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Transitions in the hospital

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https://www.readbyqxmd.com/read/28448780/integration-strategies-of-pharmacists-in-primary-care-based-accountable-care-organizations-a-report-from-the-accountable-care-organization-research-network-services-and-education
#1
Tina Joseph, Genevieve M Hale, Sara M Eltaki, Yesenia Prados, Renee Jones, Matthew J Seamon, Cynthia Moreau, Stephanie A Gernant
BACKGROUND: The accountable care organization (ACO) is an innovative health care delivery model centered on value-based care. ACOs consisting of primary care providers are increasingly becoming commonplace in practice; however, medication management remains suboptimal. PROGRAM DESCRIPTION: As experts in medication management, pharmacists perform direct patient care and assist in the transition from one provider to another, which places them in an ideal position to manage multiple aspects of patient care...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448224/patient-characteristics-associated-with-inpatient-psychiatric-re-admissions-and-the-utility-of-the-readmit-clinical-risk-index
#2
Autumn Pearl Roque, Lillian Jeannette Findlay, Chizimuzo Okoli, Peggy El-Mallakh
In response to the problem of frequent 30-day readmissions to inpatient psychiatric facilities, Vigod and colleagues (2015) developed the READMIT clinical risk index to identify risk factors for psychiatric inpatient readmissions. The purpose of this descriptive retrospective study was to examine the effectiveness of the READMIT clinical risk index to identify patients that are at high risk for a 30-day inpatient psychiatric readmission at a state psychiatric hospital in the southeastern US. Data were extracted from the discharge summaries of patients discharged between September 2013 and December 2014...
May 2017: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/28446350/the-first-aid-and-hospital-treatment-of-gunshot-and-blast-injuries
#3
Axel Franke, Dan Bieler, Benedikt Friemert, Robert Schwab, Erwin Kollig, Christoph Güsgen
BACKGROUND: When gunshot and blast injuries affect only a single person, first aid can always be delivered in conformity with the relevant guidelines. In contrast, when there is a dynamic casualty situation affecting many persons, such as after a terrorist attack, treatment may need to be focused on immediately life-threatening complications. METHODS: This review is based on pertinent publications retrieved by a selective search in Medline and on the authors' clinical experience...
April 7, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28446221/effectiveness-of-three-commonly-used-transition-phase-diets-in-the-inpatient-management-of-children-with-severe-acute-malnutrition-a-pilot-randomized-controlled-trial-in-malawi
#4
Christian J Versloot, Wieger Voskuijl, Sara J van Vliet, Meta van den Heuvel, Jane C Carter, Ajib Phiri, Marko Kerac, Geert Tom Heikens, Patrick F van Rheenen, Robert H J Bandsma
BACKGROUND: The case fatality rate of severely malnourished children during inpatient treatment is high and mortality is often associated with diarrhea. As intestinal carbohydrate absorption is impaired in severe acute malnutrition (SAM), differences in dietary formulations during nutritional rehabilitation could lead to the development of osmotic diarrhea and subsequently hypovolemia and death. We compared three dietary strategies commonly used during the transition of severely malnourished children to higher caloric feeds, i...
April 26, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28445474/cost-effectiveness-of-a-transitional-pharmaceutical-care-program-for-patients-discharged-from-the-hospital
#5
Fatma Karapinar-Çarkıt, Ronald van der Knaap, Fatiha Bouhannouch, Sander D Borgsteede, Marjo J A Janssen, Carl E H Siegert, Toine C G Egberts, Patricia M L A van den Bemt, Marieke F van Wier, Judith E Bosmans
BACKGROUND: To improve continuity of care at hospital admission and discharge and to decrease medication errors pharmaceutical care programs are developed. This study aims to determine the cost-effectiveness of the COACH program in comparison with usual care from a societal perspective. METHODS: A controlled clinical trial was performed at the Internal Medicine department of a general teaching hospital. All admitted patients using at least one prescription drug were included...
2017: PloS One
https://www.readbyqxmd.com/read/28444124/predicting-discharge-to-institutional-long-term-care-following-acute-hospitalisation-a-systematic-review-and-meta-analysis
#6
Jennifer Kirsty Harrison, Katherine E Walesby, Lorna Hamilton, Carolyn Armstrong, John M Starr, Emma L Reynish, Alasdair M J MacLullich, Terry J Quinn, Susan D Shenkin
Background: moving into long-term institutional care is a significant life event for any individual. Predictors of institutional care admission from community-dwellers and people with dementia have been described, but those from the acute hospital setting have not been systematically reviewed. Our aim was to establish predictive factors for discharge to institutional care following acute hospitalisation. Methods: we registered and conducted a systematic review (PROSPERO: CRD42015023497)...
April 21, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28443506/catestain-a-master-regulator-of-cardiovascular-functions
#7
Sushil K Mahata, Malapaka Kiranmayi, Nitish R Mahapatra
Cardiovascular disease (CVD), the most common cause of death globally, accounts for ~30% of all deaths worldwide. Hypertension is a common contributor to morbidity and mortality from CVD. The plasma concentration of chromogranin A (CgA) is elevated in patients with CVD as well as patients with established human essential hypertension and heart failure (HF). In contrast, the plasma level of the CgA-derived peptide catestatin (CST) is diminished in human essential hypertension. Low conversion of CgA-to-CST has been associated with increased mortality in patients hospitalized with acute HF...
