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Hospital Transition of care

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https://www.readbyqxmd.com/read/28524384/patient-reported-dietetic-care-post-hospital-for-free-living-patients-a-canadian-malnutrition-task-force-study
#1
H Keller, H Payette, M Laporte, P Bernier, J Allard, D Duerksen, L Gramlich, K Jeejeebhoy
BACKGROUND: Transitions out of hospital can influence recovery. Ideally, malnourished patients should be followed by someone with nutrition expertise, specifically a dietitian, post discharge from hospital. Predictors of dietetic care post discharge are currently unknown. The present study aimed to determine the patient factors independently associated with 30-days post hospital discharge dietetic care for free-living patients who transitioned to the community. METHODOLOGY: Nine hundred and twenty-two medical or surgical adult patients were recruited in 16 acute care hospitals in eight Canadian provinces on admission...
May 19, 2017: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://www.readbyqxmd.com/read/28523476/impact-of-a-patient-navigator-program-on-hospital-based-and-outpatient-utilization-over-180%C3%A2-days-in-a-safety-net-health-system
#2
Richard B Balaban, Fang Zhang, Catherine E Vialle-Valentin, Alison A Galbraith, Marguerite E Burns, Marc R Larochelle, Dennis Ross-Degnan
BACKGROUND: With emerging global payment structures, medical systems need to understand longer-term impacts of care transition strategies. OBJECTIVE: To determine the effect of a care transition program using patient navigators (PNs) on health service utilization among high-risk safety-net patients over a 180-day period. DESIGN: Randomized controlled trial conducted October 2011 through April 2013. PARTICIPANTS: Patients admitted to the general medicine service with ≥1 readmission risk factor: (1) age ≥ 60; (2) in-network inpatient admission within prior 6 months; (3) index length of stay ≥ 3 days; or (4) admission diagnosis of heart failure or (5) chronic obstructive pulmonary disease...
May 18, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28521796/effects-of-nurse-telesupport-on-transition-between-specialized-and-primary-care-in-diabetic-patients-study-protocol-for-a-randomized-controlled-trial
#3
Ana Marina Moreira, Roberta Marobin, Dimitris Varvaki Rados, Camila Bergonsi de Farias, Sabrina Coelli, Bárbara Luiza Bernardi, Lívia de Almeida Faller, Laura Ferraz Dos Santos, Ana Maria Matzenbacher, Natan Katz, Erno Harzheim, Sandra Pinho Silveiro
BACKGROUND: According to the Global Diabetes Plan, a unified health system with preventive and educational strategies is essential to proper diabetes care and primary settings should be the main site of care. In Brazil, there is limited access to outpatient hospital diabetes services, while primary-care diabetes support is underutilized. Telemedicine can be a useful adjunct to support discharge of stable patients with type 2 diabetes to the primary care setting. In this paper, we present a randomized controlled trial (RCT) protocol designed to evaluate the effects of telehealth support for stable type 2 diabetes patients discharged from hospital outpatient diabetes clinics...
May 18, 2017: Trials
https://www.readbyqxmd.com/read/28521207/strategies-to-support-transitions-from-hospital-to-home-for-children-with-medical-complexity-a-scoping-review
#4
REVIEW
Sydney Breneol, Julia Belliveau, Christine Cassidy, Janet A Curran
BACKGROUND: Children with medical complexity constitute a small but resource-intensive subgroup of children with special health care needs. Their medical fragility and resource-intensive needs put them at greater risk for inadequate transitions from hospital to home-based care, and subsequent adverse outcomes and hospital re-admissions. OBJECTIVE: This scoping literature review was conducted to map empirically researched interventions, frameworks, programs or models that could inform or support the transition from hospital to home for children with medical complexity...
