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"Avoidable admissions"

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https://www.readbyqxmd.com/read/29893435/dyspnea-and-self-management-strategies-in-patients-admitted-to-the-emergency-department-a-study-of-patients-experiences
#1
Karoline Stentoft Rybjerg Larsen, Annemette Krintel Petersen, Marianne Lisby, Marie Veje Knudsen
AIMS AND OBJECTIVE: To explore patients' experiences of acute dyspnea, physical functioning, and perspectives on course of illness prior to admission to the emergency department. BACKGROUND: Many emergency admissions are considered unnecessary and avoidable. In this perspective, it seems relevant to gain insight into the patients' perspective on acute dyspnea and the need for emergency admission. However, only few studies have investigated reasons for emergency admission from a patient perspective...
June 12, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29869851/peripherally-inserted-central-catheters-piccs-and-potential-cost-savings-and-shortened-bed-stays-in-an-acute-hospital-setting
#2
C O'Brien, J McMorrow, E O'Dwyer, P Govender, W C Torreggiani
Peripheral inserted central catheters (PICCs) have increasingly become the mainstay of patients requiring prolonged treatment with antibiotics, transfusions, oncologic IV therapy and total parental nutrition. They may also be used in delivering a number of other medications to patients. In recent years, bed occupancy rates have become hugely pressurized in many hospitals and any potential solutions to free up beds is welcome. Recent introductions of doctor or nurse led intravenous (IV) outpatient based treatment teams has been having a direct effect on early discharge of patients and in some cases avoiding admission completely...
January 10, 2018: Irish Medical Journal
https://www.readbyqxmd.com/read/29767481/supporting-care-home-staff-to-manage-residents-care-safely-and-avoid-admissions
#3
Susan Wills, Dena Ross
The community matron care homes team (CHT) was set up in Sandwell, West Midlands in 2011 to support care home staff to manage residents' care safely and reduce unplanned and/or avoidable use of acute health services. The service was reviewed in 2015 and attention focused on care homes with the highest levels of hospital use and emergency 999 services. Working with these care home staff and health professionals, a training and education opportunity to aid staff to manage residents in crisis was sourced, organised and implemented...
May 16, 2018: Nursing Older People
https://www.readbyqxmd.com/read/29705762/does-practice-analysis-agree-with-the-ambulatory-care-sensitive-conditions-list-of-avoidable-unplanned-admissions-a-cross-sectional-study-in-the-east-of-england
#4
Robert Fleetcroft, Antonia Hardcastle, Nicholas Steel, Gill M Price, Sarah Purdy, Alistair Lipp, Phyo Kyaw Myint, Amanda Howe
OBJECTIVES: To use significant event audits (SEAs) in primary care to determine which of a sample of emergency (unplanned) admissions were potentially avoidable; and compare with the National Health Service (NHS) list of ambulatory care sensitive conditions (ACSCs). DESIGN: Analysis of unplanned medical admissions randomly identified in secondary care. SETTING: Primary care in the East of England. PARTICIPANTS: 20 general practice teams trained to use SEA on unplanned admissions to identify potentially preventable factors...
April 28, 2018: BMJ Open
https://www.readbyqxmd.com/read/29614131/association-between-quality-domains-and-health-care-spending-across-physician-networks
#5
Farah Rahman, Jun Guan, Richard H Glazier, Adalsteinn Brown, Arlene S Bierman, Ruth Croxford, Therese A Stukel
One of the more fundamental health policy questions is the relationship between health care quality and spending. A better understanding of these relationships is needed to inform health systems interventions aimed at increasing quality and efficiency of care. We measured 65 validated quality indicators (QI) across Ontario physician networks. QIs were aggregated into domains representing six dimensions of care: screening and prevention, evidence-based medications, hospital-community transitions (7-day post-discharge visit with a primary care physician; 30-day post-discharge visit with a primary care physician and specialist), potentially avoidable hospitalizations and emergency department (ED) visits, potentially avoidable readmissions and unplanned returns to the ED, and poor cancer end of life care...
