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Annals of Internal Medicine Dec 2023Heart failure affects more than 6 million people in the United States, and hospitalizations for decompensated heart failure confer a heavy toll in morbidity, mortality,... (Review)
Review
Heart failure affects more than 6 million people in the United States, and hospitalizations for decompensated heart failure confer a heavy toll in morbidity, mortality, and health care costs. Clinical trials have demonstrated effective interventions; however, hospitalization and mortality rates remain high. Key components of effective hospital care include appropriate diagnostic evaluation, triage and risk stratification, early implementation of guideline-directed medical therapy, adequate diuresis, and appropriate discharge planning.
Topics: Humans; United States; Hospitalization; Heart Failure; Patient Discharge; Health Care Costs
PubMed: 38079639
DOI: 10.7326/AITC202312190 -
Irish Journal of Medical Science Dec 2023GPT-4 is the latest version of ChatGPT which is reported by OpenAI to have greater problem-solving abilities and an even broader knowledge base. We examined GPT-4's...
GPT-4 is the latest version of ChatGPT which is reported by OpenAI to have greater problem-solving abilities and an even broader knowledge base. We examined GPT-4's ability to inform us about the latest literature in a given area, and to write a discharge summary for a patient following an uncomplicated surgery and its latest image analysis feature which was reported to be able to identify objects in photos. All things considered, GPT-4 has the potential to help drive medical innovation, from aiding with patient discharge notes, summarizing recent clinical trials, providing information on ethical guidelines, and much more.
Topics: Humans; Artificial Intelligence; Knowledge Bases; Medicine; Patient Discharge; Writing
PubMed: 37076707
DOI: 10.1007/s11845-023-03377-8 -
International Journal of Nursing Studies Sep 2023
Topics: Humans; Patient Discharge; Length of Stay; Hospitals
PubMed: 37285731
DOI: 10.1016/j.ijnurstu.2023.104533 -
Journal of Medical Virology Aug 2023
Topics: Humans; Post-Acute COVID-19 Syndrome; Patient Discharge; COVID-19; Hospitals
PubMed: 37522243
DOI: 10.1002/jmv.29014 -
Seminars in Ophthalmology Jul 2023This study aimed to report the abilities of the large language model ChatGPT (OpenAI, San Francisco, USA) in constructing ophthalmic discharge summaries and operative...
PURPOSE
This study aimed to report the abilities of the large language model ChatGPT (OpenAI, San Francisco, USA) in constructing ophthalmic discharge summaries and operative notes.
METHODS
A set of prompts was constructed through statements incorporating common ophthalmic surgeries across the subspecialties of the cornea, retina, glaucoma, paediatric ophthalmology, neuro-ophthalmology, and ophthalmic plastics surgery. The responses of ChatGPT were assessed by three surgeons carefully and analyzed them for evidence-based content, specificity of the response, presence of generic text, disclaimers, factual inaccuracies, and its abilities to admit mistakes and challenge incorrect premises.
RESULTS
A total of 24 prompts were presented to the ChatGPT. Twelve prompts assessed its ability to construct discharge summaries, and an equal number explored the potential for preparing operative notes. The response was found to be tailored based on the quality of inputs given and was provided in a matter of seconds. The ophthalmic discharge summaries had a valid but significant generic text. ChatGPT could incorporate specific medications, follow-up instructions, consultation time, and location within the discharge summaries when prompted appropriately. While the operative notes were detailed, they required significant tuning. ChatGPT routinely admits its mistakes and corrects itself immediately when confronted with factual inaccuracies. The mistakes are avoided in subsequent reports when given similar prompts.
CONCLUSION
The performance of ChatGPT in the context of ophthalmic discharge summaries and operative notes was encouraging. These are constructed rapidly in a matter of seconds. Focused training of ChatGPT on these issues with inclusion of a human verification step has an enormous potential to impact healthcare positively.
Topics: Child; Humans; Ophthalmology; Patient Discharge; Cornea; Glaucoma; Referral and Consultation
PubMed: 37133418
DOI: 10.1080/08820538.2023.2209166 -
The Nursing Clinics of North America Sep 2023Nurses play a key role in promoting successful transitions of patients with heart failure (HF) from the hospital to the ambulatory setting. Engaging patients and... (Review)
Review
Nurses play a key role in promoting successful transitions of patients with heart failure (HF) from the hospital to the ambulatory setting. Engaging patients and caregivers in discharge teaching early in the hospitalization can enhance their understanding of HF as a clinical syndrome and identify precipitants of decompensation. Effective transitional care interventions for patient with HF include a phone call within 48 to 72 hours and a follow-up appointment within 7 days. Early symptom identification and treatment are key aspects of HF care to improve quality of life and minimize risk of hospitalization.
