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The Journal of International Medical... May 2024The aging world population obliges physicians to establish measures to optimize and estimate the outcomes of increasingly frail patients. Thus, in the last few years... (Review)
Review
The aging world population obliges physicians to establish measures to optimize and estimate the outcomes of increasingly frail patients. Thus, in the last few years there has been an increase in the application of frailty indices. Multiple scales have emerged that can be applied in the perioperative setting. Each one has demonstrated some utility, either by way of establishing postoperative prognosis or as a method for the clinical optimization of patient care. Anaesthesiologists are offered a wide choice of scales, the characteristics and appropriate management of which they are often unaware. This narrative review aims to clarify the concept of frailty, describe its importance in the perioperative setting and evaluate the different scales that are most applicable to the perioperative setting. It will also establish paths for the future optimization of patient care.
Topics: Humans; Frailty; Geriatric Assessment; Aged; Frail Elderly; Prognosis; Preoperative Care; Preoperative Period
PubMed: 38818532
DOI: 10.1177/03000605241251705 -
Joint Commission Journal on Quality and... Apr 2022
Topics: Humans; Patient Care; Time Factors
PubMed: 35193808
DOI: 10.1016/j.jcjq.2022.02.002 -
British Journal of Hospital Medicine... Nov 2022Stigma in healthcare has been associated with a range of negative outcomes, such as delays in seeking treatment, avoiding clinical encounters and mental distress. This...
Stigma in healthcare has been associated with a range of negative outcomes, such as delays in seeking treatment, avoiding clinical encounters and mental distress. This editorial discusses the experience of stigma and argues that understanding shame anxiety and adopting 'shame-sensitive' practice is beneficial in healthcare.
Topics: Humans; Shame; Patient Care; Anxiety; Anxiety Disorders
PubMed: 36454068
DOI: 10.12968/hmed.2022.0441 -
Healthcare Policy = Politiques de Sante Aug 2020Each of canada's provinces and territories needs to modernize its basket of insured health services to reflect a broader conceptualization of healthcare. The narrow...
Each of canada's provinces and territories needs to modernize its basket of insured health services to reflect a broader conceptualization of healthcare. The narrow focus on hospital and physician services excludes multidisciplinary care models, such as those reflected by Family Health Teams in Ontario, Groupe de médecine de famille in Québec and primary care networks in Alberta. In these models, a wider range of services and supports is being used to respond to changing demographics and patterns of morbidity, and whose residents' care needs include social workers, mental health providers, personal support workers and dietitians.
Topics: Alberta; Canada; Delivery of Health Care; Humans; Ontario; Patient Care; Patient Care Team; Primary Health Care; Quebec
PubMed: 32813635
DOI: 10.12927/hcpol.2020.26295 -
Academic Emergency Medicine : Official... Mar 2023
Topics: Humans; Patient Care; Patient-Centered Care
PubMed: 36050595
DOI: 10.1111/acem.14591 -
WMJ : Official Publication of the State... Jul 2022The timing and pace of patient discharges are not level-loaded throughout the day at many institutions including ours, an academic medical center and adult Level I...
QUALITY PROBLEM
The timing and pace of patient discharges are not level-loaded throughout the day at many institutions including ours, an academic medical center and adult Level I trauma center located in Milwaukee, Wisconsin.
INITIAL ASSESSMENT
Only 4% of patients were being discharged with rooms marked dirty by 11 AM at our institution.
CHOISE OF SOLUTION
We put together a multidisciplinary team of approximately 30 stakeholders to develop a revised process that focused on coordination of discharge activities, plan of care awareness among team members, and communication with patients and families.
IMPLEMENTATION
The discharge process was piloted and iteratively adjusted on a single medicine floor.
EVALUATION
Our interventions made a noticeable impact on median room "ready to be cleaned" (RTBC) time without having an adverse impact on length of stay. RTBC improved by a median of 39 minutes ( = 0.019), and the proportion of rooms ready to be cleaned by 11 AM increased from 4.19% to 8.13%.
LESSONS LEARNED
Having a multidisciplinary team participate in the evaluation and development of a new process was critical. Additionally, implementing solutions on a single unit allowed for rapid iteration of changes.
Topics: Academic Medical Centers; Adult; Communication; Humans; Length of Stay; Patient Care Team; Patient Discharge; Trauma Centers; Wisconsin
PubMed: 35857695
DOI: No ID Found -
Journal of the American College of... Jan 2021
Topics: Cardiology; Humans; Outcome Assessment, Health Care; Patient Care; Societies, Medical
PubMed: 33384193
DOI: 10.1016/j.jacc.2020.12.001 -
Revista Brasileira de Enfermagem 2022To analyze the needs and facilitating and hindering elements related to transitional rehabilitation care. (Review)
Review
OBJECTIVE
To analyze the needs and facilitating and hindering elements related to transitional rehabilitation care.
METHODS
Integrative literature review oriented toward answering the question "What nursing interventions guarantee transitional rehabilitation care to dependent adult or elderly people when they return home after hospitalization?".
RESULTS
The patients did not participate much in the planning of hospital discharge and decision-making when they had to return home. Informal caretakers reported that professionals showed detachment during hospitalization and delayed guiding instructions. Health professionals mentioned lack of time to offer this care modality as a difficulty.
FINAL CONSIDERATIONS
Ensuring training, follow-up, and coordination between care levels is essential. Care integration can reduce hospital stay and the impact of post-discharge complications. Transitional care contributes to a sustainable health system, higher care quality, and client satisfaction.
Topics: Adult; Aftercare; Aged; Continuity of Patient Care; Humans; Patient Discharge; Patient Satisfaction; Transitional Care
PubMed: 35584420
DOI: 10.1590/0034-7167-2021-0399 -
Atencion Primaria May 2023
Topics: Humans; Continuity of Patient Care; Home Care Services
PubMed: 37169450
DOI: 10.1016/j.aprim.2023.102632 -
Deutsches Arzteblatt International Jul 2023Artificial intelligence (AI) is increasingly being used in patient care. In the future, physicians will need to understand not only the basic functioning of AI... (Review)
Review
BACKGROUND
Artificial intelligence (AI) is increasingly being used in patient care. In the future, physicians will need to understand not only the basic functioning of AI applications, but also their quality, utility, and risks.
METHODS
This article is based on a selective review of the literature on the principles, quality, limitations, and benefits AI applications in patient care, along with examples of individual applications.
RESULTS
The number of AI applications in patient care is rising, with more than 500 approvals in the United States to date. Their quality and utility are based on a number of interdependent factors, including the real-life setting, the type and amount of data collected, the choice of variables used by the application, the algorithms used, and the goal and implementation of each application. Bias (which may be hidden) and errors can arise at all these levels. Any evaluation of the quality and utility of an AI application must, therefore, be conducted according to the scientific principles of evidence-based medicine-a requirement that is often hampered by a lack of transparency.
CONCLUSION
AI has the potential to improve patient care while meeting the challenge of dealing with an ever-increasing surfeit of information and data in medicine with limited human resources. The limitations and risks of AI applications require critical and responsible consideration. This can best be achieved through a combination of scientific.
Topics: Humans; United States; Artificial Intelligence; Algorithms; Evidence-Based Medicine; Patient Care
PubMed: 37218054
DOI: 10.3238/arztebl.m2023.0124