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https://www.readbyqxmd.com/read/28096573/prolonged-patient-emergence-time-among-clinical-anesthesia-resident-trainees
#1
L McLean House, Nathan H Calloway, Warren S Sandberg, Jesse M Ehrenfeld
BACKGROUND AND AIMS: Emergence time, or the duration between incision closure and extubation, is costly nonoperative time. Efforts to improve operating room efficiency and identify trainee progress make such time intervals of interest. We sought to calculate the incidence of prolonged emergence (i.e., >15 min) for patients under the care of clinical anesthesia (CA) residents. We also sought to identify factors from resident training, medical history, anesthetic use, and anesthesia staffing, which affect emergence...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28033485/acculturation-needs-of-pediatric-international-medical-graduates-a-qualitative-study
#2
Amanda D Osta, Michelle M Barnes, Regina Pessagno, Alan Schwartz, Laura E Hirshfield
: Phenomenon: International medical graduates (IMGs) play a key role in host countries' health systems but face unique challenges, which makes effective, tailored support for IMGs essential. Prior literature describing the acculturation needs of IMGs focused primarily on communication content and style. We conducted a qualitative study to explore acculturation that might be specific to IMG residents who care for children. APPROACH: In a study conducted from November 2011 to April 2012, we performed four 90-minute semistructured focus groups with 26 pediatric IMG residents from 12 countries...
December 29, 2016: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/28018540/development-of-a-comprehensive-communication-skills-curriculum-for-pediatrics-residents
#3
Eleanor B Peterson, Kimberly A Boland, Kristina A Bryant, Tara F McKinley, Melissa B Porter, Katherine E Potter, Aaron W Calhoun
BACKGROUND : Effective communication is an essential element of medical care and a priority of medical education. Specific interventions to teach communication skills are at the discretion of individual residency programs. OBJECTIVE : We developed the Resident Communication Skills Curriculum (RCSC), a formal curriculum designed to teach trainees the communication skills essential for high-quality practice. METHODS : A multidisciplinary working group contributed to the development of the RCSC, guided by an institutional needs assessment, literature review, and the Accreditation Council for Graduate Medical Education core competencies...
December 2016: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/27998549/patient-hand-off-initiation-and-evaluation-phone-study-a-randomized-trial-of-patient-handoff-methods
#4
Jesse Clanton, Aimee Gardner, Michael Subichin, Patrick McAlvanah, William Hardy, Amar Shah, Joel Porter
BACKGROUND: As residency work hour restrictions have tightened, transitions of care have become more frequent. Many institutions dedicate significant time and resources to patient handoffs despite the fact that the ideal method is relatively unknown. We sought to compare the effect of a rigorous formal handoff approach to a minimized but focused handoff process on patient outcomes. METHODS: A randomized prospective trial was conducted at a large teaching hospital over ten months...
November 23, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27968889/patient-safety-culture-in-surgical-departments-versus-other-departments-in-county-hospitals-of-hubei-province-china-a-cross-sectional-survey
#5
Manli Wang, Hongbing Tao, Haiqing Fang, Zhaohui Cheng, Miao Cai, Xiaojun Lin, Chang Xu
BACKGROUND: Patient safety culture affects hospital safety and performance. The Hospital Survey on Patient Safety Culture (HSOPSC) is widely used to assess the safety culture in hospital and unit level. We aimed to assess strengths and weaknesses of surgical departments compared with others in county hospitals of China with HSOPSC. METHODS: A cross-sectional study was conducted in 2015 with a Chinese translation of HSOPSC being administered to 1500 staff from 19 county hospitals in Xiaogan city of Hubei province China...
October 2016: Lancet
https://www.readbyqxmd.com/read/27965029/packaging-patients-and-handing-them-over-communication-context-and-persuasion-in-the%C3%A2-emergency-department
#6
Peter Nugus, Sally McCarthy, Anne Holdgate, Jeffrey Braithwaite, Anna Schoenmakers, Cordula Wagner
STUDY OBJECTIVE: Communication is commonly understood by health professional researchers to consist of relatively isolated exchanges of information. The social and organizational context is given limited credit. This article examines the significance of the environmental complexity of the emergency department (ED) in influencing communication strategies and makes the case for adopting a richer understanding of organizational communication. METHODS: This study draws on approximately 12 months (1,600 hours) of ethnographic observations, yielding approximately 4,500 interactions across 260 clinicians and staff in the EDs of 2 metropolitan public teaching hospitals in Sydney, Australia...
