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https://www.readbyqxmd.com/read/28351062/using-national-health-care-databases-and-problem-based-practice-analysis-to-inform-integrated-curriculum-development
#1
Amy J Baker, Mark R Raymond, Steven A Haist, John R Boulet
One challenge when implementing case-based learning, and other approaches to contextualized learning, is determining which clinical problems to include. This article illustrates how health care utilization data, readily available from the National Center for Health Statistics (NCHS), can be incorporated into an educational needs assessment to identify medical problems physicians are likely to encounter in clinical practice. The NCHS survey data summarize patient demographics, diagnoses, and interventions for tens of thousands of patients seen in various settings, including emergency departments (EDs), clinics, and hospitals...
April 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28350636/the-impact-of-hospital-health-network-affiliation-on-discharge-communication-preferences-of-primary-care-providers
#2
David Y Ming, Alyssa M Stephany, John A Gallis, Benjamin J Powers
Primary care physicians (PCPs) experience differential postdischarge access to electronic health records, depending upon affiliation with the discharging hospital's health network. To better understand whether this affiliation impacts discharge communication preferences, we surveyed a convenience sample of PCPs in and out of our hospital's health network. We also surveyed hospitalists and compared PCPs' and hospitalists' responses. We found that PCP discharge communication preferences differed by hospital health network affiliation...
March 27, 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/28346946/association-between-a-virtual-glucose-management-service-and-glycemic-control-in-hospitalized-adult-patients-an-observational-study
#3
Robert J Rushakoff, Mary M Sullivan, Heidemarie Windham MacMaster, Arti D Shah, Alvin Rajkomar, David V Glidden, Michael A Kohn
Background: Inpatient hyperglycemia is common and is linked to adverse patient outcomes. New methods to improve glycemic control are needed. Objective: To determine whether a virtual glucose management service (vGMS) is associated with improved inpatient glycemic control. Design: Cross-sectional analyses of three 12-month periods (pre-vGMS, transition, and vGMS) between 1 June 2012 and 31 May 2015. Setting: 3 University of California, San Francisco, hospitals...
March 28, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28346245/hospitalist-versus-subspecialist-perspectives-on-reasons-timing-and-impact-of-consultation
#4
Kelly Pacitti, Anne Mathew, Amanda Royse, John O Elliott, Kim Jordan
BACKGROUND: Hospitalists frequently consult medical subspecialists in the management of inpatients. Given the potential impact on health resource utilization, it is important to understand the working relationship between these groups. METHODS: A cross-sectional survey of hospitalists, n = 655, and subspecialists across Ohio (nephrologists and endocrinologists), n = 293, was conducted to investigate perceptions and communication about reasons, timing, and impact of hospital consultations...
March 24, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28345682/-occupational-exposure-in-orthopedic-procedures-under-fluoroscopic-control
#5
Edyta Owsiak, Renata Kopeć, Maciej Budzanowski, Maria A Staniszewska
BACKGROUND: In interventional radiology the highest radiation doses are usually recorded for both the medical staff and the patients. Interventional procedures with X-rays are implemented in a number of medical specializations. This paper concerns the exposure of interventional teams performing orthopedic procedures under X-rays control. MATERIAL AND METHODS: Doses for interventional teams were measured in the 3 Łódź hospitals. Thermoluminescent dosemeters were applied to measure the following dose equivalents: Hp(3) for eye lens, Hp(0...
March 24, 2017: Medycyna Pracy
https://www.readbyqxmd.com/read/28345443/economic-burden-of-irritable-bowel-syndrome-with-diarrhea-retrospective-analysis-of-a-u-s-commercially-insured-population
#6
Jessica L Buono, Kush Mathur, Amelia J Averitt, David A Andrae
BACKGROUND: The economic burden associated with irritable bowel syndrome with diarrhea (IBS-D) is not well understood. OBJECTIVES: To (a) evaluate total annual all-cause, gastrointestinal (GI)-related, and symptom-related (i.e., IBS, diarrhea, abdominal pain) health care resource use and costs among IBS-D patients in a U.S. commercially insured population and (b) estimate incremental all-cause health care costs of IBS-D patients versus matched controls. METHODS: Patients aged ≥ 18 years with 12 months of continuous medical and pharmacy benefit eligibility in 2013 were identified from the Truven Health MarketScan research database...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28344837/exploring-supervisor-related-job-resources-as-mediators-between-supervisor-conflict-and-job-attitudes-in-hospital-employees
#7
Achim Elfering, Christin Gerhardt, Simone Grebner, Urs Müller
BACKGROUND: Conservation of resources theory assumes loss of resources as a cause of job strain. In hospital work, conflicts with supervisors are tested to predict lower resources, that is, supervisory social support, participation possibilities, and appreciation. All three resources are expected to predict, in turn, experienced stress (job strain) and lower job satisfaction, lower affective commitment, and a higher resigned attitude towards the job (job attitudes). METHODS: The sample included 1,073 employees from 14 Swiss hospitals (n = 604 nurses, n = 81 physicians, n = 135 medical therapists, and n = 253 technical and administrative staff)...
