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https://www.readbyqxmd.com/read/29437836/prospective-observational-study-on-high-value-care-topics-discussed-on-multidisciplinary-rounds
#1
Jimmy B Beck, Corrie E McDaniel, Miranda C Bradford, Doug Brock, Carolyn D Sy, Tiffany Chen, Jeffrey Foti, Andrew A White
OBJECTIVES: Establishing a high-value care (HVC) culture within an institution requires a multidisciplinary commitment and participation. Bedside rounds provide an ideal environment for role modeling and learning behaviors that promote an HVC culture. However, little is understood regarding the types of HVC discussions that take place at the bedside and who participates in those discussions. METHODS: A prospective observational study at a tertiary-care, university-affiliated, free-standing children's hospital...
February 6, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29377988/outcomes-from-the-delphi-process-of-the-thoracic-robotic-curriculum-development-committee
#2
Giulia Veronesi, Patrick Dorn, Joel Dunning, Giuseppe Cardillo, Ralph A Schmid, Justin Collins, Jean-Marc Baste, Stefan Limmer, Ghada M M Shahin, Jan-Hendrik Egberts, Alessandro Pardolesi, Elisa Meacci, Sasha Stamenkovic, Gianluca Casali, Jens C Rueckert, Mauro Taurchini, Nicola Santelmo, Franca Melfi, Alper Toker
OBJECTIVES: As the adoption of robotic procedures becomes more widespread, additional risk related to the learning curve can be expected. This article reports the results of a Delphi process to define procedures to optimize robotic training of thoracic surgeons and to promote safe performance of established robotic interventions as, for example, lung cancer and thymoma surgery. METHODS: In June 2016, a working panel was spontaneously created by members of the European Society of Thoracic Surgeons (ESTS) and European Association for Cardio-Thoracic Surgery (EACTS) with a specialist interest in robotic thoracic surgery and/or surgical training...
January 25, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29350514/hospitalized-patients-and-family-members-preferences-for-real-time-transparent-access-to-their-hospital-records
#3
Michael J Waxman, Kurt Lozier, Lana Vasiljevic, Kira Novakofski, James Desemone, John O'Kane, Elizabeth M Dufort, David Wood, Ashar Ata, Louis Filhour, Richard J Blinkhorn
OBJECTIVES: To better understand patient satisfaction and perceived engagement with traditional hospital-based communication and to elicit patient preferences for health information technologies that would lead to improved satisfaction and engagement. STUDY DESIGN: We performed a mixed-methods study involving qualitative interviews followed by a survey of hospitalized patients and their family members at a single large academic medical center. METHODS: We conducted semi-structured interviews with 41 patients and surveyed 267 patients or family members to elicit their perspectives on satisfaction with traditional hospital communication methods, information needed to more fully engage in the patients' medical care, and potential solutions for improved hospital-based communication...
January 1, 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29324048/peer-observation-of-rounds-leads-to-collegial-discussion-of-teaching
#4
J Rush Pierce, Patrick Rendón, Deepti Rao
PROBLEM: Faculty in the Division of Hospital Medicine provide most of the clinical teaching for learners at our institution. The majority of these faculty are Assistant Professors with limited formal instruction in clinical teaching. Previous Divisional strategies to improve clinical teaching ability included discussion of effective teaching behaviors, developing written expectations for teaching faculty, and instituting seminars on effective clinical teaching. Heretofore, the Division had not utilized a direct observation exercise...
January 11, 2018: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29314328/nurse-to-nurse-shift-handoffs-on-medical-surgical-units-a-process-within-the-flow-of-nursing-care
#5
Katherine M Ernst, Sara A McComb, Cathaleen Ley
AIMS AND OBJECTIVES: To qualitatively investigate the medical-surgical nurse shift handoff as a process within the workflow of the exchanging nurses. Specifically, this study sought to identify the ideal handoff, ways the handoff deviated from ideal, and subsequent effect on nursing care. BACKGROUND: The functions as well as information content of the handoff have been studied. However, typical studies look at the handoff as an isolated activity utilising nurse perceptions as the primary measure of quality...
