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https://www.readbyqxmd.com/read/29051001/episode-based-payment-variation-for-urological-cancer-surgery
#1
Chad Ellimoottil, Jonathan Li, Zaojun Ye, James M Dupree, Hye Sung Min, Deborah Kaye, Lindsey A Herrel, David C Miller
OBJECTIVE: To investigate payment variation for three common urological cancer surgeries and evaluate the potential for applying bundled payment programs to these procedures. METHODS: Using 2008-2011 Surveillance, Epidemiology, and End Results-Medicare linked data, we identified all beneficiaries aged greater than 65 years who underwent cystectomy, prostatectomy, or nephrectomy for cancer. Total episode payments were determined by aggregating hospital, professional, and post-acute care claims from the index surgical hospitalization through 90 days post-discharge...
October 16, 2017: Urology
https://www.readbyqxmd.com/read/29045978/-clinicopathologic-features-of-infant-dysembryoplastic-neuroepithelial-tumor-a-case-report-and-literature-review
#2
H Wang, J T Ye, H X Yao, D Li, Y Dong
Dysembryoplastic neuroepithelial tumor (DNT) has traditionally been viewed as rare benign tumors that present with seizure widely considered curable with surgery alone. Most DNTs occur in childhood and young adults. However, rare reported cases occur in infants. This paper reported an infant case of DNT and its diagnosis, differential diagnosis, treatment, molecular features and prognosis based on the review of current literatures. The age onset of this patient was only 11 months old. The clinical manifestations were partial seizures and the imaging data untypical; CT and MRI were all supportive of astrocytoma...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29041658/endoscopic-imaging-of-quantum-gases-through-a-fiber-bundle
#3
Daniel Benedicto-Orenes, Anna Kowalczyk, Kai Bongs, Giovanni Barontini
We use a coherent fiber bundle to demonstrate the endoscopic absorption imaging of quantum gases. We show that the fiber bundle introduces spurious noise in the picture mainly due to the strong core-to-core coupling. By direct comparison with free-space pictures, we observe that there is a maximum column density that can be reliably measured using our fiber bundle, and we derive a simple criterion to estimate it. We demonstrate that taking care of not exceeding such maximum, we can retrieve exact quantitative information about the atomic system, making this technique appealing for systems requiring isolation form the environment...
August 21, 2017: Optics Express
https://www.readbyqxmd.com/read/29036028/appropriateness-of-the-use-of-mri-in-the-diagnosis-and-treatment-of-wrist-ligamentous-injury
#4
Brett F Michelotti, Alexandra Mathews, Kevin C Chung
BACKGROUND: When diagnosing wrist ligamentous injury, we hypothesize that MRI is used injudiciously and is associated with unnecessary cost. METHODS: A retrospective review was conducted of patients, ages 20-60 years, who underwent an MRI for possible wrist ligamentous injury at a tertiary care center between 2009 and 2014. Treatment recommendation was classified as non-operative, operative, or equivocal. If the MRI-directed treatment recommendation differed from the pre-MRI treatment recommendation, we noted that the MRI influenced patient care (impact study)...
October 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29031625/ideal-i-cpr-looking-beyond-shadows-in-a-cave
#5
Nicolas Segal, Scott Youngquist, Keith Lurie
Survival rates after cardiac arrest have shown minimal improvement in the last 60 years. However, in some forward-thinking cities and hospitals, out-of and in-hospital cardiac arrest survival rates exceed 20% and 40% respectively. These beacons of hope can enlighten us, providing a clearer vision of what it takes to provide Ideal cardiopulmonary resuscitation. To make progress in a field that has seemingly stagnated for too many decades, we must be open to new ideas and develop bundles of care that work in communities with varying EMS systems and various existing infrastructure to bring the best practices to the rest of the country...
October 12, 2017: Resuscitation
https://www.readbyqxmd.com/read/29027478/educational-initiative-to-standardize-concussion-management-in-pediatric-primary-care
#6
Alex M Taylor, Lise E Nigrovic, Meredith L Saillant, Emily K Trudell, Jonathan R Modest, Madeleine Kuhn, Louis Vernacchio
Pediatric primary care providers report limited training and tools to manage concussion. We developed a learning community intervention for a large independent pediatric practice association affiliated with a university hospital to standardize concussion management and improve the use of consensus-based guidelines. The learning community included in-person and online didactics, followed by a web-based reinforcement platform to educate and train clinicians on our treatment algorithm and decision support tools...