May 4, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28514640/digital-disruption-syndromes
#5
Clair Sullivan, Andrew Staib
The digital transformation of hospitals in Australia is occurring rapidly in order to facilitate innovation and improve efficiency. Rapid transformation can cause temporary disruption of hospital workflows and staff as processes are adapted to the new digital workflows. The aim of this paper is to outline various types of digital disruption and some strategies for effective management. A large tertiary university hospital recently underwent a rapid, successful roll-out of an integrated electronic medical record (EMR)...
May 18, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28514524/transition-from-hospital-to-home-parents-perception-of-their-preparation-and-readiness-for-discharge-with-their-preterm-infant
#6
Laurene Aydon, Yvonne Hauck, Jamee Murdoch, Daphne Siu, Mary Sharp
AIMS: To explore the experiences of parents with babies born between 28-32 weeks gestation during transition through the Neonatal Intensive Care Unit (NICU) and discharge to home. BACKGROUND: Following birth of a preterm baby, parents undergo a momentous journey through the NICU prior to their arrival home. The complexity of the journey varies on the degree of prematurity and problems faced by each baby. The NICU environment has many stressors and facilitating education to assist parents to feel ready for discharge can be challenging for all health professionals...
May 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28513869/transition-of-intravenous-treprostinil-to-oral-therapy-in-a-patient-with-functional-class-iv-chronic-thromboembolic-pulmonary-hypertension
#7
Kristina M Thurber, Breann M Williams, Ruth E Bates, Robert P Frantz
Chronic thromboembolic pulmonary hypertension (CTEPH) occurs when pulmonary emboli fail to resolve with anticoagulation. For patients with inoperable or residual CTEPH, riociguat is currently the only therapy approved by the United States Food and Drug Administration. However, some patients with CTEPH may require therapy beyond riociguat, such as intravenous prostacyclins, which can present significant administration challenges in patients with complex comorbid conditions. We describe a 42-year-old man with T12 paraplegia complicated by CTEPH (functional class IV with substantial right ventricular dysfunction) and severe pressure ulcers...
May 17, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28509706/length-of-stay-mortality-cost-and-perceptions-of-care-associated-with-transition-from-an-open-to-closed-staffing-model-in-the-cardiac-intensive-care-unit
#8
Jason N Katz, Anton Lishmanov, Sean van Diepen, Dongqing Yu, Haipeng Shen, Eric Pauley, Jatin Bhatia, Adam Buntaine, Arun Das, Cristie Dangerfield, Brooke McLaughlin, George A Stouffer, Prashant Kaul
BACKGROUND: Organizational models in the intensive care unit (ICU) have classically been described as either closed or open, depending on the presence or absence of a dedicated ICU team. Although a closed model has been shown to improve patient outcomes in medical and surgical ICUs, the merits of various care models have not been previously explored in the cardiac ICU (CICU) setting. METHODS: From November 2012 to March 2014, data were prospectively collected on all admissions before and after transition from an open to closed CICU at our institution...
June 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28508990/adolescents-with-congenital-heart-disease-their-opinions-about-the-preparation-for-transfer-to-adult-care
#9
Åsa Burström, Ewa-Lena Bratt, Björn Frenckner, Margret Nisell, Katarina Hanséus, Annika Rydberg, Maria Öjmyr-Joelsson
The aim of the study was to explore what adolescents with congenital heart disease (CHD) view as important in the preparation for the transfer to adult care. We performed interviews in four focus groups with adolescents (14-18 years old) at four university hospitals in Sweden. Data was analysed using qualitative content analysis. The analysis revealed one main category; Becoming a manager of the condition and four subcategories; Sufficient knowledge about the health, Be a participant in the care, Parental support, and Communicate with others about the health...
