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https://www.readbyqxmd.com/read/28223112/understanding-and-applying-the-concept-of-value-creation-in-radiology
#1
David B Larson, Daniel J Durand, Daniel S Siegal
The concept of value in radiology has been strongly advocated in recent years as a means of advancing patient care and decreasing waste. This article explores the concept of value creation in radiology and offers a framework for how radiology practices can create value according to the needs of their referring clinicians. Value only exists in the eyes of a customer. We propose that the primary purpose of diagnostic radiology is to answer clinical questions using medical imaging to help guide management of patient care...
February 17, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28222904/the-2016-proposal-for-the-reorganisation-of-urgent-care-provision-in-belgium-a-political-struggle-to-co-locate-primary-care-providers-and-emergency-departments
#2
Koen Van den Heede, Wilm Quentin, Cécile Dubois, Stephan Devriese, Carine Van de Voorde
Internationally the number of emergency department (ED) visits is on the rise while evidence suggests that a substantial proportion of these patients do not require emergency care but primary care. This paper presents the Belgian 2016 proposal for the reorganisation of urgent care provision and places it into its political context. The proposal focused on re-designing patient flow aiming to reduce inappropriate ED visits by improving guidance of patients through the system. Initially policymakers envisaged, as cornerstone of the reform, to roll-out as standard model the co-location of primary care centres and EDs...
February 17, 2017: Health Policy
https://www.readbyqxmd.com/read/28215655/the-caregiver-perspective-on-unscheduled-72-hour-return-visits-to-pediatric-acute-care-sites-a-focus-on-discharge-processes
#3
Nidhya Navanandan, Sarah K Schmidt, Natasha Cabrera, Michael C DiStefano, Rakesh D Mistry
OBJECTIVE: To characterize pediatric caregivers' reasons for 72-hour emergency department (ED) and urgent care (UC) returns. METHODS: A sample of caregivers returning within 72 hours of initial visit to a pediatric ED or affiliated UC site were surveyed from 11/14-6/15; patients evaluated at outside ED/UCs, scheduled for return, or non-English/Spanish speaking were excluded. Caregiver surveys underwent item generation, validation, and pilot testing. Survey items included caregiver reasons for unscheduled returns, with a specific assessment of delivery of key components of discharge instructions (diagnosis, duration of illness, home care, return precautions)...
February 12, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28214061/open-physeal-fracture-of-the-distal-phalanx-of-the-hallux-case-study-diagnosis-and-management
#4
Brandon Morris, Scott Mullen, Paul Schroeppel, Bryan Vopat
Open physeal fractures of the distal phalanx of the hallux are the lesser described counterpart to the same fracture of the finger, known by its eponym as a "Seymour fracture". Displaced Salter-Harris phalangeal fractures present with a concomitant nailbed or soft tissue injury. Often these fractures occur in the summer months when open-toe footwear can be worn, however, they may occur indoors as well. Frequently, the injury results from direct axial load of the toe, or "stubbing", which causes the fracture and associated soft tissue injury...
February 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28213342/virtual-visits-for-acute-nonurgent-care-a-claims-analysis-of-episode-level-utilization
#5
Aliza S Gordon, Wallace C Adamson, Andrea R DeVries
BACKGROUND: Expansion of virtual health care-real-time video consultation with a physician via the Internet-will continue as use of mobile devices and patient demand for immediate, convenient access to care grow. OBJECTIVE: The objective of the study is to analyze the care provided and the cost of virtual visits over a 3-week episode compared with in-person visits to retail health clinics (RHC), urgent care centers (UCC), emergency departments (ED), or primary care physicians (PCP) for acute, nonurgent conditions...
February 17, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28211045/walk-in-clinics-versus-physician-offices-and-emergency-rooms-for-urgent-care-and-chronic-disease-management
#6
REVIEW
Connie E Chen, Christopher T Chen, Jia Hu, Ateev Mehrotra
BACKGROUND: Walk-in clinics are growing in popularity around the world as a substitute for traditional medical care delivered in physician offices and emergency rooms, but their clinical efficacy is unclear. OBJECTIVES: To assess the quality of care and patient satisfaction of walk-in clinics compared to that of traditional physician offices and emergency rooms for people who present with basic medical complaints for either acute or chronic issues. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, six other databases, and two trials registers on 22 March 2016 together with reference checking, citation searching, and contact with study authors to identify additional studies...
February 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28198965/development-of-a-virtual-learning-environment-for-cardiorespiratory-arrest-training
#7
Anazilda Carvalho da Silva, Andrea Bernardes, Yolanda Dora Martinez Évora, Maria Célia Barcellos Dalri, Alexandre Ribeiro da Silva, Camila Santana Justo Cintra Sampaio
OBJECTIVE: To develop a Virtual Learning Environment (VLE) aiming at the training of nursing team workers and emergency vehicle drivers in Basic Life Support (BLS) to attend Cardiorespiratory arrest, and to evaluate the quality of its contents among specialists in the area of Emergency and Urgent care. METHOD: Applied research of technological development. The methodology used was based on the Instructional Design Model (ADDIE), which structures the teaching-learning planning in different stages (analysis, design, development, implementation and evaluation)...
