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https://www.readbyqxmd.com/read/28531888/right-trac%C3%A2-post-hospitalization-care-transitions-program-to-reduce-readmissions-for-hemodialysis-patients
#1
Rebecca L Wingard, Kathryn McDougall, Billie Axley, Andrew Howard, Cathleen O'Keefe, Nancy Armistead, Janet R Lynch, Sophia Rosen, Len Usvyat, Franklin W Maddux
BACKGROUND: Hemodialysis (HD) patients have high hospitalization rates. This nonrandomized trial tested the effect of a bundle of renal-specific "Right TraC™" strategies on 30-day all-cause readmission rates and, secondarily, 90-day readmissions and overall admissions among HD patients. METHODS: Twenty-six Fresenius clinics in West Virginia, Ohio, and Kentucky participated in the interventions. Eighteen matched clinics served as controls; intervention clinics also served as their own controls...
May 23, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28523476/impact-of-a-patient-navigator-program-on-hospital-based-and-outpatient-utilization-over-180%C3%A2-days-in-a-safety-net-health-system
#2
Richard B Balaban, Fang Zhang, Catherine E Vialle-Valentin, Alison A Galbraith, Marguerite E Burns, Marc R Larochelle, Dennis Ross-Degnan
BACKGROUND: With emerging global payment structures, medical systems need to understand longer-term impacts of care transition strategies. OBJECTIVE: To determine the effect of a care transition program using patient navigators (PNs) on health service utilization among high-risk safety-net patients over a 180-day period. DESIGN: Randomized controlled trial conducted October 2011 through April 2013. PARTICIPANTS: Patients admitted to the general medicine service with ≥1 readmission risk factor: (1) age ≥ 60; (2) in-network inpatient admission within prior 6 months; (3) index length of stay ≥ 3 days; or (4) admission diagnosis of heart failure or (5) chronic obstructive pulmonary disease...
May 18, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28521309/care-transitions-and-adult-day-services-moderate-the-longitudinal-links-between-stress-biomarkers-and-family-caregivers-functional-health
#3
Yin Liu, David M Almeida, Michael J Rovine, Steven H Zarit
BACKGROUND: Stress biomarkers have been linked to health and well-being. There are, however, few studies on how dysregulation in the hypothalamic-pituitary-adrenal axis and sympathetic nervous system actually affects functional health of family caregivers of persons with dementia. Further, it is not clear whether and how factors affecting caregiving stressor exposures such as care transitions and adult day services (ADS) use may affect such association. OBJECTIVE: First, to examine the association of daily stress biomarkers and functional health over time among family caregivers of persons with dementia...
May 19, 2017: Gerontology
https://www.readbyqxmd.com/read/28489227/using-quality-improvement-in-resident-education-to-improve-transition-care
#4
Sofija D Volertas, Rita Rossi-Foulkes
The importance of a specific transition process is recognized by many health organizations. Got Transition, a cooperative endeavor aimed at improving the transition from pediatric to adult health care, developed Six Core Elements defining the basic components of health care transition support. In this article, we review the Six Core Elements by presenting a model that combines resident quality improvement and transition care training. In this Internal Medicine-Pediatrics residency program, ambulatory training for residents takes place in a combined adult and pediatric clinic...
May 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28479411/end-of-life-place-of-care-health-care-settings-and-health-care-transitions-among-cancer-patients-impact-of-an-integrated-cancer-palliative-care-plan
#5
V Casotto, M Rolfini, E Ferroni, V Savioli, N Gennaro, F Avossa, M Cancian, F Figoli, D Mantoan, A Brambilla, M C Ghiotto, U Fedeli, M Saugo
CONTEXT: Frequent end-of-life health care setting transitions can lead to an increased risk of fragmented care and exposure to unnecessary treatments. OBJECTIVES: We assessed the relationship between the presence and the intensity of an Integrated Cancer Palliative Care plan and the occurrence of multiple transitions during the last month of life. METHODS: Decedents of cancer aged 18-85 years residents in two Regions of Italy where investigated accessing their integrated administrative data (Death Certificates, Hospital Discharges, Hospice and Home care records)...
May 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28471846/care-transitions-among-medicare-beneficiaries-at-the-end-of-life
#6
Susan E Lowey
No abstract text is available yet for this article.
May 3, 2017: Nursing
https://www.readbyqxmd.com/read/28471516/european-academy-of-paediatric-consensus-statement-on-successful-transition-from-paediatric-to-adult-care-for-adolescents-with-chronic-conditions
#7
Artur Mazur, Lukasz Dembinski, Lenneke Schrier, Adamos Hadjipanayis, Pierre-André Michaud
Around one in ten adolescents suffer from chronic conditions and disabilities and the transition from paediatric to adult care can be particularly challenging. Unplanned transfers can complicate education, work and health and result in patients being lost to follow up, poor treatment adherence and more frequent hospitalisation. The Adolescent Health and Medicine Working Group of the European Academy of Paediatrics has developed a consensus statement for successful transition CONCLUSION: This statement will help paediatricians, adult care specialists, policy makers and other stakeholders to handle chronic care transitions so that they meet the expectations and needs of adolescents and their families...
