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https://www.readbyqxmd.com/read/27926675/improvement-in-total-joint-replacement-quality-metrics-year-one-versus-year-three-of-the-bundled-payments-for-care-improvement-initiative
#1
John M Dundon, Joseph Bosco, James Slover, Stephen Yu, Yousuf Sayeed, Richard Iorio
BACKGROUND: In January 2013, a large, tertiary, urban academic medical center began participation in the Bundled Payments for Care Improvement (BPCI) initiative for total joint arthroplasty, a program implemented by the Centers for Medicare & Medicaid Services (CMS) in 2011. Medicare Severity-Diagnosis Related Groups (MS-DRGs) 469 and 470 were included. We participated in BPCI Model 2, by which an episode of care includes the inpatient and all post-acute care costs through 90 days following discharge...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27926663/the-impact-of-value-based-healthcare-for-inflammatory-bowel-diseases-on-healthcare-utilization-a-pilot-study
#2
Welmoed K van Deen, Arlen Spiro, A Burak Ozbay, Martha Skup, Adriana Centeno, Natalie E Duran, Precious N Lacey, Darius Jatulis, Eric Esrailian, Martijn G H van Oijen, Daniel W Hommes
BACKGROUND AND OBJECTIVES: Value-based healthcare (VBHC) is considered to be the solution that will improve quality and decrease costs in healthcare. Many hospitals are implementing programs on the basis of this strategy, but rigorous scientific reports are still lacking. In this pilot study, we present the first-year outcomes of a VBHC program for inflammatory bowel disease (IBD) management that focuses on highly coordinated care, task differentiation of providers, and continuous home monitoring...
December 6, 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27925550/impact-of-medication-errors-in-nursing-homes-surprisingly-low
#3
(no author information available yet)
Serious outcomes as a result medication errors among nursing home residents are 'surprisingly low', despite these errors being common, say Australian researchers.
December 7, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27925447/rehospitalization-of-preterm-infants-according-to-the-discharge-risk-level
#4
Burcu Aykanat Girgin, Güler Cimete
PURPOSE: The rehospitalization rate of preterm infants is between 22 and 52% within the first year after discharge. The purpose of this study was to investigate the rehospitalization of preterm infants within 2 months following discharge, considering the level of risks originating from the infant, parents, and the social factors. DESIGN AND METHODS: The sample was composed of 238 preterm infants and their parents. The data were collected with a Descriptive Information Form, the Post-Discharge Infant Follow-up Form, and the Neonatal Discharge Assessment Tool (N-DAT)...
December 7, 2016: Journal for Specialists in Pediatric Nursing: JSPN
https://www.readbyqxmd.com/read/27924231/a-tobacco-cessation-intervention-with-rural-medically-underserved-blue-collar-employees-a-quasiexperimental-study
#5
Telisa Stewart, Margaret K Formica, Anna M Adachi-Mejia, Dongliang Wang, Meg Gerrard
BACKGROUND: The aim of this study was to increase knowledge regarding the dangers associated with tobacco use, and decrease secondhand smoke exposure and tobacco use behaviors with an antitobacco messaging campaign among rural, medically underserved, blue-collar workers. METHODS: A quasiexperimental study was conducted with employees at two worksites. One worksite received the intervention, which consisted of nine different antitobacco messages. Baseline and follow-up surveys were conducted at each worksite to assess change in knowledge and behavior; the data were compared across the two worksites...
December 2016: Safety and Health At Work
https://www.readbyqxmd.com/read/27922462/fostering-evidence-based-quality-improvement-for-patient-centered-medical-homes-initiating-local-quality-councils-to-transform-primary-care
#6
Susan E Stockdale, Jessica Zuchowski, Lisa V Rubenstein, Negar Sapir, Elizabeth M Yano, Lisa Altman, Jacqueline J Fickel, Skye McDougall, Timothy Dresselhaus, Alison B Hamilton
BACKGROUND: Although the patient-centered medical home endorses quality improvement principles, methods for supporting ongoing, systematic primary care quality improvement have not been evaluated. We introduced primary care quality councils at six Veterans Health Administration sites as an organizational intervention with three key design elements: (a) fostering interdisciplinary quality improvement leadership, (b) establishing a structured quality improvement process, and (c) facilitating organizationally aligned frontline quality improvement innovation...
December 3, 2016: Health Care Management Review
https://www.readbyqxmd.com/read/27920510/the-clock-in-the-box-a-brief-cognitive-screen-is-associated-with-failure-to-return-home-in-an-elderly-hospitalized-sample
#7
Colleen E Jackson, Laura J Grande, Kelly Doherty, Elizabeth Archambault, Brittany Kelly, Jane A Driver, William P Milberg, Regina McGlinchey, James L Rudolph
PURPOSE: Cognitive screening upon hospital admission can provide important information about the patient's ability to process information during the inpatient stay. The Clock-in-the-Box (CIB) is a rapidly administered cognitive screening measure which has been previously validated with cognitive screening and neuropsychological assessments. The purpose of this study is to demonstrate the predictive validity of the CIB for discharge location among a sample of older medical inpatients. PATIENTS AND METHODS: Hospitalized Veterans (N=218), aged 55 years and older, were recruited on the day after admission after they gave their consent...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27920270/think-like-a-hacker-insights-on-the-latest-attack-vectors-and-security-controls-for-medical-device-applications
#8
Mandeep Khera
Ready or not, the Internet of things (IoT) is here. No longer just a buzz term, it'll continue to grow at an unprecedented pace over the next few years expecting to reach over 25 billion connected devices by 2020. History shows us that most fast growth technology solutions focus on solving business problems first and security is an afterthought. Unfortunately, IoT is following the same trend. Most IoT devices, apps, and infrastructure were developed without security in mind and are likely going to become targets of hackers...