May 16, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28506976/implementation-of-postdischarge-follow-up-telephone-calls-at-a-comprehensive-cancer-center
#10
Shrina D Patel, Phuoc Anh Anne Nguyen, Melissa Bachler, Bradley Atkinson
PURPOSE: The development and implementation of a pharmacy-driven, postdischarge follow-up telephone call program to assess medication adherence, provide education, and address medication-related concerns are discussed. SUMMARY: Many readmissions are avoidable through effective discharge planning and patient follow-up after hospitalization. However, there is limited information on how to effectuate this process. To address this barrier, a team consisting of a clinical pharmacy specialist, a clinical pharmacy manager, a postgraduate year 1 pharmacy resident, and an education specialist at The University of Texas MD Anderson Cancer Center collaborated to create a postdischarge telephone call program within a transitions-of-care (TOC) pilot program...
June 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28504894/preventing-burdensome-transitions-of-nursing-home-residents-with-advanced-dementia-it-s-more-than-advance-directives
#11
Ruth Palan Lopez, Susan L Mitchell, Jane L Givens
BACKGROUND: Although a palliative approach to care is recommended for people with advanced dementia, many nursing home (NH) residents with dementia experience burdensome interventions such as hospital transfers at the end of life. OBJECTIVE: The goal of this study was to examine how decisions to transfer NH residents with advanced dementia are made, from the perspective of NH nurses and physicians. METHODS: A qualitative, descriptive method was used...
May 15, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28502246/time-in-assertive-community-treatment-a-statewide-quality-improvement-initiative-to-reduce-length-of-participation
#12
Steven Huz, Helle Thorning, Candace N White, Lin Fang, Bikki Tran Smith, Marleen Radigan, Lisa B Dixon
The investigators describe a New York State initiative to increase flow through assertive community treatment (ACT) while encouraging transition to less intensive services. This initiative began as ACT approached full capacity and as evidence emerged that participants can sustain recovery post-ACT. Comparison of performance indicators over time showed that time in ACT decreased, turnover rate increased, and the percentage of ACT participants who met treatment objectives rose. Also, post-ACT rates of ambulatory behavioral health follow-up increased while rates of psychiatric inpatient hospitalization decreased...
May 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28501337/late-in-hospital-management-of-patients-hospitalized-with-acute-heart-failure
#13
REVIEW
Nicole B Cyrille, Snehal R Patel
Acute Heart Failure (AHF) hospitalization presents a significant financial burden and portends a poor prognosis following discharge. As such, there has been significant emphasis on the late inpatient management of patients hospitalized with AHF to ensure successful transition to the outpatient setting and to reduce overall readmission and mortality rates. Thorough discharge planning and a multidisciplinary team approach are essential and as outlined in this review should focus on four key elements: the assessment of patients' readiness for discharge, optimization of goal directed medical therapy and appropriate device therapy, patient education and transition to the outpatient care...
May 10, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28491911/navigating-long-term-care
#14
James D Holt
Americans over age 65 constitute a larger percentage of the population each year: from 14% in 2010 (40 million elderly) to possibly 20% in 2030 (70 million elderly). In 2015, an estimated 66 million people provided care to the ill, disabled, and elderly in the United States. In 2000, according to the Centers for Disease Control and Prevention (CDC), 15 million Americans used some form of long-term care: adult day care, home health, nursing home, or hospice. In all, 13% of people over 85 years old, compared with 1% of those ages 65 to 74, live in nursing homes in the United States...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/28490869/pulmonary-infection-control-window-as-a-switching-point-for-sequential-ventilation-in-the-treatment-of-copd-patients-a-meta-analysis
#15
Yingying Lv, Qiurong Lv, Quanchao Lv, Tianwen Lai
PURPOSE: Choosing the appropriate time to switch to noninvasive positive-pressure ventilation (NPPV) plays a crucial role in promoting successful weaning. However, optimal timing for transitioning and weaning patients from mechanical ventilation (MV) to NPPV has not been clearly established. In China, the pulmonary infection control (PIC) window as a switching point for weaning from MV has been performed for many years, without definitive evidence of clinical benefit. This study aimed to summarize the evidence for NPPV at the PIC window for patients with respiratory failure from COPD...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28490305/long-term-risk-of-severe-retinopathy-in-childhood-onset-type-1-diabetes-a-data-linkage-study
#16
Mary White, Matthew A Sabin, Costan G Magnussen, Michele A O'Connell, Peter G Colman, Fergus Cameron
OBJECTIVES: To determine the relationship between glycaemic control trajectory and the long term risk of severe complications in people with type 1 diabetes mellitus, as well as the effects of paediatric and adult HbA1c levels. DESIGN, SETTING, PARTICIPANTS: Data linkage study of data for adults with childhood-onset type 1 diabetes (diagnosed during 1975-2010) who had transitioned from paediatric diabetes care at the Royal Children's Hospital (Melbourne) to adult diabetes care at the Royal Melbourne Hospital during 1992-2013...
