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https://www.readbyqxmd.com/read/27890407/postoperative-tachycardia-clinically-meaningful-or-benign-consequence-of-orthopedic-surgery
#1
Alana E Sigmund, Yixin Fang, Matthew Chin, Harmony R Reynolds, Leora I Horwitz, Ezra Dweck, Eduardo Iturrate
OBJECTIVE: To determine the clinical significance of tachycardia in the postoperative period. PATIENTS AND METHODS: Individuals 18 years or older undergoing hip and knee arthroplasty were included in the study. Two data sets were collected from different time periods: development data set from January 1, 2011, through December 31, 2011, and validation data set from December 1, 2012, through September 1, 2014. We used the development data set to identify the optimal definition of tachycardia with the strongest association with the vascular composite outcome (pulmonary embolism and myocardial necrosis and infarction)...
November 24, 2016: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/27706470/comparison-of-approaches-for-heart-failure-case-identification-from-electronic-health-record-data
#2
Saul Blecker, Stuart D Katz, Leora I Horwitz, Gilad Kuperman, Hannah Park, Alex Gold, David Sontag
Importance: Accurate, real-time case identification is needed to target interventions to improve quality and outcomes for hospitalized patients with heart failure. Problem lists may be useful for case identification but are often inaccurate or incomplete. Machine-learning approaches may improve accuracy of identification but can be limited by complexity of implementation. Objective: To develop algorithms that use readily available clinical data to identify patients with heart failure while in the hospital...
October 5, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27503972/accounting-for-patients-socioeconomic-status-does-not-change-hospital-readmission-rates
#3
Susannah M Bernheim, Craig S Parzynski, Leora Horwitz, Zhenqiu Lin, Michael J Araas, Joseph S Ross, Elizabeth E Drye, Lisa G Suter, Sharon-Lise T Normand, Harlan M Krumholz
There is an active public debate about whether patients' socioeconomic status should be included in the readmission measures used to determine penalties in Medicare's Hospital Readmissions Reduction Program (HRRP). Using the current Centers for Medicare and Medicaid Services methodology, we compared risk-standardized readmission rates for hospitals caring for high and low proportions of patients of low socioeconomic status (as defined by their Medicaid status or neighborhood income). We then calculated risk-standardized readmission rates after additionally adjusting for patients' socioeconomic status...
August 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27385247/declining-admission-rates-and-thirty-day-readmission-rates-positively-associated-even-though-patients-grew-sicker-over-time
#4
Kumar Dharmarajan, Li Qin, Zhenqiu Lin, Leora I Horwitz, Joseph S Ross, Elizabeth E Drye, Amena Keshawarz, Faseeha Altaf, Sharon-Lise T Normand, Harlan M Krumholz, Susannah M Bernheim
Programs from the Centers for Medicare and Medicaid Services simultaneously promote strategies to lower hospital admissions and readmissions. However, there is concern that hospitals in communities that successfully reduce admissions may be penalized, as patients that are ultimately hospitalized may be sicker and at higher risk of readmission. We therefore examined the relationship between changes from 2010 to 2013 in admission rates and thirty-day readmission rates for elderly Medicare beneficiaries. We found that communities with the greatest decline in admission rates also had the greatest decline in thirty-day readmission rates, even though hospitalized patients did grow sicker as admission rates declined...
July 1, 2016: Health Affairs
https://www.readbyqxmd.com/read/27076505/explanation-and-elaboration-of-the-squire-standards-for-quality-improvement-reporting-excellence-guidelines-v-2-0-examples-of-squire-elements-in-the-healthcare-improvement-literature
#5
Daisy Goodman, Greg Ogrinc, Louise Davies, G Ross Baker, Jane Barnsteiner, Tina C Foster, Kari Gali, Joanne Hilden, Leora Horwitz, Heather C Kaplan, Jerome Leis, John C Matulis, Susan Michie, Rebecca Miltner, Julia Neily, William A Nelson, Matthew Niedner, Brant Oliver, Lori Rutman, Richard Thomson, Johan Thor
Since its publication in 2008, SQUIRE (Standards for Quality Improvement Reporting Excellence) has contributed to the completeness and transparency of reporting of quality improvement work, providing guidance to authors and reviewers of reports on healthcare improvement work. In the interim, enormous growth has occurred in understanding factors that influence the success, and failure, of healthcare improvement efforts. Progress has been particularly strong in three areas: the understanding of the theoretical basis for improvement work; the impact of contextual factors on outcomes; and the development of methodologies for studying improvement work...
