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transitional care interventions

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https://www.readbyqxmd.com/read/28633453/a-multifaceted-quality-improvement-strategy-reduces-the-risk-of-catheter-associated-urinary-tract-infection
#1
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/28626151/changes-in-social-interaction-over-20-years-and-the-effects-of-community-resources-use-among-community-dwelling-elderly-persons
#2
Kumi Watanabe, Emiko Tanaka, Bailiang Wu, Zyunko Kobayashi, Yukiko Mochizuki, Yeon Kim, Taeko Watanabe, Rika Okumura, Sumio Ito, Tokie Anme
Objectives Recently, social isolation has been reported to be a critical problem among Japanese elderly persons. However, few studies have compared social interaction in the past and the present or investigated its predictive factors. This study aimed to clarify the transitional changes in social interaction over 20 years and explore the factors related to social interaction focusing on the use of community resources.Methods The participants were community-dwelling elderly persons aged 65 years and over...
2017: [Nihon Kōshū Eisei Zasshi] Japanese Journal of Public Health
https://www.readbyqxmd.com/read/28623892/improving-transitions-in-acute-stroke-patients-discharged-to-home-the-michigan-stroke-transitions-trial-mistt-protocol
#3
Mathew J Reeves, Anne K Hughes, Amanda T Woodward, Paul P Freddolino, Constantinos K Coursaris, Sarah J Swierenga, Lee H Schwamm, Michele C Fritz
BACKGROUND: For some stroke patients and caregivers, navigating the transition between hospital discharge and returning home is associated with substantial psychosocial and health-related challenges. Currently, no evidence-based standard of care exists that addresses the concerns of stroke patients and caregivers during the transition period. Objectives of the Michigan Stroke Transitions Trial (MISTT) are to test the impact of a social worker home-based case management program, as well as an online information and support resource, on patient and caregiver outcomes after returning home...
June 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28619024/communication-with-young-people-in-paediatric-and-adult-endocrine-consultations-an-intervention-development-and-feasibility-study
#4
J Downing, H Gleeson, P E Clayton, J R E Davis, P Dimitri, J Wales, B Young, P Callery
BACKGROUND: Communication is complex in endocrine care, particularly during transition from paediatric to adult services. The aims of this study were to examine the feasibility of interventions to support young people to interact with clinicians. METHODS: Development and evaluation of a complex intervention in 2 phases: Pre-intervention observational study; Intervention feasibility study. Purposive sample of recordings of 62 consultations with 58 young people aged 11-25 years with long-term endocrine conditions in two paediatric and two adult endocrine clinics...
June 15, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28617022/reducing-hospital-readmission-through-team-based-primary-care-a-7-week-pilot-study-integrating-behavioral-health-and-pharmacy
#5
Lauren N DeCaporale-Ryan, Nabila Ahmed-Sarwar, Robbyn Upham, Karen Mahler, Katie Lashway
INTRODUCTION: A team-based service delivery model was applied to provide patients with biopsychosocial care following hospital discharge to reduce hospital readmission. Most previous interventions focused on transitions of care occurred in the inpatient setting with attention to predischarge strategies. These interventions have not considered psychosocial stressors, and few have explored management in primary care settings. METHOD: A 7-week team-based service delivery model was implemented in a family medicine practice emphasizing a biopsychosocial approach...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28605555/operationalizing-multidisciplinary-assessment-and-treatment-as-a-quality-metric-for-interventional-pain-practices
#6
Edward K Heres, David Itskevich, Ajay D Wasan
Objective.:  Quality improvement (QI) is an underutilized approach among pain medicine specialists to improve comprehensive pain assessment and the delivery of multimodal pain care. We report the results of a QI program that utilized peer review and financial incentives to improve these processes in interventional pain clinics. Design.:  Retrospective chart review. Setting.:  Eight academic and community-based practices that included separate hospital-based and non-hospital-based interventional pain clinics...
June 12, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28601691/effects-of-a-nurse-led-transitional-care-program-on-clinical-outcomes-health-related-knowledge-physical-and-mental-health-status-among-chinese-patients-with-coronary-artery-disease-a-randomized-controlled-trial
#7
Pan Zhang, Yu-Ding Hu, Feng-Mei Xing, Chang-Zai Li, Wang-Feng Lan, Xiao-Li Zhang
BACKGROUND: Coronary artery disease is a major cause of morbidity and mortality among adults worldwide, including China. After a hospital stay, transitional care could help to ensure improved patient care and outcomes, and reduce Medicare costs. Nevertheless, the results of the existing transitional care are not always satisfactory and our knowledge of how to perform effective transitional care for patients with coronary artery disease is limited in mainland China. OBJECTIVES: To examine the effectiveness of a nurse-led transitional care program on clinical outcomes, health-related knowledge, and physical and mental health status among Chinese patients with coronary artery disease...