December 4, 2016: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/27920118/patients-views-on-general-practitioners-role-during-treatment-and-follow-up-of-colorectal-cancer-a-qualitative-study
#9
Daan Brandenbarg, Carriene Roorda, Michelle Stadlander, Geertruida H de Bock, Marjolein Y Berger, Annette J Berendsen
PURPOSE: To clarify experiences and preferences of patients regarding the current and future role of GPs during treatment and follow-up care of colorectal cancer (CRC). METHODS: Qualitative semi-structured, audio-recorded, face-to-face interviews in patients' homes in the north of the Netherlands were performed. Patients were sampled purposively on age, gender, time since diagnoses and primary health care use. Data were transcribed verbatim and analysed thematically by two independent researchers until saturation was reached...
December 5, 2016: Family Practice
https://www.readbyqxmd.com/read/27919389/older-patients-use-of-technology-for-a-post-discharge-nutritional-intervention-a-mixed-methods-feasibility-study
#10
T Lindhardt, M H Nielsen
BACKGROUND: Malnutrition is frequent in older people and a precursor for morbidity and hospitalisation; furthermore low intake and weight loss during and after hospitalisation is well-described. Such patients are often excluded from technology projects on account of lack of skills. This is a barrier for their access to many current and future health care offers. OBJECTIVES: To test the acceptability, feasibility and preliminary efficacy of technology-supported energy- and protein-enforced homedelivered meals for older patients discharged from hospital...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27918840/resilience-and-risk-for-alcohol-use-disorders-a-swedish-twin-study
#11
Elizabeth C Long, Sara L Lönn, Jianguang Ji, Paul Lichtenstein, Jan Sundquist, Kristina Sundquist, Kenneth S Kendler
BACKGROUND: Resilience has been shown to be protective against alcohol use disorders (AUDs), but the magnitude and nature of the relationship between these 2 phenotypes are not clear. The aim of this study was to examine the strength of this relationship and the degree to which it results from common genetic or common environmental influences. METHODS: Resilience was assessed on a 9-point scale during a personal interview in 1,653,721 Swedish men aged 17 to 25 years...
December 5, 2016: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/27916337/nutritionday-10-years-of-growth
#12
REVIEW
Karin Schindler, Claude Pichard, Isabella Sulz, Dorothee Volkert, Melanie Streicher, Pierre Singer, Olle Ljungqvist, Andre Van Gossum, Peter Bauer, Michael Hiesmayr
BACKGROUND & AIMS: Despite high prevalence at hospital admission, disease related malnutrition (DRM) remains under recognized and undertreated. DRM is associated with increased morbidity, hospital readmission rate, and burden for the healthcare system. The compelling need to increase awareness and knowledge through an international survey has triggered the launch of the nutritionDay (ND) concept. METHODS: ND is a worldwide annual systematic collection and analysis of data in hospital wards, intensive care units and nursing homes...
November 11, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27915457/combined-use-of-the-rationalization-of-home-medication-by-an-adjusted-stopp-in-older-patients-rasp-list-and-a-pharmacist-led-medication-review-in-very-old-inpatients-impact-on-quality-of-prescribing-and-clinical-outcome
#13
Lorenz Van der Linden, Liesbeth Decoutere, Karolien Walgraeve, Koen Milisen, Johan Flamaing, Isabel Spriet, Jos Tournoy
BACKGROUND: Polypharmacy and potentially inappropriate drugs have been associated with negative outcomes in older adults which might be reduced by pharmacist interventions. OBJECTIVES: Our objective was to evaluate the effect of a pharmacist intervention, consisting of the application of the Rationalization of home medication by an Adjusted STOPP in older Patients (RASP) list and a pharmacist-led medication review on polypharmacy, the quality of prescribing, and clinical outcome in geriatric inpatients...
December 3, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27914817/what-really-happens-in-the-home-the-medication-environment-of-urban-minority-youth
#14
Andrea A Pappalardo, Kelly Karavolos, Molly A Martin
BACKGROUND: Asthma disproportionately affects minority youth. Understanding the home medication environment and its relation to medication adherence can shape interventions to improve health outcomes. OBJECTIVE: The objective of this study was to describe the asthma medication environment in the homes of urban minority youth and to determine predictors of medication use and technique in this population. METHODS: Baseline data from 2 cohorts of minority youth with asthma in Chicago were combined for cross-sectional analysis...
