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https://www.readbyqxmd.com/read/28330452/a-structure-process-and-outcome-evaluation-of-the-geriatric-emergency-department-intervention-model-of-care-a-study-protocol
#1
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
#2
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/a-randomized-controlled-trial-of-an-intervention-to-maintain-suppression-of-hiv-viremia-following-prison-release-the-impact-trial
#3
David Alain 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 multi-dimensional 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...
March 8, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28266919/outpatient-management-of-neonatal-abstinence-syndrome-a-quality-improvement-project
#4
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
https://www.readbyqxmd.com/read/28256931/barriers-to-discharge-from-inpatient-rehabilitation-a-teamwork-approach
#5
Lisanne Catherine Cruz, Jeffrey S Fine, Subhadra Nori
Purpose In order to prevent adverse events during the discharge process, coordinating appropriate community resources, medication reconciliation, and patient education needs to be implemented before the patient leaves the hospital. This coordination requires communication and effective teamwork amongst staff members. In order to address these concerns, the purpose of this paper is to incorporate the TeamSTEPPS principles to develop a discharge plan that would best meet the needs of the patients as they return to the community...
March 13, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28231606/user-participation-is-a-family-matter-a-multiple-case-study-of-the-experiences-of-older-hospitalized-people-and-their-relatives
#6
Ingrid Nyborg, Lars Johan Danbolt, Marit Kirkevold
AIMS AND OBJECTIVES: The purpose of this multiple case study was to compare and contrast older people's and their relatives' experiences of participation in decision-making processes regarding the planning of everyday life after discharge from hospital. BACKGROUND: Internationally, patient involvement in health services is established to benefit patient health and to improve quality of the services. The literature shows that at hospital discharge older people would benefit from better communication and more active participation of relatives in the discharge planning...
February 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28217384/decreasing-hospital-length-of-stay-following-lumbar-fusion-utilizing-multidisciplinary-committee-meetings-involving-surgeons-and-other-caretakers
#7
Lisa B E Shields, Lisa Clark, Steven D Glassman, Christopher B Shields
BACKGROUND: Although hospital length of stay (LOS) following lumbar fusion has decreased for a variety of reasons, different institutions find their LOS over the benchmarks published by the national Agency for Healthcare Research and Quality (AHRQ). Over a 3-year period, this prospective study introduced utilization of multidisciplinary committee meetings between surgeons and other caretakers to decrease LOS following spinal fusion surgery without compromising the quality of care. METHODS: A multidisciplinary committee was established to assess factors and institute recommendations that influence hospital LOS following lumbar fusion compared to the national compared to the national AHRQ benchmark at baseline and at 1 and 2 years after adjusting our standard practice...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28214078/the-optimize-heart-failure-care-program-initial-lessons-from-global-implementation
#8
Martin R Cowie, Yuri M Lopatin, Clara Saldarriaga, Cândida Fonseca, David Sim, Jose Antonio Magaña, Denilson Albuquerque, Marcelo Trivi, Gustavo Moncada, Baldomero A González Castillo, Mario Osvaldo Speranza Sánchez, Edward Chung
Hospitalization for heart failure (HF) places a major burden on healthcare services worldwide, and is a strong predictor of increased mortality especially in the first three months after discharge. Though undesirable, hospitalization is an opportunity to optimize HF therapy and advise clinicians and patients about the importance of continued adherence to HF medication and regular monitoring. The Optimize Heart Failure Care Program (www.optimize-hf.com), which has been implemented in 45 countries, is designed to improve outcomes following HF hospitalization through inexpensive initiatives to improve prescription of appropriate drug therapies, patient education and engagement, and post-discharge planning...
February 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28213305/risk-of-suicide-according-to-the-level-of-psychiatric-contact-in-the-older-people-analysis-of-national-health-insurance-databases-in-taiwan
#9
Shin-Ting Yeh, Yee-Yung Ng, Shiao-Chi Wu
PURPOSE: Suicide in the older people is a serious problem worldwide; however the effect of psychiatric contact on the risk of suicide has not been fully explored. The aim of this study was to investigate the relationship between psychiatric contact and suicide in the older people in Taiwan. METHODS: A population-based database was used in this national case-control study. Propensity score matching was used to match older people who did and did not commit suicide from 2010 to 2012 by calendar year, gender, age, and area of residence...