2018: PloS One
https://www.readbyqxmd.com/read/29225926/does-expanding-primary-healthcare-improve-hospital-efficiency-evidence-from-a-panel-analysis-of-avoidable-hospitalisations-in-5506-municipalities-in-brazil-2000-2014
#6
Everton Nunes da Silva, Timothy Powell-Jackson
Background: Hospitals account for the major share of health expenditure. Primary healthcare may improve efficiency at the hospital level by reducing avoidable admissions. We examined whether rapid expansion of primary healthcare in the context of Brazil's Family Health Strategy (FHS) was associated with a reduction in avoidable hospitalisations. Methods: We constructed panel data for 5506 municipalities over 2000-2014. Our primary outcome was the rate of avoidable hospitalisations, defined with reference to the official list of ambulatory care sensitive conditions (ACSC)...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29170350/53-piloting-patch-providing-assessment-and-treatment-for-children-at-home-and-piecing-together-what-works
#7
Caroline Ward, Katie Knight, Mary-Rose Ballard, Georgina Keogh, Miriam Samuel, Sara Buttle, Claire Robb, Francesca Cleugh
AIMS: PATCH is a pilot acute community children's nurse led service delivering assessment and treatment for children at home who are moderately unwell and might otherwise be admitted to hospital or attend Paediatric Emergency Department (PED). Children are referred by PED or GP and followed up via telephone support and home visits depending on clinical need for duration of acute illness. METHODS: Pilot year funded by Imperial Charity. Using evaluation to build business case for sustained commissioned service...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29137504/avoidable-hospital-admissions-from-diabetes-complications-in-japan-singapore-hong-kong-and-communities-outside-beijing
#8
Jianchao Quan, Huyang Zhang, Deanette Pang, Brian K Chen, Janice M Johnston, Weiyan Jian, Zheng Yi Lau, Toshiaki Iizuka, Gabriel M Leung, Hai Fang, Kelvin B Tan, Karen Eggleston
Improving the quality of primary care may reduce avoidable hospital admissions. Avoidable admissions for conditions such as diabetes are used as a quality metric in the Health Care Quality Indicators of the Organization for Economic Cooperation and Development (OECD). Using the OECD indicators, we compared avoidable admission rates and spending for diabetes-related complications in Japan, Singapore, Hong Kong, and rural and peri-urban Beijing, China, in the period 2008-14. We found that spending on diabetes-related avoidable hospital admissions was substantial and increased from 2006 to 2014...
November 2017: Health Affairs
https://www.readbyqxmd.com/read/29079490/expedited-discharge-from-an-academic-emergency-department-a-pilot-program
#9
Andrew Goldsmith, Luis Ticona, Ryan Thompson, Benjamin A White, Joan Strauss, Robert Seger, David F M Brown, Ali S Raja, Brian J Yun
BACKGROUND: As the numbers of emergency department (ED) visits and inpatient admissions continue to increase, there is growing interest in alternatives to inpatient hospitalization. OBJECTIVE: Our aim was to investigate a novel approach to expediting discharges from the ED with multidisciplinary discharge services to prevent an avoidable admission into the hospital. METHODS: This pilot study was conducted at a large urban tertiary-care ED in 2016...
December 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29072867/measuring-impact-of-telephone-triage-in-acute-medicine
#10
Huma Asmat, Shah Khalid Shinwari, Tim Cooksley, Roger Duckitt, Ivan Le Jeune, Christian P Subbe
The Society for Acute Medicine's Benchmarking Audit (SAMBA) was undertaken for the 5th time in June 2016. For the first time, data on telephone triage calls prior to admission to Acute Medical Units were collected: 1238 patients were referred from Emergency Departments, 925 from General Practitioners (GPs), 52 from clinics and 147 from other sources. Calls from Emergency Departments rarely resulted in admission avoidance. Calls from Primary Care resulted in avoidance of an admission in 115 (12%) patients; the percentage of avoided admissions was highest if the call was taken by a Consultant...
2017: Acute Medicine
https://www.readbyqxmd.com/read/29056562/causes-of-hospital-admissions-in-domus-a-randomized-controlled-trial-of-specialized-palliative-cancer-care-at-home
#11
Kirstine Skov Benthien, Mie Nordly, Annika von Heymann-Horan, Kristina Rosengaard Holmenlund, Helle Timm, Geana Paula Kurita, Christoffer Johansen, Jakob Kjellberg, Hans von der Maase, Per Sjøgren
CONTEXT: Avoidable hospital admissions are important negative indicators of quality of end-of-life care. Specialized palliative care (SPC) may support patients remaining at home. OBJECTIVES: Therefore, the purpose of this study was to investigate if SPC at home could prevent hospital admissions in patients with incurable cancer. METHODS: These are secondary results of Domus: a randomized controlled trial of accelerated transition to SPC with psychological intervention at home (Clinicaltrials...
March 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28992984/avoidable-hospitalizations-due-to-adverse-drug-reactions-in-an-acute-geriatric-unit-analysis-of-3-292-patients
#12
Mateu Cabré, Lorena Elias, Mireia Garcia, Elisabet Palomera, Mateu Serra-Prat
OBJECTIVE: To determine prevalence of admissions due to an adverse drug reaction (ADR) and determine whether or not admission was avoidable, and what drugs and risk factors were implicated. DESIGN: Cross-sectional observational study. STUDY SAMPLE: All patients hospitalized in an acute geriatric unit during the period January 2001 to December 2010 were studied. MEASUREMENT: To determine whether admissions were due toADR, we used the World Health Organization-Uppsala Monitoring Centre criteria and the Naranjo scale...
March 23, 2018: Medicina Clínica
https://www.readbyqxmd.com/read/28971143/glasgow-blatchford-score-of-limited-benefit-for-low-risk-urban-patients-a-mixed-methods-study
#13
David A Leiman, Angela M Mills, Frances S Shofer, Andrew T Weber, Erin R Leiman, Brian P Riff, James D Lewis, Shivan J Mehta
BACKGROUND AND STUDY AIMS:  Most patients with upper gastrointestinal bleeding (UGIB) are hospitalized. Risk-stratifying UGIB with scoring tools may decrease avoidable admissions, thereby reducing the cost of care. We sought to describe how frequently low-risk UGIB patients present to urban emergency departments (ED) and the proportion who are admitted to examine how incorporating risk scores into decision support might diminish healthcare utilization in this population. PATIENTS AND METHODS:  This is a retrospective cohort study of ED patients presenting from 2009 - 2013 to three urban hospitals that do not use electronic UGIB decision support...
