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https://www.readbyqxmd.com/read/28738031/perioperative-care-implementation-evidence-based-practice-for-patients-with-pancreaticoduodenectomy-using-the-enhanced-recovery-after-surgery-guidelines-%C3%A2
#1
Cesar Aviles, Marilyn Hockenberry, Dionisios Vrochides, David Iannitti, Allyson Cochran, Kendra Tezber, Misty Eller, Janet Desamero
BACKGROUND: Pancreatic adenocarcinoma is an aggressive cancer that carries a poor prognosis. Pancreaticoduodenectomy (PD) offers the only potential cure, but the associated morbidity is high. The Enhanced Recovery After Surgery (ERAS) evidence-based guidelines for perioperative care for PD can be used to reduce variations in practice.
. OBJECTIVES: The primary aim was to evaluate the feasibility of the ERAS guidelines for patients undergoing PD. Secondary aims were to assess length of stay (LOS), readmission within 30 days, 30-day mortality, and total surgical complication rates...
August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28737996/integrating-palliative-and-oncology-care-for-patients-with-advanced-cancer-a-quality-improvement-intervention
#2
Laura C Hanson, Frances Collichio, Stephen A Bernard, William A Wood, Matt Milowsky, Erin Burgess, Crista J Creedle, Summer Cheek, Lydia Chang, Bhisham Chera, Alexandra Fox, Feng-Chang Lin
BACKGROUND: Practice guidelines recommend palliative care for patients with advanced cancer, but gaps in access and quality of care persist. OBJECTIVE: To increase goals-of-care (GOC) communication for hospitalized patients with Stage IV cancer. METHODS: An interdisciplinary team designed a quality improvement intervention to enhance oncology palliative care, including training in communication skills and triggers for palliative care consults...
July 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28737647/risk-factors-for-30-day-hospital-readmission-for-diverticular-hemorrhage
#3
Jonah N Rubin, Daniel Shoag, John N Gaetano, Dejan Micic, Neil Sengupta
INTRODUCTION: The 2010 Affordable Care Act introduced the Hospital Readmissions Reduction Program to reduce health care utilization. Diverticular disease and its complications remain a leading cause of hospitalization among gastrointestinal disease. We sought to determine risk factors for 30-day hospital readmissions after hospitalization for diverticular bleeding. MATERIALS AND METHODS: We utilized the 2013 National Readmission Database sponsored by the Agency for Healthcare Research and Quality focusing on hospitalizations with the primary or secondary discharge diagnosis of diverticular hemorrhage or diverticulitis with hemorrhage...
July 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28737412/integrated-care-clinic-creating-enhanced-clinical-pathways-for-integrated-behavioral-health-care-in-a-family-medicine-residency-clinic-serving-a-low-income-minority-population
#4
Jerica M Berge, Lisa Trump, Stephanie Trudeau, Damir S Utržan, Michele Mandrich, Andrew Slattengren, Tanner Nissly, Laura Miller, Macaran Baird, Eli Coleman, Michael Wootten
INTRODUCTION: Research examining the implementation and effectiveness of integrated behavioral health (BH) care in family medicine/primary care is growing. However, research identifying ways to consistently use integrated BH in busy family medicine/primary care settings with underserved populations is limited. This study describes 1 family medicine clinic's transformation into a fully integrated BH care clinic through the development of an Integrated Care Clinic (ICC) and enhanced clinical pathways to promote regular use of behavioral health clinicians (BHCs)...
July 24, 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28737273/recovery-free-of-heart-failure-after-acute-coronary-syndrome-and-coronary-revascularization
#5
Alec Falkenham, Manu K Saraswat, Chloe Wong, Kareem Gawdat, Tanya Myers, Jahanara Begum, Karen J Buth, Ian Haidl, Jean Marshall, Jean-Francois Légaré
AIMS: Previous studies have examined risk factors for the development of heart failure (HF) subsequent to acute coronary syndrome (ACS). Our study seeks to clarify the clinical variables that best characterize patients who remain free from HF after coronary artery bypass grafting (CABG) surgery for ACS to determine novel biological factors favouring freedom from HF in prospective translational studies. METHODS AND RESULTS: Nova Scotia residents (1995-2012) undergoing CABG within 3 weeks of ACS were included...