February 1, 2017: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/28209101/role-of-heart-rate-variability-in-predicting-post-endoscopic-retrograde-cholangiopancreatography-pancreatitis
#10
Y Tryliskyy, G J Bryce
INTRODUCTION: Early recognition of post-ERCP pancreatitis (PEP) would help deliver an appropriate discharge plan following ERCP. Functioning of the autonomic nervous system can be measured using non-invasive heart rate variability techniques (HRV) and provides quantitative information about the modulation of cardiac vagal and sympathetic activity. Pain evoked sympathetic activation is a well-known phenomenon, as exhibited in those suffering PEP. The aim of this study is to determine if a single post-procedural measurement of HRV identifies those at risk of developing PEP...
September 2016: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/28196463/factors-associated-with-outpatient-visit-attendance-after-discharge-from-inpatient-psychiatric-units-in-a-new-york-city-hospital
#11
Jennifer L Humensky, Omar Fattal, Rachel Feit, Sarah D Mills, Roberto Lewis-Fernández
OBJECTIVE: A class action lawsuit in New York (Koskinas v. Cuomo) established the right of psychiatric inpatients to receive discharge planning, including arranging outpatient treatment. The attendance rate of the initial outpatient appointment after discharge from inpatient treatment in one city hospital was examined to determine whether rates varied by inpatient unit type. METHODS: The authors performed retrospective chart review of 1,884 discharges to outpatient care...
February 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28192029/the-n-by-t-target-discharge-strategy-for-inpatient-units
#12
Pratik J Parikh, Nicholas Ballester, Kylie Ramsey, Nan Kong, Nancy Pook
BACKGROUND: Ineffective inpatient discharge planning often causes discharge delays and upstream boarding. While an optimal discharge strategy that works across all units at a hospital is likely difficult to identify and implement, a strategy that provides a reasonable target to the discharge team appears feasible. METHODS: We used observational and retrospective data from an inpatient trauma unit at a Level 2 trauma center in the Midwest US. Our proposed novel n-by-T strategy-discharge n patients by the Tth hour-was evaluated using a validated simulation model...
February 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28188966/where-to-go-if-not-the-hospital-reviewing-geriatric-bed-utilization-in-an-acute-care-hospital-in-singapore
#13
Ke Zhou, Arpana R Vidyarthi, Chek Hooi Wong, David Matchar
AIM: Singapore is one of the fastest-aging countries in the world, and the demand for acute hospital care for older adults is expected to triple in the next 25 years. Hence, it is crucial to understand the opportunities in reducing potentially avoidable bed days (PABD), which are days spent in acute hospitals delivering only non-acute services. We aimed to access the prevalence, causes and consequences of PABD among geriatric patients. METHODS: We examined all hospitalizations from 1 August through 31 December 2013 in the geriatric wards of an acute hospital in Singapore...
February 11, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28188268/design-and-rationale-of-a-randomized-trial-of-a-care-transition-strategy-in-patients-with-acute-heart-failure-discharged-from-the-emergency-department-guided-hf-get-with-the-guidelines-in-emergency-department-patients-with-heart-failure
#14
Gregory J Fermann, Phillip D Levy, Peter Pang, Javed Butler, S Imran Ayaz, Douglas Char, Patrick Dunn, Cathy A Jenkins, Christy Kampe, Yosef Khan, Vijaya A Kumar, JoAnn Lindenfeld, Dandan Liu, Karen Miller, W Frank Peacock, Samaa Rizk, Chad Robichaux, Russell L Rothman, Jon Schrock, Adam Singer, Sarah A Sterling, Alan B Storrow, Cheryl Walsh, John Wilburn, Sean P Collins
GUIDED-HF (Get With the Guidelines in Emergency Department Patients With Heart Failure) is a multicenter randomized trial of a patient-centered transitional care intervention in patients with acute heart failure (AHF) who are discharged either directly from the emergency department (ED) or after a brief period of ED-based observation. To optimize care and reduce ED and hospital revisits, there has been significant emphasis on improving transitions at the time of hospital discharge for patients with HF. Such efforts have been almost exclusively directed at hospitalized patients; individuals with AHF who are discharged from the ED or ED-based observation are not included in these transitional care initiatives...
