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Hospital Transition of care

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https://www.readbyqxmd.com/read/28639550/the-role-of-nurse-leaders-in-advancing-carer-communication-needs-across-transitions-of-care-a-call-to-action
#1
Sonia A Udod, Michelle Lobchuk
This paper focuses on the central role of senior nurse leaders in advancing organizational resources and support for communication between healthcare providers and carers that influences patient and carer outcomes during the transition from hospital to the community. A Think Tank (Lobchuk 2012) funded by the Canadian Institutes of Health Research (CIHR) gathered interdisciplinary and intersectoral stakeholders from local, national and international levels to develop a Family Carer Communication Research Collaboration...
2017: Nursing Leadership
https://www.readbyqxmd.com/read/28638566/necessity-is-the-mother-of-invention-an-innovative-hospitalist-resident-initiative-for-improving-quality-and-reducing-readmissions-from-skilled-nursing-facilities
#2
Sunny Petigara, Mahesh Krishnamurthy, David Livert
Background: Hospital readmissions have been a major challenge to the US health system. Medicare data shows that approximately 25% of Medicare skilled nursing facility (SNF) residents are readmitted back to the hospital within 30 days. Some of the major reasons for high readmission rates include fragmented information exchange during transitions of care and limited access to physicians round-the-clock in SNFs. These represent safety, quality, and health outcome concerns. Aim: The goal of the project was to reduce hospital readmission rates from SNFs by improving transition of care and increasing physician availability in SNFs (five to seven days a week physical presence with 24/7 accessibility by phone)...
March 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28638496/effect-of-early-follow-up-after-hospital-discharge-on-outcomes-in-patients-with-heart-failure-or-chronic-obstructive-pulmonary-disease-a-systematic-review
#3
(no author information available yet)
BACKGROUND: Transitions in care can increase patients' vulnerability to adverse events. In particular, patients admitted for heart failure or chronic obstructive pulmonary disorder (COPD) have high rates of readmission and return emergency department visits. Heart failure patients have the highest 30-day readmission rates in Canada, and COPD patients comprise the highest volume of readmissions. Combined, these two conditions account for the largest number of emergency department returns...
2017: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/28637560/despite-trauma-center-closures-trauma-system-regionalization-reduces-mortality-and-time-to-definitive-care-in-severely-injured-patients
#4
Jack C He, David Schechtman, Debra L Allen, Jillian J Cremona, Jeffrey A Claridge
The Northern Ohio Trauma System (NOTS), consisting of multiple hospital systems, was established in 2010 to improve trauma outcomes. This study assessed its impact on mortality and time to definitive care, focusing especially on the severely injured patients. NOTS trauma registry was queried for all trauma activations from 2008 to 2013. The years between 2008-2009 and 2011-2013 were designated as pre- and post-NOTS, respectively. Data from 2010 was excluded as a transitional year. Two trauma centers (TCs) closed in 2010...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28634181/outcomes-after-observation-stays-among-older-adult-medicare-beneficiaries-in-the-usa-retrospective-cohort-study
#5
Kumar Dharmarajan, Li Qin, Maggie Bierlein, Jennie E S Choi, Zhenqiu Lin, Nihar R Desai, Erica S Spatz, Harlan M Krumholz, Arjun K Venkatesh
Objective To characterize rates and trends over time of emergency department treatment-and-discharge stays, repeat observation stays, inpatient stays, any hospital revisit, and death within 30 days of discharge from observation stays.Design Retrospective cohort study.Setting 4750 hospitals in the USA.Participants Nationally representative sample of Medicare fee for service beneficiaries aged 65 or over discharged after 363 037 index observation stays, 2 540 000 index emergency department treatment-and-discharge stays, and 2 667 525 index inpatient stays from 2006-11...
June 20, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28633453/a-multifaceted-quality-improvement-strategy-reduces-the-risk-of-catheter-associated-urinary-tract-infection
#6
Cecelia N Theobald, Matthew J Resnick, Thomas Spain, Robert S Dittus, Christianne L Roumie
Objective: Catheter-associated urinary tract infections (CAUTIs) are common and preventable hospital-acquired infections, yet their rate continues to rise nationwide. We describe the implementation of a multifaceted program to reduce catheter use and CAUTI rates while simultaneously addressing barriers to long-term success. Design/Setting/Participants: Pre-post study of medical inpatient veterans between December 2012 and February 2015. Intervention: Five component intervention: (i) a bedside catheter reminder; (ii) multidisciplinary educational campaign; (iii) structured catheter order set with clinical decision support; (iv) automated catheter discontinuation orders; and (v) protocol for post-catheter removal care...
