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https://www.readbyqxmd.com/read/28107287/case-volume-and-revisits-in-children-undergoing-gastrostomy-tube-placement
#1
Marjorie J Arca, Shawn J Rangel, Matt Hall, David H Rothstein, Martin L Blakely, Peter C Minneci, Samir S Shah, Kurt F Heiss, Charles L Snyder, Loren Berman, Marybeth Browne, Charles D Vinocur, Mehul V Raval, Adam B Goldin
OBJECTIVE: Emergency department (ED) visits and hospital readmissions are common following gastrostomy tube (GT) placement in children. We sought to characterize inter-hospital variation in revisit rates and explore the association between this outcome and hospital-specific GT case volume. STUDY DESIGN: We conducted a retrospective cohort study from 38 hospitals using the Pediatric Health Information System (PHIS) database. Patients <18 years who had a GT placed in 2010-2012 were assessed for a GT-related (mechanical or infectious) ED visit or inpatient readmission at 30 and 90 days following discharge from GT placement...
January 20, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28107264/readmission-and-late-mortality-after-critical-illness-in-childhood
#2
Mary E Hartman, Mohammed J Saeed, Tellen Bennett, Katri Typpo, Renee Matos, Margaret A Olsen
OBJECTIVES: Little is known about the ongoing mortality risk and healthcare utilization among U.S. children after discharge from a hospitalization involving ICU care. We sought to understand risks for hospital readmission and trends in mortality during the year following ICU discharge. DESIGN: Retrospective observational cohort study. SETTING: This study was performed using administrative claims data from 2006-2013 obtained from the Truven Health Analytics MarketScan Database...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28107252/multimorbidity-and-the-risk-of-all-cause-30-day-readmission-in-the-setting-of-multidisciplinary-management-of-chronic-heart-failure-a-retrospective-analysis-of-830-hospitalized-patients-in-australia
#3
Joshua F Wiley, Yih-Kai Chan, Yasmin Ahamed, Jocasta Ball, Melinda J Carrington, Barbara Riegel, Simon Stewart
BACKGROUND: Multimorbidity has an adverse effect on health outcomes in hospitalized individuals with chronic heart failure (CHF), but the modulating effect of multidisciplinary management is unknown. OBJECTIVE: The aim of this study was to test the hypothesis that increasing morbidity would independently predict an increasing risk of 30-day readmission despite multidisciplinary management of CHF. METHODS: We studied patients hospitalized for any reason with heart failure receiving nurse-led, postdischarge multidisciplinary management...
January 20, 2017: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28107231/national-database-research-in-spine-surgery-limitations-in-the-current-literature
#4
Arjun S Sebastian
Many of the studies in the spine surgical literature using national databases have been directed at examining adverse events, readmission rates, cost, and risk factors for poorer outcomes. Although such studies allow for assessment of large cohorts taken from multiple institutions, they are limited by data collection methods, short-term follow-up, and minimal assessment of functional outcomes. Furthermore, few studies are directed at producing actionable practice changes to improve patient care. Recent work aimed at producing databases with more relevance to spine surgery represent exciting developments to the rapidly growing field of health outcomes research...