October 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/29027207/resource-availability-for-the-management-of-maternal-sepsis-in-malawi-other-low-income-countries-and-lower-middle-income-countries
#7
Mohammed Abdu, Amie Wilson, Chisale Mhango, Fatima Taki, Arri Coomarasamy, David Lissauer
OBJECTIVE: To assess the availability of key resources for the management of maternal sepsis and evaluate the feasibility of implementing the Surviving Sepsis Campaign (SSC) recommendations in Malawi and other low-resource settings. METHODS: A cross-sectional study was conducted at health facilities in Malawi, other low-income countries, and lower-middle-income countries during January-March 2016. English-speaking healthcare professionals (e.g. doctors, nurses, midwives, and administrators) completed a questionnaire/online survey to assess the availability of resources for the management of maternal sepsis...
October 13, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29026766/hand-hygiene-knowledge-of-primary-health-care-workers-in-abha-city-south-western-saudi-arabia
#8
Ahmed A Mahfouz, Ahmed Abolyazid, Hasan M Al-Musa, Nabil J Awadallah, Aesha Faraheen, Shamsunhar Khalil, Mohammad N El-Gamal, Khalid M Al-Musa
PURPOSE: The aim of this is to find out the hand hygiene (HH) knowledge among primary health care workers (PHCWs) in Abha health district, southwestern Saudi Arabia. METHODS: Data were collected through an anonymous self-administered questionnaire. The questionnaire was based on a WHO "Knowledge Questionnaire for Health Care Workers." RESULTS: The study included 478 PHCWs (239 males and 239 females). The sample included 186 physicians, 212 nurses, and 80 technicians...
January 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29026536/implementation-of-central-line-associated-bloodstream-infection-prevention-bundles-in-a-surgical-intensive-care-unit-using-peer-tutoring
#9
Sang-Won Park, Suhui Ko, Hye-Sun An, Ji Hwan Bang, Woo-Young Chung
BACKGROUND: Central line-associated bloodstream infections (CLABSIs) can be prevented through well-coordinated, multifaceted programs. However, implementation of CLABSI prevention programs requires individualized strategies for different institutional situations, and the best strategy in resource-limited settings is uncertain. Peer tutoring may be an efficient and effective method that is applicable in such settings. METHODS: A prospective intervention was performed to reduce CLABSIs in a surgical intensive care unit (SICU) at a tertiary hospital...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29026472/clinical-features-and-antimicrobial-resistance-of-bacterial-agents-of-ventilator-associated-tracheobronchitis-in-hamedan-iran
#10
Seyyed Hamid Hashemi, Naeimeh Hashemi, Farzaneh Esna-Ashari, Abbas Taher, Arash Dehghan
OBJECTIVES: Ventilator-associated tracheobronchitis (VAT) is a common cause of mortality and morbidity in patients admitted to intensive care units (ICUs). This study was conducted to evaluate the clinical course, etiology, and antimicrobial resistance of bacterial agents of VAT in ICUs in Hamedan, Iran. METHODS: During a 12-month period, all patients with VAT in a medical and a surgical ICU were included. The criteria for the diagnosis of VAT were fever, mucus production, a positive culture of tracheal secretions, and the absence of lung infiltration...
September 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/29021109/design-and-impact-of-bundled-payment-for-detox-and-follow-up-care
#11
Amity E Quinn, Dominic Hodgkin, Jennifer N Perloff, Maureen T Stewart, Mary Brolin, Nancy Lane, Constance M Horgan
INTRODUCTION: Recent payment reforms promote movement from fee-for-service to alternative payment models that shift financial risk from payers to providers, incentivizing providers to manage patients' utilization. Bundled payment, an episode-based fixed payment that includes the prices of a group of services that would typically treat an episode of care, is expanding in the United States. Bundled payment has been recommended as a way to pay for comprehensive SUD treatment and has the potential to improve treatment engagement after detox, which could reduce detox readmissions, improve health outcomes, and reduce medical care costs...