July 24, 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28737066/%C3%AE-blockade-in-heart-failure-with-reduced-ejection-fraction-does-heart-rate-control-influence-readmissions
#6
Ryan E Owens, Jennifer D Twilla, Timothy H Self, Abdulrahman I Alshaya, Carlvin J Metra, Carolyn Cummings, Carrie S Oliphant
BACKGROUND: Raised resting heart rate (HR), >70 beats per minute (bpm), has been shown to be a risk factor for adverse cardiovascular outcomes and hospital readmissions, specifically in patients with heart failure with reduced ejection fraction (HF rEF). Given their mortality benefit, β-blockers are recommended in HF rEF, with a goal to titrate to a maximum tolerated dose rather than a specific HR target. OBJECTIVE: To determine the impact of optimal HR control achievement prior to hospital discharge on hospital readmissions in patients with HF rEF receiving β-blockade...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28736060/subtotal-vs-total-parathyroidectomy-with-autotransplantation-for-patients-with-renal-hyperparathyroidism-have-similar-outcomes
#7
Kevin Anderson, Ewa Ruel, Mohamed A Adam, Samantha Thomas, Linda Youngwirth, Michael T Stang, Randall P Scheri, Sanziana A Roman, Julie A Sosa
BACKGROUND: The optimal surgery for patients with renal hyperparathyroidism has been controversial, as either subtotal parathyroidectomy (subtotal PTX) or total parathyroidectomy with auto-transplantation (total PTX-AT) may be employed. METHODS: Adult patients having subtotal PTX or total PTX-AT for secondary hyperparathyroidism were identified from the American College of Surgeons National Surgical Quality Improvement Program, 2005-2013. RESULTS: Of 1130 patients, the majority (n = 765, 68%) underwent subtotal PTX...
July 17, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28735841/the-perioperative-effects-of-chronic-preoperative-opioid-use-on-shoulder-arthroplasty-outcomes
#8
Jonathan W Cheah, David C Sing, Dell McLaughlin, Brian T Feeley, C Benjamin Ma, Alan L Zhang
HYPOTHESIS AND BACKGROUND: Chronic opioid therapy is an increasingly used modality for the treatment of osteoarthritis-associated pain. We hypothesized that chronic opioid use would be associated with adverse outcomes in shoulder arthroplasty. METHODS: A retrospective analysis of patients undergoing elective anatomic total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (rTSA) at a single institution from 2012-2015 was performed. Patients were stratified by preoperative opioid use (nonusers, short-acting opioid users, and long-acting opioid users), and their postoperative clinical outcomes were assessed...
July 20, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28735437/prospective-and-retrospective-study-of-videoconference-telemedicine-follow-up-after-elective-neurosurgery-results-of-a-pilot-program
#9
Melissa Reider-Demer, Pushpa Raja, Neil Martin, Mariel Schwinger, Diana Babayan
Existing literature suggests that use of telemedicine during postoperative appointments can increase access to care and is valued by patients and providers alike. While research examining the clinical equivalency of telemedicine visits for postoperative care has been growing, few studies have reported on telemedicine follow-up after neurosurgery. This study examined if a videoconferencing visit could substitute for an in-person clinic visit for elective neurosurgical cases in the USA. This was a single-center prospective study of patients who underwent elective neurosurgical procedures (aneurysm clipping, resection of cavernous angiomas, resection of arterial venous malformation, microvascular decompression for trigeminal neuralgia and hemifacial spasm, and certain benign brain tumors) and were offered telemedicine follow-up care by an allied health professional during the first 90 days after neurosurgery...
July 22, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28734963/variability-in-elective-day-surgery-rates-between-belgian-hospitals-analyses-of-administrative-data-explained-by-surgical-experts
#10
Roos Leroy, Cécile Camberlin, Mélanie Lefèvre, Koen Van den Heede, Carine Van de Voorde, Claire Beguin
BACKGROUND: In the last decades, day surgery has steadily and significantly grown in many countries, yet the increase has been uneven. There are large variations in day-surgery activity between countries, but also within countries between hospitals and surgeons. This paper explores the variability in day-care activity for elective surgical procedures between Belgian hospitals. MATERIALS AND METHODS: The administrative hospital data of all patients formally admitted in a Belgian hospital for inpatient or day-surgery care between 2011 and 2013 were analysed and summarized in graphs...
