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https://www.readbyqxmd.com/read/28430963/integrated-care-for-older-populations-and-its-implementation-facilitators-and-barriers-a-rapid-scoping-review
#1
Diane E Threapleton, Roger Y Chung, Samuel Y S Wong, Eliza Wong, Patsy Chau, Jean Woo, Vincent C H Chung, Eng-Kiong Yeoh
Purpose: Inform health system improvements by summarizing components of integrated care in older populations. Identify key implementation barriers and facilitators. Data sources: A scoping review was undertaken for evidence from MEDLINE, the Cochrane Library, organizational websites and internet searches. Eligible publications included reviews, reports, individual studies and policy documents published from 2005 to February 2017. Study selection: Initial eligible documents were reviews or reports concerning integrated care approaches in older/frail populations...
April 20, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28416020/patient-and-family-centered-performance-measures-focused-on-actionable-processes-of-care-for-persistent-and-chronic-critical-illness-protocol-for-a-systematic-review
#2
Louise Rose, Laura Istanboulian, Laura Allum, Lisa Burry, Craig Dale, Nicholas Hart, Claire Kydonaki, Pam Ramsay, Natalie Pattison, Bronwen Connolly
BACKGROUND: Approximately 5 to 10% of critically ill patients transition from acute critical illness to a state of persistent and in some cases chronic critical illness. These patients have unique and complex needs that require a change in the clinical management plan and overall goals of care to a focus on rehabilitation, symptom relief, discharge planning, and in some cases, end-of-life care. However, existing indicators and measures of care quality, and tools such as checklists, that foster implementation of best practices, may not be sufficiently inclusive in terms of actionable processes of care relevant to these patients...
April 17, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28416016/variation-in-rates-of-icu-readmissions-and-post-icu-in-hospital-mortality-and-their-association-with-icu-discharge-practices
#3
Nelleke van Sluisveld, Ferishta Bakhshi-Raiez, Nicolette de Keizer, Rebecca Holman, Gert Wester, Hub Wollersheim, Johannes G van der Hoeven, Marieke Zegers
BACKGROUND: Variation in intensive care unit (ICU) readmissions and in-hospital mortality after ICU discharge may indicate potential for improvement and could be explained by ICU discharge practices. Our objective was threefold: (1) describe variation in rates of ICU readmissions within 48 h and post-ICU in-hospital mortality, (2) describe ICU discharge practices in Dutch hospitals, and (3) study the association between rates of ICU readmissions within 48 h and post-ICU in-hospital mortality and ICU discharge practices...
April 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28413367/discharge-planning-screening-older-patients-for-multidisciplinary-team-referral
#4
Carolyn Hegarty, Clare Buckley, Rachel Forrest, Bob Marshall
The objective was to determine whether the Elders Risk Assessment Index can predict multi-disciplinary team referral of older patients (≥ 65 years) in Emergency Department same-day discharges. The study identified 1,376 qualifying individuals from a regional New Zealand hospital database. Of these, 12.7 % were referred to the multi-disciplinary team. Univariate and multivariate analyses were used to explore associations between the Index, its components, and other demographic factors with referral. With every unit increase in the Index there was a 9% increase in the odds of being referred...
October 10, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28413365/integrating-the-principles-of-evidence-based-medicine-and-evidence-based-public-health-impact-on-the-quality-of-patient-care-and-hospital-readmission-rates-in-jordan
#5
Mohammad S Alyahya, Heba H Hijazi, Hussam A Alshraideh, Mohammad Aser Alsharman, Rabah Al Abdi, Heather Lea Harvey
INTRODUCTION: Hospital readmissions impose not only an extra burden on health care systems but impact patient health outcomes. Identifying modifiable behavioural risk factors that are possible causes of potentially avoidable readmissions can lower readmission rates and healthcare costs. METHODS: Using the core principles of evidence based medicine and public health, the purpose of this study was to develop a heuristic guide that could identify what behavioural risk factors influence hospital readmissions through adopting various methods of analysis including regression models, t-tests, data mining, and logistic regression...
August 31, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28411866/addressing-the-challenges-of-sleeve-gastrectomy-in-end-stage-renal-disease-analysis-of-100-consecutive-renal-failure-patients
#6
Young Kim, Junzi Shi, Christopher M Freeman, Andrew D Jung, Vikrom K Dhar, Shimul A Shah, E Steve Woodle, Tayyab S Diwan
BACKGROUND: While previous studies have demonstrated short-term efficacy of laparoscopic sleeve gastrectomy in candidates awaiting renal transplantation, the combination of morbid obesity and end-stage renal disease presents unique challenges to perioperative care. We demonstrate how increasing experience and the development of postoperative care guidelines can improve outcomes in this high-risk population. METHODS: Single-center medical records were reviewed for renal transplantation candidates undergoing laparoscopic sleeve gastrectomy between 2011 and 2015 by a single surgeon...