February 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28106651/evaluating-the-impact-of-intraoperative-surgical-team-handoffs-on-patient-outcomes
#5
Lauren E Giugale, Sarah Sears, Erin S Lavelle, Charelle M Carter-Brooks, Michael Bonidie, Jonathan P Shepherd
OBJECTIVE: The aim of the study was to assess the impact of intraoperative personnel handoffs on clinical outcomes in patients undergoing minimally invasive sacrocolpopexy (SCP). METHODS: We retrospectively reviewed SCPs performed at an academic center between 2009 and 2014. We analyzed the number of staff handoffs, defined as any instance a scrub technician (tech) or circulating nurse handed off responsibility for a break or shift change. Outcomes included operative (OR) time and composite variables for major complications (conversion to an open procedure, bladder injury, bowel injury, blood transfusion, infection, ileus, bowel obstruction, readmission, or mesh complication) and prolapse recurrence (prolapse at or beyond the hymen or retreatment)...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28106498/performing-concurrent-operations-in-academic-vascular-neurosurgery-does-not-affect-patient-outcomes
#6
Corinna C Zygourakis, Janelle Lee, Julio Barba, Errol Lobo, Michael T Lawton
OBJECTIVE Concurrent surgeries, also known as "running two rooms" or simultaneous/overlapping operations, have recently come under intense scrutiny. The goal of this study was to evaluate the operative time and outcomes of concurrent versus nonconcurrent vascular neurosurgical procedures. METHODS The authors retrospectively reviewed 1219 procedures performed by 1 vascular neurosurgeon from 2012 to 2015 at the University of California, San Francisco. Data were collected on patient age, sex, severity of illness, risk of mortality, American Society of Anesthesiologists (ASA) status, procedure type, admission type, insurance, transfer source, procedure time, presence of resident or fellow in operating room (OR), number of co-surgeons, estimated blood loss (EBL), concurrent vs nonconcurrent case, severe sepsis, acute respiratory failure, postoperative stroke causing neurological deficit, unplanned return to OR, 30-day mortality, and 30-day unplanned readmission...
January 20, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28105883/measuring-health-literate-discharge-practices
#7
Jennifer Innis, Jan Barnsley, Whitney Berta, Imtiaz Daniel
Purpose Health literate discharge practices meet patient and family health literacy needs in preparation for care transitions from hospital to home. The purpose of this paper is to measure health literate discharge practices in Ontario hospitals using a new organizational survey questionnaire tool and to perform psychometric testing of this new survey. Design/methodology/approach This survey was administered to hospitals in Ontario, Canada. Exploratory factor analysis and reliability testing were performed...
February 13, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28104806/reducing-unnecessary-testing-an-intervention-to-improve-resident-ordering-practices
#8
Jose Melendez-Rosado, Kristine M Thompson, Jed C Cowdell, Catalina Sanchez Alvarez, Ryan L Ung, Armando Villanueva, Kayin B Jeffers, Jaafer S Imam, Mario V Mitkov, Tasneem A Kaleem, Lewis Jacob, Nancy L Dawson
PURPOSE OF THE STUDY: To reduce the number of unnecessary laboratory tests ordered through a measurement of effects of education and cost awareness on laboratory ordering behaviour by internal medicine residents for common tests, including complete blood cell count (CBC) and renal profile (RP), and to evaluate effects of cost awareness on hospitalisation, 30-day readmission rate and mortality rate. STUDY DESIGN: 567 patients admitted during February, March and April 2014 were reviewed as the control group...
January 19, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28104599/telephone-follow-up-calls-for-older-patients-after-hospital-discharge
#9
Ebony Lewis, Sarah Samperi, Christopher Boyd-Skinner
Population ageing poses many challenges. Recurrent readmission to hospital by frail older people places a strain on health systems and the individual. Registered nurses with experience in emergency department, ICU and aged care conducted telephone follow-up calls to patients or bereaved family members after an acute hospital admission. During follow-up calls, many patients reported feelings of loneliness and social isolation post-discharge. It was also found that patients may not be aware of support services available in the community...
January 18, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28104428/long-term-clinical-outcomes-and-predictors-for-survivors-of-out-of-hospital-cardiac-arrest
#10
Mony Shuvy, Laurie J Morrison, Maria Koh, Feng Qiu, Jason E Buick, Paul Dorian, Damon C Scales, Jack V Tu, P Richard Verbeek, Harindra C Wijeysundera, Dennis T Ko
AIMS: Improvement in resuscitation efforts has translated to an increasing number of survivors after out-of-hospital cardiac arrest (OHCA). Our objectives were to assess the long-term outcomes and predictors of mortality for patients who survived OHCA. METHODS: We conducted a population-based cohort study linking the Toronto RescuNET cardiac arrest database with administrative databases in Ontario, Canada. We included patients with non-traumatic OHCA from December 1, 2005 to December 31, 2014...