November 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/29017806/implementation-of-a-bundled-protocol-significantly-reduces-risk-of-spinal-cord-ischemia-after-branched-or-fenestrated-endovascular-aortic-repair
#12
Salvatore T Scali, Moses Kim, Paul Kubilis, Robert J Feezor, Kristina A Giles, Brittney Miller, Javairiah Fatima, Thomas S Huber, Scott A Berceli, Martin Back, Adam W Beck
OBJECTIVE: Spinal cord ischemia (SCI) is a devastating complication after branched or fenestrated endovascular aortic repair (B/FEVAR) for thoracoabdominal aortic disease. The purpose of this analysis was to describe the impact of a bundled clinical care protocol designed to reduce the risk of SCI in this population of patients. METHODS: A bundled SCI prevention protocol including cerebrospinal fluid drainage, blood pressure parameters, transfusion goals, and pharmacologic adjuncts (steroids, naloxone) was initiated in May 2015...
October 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29016505/implementing-a-systematic-approach-to-reduce-cesarean-birth-rates-in-nulliparous-women
#13
Amy D Bell, Saju Joy, Susan Gullo, Robert Higgins, Eleanor Stevenson
OBJECTIVE: To implement a systematic approach to safely reduce nulliparous cesarean birth rates. METHODS: This is a quality improvement project at two rural community hospitals and one urban community hospital in North Carolina. These facilities implemented a systematic approach to reduce nulliparous cesarean birth rates, aligning with recommendations developed by the Council on Patient Safety in Women's Health Care: Patient Safety Bundle on the Safe Reduction of Primary Cesarean Births...
October 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28990972/managing-chest-pain-in-patients-with-concomitant-left-bundle-branch-block
#14
Andrew Wyant, Somu Chatterjee, Tamara Bennett
Diagnosis and timely management of acute myocardial infarction (MI) relies heavily on the ST-segment elevation sum. Presence of concomitant left bundle-branch block (LBBB) in patients presenting with possible acute MI presents a diagnostic dilemma. The LBBB pattern distorts ST-segment changes, delaying or preventing accurate diagnosis. This article reviews the Sgarbossa criteria and ST/S ratio and presents a treatment algorithm that may help improve patient care and reduce morbidity and mortality.
October 5, 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28990665/transcutaneous-electrical-nerve-stimulation-tens-for-fibromyalgia-in-adults
#15
REVIEW
Mark I Johnson, Leica S Claydon, G Peter Herbison, Gareth Jones, Carole A Paley
BACKGROUND: Fibromyalgia is characterised by persistent, widespread pain; sleep problems; and fatigue. Transcutaneous electrical nerve stimulation (TENS) is the delivery of pulsed electrical currents across the intact surface of the skin to stimulate peripheral nerves and is used extensively to manage painful conditions. TENS is inexpensive, safe, and can be self-administered. TENS reduces pain during movement in some people so it may be a useful adjunct to assist participation in exercise and activities of daily living...
October 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28989506/twoc-around-the-clock-a-multimodal-approach-to-improving-catheter-care
#16
Carolyn H Dawson, Melanie Gallo, Kate Prevc
BACKGROUND: Urinary tract infections (UTI) are the second-largest group of healthcare-associated infections (HCAI). The Saving Lives Urinary Catheter Care Bundle was introduced to reduce catheter-associated urinary tract infections (CAUTI). In response, we implemented a catheter care group to examine ways to improve catheter care in an acute hospital NHS Trust. METHODS: We adopted a multimodal approach, revolving around four components: (1) Catheter Care Pathway; (2) HOUDINI checklist; (3) catheter magnets; and (4) use of bladder ultrasound scanners...