April 14, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28601329/predictors-of-readmission-in-nonagenarians-analysis-of-the-american-college-of-surgeons-national-surgical-quality-improvement-project-dataset
#8
Zachary Hothem, Dustin Baker, Christina S Jenkins, Jason Douglas, Rose E Callahan, Catherine C Shuell, Graham W Long, Robert J Welsh
BACKGROUND: Increased longevity has led to more nonagenarians undergoing elective surgery. Development of predictive models for hospital readmission may identify patients who benefit from preoperative optimization and postoperative transition of care intervention. Our goal was to identify significant predictors of 30-d readmission in nonagenarians undergoing elective surgery. METHODS: Nonagenarians undergoing elective surgery from January 2011 to December 2012 were identified using the American College of Surgeons National Surgical Quality Improvement Project participant use data files...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28599601/effect-of-pharmacy-supported-transition-of-care-interventions-on-30-day-readmissions-a-systematic-review-and-meta-analysis
#9
Claire R Rodrigues, Amanda R Harrington, Nicole Murdock, John T Holmes, Eliza Z Borzadek, Kristin Calabro, Jennifer Martin, Marion K Slack
OBJECTIVE: To describe pharmacy-supported transition-of-care (TOC) interventions and determine their effect on 30-day all-cause readmissions. DATA SOURCES: MEDLINE/PubMed, EMBASE, International Pharmaceutical Abstracts, ABI Inform Complete, PsychINFO, Web of Science, Academic Search Complete, CINHAL, Cochrane library, OIASTER, ProQuest Dissertations & Theses, ClinicalTrials.gov , and relevant websites were searched from January 1, 1995, to December 31, 2015. STUDY SELECTION AND DATA EXTRACTION: PICOS+E criteria were utilized...
June 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28599029/transition-consultation-models-in-two-academic-medical-centers
#10
Jessica I Gold, Rebecca Boudos, Parag Shah, Rita Rossi-Foulkes
Health care transition (HCT), the organized progression from pediatric- to adult-focused models of care, is crucial for patients with chronic childhood conditions. More adolescents with chronic conditions now survive into adulthood and have increased risk of adverse events during HCT. Got Transition-an agreement between the Maternal and Child Health Bureau and the National Alliance to Advance Adolescent Health-developed the Six Core Elements of Health Care Transition 2.0, defining the components of HCT. Most HCT programs incorporate these elements, but delivery varies...
June 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28597827/inflammatory-bowel-disease-in-childhood-and-adolescence
#11
Jan Däbritz, Patrick Gerner, Axel Enninger, Martin Claßen, Michael Radke
BACKGROUND: The incidence of inflammatory bowel disease (IBD) in childhood and adolescence is 5-11 cases per 100 000 persons per year, corresponding to a new diagnosis of IBD in 800-1470 patients in Germany each year. METHODS: This review is based on pertinent publications retrieved by a selective search in PubMed, including guidelines from Germany and abroad. RESULTS: Children and adolescents with IBD often have extensive involvement and an aggressive course of disease...
May 12, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28581820/barriers-and-facilitators-to-hiv-testing-among-zambian-female-sex-workers-in-three-transit-hubs
#12
Michael M Chanda, Amaya G Perez-Brumer, Katrina F Ortblad, Magdalene Mwale, Steven Chongo, Nyambe Kamungoma, Catherine Kanchele, Andrew Fullem, Leah Barresi, Till Bärnighausen, Catherine E Oldenburg
Zambia has a generalized HIV epidemic, and HIV is concentrated along transit routes. Female sex workers (FSWs) are disproportionately affected by the epidemic. HIV testing is the crucial first step for engagement in HIV care and HIV prevention activities. However, to date little work has been done with FSWs in Zambia, and little is known about barriers and facilitators to HIV testing in this population. FSW peer educators were recruited through existing sex worker organizations for participation in a trial related to HIV testing among FSWs...
June 5, 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28576266/safety-and-tolerability-of-transitioning-from-cangrelor-to-ticagrelor-in-patients-who-underwent-percutaneous-coronary-intervention
#13
Hisham A Badreldin, Danielle Carter, Bryan M Cook, Arman Qamar, Muthiah Vaduganathan, Deepak L Bhatt
The 3 phase 3 CHAMPION (Cangrelor vs Standard Therapy to Achieve Optimal Management of Platelet Inhibition) trials collectively demonstrated the safety of transitioning from cangrelor, a potent, parenteral rapidly-acting P2Y12 inhibitor, to clopidogrel in patients who underwent percutaneous coronary intervention (PCI). However, variation in timing of therapy, site-specific binding, and drug half-lives may theoretically complicate switching to other oral P2Y12 inhibitors. Since regulatory approval, limited data are available regarding the "real-world" safety and tolerability of transitioning to these more potent oral P2Y12 antagonists...
May 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28575351/-enquire-into-all-the-circumstances-of-the-patient-narrowly-john-rutherford-s-clinical-lectures-in-edinburgh-1749-53
#14
Stephen C Craig
Early eighteenth-century Edinburgh provided a unique learning environment for aspiring practitioners: one in which the unity of medicine and surgery was appreciated and clinical observations and a reasoning practitioner became the well spring of proper patient care. John Rutherford, a surgical apprentice in this environment, student on the wards of London hospitals and under Boerhaave at Leiden, became one of the original medical professors at the University of Edinburgh medical school in 1726. Rutherford taught the popular, theory-based Practice of Medicine for twenty-two years...