January 16, 2017: Resuscitation
https://www.readbyqxmd.com/read/28104336/indicators-of-cognitive-impairment-from-a-medical-record-review-correlations-with-early-30-d-readmissions-among-hospitalized-patients-in-a-nephrology-unit
#11
Matthew J Jasinski, Mark A Lumley, Sandeep Soman, Jerry Yee, Mark W Ketterer
BACKGROUND: Patients with end-stage renal disease have the highest 30-day hospital readmission rates of any medical condition. Previous research suggests that cognitive impairment contributes to readmission. It is important to identify patients at risk for early readmission, and this might be accomplished efficiently using medical record data. METHOD: We reviewed the medical records of 100 patients with kidney disease (57 women, mean age = 61.2) who were hospitalized in the nephrology unit at an urban U...
October 19, 2016: Psychosomatics
https://www.readbyqxmd.com/read/28104101/preventing-hospitalizations-from-acute-exacerbations-of-chronic-obstructive-pulmonary-disease
#12
REVIEW
Jessica E Burchette, G Douglas Campbell, Stephen A Geraci
Chronic obstructive lung disease is among the leading causes of adult hospital admissions and readmissions in the United States. Preventing acute exacerbations is the primary approach in therapy. Combinations of smoking cessation, pulmonary rehabilitation, vaccinations and inhaled and oral medications may all reduce the overall risk of acute exacerbations. When prevention is unsuccessful, treatment of exacerbations often does not require hospitalization but can be safely executed in the outpatient setting. In the patient who does not require mechanical ventilation or who manifests respiratory acidosis, oxygen supplementation, frequent short-acting inhaled bronchodilators, oral corticosteroids and often antibiotics can abort the decompensation and sometimes return the patient to his or her pre-attack baseline lung function...
January 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28103418/three-hundred-and-sixty-eight-consecutive-pancreaticoduodenetomies-with-zero-mortality
#13
Seiji Oguro, Jiro Yoshimoto, Hiroshi Imamura, Yoichi Ishizaki, Seiji Kawasaki
BACKGROUND/PURPOSE: Only a limited number of reports have documented zero mortality in consecutive pancreaticoduodenetomy series. The aim of this study is to review and verify our management aiming to eliminate mortality after pancreaticoduodenetomy. METHODS: Three hundred sixty-eight consecutive patients undergoing pancreaticoduodenetomy between 2002 and 2015 were retrospectively reviewed. During this period, in order to enhance the safety of pancreaticoduodenetomy, we have employed a consistent strategy consisting of early ligation of the inferior pancreatoduodenal artery, mucosal sutureless pancreaticojejunostomy combined with external pancreatic duct stenting, conditional two-stage pancreaticojejunostomy, jejunal decompression using tube jejunostomy, application of an omental flap to cover the stump of the gastroduodenal artery, and careful postoperative drain management...
January 19, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28101791/strategies-to-reduce-30-day-readmissions-in-patients-with-cirrhosis
#14
REVIEW
Elliot B Tapper, Michael Volk
PURPOSE OF REVIEW: Approximately, one quarter of patients discharged after a hospitalization for decompensated cirrhosis will be readmitted within 30 days. These readmissions have been associated with increased morbidity and mortality, can be financially harmful to the health system, and may be partially preventable. This review summarizes the literature on readmissions, providing clinicians with tools for risk prediction and a taxonomy for preventative interventions. RECENT FINDINGS: Readmission strategies can be categorized according to complexity (simple versus complex) and specificity (focused versus broad)...
January 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28101720/enhanced-recovery-after-surgery-programs-for-liver-resection-a-meta-analysis
#15
Cheng Wang, Guoqun Zheng, Wenlong Zhang, Fabiao Zhang, Shangdong Lv, Aidong Wang, Zheping Fang
BACKGROUND AND AIMS: Due to the limited number of high-quality randomized controlled trials on enhanced recovery after surgery for hepatectomy, previous reviews have not been sufficiently comprehensive. Our objectives were to evaluate and compare the safety and efficacy of enhanced recovery after surgery programs and traditional care in patients undergoing open or laparoscopic surgery and to assess the optimized items for hepatectomy. METHODS: We searched the PubMed, Embase, and the Cochrane Library databases for all the relevant studies regardless of study design...