April 13, 2016: BMJ Quality & Safety
https://www.readbyqxmd.com/read/27065180/quasi-experimental-evaluation-of-the-effectiveness-of-a-large-scale-readmission-reduction-program
#6
Grace Y Jenq, Margaret M Doyle, Beverly M Belton, Jeph Herrin, Leora I Horwitz
IMPORTANCE: Feasibility, effectiveness, and sustainability of large-scale readmission reduction efforts are uncertain. The Greater New Haven Coalition for Safe Transitions and Readmission Reductions was funded by the Center for Medicare & Medicaid Services (CMS) to reduce readmissions among all discharged Medicare fee-for-service (FFS) patients. OBJECTIVE: To evaluate whether overall Medicare FFS readmissions were reduced through an intervention applied to high-risk discharge patients...
May 1, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/26957646/self-care-after-hospital-discharge-knowledge-is-not-enough
#7
Leora I Horwitz
No abstract text is available yet for this article.
March 8, 2016: BMJ Quality & Safety
https://www.readbyqxmd.com/read/26866338/patient-recall-imaging-in-the-ambulatory-setting
#8
Soterios Gyftopoulos, Danny Kim, Eric Aaltonen, Leora I Horwitz
OBJECTIVE: Recalling a patient to repeat a radiology examination is an adverse and, in certain cases, preventable event. Our objectives were to assess the rate of patient recalls for all imaging performed in the outpatient setting at our institution and to characterize the underlying reasons for the recalls. MATERIALS AND METHODS: We performed a retrospective review of all repeat imaging requests for an inadequate initial imaging study between January 2012 and March 2015...
April 2016: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/26784781/association-of-occupation-as-a-physician-with-likelihood-of-dying-in-a-hospital
#9
COMPARATIVE STUDY
Saul Blecker, Norman J Johnson, Sean Altekruse, Leora I Horwitz
No abstract text is available yet for this article.
January 19, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/26662729/implications-of-including-do-not-resuscitate-status-in-hospital-mortality-measures
#10
COMMENT
Leora I Horwitz
No abstract text is available yet for this article.
January 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/26638147/integrating-new-practices-a-qualitative-study-of-how-hospital-innovations-become-routine
#11
Amanda L Brewster, Leslie A Curry, Emily J Cherlin, Kristina Talbert-Slagle, Leora I Horwitz, Elizabeth H Bradley
BACKGROUND: Hospital quality improvement efforts absorb substantial time and resources, but many innovations fail to integrate into organizational routines, undermining the potential to sustain the new practices. Despite a well-developed literature on the initial implementation of new practices, we have limited knowledge about the mechanisms by which integration occurs. METHODS: We conducted a qualitative study using a purposive sample of hospitals that participated in the State Action on Avoidable Rehospitalizations (STAAR) initiative, a collaborative to reduce hospital readmissions that encouraged members to adopt new practices...
2015: Implementation Science: IS
https://www.readbyqxmd.com/read/26595453/changes-in-discharge-location-and-readmission-rates-under-medicare-bundled-payment
#12
Lindsay E Jubelt, Keith S Goldfeld, Wei-yi Chung, Saul B Blecker, Leora I Horwitz
No abstract text is available yet for this article.
January 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/26149225/development-and-validation-of-an-algorithm-to-identify-planned-readmissions-from-claims-data
#13
Leora I Horwitz, Jacqueline N Grady, Dorothy B Cohen, Zhenqiu Lin, Mark Volpe, Chi K Ngo, Andrew L Masica, Theodore Long, Jessica Wang, Megan Keenan, Julia Montague, Lisa G Suter, Joseph S Ross, Elizabeth E Drye, Harlan M Krumholz, Susannah M Bernheim
BACKGROUND: It is desirable not to include planned readmissions in readmission measures because they represent deliberate, scheduled care. OBJECTIVES: To develop an algorithm to identify planned readmissions, describe its performance characteristics, and identify improvements. DESIGN: Consensus-driven algorithm development and chart review validation study at 7 acute-care hospitals in 2 health systems. PATIENTS: For development, all discharges qualifying for the publicly reported hospital-wide readmission measure...
October 2015: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/25730582/mortality-trends-in-diabetes-mellitus-reply
#14
LETTER
Neel M Butala, Benjamin K Johnson, Leora I Horwitz
No abstract text is available yet for this article.
March 2015: JAMA Internal Medicine
https://www.readbyqxmd.com/read/25665806/association-of-hospital-volume-with-readmission-rates-a-retrospective-cross-sectional-study
#15
Leora I Horwitz, Zhenqiu Lin, Jeph Herrin, Susannah Bernheim, Elizabeth E Drye, Harlan M Krumholz, Harold J Hines, Joseph S Ross
OBJECTIVE: To examine the association of hospital volume (a marker of quality of care) with hospital readmission rates. DESIGN: Retrospective cross-sectional study. SETTING: 4651 US acute care hospitals. STUDY DATA: 6,916,644 adult discharges, excluding patients receiving psychiatric or medical cancer treatment. MAIN OUTCOME MEASURES: We used Medicare fee-for-service data from 1 July 2011 to 30 June 2012 to calculate observed-to-expected, unplanned, 30 day, standardized readmission rates for hospitals and for specialty cohorts medicine, surgery/gynecology, cardiorespiratory, cardiovascular, and neurology...
