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Patient transfer quality

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https://www.readbyqxmd.com/read/28209192/learning-from-2523-trauma-deaths-in-india-opportunities-to-prevent-in-hospital-deaths
#1
Nobhojit Roy, Deepa Kizhakke Veetil, Monty Uttam Khajanchi, Vineet Kumar, Harris Solomon, Jyoti Kamble, Debojit Basak, Göran Tomson, Johan von Schreeb
BACKGROUND: A systematic analysis of trauma deaths is a step towards trauma quality improvement in Indian hospitals. This study estimates the magnitude of preventable trauma deaths in five Indian hospitals, and uses a peer-review process to identify opportunities for improvement (OFI) in trauma care delivery. METHODS: All trauma deaths that occurred within 30 days of hospitalization in five urban university hospitals in India were retrospectively abstracted for demography, mechanism of injury, transfer status, injury description by clinical, investigation and operative findings...
February 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28194689/exploring-physician-perspectives-of-residency-holdover-handoffs-a-qualitative-study-to-understand-an-increasingly-important-type-of-handoff
#2
Jonathan A Duong, Trevor P Jensen, Sasha Morduchowicz, Michelle Mourad, James D Harrison, Sumant R Ranji
BACKGROUND: The term "holdover admissions" refers to patients admitted by an overnight physician and whose care is then transferred to a new primary team the next morning. Descriptions of the holdover process in internal medicine are sparse. OBJECTIVE: To identify important factors affecting the quality of holdover handoffs at an internal medicine (IM) residency program and to compare them to previously identified factors for other handoffs. DESIGN: We undertook a qualitative study using structured focus groups and interviews...
February 13, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28188072/adjuvant-combination-therapy-with-gemcitabine-and-autologous-%C3%AE-%C3%AE-t-cell-transfer-in-patients-with-curatively-resected-pancreatic-cancer
#3
Taku Aoki, Hirokazu Matsushita, Mayumi Hoshikawa, Kiyoshi Hasegawa, Norihiro Kokudo, Kazuhiro Kakimi
BACKGROUND AIMS: The outcome for pancreatic cancer after surgery remains highly unsatisfactory, and development of more effective therapies is urgently needed. Therefore, we conducted a phase I clinical study of a novel combination of gemcitabine (GEM) and autologous γδ T-cell therapy for patients with curatively resected pancreatic cancer (University Hospital Medical Information Clinical Trials Registry identifier 000000931). METHODS: From July 2008 to December 2012, 56 consenting patients were recruited...
February 7, 2017: Cytotherapy
https://www.readbyqxmd.com/read/28187504/extreme-spermatogenesis-failure-andrological-phenotype-and-intracytoplasmic-sperm-injection-outcomes
#4
P Plouvier, A-L Barbotin, F Boitrelle, D Dewailly, V Mitchell, J-M Rigot, V Lefebvre-Khalil, G Robin
Patients with very low sperm count through direct sperm examination can exhibit extreme oligozoospermia or cryptozoospermia (after centrifugation). The management of these patients is a real challenge for both clinicians and biologists. In this retrospective and comparative cohort study, we compared the andrological phenotype of patients with extreme alterations of spermatogenesis and assessed whether the origin of spermatozoa (testicular or ejaculate) had any influence on intracytoplasmic sperm injection (ICSI) outcomes...