January 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28101609/patient-preparation-for-transitions-of-surgical-care-is-failing-to-prepare-surgical-patients-preparing-them-to-fail
#16
Luke A Martin, Samuel R G Finlayson, Benjamin S Brooke
BACKGROUND: Transitions of care before and after surgery are critical for patient preparation. We sought to determine whether the degree of exposure to health information resources before and after surgery increases preparedness and decreases hospital readmission. METHODS: A national Web-based, cross-sectional survey was conducted of 1917 patients and caregivers who had a recent surgical encounter. Health information resources used before and after surgery were correlated with patient level of preparedness...
January 18, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28100340/-outcome-comparison-of-different-therapy-procedures-in-surgical-high-risk-elderly-patients-with-severe-aortic-stenosis
#17
Y Q Ye, Y T Wang, Z Li, M Y Wang, H Y Xu, W J Zhang, Q R Liu, G N Niu, Y J Wu
Objective: To compare the outcome of surgical high-risk elderly patients with severe aortic stenosis(SAS) treated by different therapy procedures, including transcatheter aortic valve implantation(TAVI), surgical aortic valve replacement(SAVR), and drug therapy. Methods: We retrospectively analyzed the clinical data of 242 surgical high-risk elderly (age ≥65 years old) SAS patients hospitalized in Fuwai Hospital between September 2012 and June 2015. According to the treatment method, patients were divided into TAVI group (81 cases), SAVR group (59 cases) and drug therapy group (102 cases)...
January 25, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28100157/characterization-of-planned-and-unplanned-30-day-readmissions-following-vascular-surgical-procedures
#18
Georges Tahhan, Alik Farber, Nishant K Shah, Brianna M Krafcik, Teviah E Sachs, Jeffrey A Kalish, Matthew R Peacock, Jeffrey J Siracuse
OBJECTIVE: Thirty-day readmission is increasingly used as a quality of care indicator. Patients undergoing vascular surgery have historically been at high risk for readmission. We analyzed hospital readmission details to identify patients at high risk for readmission in order to better understand these readmissions and improve resource utilization in this patient population. METHODS: A retrospective review and analysis of our medical center's admission and discharge data were conducted from October 2012 to March 2015...
January 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28099387/use-of-an-evidence-based-algorithm-for-patients-with-traumatic-hemothorax-reduces-need-for-additional-interventions
#19
Bradley M Dennis, Stephen P Gondek, Richard A Guyer, Susan E Hamblin, Oliver L Gunter, Oscar D Guillamondegui
BACKGROUND: Concerted management of the traumatic hemothorax is ill-defined. Surgical management of specific hemothoraces may be beneficial. A comprehensive strategy to delineate appropriate patients for additional procedures does not exist. We developed an evidence-based algorithm for hemothorax management. We hypothesize the use of this algorithm will decrease additional interventions. METHODS: A pre/post study was performed on all patients admitted to our trauma service with traumatic hemothorax from August 2010 to September 2013...
January 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28099378/acs-level-i-trauma-centers-outcomes-do-not-correlate-with-patients-perception-of-hospital-experience
#20
Bellal Joseph, Asad Azim, Terence O'Keeffe, Kareem Ibraheem, Narong Kulvatunyou, Andrew Tang, Gary Vercruysse, Randall Friese, Rifat Latifi, Peter Rhee
INTRODUCTION: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is a data collection methodology for measuring a patient's perception of his/her hospital experience, and it has been selected by the Centers of Medicare and Medicaid Services (CMS) as the validated and transparent national survey tool with publicly available results. Since 2012, hospital reimbursements rates have been linked to HCAHPS data based on patient satisfaction scores. The aim of this study was, therefore, to assess whether HCAHPS scores of Level-1 trauma centers correlate with actual hospital performance...
January 17, 2017: Journal of Trauma and Acute Care Surgery
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