Identifying Preventable Readmissions: An Interdisciplinary Approach to Building a Conceptual Model

Background: Reducing preventable hospital readmissions is a complex and challenging goal without a clear roadmap for successful attainment. The problem is compounded by the lack of consensus on the defining criteria for preventable readmissions. We [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Identifying Preventable Readmissions: An Interdisciplinary Approach to Building a Conceptual Model

Postdischarge Problems Identified by Nurse Advice Line Calls Following Hospital Discharge

Background: Approximately 20% of patients are either readmitted or have additional visits to emergency rooms or urgent care clinics within 30 days of hospital discharge. Patients discharged from our urban, academic safety net hospital are [...]

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Epidemiology of Medication Warnings at an Academic Medical Center

Background: Implementation of computerized provider order entry (CPOE) with drug–drug and drug–allergy checking is an important patient safety measure. The most commonly used CPOE systems, however, generate numerous warnings, which may lead to "alert fatigue." [...]

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Urine Sampling in Hospitalised Patients Is Erroneous and Unreliable for Clinical Care

Background: Catheter associated UTI's (CA–UTI) are preventable and high impact secondary to associated costs and poor outcomes. Our UTI prevention group has worked to prevent CA–UTIs, implementing a nursing driven foley removal protocol, prevention guidelines [...]

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Relationship Between 25Hydroxyvitamin D and Peripheral Arterial Disease As Measured by Anklebrachial Index

Background: Low serum 25(OH) D levels are associated with higher prevalence of peripheral arterial disease (PAD). It has been proposed that this inverse relationship is non–linear in that the association diminishes with rising 25(OH) D [...]

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The Impact of Copd on Management and Outcomes of Patients Hospitalized with Acute Myocardial Infarction; a Tenyear Retrospective Observational Study

Background: There are limited data regarding contemporary trends in management and outcomes of patients with COPD who develop acute myocardial infarction (AMI). The objective of this population–based study was to describe the management and short–term [...]

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Observation Status: Impact on Hospital and Patient Outcomes

Background: Hospitals vary in their procedures for assigning patients to "observation" status (OBS). This outpatient designation has a number of implications including reduced hospital payments, lower patient co–payments, and often results in OBS time not [...]

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The Scope of Practice of Nurse Practitioners and Physician Assistants on Inpatient Medicine Services in the Veterans Health Administration

Background: Nurse Practitioners (NPs) and Physician Assistants (PAs) have been shown to be cost–effective substitutes for physicians with similar outcomes in primary care and surgical settings. The Veterans Health Administration (VHA) is one of the [...]

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Improving Care Transitions Through Use of a Coaching Intervention

Background: Preventable rehospitalizations are disconcerting for patients, contribute to high costs, and are partly due to deficiencies in patients' ability to execute post–discharge care plans. Increasing patient engagement and self–empowerment through use of an evidence–based [...]

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Enhancing the Quality of Familycentered Rounds: The Rounding Apgar

Background: Conducting Family–Centered Rounds (FCR) has become a common practice in pediatric hospital medicine. As many learners may be a part of the pediatric inpatient team for a brief time, orientation to the goals and [...]

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Palliative Care Referral of Hospitalized Congestive Heart Failure Patients

Background: Congestive heart failure (CHF) is a leading cause of hospitalization nationwide in people over more than 65. Moreover, CHF exacerbation is one of the leading causes of readmission –— creating a substantial financial burden [...]

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Effectiveness of Patient Centered Team Rounds at the Bedside in an Adult Hospitalist Practice

Background: Institutions that focus on patient–family centered care have seen improvements in their patient and staff satisfaction. Bedside rounding with the patient/family involved is a tool that hospitalists can use to deliver care that centers [...]

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Surveillance and Pharmacist Intervention for Vulnerable Hospitalized Geriatric Patients on Highrisk Medication Regimens

Background: Clinical decision support systems are useful tools to discourage the use of potentially inappropriate medications (PIMs) in the geriatric inpatient population. These interventions have had variable success, in large part because geriatric medication decisions [...]

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Confused Patient, Puzzled Doctor

Case Presentation: A 70–year–old man presented with confusion, mumbling, malaise, and headache after having recently taken oral antibiotics for a skin lesion on his forehead. His prior history was complicated by previously treated chronic lymphocytic [...]

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