2015: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/25660836/intravenous-fluids-in-acute-decompensated-heart-failure
#16
Behnood Bikdeli, Kelly M Strait, Kumar Dharmarajan, Shu-Xia Li, Purav Mody, Chohreh Partovian, Steven G Coca, Nancy Kim, Leora I Horwitz, Jeffrey M Testani, Harlan M Krumholz
OBJECTIVES: This study sought to determine the use of intravenous fluids in the early care of patients with acute decompensated heart failure (HF) who are treated with loop diuretics. BACKGROUND: Intravenous fluids are routinely provided to many hospitalized patients. METHODS: We conducted a retrospective cohort study of patients admitted with HF to 346 hospitals from 2009 to 2010. We assessed the use of intravenous fluids during the first 2 days of hospitalization...
February 2015: JACC. Heart Failure
https://www.readbyqxmd.com/read/25656852/trajectories-of-risk-after-hospitalization-for-heart-failure-acute-myocardial-infarction-or-pneumonia-retrospective-cohort-study
#17
MULTICENTER STUDY
Kumar Dharmarajan, Angela F Hsieh, Vivek T Kulkarni, Zhenqiu Lin, Joseph S Ross, Leora I Horwitz, Nancy Kim, Lisa G Suter, Haiqun Lin, Sharon-Lise T Normand, Harlan M Krumholz
OBJECTIVE: To characterize the absolute risks for older patients of readmission to hospital and death in the year after hospitalization for heart failure, acute myocardial infarction, or pneumonia. DESIGN: Retrospective cohort study. SETTING: 4767 hospitals caring for Medicare fee for service beneficiaries in the United States, 2008-10. PARTICIPANTS: More than 3 million Medicare fee for service beneficiaries, aged 65 years or more, surviving hospitalization for heart failure, acute myocardial infarction, or pneumonia...
2015: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/25627860/association-of-inpatient-and-outpatient-glucose-management-with-inpatient-mortality-among-patients-with-and-without-diabetes-at-a-major-academic-medical-center
#18
COMPARATIVE STUDY
Neel M Butala, Benjamin K Johnson, James D Dziura, Jesse S Reynolds, Janis E Bozzo, Thomas J Balcezak, Silvio E Inzucchi, Leora I Horwitz
BACKGROUND: Hospitalized patients with diabetes have experienced a disproportionate reduction in mortality over the past decade. OBJECTIVE: To examine whether this differential decrease affected all patients with diabetes, and to identify explanatory factors. DESIGN: Serial, cross-sectional observational study. SETTING: Academic medical center. PATIENTS: All adult, nonobstetric patients with an inpatient discharge between January 1, 2000 and December 31, 2010...
April 2015: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/25587092/association-of-discharge-summary-quality-with-readmission-risk-for-patients-hospitalized-with-heart-failure-exacerbation
#19
RANDOMIZED CONTROLLED TRIAL
Mohammed Salim Al-Damluji, Kristina Dzara, Beth Hodshon, Natdanai Punnanithinont, Harlan M Krumholz, Sarwat I Chaudhry, Leora I Horwitz
No abstract text is available yet for this article.
January 2015: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/25587091/hospital-variation-in-quality-of-discharge-summaries-for-patients-hospitalized-with-heart-failure-exacerbation
#20
RANDOMIZED CONTROLLED TRIAL
Mohammed Salim Al-Damluji, Kristina Dzara, Beth Hodshon, Natdanai Punnanithinont, Harlan M Krumholz, Sarwat I Chaudhry, Leora I Horwitz
BACKGROUND: Single-site studies have demonstrated inadequate quality of discharge summaries in timeliness, transmission, and content, potentially contributing to adverse outcomes. However, degree of hospital-level variation in discharge summary quality for patients hospitalized with heart failure (HF) is uncertain. METHODS AND RESULTS: We analyzed discharge summaries of patients enrolled in the Telemonitoring to Improve Heart Failure Outcomes (Tele-HF) study. We assessed hospital-level performance on timeliness (fraction of summaries completed on the day of discharge), documented transmission to the follow-up physician, and content (presence of components suggested by the Transitions of Care Consensus Conference)...
January 2015: Circulation. Cardiovascular Quality and Outcomes
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