January 4, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29300237/dedicated-afternoon-rounds-for-icu-patients-families-and-family-satisfaction-with-care
#6
Urs Weber, Jennifer Johnson, Nathanial Anderson, Andrea K Knies, Belinda Nhundu, Cynthia Bautista, Kevin B Huang, Muhammad Hamza, Jessica White, Anna Coppola, Kathleen M Akgün, David M Greer, Evie G Marcolini, Emily J Gilmore, Nils H Petersen, Nona Timario, Kelly Poskus, Kevin N Sheth, David Y Hwang
OBJECTIVE: It was hypothesized that adding dedicated afternoon rounds for patients' families to supplement standard family support would improve overall family satisfaction with care in a neuroscience ICU. DESIGN: Pre- and postimplementation (pre-I and post-I) design. SETTING: Single academic neuroscience ICU. PATIENTS: Patients in the neuroscience ICU admitted for longer than 72 hours or made comfort measures only at any point during neuroscience ICU admission...
January 3, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29276300/multilayer-model-of-pharmacy-participation-in-the-antimicrobial-stewardship-program-at-a-large-academic-medical-center
#7
Yanina Dubrovskaya, Marco R Scipione, Justin Siegfried, Shin-Pung Jen, Vinh Pham, John Papadopoulos, Arnold Decano, Tyler Lewis, Arash Dabestani
Purpose: Leveraging pharmacy personnel resources for the purpose of antimicrobial stewardship program (ASP) operations presents a challenging task. We describe our experience integrating all pharmacists into an ASP, and evaluate the impact on ASP interventions, antimicrobial utilization, rate of selected hospital-onset infections and readmission. Summary: During a study period (January 1 to December 31, 2015), a total of 14 552 ASP-related pharmacy interventions were performed (ASP clinical pharmacotherapy specialists [CPS] n = 4025; non-ASP CPS n = 4888; hospital pharmacists n = 5639)...
October 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/29171329/defining-curricular-priorities-for-student-as-teacher-programs-a-national-delphi-study
#8
Jasmine Rana, Amy Sullivan, Molly Brett, Amy R Weinstein, Katharyn M Atkins
BACKGROUND: "Student-as-Teacher" (SaT) programs have been growing in number to prepare medical students for their teaching roles in residency and beyond, but it remains unknown what content areas should be covered in SaT curricula. AIM: To determine five to ten "essential" content areas for inclusion in SaT curricula using expert opinion. METHODS: Using a three-round Delphi process, moderators iteratively surveyed a panel of 28 medical educators (25 academy directors and three individuals identified as having expertise in undergraduate medical education) representing 25 medical schools in the United States...
November 24, 2017: Medical Teacher
https://www.readbyqxmd.com/read/29167032/using-the-evidence-based-practice-service-nursing-bundle-to-increase-patient-satisfaction
#9
Mary Kate Dilts Skaggs, Juli F Daniels, Angela J Hodge, Valerie L DeCamp
ABSTRACTINTRODUCTION: Patient satisfaction and patient experience goals are often linked to financial consequences. Although the link does exist, the bottom line is not only about money; it's about providing a quality experience for ED patients and creating an environment that engages staff. Evidence-based practice (EBP) strategies that have positive impact on patient perceptions of their ED care and increased satisfaction ratings include AIDET, Hourly Rounding, and Bedside Shift Report, which incorporate updates of test results and explanations of events occurring during a patient's visit...
November 19, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/29117055/improving-patient-experience-through-nursing-satisfaction
#10
Amanda McNicholas, Abby McCall, Alanna Werner, Ronda Wounderly, Erin Marinchak, Pamela Jones
Patient experience is a vital component of quality health care. In our institution we sought to improve both nursing satisfaction and collaboration, in conjunction with improving patient experience, predicting the two are directly proportional. We hypothesized that a more satisfied nursing team would result in an overall improvement in patient experience. To explore this hypothesis, we implemented multiple process changes to create an advanced practitioner-directed floor (APDF) on our 28-bed trauma, medical-surgical unit...