December 10, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27956266/what-s-ideal-a-case-study-exploring-handoff-routines-in-practice
#7
Saira N Haque, Carsten S Oesterlund, Lawrence M Fagan
BACKGROUND: Handoffs of care in the healthcare system between responsible providers have traditionally been conceptualized and studied at the point of patient transfer. Thus, clinical practice and associated information systems are designed with the concept of the handoff as a solitary event. This viewpoint does not consider the routine activities necessary for a successful handoff. We propose expanding the analysis of the handoff beyond the single point of transfer to include a routine of interrelated activities leading up to the transfer of responsibility...
December 9, 2016: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/27940799/standardization-of-inpatient-handoff-communication
#8
Jennifer A Jewell
Handoff communication is identified as an integral part of hospital care. Throughout medical communities, inadequate handoff communication is being highlighted as a significant risk to patients. The complexity of hospitals and the number of providers involved in the care of hospitalized patients place inpatients at high risk of communication lapses. This miscommunication and the potential resulting harm make effective handoffs more critical than ever. Although hospitalized patients are being exposed to many handoffs each day, this report is limited to describing the best handoff practices between providers at the time of shift change...
November 2016: Pediatrics
https://www.readbyqxmd.com/read/27940798/handoffs-transitions-of-care-for-children-in-the-emergency-department
#9
(no author information available yet)
Transitions of care (ToCs), also referred to as handoffs or sign-outs, occur when the responsibility for a patient's care transfers from 1 health care provider to another. Transitions are common in the acute care setting and have been noted to be vulnerable events with opportunities for error. Health care is taking ideas from other high-risk industries, such as aerospace and nuclear power, to create models of structured transition processes. Although little literature currently exists to establish 1 model as superior, multiorganizational consensus groups agree that standardization is warranted and that additional work is needed to establish characteristics of ToCs that are associated with clinical or practice outcomes...
November 2016: Pediatrics
https://www.readbyqxmd.com/read/27940423/impact-of-structured-rounding-tools-on-time-allocation-during-multidisciplinary-rounds-an-observational-study
#10
Joanna Abraham, Thomas G Kannampallil, Vimla L Patel, Bela Patel, Khalid F Almoosa
BACKGROUND: Recent research has shown evidence of disproportionate time allocation for patient communication during multidisciplinary rounds (MDRs). Studies have shown that patients discussed later during rounds receive lesser time. OBJECTIVE: The aim of our study was to investigate whether disproportionate time allocation effects persist with the use of structured rounding tools. METHODS: Using audio recordings of rounds (N=82 patients), we compared time allocation and communication breakdowns between a problem-based Subjective, Objective, Assessment, and Plan (SOAP) and a system-based Handoff Intervention Tool (HAND-IT) rounding tools...
December 9, 2016: JMIR Human Factors
https://www.readbyqxmd.com/read/27923083/resident-shift-handoff-strategies-in-us-internal-medicine-residency-programs
#11
LETTER
Charlie M Wray, Saima Chaudhry, Amber Pincavage, Rachel Miller, Linda DeCherrie, Karin Ouchida, Vineet M Arora
No abstract text is available yet for this article.
December 6, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27913246/measuring-content-overlap-during-handoff-communication-using-distributional-semantics-an-exploratory-study
#12
Joanna Abraham, Thomas Kannampallil, Vignesh Srinivasan, William Galanter, Gail Tagney, Trevor Cohen
OBJECTIVE: We develop and evaluate a methodological approach to measure the degree and nature of overlap in handoff communication content within and across clinical professions. This extensible, exploratory approach relies on combining techniques from conversational analysis and distributional semantics. MATERIALS AND METHODS: We audio-recorded handoff communication of residents and nurses on the General Medicine floor of a large academic hospital (n=120 resident and n=120 nurse handoffs)...
November 29, 2016: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/27902662/surveillance-a-nursing-intervention-for-improving-patient-safety-in-critical-care-environment
#13
Dale M Pfrimmer, Maren R Johnson, Martha L Guthmiller, Joanna L Lehman, Vickie K Ernste, Lori M Rhudy
BACKGROUND: Nursing surveillance has been identified as a key intervention in early recognition and prevention of errors/adverse events. Nursing Intervention Classification (NIC) defines surveillance as "the purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making." Because nurses are the main staffing constant in the critical care environment, the importance of surveillance as an intervention is fundamental. OBJECTIVE: The aim of this study was to explore how surveillance is expressed by critical care nurses...
