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Nathan H Moore, Emily D Fondahn, Jack D Baty, Melvin S Blanchard
No abstract text is available yet for this article.
November 3, 2017: Healthcare
David G Coughlin, Monisha A Kumar, Neha N Patel, Rebecca L Hoffman, Scott E Kasner
BACKGROUND: Early unplanned readmissions of "bouncebacks" to intensive care units are a healthcare quality metric and result in higher mortality and greater cost. Few studies have examined bouncebacks to the neurointensive care unit (neuro-ICU), and we sought to design and implement a quality improvement pilot to reduce that rate. METHODS: First, we performed a retrospective chart review of 504 transfers to identify potential bounceback risk factors. Risk factors were assessed on the day of transfer by the transferring physician identifying patients as "high risk" or "low risk" for bounceback...
September 19, 2017: Neurocritical Care
Courtney L Shepard, Julian Wan
INTRODUCTION: More pediatric patients seem to present to the emergency department (ED) for non-urgent matters after urologic procedures than adult patients. Under new and expanding healthcare reform, pediatric urologists may be penalized for these visits. We compare our 30-day postoperative bounceback rates to the ED and the acuity of the concerns in these populations. MATERIALS AND METHODS: All urology consults at our institution are maintained on a prospectively tracked database...
August 2017: Journal of Pediatric Urology
Joanne Reeve, Lucy Cooper, Sean Harrington, Peter Rosbottom, Jane Watkins
BACKGROUND: Health services face the challenges created by complex problems, and so need complex intervention solutions. However they also experience ongoing difficulties in translating findings from research in this area in to quality improvement changes on the ground. BounceBack was a service development innovation project which sought to examine this issue through the implementation and evaluation in a primary care setting of a novel complex intervention. METHODS: The project was a collaboration between a local mental health charity, an academic unit, and GP practices...
September 6, 2016: BMC Health Services Research
Vesa Aho, Keijo Mattila, Thomas Kühn, Pekka Kekäläinen, Otto Pulkkinen, Roberta Brondani Minussi, Maija Vihinen-Ranta, Jussi Timonen
From macroscopic to microscopic scales it is demonstrated that diffusion through membranes can be modeled using specific boundary conditions across them. The membranes are here considered thin in comparison to the overall size of the system. In a macroscopic scale the membrane is introduced as a transmission boundary condition, which enables an effective modeling of systems that involve multiple scales. In a mesoscopic scale, a numerical lattice-Boltzmann scheme with a partial-bounceback condition at the membrane is proposed and analyzed...
April 2016: Physical Review. E
Nisa Atigapramoj, Steven Bin
Bouncebacks! Pediatrics is the third book of the Bouncebacks! series and describes 28 real pediatric cases from the emergency department. Each chapter is authored by the attending physician and/or resident who cared for these patients. Chapters are written with an interior dialogue due to the familiarity and personal experience with each case. The cases begin with the physician's version of the initial emergency department visit, complete with actual chart documentation and the presumptive diagnosis. This is followed by a discussion of the encounter, including salient pieces of the history and physical exam, findings that were overlooked, risk management and patient safety issues, and insights on the medical-legal aspects of the case, specifically regarding chart documentation...
February 29, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Jason H Wasfy, Sandhya K Rao, Neil Kalwani, Melissa D Chittle, Calvin A Richardson, Kathleen M Gallen, Eric M Isselbacher, Alexandra B Kimball, Timothy G Ferris
AIMS: Cardiac e-consults may be an effective way to deliver value-oriented outpatient cardiology care in an accountable care organization. Initial results of cardiac e-consults have demonstrated high satisfaction among both patients and referring providers, no known adverse events, and low rates of diagnostic testing. Nevertheless, differences between e-consults and traditional consults, effects of e-consults on traditional consult volume, and whether patients seek traditional consults after e-consults are unknown...
March 2016: American Heart Journal
Molywan Vat, Carol Common, Andrea Maria Laizner, Coralie Borduas, Christine Maheu
AIMS AND OBJECTIVES: To understand the patients' reasons for returning to the emergency department soon after their discharge from an internal medicine unit and to compare these reasons with the liaison nurse clinician's risk assessment tools used for discharge planning. BACKGROUND: Returns to the emergency departments soon after discharge from the hospital are a recurrent problem. Factors precipitating readmission to hospital have been analysed through the lens of health care providers, but few studies have explored the patients' perspectives on their reasons for returning to the emergency departments...
December 2015: Journal of Clinical Nursing
Joshua B Moskovitz, Zachary Ginsberg
BACKGROUND: National emergency department (ED) bounceback rates within 30 days of previous ED discharge have been found to be as high as 26%. We hypothesize that having a primary care physician (PCP) would prevent bouncebacks to the ED because a patient would have a medical resource for follow-up and continued care. METHODS: We performed a prospective, consecutive, anonymous survey study of adult ED patients at a suburban teaching hospital with 88,000 visits annually, from July 5, 2011 through August 8, 2011...
July 2015: Journal of Emergency Medicine
Mark Hartney, Yazhuo Liu, Vic Velanovich, Peter Fabri, Jorge Marcet, Michael Grieco, Shuai Huang, Jose Zayas-Castro
BACKGROUND: We sought to identify risks for 30-day readmission in patients undergoing colorectal surgery. METHODS: We reviewed 2011 American College of Surgery National Surgical Quality Improvement Program data to identify patients readmitted after colorectal surgery. We found 3,228 readmissions from 30,412 records. Using statistically suggestive variables from logistic regression (P < .1), we built conditional inference trees (CTREES) with subsampled records to identify combined risks...
