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https://www.readbyqxmd.com/read/29877987/validation-of-the-registered-nurse-assessment-of-readiness-for-hospital-discharge-scale
#1
Kathleen L Bobay, Marianne E Weiss, Debra Oswald, Olga Yakusheva
BACKGROUND: Statistical models for predicting readmissions have been published for high-risk patient populations but typically focus on patient characteristics; nurse judgment is rarely considered in a formalized way to supplement prediction models. OBJECTIVES: The purpose of this study was to determine psychometric properties of long and short forms of the Registered Nurse Readiness for Hospital Discharge Scale (RN-RHDS), including reliability, factor structure, and predictive validity...
June 5, 2018: Nursing Research
https://www.readbyqxmd.com/read/29776436/rates-and-causes-of-30-day-readmission-and-emergency-room-utilization-following-head-and-neck-surgery
#2
Vincent Wu, Stephen F Hall
BACKGROUND: Unplanned returns to hospital are common, costly, and potentially avoidable. We aimed to investigate and characterize reasons for all-cause readmissions to hospital as in-patients (IPs) and visits to the Emergency Department (ED) within 30-days following patient discharge post head and neck surgery (HNS). METHODS: Retrospective case series with chart review. All patients within the Department of Otolaryngology - Head and Neck Surgery who underwent HNS for benign and malignant disease from January 1, 2010 to May 31, 2015 were identified...
May 18, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29656979/reducing-length-of-stay-does-not-increase-emergency-room-visits-or-readmissions-in-patients-undergoing-primary-hip-and-knee-arthroplasties
#3
Andrea H Stone, Leah Dunn, James H MacDonald, Paul J King
BACKGROUND: Total hip and total knee arthroplasty (total joint arthroplasty [TJA]) are 2 of the most common elective surgeries. Identifying which patients are at highest risk for emergency room (ER) visits or readmissions within 90 days of surgery and the reasons for return are crucial to formulate ways to decrease these visits and improve patient outcomes. METHODS: This is a retrospective review of a consecutive series of 7466 unilateral primary TJA performed from July 2013 to June 2017; any patients who had an ER visit or readmission in the first 90 days after surgery were identified, and a detailed chart review was performed...
March 27, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29614131/association-between-quality-domains-and-health-care-spending-across-physician-networks
#4
Farah Rahman, Jun Guan, Richard H Glazier, Adalsteinn Brown, Arlene S Bierman, Ruth Croxford, Therese A Stukel
One of the more fundamental health policy questions is the relationship between health care quality and spending. A better understanding of these relationships is needed to inform health systems interventions aimed at increasing quality and efficiency of care. We measured 65 validated quality indicators (QI) across Ontario physician networks. QIs were aggregated into domains representing six dimensions of care: screening and prevention, evidence-based medications, hospital-community transitions (7-day post-discharge visit with a primary care physician; 30-day post-discharge visit with a primary care physician and specialist), potentially avoidable hospitalizations and emergency department (ED) visits, potentially avoidable readmissions and unplanned returns to the ED, and poor cancer end of life care...
2018: PloS One
https://www.readbyqxmd.com/read/29494475/survival-and-safety-outcomes-of-icu-patients-discharged-directly-home-a-direct-from-icu-sent-home-study
#5
Vincent I Lau, Joyce N H Lam, John Basmaji, Fran A Priestap, Ian M Ball
OBJECTIVES: Evaluate outcomes (mortality, morbidity, unplanned return visits) of patients who are discharged directly to home from the ICU. DESIGN: Prospective cohort study. SETTING: Two tertiary care medical-surgical-trauma ICUs at Canadian hospitals over 1 year (February 2016-2017). SUBJECTS: All adult patients who were either discharged directly to home (Recruited and Nonrecruited cohorts) from ICU or discharged home within 24 hours after ward transfer (Ward Transfer cohort)...
June 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29370884/risk-of-major-complications-following-thyroidectomy-and-parathyroidectomy-utility-of-the-nsqip-surgical-risk-calculator
#6
Joseph Margolick, Sam M Wiseman
BACKGROUND: The primary objective of this study was to determine rates of reoperation, ED visits, and hospital readmission after thyroid and parathyroid surgery at a tertiary hospital. A secondary objective was to determine if scores from the American College of Surgeons Surgical Risk Calculator (ACS SRC) predicted these events. METHODS: We retrospectively reviewed the records of patients undergoing parathyroid and thyroid surgery between 2011 and 2014. Patients who underwent an unplanned reoperation, returned to the ED, or were readmitted to hospital were evaluated using the ACS SRC...
May 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29361411/unplanned-emergency-department-or-urgent-care-visits-after-outpatient-rotator-cuff-repair-potential-for-avoidance
#7
Ronald A Navarro, Charles C Lin, Abtin Foroohar, Steven R Crain, Michael P Hall
BACKGROUND: With the cost of health care rising, the potential to avoid costs from an unplanned return to the emergency department (ED) or urgent care center (UC) after elective outpatient rotator cuff repair (RCR) has been discussed but not extensively assessed. METHODS: Outpatient RCR procedures were queried in a closed health care system, and all unplanned ED and UC visits within 7 days of procedures were collected and compared with other typical outpatient orthopedic procedures (knee arthroscopy, carpal tunnel release, and anterior cruciate ligament reconstruction)...
