MCs using the OM3. SETTING AND PARTICIPANTS: All physicians, residents and fellows from the division of nephrology at a large academic medical center were invited to participate...
March 12, 2018: International Urology and Nephrology
Andrew J Jacobs, Carol D Morris, Adam S Levin
BACKGROUND: Reported rates of the incidence of lymph node metastasis in soft tissue sarcoma vary considerably. Many are based on single-institution series and small patient populations. Certain sarcoma subtypes, including synovial sarcoma, have been associated with a higher risk of lymph node involvement. Most single centers have insufficient numbers of patients to assess lymph node metastasis accurately, but larger national databases may allow a more accurate estimation. QUESTIONS/PURPOSES: We queried a large national database and asked the following questions: (1) What proportion of patients with soft tissue sarcoma have lymph node metastasis and distant metastasis? (2) What histologic subtypes are associated with increased risk of nodal metastasis? (3) What is the impact of lymph node metastases and histologic subtype on survival? (4) Does lymph node excision improve survival of patients with soft tissue sarcoma? METHODS: The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program is a national database that covers a geographic cross-section representing approximately 28% of the US population across demographic groups...
March 2018: Clinical Orthopaedics and related Research
Nienke Elske Dijkstra, Carolina Geertruida Maria Sino, Eibert Rob Heerdink, Marieke Joanna Schuurmans
BACKGROUND: Home care patients often use many medications and are prone to drug-related problems (DRPs). For the management of problems related to drug use, home care could add to the multidisciplinary expertise of general practitioners (GPs) and pharmacists. The home care observation of medication-related problems by home care employees (HOME)-instrument is paper-based and assists home care workers in reporting potential DRPs. To facilitate the multiprofessional consultation, a digital report of DRPs from the HOME-instrument and digital monitoring and consulting of DRPs between home care and general practices and pharmacies is desired...
March 7, 2018: JMIR Human Factors
M Durán-Poveda, P Jimenez-Fonseca, M Sirvent-Ochando, P P García-Luna, J L Pereira-Cunill, B Lema-Marqués, M T Parejo-Arrondo, C Belda-Iniesta
INTRODUCTION: Malnutrition is a common complication in cancer patients and can negatively affect the outcome of treatments. This study aimed to reach a consensus on nutritional needs and optimize nutritional care in the management of cancer patients at a national level. METHODS: A qualitative, multicenter, two-round Delphi study involving 52 specialists with experience in nutritional support in cancer patients was conducted. RESULTS: Regarding the presence of malnutrition, 57...
March 2, 2018: Clinical & Translational Oncology
Gisele Alborghetti Nai, Andressa Bazan, Caroline Andrade Rocha, Juliana Souza Nagy, Isadora Tanaka Campos
Melanomas of the female genital tract may occur in the vulva, the vagina, the ovary or the cervix. Pregnancy has been considered an aggravating factor in the evolution and prognosis of melanoma. A 35-year-old female presented with vaginal bleeding 2 months after a term cesarean delivery. An endovaginal ultrasound revealed a lesion in the uterine cervix. The pathological report revealed a small round-cell neoplasm, and the immunohistochemistry confirmed the diagnosis of malignant melanoma. A positron emission tomography revealed an expansive hypermetabolic lesion centered on the cervix, and hypermetabolic lesions in the liver and right kidney...
February 23, 2018: Revista Brasileira de Ginecologia e Obstetrícia
Rupak Roy, Kumar Saurabh, Nicey R Thomas
PURPOSE: To describe multicolor imaging findings in a case of acute retinal pigment epitheliitis. SETTING: Vitreoretinal department of a tertiary care center in Eastern India. METHODS: A 28-year-old lady presented with acute vision loss in the right eye since 3 days. Left eye examination was unremarkable. Best-corrected visual acuity in the right eye was 20/40. Anterior segment examination revealed clear lens with no evidence of inflammation...
February 22, 2018: Retinal Cases & Brief Reports
G Koki, E Epée, G Helles, Y Bilong, A V Dohvoma, P Biangoup, S Bimbaï, A Omgbwa Eballé, A L Bella, C Ebana Mvogo
PURPOSE: To evaluate the total cost of treatment of diabetic retinopathy by argon laser for a patient when indicated. PATIENTS AND METHOD: Prospective cross-sectional and descriptive survey, carried out in the angiography and laser center of the Yaoundé Central Hospital from October 2014 to October 2015. All consecutive diabetic patients with retinopathy and suitable indication for argon laser treatment were included. The costs related to the initial and final fluorescein angiography, the appointment for follow-up, round-trip transportation costs from the patient's home and the cost of laser treatment were included...