May 4, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28467104/the-effectiveness-of-standardized-handoff-tool-interventions-during-inter-and-intra-facility-care-transitions-on-patient-related-outcomes-a-systematic-review
#8
Jennifer L Rosenthal, Robert Doiron, Sarah C Haynes, Brock Daniels, Su-Ting T Li
Improving physician handoffs is a patient safety priority. The authors hypothesize that standardized handoff interventions during care transitions improve patient-related outcome measures. PubMed, Cochrane, PsycINFO, CINAHL, Embase, and Web of Science were searched for publications from 2000 to May 2016. Eligible studies compared standardized handoff intervention(s) with no standardized handoff intervention and measured patient-related outcomes. Studies were evaluated independently for eligibility for inclusion by at least 2 authors in a 2-stage process; 14 articles met inclusion criteria...
May 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28466656/discussing-future-goals-and-legal-aspects-of-health-care-essential-steps-in-transitioning-youth-to-adult-oriented-care
#9
Lynn F Davidson, Maya Doyle, Ellen J Silver
Discussing realistic future goals with the adolescent alone and with family, and reviewing legal aspects of health care transition (HCT), are essential steps in the transition from pediatric to adult-oriented care. Secondary analysis of datasets from 2 studies related to HCT assessed differences in provider practice for youth with and without special health care needs (SHCNs). Across both datasets, between 57% and 68.6% of providers reported some discussion of future goals with adolescent or with family. However, only 28...
May 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28462358/the-experience-of-transitional-care-for-non-medically-complex-older-adults-and-their-family-caregivers
#10
Alexandros Georgiadis, Oonagh Corrigan
Transitional care research has mainly focused on the experiences of older adults with complex medical conditions. To date, few publications examine the experience of transitional care for non-medically complex older adults. In this article, we draw on and thematically analyze interview and audio-diary data collected at three hospitals in Eastern England, and we explore the experience of transitional care of 18 older adults and family caregivers. Participants reported mixed experiences when describing their care transitions, which indicated variations in care quality...
January 2017: Global Qualitative Nursing Research
https://www.readbyqxmd.com/read/28460055/health-care-transition-for-young-adults-with-type-1-diabetes-stakeholder-engagement-for-defining-optimal-outcomes
#11
Jessica S Pierce, Karen Aroian, Elizabeth Schifano, Amy Milkes, Tiani Schwindt, Anthony Gannon, Tim Wysocki
Research on the transition to adult care for young adults with type 1 diabetes (T1D) emphasizes transition readiness, with less emphasis on transition outcomes. The relatively few studies that focus on outcomes use a wide variety of measures with little reliance on stakeholder engagement for measure selection. This study engaged multiple stakeholders (i.e., young adults with T1D, parents, pediatric and adult health care providers, and experts) in qualitative interviews to identify the content domain for developing a multidimensional measure of health care transition (HCT) outcomes...
April 27, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/28457656/stimulating-patient-engagement-in-medical-device-development%C3%A2-in-kidney-disease-a-report-of-a-kidney-health%C3%A2-initiative-workshop
#12
Frank P Hurst, Dolph Chianchiano, Linda Upchurch, Benjamin R Fisher, Jennifer E Flythe, Celeste Castillo Lee, Terri Hill, Carolyn Y Neuland
New technologies challenge current dialysis treatment paradigms as devices become smaller, more portable, and increasingly used outside the dialysis clinic. It is unclear how patients will view this care transition, and it will be important to consider patient and care partner perspectives during all aspects of development for novel dialysis therapies, from design and clinical trials to regulatory approval. To gain insight into this area, the Kidney Health Initiative, a public-private partnership between the American Society of Nephrology, the US Food and Drug Administration, and nearly 80 member organizations and companies dedicated to enhancing patient safety and fostering innovation in kidney disease, convened a workshop of patients, care partners, and other kidney community stakeholders...
April 27, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28453826/unplanned-readmissions-within-30-days-after-discharge-improving-quality-through-easy-prediction
#13
Francesca Casalini, Susanna Salvetti, Silvia Memmini, Elena Lucaccini, Gabriele Massimetti, Pier Luigi Lopalco, Gaetano Pierpaolo Privitera
Objective: To propose an easy predictive model for the risk of rehospitalization, built from hospital administrative data, in order to prevent repeated admissions and to improve transitional care. Design: Retrospective cohort study. Setting: Azienda Ospedaliero Universitaria Pisana (Pisa University Hospital). Participants: Patients residing in the territory of the province of Pisa (Tuscany Region) with at least one unplanned hospital admission leading to a medical Diagnosis-Related Group (DRG) in the calendar year 2012...
April 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28453819/evaluation-of-a-care-transition-program-with-pharmacist-provided-home-based-medication-review-for-elderly-singaporeans-at-high-risk-of-readmissions
#14
McVin Hua Heng Cheen, Chong Ping Goon, Wan Chee Ong, Paik Shia Lim, Choon Nam Wan, Mei Yan Leong, Giat Yeng Khee
Objective: This study aimed to determine whether pharmacist-provided home-based medication review (HBMR) can reduce readmissions in the elderly. Design: Retrospective cohort study. Setting: Patient's home. Participants: Records of patients referred to a care transition program from March 2011 through March 2015 were reviewed. Patients aged 60 years and older taking more than 5 medications and had at least 2 unplanned admissions within 3 months preceding the first home visit were included...