January 17, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29342059/patients-living-alone-can-be-safely-discharged-directly-home-after-total-joint-arthroplasty-a-prospective-cohort-study
#8
Andrew N Fleischman, Matthew S Austin, James J Purtill, Javad Parvizi, William J Hozack
BACKGROUND: Despite the expense and potential hazards of inpatient rehabilitation, there is a prevailing belief that patients living alone cannot be safely discharged directly home after total joint arthroplasty. The purpose of this study was to assess the safety and efficacy of direct home discharge for patients living alone during convalescence after primary total joint arthroplasty. METHODS: We prospectively studied 910 consecutive patients undergoing primary, unilateral total hip arthroplasty or total knee arthroplasty over an 8-month period...
January 17, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29318355/an-enhanced-recovery-after-surgery-eras-protocol-for-ambulatory-anorectal-surgery-reduced-postoperative-pain-and-unplanned-returns-to-care-after-discharge
#9
Aaron B Parrish, Sean M O'Neill, Steven R Crain, Tara A Russell, Deepak K Sonthalia, Vu T Nguyen, Armen Aboulian
BACKGROUND: Ambulatory surgery for anorectal procedures has been proven to be safe and effective. Specific perioperative pathways combining multiple interventions have been shown to optimize recovery and outcomes associated with inpatient colorectal surgery. However, there are no major studies describing and evaluating a standardized protocol for ambulatory anorectal surgery. The purpose of this study was to evaluate the outcomes of a modified enhanced recovery after surgery (ERAS) protocol for ambulatory anorectal surgery...
January 9, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29240278/predictors-of-returns-to-the-emergency-department-after-head-and-neck-surgery
#10
R Michael Baskin, Jingnan Zhang, Carolyn Dirain, Paul Lipori, Gileno Fonseca, Raja Sawhney, Brian J Boyce, Natalie L Silver, Peter T Dziegielewski
BACKGROUND: Thirty-day hospital readmissions have become a measure of quality of care. Many readmissions enter through the emergency department. The purposes of this study were to determine the rate, risk factors, and costs of 30-day returns to the emergency department (30dEDRs) after head and neck surgery. METHODS: All adult patients undergoing head and neck surgery at the University of Florida from 2012 to 2014 were reviewed. Univariate and multivariate logistic regression analyses were performed to identify risk factors for 30dEDRs...
March 2018: Head & Neck
https://www.readbyqxmd.com/read/29231962/symptoms-reported-by-frail-elderly-adults-independently-predict-30-day-hospital-readmission-or-emergency-department-care
#11
Lynn S Borkenhagen, Rozalina G McCoy, Rachel D Havyer, Stephanie M Peterson, James M Naessens, Paul Y Takahashi
OBJECTIVES: To assess the degree to which self-reported symptoms predict unplanned readmission or emergency department (ED) care within 30 days of high-risk, elderly adults enrolled in a posthospitalization care transition program (CTP). DESIGN: Retrospective cohort study. SETTING: Posthospitalization CTP at Mayo Clinic, Rochester, Minnesota, from January 1, 2013, through March 3, 2015. PARTICIPANTS: Frail, elderly adults (N = 230; mean age 83...
February 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29186213/returns-to-emergency-department-observation-or-inpatient-care-within-30-days-after-hospitalization-in-4-states-2009-and-2010-versus-2013-and-2014
#12
Teryl K Nuckols, Kathryn R Fingar, Marguerite L Barrett, Grant Martsolf, Claudia A Steiner, Carol Stocks, Pamela L Owens
BACKGROUND: Nationally, readmissions have declined for acute myocardial infarction (AMI) and heart failure (HF) and risen slightly for pneumonia, but less is known about returns to the hospital for observation stays and emergency department (ED) visits. OBJECTIVE: To describe trends in rates of 30-day, all-cause, unplanned returns to the hospital, including returns for observation stays and ED visits. DESIGN: By using Healthcare Cost and Utilization Project data, we compared 210,007 index hospitalizations in 2009 and 2010 with 212,833 matched hospitalizations in 2013 and 2014...
May 1, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28704268/safe-discharge-and-outpatient-investigation-of-ureteric-colic-a-retrospective-analysis
#13
Michael Stewart
BACKGROUND: Computed tomography of the kidneys, ureters and bladder is the recommended imaging modality for suspected urolithiasis. Early scanning is advised in guidelines, but there is limited published evidence to support this recommendation. PATIENTS AND METHODS: In a retrospective study, we reviewed patients managed according to a local guideline. Patients without high-risk features were either imaged during their initial visit (if in the daytime) or discharged for outpatient scans...