February 19, 2018: Journal Français D'ophtalmologie
Bharath R Ravichandran, Matthew W Gillespie, Tracy M Sparkes, Carla Williams, Stephen T Bartlett, Abdolreza Haririan, Brian M Masters
Background Given the complexity of solid organ transplant recipients, a multidisciplinary approach is required. To promote medication safety and enable providers to focus on the medical and surgical needs of these patients, our department of pharmacy created a collaborative practice agreement between physicians and pharmacists. Through this agreement, credentialed pharmacists are empowered to provide inpatient services including initiation and adjustment of medications through independent review of laboratory results after multidisciplinary rounds...
February 21, 2018: International Journal of Clinical Pharmacy
Virak Khieu, Vandine Or, Chhakda Tep, Peter Odermatt, Reiko Tsuyuoka, Meng Chuor Char, Molly A Brady, Joshua Sidwell, Aya Yajima, Rekol Huy, Kapa D Ramaiah, Sinuon Muth
BACKGROUND: Endemicity of lymphatic filariasis (LF) in Cambodia was proven in 1956 when microfilariae were detected in mosquitos in the Kratié province. In 2001, an extensive study confirmed the presence of both Brugia malayi and Wuchereria bancrofti microfilariae. In 2003, the Ministry of Health established a national task force to develop policies and strategies for controlling and eliminating neglected tropical diseases (NTDs), with the goal of eliminating LF by 2015. This article summarizes the work accomplished to eliminate LF as a public health problem in Cambodia...
February 20, 2018: Infectious Diseases of Poverty
Christian Schmidt, Alper Öner, Miriam Mann, Katja Krockenberger, Melanie Abbondanzieri, Bernard Brandewiede, Armin Brüge, Gisela Hostenkamp, Axel Kaiser, Henriette Neumeyer, Andreas Ziegler
BACKGROUND: Cardiovascular diseases are the major cause of death globally and represent a major economic burden on health care systems. Positive effects of disease management programs have been shown for patients with heart failure (HF). Remote monitoring and telemonitoring with active intervention are beneficial in atrial fibrillation (AF) and therapy-resistant hypertension (TRH), respectively. For these patients, we have developed a novel integrated care concept (NICC) which combines telemedicine with intensive support by a care center, including a call center, an integrated care network including inpatient and outpatient care providers and guideline therapy for patients...
February 20, 2018: Trials
Nitesh Sood, David T Martin, Rachel Lampert, Jeptha P Curtis, Craig Parzynski, Jude Clancy
BACKGROUND: Transvenous lead extraction is an integral part of management of patients with cardiovascular implantable electronic devices. Real-world incidence and predictors of perioperative complications in extractions involving implantable cardioverter-defibrillator leads have not been described in detail. METHODS AND RESULTS: Data from the National Cardiovascular Data Registry Implantable Cardioverter-Defibrillator Registry were analyzed. Lead extraction was defined as removal of leads implanted for >1 year...
February 2018: Circulation. Arrhythmia and Electrophysiology
Ariane Plaisance, Holly O Witteman, Annie LeBlanc, Jennifer Kryworuchko, Daren Keith Heyland, Mark H Ebell, Louisa Blair, Diane Tapp, Audrey Dupuis, Carole-Anne Lavoie-Bérard, Carrie Anna McGinn, France Légaré, Patrick Michel Archambault
BACKGROUND: Upon admission to an intensive care unit (ICU), all patients should discuss their goals of care and express their wishes concerning life-sustaining interventions (e.g., cardiopulmonary resuscitation (CPR)). Without such discussions, interventions that prolong life at the cost of decreasing its quality may be used without appropriate guidance from patients. OBJECTIVES: To adapt an existing decision aid about CPR to create a wiki-based decision aid individually adapted to each patient's risk factors; and to document the use of a wiki platform for this purpose...
2018: PloS One
Kelly E Rea, Priyanka Rao, Elizabeth Hill, Kate M Saylor, Melissa K Cousino
CONTEXT: Family-centered rounding (FCR) is of increasing importance in pediatric medicine. Although researchers have begun to understand the effect of FCR on providers and systematic health care outcomes, we provide a systematic review of the literature regarding families' experiences with FCR. OBJECTIVE: To systematically review patient and family experiences with pediatric FCR. DATA SOURCES: Our data sources included PubMed, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Scopus, and Embase...
