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Care coordination high risk

William J Meurer, Bradley Barth, Michael Abraham, Jerome Hoffman, Gary M Vilke, Gerard DeMers
BACKGROUND: Stroke treatment is a continuum that begins with the rapid identification of symptoms and treatment with transition to successful rehabilitation. Therapies for acute ischemic stroke (AIS) may vary based on anatomic location, interval from symptom onset, and coexisting health conditions. Successful therapy requires a seamless systematic approach with coordination from prehospital environment through acute management at medical facilities to disposition and long-term care of the patient...
March 12, 2018: Journal of Emergency Medicine
Beth S Brodsky, Aliza Spruch-Feiner, Barbara Stanley
Suicide is reaching epidemic proportions, with over 44,000 deaths by suicide in the US, and 800,000 worldwide in 2015. This, despite research and development of evidence-based interventions that target suicidal behavior directly. Suicide prevention efforts need a comprehensive approach, and research must lead to effective implementation across public and mental health systems. A 10-year systematic review of evidence-based findings in suicide prevention summarized the areas necessary for translating research into practice...
2018: Frontiers in Psychiatry
Kate Laver, Emmanuel Gnanamanickam, Craig Whitehead, Susan Kurrle, Megan Corlis, Julie Ratcliffe, Wendy Shulver, Maria Crotty
Objectives Health services worldwide are increasingly adopting consumer directed care approaches. Traditionally, consumer directed care models have been implemented in home care services and there is little guidance as to how to implement them in residential care. This study used a citizens' jury to elicit views of members of the public regarding consumer directed care in residential care. Methods A citizens' jury involving 12 members of the public was held over two days in July 2016, exploring the question: For people with dementia living in residential care facilities, how do we enable increased personal decision making to ensure that care is based on their needs and preferences? Jury members were recruited through a market research company and selected to be broadly representative of the general public...
January 1, 2018: Journal of Health Services Research & Policy
Takeshi Yamamoto
High-risk pulmonary embolism (PE) is a life-threatening disorder associated with high mortality and morbidity. Most deaths in patients with shock occur within the first few hours after presentation, and rapid diagnosis and treatment is therefore essential to save patients' lives. The main manifestations of major PE are acute right ventricular (RV) failure and hypoxia. RV pressure overload is predominantly related to the interaction between the mechanical pulmonary vascular obstruction and the underlying cardiopulmonary status...
2018: Journal of Intensive Care
Jan Wilhelm, Ximena Calvo, Carola Escobar, Gabriela Moreno, Liliana Véliz, Rodolfo Villena, Marcela Potin
Although vaccines have had a tremendous impact in public health they are questioned by certain groups that consider them unnecessary or unsafe and argue in favor of the right to decide to be vaccinated or not. However vaccines must have special considerations because unlike other medical decisions, not vaccinating has consequences not only for the individual but also for other members of the community. Immunizing a high proportion of the population limits the circulation of an infectious agent attaining what is called herd immunity that protects the susceptible members of the group...
December 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Joanna-Grace M Manzano, Ming Yang, Hui Zhao, Linda S Elting, Marina C George, Ruili Luo, Maria E Suarez-Almazor
PURPOSE: Readmission within 30 days has been used as a metric for quality of care received at hospitals for certain diagnoses. In the era of accountability, value-based care, and increasing cancer costs, policymakers are looking into cancer readmissions as well. It is important to describe the readmission profile of patients with cancer in the most clinically relevant approach to inform policy and health care delivery that can positively impact patient outcomes. PATIENTS AND METHODS: We conducted a retrospective cohort study using linked Texas Cancer Registry and Medicare claims data...
February 13, 2018: Journal of Oncology Practice
Marie-Ève Beauregard, Sylvie Provost, Raynald Pineault, Dominique Grimard, José Pérez, Michel Fournier
INTRODUCTION: In 2011, the Agence de la santé et des services sociaux de Montréal (ASSSM), in partnership with the region's Centres de santé et de services sociaux (CSSS), coordinated the implementation of a program on cardiometabolic risk based on the Chronic Care Model. The program, intended for patients suffering from diabetes or hypertension, involved a series of individual follow-up appointments, group classes and exercise sessions. Our study assesses the impact on patient health outcomes of variations in the implementation of some aspects of the program among the six CSSSs taking part in the study...
