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Transitions in the hospital

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https://www.readbyqxmd.com/read/28647577/transitions-from-skilled-nursing-facility-to-home-the-relationship-of-early-outpatient-care-to-hospital-readmission
#1
Jennifer L Carnahan, James E Slaven, Christopher M Callahan, Wanzhu Tu, Alexia M Torke
BACKGROUND: Many adults are discharged to skilled nursing facilities (SNFs) prior to returning home from the hospital. Patient characteristics and factors that can help to prevent postdischarge adverse outcomes are poorly understood. OBJECTIVE: To identify whether early post-SNF discharge care reduces likelihood of 30-day hospital readmissions. DESIGN: Secondary data analysis using the Electronic Medical Record, Medicare, Medicaid and the Minimum Data Set...
June 21, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28647442/the-impact-of-the-transition-from-volume-to-value-on-heart-failure-care-implications-of-novel-payment-models-and-quality-improvement-initiatives
#2
REVIEW
Dushyanth Srinivasan, Nihar R Desai
In response to wide variation in quality and outcomes as well as escalating health care costs, the U.S. health care system is transitioning away from a volume based payment system to a quality- and value-based system. Medicare, the largest insurer and payer of healthcare, has accelerated the movement towards value-based care with the development and implementation of myriad alternative payment models and pay for performance programs as part of the Affordable Care Act. Given that heart failure affects a significant number of Medicare patients and these patients account for a disproportionate amount of healthcare utilization and spending, heart failure has become a focal point for these initiatives...
June 21, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28643378/effects-of-weight-based-ultrafiltration-rate-limits-on-intradialytic-hypotension-in-hemodialysis
#3
James L Pirkle, Mary E Comeau, Carl D Langefeld, Gregory B Russell, Somer S Balderston, Barry I Freedman, John M Burkart
INTRODUCTION: High ultrafiltration (UF) rates can result in intradialytic hypotension and are associated with increased mortality. The effects of a weight-based UF rate limit on intradialytic hypotension and the potential for unwanted fluid weight gain and hospitalizations for volume overload are unknown. METHODS: This retrospective cohort study examined 123 in-center hemodialysis patients at one facility who transitioned to 13 mL/kg/h maximum UF rates. Patients were studied for an 8 week UF rate limit exposure period and compared to the 8-week period immediately prior, during which the cohort served as its own historical control...
June 23, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28643030/hospital-electronic-prescribing-system-implementation-impact-on-discharge-information-communication-and-prescribing-errors-a-before-and-after-study
#4
Pamela Ruth Mills, Anita Elaine Weidmann, Derek Stewart
PURPOSE: The study aimed to test the hypothesis that hospital electronic prescribing and medicine administration system (HEPMA) implementation impacted patient discharge letter quality, nature and frequency of prescribing errors. METHOD: A quasi experimental before and after retrospective case note review was conducted in one United Kingdom district general hospital. The total sample size was 318 (random samples of 159 before and after implementation), calculated to achieve a 10% error reduction with a power of 80% and p < 0...
June 22, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28639550/the-role-of-nurse-leaders-in-advancing-carer-communication-needs-across-transitions-of-care-a-call-to-action
#5
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/28639184/building-a-successful-superficial-venous-program
#6
REVIEW
Andrew Galmer, Jonathan Dunn, Maja Zaric, Joe F Lau, Mitchell Weinberg
As the treatment of superficial venous insufficiency transitioned from the hospital to the office setting, a remarkable increase in provider interest developed. However, the novelty of the disease process and procedural opportunities are tempered by the challenges associated with knowledge acquisition, skill development, strategic planning, and program development. Only a unique recipe of clinical growth, technical acumen, management skill, operational efficiency, and financial sense lead to program success...
August 2017: Current Treatment Options in Cardiovascular Medicine
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
#7
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
#8
(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
#9
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/28634703/isoperistaltic-versus-antiperistaltic-side-to-side-anastomosis-after-right-laparoscopic-hemicolectomy-for-cancer-isovanti-trial-study-protocol-for-a-randomised-clinical-trial
#10
N Ibañez, J Abrisqueta, J Luján, Q Hernández, P Parrilla
BACKGROUND: It is believed that loosing ileocecal valve is well tolerated in patients who do not have short bowel syndrome or Crohn disease. From the hypothesis of colonic peristalsis and transit is regulated by that ileocecal valvular mechanism, we try to find out if the creation of a new pseudo-valvular mechanism as antiperistaltic anastomosis could be considered after right hemicolectomy can cause any short- or long-term changes in gastrointestinal habits. PURPOSE: The purpose of the study at primary endpoint is to compare early (occurring within 30 days of surgery) and late (occurring during the follow-up) postoperative complications between both groups The purpose of the study at secondary endpoint is to compare intraoperative and postoperative events between experimental and control groups in terms of operating time, first oral tolerance day, first flatus and faeces, length of hospital stay and orocecal transit; comparing rates of gastrointestinal life quality and comparing mortality rates between both groups...