June 17, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28629784/-from-paediatric-urological-care-to-adult-urology-assessment-of-a-transition-consultation-for-adolescents
#7
L Even, S Mouttalib, J Moscovici, M Soulie, P Rischmann, X Game, P Galinier, O Bouali
To provide an adequate lifelong urological care in the complex period of adolescence, a transition consultation conducted by a paediatric surgeon and an urologist was developed in our institution. As a real rite of passage, it allows the follow-up and the adapted care of urological conditions, sometimes complex, and permits the transition between childhood and the world of grown-ups. We reported our experience at the Children Hospital of our institution (paediatric surgery and urology departments). During a 6 months period (January-July 2015), forty-five young adults with a mean age of 17...
June 16, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28627006/parents-perceptions-during-the-transition-to-home-for-their-child-with-a-congenital-heart-defect-how-can-we-support-families-of-children-with-hypoplastic-left-heart-syndrome
#8
Sarita March
PURPOSE: The aim of the study was to explore the literature related to transitions in healthcare between the hospital and home that caregivers experience with a child who has a congenital heart defect (CHD), specifically related to hypoplastic left heart syndrome (HLHS). DESIGN AND METHODS: A systematic literature review was conducted searching OVID Medline, CINAHL, and PubMed to discover the caregivers' perceptions on their transitions between hospital care and home care of their child with a CHD...
June 18, 2017: Journal for Specialists in Pediatric Nursing: JSPN
https://www.readbyqxmd.com/read/28624064/assessing-written-communication-during-interhospital-transfers-of-emergency-general-surgery-patients
#9
Felicity N R Harl, Megan C Saucke, Caprice C Greenberg, Angela M Ingraham
BACKGROUND: Poor communication causes fragmented care. Studies of transitions of care within a hospital and on discharge suggest significant communication deficits. Communication during transfers between hospitals has not been well studied. We assessed the written communication provided during interhospital transfers of emergency general surgery patients. We hypothesized that patients are transferred with incomplete documentation from referring facilities. METHODS: We performed a retrospective review of written communication provided during interhospital transfers to our emergency department (ED) from referring EDs for emergency general surgical evaluation between January 1, 2014 and January 1, 2016...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28623892/improving-transitions-in-acute-stroke-patients-discharged-to-home-the-michigan-stroke-transitions-trial-mistt-protocol
#10
Mathew J Reeves, Anne K Hughes, Amanda T Woodward, Paul P Freddolino, Constantinos K Coursaris, Sarah J Swierenga, Lee H Schwamm, Michele C Fritz
BACKGROUND: For some stroke patients and caregivers, navigating the transition between hospital discharge and returning home is associated with substantial psychosocial and health-related challenges. Currently, no evidence-based standard of care exists that addresses the concerns of stroke patients and caregivers during the transition period. Objectives of the Michigan Stroke Transitions Trial (MISTT) are to test the impact of a social worker home-based case management program, as well as an online information and support resource, on patient and caregiver outcomes after returning home...
June 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28622983/the-effect-of-a-comprehensive-care-transition-model-on-cost-and-utilization-for-medically-complex-children-with-cerebral-palsy
#11
Steven W Howard, Zidong Zhang, Paula Buchanan, Eric Armbrecht, Christine Williams, Geneva Wilson, Janna Hutchinson, Lindsey Pearson, Samantha Ellsworth, Caitlin M Byler, Travis Loux, Jing Wang, Steph Bernell, Nicholas Holekamp
INTRODUCTION: Our aim was to evaluate cost and acute care utilization related to an organized approach to care coordination and transitional care after major acute care hospitalization for children with medical complexities, including cerebral palsy. METHODS: A retrospective cohort of 32 patients from Ranken Jordan Pediatric Bridge Hospital (RJPBH) who received the Care Beyond the Bedside model was compared with 151 patients receiving standard care elsewhere across Missouri...
June 13, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28618896/managing-risk-during-care-transitions-when-approaching-end-of-life-a-qualitative-study-of-patients-and-health-care-professionals-decision-making
#12
Maureen A Coombs, Roses Parker, Kay de Vries
BACKGROUND: Increasing importance is being placed on the coordination of services at the end of life. AIM: To describe decision-making processes that influence transitions in care when approaching the end of life. DESIGN: Qualitative study using field observations and longitudinal semi-structured interviews. SETTING/PARTICIPANTS: Field observations were undertaken in three sites: a residential care home, a medical assessment unit and a general medical unit in New Zealand...