November 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29094620/tele-attending-can-emulate-and-even-improve-bedside-teaching-and-learning
#11
Robert J Adams
Telemedicine can be used for education as well as clinical care. Wearable platforms now allow a remote student to "tele-present" cases to "Tele-Attending" elsewhere in real time. Most of the features that medical students rate as important can be accommodated in this paradigm. Augmenting the bedside case presentation with teaching material from on-line sources may even improve bedside rounds. Tele-attending should be explored in particular to meet needs of students at Regional Medical Centers.
November 2, 2017: Medical Teacher
https://www.readbyqxmd.com/read/29073318/bedside-assessment-of-the-necessity-of-daily-lab-testing-for-patients-nearing-discharge
#12
Surafel Tsega, Michelle O'Connor, Jashvant Poeran, Colin Iberti, Hyung J Cho
As part of the Choosing Wisely® campaign, the Society of Hospital Medicine recommends against performing "repetitive complete blood count chemistry testing in the face of clinical and lab stability." With this recommendation as a framework, we targeted 2 hospitalist-run inpatient medicine units that employed bedside, scripted, interdisciplinary rounds. Our multifaceted intervention included prompting the hospitalist to identify clinically stable patients for next-day discharge and to discontinue labs when appropriate...
October 18, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29064517/framtidens-rond-%C3%A2-ett-personcentrerat-och-teambaserat-m%C3%A3-te-med-patienten-den-traditionella-ronden-g%C3%A3-r-inte-att-f%C3%A3-rsvara-etiskt-eller-juridiskt
#13
Anders Ågård, Ingemar Engström, Ulrika Sandén, Valdemar Erling
The aim of this article is to elucidate the traditional ward round from an historical, ethical and legal perspective. On the traditional ward round in hospitals, a senior clinician leads a group of other clinicians and health professionals on a walking tour through the ward to visit the patients for whom they are responsible at bedside. It is a long-lived tradition or routine, which has been substantially resistant to change. We recommend that work designed to improve the ward round should begin from values or ethical principles, such as respecting the patient's integrity and right to participate in decision-making...
October 17, 2017: Läkartidningen
https://www.readbyqxmd.com/read/29017863/surgical-volunteerism-as-a-collaborative-teaching-activity-can-benefit-surgical-residents-in-low-middle-income-countries
#14
EDITORIAL
Ryan A Hayton, Dustin K Donley, Arega Fekadu, Bradley K Woods, Cassandra K Graybill, Tamara N Fitzgerald
Surgical care is desperately needed in low-middle income countries (LMIC). Due to small numbers of faculty in local training programs, residents have limited exposure to subspecialists. We describe a teaching activity between visiting surgeons from the U.S. and a residency program in Malawi as an example for how surgeons in high income countries can meaningfully contribute. A short-term education activity was developed where residents participated in a pre-test on pediatric surgical management, lectures, intra-operative instruction, bedside rounds and a post-test...
October 7, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28956551/a-return-to-humane-medicine-osler-s-legacy
#15
Lucia Craxì, Simona Giardina, Antonio Gioacchino Spagnolo
Sir William Osler is celebrated today not only for his contributions to the advancement of medical education, but also for the humanism he brought to the practice of medicine. He was a doctor whose bedside skills and manners were emulated, and can legitimately be called an infectious diseases specialist. Nonetheless, he was also a humanist in the broader sense of the term, a student of human affairs and human nature, who emphasised compassion for the individual. To what extent, if any, are today's challenges influenced by departures from the paradigms created by Osler? In this paper we sought to ascertain whether such a tradition is still relevant to current practice and may foster a new perspective...