April 12, 2017: Surgery
https://www.readbyqxmd.com/read/28406339/a-case-study-of-healthcare-providers-goals-during-interprofessional-rounds
#7
Michael Prystajecky, Tiffany Lee, Sylvia Abonyi, Robert Perry, Heather Ward
Daily interprofessional rounds enhance collaboration among healthcare providers and improve hospital performance measures. However, it is unclear how healthcare providers' goals influence the processes and outcomes of interprofessional rounds. The purpose of this case study was to explore the goals of healthcare providers attending interprofessional rounds in an internal medicine ward. The second purpose was to explore the challenges encountered by healthcare providers while pursuing these goals. Three focus groups were held with healthcare providers of diverse professional backgrounds...
April 13, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28403508/impact-of-transitional-care-services-for-chronically-ill-older-patients-a-systematic-evidence-review
#8
Mélanie Le Berre, Geva Maimon, Nadia Sourial, Muriel Guériton, Isabelle Vedel
Transitions in care from hospital to primary care for older patients with chronic diseases (CD) are complex and lead to increased mortality and service use. In response to these challenges, transitional care (TC) interventions are being widely implemented. They encompass education on self-management, discharge planning, structured follow-up and coordination among the different healthcare professionals. We conducted a systematic review to determine the effectiveness of interventions targeting transitions from hospital to the primary care setting for chronically ill older patients...
April 12, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28403308/patient-with-stroke-hospital-discharge-planning-functionality-and-quality-of-life
#9
Henrique José Mendes Nunes, Paulo Joaquim Pina Queirós
Stroke still causes high levels of human inability and suffering, and it is one of the main causes of death in developed countries, including Portugal. OBJECTIVE: analyze the strategies of hospital discharge planning for these patients, increasing the knowledge related to hospitalhome transition, discharge planning processes and the main impact on the quality of life and functionality. METHOD: integrative literature review using the PICOD criteria, with database research...
April 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28400222/self-reported-health-and-safety-awareness-improves-prediction-of-level-of-care-needs-in-veterans-discharged-from-a-post-acute-unit
#10
Julija Stelmokas, Linas A Bieliauskas, Katherine A Kitchen Andren, Robert Hogikyan, Neil B Alexander
OBJECTIVES: Evaluate the differential value of a self-reported health and safety awareness measure relative to other medical, psychosocial, and cognitive factors in predicting level of care (LOC) needs following hospital discharge. DESIGN: Retrospective medical record review. SETTING: Community Living Center Post-Acute Care (CLC-PAC) unit at a Veterans Affairs (VA) hospital. PARTICIPANTS: 175 Veterans admitted to the VA hospital or directly to the CLC-PAC from home...
April 8, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28396183/the-impact-of-health-literacy-and-clinicodemographic-factors-on-use-of-discharge-services-after-radical-cystectomy
#11
Stephen F Kappa, Kristen R Scarpato, Kathryn M Goggins, Sunil Kripalani, Kelvin A Moses
PURPOSE: There are few data regarding the relationship between health literacy and discharge disposition. We hypothesized that patient discharge needs after radical cystectomy (RC) are affected by health literacy. MATERIALS AND METHODS: We identified 504 patients who underwent RC and completed the validated Brief Health Literacy Screen (BHLS) since November 2010. Bivariate and logistic regression analyses were performed to determine if health literacy was associated with utilization of discharge resources after RC...
April 7, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28369687/caregiver-integration-during-discharge-planning-for-older-adults-to-reduce-resource-use-a-metaanalysis
#12
Juleen Rodakowski, Philip B Rocco, Maqui Ortiz, Barbara Folb, Richard Schulz, Sally C Morton, Sally Caine Leathers, Lu Hu, A Everette James
OBJECTIVES: To determine the effect of integrating informal caregivers into discharge planning on postdischarge cost and resource use in older adults. DESIGN: A systematic review and metaanalysis of randomized controlled trials that examine the effect of discharge planning with caregiver integration begun before discharge on healthcare cost and resource use outcomes. MEDLINE, EMBASE, and the Cochrane Library databases were searched for all English-language articles published between 1990 and April 2016...
April 3, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28369024/a-statewide-survey-report-of-roles-and-responsibilities-in-current-utah-care-management-processes
#13
Brenda Luther, Marc-Aurel Martial, Joyce Barra
PURPOSE OF THE STUDY: Measure current roles and responsibilities of care managers in the state of Utah. PRIMARY PRACTICE SETTING: All settings of health care including inpatient, outpatient, community, payer, post-acute, and transitional care settings. METHODS AND SAMPLE: A quantitative descriptive survey design was used to assess and describe current care management roles and responsibilities of 191 care managers within the state of Utah...
