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"Discharge planning"

Cédric Mabire, Andrew Dwyer, Antoine Garnier, Joanie Pellet
AIM: To determine the effectiveness of nursing discharge planning interventions on health-related outcomes for older inpatients discharged home. BACKGROUND: Inadequate discharge planning for the aging population poses significant challenges for health services. Effective discharge planning interventions have been examined in several studies, but little information is available on nursing interventions for older people. Despite the research published on the importance of discharge planning, the impact on patient's health outcomes still needs to be evaluated in practice...
October 6, 2017: Journal of Advanced Nursing
Ross Coomber, Zeiad Alshameeri, Antonio Francesco Masia, Federico Mela, Martyn J Parker
There are no specific guidelines for treating Parkinson's disease patients who present with a hip fracture. Here we present a large cohort of patients with Parkinson's disease who suffered hip fractures. Our aim was to assess for differences between a Parkinson's disease population and a non-Parkinson's disease population with hip fractures and make recommendations on management guidelines. We performed a comprehensive analysis of prospectively collected data on all patients with hip fracture who were admitted into our department over a period of 29 years...
August 25, 2017: Injury
Shannon Freeman, Kristen Bishop, Lina Spirgiene, Erica Koopmans, Fernanda C Bothelo, Trina Fyfe, Beibei Xiong, Stacey Patchett, Martha MacLeod
BACKGROUND: Long-term care facilities (LTCFs) are often places where persons with complex health needs that cannot be met in a community setting, reside and are cared for until death. However, not all persons experience continuous declines in health and functioning. For some residents who experience improvement in personal abilities and increased independence, transition from the LTCF to the community may be an option. This scoping review aimed to synthetize the existing evidence regarding the transition process from discharge planning to intervention and evaluation of outcomes for residents transitioning from LTCFs to the community...
October 4, 2017: BMC Health Services Research
Angela K Kamermayer, A Renee Leasure, Lisa Anderson
BACKGROUND: The Affordable Care Act of 2010 set forth payment models that provided $10 billion to incent the health care system in developing innovative programs that target reform, including transitional care to reduce preventable readmissions. While transitional care programs exist, US hospitals remain challenged, with 1 in 5 readmissions within 30 days. OBJECTIVE: This systematic review examined the effectiveness of select evidence-based transitions-of-care interventions on reducing 30-day readmission rates, reducing emergency room visits, and reducing mortality rates...
November 2017: Dimensions of Critical Care Nursing: DCCN
Lian Leng Low, Wei Yi Tay, Shu Yun Tan, Elian Hui San Chia, Rachel Marie Towle, Kheng Hock Lee
BACKGROUND: Organizing care into integrated practice units (IPUs) around conditions and patient segments has been proposed to increase value. We organized transitional care into an IPU (THC-IPU) for a patient segment of functionally dependent patients with limited community ambulation. METHODS: 1,166 eligible patients were approached for enrolment into THC-IPU. THC-IPU patients received a comprehensive assessment within two weeks of discharge; medication reconciliation; education using standardized action plans and a dedicated nurse case manager for up to 90 days after discharge...
August 14, 2017: International Journal of Integrated Care
Jane McCusker, T T Minh Vu, Nathalie Veillette, Sylvie Cossette, Alain Vadeboncoeur, Antonio Ciampi, Deniz Cetin-Sahin, Eric Belzile
OBJECTIVES: To develop and validate a comprehensive quality assessment tool for emergency department (ED) geriatric care. DESIGN: Four-step study: (1) Content development of tool by a multidisciplinary panel, (2) survey of ED lead physicians and nurses, (3) development of subscales using principal component analysis and clinical judgment, (4) reliability and validity assessment. SETTING: Province of Quebec, Canada. PARTICIPANTS: Lead ED nurses and physicians at 76 Quebec EDs who participated in a 2013/14 survey (66% of 116 adult nonpsychiatric EDs in the province)...
September 27, 2017: Journal of the American Geriatrics Society
Hanaa N Dakour Aridi, Satinderjit Locham, Besma Nejim, Nasr S Ghajar, Husain Alshaikh, Mahmoud B Malas
OBJECTIVE: Reducing readmissions is an important target for improving patient care and enhancing health care quality and cost-effectiveness. The aim of this study was to assess rates, risk factors, and indications of 30-day readmission after open aortic repair (OAR) and endovascular aneurysm repair (EVAR) of infrarenal abdominal aortic aneurysms (AAAs). METHODS: A retrospective analysis of the Premier Healthcare Database from 2009 to 2015 was performed. Indications for readmission after the index procedure, risk factors, and outcomes of the index admission and rehospitalization were evaluated...