April 24, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28441676/transitioning-from-volume-to-value-one-academic-medical-center-s-approach-to-improving-population-health
#8
Stephanie A C Halvorson, Mary E Tanski, Thomas R Yackel
PROBLEM: The U.S. health care system is undergoing a major transformation. Clinical delivery systems are now being paid according to the value of the care they provide, in accordance with the Triple Aim, which incorporates improving the quality and cost of care and the patient experience. Increasingly, financial risk is being transferred from insurers to clinical delivery systems that become responsible for both episode-based clinical care and the longitudinal care of patients. Thus, these delivery systems need to develop strategies to manage the health of populations...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441324/designing-fit-for-purpose-health-and-social-services-for-ageing-populations
#9
Jean Woo
Population ageing is occurring in all countries, regardless of the level of economic development. While the rising burden of chronic diseases and disabilities as a consequence of this demographic transition is well recognized, the increasing prevalence of geriatric syndromes as a public health issue is not as well recognized. Recently the World Health Organization's World Health and Ageing Report emphasized functional ability as an important outcome for aging populations, highlighting the concept of raising intrinsic capacity throughout the life course...
April 25, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28440016/outcomes-and-feasibility-of-the-short-transitional-intervention-in-psychiatry-in-improving-the-transition-from-inpatient-treatment-to-the-community-a-pilot-study
#10
Anna Hegedüs, Bernd Kozel, Niklaus Fankhauser, Ian Needham, Johann Behrens
Discharge from psychiatric inpatient care is frequently described as chaotic, stressful, and emotionally charged. Following discharge, service users are vulnerable to becoming overwhelmed by the challenges involved in readapting to their home environments, which could result in serious problems and lead to readmission. The short transitional intervention in psychiatry (STeP) is a bridging intervention that includes pre- and post-discharge sections. It aims to prepare patients for specific situations in the period immediately following discharge from a psychiatric hospital...
April 25, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28439351/residents-exposure-to-educational-experiences-in-facilitating-hospital-discharges
#11
Eric Young, Chad Stickrath, Monica McNulty, Aaron J Calderon, Elizabeth Chapman, Jed D Gonzalo, Ethan F Kuperman, Max Lopez, Christopher J Smith, Joseph R Sweigart, Cecelia N Theobald, Robert E Burke
BACKGROUND: There is an incomplete understanding of the most effective approaches for motivating residents to adopt guideline-recommended practices for hospital discharges. OBJECTIVE: We evaluated internal medicine (IM) residents' exposure to educational experiences focused on facilitating hospital discharges and compared those experiences based on correlations with residents' perceived responsibility for safely transitioning patients from the hospital. METHODS: A cross-sectional, multi-center survey of IM residents at 9 US university- and community-based training programs in 2014-2015 measured exposure to 8 transitional care experiences, their perceived impact on care transitions attitudes, and the correlation between experiences and residents' perceptions of postdischarge responsibility...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28439147/a-semi-parametric-transformation-frailty-model-for-semi-competing-risks-survival-data
#12
Fei Jiang, Sebastien Haneuse
In the analysis of semi-competing risks data interest lies in estimation and inference with respect to a so-called non-terminal event, the observation of which is subject to a terminal event. Multi-state models are commonly used to analyse such data, with covariate effects on the transition/intensity functions typically specified via the Cox model and dependence between the non-terminal and terminal events specified, in part, by a unit-specific shared frailty term. To ensure identifiability, the frailties are typically assumed to arise from a parametric distribution, specifically a Gamma distribution with mean 1...
March 2017: Scandinavian Journal of Statistics, Theory and Applications
https://www.readbyqxmd.com/read/28438820/use-of-an-argatroban-based-purge-solution-in-a-percutaneous-ventricular-assist-device
#13
Benjamin Laliberte, Brent N Reed
PURPOSE: The use of an argatroban-based percutaneous ventricular assist device (pVAD) purge solution in a patient with suspected heparin-induced thrombocytopenia (HIT) is described. SUMMARY: A 70-year-old woman in cardiogenic shock was admitted to a coronary care unit after being discovered unresponsive at home. A transthoracic echocardiogram revealed a low ejection fraction and findings consistent with takotsubo cardiomyopathy. Administration of multiple inotropes and vasopressors was initially required for hemodynamic support...
May 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28438589/specialty-palliative-care-consultations-for-nursing-home-residents-with-dementia
#14
Susan C Miller, Julie C Lima, Orna Intrator, Edward Martin, Janet Bull, Laura C Hanson
CONTEXT: U.S. nursing home (NH) residents with dementia have limited access to specialty palliative care beyond Medicare hospice. OBJECTIVES: To examine the value of expanded palliative care access for NH residents with moderate to very severe dementia. METHODS: We merged palliative care consultation data in 31 NHs in two states to Medicare data to identify residents with consultations, moderate to very severe dementia, and deaths in 2006-2010...