February 2018: Health Promotion and Chronic Disease Prevention in Canada
Brian G Tang, Henry C Lee, Erika E Gray, Jeffrey B Gould, Susan R Hintz
OBJECTIVE:  This article characterizes programmatic features of a population-based network of high-risk infant follow-up programs and identifies potential challenges associated with attendance from the providers' perspective. STUDY DESIGN:  A web-based survey of high-risk infant follow-up program directors, coordinators, and providers of a statewide high-risk infant follow-up system. Frequencies and percentages were used to describe the survey responses. RESULTS:  Of the 68 high-risk infant follow-up programs in California, 56 (82%) responded to the survey...
February 13, 2018: American Journal of Perinatology
Robert J Graham, Michael L McManus, Angie Mae Rodday, Ruth Ann Weidner, Susan K Parsons
OBJECTIVE: To describe program design, costs, and savings implications of a critical care-based care coordination model for medically complex children with chronic respiratory failure. DESIGN: All program activities and resultant clinical outcomes were tracked over 4 years using an adapted version of the Care Coordination Measurement Tool. Patient characteristics, program activity, and acute care resource utilization were prospectively documented in the adapted version of the Care Coordination Measurement Tool and retrospectively cross-validated with hospital billing data...
February 3, 2018: Pediatric Critical Care Medicine
Line Toft Tengberg
Critically ill acute high-risk abdominal surgery patients represent a major challenge to health care providers, with the typical patient being elderly and frail, and with severe and multiple comorbidities. The mortality rate in this population is high, and the postoperative course is characterized by complications, prolonged hospitalisation and considerable risk of permanent disability. With an ageing population, the number of elderly patients, as well as challenges concerning treatment will arise, calling for a coordinated effort both nationally and internationally to enhance treatment in this vulnerable patient group...
February 2018: Danish Medical Journal
Robin Mathews, William Wang, Lisa A Kaltenbach, Laine Thomas, Rashmee U Shah, Murtuza Ali, Eric D Peterson, Tracy Y Wang
Background -Medication adherence is important to improve long-term outcomes after acute myocardial infarction (MI). We hypothesized that there is significant variation among United States (U.S.) hospitals in terms of post-MI medication adherence, and that patients treated at hospitals with higher post-MI medication adherence will have better long-term cardiovascular outcomes. Methods -We identified 19,704 Medicare patients discharged after acute MI from 347 U.S. hospitals participating in the Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines (ACTION Registry-GWTG) from 1/2/2007 to 10/1/2010...
January 31, 2018: Circulation
Gilgamesh Eamer, Amir Taheri, Sidian S Chen, Quinn Daviduck, Thane Chambers, Xinzhe Shi, Rachel G Khadaroo
BACKGROUND: Aging populations are at increased risk of postoperative complications. New methods to provide care for older people recovering from surgery may reduce surgery-related complications. Comprehensive geriatric assessment (CGA) has been shown to improve some outcomes for medical patients, such as enabling them to continue living at home, and has been proposed to have positive impacts for surgical patients. CGA is a coordinated, multidisciplinary collaboration that assesses the medical, psychosocial and functional capabilities and limitations of an older person, with the goal of establishing a treatment plan and long-term follow-up...
January 31, 2018: Cochrane Database of Systematic Reviews
Estelle Everett, Nestoras Mathioudakis
Diabetic foot ulcers (DFUs) are a serious complication of diabetes that results in significant morbidity and mortality. Mortality rates associated with the development of a DFU are estimated to be 5% in the first 12 months, and 5-year morality rates have been estimated at 42%. The standard practices in DFU management include surgical debridement, dressings to facilitate a moist wound environment and exudate control, wound off-loading, vascular assessment, and infection and glycemic control. These practices are best coordinated by a multidisciplinary diabetic foot wound clinic...