July 19, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28734748/effects-of-arginine-based-immunonutrition-on-inpatient-total-costs-and-hospitalization-outcomes-for-patients-undergoing-colorectal-surgery
#11
Souvik Banerjee, Louis P Garrison, Aurelie Danel, Juan B Ochoa Gautier, David R Flum
OBJECTIVE: The aim of this study was to assess the effects of an arginine-based immunonutrition intervention for patients undergoing elective colorectal surgery on postsurgical utilization and cost outcomes. METHODS: This analysis was based on data from two Washington State databases: Surgical Care and Outcomes Assessment Program (SCOAP) linked to the Comprehensive Hospital Abstract Reporting System (CHARS). The sample (N=722) comprises adult patients who underwent elective colorectal surgery with anastomosis in a Washington State hospital that participated in the Strong for Surgery (S4S) initiative between January 1, 2012, and December 31, 2013...
June 24, 2017: Nutrition
https://www.readbyqxmd.com/read/28734614/correlation-of-the-caprini-score-and-venous-thromboembolism-incidence-following-primary-total-joint-arthroplasty-results-of-a-single-institution-protocol
#12
Dexter K Bateman, Robert W Dow, Andrzej Brzezinski, Howard Y Bar-Eli, Stephen T Kayiaros
BACKGROUND: Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis, is a serious complication after total joint arthroplasty (TJA). Risk assessment models are increasingly used to provide patient-specific risk stratification. A recently implemented protocol mandates calculation of a Caprini Score for all surgical patients at our institution. We investigated the accuracy of the Caprini Score in predicting VTE events following TJA. METHODS: A retrospective review of patients undergoing primary total hip (THA) and total knee arthroplasty (TKA) over a 1-year time period was performed...
July 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28734149/discharge-management-strategies-and-post-discharge-care-interventions-for-depression-systematic%C3%A2-review-and-meta-analysis
#13
REVIEW
F Holzinger, S Fahrenkrog, S Roll, F Kleefeld, M Adli, C Heintze
BACKGROUND: Patients with depression require treatment continuity when discharged from inpatient care. Interventions aimed at optimizing transition into outpatient care may be effective in preventing symptom deterioration and readmission. We aimed to evaluate the effectiveness of care transition interventions for patients with depression after psychiatric hospitalization. METHODS: Systematic review and random-effects meta-analysis of controlled trials. Primary outcomes were readmissions and symptoms of depression...
July 11, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28733982/postoperative-complications-in-individuals-aged-70-and-over-undergoing-elective-surgery-for-colorectal-cancer
#14
Katleen Fagard, Julie Casaer, Albert Wolthuis, Johan Flamaing, Koen Milisen, Jean-Pierre Lobelle, Hans Wildiers, Cindy Kenis
AIM: This study aims to describe the nature, incidence, severity and outcomes of in-hospital postoperative complications (POCs) in older patients undergoing elective surgery for colorectal cancer (CRC).. METHOD: Patients were identified from a prospectively collected database (2009-2015) focusing on the implementation of geriatric screening and assessment in patients with cancer. Medical and surgical POCs were retrieved retrospectively from the medical records, and the severity of the POCs was graded by the Clavien-Dindo (CD) grading system...
July 22, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28733926/perioperative-management-of-endocrine-insufficiency-after-total-pancreatectomy-for-neoplasia
#15
REVIEW
Ajay V Maker, Raashid Sheikh, Vinita Bhagia
PURPOSE: Indications for total pancreatectomy (TP) have increased, including for diffuse main duct intrapapillary mucinous neoplasms of the pancreas and malignancy; therefore, the need persists for surgeons to develop appropriate endocrine post-operative management strategies. The brittle diabetes after TP differs from type 1/2 diabetes in that patients have absolute deficiency of insulin and functional glucagon. This makes glucose management challenging, complicates recovery, and predisposes to hospital readmissions...