March 2017: Safety and Health At Work
https://www.readbyqxmd.com/read/28344421/impact-of-physician-coordinated-intensive-follow-up-on-long-term-medical-costs-in-patients-with-unstable-angina-undergoing-percutaneous-coronary-intervention
#8
Jing-Jing Jia, Ping-Shuan Dong, Lai-Jing Du, Zhi-Guo Li, Li-Hong Lai, Xu-Ming Yang, Shao-Xin Wang, Xi-Shan Yang, Zhi-Juan Li, Xi-Yan Shang, Xi-Mei Fan
BACKGROUND: To investigate the impact of professional physician-coordinated intensive follow-up on long-term expenditures after percutaneous coronary intervention (PCI) in unstable angina (UA) patients. METHODS: In this study, there were 669 UA patients who underwent successful PCI and followed up for 3 years, then divided into the intensive follow-up group (N = 337), and the usual follow-up group (N = 332). Patients were provided with detailed discharge information and individualized follow-up schedules...
March 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/28343857/staphylococcus-aureus-nasal-carriage-in-health-care-workers-first-report-from-a-major-public-hospital-in-argentina
#9
Carina Andrea Boncompain, Cristian Alejandro Suárez, Héctor Ricardo Morbidoni
Staphylococcus aureus causes numerous mild to severe infections in humans, both in health facilities and in the community. Patients and health care workers (HCWs) may disseminate strains during regular medical examinations or hospitalization. The aim of this study was to determine the nasal carriage rate of methicillin-susceptible and methicillin-resistant S. aureus among health care workers at Hospital Provincial del Centenario, a public general hospital in Rosario, Argentina. A transversal study was conducted on 320 health care workers...
March 24, 2017: Revista Argentina de Microbiología
https://www.readbyqxmd.com/read/28343816/the-risk-of-unintentional-out-of-network-encounters-with-hospital-based-physicians-at-in-network-hospitals
#10
Lawrence H Brown, Robert A Weston, John E Gough
OBJECTIVE: When hospital-based specialists including emergency physicians, anesthesiologists, pathologists and radiologists are not included in the same insurance networks as their parent hospitals, it creates confusion and leads to unexpected costs for patients. This study explored the frequency with which hospital-based physicians at academic medical centers are not included in the network directories for the same insurance networks as their parent teaching hospitals. METHODS: We studied teaching hospitals with residency programs in all four hospital-based specialties...
March 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28343797/early-brain-edema-is-a-predictor-of-in-hospital-mortality-in-traumatic-brain-injury
#11
Brian Tucker, Jill Aston, Megan Dines, Elena Caraman, Marianne Yacyshyn, Mary McCarthy, James E Olson
BACKGROUND: Identifying patients who may progress to a poor clinical outcome will encourage earlier appropriate therapeutic interventions. Brain edema may contribute to secondary injury in traumatic brain injury (TBI) and thus, may be a useful prognostic indicator. OBJECTIVE: We determined whether the presence of brain edema on the initial computed tomography (CT) scan of TBI patients would predict poor in-hospital outcome. METHODS: We performed a retrospective review of all trauma patients with nonpenetrating head trauma at a Level I Trauma Center...
March 23, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28343733/low-risk-papillary-microcarcinoma-of-the-thyroid-a-review-of-active-surveillance-trials
#12
REVIEW
Y Ito, A Miyauchi, H Oda
Papillary microcarcinoma (PMC) of the thyroid is defined as papillary thyroid carcinoma (PTC) measuring ≤1 cm. Many autopsy studies on subjects who died of non-thyroidal diseases reported latent small thyroid carcinoma in up to 5.2% of the subjects. A mass screening study for thyroid cancer in Japanese adult women detected small thyroid cancer in 3.5% of the examinees. This incidence was close to the incidence of latent thyroid cancer and more than 1000 times the prevalence of clinical thyroid cancer in Japanese women reported at that time...
March 16, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28343186/-profile-of-adults-suffering-from-copd-in-poland
#13
Marcin Nowak, Mateusz Jankowski, Grzegorz M Brożek, Szymon Skoczyński, Patrycja Rzepka-Wrona, Ewa Pierzchała, Jan E Zejda, Władysław Pierzchała
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases in adults. It is estimated, that in Poland around two million people suffer from COPD. THE AIM: The aim of this study, was to characterize population of patients with COPD in Poland. MATERIAL AND METHODS: The study, established and coordinated by the Polish Respiratory Society, included a representative sample of 500 GPs where were asked to fill questionnaires on diagnosis and treatment of their COPD patients...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28342656/nurses-are-as-specific-and-are-earlier-in-calling-in-hospital-stroke-alerts-compared-to-physicians
#14
Pravin George, Dolora R Wisco, James Gebel, Ken Uchino, Christopher R Newey
INTRODUCTION: In-hospital stroke alerts are typically activated by nurses or physicians when a patient's neurological status acutely changes from baseline. It is unclear if knowledge of stroke symptoms translates to accurate activation of the acute stroke team. We hypothesized that nurses who activate the stroke alert system would correctly identify as great a proportion of acute strokes as physicians. We also investigated the time to activation of these in-hospital stroke alerts. METHODS: We retrospectively reviewed consecutive inpatient stroke team calls over a 12-month period at a single, tertiary care center...