September 22, 2017: Journal of Vascular Surgery
D Jones, R Musselman, E Pearsall, M McKenzie, H Huang, Robin S McLeod
BACKGROUND: With the adoption of enhanced recovery after surgery (ERAS) programs, patients are being discharged earlier and require more post-discharge teaching, educational materials, and information. OBJECTIVE: The purpose of this study is to assess satisfaction, discharge needs, and follow-up concerns of patients within an ERAS implementation program (iERAS). METHODS: Between 2012 and 2015, the iERAS program was undertaken at an academic hospital where 554 patients having elective colorectal surgery were enrolled...
September 20, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Agustín Ciapponi, Simon Lewin, Cristian A Herrera, Newton Opiyo, Tomas Pantoja, Elizabeth Paulsen, Gabriel Rada, Charles S Wiysonge, Gabriel Bastías, Lilian Dudley, Signe Flottorp, Marie-Pierre Gagnon, Sebastian Garcia Marti, Claire Glenton, Charles I Okwundu, Blanca Peñaloza, Fatima Suleman, Andrew D Oxman
BACKGROUND: Delivery arrangements include changes in who receives care and when, who provides care, the working conditions of those who provide care, coordination of care amongst different providers, where care is provided, the use of information and communication technology to deliver care, and quality and safety systems. How services are delivered can have impacts on the effectiveness, efficiency and equity of health systems. This broad overview of the findings of systematic reviews can help policymakers and other stakeholders identify strategies for addressing problems and improve the delivery of services...
September 13, 2017: Cochrane Database of Systematic Reviews
Edward Alan Miller, Stefanie Gidmark, Emily Gadbois, James L Rudolph, Orna Intrator
Veterans enrolled within the Veterans Health Administration (VHA) of the U.S. Department of Veterans Affairs (VA) may receive nursing home (NH) care in VHA-operated Community Living Centers (CLCs), State Veterans Homes (SVHs), or community NHs, which may or may not be under contract with the VHA. This study examined VHA staff perceptions of how Veterans' eligibility for VA and other payment impacts NH referrals within VA Medical Centers (VAMCs). Thirty-five semistructured interviews were performed with discharge planning and contracting staff from 12 VAMCs from around the country...
January 1, 2017: Research on Aging
Nobuo Sakata, Yasuyuki Okumura, Yasuyuki Shirakawa
Objective The aim of this study was to investigate the association between economic status and discharge destination of elderly patients from acute care hospitals.Method We conducted a case-control study using data from a survey of elderly discharged patients conducted under the subsidy program of the Japanese Ministry of Health, Labour and Welfare. The questionnaires were mailed to 1,068 acute care hospitals located in the Kanto and Kansai region. The survey asked medical social workers or nurses, who were responsible for the discharge planning, to answer questions about the discharge of elderly patients from their hospitals...
2017: [Nihon Kōshū Eisei Zasshi] Japanese Journal of Public Health
Melanie Rushton, Michelle Howarth, Maria J Grant, Felicity Astin
AIMS AND OBJECTIVES: This critical review examines the extent that individualised education helps reduce depression, anxiety and improves self-care for people who've undergone Coronary Artery Bypass Graft surgery (CABG). BACKGROUND: Individualised discharge planning is increasingly important following cardiac surgery due to recurrent admissions as well as the issue of anxiety and depression, often due to lack of preparation. The hospital to home transition is fundamental in the recovery process...
September 7, 2017: Journal of Clinical Nursing
Jeffrey M Baumgardner, Justin L Sewell, Lukejohn W Day
BACKGROUND AND STUDY AIMS:  Limited international data have shown that non-physicians can safely perform upper endoscopy, but no such study has been performed in the United States. Our aim was to assess the quality of outpatient upper endoscopies performed by nurse practitioners (NPs). PATIENTS AND METHODS:  Retrospective chart review of upper endoscopies performed by 3 NPs between 2010 and 2013 was performed. Comparisons among all NPs performing upper endoscopy and assessment of individual NP performance over time with respect to quality indicators were performed...