November 2016: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/28183503/a-66-year-old-woman-with-sudden-onset-of-disseminated-intravascular-coagulation-lactic-acidosis-and-hypoglycemia
#8
Benjamin Henkle, Patrick Arndt
A 66-year-old woman presented to an urgent care clinic for 2 to 3 weeks of general malaise, nausea/vomiting, night sweats, and dyspnea. On examination, she was tachycardic, and her laboratory evaluation was normal except for a lactate level of 4.4 mmol/L and platelet count of 118 × 10(9)/L. CT imaging was performed. Two days later in the follow-up clinic, the patient's international normalized ratio (INR) was elevated, and she was hospitalized with initial findings of disseminated intravascular coagulation (DIC) (ie, INR > 10, platelets 97 × 10(9)/L, fibrinogen < 60 mg/dL, positive D-dimer result)...
February 2017: Chest
https://www.readbyqxmd.com/read/28178012/emergency-department-interventions-for-persons-with-dementia-presenting-with-ambulatory-care-sensitive-conditions-a-scoping-review-protocol
#9
Beverley A Temple, Preetha Krishnan, Beverly O'Connell, Lyle G Grant, Lisa Demczuk
The objective of this scoping review is to examine and map, within existing literature, the characteristics of emergency department/urgent care interventions, strategies or contextual factors, implemented to reduce unnecessary hospitalization of people with dementia (PWD) presenting at the emergency department/urgent care with ambulatory care-sensitive conditions (ACSC).More specifically, the review questions are.
February 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28169982/effect-of-an-asthma-guideline-in-2-pediatric-emergency-departments-and-an-urgent-care-center
#10
Jennifer J Dilts, Sharon G Humiston, Brian R Lee, Nancy H Allen, Jeffrey G Michael
OBJECTIVES: The objective of this study was to evaluate ordering of albuterol via metered-dose inhaler with spacer (MDI-spacer), length of stay (LOS), and 72-hour return rates before and after publication of an internally developed pediatric asthma clinical practice guideline (CPG). METHODS: The internally developed CPG reflected national recommendations. It was explained at faculty meetings by a respected clinician and published on the intranet on February 6, 2012...
February 4, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28152833/understanding-total-cost-of-cancer-care-to-determine-strategic-interventions-to-improve-value
#11
Salimah Velji, Kavita Patel, Basit Chaudhry, Sonia Grizzle, Catherine A Lyons, Rogerio Lilenbaum
: 3 Background: Cancer centers across the country are largely unprepared to move toward value-based payment. Total cost of care data is not readily available and centers do not know how much of their patients' care is received at other hospitals, when in the trajectory of illness greatest cost is incurred, or the elements of care that present the greatest opportunity for savings. A previous examination of practice patterns Smilow Cancer Hospital (SCH) demonstrated that our patients had high rates of ED visits, hospital admissions and ICU use in their last month of life...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152800/acute-hospitalizations-in-cancer-patients-treated-with-definitive-radiotherapy-a-retrospective-cohort-study-with-implications-for-an-urgent-care-clinic
#12
Peter Edward Gabriel, Daniel Owen, Melody Ju Xu, Charles B Simone, John Peter Plastaras, John Paul Christodouleas, Wei-Ting Hwang, Neha Vapiwala
: 312 Background: Reasons for hospitalizations in patients undergoing curative-intent radiotherapy (RT) have not been well characterized previously. Implementation of urgent cancer care clinics could decrease rates of hospitalization, but the reasons for acute visits must be better understood. This retrospective cohort study investigates emergency department (ED) visits or admissions in patients treated with definitive RT. METHODS: Under an IRB-approved protocol, the cohort was defined as all consecutive patients >=18 yo who began RT (RTSTART) between 7/1/11 and 12/31/13 for nonmetastatic disease with curative intent...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28141722/sudden-onset-of-refusal-to-eat-on-waking-after-a-nightmare-in-a-6-year-old-girl
#13
Maria Zaccagnino, Sheila Gahagan, Andrea Spencer, Michael Jellinek, Martin T Stein
Bridgette is a 6-year-old girl, who presented with sudden onset of refusal to eat or drink. The only precipitating event was a nightmare the previous night. She described a dream in which her mother and maternal aunt, dressed as witches, and father and maternal uncle, appearing as bats, wanted to kill her by making her eat and drink from a cauldron. Bridgette stated, "I can't eat anymore, I'm afraid of dying." Bridgette's eating pattern and behavior were described as previously normal. Motor, social, and language milestones were also normal...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28141720/sexuality-and-intellectual-disability
#14
Jodi Wenger, Alison Downes, Nathan Blum, Marilyn Augustyn
Amad is a wonderful 16-year-old young man from Syria who has recently relocated to the United States from his war-torn native country. In his last few years in Syria, he was primarily at home with his mother, and they sought refuge with a maternal aunt in the United States seeking asylum and treatment of Amad's disability.At 8 years of age, he had intelligence testing in the United Arab Emirates, which showed a verbal intelligence score on the Wechsler intelligence scale for children (WISC) of 68 and a performance of 64...