May 2017: Professional Case Management
https://www.readbyqxmd.com/read/28360503/the-role-of-copy-and-paste-function-in-orthopedic-trauma-progress-notes
#14
Wesley Winn, Irshad A Shakir, Heidi Israel, Lisa K Cannada
INTRODUCTION: The electronic medical record (EMR) is standard in institutions. While there is not concern for legibility of notes and access to charts, there is an ease of copy and paste for daily notes. This may not lead to accurate portrayal of patient's status. Our purpose was to evaluate the use of copy and paste functions in daily notes of patients with injuries at high risk for complications. METHODS: IRB approval was obtained for a retrospective review. Inclusion criteria included patients aged 18 and older treated at our Level 1 Trauma Center after implementation of Epic Systems Corporation, Verona, WI, USA...
January 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28351267/discharging-patients
#15
Bing Raz
What was the nature of the CPD activity, practice-related feedback and/or event and/or experience in your practice? Delayed discharge from hospital can have significant effects on patients and healthcare organisations, for example, longer hospital stays, increased readmissions and financial cost. The CPD article provided information about effective discharge planning, to reduce delays and improve patient care.
March 29, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28342694/nursing-led-home-visits-post-hospitalization-for-children-with-medical-complexity
#16
Sarah Wells, Margaret O'Neill, Jayne Rogers, Kevin Blaine, Amy Hoffman, Sarah McBride, Meghan M Tschudy, Igor Shumskiy, Sangeeta Mauskar, Jay G Berry
PURPOSE: Hospital discharge for children with medical complexity (CMC) can be challenging for families. Home visits could potentially benefit CMC and their families after leaving the hospital. We assessed the utility of post-discharge home visits to identify and address health problems for recently hospitalized CMC. DESIGN AND METHODS: A prospective study of 36 CMC admitted to a children's hospital from 4/15/2015 to 4/14/2016 identified with a possible high risk of hospital readmission and offered a post-discharge home visit within 72h of discharge...
March 23, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28330452/a-structure-process-and-outcome-evaluation-of-the-geriatric-emergency-department-intervention-model-of-care-a-study-protocol
#17
Elizabeth Marsden, Andrea Taylor, Marianne Wallis, Alison Craswell, Marc Broadbent, Adrian Barnett, Kim-Huong Nguyen, Julia Crilly, Colleen Johnston, Amanda Glenwright
BACKGROUND: Emergency departments are chaotic environments in which complex, frail older persons living in the community and residential aged care facilities are sometimes subjected to prolonged emergency department lengths of stay, excessive tests and iatrogenic complications. Given the ageing population, the importance of providing appropriate, quality health care in the emergency department for this cohort is paramount. One possible solution, a nurse-led, physician-championed, emergency department gerontological intervention team, which provides frontload assessment, early collateral communication and appropriate discharge planning, has been developed...
March 23, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28325207/using-a-systematic-framework-of-interventions-to-improve-early-discharges
#18
Hemali Patel, Sasha Morduchowicz, Michelle Mourad
BACKGROUND: Late-afternoon hospital discharges can lead to admission bottlenecks and negatively affect the flow of patients needing hospital admission. Delays in discharge are a prevalent health care problem and have been linked to increased length of stay, lower patient satisfaction scores, and adverse outcomes. As a result, hospitals are placing a renewed emphasis on early discharge as a way to reduce admission delays and achieve optimal patient flow. This study shows that the Model for Improvement (MFI) is an effective approach for complex improvement efforts...
April 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28277487/randomized-controlled-trial-of-an-intervention-to-maintain-suppression-of-hiv-viremia-after-prison-release-the-impact-trial
#19
David A Wohl, Carol E Golin, Kevin Knight, Michele Gould, Jessica Carda-Auten, Jennifer S Groves, Sonia Napravnik, Stephen R Cole, Becky L White, Cathie Fogel, David L Rosen, Michael J Mugavaro, Brian W Pence, Patrick M Flynn
BACKGROUND: HIV-infected individuals transitioning from incarceration to the community are at risk for loss of viral suppression. We compared the effects of imPACT, a multidimensional intervention to promote care engagement after release, to standard care on sustaining viral suppression after community re-entry. METHODS: This trial randomized 405 HIV-infected inmates being released from prisons in Texas and North Carolina with HIV-1 RNA levels <400 copies/mL to imPACT versus standard care...
May 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28266919/outpatient-management-of-neonatal-abstinence-syndrome-a-quality-improvement-project
#20
Kim T Chau, Jacqueline Nguyen, Branko Miladinovic, Carol M Lilly, Terri L Ashmeade, Maya Balakrishnan
BACKGROUND: An increasing number of infants are diagnosed with neonatal abstinence syndrome (NAS). The study's primary objectives were to describe an academic medical center's level IV neonatal ICU's (NICU's) comprehensive outpatient NAS management effort, measure guideline compliance, and assess its safety. Secondary objectives were to describe the duration and cumulative methadone exposure, and to improve parent and provider knowledge of NAS. METHODS: The study included 22 infants having a gestational age of 35-41 weeks, diagnosed with NAS, and discharged for outpatient methadone management...
November 2016: Joint Commission Journal on Quality and Patient Safety
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