November 30, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/27914750/-medical-prescription-and-informed-consent-for-the-use-of-physical-restraints-in-nursing-homes-in-the-canary-islands-spain
#15
Gabriel J Estévez-Guerra, Emilio Fariña-López, Eva Penelo
OBJECTIVE: To identify the frequency of completion of informed consent and medical prescription in the clinical records of older patients subject to physical restraint, and to analyse the association between patient characteristics and the absence of such documentation. METHODS: A cross-sectional and descriptive multicentre study with direct observation and review of clinical records was conducted in nine public nursing homes, comprising 1,058 beds. RESULTS: 274 residents were physically restrained...
November 30, 2016: Gaceta Sanitaria
https://www.readbyqxmd.com/read/27913972/in-hospital-diagnosis-of-sleep-apnea-in-stroke-patients-using-a-portable-acoustic-device
#16
Clodagh M Ryan, Kelly Wilton, T Douglas Bradley, Hisham Alshaer
PURPOSE: Sleep apnea (SA) is highly prevalent in post-stroke patients. Due to physical disability and relative inaccessibility of polysomnography (PSG) to test for SA, patients with stroke frequently remain undiagnosed and untreated. Portable SA monitoring can facilitate at-home or in-hospital testing for SA. However, portable SA monitoring is not recommended in those with complex medical conditions, such as stroke, due to the lack of validation of portable monitoring in such patients...
December 2, 2016: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/27913873/impact-of-intensity-and-timing-of-integrated-home-palliative-cancer-care-on-end-of-life-hospitalization-in-northern-italy
#17
M Pellizzari, D Hui, E Pinato, M Lisiero, S Serpentini, L Gubian, F Figoli, M Cancian, C De Chirico, E Ferroni, F Avossa, M Saugo
PURPOSE: The Veneto Region implemented a novel integrated home-based palliative cancer care (HPCC) program embedded in primary care. We examined the impact of timing and intensity of this program on the quality of end-of-life (EOL) care. METHODS: We selected adult cancer patients died in the Veneto Region between March and December 2013, excluding those died from haematological malignancies as well as the very elderly (85+ years). We retrieved the claim-based data on hospitalization and homecare visits, and defined two observation windows: 90 to 16 days before death to examine intensity of HPCC exposure, and the last 15 days of life to examine EOL outcomes, including hospital death, any hospital stay for medical reasons and hospital stay ≥7 days for medical reasons...
December 2, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27913762/aspen-felanpe-clinical-guidelines-nutrition-support-of-adult-patients-with-enterocutaneous-fistula
#18
Vanessa J Kumpf, Jose Eduardo de Aguilar-Nascimento, Jose Ignacio Diaz-Pizarro Graf, Amber M Hall, Liam McKeever, Ezra Steiger, Marion F Winkler, Charlene W Compher
BACKGROUND: The management of patients with enterocutaneous fistula (ECF) requires an interdisciplinary approach and poses a significant challenge to physicians, wound/stoma care specialists, dietitians, pharmacists, and other nutrition clinicians. Guidelines for optimizing nutrition status in these patients are often vague, based on limited and dated clinical studies, and typically rely on individual institutional or clinician experience. Specific nutrient requirements, appropriate route of feeding, role of immune-enhancing formulas, and use of somatostatin analogues in the management of patients with ECF are not well defined...
December 2, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27913561/hospitals-and-patients-working-in-unity-how-r-u-protocol-for-a-prospective-feasibility-study-of-telephone-peer-support-to-improve-older-patients-quality-of-life-after-emergency-department-discharge
#19
Judy A Lowthian, Alyse Lennox, Andrea Curtis, Jeremy Dale, Colette Browning, De Villiers Smit, Gillian Wilson, Debra O'Brien, Cate Rosewarne, Lee Boyd, Cath Garner, Peter Cameron
INTRODUCTION: Older people presenting to an emergency department (ED) have a higher likelihood of social isolation, loneliness and depression; which are all associated with negative health outcomes and increased health service use, including higher rates of ED attendance. The HOW R U? study aims to ascertain the feasibility and acceptability of a postdischarge telephone support programme for older ED patients following discharge. The intervention, which aims to improve quality of life, will be delivered by hospital-based volunteers...
December 2, 2016: BMJ Open
https://www.readbyqxmd.com/read/27912905/effects-of-aromatherapy-on-agitation-and-related-caregiver-burden-in-patients-with-moderate-to-severe-dementia-a-pilot-study
#20
Tugce Turten Kaymaz, Leyla Ozdemir
We examined the effects of aromatherapy on agitation in patients with dementia and evaluated related caregiver burden. Patients and their caregivers from two hospitals in Turkey were selected and divided into an intervention group (n = 14) and a control group (n = 14). Patients were stratified according to their dementia phase and intake of antipsychotic medication. The intervention group received aromatherapy via massage and inhalation at home for 4 weeks. The control group received no intervention. Data were collected using the Neuropsychiatric Inventory (NPI), the Cohen-Mansfield Agitation Inventory (CMAI) and the Zarit Burden Interview (ZBI)...
November 29, 2016: Geriatric Nursing
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