June 21, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28634181/outcomes-after-observation-stays-among-older-adult-medicare-beneficiaries-in-the-usa-retrospective-cohort-study
#11
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
#12
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/28631501/ambivalence-in-rehabilitation-thematic-analysis-of-the-experiences-of-lower-limb-amputated-veterans
#13
Jan Christensen, Henning Langberg, Patrick Doherty, Ingrid Egerod
BACKGROUND: Knowledge about the organization and factors of importance to rehabilitation of veterans with lower limb amputation is sparse. The aim of this study was, therefore, to improve understanding of the influences of "military identity" on the organization of rehabilitation services and to investigate those factors influential in achieving successful rehabilitation, including interprofessional collaboration between different sectors involved in the rehabilitation of veterans with lower limb amputations...
June 20, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28631387/umeclidinium-bromide-versus-placebo-for-people-with-chronic-obstructive-pulmonary-disease-copd
#14
REVIEW
Han Ni, Aung Htet, Soe Moe
BACKGROUND: People with chronic obstructive pulmonary disease (COPD) have poor quality of life, reduced survival, and accelerated decline in lung function, especially associated with acute exacerbations, leading to high healthcare costs. Long-acting bronchodilators are the mainstay of treatment for symptomatic improvement, and umeclidinium is one of the new long-acting muscarinic antagonists approved for treatment of patients with stable COPD. OBJECTIVES: To assess the efficacy and safety of umeclidinium bromide versus placebo for people with stable COPD...
June 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28629784/-from-paediatric-urological-care-to-adult-urology-assessment-of-a-transition-consultation-for-adolescents
#15
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/28627832/molecular-epidemiological-traits-of-group-a-rotaviruses-in-japanese-children-during-transitional-period-of-rotavirus-vaccine-implementation-2011-2014
#16
Sayaka Takanashi, Aksara Thongprachum, Shoko Okitsu, Shuichi Nishimura, Masaaki Kobayashi, Hideaki Kikuta, Atsuko Yamamoto, Kumiko Sugita, Tsuneyoshi Baba, Satoshi Hayakawa, Masashi Mizuguchi, Hiroshi Ushijima
BACKGROUND: Group A rotavirus (RVA) vaccines have been introduced in Japan since 2011. To investigate the molecular epidemiological traits of RVA during the transitional period of rotavirus vaccine implementation in Japan, this study was undertaken by following up three-decade long surveillance conducted in the same regions. METHODS: RVA were screened and genotyped by RT-PCR from diarrheal samples collected from non-hospitalized patients in six localities (Hokkaido, Tokyo, Shizuoka, Osaka, Kyoto, and Saga) during 2011 - 2014...
May 1, 2017: Clinical Laboratory
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
#17
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/28626128/a-case-of-matrix-producing-carcinoma-of-the-breast
#18
Yuzuru Inoue, Fumi Joden, Kei Yabuki, Nagahiro Sato, Noritaka Minagawa, Takefumi Katsuki, Norihiro Sato, Takahisa Nagata, Kazunori Shibao, Atsuji Matsuyama, Takatoshi Aoki, Keiji Hirata
A 61-year-old woman was referred to our hospital because of a right breast mass. A 19 mm hard mass was palpable in the A area of the right breast. A contrast-enhanced MRI showed rim enhancement at the peripheral region of the tumor, which was thought to represent the carcinoma component mainly at the periphery and the matrix component inside the tumor. A low density mass with rim enhancement at the peripheral region was observed in a contrast-enhanced CT, the same as in the MRI. Neither axillary lymph node metastasis nor distant metastasis was observed...
2017: Journal of UOEH
https://www.readbyqxmd.com/read/28625318/prognostic-value-of-different-allelic-polymorphism-of-aldosterone-synthase-receptor-in-a-congestive-heart-failure-european-continental-ancestry-population
#19
Mauro Feola, Martino Monteverde, Daniela Vivenza, Marzia Testa, Laura Leto, Valentina Astesana, Francesco Mussapi, Antonello Vado, Marco Merlano, Cristiana Lo Nigro
Aldosterone synthase (CYP11B2) is as an 9-exon gene on chromosome 8q22 and exists as a common single nucleotide polymorphism C-T transition for position -344. The aim of this study was to assess the -344T/C polymorphism of the aldosterone synthase promoter in a European continental ancestry congestive heart failure (CHF) population. METHODS: Patients discharged after an acute decompensation were enrolled and underwent echocardiography, determination of BNP, evaluation of non-invasive cardiac outputs and determination of -344 T/C SNP in the aldosterone synthase gene...
February 2017: Archives of Medical Research
https://www.readbyqxmd.com/read/28624064/assessing-written-communication-during-interhospital-transfers-of-emergency-general-surgery-patients
#20
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
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