September 1, 2017: Le Infezioni in Medicina
https://www.readbyqxmd.com/read/28864431/palliative-care-professional-development-for-critical-care-nurses-a-multicenter-program
#16
Wendy G Anderson, Kathleen Puntillo, Jenica Cimino, Janice Noort, Diana Pearson, Deborah Boyle, Michelle Grywalski, Jeannette Meyer, Edith O'Neil-Page, Julia Cain, Heather Herman, Susan Barbour, Kathleen Turner, Eric Moore, Solomon Liao, Bruce Ferrell, William Mitchell, Kyle Edmonds, Nathan Fairman, Denah Joseph, John MacMillan, Michelle M Milic, Monica Miller, Laura Nakagawa, David L O'Riordan, Christopher Pietras, Kathryn Thornberry, Steven Z Pantilat
BACKGROUND: Integrating palliative care into intensive care units (ICUs) requires involvement of bedside nurses, who report inadequate education in palliative care. OBJECTIVE: To implement and evaluate a palliative care professional development program for ICU bedside nurses. METHODS: From May 2013 to January 2015, palliative care advanced practice nurses and nurse educators in 5 academic medical centers completed a 3-day train-the-trainer program followed by 2 years of mentoring to implement the initiative...
September 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28857791/the-high-value-care-rounding-tool-development-and-validity-evidence
#17
Corrie E McDaniel, Andrew A White, Miranda C Bradford, Carolyn D Sy, Tiffany Chen, Doug Brock, Jeffrey Foti, Jimmy B Beck
Little is known about current practices in high-value care (HVC) bedside teaching. A lack of instruments for measuring bedside HVC behaviors confounds efforts to assess the impact of curricular interventions. The authors aimed to define observable HVC concepts by developing an instrument to measure the content and frequency of HVC discussions.The authors developed the HVC Rounding Tool in four iterative phases, using Messick's validity framework. Phases 1 and 2 were designed to collect evidence of content validity, Phases 3 and 4 to collect evidence of response process and internal structure...
August 29, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28808863/warm-handoffs-a-novel-strategy-to-improve-end-of-rotation-care-transitions
#18
Harry S Saag, Jingjing Chen, Joshua L Denson, Simon Jones, Leora Horwitz, Patrick M Cocks
BACKGROUND: Hospitalized medical patients undergoing transition of care by house staff teams at the end of a ward rotation are associated with an increased risk of mortality, yet best practices surrounding this transition are lacking. AIM: To assess the impact of a warm handoff protocol for end-of-rotation care transitions. SETTING: A large, university-based internal medicine residency using three different training sites. PARTICIPANTS: PGY-2 and PGY-3 internal medicine residents...
August 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28800520/a-modified-delphi-process-to-identify-clinical-and-research-priorities-in-patient-and-family-centred-critical-care
#19
Simon J W Oczkowski, Selena Au, Amanda Roze des Ordons, Marlyn Gill, Melissa L Potestio, Orla Smith, Tasnim Sinuff, Henry T Stelfox, Alison E Fox-Robichaud
PURPOSE: To identify elements which enable patient and family centred care (PFCC) in the intensive care unit (ICU) and priorities for PFCC research. MATERIALS AND METHODS: We engaged a panel of multidisciplinary stakeholders in a modified Delphi process. Items generated from a literature review and panelist suggestions were rated in 3 successive rounds on a scale from 1 to 7. Median score was used to rate each item's priority, with 5 or more indicating "essential priority," 4 or 5 "moderate priority" and 3 or less "low priority...
August 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28771651/bedside-rounds-valued-but-not-preferred-perceptions-of-internal-medicine-residents-and-attending-physicians-in-a-diverse-academic-training-program
#20
Naseema B Merchant, Daniel G Federman
OBJECTIVES: Bedside rounds/rounding (BDR) is an important tool for patient-centered care and trainee education. This study aimed at understanding the attitudes toward BDR among residents and attending physicians. METHODS: A survey was conducted using the Qualtrics survey tool. Responses were measured using a five-point Likert scale. RESULTS: The survey was sent to 301 attending physicians and 195 residents. Attending physicians conducted BDR 19% of the time...
August 2017: Southern Medical Journal
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