October 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28957486/admissions-to-inpatient-care-facilities-in-the-last-year-of-life-of-community-dwelling-older-people-in-europe
#14
Anouk Overbeek, Lieve Van den Block, Ida J Korfage, Yolanda W H Penders, Agnes van der Heide, Judith A C Rietjens
Background: In the last year of life, many older people rather avoid admissions to inpatient care facilities. We describe and compare such admissions in the last year of life of 5092 community-dwelling older people in 15 European countries (+Israel). Methods: Proxy-respondents of the older people, who participated in the longitudinal SHARE study, reported on admissions to inpatient care facilities (hospital, nursing home or hospice) during the last year of their life...
October 1, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/28892716/neuroscience-step-down-unit-admission-criteria-for-patients-with-intracerebral-hemorrhage
#15
Ayham M Alkhachroum, Oladi Bentho, Neel Chari, Ashish Kulhari, Wei Xiong
OBJECTIVES: The goal of our study is to determine optimal criteria which can be used to avoid admission to neuroscience intensive care units for patients with intracerebral hemorrhage (ICH). PATIENTS AND METHODS: This is a retrospective cohort study of 431 patients with primary ICH from January 2013 to the end of December 2015 and reviewed multiple admitting characteristics. Based on these needs, we tested the following step-down unit admission criteria: Supratentorial ICH, ICH volume <20 cc, no Intraventricular hemorrhage (IVH), systolic BP <200mmHg, no respiratory failure, GCS≥12...
November 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28874939/rapid-primary-care-follow-up-from-the-ed-to-reduce-avoidable-hospital-admissions
#16
Amanda S Carmel, Peter Steel, Robert Tanouye, Aleksey Novikov, Sunday Clark, Sanjai Sinha, Judy Tung
INTRODUCTION: Hospital admissions from the emergency department (ED) now account for approximately 50% of all admissions. Some patients admitted from the ED may not require inpatient care if outpatient care could be optimized. However, access to primary care especially immediately after ED discharge is challenging. Studies have not addressed the extent to which hospital admissions from the ED may be averted with access to rapid (next business day) primary care follow-up. We evaluated the impact of an ED-to-rapid-primary-care protocol on avoidance of hospitalizations in a large, urban medical center...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28791786/emergency-department-provider-perspectives-on-benzodiazepine-opioid-coprescribing-a-qualitative-study
#17
Howard S Kim, Danielle M McCarthy, Jason A Hoppe, D Mark Courtney, Bruce L Lambert
OBJECTIVE: Benzodiazepines and opioids are prescribed simultaneously (i.e., "coprescribed") in many clinical settings, despite guidelines advising against this practice and mounting evidence that concomitant use of both medications increases overdose risk. This study sought to characterize the contexts in which benzodiazepine-opioid coprescribing occurs and providers' reasons for coprescribing. METHODS: We conducted focus groups with emergency department (ED) providers (resident and attending physicians, advanced practice providers, and pharmacists) from three hospitals using semistructured interviews to elicit perspectives on benzodiazepine-opioid coprescribing...
January 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28754601/magnesium-sulfate-infusion-for-acute-asthma-in-the-emergency-department
#18
REVIEW
Jose Enrique Irazuzta, Nicolas Chiriboga
OBJECTIVES: To describe the role of intravenous magnesium sulfate (MgSO4 ) as therapy for acute severe asthma in the pediatric emergency department (ED). SOURCE: Publications were searched in the PubMed and Cochrane databases using the following keywords: magnesium AND asthma AND children AND clinical trial. A total of 53 publications were retrieved using this criteria. References of relevant articles were also screened. The authors included the summary of relevant publications where intravenous magnesium sulfate was studied in children (age <18 years) with acute asthma...
November 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28724143/potentially-avoidable-surgical-intensive-care-unit-admissions-and-disposition-delays
#19
Navpreet K Dhillon, Ara Ko, Eric J T Smith, Mayumi Kharabi, Joseph Castongia, Michael Nurok, Bruce L Gewertz, Eric J Ley
Importance: High health care costs encourage initiatives that avoid overuse of resources and identify opportunities to promote appropriate care. Objective: To investigate the causes of potentially avoidable surgical intensive care unit (SICU) admissions and disposition delays to determine whether targeted interventions could decrease these stays. Design, Setting, and Participants: This prospective, observational study focused on potentially avoidable SICU days, as determined by observers with input from the rounding intensivists at a 24-bed open SICU at an urban, academic hospital...
November 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28560903/-susan-and-dena-s-vision-hard-work-and-enthusiasm-were-unbeatable
#20
Elaine Cole
Susan Wills and Dena Ross have reduced unplanned and avoidable admissions by supporting the carers to manage residents safely in their nursing homes.
May 31, 2017: Nursing Older People
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