Topics: Humans; Quality of Life; Hospitalization; Patient Discharge; Continuity of Patient Care; Heart Failure
PubMed: 37536781
DOI: 10.1016/j.cnur.2023.05.001 -
JACC. Cardiovascular Interventions Jul 2023Percutaneous transcatheter interventions have evolved as standard therapies for a variety of cardiovascular diseases, from revascularization for atherosclerotic vascular... (Review)
Review
Percutaneous transcatheter interventions have evolved as standard therapies for a variety of cardiovascular diseases, from revascularization for atherosclerotic vascular lesions to the treatment of structural cardiac diseases. Concomitant technological innovations, procedural advancements, and operator experience have contributed to effective therapies with low complication rates, making early hospital discharge safe and common. Same-day discharge presents numerous potential benefits for patients, providers, and health care systems. There are several key elements that are shared across the spectrum of interventional cardiology procedures to create a successful same-day discharge pathway. These include appropriate patient and procedure selection, close postprocedural observation, predischarge assessments specific for each type of procedure, and the existence of a patient support system beyond hospital discharge. This review provides the rationale, available data, and a framework for same-day discharge across the spectrum of coronary, peripheral, and structural cardiovascular interventions.
Topics: Humans; Patient Discharge; Treatment Outcome; Heart; Heart Diseases; Cardiovascular Diseases
PubMed: 37438024
DOI: 10.1016/j.jcin.2023.05.015 -
ANZ Journal of Surgery Sep 2023
Topics: Humans; Patient Discharge; Patient Care; Hospitals
PubMed: 37710411
DOI: 10.1111/ans.18612 -
Research in Social & Administrative... Aug 2023Previous studies on hospital discharge showed limited patient involvement, despite its positive outcomes. In this study, provider-patient communication used to enhance... (Observational Study)
Observational Study
OBJECTIVES
Previous studies on hospital discharge showed limited patient involvement, despite its positive outcomes. In this study, provider-patient communication used to enhance patient participation during discharge medication counselling was examined.
METHODS
This study comprises a qualitative descriptive observational study. Thirty-four discharge consultations were observed, audio recorded and analysed. We conducted a deductive analysis, elaborating on findings from earlier research. We selected themes and underlying codes illustrating professional-patient communication. For every theme, we identified examples to demonstrate its manifestation during discharge medication counselling. We also assessed what information healthcare professionals (HCPs) shared.
RESULTS
HCPs used cues to increase patient participation, e.g. inquired about patient's preferences, showed empathy and support, and verified understanding of information shared. Patient participation occurred through asking questions, and expressing concerns. A central component in discharge medication counselling was the transmission of information from HCPs to patients. This resulted in HCPs taking a leading role.
CONCLUSIONS
Several HCP cues were detected inviting patients to participate in consultations. Some patients participated in discharge medication counselling. This was influenced by timing of discharge consults, the performing HCP and presence of a relative.
PRACTICE IMPLICATIONS
HCPs shared a lot of information with patients. However, this does not automatically mean that patients will be able to understand and apply this information. HCPs should understand the importance of using cues to enable patient participation. One example is using the teach-back method for verifying patient understanding. It may also be desirable to ensure that a relative is present when discharge information is offered.
Topics: Humans; Patient Participation; Patient Discharge; Health Personnel; Communication; Counseling
PubMed: 37202280
DOI: 10.1016/j.sapharm.2023.05.008 -
Current Opinion in Cardiology Nov 2023This review discusses current guidelines and evidence-based care for the preoperative optimization of patients who are undergoing coronary artery bypass grafting (CABG)... (Review)
Review
PURPOSE OF REVIEW
This review discusses current guidelines and evidence-based care for the preoperative optimization of patients who are undergoing coronary artery bypass grafting (CABG) and for enabling rapid discharge after surgery.
RECENT FINDINGS
Since the Enhanced Recovery After Cardiac Surgery Society (ERAS Cardiac) issued guidelines for perioperative care, in 2019, there has been a significant body of research that has added to and provided further guidance regarding preoperative optimization and accelerated recovery after CABG.
SUMMARY
A review of the current literature provides a framework for a pragmatic approach to preoperative optimization, utilizing the time from referral to surgery to mitigate multiple aspects of the patient condition, leading to improved patient outcomes and reduced length of stay and cost to the healthcare system.
Topics: Humans; Patient Discharge; Coronary Artery Bypass; Length of Stay
PubMed: 37668170
DOI: 10.1097/HCO.0000000000001076