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Physician–patient communication

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https://www.readbyqxmd.com/read/29784444/enacting-high-reliability-principles-while-caring-for-people-with-ebola-virus-disease
#1
Bonnie Mowinski Jennings, Katherine A Yeager, Nancye R Feistritzer, Mary M Gullatte, Kristy K Martyn
BACKGROUND: Fear surrounds Ebola Virus Disease (EVD) because it is highly infectious. Yet members of the Serious Communicable Diseases Unit (SCDU) at Emory University Hospital (EUH) had to overcome that fear when caring for patients with EVD. PURPOSE: The analysis reported here illustrates how the members of EUH's SCDU tacitly enacted high reliability (HR) principles while caring for patients with EVD. METHODS: A qualitative study was conducted to describe the experience of members of the EUH SCDU who worked with EVD patients in 2014...
May 18, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29783126/systemic-therapy-for-intermediate-and-advanced-hepatocellular-carcinoma-sorafenib-and-beyond
#2
REVIEW
Jean-Luc Raoul, Masatoshi Kudo, Richard S Finn, Julien Edeline, Maria Reig, Peter R Galle
The hepatocellular carcinoma (HCC) treatment landscape changed a decade ago, with sorafenib demonstrating survival benefit in the first-line setting and becoming the first systemic therapy to be approved for HCC. More recently, regorafenib and nivolumab have received approval in the second-line setting after sorafenib, with further positive phase 3 studies emerging in the first line (lenvatinib non-inferior to sorafenib) and second line versus placebo (cabozantinib and ramucirumab). A key recommendation in the management of patients receiving sorafenib is to promote close communication between the patient and the physician so that adverse events (AEs) are detected early and severe AEs can be prevented...
May 17, 2018: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/29782309/in-memoriam-assistant-professor-kre%C3%A5-imir-kostovi%C3%A4-md-phd-16-october-1969-15-october-2017
#3
Branka Marinović
On a Sunday afternoon almost six months ago, we were deeply moved by the news that our Krešimir is no longer with us. The sad news spread from Sarajevo with the speed only most horrible and saddest news can achieve. And everybody who was reached by these news wondered whether it was possible and whether it was true. Because our professor Kostović left us a day before his 48th birthday. Krešimir Kostović was born on the 16th October 1969 in Zagreb, where he completed primary and secondary education. He enrolled at the University of Zagreb School of Medicine in 1988, and got his medical degree in 1995...
April 2018: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/29781980/disclosure-coaching-an-ask-tell-ask-model-to-support-clinicians-in-disclosure-conversations
#4
Jo Shapiro, Lynne Robins, Pamela Galowitz, Thomas H Gallagher, Sigall Bell
Error disclosure is a high-stakes, emotionally charged interaction for patients and families as well as clinicians. A failed disclosure can result in emotional distress, reduced patient and family trust, litigation, and lost opportunities to learn from and prevent subsequent errors. However, many clinicians have little expertise in handling these challenging interactions and can inadvertently make a bad situation worse. Even those clinicians who have had formal disclosure training may have trouble remembering what they were taught when faced with the need to actually discuss an error with patients...
May 16, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29781461/oral-agents-challenges-with-self-administered-medication-adherence-in-clinical-trials
#5
Rosilyn Gborogen, Carolee Polek
BACKGROUND: In oral agent clinical trials, patients may not be adherent to self-administration of study medication; this nonadherence can affect validity and reliability. Many factors contribute to nonadherence to protocol requirements, and managing patients with fidelity issues is the responsibility of the research team. OBJECTIVES: The aim is to identify which group (patients, physicians/principal investigators, nurses, or other personnel) research nurses report as most responsible for protocol nonadherence and to characterize the most observed causes and contributors to nonadherence within each group...
June 1, 2018: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29779819/barriers-for-nutritional-care-in-the-transition-from-hospital-to-the-community-among-older-patients
#6
Yulia Ginzburg, Inbar Shmilovitz, Nechama Monastyrsky, Ronit Endevelt, Danit R Shahar
BACKGROUND & AIMS: Data on the continuity of nutritional care in the transition from the hospital to the community is scarce although its impact on medical complications is highly significant. The aim of the current study is to determine level of adherence to dietary recommendations after hospitalization and identify barriers for adherence. METHODS: A prospective study among patients age ≥65 who were treated with oral nutritional supplements (ONS) during their hospitalization and discharged with dietary recommendations...
June 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29779398/handoff-tool-enabling-standardized-transitions-between-the-emergency-department-and-the-hospitalist-inpatient-service-at-a-major-cancer-center
#7
Carmen E Gonzalez, Norman Brito-Dellan, Srinivas R Banala, David Rubio, Mohamed Ait Aiss, Terry W Rice, Karen Chen, Diane C Bodurka, Carmelita P Escalante
Communication failures during patient handoff can lead to serious errors. A quality improvement team created a standardized handoff tool/process (DE-PASS: Decisive problem requiring admission, Evaluation time, Patient summary, Acute issues/action list, Situation unfinished/awareness, Signed out to) for admitting patients from the emergency department (ED) to the hospitalist inpatient service of a tertiary cancer center. DE-PASS mirrors the institution's ED workflow, stratifies patients as stable/urgent/emergent, and establishes requirements for verbal and email communications between providers...