February 2017: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/28100142/reduction-in-jail-emergency-department-visits-and-closure-after-implementation-of-on-site-urgent-care
#15
Erick Eiting, Carrie S Korn, Erin Wilkes, Glenn Ault, Sean O Henderson
This descriptive study evaluates the impact of implementation of full service on-site urgent care services at the Los Angeles County Jail (LACJ) by examining the number of patients seen at the referral hospital, Los Angeles County + University of Southern California Medical Center (LAC+USC), and the number of hours that the referral hospital was closed to transfers in the periods before and after the development of the LACJ Urgent Care. The appropriate utilization of public resources is a critical priority for an overburdened county medical health care system...
January 2017: Journal of Correctional Health Care
https://www.readbyqxmd.com/read/28098545/increase-in-urgent-care-center-visits-for-sexually-transmitted-infections-united-states-2010-2014
#16
William S Pearson, Guoyu Tao, Karen Kroeger, Thomas A Peterman
During 2010-2014, urgent care centers saw a ≈2-fold increase in the number of visits for chlamydia and gonorrhea testing and a >3-fold increase in visits by persons with diagnosed sexually transmitted infections. As urgent care becomes more popular, vigilance is required to ensure proper management of these diseases.
February 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28060178/assessment-of-splints-applied-for-pediatric-fractures-in-an-emergency-department-urgent-care-environment
#17
Joshua M Abzug, Brandon S Schwartz, Aaron J Johnson
BACKGROUND: Fractures are common in the pediatric population. The initial evaluation is rarely by an orthopaedic surgeon, but commonly an emergency room or urgent care center physician/extender. This typically involves splint application by a nonorthopaedist to immobilize the extremity and provide stabilization. Iatrogenic injuries from inappropriate splint placement are a potential public health and legal concern that can lead to complications. The primary purpose of this study was to prospectively evaluate the adequacy of all splints placed on patients who presented to a pediatric orthopaedic office; secondary outcomes included assessing prevalence and types of complications that were associated with inadequate splints...
January 5, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28031377/urine-cotinine-screening-detect-nearly-ubiquitous-tobacco-smoke-exposure-in-urban-adolescents
#18
Neal L Benowitz, Shonul Jain, Delia A Dempsey, Natalie Nardone, Gideon St Helen, Peyton Jacob
INTRODUCTION: Routine biochemical assessment of tobacco smoke exposure could lead to more effective interventions to reduce or prevent secondhand smoke (SHS)-related disease in adolescents. Our aim was to determine using urine cotinine (major nicotine metabolite) measurement the prevalence of tobacco smoke exposure among adolescents receiving outpatient care at an urban public hospital. METHODS: Surplus urine was collected in 466 adolescents attending pediatric or urgent care clinics at San Francisco General Hospital, serving families with lower levels of income and education, in 2013-14...
December 28, 2016: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28030459/implementation-and-sequencing-of-practice-transformation-in-urban-practices-with-underserved-patients
#19
Denise D Quigley, Zachary S Predmore, Alex Y Chen, Ron D Hays
BACKGROUND: Patient-centered medical home (PCMH) has gained momentum as a model for primary-care health services reform. METHODS: We conducted interviews at 14 primary care practices undergoing PCMH transformation in a large urban federally qualified health center in California and used grounded theory to identify common themes and patterns. RESULTS: We found clinics pursued a common sequence of changes in PCMH transformation: Clinics began with National Committee for Quality Assurance (NCQA) level 3 recognition, adding care coordination staff, reorganizing data flow among teams, and integrating with a centralized quality improvement and accountability infrastructure...
January 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28029719/domestic-violence-and-abuse-screening-in-emergency-department-a-rapid-review-of-the-literature
#20
REVIEW
Irfan Ahmad, Parveen Azam Ali, Salma Rehman, Ashfaque Talpur, Katie Dhingrra
AIM: The aim of the review was to identify intimate partner violence screening interventions used in emergency departments (ED) and to explore factors affecting intimate partner violence screening in EDs. BACKGROUND: Intimate partner violence against women is now clearly recognised as a global health and societal issue. Nurses working in emergency and urgent care settings can play a crucial role in identification, prevention and management of intimate partner violence Research exploring optimal methods of IPV screening and factors affecting intimate partner violence screening in EDs is relatively limited...
December 28, 2016: Journal of Clinical Nursing
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