October 2014: Surgery
A Britton Christmas, Elizabeth Freeman, Angela Chisolm, Peter E Fischer, Gaurav Sachdev, David G Jacobs, Ronald F Sing
Return transfer (RT) to the intensive care unit (ICU) negatively impacts patient outcomes, length of stay (LOS), and hospital costs. This study assesses the most common events necessitating RT in trauma patients. We performed a retrospective chart review of ICU RT from 2004 to 2008. Patient demographics, injuries and injury severity, reason for transfer, LOS, interventions, and outcomes data were collected. Overall, 158 patients required readmission to the ICU. Respiratory insufficiency/failure (48%) was the most common reason for RT followed by cardiac (16%) and neurological (13%) events...
August 2014: American Surgeon
Jeremy Segrott, Heather Rothwell, Menna Thomas
School-based interventions for young people with emotional/mental health problems are often provided by external practitioners and their relationship with host schools is a key influence on implementation. Poor integration within school systems, schools' tendency to define interventions around pupils' behaviour and teachers' control over access, may undermine therapeutic relationships. This study examines how one school-based intervention-Bounceback-addressed these challenges. Methods comprised interviews with programme staff, school staff and service users...
September 2013: Pastoral Care in Education
Renee Y Hsia, Steven M Asch, Robert E Weiss, David Zingmond, Gelareh Gabayan, Li-Jung Liang, Weijuan Han, Heather McCreath, Benjamin C Sun
OBJECTIVE: Emergency department (ED) crowding is linked with poor quality of care and worse outcomes, including higher mortality. With the growing emphasis on hospital performance measures, there is additional concern whether inadequate care during crowded periods increases a patient's likelihood of subsequent inpatient admission. We sought to determine if ED crowding during the index visit was associated with these "bounceback" admissions. METHODS: We used comprehensive, nonpublic, statewide ED and inpatient discharge data from the California Office of Statewide Health Planning and Development from 2007 to identify index outpatient ED visits and bounceback admissions within 7 days...
November 2013: Medical Care
Lin Zheng, Zhaoli Guo, Baochang Shi
The lattice Boltzmann equation (LBE) method has been shown to be a promising tool for microscale gas flows. However, few works focus on the microtube flows, and there still are some fundamental problems for the LBE to such flows. In this paper, a recently proposed axisymmetric LBE with three kinetic boundary conditions, i.e., the combination of bounceback and specular reflection scheme, the combination of the Maxwell and specular-reflection scheme, and the combination of the Maxwell and bounceback scheme, have been investigated in detail...
July 2012: Physical Review. E, Statistical, Nonlinear, and Soft Matter Physics
Jay K Udani, Betsy B Singh, Vijay J Singh, Elizabeth Sandoval
BACKGROUND: Delayed onset muscle soreness (DOMS) is muscle pain and discomfort experienced approximately one to three days after exercise. DOMS is thought to be a result of microscopic muscle fiber tears that occur more commonly after eccentric exercise rather than concentric exercise. This study sought to test the efficacy of a proprietary dietary supplement, BounceBack, to alleviate the severity of DOMS after standardized eccentric exercise. METHODS: The study was a randomized, double-blind, placebo-controlled, crossover study...
2009: Journal of the International Society of Sports Nutrition
Kendra Moldenhauer, Allison Sabel, Eugene S Chu, Philip S Mehler
DHMC's clinical triggers program is a promising approach that addresses an unmet patient need. We have seen dramatic reductions in our non-ICU cardiopulmonary arrest rates, along with our ICU bounceback rates. In the context of our hospital, this program aligns well with our teaching mission while maximizing the resources that are currently available. RRTs are certainly one way to prevent the unnoticed deterioration of patients, but programs such as ours, which focus on prevention of ongoing deterioration, may yield more benefit for the patients in institutions similar to DHMC...
March 2009: Joint Commission Journal on Quality and Patient Safety
Robert Cunningham, Douglas B Sherlock
Enrollment in Blue Cross and Blue Shield (BCBS) plans has grown by almost seventeen million since 1994, and recent financial performance indicators are positive for most plans in the Blues system. These gains have been achieved by for-profit, nonprofit, and mutually owned plans. A journalistic analysis of distinctive features contributing to recent successes is offered, combining observations of financial analysts, health services researchers, and BCBS officials. Long-term stability, broad provider networks, and conservative financial management have given the Blues advantages vis-à-vis many managed care organizations that have lost market share in the same period...
January 2002: Health Affairs
S L Hammond, V S Freimuth, W Morrison
This article presents the gatekeeping funnel as a model of the process that a public service announcement (PSA) goes through from distribution until it reaches its target audience. Process measures such as bounceback postcards, the Broadcast Advertisers Report (BAR), and analysis of audience response are suggested as ways of monitoring this funneling process. The model is then applied to the National Cancer Institute's PSA campaign designed to promote cancer prevention awareness. Three waves of PSAs were distributed between March 1984 and May 1985...
1987: Health Education Quarterly
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