April 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28439351/residents-exposure-to-educational-experiences-in-facilitating-hospital-discharges
#15
Eric Young, Chad Stickrath, Monica McNulty, Aaron J Calderon, Elizabeth Chapman, Jed D Gonzalo, Ethan F Kuperman, Max Lopez, Christopher J Smith, Joseph R Sweigart, Cecelia N Theobald, Robert E Burke
BACKGROUND: There is an incomplete understanding of the most effective approaches for motivating residents to adopt guideline-recommended practices for hospital discharges. OBJECTIVE: We evaluated internal medicine (IM) residents' exposure to educational experiences focused on facilitating hospital discharges and compared those experiences based on correlations with residents' perceived responsibility for safely transitioning patients from the hospital. METHODS: A cross-sectional, multi-center survey of IM residents at 9 US university- and community-based training programs in 2014-2015 measured exposure to 8 transitional care experiences, their perceived impact on care transitions attitudes, and the correlation between experiences and residents' perceptions of postdischarge responsibility...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28438589/specialty-palliative-care-consultations-for-nursing-home-residents-with-dementia
#16
Susan C Miller, Julie C Lima, Orna Intrator, Edward Martin, Janet Bull, Laura C Hanson
CONTEXT: U.S. nursing home (NH) residents with dementia have limited access to specialty palliative care beyond Medicare hospice. OBJECTIVES: To examine the value of expanded palliative care access for NH residents with moderate to very severe dementia. METHODS: We merged palliative care consultation data in 31 NHs in two states to Medicare data to identify residents with consultations, moderate to very severe dementia, and deaths in 2006-2010...
April 21, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28437261/training-in-intraoperative-handover-and-display-of-a-checklist-improve-communication-during-transfer-of-care-an-interventional-cohort-study-of-anaesthesia-residents-and-nurse-anaesthetists
#17
Marion Jullia, Anaïs Tronet, Fabiola Fraumar, Vincent Minville, Olivier Fourcade, Xavier Alacoque, Yannick LeManach, Matt M Kurrek
BACKGROUND: Handovers during anaesthesia are common, and failures in communication may lead to morbidity and mortality. OBJECTIVES: We hypothesised that intraoperative handover training and display of a checklist would improve communication during anaesthesia care transition in the operating room. DESIGN: Interventional cohort study. SETTING: Single-centre tertiary care university hospital. PARTICIPANTS: A total of 204 random observations of handovers between anaesthesia providers (residents and nurse anaesthetists) over a 6-month period in 2016...
April 21, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28435497/improved-accuracy-and-quality-of-information-during-emergency-department-care-transitions
#18
Nnaemeka Okafor, Justin Mazzillo, Sara Miller, Kimberly A Chambers, Samar Yusuf, Vanessa Garza-Miranda, Yashwant Chathampally
INTRODUCTION: Suboptimal communication during emergency department (ED) care transitions has been shown to contribute to medical errors, sometimes resulting in patient injury and litigation. The study objective was to determine whether a standardized checkout process would decrease the number of relevant missed clinical items (MCI). METHODS: In this prospective pre- and post-intervention study conducted in an urban academic ED, we collected data on omitted or inaccurately conveyed medical information before and after the initiation of a standardized checkout process...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28395703/the-measurement-of-transitions-in-cancer-scale
#19
Dena Schulman-Green, Sangchoon Jeon, Ruth McCorkle, Jane Dixon
BACKGROUND AND PURPOSE: Health-illness transitions are changes in life phase, situation, or status related to shifts between health and illness. We report on the development and psychometric evaluation of the Measurement of Transitions in Cancer Scale (MOT-CA), a 7-item instrument that assesses extent and management of a range of transitions experienced by cancer patients. METHODS: We identified content domains, developed operational definitions, generated items, conducted expert review (n = 7) and cognitive interviews (n = 13), and tested MOT-CA with our target population (n = 105)...
April 1, 2017: Journal of Nursing Measurement
https://www.readbyqxmd.com/read/28371889/development-and-implementation-of-a-risk-identification-tool-to-facilitate-critical-care-transitions-for-high-risk-surgical-patients
#20
Rebecca L Hoffman, Jason Saucier, Serena Dasani, Tara Collins, Daniel N Holena, Meghan Fitzpatrick, Boris Tsypenyuk, Niels D Martin
Quality problem: Patients recently discharged from the intensive care unit (ICU) are at high risk for clinical deterioration. Initial assessment: Unreliable and incomplete handoffs of complex patients contributed to preventable ICU readmissions. Respiratory decompensation was responsible for four times as many readmissions as other causes. Choice of solution: Form a multidisciplinary team to address care coordination surrounding the transfer of patients from the ICU to the surgical ward...
March 22, 2017: International Journal for Quality in Health Care
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