February 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28170431/bedside-or-not-bedside-evaluation-of-patient-satisfaction-in-intensive-medical-rehabilitation-wards
#15
Christophe Luthy, Patricia Francis Gerstel, Angela Pugliesi, Valérie Piguet, Anne-Françoise Allaz, Christine Cedraschi
BACKGROUND: Concerns that bedside presentation (BsP) rounds could make patients uncomfortable led many residency programs to move daily rounds outside the patients' room (OsPR). We performed a prospective quasi-experimental controlled study measuring the effect of these two approaches on patient satisfaction. METHODS: Patient satisfaction was measured using the Picker questionnaire (PiQ). Results are expressed in problematic percentage scores scaled from 0 = best-100 = worst...
2017: PloS One
https://www.readbyqxmd.com/read/28148626/role-of-transitional-care-measures-in-the-prevention-of-readmission-after-critical-illness
#16
Jessica S Peters
Transitioning from the critical care unit to the medical-surgical care area is vital to patients' recovery and resolution of critical illness. Such transitions are necessary to optimize use of available hospital resources to meet patient care needs. One in 10 patients discharged from the intensive care unit are readmitted to the unit during their hospitalization. Critical care readmission is associated with significant increases in illness acuity, overall length of stay, and health care costs as well as a potential 4-fold increased risk of mortality...
February 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28144974/thinking-about-the-patient-s-wishes-practical-wisdom-of-discharge-planning-nurses-in-assisting-surrogate-decision-making
#17
Yoko Kageyama, Midori Asano
BACKGROUND: The accelerating trend towards shorter hospital stays in Japan has made modes of decision-making essential for effective patient transition from the hospital to recuperation in the regional community, and the ageing of the population has brought a rise in surrogate decision-making by the families of patients lacking decision-making ('self-decision') capacity. AIM: To verbalise and elucidate the practical wisdom of discharge planning nurses by focusing on the perceptions and judgements, they apply in practice and describing their methodology in concrete terms...
January 31, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28144467/predictors-of-health-promoting-behaviors-in-coronary-artery-bypass-surgery-patients-an-application-of-pender-s-health-promotion-model
#18
Hossein Mohsenipoua, Fereshteh Majlessi, Davood Shojaeizadeh, Abbas Rahimiforooshani, Rahman Ghafari, Valiollah Habibi
BACKGROUND: Advances in coronary artery surgery have reduced patient morbidity and mortality. Nevertheless, patients still have to face physical, psychological, and social problems after discharge from hospital. OBJECTIVES: The objective of this study was to determine the efficacy of Pender's health promotion model in predicting cardiac surgery patients' lifestyles in Iran. METHODS: This cross-sectional study comprised 220 patients who had undergone coronary artery bypass graft (CABG) surgery in Mazandaran province (Iran) in 2015...
September 2016: Iranian Red Crescent Medical Journal
https://www.readbyqxmd.com/read/28132695/barriers-and-facilitators-to-successful-transition-from-long-term-residential-substance-abuse-treatment
#19
Jennifer I Manuel, Yeqing Yuan, Daniel B Herman, Dace S Svikis, Obie Nichols, Erin Palmer, Sherry Deren
Although residential substance abuse treatment has been shown to improve substance use and other outcomes, relapse is common. This qualitative study explores factors that hinder and help individuals during the transition from long-term residential substance abuse treatment to the community. Semi-structured interviews were conducted with 32 individuals from residential substance abuse treatment. Based on the socio-ecological model, barriers and facilitators to transition were identified across five levels: individual, interpersonal, organizational, community, and policy...
March 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28129966/nationwide-trends-in-syncope-hospitalizations-and-outcomes-from-2004-to-2014
#20
Roopinder K Sandhu, Robert S Sheldon, Anamaria Savu, Padma Kaul
BACKGROUND: We examined the prevalence, comorbidity burden, and outcomes of patients who presented to acute care hospitals with a primary diagnosis of syncope over a 10-year period in Canada. METHODS: The Canadian Institute for Health Information Discharge Abstract Database (which contains detailed health information from all Canadian provinces and territories except Quebec) was used to identify hospitalizations of patients with a primary diagnosis of syncope (International Classification of Diseases-10th Revision code R55) 20 years of age or older in Canada from 2004 to 2014...
November 11, 2016: Canadian Journal of Cardiology
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