July 21, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28733746/comparative-analysis-of-perioperative-outcomes-of-robotic-versus-open-transversus-abdominis-release
#16
Luis A Martin-Del-Campo, Adam S Weltz, Igor Belyansky, Yuri W Novitsky
BACKGROUND: Transversus abdominis release (TAR) has evolved as an effective approach to complex abdominal wall reconstructions. Although the role of robotics in hernia surgery is rapidly expanding, the benefits of a robotic approach for abdominal wall reconstruction have not been established well. We aimed to compare the impact of the application of robotics to the TAR procedure on the perioperative outcomes when compared to the open TAR repairs. METHODS: Case-matched comparison of patients undergoing robotic TAR (R-TAR) at two specialized hernia centers to a matched historic cohort of open TAR (O-TAR) patients was performed...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28733370/reliable-adherence-to-a-copd-care-bundle-mitigates-system-level-failures-and-reduces-copd-readmissions-a-system-redesign-using-improvement-science
#17
Muhammad Ahsan Zafar, Ralph J Panos, Jonathan Ko, Lisa C Otten, Anthony Gentene, Maria Guido, Katherine Clark, Caroline Lee, Jamie Robertson, Evaline A Alessandrini
BACKGROUND: Readmissions of chronic obstructive pulmonary disease (COPD) have devastating effects on patient quality-of-life, disease progression and healthcare cost. Effective interventions to reduce COPD readmissions are needed. OBJECTIVES: Reduce 30-day all-cause readmissions by (1) creating a COPD care bundle that addresses care delivery failures, (2) using improvement science to achieve 90% bundle adherence. SETTING: An 800-bed academic hospital in Ohio, USA...
July 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28733067/hospital-quality-variation-matters-a-time-trend-and-cross-section-analysis-of-outcomes-in-german-hospitals-from-2006-to-2014
#18
Christoph Pross, Reinhard Busse, Alexander Geissler
Awareness of care variation and associated differences in outcome quality is important for patients to recognize and leverage the benefits of hospital choice and for policy makers, providers, and suppliers to adapt initiatives to improve hospital quality of care. We examine panel data on outcome quality in German hospitals between 2006 and 2014 for cholecystectomy, pacemaker implantation, hip replacement, percutaneous coronary intervention (PCI), stroke, and acute myocardial infarction (AMI). We use risk-adjusted and unadjusted outcomes based on 16 indicators...
July 8, 2017: Health Policy
https://www.readbyqxmd.com/read/28730986/long-term-use-of-left-ventricular-assist-devices-a-report-on-clinical-outcomes
#19
Sneha Raju, Jane MacIver, Farid Foroutan, Carolina Alba, Filio Billia, Vivek Rao
BACKGROUND: The literature examining clinical outcomes and readmissions during extended (> 1 yr) left ventricular assist device (LVAD) support is scarce, particularly in the era of continuous-flow LVADs. METHODS: We completed a retrospective cohort study on consecutive LVAD patients from June 2006 to March 2015, focusing on those who received more than 1 year of total LVAD support time. Demographic characteristics, clinical outcomes and readmissions were analyzed using standard statistical methods...
August 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28730744/improving-hospital-discharge-arrangements-for-people-who-are-homeless-a-realist-synthesis-of-the-intermediate-care-literature
#20
REVIEW
Michelle Cornes, Martin Whiteford, Jill Manthorpe, Joanne Neale, Richard Byng, Nigel Hewett, Michael Clark, Alan Kilmister, James Fuller, Robert Aldridge, Michela Tinelli
This review presents a realist synthesis of "what works and why" in intermediate care for people who are homeless. The overall aim was to update an earlier synthesis of intermediate care by capturing new evidence from a recent UK government funding initiative (the "Homeless Hospital Discharge Fund"). The initiative made resources available to the charitable sector to enable partnership working with the National Health Service (NHS) in order to improve hospital discharge arrangements for people who are homeless...
July 20, 2017: Health & Social Care in the Community
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