July 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28617022/reducing-hospital-readmission-through-team-based-primary-care-a-7-week-pilot-study-integrating-behavioral-health-and-pharmacy
#13
Lauren N DeCaporale-Ryan, Nabila Ahmed-Sarwar, Robbyn Upham, Karen Mahler, Katie Lashway
INTRODUCTION: A team-based service delivery model was applied to provide patients with biopsychosocial care following hospital discharge to reduce hospital readmission. Most previous interventions focused on transitions of care occurred in the inpatient setting with attention to predischarge strategies. These interventions have not considered psychosocial stressors, and few have explored management in primary care settings. METHOD: A 7-week team-based service delivery model was implemented in a family medicine practice emphasizing a biopsychosocial approach...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28615932/expanding-the-inspired-copd-outreach-program%C3%A2-to-the-emergency-department-a-feasibility-assessment
#14
Darcy Gillis, Jillian Demmons, Graeme Rocker
BACKGROUND: The Halifax-based INSPIRED COPD Outreach Program™ is a facility-to-community home-based novel clinical initiative that through improved care transitions, self-management, and engagement in advance care planning has demonstrated a significant (60%-80%) reduction in health care utilization with substantial cost aversion. By assessing the feasibility of expanding INSPIRED into the emergency department (ED) we anticipated extending reach and potential for positive impact of INSPIRED to those with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) who avoid hospital admission...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28611899/perspectives-on-home-based-healthcare-as-an-alternative-to-hospital-admission-after-emergency-treatment
#15
Amy Stuck, Christopher Crowley, Tracy Martinez, Alan Wittgrove, Jesse J Brennan, Theodore C Chan, Edward M Castillo
INTRODUCTION: The study objective was to explore emergency physicians' (EP) awareness, willingness, and prior experience regarding transitioning patients to home-based healthcare following emergency department (ED) evaluation and treatment; and to explore patient selection criteria, processes, and services that would facilitate use of home-based healthcare as an alternative to hospitalization. METHODS: We provided a five-question survey to 52 EPs, gauging previous experience referring patients to home-based healthcare, patient selection, and motivators and challenges when considering home-based options as an alternative to admission...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28609187/integrating-social-services-and-home-based-primary-care-for-high-risk-patients
#16
Joe Feinglass, Greg Norman, Robyn L Golden, Naoko Muramatsu, Michael Gelder, Thomas Cornwell
There is a consensus that our current hospital-intensive approach to care is deeply flawed. This review article describes the research evidence for developing a better system of care for high-cost, high-risk patients. It reviews the evidence that home-centered care and integration of health care with social services are the cornerstones of a more humane and efficient system. The article describes the strengths and weaknesses of research evaluating the effects of social services in addressing social determinants of health, and how social support is critical to successful acute care transition programs...
June 13, 2017: Population Health Management
https://www.readbyqxmd.com/read/28607334/interhospital-transfer-of-critically-ill-patients
#17
Thomas Kiss, Alisa Bölke, Peter M Spieth
Transportation of a patient between medical facilities without interruption of the medical treatment can be a challenging task. This review aims to define the term "interhospital transport" and give a general overview of the steps for organizing a transfer. Furthermore we discuss the team qualification, equipment standards and how to manage adverse events before and during transport by means of patient triage. The advanced interhospital transport of the critically ill patient can be defined as follows: "transportation of a patient between medical facilities without interruption of the medical treatment and monitoring due to the underlying disease by means of specific medical, technical equipment and knowledge with the objective of improved patient care"...
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28605555/operationalizing-multidisciplinary-assessment-and-treatment-as-a-quality-metric-for-interventional-pain-practices
#18
Edward K Heres, David Itskevich, Ajay D Wasan
Objective.:  Quality improvement (QI) is an underutilized approach among pain medicine specialists to improve comprehensive pain assessment and the delivery of multimodal pain care. We report the results of a QI program that utilized peer review and financial incentives to improve these processes in interventional pain clinics. Design.:  Retrospective chart review. Setting.:  Eight academic and community-based practices that included separate hospital-based and non-hospital-based interventional pain clinics...
June 12, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28604209/a-literature-review-exploring-role-transitions-in-caring-for-a-child-requiring-long-term-ventilationin-recent-years-the-uk-and-other-high-income-countries-have-seen-an-increase-in-the-use-of-long-term-ventilation-ltv-in-paediatric-intensive-care-neupane-et
#19
Emily Goss
Government policies advocate that children should be cared for at home ( Noyes et al 2006 ), although medically stable LTV children often stay in hospital months longer than is necessary ( NHS England 2015 ). Research shows that parents of these children develop a dual role as parents and nurses, which leads to role conflict and ambiguity ( Hewitt-Taylor 2011 ).
June 12, 2017: Nursing Children and Young People
https://www.readbyqxmd.com/read/28604141/cost-effectiveness-of-subdermal-implantable-buprenorphine-versus-sublingual-buprenorphine-to-treat-opioid-use-disorder
#20
John A Carter, Ryan Dammerman, Michael Frost
AIMS: Subdermal implantable buprenorphine (BSI) was recently approved to treat opioid use disorder (OUD) in clinically-stable adults. In the pivotal clinical trial, BSI was associated with a higher proportion of completely-abstinent patients (85.7% vs 71.9%; P = 0.03) versus sublingual buprenorphine (SL-BPN). Elsewhere, relapse to illicit drug use is associated with diminished treatment outcomes and increased costs. Herein, we evaluated the cost-effectiveness of BSI versus SL-BPN from a US societal perspective...
June 10, 2017: Journal of Medical Economics
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