May 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29777924/views-and-experiences-with-regard-to-antibiotic-use-of-hospitalised-patients-in-five-european-countries-a-qualitative-descriptive-study
#8
V Zanichelli, A A Monnier, G Tebano, M Stanić Benić, I C Gyssens, C Pulcini, V Vlahović-Palčevski, M Schindler, S Harbarth, M Hulscher, B D Huttner
OBJECTIVES: To explore inpatients experiences and views with regard to antibiotics in 5 European hospitals. METHODS: Qualitative study where a patient-centred framework was used to explore inpatients' experiences concerning antibiotic treatment. A purposeful sample of inpatients treated with antibiotics in 5 hospitals (Belgium-BE, Croatia-HR, France-FR, Netherlands-NL, Switzerland-CH) participated in interviews (all centres) and focus groups (CH). RESULTS: 31 interviews (BE=5, HR=10, F=9, NL=5, CH=2) and three focus groups (CH= 11 participants) were performed...
May 16, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29775080/mindfulness-meditation-and-interprofessional-cardiopulmonary-resuscitation-a-mixed-methods-pilot-study
#9
Diana J Kelm, Jennifer L Ridgeway, Becca L Gas, Monali Mohan, David A Cook, Darlene R Nelson, Roberto P Benzo
PROBLEM: Mindfulness training includes mindfulness meditation, which has been shown to improve both attention and self-awareness. Medical providers in the intensive care unit often deal with difficult situations with strong emotions, life-and-death decisions, and both interpersonal and interprofessional conflicts. The effect of mindfulness meditation training on healthcare providers during acute care tasks such as cardiopulmonary resuscitation remains unknown. Mindfulness meditation has the potential to improve provider well-being and reduce stress in individuals involved in resuscitation teams, which could then translate into better team communication and delivery of care under stress...
May 18, 2018: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29773941/periodontal-disease-and-diabetes-perceptions-communication-and-referral-between-rural-primary-care-physicians-and-dentists
#10
Paige M Fisketjon, Eric L Johnson
Background and objective: Connections between oral health and systemic disease, specifically diabetes, are well described in the literature. Screening strategies for diabetes in dental settings and dental screenings in diabetes care settings exist. The purpose of this study was to evaluate the communication and referral patterns between dentists and physicians in a rural state with respect to recognition of dental disease and diabetes. Methods: Surveys were sent to the members of the North Dakota Academy of Family Physicians, the North Dakota Medical Association, and the North Dakota Dental Association...
May 2018: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29773700/implications-of-involving-pharmacy-technicians-in-obtaining-a-best-possible-medication-history-from-the-perspectives-of-pharmaceutical-medical-and-nursing-staff-a-qualitative-study
#11
Andrea Niederhauser, Chantal Zimmermann, Liat Fishman, David L B Schwappach
OBJECTIVES: In recent years, the involvement of pharmacy technicians in medication reconciliation has increasingly been investigated. The aim of this study was to assess the implications on professional roles and collaboration when a best possible medication history (BPMH) at admission is obtained by pharmacy technicians. DESIGN: Qualitative study with semistructured interviews. Data were analysed using a qualitative content analysis approach. SETTING: Internal medicine units in two mid-sized Swiss hospitals...
May 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29773480/must-i-respond-if-my-health-is-at-risk
#12
Kenneth V Iserson
BACKGROUND: Widespread epidemics, pandemics, and other risk-prone disasters occur with disturbing regularity. When such events occur, how should, and will, clinicians respond? The moral backbone of medical professionals-a duty to put the needs of patients first-may be sorely tested. DISCUSSION: It is incumbent on health care professionals to ask what we must do and what we should do if a dangerous health care situation threatens both ourselves and our community...
May 14, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29770734/post-transfusion-hemoglobin-values-and-patient-blood-management
#13
Jan Moerman, Edith Vermeulen, Mia Van Mullem, Anne-Mie Badts, Peter Lybeert, Veerle Compernolle, Jørgen Georgsen
Objectives The objective of this retrospective study was to evaluate the added value of communicating post-transfusion hemoglobin values to clinicians as a strategy to improve RBC utilization in a 500-bed hospital. Methods The total number of RBC transfusions, the mean number of RBC units transfused per patient, the mean pre- and post-transfusion hemoglobin values, the ratio of patients transfused and the ratio of patients with a post-transfusion hemoglobin > 10.5 g/dL were calculated per service and per department for six months...