February 6, 2018: Pediatrics
Joseph F Golob, John J Como, Jeffrey A Claridge
With the advent of the electronic medical record, the documentation burden of the trauma surgeon has become overwhelming. To help, our trauma division added scribes to the rounding team. We hypothesized that scribe utilization would improve our documentation efficiency and offer a financial benefit to the institution. A review of trauma surgeon documentation and billing was performed at a Level I trauma center over two time periods: January to May 2014 (no scribes) and January to May 2015 (scribes). The number of notes written by trauma surgeons was obtained, as were documentation charges...
January 1, 2018: American Surgeon
Ryan P McLynn, Taylor D Ottesen, Nathaniel T Ondeck, Jonathan J Cui, Lee E Rubin, Jonathan N Grauer
BACKGROUND: The Rothman Index is a comprehensive measure of overall patient status in the inpatient setting already in use at many medical centers. It ranges from 100 (best score) to -91 (worst score) and is calculated based on 26 variables encompassing vital signs, routine laboratory values, and organ system assessments from nursing rounds from the electronic medical record. Past research has shown an association of Rothman Index with complications, readmission, and death in certain populations, but it has not been evaluated in geriatric patients with hip fractures, a potentially vulnerable patient population...
February 5, 2018: Clinical Orthopaedics and related Research
Rachel A Burton, Nicole M Lallemand, Rebecca A Peters, Stephen Zuckerman
BACKGROUND: Through the Multi-Payer Advanced Primary Care Practice (MAPCP) Demonstration, Medicare, Medicaid, and private payers offered supplemental payments to 849 primary care practices that became patient-centered medical homes (PCMHs) in eight states; practices also received technical assistance and data reports. Average Medicare payments were capped at $10 per beneficiary per month in each state. OBJECTIVE: Since there was variation in the eight participating states' demonstration designs, experiences, and outcomes, we conducted a qualitative multi-case analysis to identify the key factors that differentiated states that were estimated to have generated net savings for Medicare from states that did not...
February 5, 2018: Journal of General Internal Medicine
Eileen E Reynolds, Carol Bates, Martha Richardson, Risa B Burns
Hormone therapy (HT) was widely prescribed in the 1980s and 1990s and has been controversial since the initial results of the Women's Health Initiative (WHI) trial in the early 2000s suggested that it increased risk for breast cancer and coronary heart disease and did not prolong life. However, more recent data and reexamination of the WHI results suggest that HT is safe and effective for many women when used around the time of menopause. Two experts debate the 2017 Hormone Therapy Position Statement of The North American Menopause Society, which recommends HT as first-line treatment of vasomotor symptoms, and apply it to the care of Ms...
February 6, 2018: Annals of Internal Medicine
Rebecca Blankenburg, Joan F Hilton, Patrick Yuan, Stephanie Rennke, Brad Monash, Stephanie M Harman, Debbie S Sakai, Poonam Hosamani, Adeena Khan, Ian Chua, Eric Huynh, Lisa Shieh, Lijia Xie
BACKGROUND: Shared decision-making (SDM) improves patient engagement and may improve outpatient health outcomes. Little is known about inpatient SDM. OBJECTIVE: To assess overall quality, provider behaviors, and contextual predictors of SDM during inpatient rounds on medicine and pediatrics hospitalist services. DESIGN: A 12-week, cross-sectional, single-blinded observational study of team SDM behaviors during rounds, followed by semistructured patient interviews...
February 5, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Temple A Ratcliffe, Meghan A Crabtree, Raymond F Palmer, Jacqueline A Pugh, Holly J Lanham, Luci K Leykum
BACKGROUND: Attending rounds remain the primary venue for formal teaching and learning at academic medical centers. Little is known about the effect of increasing clinical demands on teaching during attending rounds. OBJECTIVE: To explore the relationships among teaching time, teaching topics, clinical workload, and patient complexity variables. DESIGN: Observational study of medicine teaching teams from September 2008 through August 2014...
February 1, 2018: Journal of General Internal Medicine
Catherine M Walsh, Li-Jung Liang, Tristan Grogan, Courtney Coles, Norma McNair, Teryl K Nuckols
BACKGROUND: Most fall prevention programs are only modestly effective, and their sustainability is unknown. An academic medical center implemented a series of fall prevention interventions from 2001 to 2014. METHODS: The medical center's series of fall prevention interventions were as follows: reorganized the Falls Committee (2001), started flagging high-risk patients (2001), improved fall reporting (2002), increased scrutiny of falls (2005), instituted hourly nursing rounds (2006), reorganized leadership systems (2007), standardized fall prevention equipment (2008), adapted to a move to a new hospital building (2008), routinely investigated root causes (2009), mitigated fall risk during hourly nursing rounds (2009), educated patients about falls (2011), and taught nurses to think critically about risk (2012)...
February 2018: Joint Commission Journal on Quality and Patient Safety
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"