March 22, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28342622/an-analysis-of-the-relationship-between-burnout-socio-demographic-and-workplace-factors-and-job-satisfaction-among-emergency-department-health-professionals
#15
Menderes Tarcan, Neşet Hikmet, Benjamin Schooley, Mehmet Top, Gamze Yorgancıoglu Tarcan
INTRODUCTION: Burnout among emergency medical practitioners and personnel negatively affects career satisfaction and job performance and can lead to mental health issues, including anxiety, depression, and suicide. PURPOSE: This study investigated the relationship between the perceptions of burnout and job satisfaction of those working in two different hospital's emergency departments assessing the effect of burnout dimensions and additional factors (age, position, marital status, annual income, employment type, gender, patient encounters, and household economic well-being) on job satisfaction...
April 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28342441/building-a-community-of-practice-in-rural-medical-education-growing-our-own-together
#16
Randall L Longenecker, David Schmitz
CONTEXT: This article chronicles the rise, decline, and recent resurgence of rural training track residency programs (RTTs) in the USA over the past 30 years and the emergence of a healthy community of practice in rural medical education. This has occurred during a time in the USA when federal and state funding of graduate medical education has been relatively stagnant and the rules around finance and accreditation of rural programs have been challenging. ISSUE: Many of the early family residency programs developed in the 1970s included a curricular focus on rural practice...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28340798/effect-of-interviews-done-by-intensive-care-physicians-on-organ-donation
#17
D Birtan, M K Arslantas, P C Dincer, G T Altun, B Bilgili, F B Ucar, C A Bozoklar, H O Ayanoglu
In this study, we examined the correspondence between intensive care unit physicians and the relatives of potential brain-dead donors regarding the decision to donate or the reasons for refusing organ donation. A total of 12 consecutive cases of potential brain-dead patients treated in intensive care units of Marmara University Pendik Education and Research Hospital in 2013 were evaluated. For each of the cases, the Potential Donor Questionnaire, and Family Notification, Brain Death Criteria Fulfilment and Organ Donation Conversation Questionnaires were used to collect the required data...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28340584/validation-of-the-german-version-of-two-scales-ris-rcs-hcp-for-measuring-regret-associated-with-providing-healthcare
#18
Silvia C Richner, Stéphane Cullati, Boris Cheval, Ralph E Schmidt, Pierre Chopard, Christoph A Meier, Delphine S Courvoisier
BACKGROUND: The regret intensity scale (RIS) and the regret coping scale for healthcare professionals (RCS-HCP) working in hospitals assess the experience of care-related regrets and how healthcare professional deal with these negative events. The aim of this study was to validate a German version of the RIS and the RCS-HCP. METHODS: The RIS and RCS-HCP in German were first translated into German (forward- and backward translations) and then pretested with 16 German-speaking healthcare professionals...
March 24, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28340130/falling-down-on-the-job-evaluation-and-treatment-of-fall-risk-among-older-adults-with-upper-extremity-fragility-fractures
#19
Christine M McDonough, Carrie H Colla, Donald Carmichael, Anna N A Tosteson, Tor D Tosteson, John-Erik Bell, Robert V Cantu, Jonathan D Lurie, Julie P W Bynum
Background: Clinical practice guidelines recommend fall risk assessment and intervention for older adults who sustain a fall-related injury to prevent future injury and mobility decline. Objective: To describe how often Medicare beneficiaries with upper extremity fracture receive evaluation and treatment for fall risk. Design: Observational cohort. Methods Subjects: Fee-for-service beneficiaries age 66 to 99 treated as outpatients for proximal humerus or distal radius/ulna ("wrist") fragility fractures were studied using Carrier and Outpatient Hospital files...
March 2, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28338533/sepsis-patients-in-the-emergency-department-stratification-using-the-clinical-impression-score-predisposition-infection-response-and-organ-dysfunction-score-or-quick-sequential-organ-failure-assessment-score
#20
Vincent M Quinten, Matijs van Meurs, Anna E Wolffensperger, Jan C Ter Maaten, Jack J M Ligtenberg
OBJECTIVE: The aim of this study was to compare the stratification of sepsis patients in the emergency department (ED) for ICU admission and mortality using the Predisposition, Infection, Response and Organ dysfunction (PIRO) and quick Sequential Organ Failure Assessment (qSOFA) scores with clinical judgement assessed by the ED staff. PATIENTS AND METHODS: This was a prospective observational study in the ED of a tertiary care teaching hospital. Adult nontrauma patients with suspected infection and at least two Systemic Inflammatory Response Syndrome criteria were included...
March 23, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
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