January 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/27896691/a-pilot-study-of-the-chronology-of-present-illness-restructuring-the-hpi-to-improve-physician-cognition-and-communication
#14
Laura M Mazer, Tina Storage, Sylvia Bereknyei, Jeffrey Chi, Kelley Skeff
BACKGROUND: Patient history-taking is an essential clinical skill, with effects on diagnostic reasoning, patient-physician relationships, and more. We evaluated the impact of using a structured, timeline-based format, the Chronology of Present Illness (CPI), to guide the initial patient interaction. OBJECTIVE: To determine the feasibility and impact of the CPI on the patient interview, written notes, and communication with other providers. DESIGN: Internal medicine residents used the CPI during a 2-week night-float rotation...
November 28, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27885832/defining-pediatric-inpatient-cardiology-care-delivery-models-a-survey-of-pediatric-cardiology-programs-in-the-usa-and-canada
#15
Antonio R Mott, Steven R Neish, Melissa Challman, Timothy F Feltes
BACKGROUND: The treatment of children with cardiac disease is one of the most prevalent and costly pediatric inpatient conditions. The design of inpatient medical services for children admitted to and discharged from noncritical cardiology care units, however, is undefined. North American Pediatric Cardiology Programs were surveyed to define noncritical cardiac care unit models in current practice. METHOD: An online survey that explored institutional and functional domains for noncritical cardiac care unit was crafted...
November 25, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27870940/blood-based-biomarkers-in-alzheimer-disease-current-state-of-the-science-and-a-novel-collaborative-paradigm-for-advancing-from-discovery-to-clinic
#16
Sid E O'Bryant, Michelle M Mielke, Robert A Rissman, Simone Lista, Hugo Vanderstichele, Henrik Zetterberg, Piotr Lewczuk, Holly Posner, James Hall, Leigh Johnson, Yiu-Lian Fong, Johan Luthman, Andreas Jeromin, Richard Batrla-Utermann, Alcibiades Villarreal, Gabrielle Britton, Peter J Snyder, Kim Henriksen, Paula Grammas, Veer Gupta, Ralph Martins, Harald Hampel
The last decade has seen a substantial increase in research focused on the identification of blood-based biomarkers that have utility in Alzheimer's disease (AD). Blood-based biomarkers have significant advantages of being time- and cost-efficient as well as reduced invasiveness and increased patient acceptance. Despite these advantages and increased research efforts, the field has been hampered by lack of reproducibility and an unclear path for moving basic discovery toward clinical utilization. Here we reviewed the recent literature on blood-based biomarkers in AD to provide a current state of the art...
January 2017: Alzheimer's & Dementia: the Journal of the Alzheimer's Association
https://www.readbyqxmd.com/read/27870725/patients-perceptions-of-bedside-handoff-further-evidence-to-support-a-culture-of-always
#17
(no author information available yet)
No abstract text is available yet for this article.
January 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/27861833/organizational-factors-affect-safety-net-hospitals-breast-cancer-treatment-rates
#18
Nina A Bickell, Alexandra DeNardis Moss, Maria Castaldi, Ajay Shah, Alan Sickles, Peter Pappas, Theophilus Lewis, Margaret Kemeny, Shalini Arora, Lori Schleicher, Kezhen Fei, Rebeca Franco, Ann Scheck McAlearney
OBJECTIVE: To identify key organizational approaches associated with underuse of breast cancer care. SETTING: Nine New York City area safety-net hospitals. STUDY DESIGN: Mixed qualitative-quantitative, cross-sectional cohort. METHODS: We used qualitative comparative analysis (QCA) of key stakeholder interviews, defined organizational "conditions," calibrated conditions, and identified solution pathways. We defined underuse as no radiation after lumpectomy in women <75 years or mastectomy in women with ≥4 positive nodes, or no systemic therapy in women with tumors ≥1 cm...
November 14, 2016: Health Services Research
https://www.readbyqxmd.com/read/27861445/electronic-care-coordination-from-the-preoperative-clinic
#19
Vinca W Chow, David L Hepner, Angela M Bader
Fragmented and variable perioperative care exposes patients to unnecessary risks and handoff errors. The perioperative surgical home aims to optimize quality, value-based care. We performed a retrospective evaluation of how a preoperative assessment center could coordinate care through e-mails sent to a patient's healthcare team that initiate discussion on critical clinical information. During 100 clinic days on which 8122 patients were evaluated, 606 triggered e-mails, with a potential impact on 19 elements across the perioperative care spectrum...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27850890/1254-assessment-of-the-quality-of-postoperative-handoffs
#20
Christina Hanowsky, Michael Wilhelm
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
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