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The Bone & Joint Journal Jan 2020
Topics: Biomedical Technology; Humans; Orthopedic Procedures; Patient Care
PubMed: 31888360
DOI: 10.1302/0301-620X.102B1.BJJ-2019-1483 -
Annals of the Royal College of Surgeons... Sep 2017
Topics: Awards and Prizes; Biomedical Research; General Surgery; Humans; Patient Care; Publishing
PubMed: 28853607
DOI: 10.1308/rcsann.2017.0160 -
American Family Physician May 2021More than 5 million patients in the United States are admitted to intensive care units (ICUs) annually, and an increasing percentage of patients treated in the ICU...
More than 5 million patients in the United States are admitted to intensive care units (ICUs) annually, and an increasing percentage of patients treated in the ICU survive to hospital discharge. Because these patients require follow-up in the outpatient setting, family physicians should be prepared to provide ongoing care and screening for post-ICU complications. Risk factors for complications after ICU discharge include previous ICU admissions, preexisting mental illness, greater number of comorbidities, and prolonged mechanical ventilation or higher opioid exposure while in the ICU. Early nutritional support and mobilization in the ICU decrease the risk of complications. After ICU discharge, patients should be screened for depression, anxiety, insomnia, and cognitive impairment using standardized screening tools. Physicians should also inquire about weakness, fatigue, neuropathy, and functional impairment and perform a targeted physical examination and laboratory evaluation as indicated; treatment depends on the underlying cause. Exercise regimens are beneficial for reducing several post-ICU complications. Patients who were treated for COVID-19 in the ICU may require additional instruction on reducing the risk of virus transmission. Telemedicine and telerehabilitation allow patients with COVID-19 to receive effective care without increasing exposure risk in communities, hospitals, and medical offices.
Topics: Aftercare; Ambulatory Care; COVID-19; Cognitive Dysfunction; Continuity of Patient Care; Critical Care; Health Services Needs and Demand; Humans; Intensive Care Units; Patient Discharge; Physical Functional Performance; Quality Improvement; SARS-CoV-2; United States
PubMed: 33983005
DOI: No ID Found -
Intensive & Critical Care Nursing Apr 2021Improving care of critically ill patients requires using an interprofessional care model and care standardisation.
BACKGROUND
Improving care of critically ill patients requires using an interprofessional care model and care standardisation.
OBJECTIVES
Determine whether collaborative patient care rounds in the intensive care unit increases practice consistency with respect to common considerations such as delirium prevention, device use, and indicated prophylaxis, among others. Secondary objective to assess whether collaborative interprofessional format improved nursing perceptions of collaboration.
METHODS
Single centre, pre- and post- intervention design. collaborative patient care rounding format implemented in three intensive care units in an academic tertiary care centre. format consisted of scripted nursing presentation, provider checklist of additional practice considerations, and daily priority goals documentation. measurements included nursing participation, consideration of selected practice items, daily goal verbalisation, and nursing perception of collaboration.
RESULTS
Pre- and post-intervention measurements indicate gains in consideration of eight of thirteen bundle items (p < 0.05), with the greatest gains seen in nurse-presented items. Increases were observed in verbalisation of daily goals (59.8% versus 89.1%, p < 0.0001), nurse participation (83.9% versus 91.8%, p = 0.056), and nurse collaboration ratings (p < 0.0001).
CONCLUSION
This study describes implementation of collaborative patient care rounds with corresponding increases in consideration of selected practice items, verbalisation of daily goals, and perceptions of collaboration.
Topics: Critical Care; Humans; Intensive Care Units; Patient Care; Patient Care Team; Teaching Rounds
PubMed: 33262010
DOI: 10.1016/j.iccn.2020.102974 -
Heart Failure Clinics Jul 2015Clinical practice guidelines endorse the use of palliative care in patients with symptomatic heart failure. Palliative care is conceptualized as supportive care afforded... (Review)
Review
Clinical practice guidelines endorse the use of palliative care in patients with symptomatic heart failure. Palliative care is conceptualized as supportive care afforded to most patients with chronic, life-limiting illness. However, the optimal content and delivery of palliative care interventions remains unknown and its integration into existing heart failure disease management continues to be a challenge. Therefore, this article comments on the current state of multidisciplinary care for such patients, explores evidence supporting a team-based approach to palliative and end-of-life care for patients with heart failure, and identifies high-priority areas for research.