May 15, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28488196/a-multi-state-approach-to-patients-affected-by-chronic-heart-failure-the-value-added-by-administrative-data
#17
Francesco Grossetti, Francesca Ieva, Anna Maria Paganoni
Healthcare administrative databases are becoming more and more important and reliable sources of clinical and epidemiological information. They are able to track several interactions between a patient and the public healthcare system. In the present study, we make use of data extracted from the administrative data warehouse of Regione Lombardia, a region located in the northern part of Italy whose capital is Milan. Data are within a project aiming at providing a description of the epidemiology of Heart Failure (HF) patients at regional level, to profile health service utilization over time, and to investigate variations in patient care according to geographic area, socio-demographic characteristic and other clinical variables...
May 9, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28487185/structures-processes-and-outcomes-of-the-aussie-heart-guide-program-a-nurse-mentor-supported-home-based-cardiac-rehabilitation-program-for-rural-patients-with-acute-coronary-syndrome
#18
Terence J Frohmader, Frances Lin, Wendy P Chaboyer
BACKGROUND: Cardiac rehabilitation has a number of benefits for patients, yet participation in it is sub-optimal, especially in regional Australia. Innovative models of cardiac rehabilitation are needed to improve participation. Providing nurse mentors to support patients transitioning from hospital to home represents a new model of service delivery in Australia. OBJECTIVES: To explore the impact of a home based cardiac rehabilitation program in assisting patients to recover from Acute Coronary Syndrome and meeting the expectations of nurse mentors delivering the program...
May 6, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28485716/the-former-yugoslav-republic-of-macedonia-health-system-review
#19
Neda Milevska Kostova, Snezhana Chichevalieva, Ninez A Ponce, Ewout van Ginneken, Juliane Winkelmann
This analysis of the health system of the former Yugoslav Republic of Macedonia reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. The country has made important progress during its transition from a socialist system to a market-based system, particularly in reforming the organization, financing and delivery of health care and establishing a mix of private and public providers. Though total health care expenditure has risen in absolute terms in recent decades, it has consistently fallen as share of GDP, and high levels of private health expenditure remain...
May 2017: Health Systems in Transition
https://www.readbyqxmd.com/read/28479411/end-of-life-place-of-care-health-care-settings-and-health-care-transitions-among-cancer-patients-impact-of-an-integrated-cancer-palliative-care-plan
#20
V Casotto, M Rolfini, E Ferroni, V Savioli, N Gennaro, F Avossa, M Cancian, F Figoli, D Mantoan, A Brambilla, M C Ghiotto, U Fedeli, M Saugo
CONTEXT: Frequent end-of-life health care setting transitions can lead to an increased risk of fragmented care and exposure to unnecessary treatments. OBJECTIVES: We assessed the relationship between the presence and the intensity of an Integrated Cancer Palliative Care plan and the occurrence of multiple transitions during the last month of life. METHODS: Decedents of cancer aged 18-85 years residents in two Regions of Italy where investigated accessing their integrated administrative data (Death Certificates, Hospital Discharges, Hospice and Home care records)...
May 4, 2017: Journal of Pain and Symptom Management
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