March 2017: Journal of Infection Prevention
https://www.readbyqxmd.com/read/28989500/prospective-multicentre-study-in-intensive-care-units-in-five-cities-from-the-kingdom-of-saudi-arabia-impact-of-the-international-nosocomial-infection-control-consortium-inicc-multidimensional-approach-on-rates-of-central-line-associated-bloodstream-infection
#17
Hail M Al-Abdely, Areej Dhafer Alshehri, Victor Daniel Rosenthal, Yassir Khidir Mohammed, Weam Banjar, Pablo Wenceslao Orellano, Abdullah Mufareh Assiri, Nahla Moustafa Abedel Kader, Hessa Abdullah Al Enizy, Diaa Abdullah Mohammed, Duaa Khalil Al-Awadi, Analen Fabros Cabato, Maria Wasbourne, Randa Saliya, Rosita Gasmin Aromin, Evangelina Balon Ubalde, Hanan Hanafy Diab, Modhi Abdullah Alkamaly, Nawal Mohammed Alanazi, Ibtesam Yahia Hassan Assiry, Apsia Musa Molano, Celia Flores Baldonado, Mohamed Al-Azhary, Sharifa Al Atawi, Apsia Musa Molano, Fatima Mohammad Al Adwani, Arlu Marie Casuyon Pahilanga, Raslan Nakhla, Fatma Mohammad Al Adwani, Deepa Sasithran Nair, Grace Sindayen, Annalyn Amor Malificio, Najla Jameel Helali, Haya Barjas Al Dossari, Ashraf Kelany, Abdulmajid Ghowaizi Algethami, Leigh Yanne, Avigail Tan, Sheema Babu, Shatha Mohammad Abduljabbar, Syed Zahid Bukhari, Roaa Hasan Basri, Jeyashri Jaji Mushtaq, Hala Rushdi, Abdullah Abdulaziz Turkistani, Jerlie Mae Gonzales Celiz, Mohammed Abdullah Al Raey, Ibrahim Am Al-Zaydani Asiri, Saeed Ali Aldarani, Elizabeth Laungayan Cortez, Nadia Lynette Demaisip, Misbah Rehman Aziz, Ali Omer Abdul Aziz, Batool Al Manea, Eslam Samy, Mervat Al-Dalaton, Mohammed Jkedeb Alaliany
OBJECTIVE: To analyse the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and INICC Surveillance Online System (ISOS) on central line-associated bloodstream infection (CLABSI) rates in five intensive care units (ICUs) from October 2013 to September 2015. DESIGN: Prospective, before-after surveillance study of 3769 patients hospitalised in four adult ICUs and one paediatric ICU in five hospitals in five cities...
January 2017: Journal of Infection Prevention
https://www.readbyqxmd.com/read/28984751/bla-oxa48-gene-microorganisms-outbreak-in-a-tertiary-children-s-hospital-over-3-years-2012-2014-case-report
#18
Rafael Herruzo, Guillermo Ruiz, Veronica Perez-Blanco, Sara Gallego, Eduardo Mora, Maria Jose Vizcaino, Felix Omeñaca
RATIONALE: Carbapenem-resistant Enterobacteriaceae are an emerging problem in children. Nosocomial spread remains the principal risk factor for acquisition of these microorganisms. PATIENTS CONCERNS: We describe an outbreak of Klebsiella pneumoniae OXA48 (KOXA48) in a tertiary children's hospital during the years 2012 to 2014, as well as the preventive measures put in place in colonized and infected cases. DIAGNOSES: We studied, "in vitro," the KOXA48 susceptibility to antiseptics and surface disinfectants...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28983220/similar-cost-savings-of-bundled-payment-initiatives-applied-to-lower-extremity-total-joint-arthroplasty-can-be-achieved-applying-both-models-2-and-3
#19
Allyson Alfonso, Lorraine Hutzler, Bill Robb, Chad Beste, André Blom, Joseph Bosco
BACKGROUND: In an effort to control cost and increase value, Medicare is transitioning from fee-for-service to value-based alternative payment models (APMs). The Bundled Payments for Care Improvement (BPCI) initiative represents one such voluntary APM. BPCI offers four different bundling options: model 1 covers all Diagnosis Related Groups (DRGs) and Models 2-4 cover 48 clinical episodes, including 186 separate DRGs. QUESTIONS/PURPOSES: The purpose of this investigation is to analyze and compare the cost savings achieved by two different BPCI program participants, provider A and provider B, enrolled in different models of BPCI (Models 2 and 3) for lower extremity joint replacements (LEJRs)...
October 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28978488/icu-team-composition-and-its-association-with-abcde-implementation-in-a-quality-collaborative
#20
Deena Kelly Costa, Thomas S Valley, Melissa A Miller, Milisa Manojlovich, Sam R Watson, Phyllis McLellan, Corine Pope, Robert C Hyzy, Theodore J Iwashyna
PURPOSE: Awakening, Breathing Coordination, Delirium, and Early Mobility bundle (ABCDE) should involve an interprofessional team, yet no studies describe what team composition supports implementation. MATERIALS & METHODS: We administered a survey at MHA Keystone Center ICU 2015 workshop. We measured team composition by the frequency of nurse, respiratory therapist, physician, physical therapist, nurse practitioner/physician assistant or nursing assistant involvement in 1) spontaneous awakening trials (SATs), 2) spontaneous breathing trials, 3) delirium and 4) early mobility...
September 28, 2017: Journal of Critical Care
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