April 21, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28437261/training-in-intraoperative-handover-and-display-of-a-checklist-improve-communication-during-transfer-of-care-an-interventional-cohort-study-of-anaesthesia-residents-and-nurse-anaesthetists
#15
Marion Jullia, Anaïs Tronet, Fabiola Fraumar, Vincent Minville, Olivier Fourcade, Xavier Alacoque, Yannick LeManach, Matt M Kurrek
BACKGROUND: Handovers during anaesthesia are common, and failures in communication may lead to morbidity and mortality. OBJECTIVES: We hypothesised that intraoperative handover training and display of a checklist would improve communication during anaesthesia care transition in the operating room. DESIGN: Interventional cohort study. SETTING: Single-centre tertiary care university hospital. PARTICIPANTS: A total of 204 random observations of handovers between anaesthesia providers (residents and nurse anaesthetists) over a 6-month period in 2016...
April 21, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28434275/cost-effectiveness-of-a-transitional-home-based-palliative-care-program-for-patients-with-end-stage-heart-failure
#16
Frances Kam Yuet Wong, Ching So, Alina Yee Man Ng, Po-Tin Lam, Jeffrey Sheung Ching Ng, Nancy Hiu Yim Ng, June Chau, Michael Mau Kwong Sham
BACKGROUND: Studies have shown positive clinical outcomes of specialist palliative care for end-stage heart failure patients, but cost-effectiveness evaluation is lacking. AIM: To examine the cost-effectiveness of a transitional home-based palliative care program for patients with end-stage heart failure patients as compared to the customary palliative care service. DESIGN: A cost-effectiveness analysis was conducted alongside a randomized controlled trial (Trial number: NCT02086305)...
April 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28433247/outpatient-laparoscopic-appendectomy-feasible-in-a-public-county-hospital
#17
David R Rosen, Kenji Inaba, Paul J Oh, Adam C Gutierrez, Aaron M Strumwasser, Subarna Biswas, Melody Cala, Glenn T Ault
BACKGROUND: Outpatient laparoscopic appendectomy is being used increasingly as a treatment option for acute, uncomplicated appendicitis. This was a prospective validation study in a large, urban, public safety-net hospital. STUDY DESIGN: From 2014 to 2016, all patients undergoing laparoscopic appendectomy for acute, uncomplicated appendicitis were enrolled in a prospective observational trial. Standard baseline perioperative practice (control group) was documented for 1 year...
March 13, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28432156/epidemiology-of-valvular-heart-disease-in-a-swedish-nationwide-hospital-based-register-study
#18
Pontus Andell, Xinjun Li, Andreas Martinsson, Charlotte Andersson, Martin Stagmo, Bengt Zöller, Kristina Sundquist, J Gustav Smith
OBJECTIVE: Transitions in the spectrum of valvular heart diseases (VHDs) in developed countries over the 20th century have been reported from clinical case series, but large, contemporary population-based studies are lacking. METHODS: We used nationwide registers to identify all patients with a first diagnosis of VHD at Swedish hospitals between 2003 and 2010. Age-stratified and sex-stratified incidence of each VHD and adjusted comorbidity profiles were assessed...
April 21, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28430838/elevated-pulse-pressure-levels-are-associated-with-increased-in-hospital-mortality-in-acute-spontaneous-intracerebral-hemorrhage
#19
Jason J Chang, Yasser Khorchid, Kira Dillard, Ali Kerro, Lucia Goodwin Burgess, Georgy Cherkassky, Nitin Goyal, Kristina Chapple, Anne W Alexandrov, David Buechner, Andrei V Alexandrov, Georgios Tsivgoulis
OBJECTIVES: Clinical outcome after intracerebral hemorrhage (ICH) remains poor. Definitive phase-3 trials in ICH have failed to demonstrate improved outcomes with intensive systolic blood pressure (SBP) lowering. We sought to determine whether other BP parameters-diastolic BP (DBP), pulse pressure (PP), and mean arterial pressure (MAP)-showed an association with clinical outcome in ICH. METHODS: We retrospectively analyzed a prospective cohort of 672 patients with spontaneous ICH and documented demographic characteristics, stroke severity, and neuroimaging parameters...
April 19, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28429611/consensus-statement-on-inpatient-use-of-continuous-glucose-monitoring
#20
Amisha Wallia, Guillermo E Umpierrez, Robert J Rushakoff, David C Klonoff, Daniel J Rubin, Sherita Hill Golden, Curtiss B Cook, Bithika Thompson
In June 2016, Diabetes Technology Society convened a panel of US experts in inpatient diabetes management to discuss the current and potential role of continuous glucose monitoring (CGM) in the hospital. This discussion combined with a literature review was a follow-up to a meeting, which took place in May 2015. The panel reviewed evidence on use of CGM in 3 potential inpatient scenarios: (1) the intensive care unit (ICU), (2) non-ICU, and (3) transitioning outpatient CGM use into the hospital setting. Panel members agreed that data from limited studies and theoretical considerations suggested that use of CGM in the hospital had the potential to improve patient clinical outcomes, and in particular reduction of hypoglycemia...
April 1, 2017: Journal of Diabetes Science and Technology
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