July 12, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28249348/methicillin-resistant-staphylococcus-aureus-infection-is-a-risk-factor-for-unplanned-return-to-the-operating-room-in-the-surgical-treatment-of-a-septic-knee
#14
David Jaffe, Timothy Costales, Patrick Greenwell, Matthew Christian, Ralph Frank Henn
Surgical irrigation and debridement is the mainstay of treatment after the diagnosis of a septic knee. Arthroscopic treatment has been validated as a treatment option, but there is limited literature comparing it to an open arthrotomy regarding risk factors for failing single-stage surgical treatment. A retrospective review of surgically treated native adult septic knees at one urban tertiary care center was conducted to evaluate rates of unplanned return to the operating room (OR) following both arthroscopic and open treatment of an adult septic knee...
November 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27989992/adverse-outcomes-in-older-adults-attending-emergency-departments-a-systematic-review-and-meta-analysis-of-the-identification-of-seniors-at-risk-isar-screening-tool
#15
REVIEW
Rose Galvin, Yannick Gilleit, Emma Wallace, Gráinne Cousins, Manon Bolmer, Timothy Rainer, Susan M Smith, Tom Fahey
Background: older adults are frequent users of emergency services and demonstrate high rates of adverse outcomes following emergency care. Objective: to perform a systematic review and meta-analysis of the Identification of Seniors At Risk (ISAR) screening tool, to determine its predictive value in identifying adults ≥65 years at risk of functional decline, unplanned emergency department (ED) readmission, emergency hospitalisation or death within 180 days after index ED visit/hospitalisation...
March 1, 2017: Age and Ageing
https://www.readbyqxmd.com/read/27940752/improving-guideline-based-care-of-acute-asthma-in-a-pediatric-emergency-department
#16
Matthew P Gray, Grant E Keeney, Michael J Grahl, Marc H Gorelick, Christopher D Spahr
BACKGROUND AND OBJECTIVE: Rapid repetitive administration of short-acting β-agonists (SABA) is the most effective means of reducing acute airflow obstruction in asthma. Little evidence exists that assesses process measures (ie, timeliness) and outcomes for asthma. We used quality improvement (QI) methods to improve emergency department care in accordance with national guidelines including timely SABA administration and use of asthma severity scores. METHODS: The Model for Improvement was used and interventions were targeted at 4 key drivers: knowledge, engagement, decision support, and workflow enhancement...
November 2016: Pediatrics
https://www.readbyqxmd.com/read/27938953/frequency-of-unplanned-interventions-in-patients-attending-for-a-presumed-routine-glaucoma-follow-up-appointment
#17
Jennifer Calafati, Zia S Pradhan, Catherine M Birt
OBJECTIVE: To determine the frequency of patient visits in which an unplanned treatment modification was required in chronic patients attending a glaucoma clinic for routine follow-up and to identify the treatment interventions most commonly employed. DESIGN: Prospective, cross-sectional study. PARTICIPANTS: A total of 630 previously stable patients attending a glaucoma clinic for routine follow-up. METHODS: This was a single-centre survey of all eligible patients returning to an academic glaucoma clinic...
December 2016: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/27597429/incidence-risk-factors-and-costs-for-hospital-returns-after-total-joint-arthroplasties
#18
Udai S Sibia, Abigail E Mandelblatt, Maura A Callanan, James H MacDonald, Paul J King
BACKGROUND: Unplanned hospital returns after total joint arthroplasty (TJA) reduce any cost savings in a bundled reimbursement model. We examine the incidence, risk factors, and costs for unplanned emergency department (ED) visits and readmissions within 30 days of index TJA. METHODS: We retrospectively reviewed a consecutive series of 655 TJAs (382 total knee arthroplasty and 273 total hip arthroplasty) performed between April 2014 and March 2015. Preoperative diagnosis was osteoarthritis of the hip or knee (97%) or avascular necrosis of the hip (3%)...
February 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27496370/cognitive-health-and-risk-of-ed-revisit-in-underserved-older-adults
#19
Glenn V Ostir, Stephen M Schenkel, Ivonne M Berges, Teresa Kostelec, Laura Pimentel
OBJECTIVE: The objective was to examine associations between cognitive health and unplanned emergency department (ED) revisits 30, 60, and 90 days after the initial visit. METHODS: Sociodemographic, clinical, and cognitive measures were collected on 110 white and African American adults, 65 years and older, who sought care in an inner-city ED. The information was collected via face-to-face interviews and review of the electronic medical record. Returns to the study-site ED 30, 60, and 90 days later were identified through a search of the electronic medical record...
October 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27366183/patient-characteristics-and-outcomes-of-outpatient-parenteral-antimicrobial-therapy-a-retrospective-study
#20
Marie Yan, Marion Elligsen, Andrew E Simor, Nick Daneman
Outpatient parenteral antimicrobial therapy (OPAT) is a safe and effective alternative to hospitalization for many patients with infectious diseases. The objective of this study was to describe the OPAT experience at a Canadian tertiary academic centre in the absence of a formal OPAT program. This was achieved through a retrospective chart review of OPAT patients discharged from Sunnybrook Health Sciences Centre within a one-year period. Between June 2012 and May 2013, 104 patients (median age 63 years) were discharged home with parenteral antimicrobials...
2016: Canadian Journal of Infectious Diseases & Medical Microbiology
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