February 10, 2017: Andrology
https://www.readbyqxmd.com/read/28186071/complex-clinical-communication-practices-how-do-information-receivers-assimilate-and-act-upon-information-for-patient-care
#5
Ming Chao Wong, Kwang Chien Yee, Paul Turner
Improving clinical communication is imperative to improving the quality and safety of patient care. Significant efforts have been made to improve clinical communication and patient safety, guided by the mantra of "the right information, to the right person, in the right place, at the right time". The design and implementation of information communication technologies (ICTs) has been considered as one of the major developments in improving patient care. Clinical communication in today's clinical practice is complex and involves multi-disciplinary teams using different types of media for information transfer...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28185121/the-association-between-coenzyme-q10-concentrations-in-follicular-fluid-with-embryo-morphokinetics-and-pregnancy-rate-in-assisted-reproductive-techniques
#6
Süleyman Akarsu, Funda Gode, Ahmet Zeki Isik, Zeliha Günnur Dikmen, Mustafa Agah Tekindağ
PURPOSE: This study seeks to evaluate the association between follicular fluid (FF) coenzyme Q10 (CoQ10) levels, embryo morphokinetics, and pregnancy rate. METHODS: Sixty infertile patients who underwent intracytoplasmic sperm injection (ICSI) cycles were included in the study. For each patient, CoQ10 level of the follicular fluid was measured by high-performance liquid chromatography system. After the ICSI of each oocyte, the relationship between the level of CoQ10 content of each follicular fluid, the subsequent embryo quality, and embryo morphokinetics was investigated...
February 9, 2017: Journal of Assisted Reproduction and Genetics
https://www.readbyqxmd.com/read/28178942/in-vitro-comparative-optical-bench-analysis-of-a-spherical-and-aspheric-optic-design-of-the-same-iol-model
#7
Tamer Tandogan, Gerd U Auffarth, Chul Y Choi, Stephanie Liebing, Christian Mayer, Ramin Khoramnia
BACKGROUND: To analyse objective optical properties of the spherical and aspheric design of the same intraocular lens (IOL) model using optical bench analysis. METHODS: This study entailed a comparative analysis of 10 spherical C-flex 570 C and 10 aspheric C-flex 970 C IOLs (Rayner Intraocular Lenses Ltd., Hove, UK) of 26 diopters [D] using an optical bench (OptiSpheric, Trioptics, Germany). In all lenses, we evaluated the modulation transfer function (MTF) at 50 lp/mm and 100 lp/mm and the Strehl Ratio using a 3-mm (photopic) and 4...
February 8, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/28176132/checking-rounds-for-isolation-precautions-in-the-control-of-multidrug-resistant-organisms-reduction-achieved
#8
P Barbadoro, E Martini, M G Gioia, R Stoico, S Savini, E Manso, G Serafini, E Prospero, M M D'Errico
The objective of this investigation was to analyze the effectiveness of a quality improvement initiative in limiting the spread of multidrug-resistant organisms (MDROs) in the hospital setting. During the period 2011-2013, a multimodal intervention was activated at a tertiary care center in Italy. The intervention included: laboratory-based surveillance, interdisciplinary training sessions, monitoring the adoption of isolation precautions and daily supervision provided by infection control nurses, and a monthly feedback...
February 7, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28175981/-catheter-ablation-of-ventricular-extrasystoles-and-ventricular-tachycardia-in-the-elderly
#9
Philipp Halbfaß, Karin Nentwich, Kai Sonne, Elena Ene, Franziska Fochler, Andreas Mügge, Bernhard Schieffer, Thomas Deneke
BACKGROUND: The prevalence of structural heart disease increases with higher age, and thereby the basis for ventricular arrhythmias is created. Catheter ablation has been shown to be an effective therapy option that is very safe and achieves good long-term results in patients with recurrent ventricular tachycardia (VT). Data regarding ablation in patients older than 75 years is sparse, although this patient group was included as a minority in most published VT ablation studies. Data from younger patient collectives may not be transferable to older patient cohorts due to differences in patient comorbidities and baseline characteristics...
February 7, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28169946/differences-in-utilization-of-life-support-and-end-of-life-care-for-medical-icu-patients-with-versus-without-cancer
#10
Geoffrey Koff, Urvashi Vaid, Edward Len, Albert Crawford, David A Oxman
OBJECTIVES: To explore differences in the utilization of life support and end-of-life care between patients dying in the medical ICU with cancer compared with those without cancer. DESIGN: Retrospective review of 403 deaths or hospice transfers in the medical ICU from January 1, 2012, to June 30, 2013. SETTING: Urban tertiary care university hospital. PATIENTS: Consecutive medical ICU deaths or hospice transfers over an 18-month period...