September 2017: Endoscopy International Open
Ibrahim Nassour, Sam C Wang, Alana Christie, Ali A Mokdad, Matthew R Porembka, Michael A Choti, Mathew M Augustine, Adam C Yopp, Xian-Jin Xie, John C Mansour, Rebecca M Minter, Patricio M Polanco
BACKGROUND: Despite the development of pathways to enhance recovery and discharge to home, a significant proportion of patients are discharged to inpatient facilities after pancreaticoduodenectomy (PD). The aim of this study was to determine the rate of non-home discharge (NHD) following PD in a national cohort of patients and to develop predictive nomograms for NHD. METHODS: The National Surgical Quality Improvement Program was used to construct and validate pre- and postoperative nomograms for NHD following PD...
August 31, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Andres Garcia-Arce, Florentino Rico, José L Zayas-Castro
A diverse universe of statistical models in the literature aim to help hospitals understand the risk factors of their preventable readmissions. However, these models are usually not necessarily applicable in other contexts, fail to achieve good discriminatory power, or cannot be compared with other models. We built and compared predictive models based on machine learning algorithms for 30-day preventable hospital readmissions of Medicare patients. This work used the same inclusion/exclusion criteria for diseases used by the Centers for Medicare and Medicaid Services...
August 24, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
Kim G Johnson, Adedayo Fashoyin, Ramiro Madden-Fuentes, Andrew J Muzyk, Jane P Gagliardi, Mamata Yanamadala
BACKGROUND: Studies show inpatient geriatric patients with reversible conditions like delirium may continue on antipsychotic medications without clear indications after hospital discharge. We conducted this study to determine how often geriatric patients were discharged on a newly started antipsychotic during admission with a plan for discontinuation of the antipsychotic documented in the discharge summary. DESIGN: We conducted retrospective chart review identifying geriatric inpatients in our health system started on a new antipsychotic during admission...
October 2017: Journal of the American Geriatrics Society
Takahiro Itaya, Yusuke Murakami, Akiko Ota, Eiichi Nomura, Tomoko Fukushima, Masakazu Nishigaki
BACKGROUND AND PURPOSE: Discharge planning for inpatients with acute stroke can enhance reasonable use of healthcare resources, as well as improve clinical outcomes and decrease financial burden of patients. Especially, prediction for discharge destination is crucial for discharge planning. This study aimed to develop an assessment model to identify patients with a high possibility of discharge to home after an acute stroke. METHODS: We reviewed the electronic medical records of 3200 patients with acute stroke who were admitted to a stroke center in Japan between January 1, 2011, and December 31, 2015...
October 2017: Stroke; a Journal of Cerebral Circulation
Lori E Weeks, Gloria McInnis-Perry, Colleen MacQuarrie, Sanja Jovanovic
We provided insights from older adults, their unpaid caregivers, and health-care professionals into specific roles for professionals within the health system to better meet the needs of community-dwelling older adults and their unpaid caregivers experiencing transitions between health services. We used a qualitative approach to collect data within one Canadian province from older adults and unpaid caregivers of older adults who participated in focus groups ( n = 98) and professionals working in the health system who participated in an online survey ( n = 52)...
September 2016: Canadian Journal of Nursing Research, Revue Canadienne de Recherche en Sciences Infirmières
Brittney Rohrer, Timothy P Stratton
Mental illness is more prevalent among adult inmates in Minnesota county jails than nationally. All 78 Minnesota county jails were surveyed about their continuum-of-care procedures to help ensure that inmates who have mental illness continue to receive psychiatric medications after release. Of the 28 county jails responding to the survey (36%), most estimated that greater than 40% of their inmates receive medication for mental illness during incarceration. But while 89% of respondents reported that inmates are frequently taking medication(s) to treat mental illness at release, prerelease planning for these inmates was rarely undertaken...
January 1, 2017: Journal of Correctional Health Care
Ahmed Halawa, Stephen Rowe, Fleur Roberts, Chidambaram Nathan, Ahmed Hassan, Avneesh Kumar, Branislav Suvakov, Ben Edwards, Cavin Gray
OBJECTIVES: Our aim was to apply the principles of enhanced recovery in renal transplant recipients and to assess the changes in the quality of patient care and patient satisfaction. MATERIALS AND METHODS: Our study included 286 consecutive renal transplant patients. Of these, 135 patients went through the enhanced recovery program and 151 patients had traditional recovery. Patient education and discharge planning were commenced on admission. For enhanced recovery, prolonged preoperative fasting was avoided by carbohydrate loading...
August 24, 2017: Experimental and Clinical Transplantation
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