May 29, 2017: Journal of the History of Medicine and Allied Sciences
https://www.readbyqxmd.com/read/28568245/quality-metrics-and-systems-transformation-are-we-advancing-alcohol-and-drug-screening-in-primary-care
#15
Traci Rieckmann, Stephanie Renfro, Dennis McCarty, Robin Baker, K John McConnell
OBJECTIVE: To examine the influence of Oregon's coordinated care organizations (CCOs) and pay-for-performance incentive model on completion of screening and brief intervention (SBI) and utilization of substance use disorder (SUD) treatment services. DATA SOURCES/STUDY SETTING: Secondary analysis of Medicaid encounter data from 2012 to 2015 and semiannual qualitative interviews with stakeholders in CCOs. STUDY DESIGN: Longitudinal mixed-methods design with simultaneous data collection with equal importance...
May 31, 2017: Health Services Research
https://www.readbyqxmd.com/read/28559370/listen-and-learn-engaging-young-people-their-families-and-schools-in-early-intervention-research
#16
Charlotte Connor
Recent policy guidelines highlight the importance of increasing the identification of young people at risk of developing mental health problems in order to prevent their transition to long-term problems, avoid crisis and remove the need for care through specialist mental health services or hospitalisation. Early awareness of the often insidious behavioural and cognitive changes associated with deteriorating mental well-being, however, is difficult, but it is vital if young people, their families and those who work with them are to be fully equipped with the skills to aid early help-seeking...
June 2017: Medical Humanities
https://www.readbyqxmd.com/read/28557720/a-family-centered-rounds-checklist-family-engagement-and-patient-safety-a-randomized-trial
#17
Elizabeth D Cox, Gwen C Jacobsohn, Victoria P Rajamanickam, Pascale Carayon, Michelle M Kelly, Tosha B Wetterneck, Paul J Rathouz, Roger L Brown
BACKGROUND AND OBJECTIVES: Family-centered rounds (FCRs) have become standard of care, despite the limited evaluation of FCRs' benefits or interventions to support high-quality FCR delivery. This work examines the impact of the FCR checklist intervention, a checklist and associated provider training, on performance of FCR elements, family engagement, and patient safety. METHODS: This cluster randomized trial involved 298 families. Two hospital services were randomized to use the checklist; 2 others delivered usual care...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28557586/qualitative-study-of-patients-and-caregivers-perceptions-and-information-preferences-about-hospice
#18
Areej El-Jawahri, Lara Traeger, Jennifer A Shin, Helen Knight, Kristina Mirabeau-Beale, Joel Fishbein, Harry H Vandusen, Vicki A Jackson, Angelo E Volandes, Jennifer S Temel
OBJECTIVE: The goal of this study is to assess perceptions about hospice among patients with metastatic cancer and their caregivers (i.e., family and/or friends). DESIGN AND SETTING: We conducted semi-structured interviews with 16 adult patients with a prognosis ≤12 months and 7 of their caregivers. The interviews focused on perceptions, knowledge, and information preferences about hospice. Two raters coded interviews independently (κ > 0.85). We used a framework approach for data analysis...
May 30, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28551043/improving-transitions-to-post-acute-care-for-elderly-patients-using-a-novel-video-conferencing-program-echo-care-transitions
#19
Amber B Moore, J Elyse Krupp, Alyssa B Dufour, Mousumi Sircar, Thomas G Travison, Alan Abrams, Grace Farris, Melissa L P Mattison, Lewis A Lipsitz
PURPOSE: Within 30 days of hospital discharge to a skilled nursing facility, older adults are at high risk for death, re-hospitalization and high-cost healthcare. The purpose of this study was to examine whether a novel videoconference program called Extension for Community Health Outcomes-Care Transitions (ECHO-CT) that connects an interdisciplinary hospital-based team with clinicians at skilled nursing facilities, reduces patient mortality, hospital readmission, skilled nursing facility length of stay and 30-day health care costs...
May 24, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28549765/improving-patient-centered-transitional-care-after-complex-abdominal-surgery
#20
Alexandra W Acher, Stephanie A Campbell-Flohr, Maria Brenny-Fitzpatrick, Kristine M Leahy-Gross, Sara Fernandes-Taylor, Alexander V Fisher, Suresh Agarwal, Amy J Kind, Caprice C Greenberg, Pascale Carayon, Sharon M Weber
BACKGROUND: Poor-quality transitions of care from hospital to home contribute to high rates of readmission after complex abdominal surgery. The Coordinated Transitional Care (C-TraC) program improved readmission rates in medical patients, but evidence-based surgical transitional care protocols are lacking. This pilot study evaluated the feasibility and preliminary effectiveness of an adapted surgical C-TraC protocol. STUDY DESIGN: The intervention includes in-person enrollment of patients...
May 18, 2017: Journal of the American College of Surgeons
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