February 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28169189/ovarian-stimulation-protocols-for-ivf-is-more-better-than-less
#11
REVIEW
Michael M Alper, Bart C Fauser
Conventional ovarian stimulation protocols for IVF are designed to achieve maximum oocyte yields. Conventional protocols, however, are associated with patient discomfort, increased risk of ovarian hyperstimulation syndrome and higher costs. In recent years, mild stimulation protocols have risen in popularity. These protocols typically use lower doses (≤150 IU/day), shorter duration of exogenous gonadotrophins, or both, compared with conventional protocols, with the goal of limiting the number of retrieved oocytes to less than eight...
January 24, 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/28166137/vascular-complications-and-free-flap-salvage-in-head-and-neck-reconstructive-surgery-analysis-of-150-cases-of-reexploration
#12
Yen-Hao Chiu, Dun-Hao Chang, Cherng-Kang Perng
INTRODUCTION: Despite the excellent reliability of free tissue transfer, flap failure is devastating, and in addition to patient morbidity, it may increase hospital stay and associated costs. Previous studies have evaluated factors related to flap salvage, regarding the operative strategy for flap salvage surgery. The present study aimed to share our experience of reexploration and describe operative standards dealing with vascular thrombosis. METHODS: We retrospectively reviewed 150 (of 1258) free flaps for head and neck reconstruction that showed signs of vascular compromise at our institution during a 13-year period between 2002 and 2015...
February 4, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28157644/the-future-for-follow-up-of-gynaecological-cancer-in-europe-summary-of-available-data-and-overview-of-ongoing-trials
#13
REVIEW
S C Leeson, K Beaver, N P M Ezendam, R Mačuks, P L Martin-Hirsch, T Miles, M M Jeppesen, P T Jensen, P Zola
After completing treatment, most patients follow a pre-determined schedule of regular hospital outpatient appointments, which includes clinical examinations, consultations and routine tests. After several years of surveillance, patients are transferred back to primary care. However, there is limited evidence to support the effectiveness and efficiency of this approach. This paper examines the current rationale and evidence base for hospital-based follow-up after treatment for gynaecological cancer. We investigate what alternative models of care have been formally evaluated and what research is currently in progress in Europe, in order to make tentative recommendations for a model of follow-up...
January 19, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28156629/a-whole-greater-than-the-sum-of-the-parts-close-collaboration-between-palliative-care-and-clinical-ethics
#14
(no author information available yet)
: 53 Background: The disciplines of palliative care (PC) and clinical ethics (CE) share common content but also important distinctions in method, skill set, and clinical role in a given patient encounter. Particularly in cases of advance care planning, complex decision-making, and clarifying goals oncology teams may be challenged to know which consultation service to involve. METHODS: Case report and commentary. RESULTS: A 60 year-old man with a 3-year history of glioblastoma multiforme presented with sudden onset right-sided weakness and altered mental status...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156518/the-estimated-hospital-wide-financial-impact-of-a-comprehensive-inpatient-palliative-care-pc-program
#15
Chunhua Lu, John P McQuade, A Rab Razzak, Natasha Gill, Michael A Cardamone, Deirdre Torto, Terry Langbaum, David R Holtgrave, Thomas J Smith
: 173 Background: Inpatient PC improves quality of care, patient and family satisfaction, and lowers costs. PC consultation during a cancer hospital stay led to a 14 (if by day 6) to 24% (by day 2) reduction in direct cost, and especially when people had comorbidities. (May, JCO 2015; Health Affairs 2016). We attempted to discern the financial impact of both a PC inpatient unit (PCU) and PC consultations on patients in other inpatient units for a large academic medical center, the Johns Hopkins Hospital (JHH), as we prepared to expand the PCU from 6 to11 beds and increased inpatient PC consultation capacity...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156435/sleep-quality-among-inpatients-with-acute-myeloid-leukemia
#16