January 2018: Annals of the New York Academy of Sciences
Jeffrey A Marbach, Drew Johnson, Juergen Kloo, Amit Vira, Scott Keith, Walter K Kraft, Natalie Margules, David Whellan
Hospital discharge is a high-risk time period, and acute myocardial infarction (AMI) patients often have early readmissions. The authors hypothesized that a multifaceted AMI care coordination program would reduce early hospital readmission rates. The outcomes of patients receiving care coordination (n = 304) were compared to patients receiving standard care (n = 192). Multivariable analyses of the outcomes were conducted by conditional logistic regression of propensity score matched sets. The primary outcome-hospital readmission within 30 days of discharge-occurred in 18% of standard care patients and 11...
January 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
Rebecca Tyrrell, Karen Doyle, Thomas M Scalea, Deborah M Stein
BACKGROUND: We have previously demonstrated effectiveness of a Trauma Transitional Care Coordination Program (TTCC) in reducing 30-day readmission rates for trauma patients most at risk. With program maturation, we achieved improved readmission rates for specific patient populations. METHODS: TTCC is a nursing driven program that supports patients at high risk for 30-day readmission. TTCC interventions include calls to patients within 72 hours of discharge, complete medication reconciliation, coordination of medical appointments, and individualized problem solving...
January 24, 2018: Journal of Trauma and Acute Care Surgery
Sachiko Nakamura, Koji Wada, Naoki Yanagisawa, Derek R Smith
BACKGROUND: In 2020, Japan will host the Tokyo Olympic and Paralympic Games in 2020 (Tokyo 2020) which will involve a large population influx from various countries to Tokyo, the most populated city in Japan. We summarize the potential health risks for visitors to Tokyo 2020, related to communicable disease risks and other health threats, based on recent national and local surveillance reports. METHODS: We reviewed up-to-date surveillance reports published by the National Institute of Infectious Diseases and Tokyo Metropolitan Infectious Disease Surveillance Center...
February 2, 2018: Travel Medicine and Infectious Disease
A I I King, M L Boyd, D L Raphael, A Jull
BACKGROUND: Nurse-led models of comprehensive geriatric assessment and care coordination can improve health management as well as reduce hospitalisations for high risk community dwelling older people. This study investigated the effect on healthcare utilisation of systematic case finding to identify high risk older people in the community with a subsequent comprehensive assessment and care coordination intervention by a Gerontology Nurse Specialist based in primary care. METHODS: This was a controlled before-after study design located within primary healthcare practices in Auckland, New Zealand...
January 22, 2018: BMC Geriatrics
Daniel Schwarzkopf, Hendrik Rüddel, Matthias Gründling, Christian Putensen, Konrad Reinhart
BACKGROUND: While sepsis-related mortality decreased substantially in other developed countries, mortality of severe sepsis remained as high as 44% in Germany. A recent German cluster randomized trial was not able to improve guideline adherence and decrease sepsis-related mortality within the participating hospitals, partly based on lacking support by hospital management and lacking resources for documentation of prospective data. Thus, more pragmatic approaches are needed to improve quality of sepsis care in Germany...
January 18, 2018: Implementation Science: IS
Aida Elargoubi, Anis W Belhaj Khelifa, Ons Haddad, Salma Mhalla, Nabil Sakly, Maha Mastouri
Ebola virus disease (EVD) is one of the deadliest viral diseases. It is characterized by a high mortality rate due to the lack of effective and safe treatments or vaccines and its ability to spread at an unstoppable pace. The West Africa outbreak ended but the disease may strike again at any time. The latest epidemic was, by far, the deadliest to date. The most concern was why this outbreak was so different from the previous ones. We proposed in this review firstly to summarize the principal causes of its unprecedented spread and secondly to identify the steps for an effective management approach of a future Ebola outbreak...
December 20, 2017: Folia Medica
Jackie Prokop, Marie LaPres, Brad Barron, Jon Villasurda
As the number of individuals in the United States with chronic conditions and the associated costs in caring for these individuals continues to rise, there is a need to transform how health care services are delivered. Under Section 2703 of the Affordable Care Act of 2010, the federal government provides state Medicaid programs the opportunity to improve care coordination for people with chronic conditions in a person-centered approach through the establishment of health homes. Given the complexity of care for Medicaid beneficiaries with chronic conditions, addressing the social determinants of health and providing integrated care are central to effectively improving health outcomes and generating cost-savings...
January 1, 2018: Policy, Politics & Nursing Practice
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