May 17, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29770076/the-use-of-technology-to-improve-health-care-to-saskatchewan-s-first-nations-communities
#14
I Khan, N Ndubuka, K Stewart, V McKinney, I Mendez
Background: Saskatchewan is a province of over one million people and over 13% are Indigenous peoples, many of whom live on reserve lands. Despite continued efforts, access to health care remains a significant challenge for these Indigenous people, especially those in the North. Objective: To address this challenge, Saskatchewan's health care providers have been incorporating the use of technology for various health services. This paper describes various ways technology has been used in First Nations communities in Saskatchewan...
June 1, 2017: Canada Communicable Disease Report, Relevé des Maladies Transmissibles Au Canada
https://www.readbyqxmd.com/read/29768181/description-of-hot-debriefings-after-in-hospital-cardiac-arrests-in-an-international-pediatric-quality-improvement-collaborative
#15
Todd Sweberg, Anita I Sen, Paul C Mullan, Adam Cheng, Lynda Knight, Jimena Del Castillo, Takanari Ikeyama, Roopa Seshadri, Mary Fran Hazinski, Tia Raymond, Dana E Niles, Vinay Nadkarni, Heather Wolfe
BACKGROUND: The American Heart Association recommends debriefing after attempted resuscitation from in-hospital cardiac arrest (IHCA) to improve resuscitation quality and outcomes. This is the first published study detailing the utilization, process and content of hot debriefings after pediatric IHCA. METHODS: Using prospective data from the Pediatric Resuscitation Quality Collaborative (pediRES-Q), we analyzed data from 227 arrests occurring between February 1, 2016, and August 31, 2017...
May 13, 2018: Resuscitation
https://www.readbyqxmd.com/read/29765259/shadowing-emergency-medicine-residents-by-medical-education-specialists-to-provide-feedback-on-non-medical-knowledge-based-acgme-sub-competencies
#16
Anna L Waterbrook, Karen C Spear Ellinwood, T Gail Pritchard, Karen Bertels, Ariel C Johnson, Alice Min, Lisa R Stoneking
Objective: Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management) are challenging for a supervising emergency medicine (EM) physician to evaluate in real-time on shift while also managing a busy emergency department (ED). This study examines residents' perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills. Methods: Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year...
2018: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/29765244/an-echo-to-choosing-wisely-%C3%A2-in-switzerland
#17
Lionel Chok, Johann Debrunner, Sandra Jaeggli, Karmen Kusic, Esther B Bachli
Background: Inspired by the US Choosing Wisely® , in 2016 the Swiss Society of General Internal Medicine released a list of five treatments or diagnostic tests used in the hospital and considered unnecessary based on not improving patient care and adding to health care costs. These "Smarter Medicine" recommendations were implemented in the Department of Internal Medicine, Uster Hospital, in August 2016. They were supported by lectures and weekly email communications. We analyzed the number of blood draws before and after implementation of the recommendation aimed at reducing blood tests...
2018: International Journal of General Medicine
https://www.readbyqxmd.com/read/29763535/team-based-pod-system-reduces-lengths-of-stay-for-treat-and-release-patients
#18
Nicholas Gavin, Kathy Peterson
To boost performance on a range of metrics, the 55-bed ED at NYU Lutheran Medical Center in Brooklyn, NY, transitioned to a pod system in August 2016. The approach, which is designed to foster team-based care, involves assigning physicians and nurses to designated geographic areas throughout the day, minimizing the movement of physicians as well as the need for phone communication. When coupled with other changes, including the introduction of point-of- care testing, the pod initiative has enabled the ED to reduce lengths of stay for all treat-and-release patients to less than three hours for the first time in the history of the department, according to administrators...
June 2017: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/29763389/how-should-complex-communication-responsibilities-be-distributed-in-surgical-education-settings
#19
Bradley M Dennis, Allan B Peetz
Part of any trauma surgeon's job is communicating effectively in difficult, often time-limited, situations. The ability to effectively discuss topics like goals of care in these settings has a direct effect on patient care. Many factors contribute to the complexity of these conversations, including patient, physician, surrogate, and system-specific factors. In responding to the case of Mr. D and Dr. J, we attempt to outline and analyze some of the moral challenges and ethical questions that this professional responsibility poses to trauma surgeons and trainees...
May 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29763271/adults-with-developmental-disabilities-a-comprehensive-approach-to-medical-care
#20
Clarissa Kripke
Developmental disabilities are attributable to a cognitive impairment, physical impairment, or both. They manifest during the developmental period from birth to early adulthood, and are likely to continue indefinitely. The life expectancy of most persons with developmental disabilities now approaches that of the general population. According to the neurodiversity model of care, developmental disability is accepted as a valued part of human neurologic diversity. The social model focuses on improving participation in society with accommodations such as adaptive equipment or improvements to the social and physical environment...
May 15, 2018: American Family Physician
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