Kelli Aibel, Ryan Meyerhoff, David Harpole, Amy Pickar Abernethy, Chi-Fu Jeffrey Yang
: 82 Background: Anecdotally, sleep is thought to be a significant problem for inpatients receiving treatment for acute myeloid leukemia (AML), butsleep disturbances in this setting are not well-characterized. We aimed to assess the feasibility of measuring sleep in AML patients using a wearable actigraphy device. METHODS: Using the Actigraph GT3X "watch,"we assessed the total sleep time, sleep onset latency, wake after sleep onset, number of awakenings after sleep onset, and sleep efficiency for inpatients with AML receiving induction chemotherapy during their hospitalization...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152964/publication-of-quality-improvement-in-medical-oncology-a-descriptive-numerical-summary-from-a-scoping-review
#17
Bryan B Franco, Matthew C Cheung, Adam E Haynes, Brian M Wong, Simron Singh
: 251 Background: Quality improvement (QI) is becoming a professional expectation and essential to medical oncology practice. A study of medical oncologists found that most QI interventions are not published, suggesting barriers to knowledge dissemination. We aim to describe the authors, settings of QI interventions, and publishing journals of scholarly QI literature. METHODS: We conducted a scoping review using Arksey and O'Malley's framework. A search of MEDLINE and EMBASE databases found 48,186 unique English citations from January 2001 to August 2014...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152936/improving-transitions-of-care-through-implementation-of-a-standardized-handoff-at-a-comprehensive-cancer-center
#18
Mohamed Ait Aiss, Helene P Phu, Lakeisha R Day, Varkey Abraham, Karen Chen, Mejia Rodrigo, Shehla Razvi, Carmen E Gonzalez, Norman Brito-Dellan, Srinivas Banala, David Rubio, Nicole Vaughan-Adams, Debra S Ruiz, Tan Jens, Charles F Levenback, Michael M Frumovitz, Behrouz Zand, Carmelita P Escalante
: 242 Background: Communication failures cause two-thirds of sentinel events in hospitals. These adverse occurrences are often both fatal and preventable. Consequently, improving the quality of handoffs has been identified by multiple accreditation constituents as a top priority patient safety goal. This project was part of an institutional initiative to standardize handoffs among physicians, trainees, and midlevel providers. METHODS: Four subgroups were identified as pilot areas: Gynecologic Oncology (Gyn Onc) fellows to nocturnalists, Surgical Oncology fellows, Pediatric Oncology residents and fellows, and Emergency Center attending staff to inpatient hospitalists...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152929/safer-transitions-of-care-at-a-major-cancer-center-the-emergency-center-to-hospitalist-experience
#19
Carmen E Gonzalez, Norman Brito-Dellan, David Rubio, Mohamed Ait Aiss, Terry Rice, Karen Chen, Diane C Bodurka, Carmelita P Escalante
: 247 Background: Failures in communication lead to serious medical errors particularly during transitions of care. A standardized handoff of patients requiring admission to the inpatient setting between the Emergency Center (EC) and the Hospitalist Inpatient Service (HIS) at a comprehensive cancer center was lacking during this vulnerable time. METHODS: A quality pilot study using Plan, Do, Study, Act methodology was conducted. First, root cause analysis and process mapping of the current state was performed to identify pitfalls of the handoff process between the EC and the Hospitalist Service...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152895/effects-of-admission-adm-source-time-and-provider-on-inpatient-inpt-oncology-onc-outcomes-at-the-cleveland-clinic-foundation-ccf
#20
Lindsey Martin Goodman, Lisa A Rybicki, Alberto J Montero, Bassam N Estfan, Carolyn Best, James Stevenson
: 140 Background: The quality of care transfers is known to influence clinical outcomes. In an inpt onc setting at a major tertiary care referral center, patient (pt) adm originate from many different areas and times. A detailed evaluation of onc adm by source of transfer, admission time, and provider type, may identify opportunities to improve inpt clinical outcomes. METHODS: We retrospectively reviewed all adm to the inpt solid tumor onc service from July - December 2014 from CCF regional hospital emergency departments (ED), outside hospital (OSH) ED, OSH inpt services, and CCF outpt clinics...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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