Topics: Heart Failure; Hospice Care; Humans; Palliative Care; Patient Care Team; Patient-Centered Care; Terminal Care
PubMed: 26142643
DOI: 10.1016/j.hfc.2015.03.010 -
Journal of the American College of... Nov 2020
Topics: Cardiovascular Diseases; Humans; Patient Care; Practice Guidelines as Topic; Treatment Outcome
PubMed: 33121724
DOI: 10.1016/j.jacc.2020.09.578 -
The New England Journal of Medicine May 2019
Topics: Hospitalists; Hospitalization; Humans; Internal Medicine; Internship and Residency; Medical Staff, Hospital; Patient Care; Patient Discharge
PubMed: 31067368
DOI: 10.1056/NEJMp1900543 -
Professional Case ManagementCare transitions from one setting to another are vulnerable spaces where patients are susceptible to complications. Health systems, accountable care organizations, and...
PURPOSE/OBJECTIVES
Care transitions from one setting to another are vulnerable spaces where patients are susceptible to complications. Health systems, accountable care organizations, and payers recognize that care transition interventions are necessary to reduce unnecessary cost and utilization and improve patient outcomes following a hospitalization. Multiple care transition models exist, with varying degrees of intensity and success. This article describes a quality improvement project for a care transition model that incorporates key elements from the American Case Management Association's Transitions of Care Standards and the Transitional Care Management services as outlined by the Centers for Medicare & Medicaid Services.
PRIMARY PRACTICE SETTING
A collaboratively developed care transition model was implemented between a health system population health management office and a primary care organization.
FINDINGS/CONCLUSIONS
An effective care transitions model is stronger with collaboration among core members of a patient's care team, including a nurse care manager and a primary care provider. Ongoing quality improvement is necessary to gain efficiencies and effectiveness of such a model.
IMPLICATIONS FOR CASE MANAGEMENT PRACTICE
Care managers are integral in coordinating effective transitions. Care management practice includes transition of care standards that are associated with improved outcomes for patients at high risk for readmission. Interventions inclusive of medication reconciliation, identification and addressing of health-related social needs, review of discharge instructions, and coordinated follow-up are important factors that impact patient outcomes. Patients and their health system care teams benefit from the role of a care manager when there is a collaborative, coordinated, and timely approach to hospital follow-up.
Topics: Aged; Humans; United States; Patient Transfer; Patient Readmission; Medicare; Patient Care; Transitional Care; Patient Discharge
PubMed: 38015801
DOI: 10.1097/NCM.0000000000000687 -
Cutis Oct 2015
Topics: Delivery of Health Care; Humans; Organizational Innovation; Patient Care
PubMed: 26682284
DOI: No ID Found -
Journal of General Internal Medicine Apr 2016Studies finding weak or nonexistent relationships between hospital performance on providing recommended care and hospital-level clinical outcomes raise questions about... (Review)
Review
Studies finding weak or nonexistent relationships between hospital performance on providing recommended care and hospital-level clinical outcomes raise questions about the value and validity of process of care performance measures. Such findings may cause clinicians to question the effectiveness of the care process presumably captured by the performance measure. However, one cannot infer from hospital-level results whether patients who received the specified care had comparable, worse or superior outcomes relative to patients not receiving that care. To make such an inference has been labeled the "ecological fallacy," an error that is well known among epidemiologists and sociologists, but less so among health care researchers and policy makers. We discuss such inappropriate inferences in the health care performance measurement field and illustrate how and why process measure-outcome relationships can differ at the patient and hospital levels. We also offer recommendations for appropriate multilevel analyses to evaluate process measure-outcome relationships at the patient and hospital levels and for a more effective role for performance measure bodies and research funding organizations in encouraging such multilevel analyses.
Topics: Hospitals; Humans; Outcome and Process Assessment, Health Care; Patient Care; Quality Indicators, Health Care; Quality of Health Care
PubMed: 26951280
DOI: 10.1007/s11606-015-3564-3