Author: Katherine L. Hand
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
"Readmission after hospitalization occurs frequently and is a concern for healthcare systems. Adults with chronic illness frequently have the highest readmission rates, often related to adverse events, medication errors, or worsening symptoms. A systematic review of literature related to readmission was conducted. An evidenced-based practice project was implemented to reduce readmission rates within 30 days after hospitalization. The intervention was a telephone call within 24-72 hours after discharge by a nurse practitioner using a prepared script. The purpose of the call was focused upon assessment of patient understanding of medication dosage, side effects, symptoms of worsening conditions, and scheduling of follow-up appointments. The results demonstrated that telephone intervention by a nurse practitioner has the potential to reduce readmission rate for hospitalized adults. Involvement of an advanced practice nurse to contact the patient by telephone during the transition to home after dismissal from the hospital, results in improved management of the condition after discharge. Reconceptualization of the discharge process as a transition period will bridge the gap in healthcare until the follow-up appointment. Telephone contact will individualize health care to meet the needs of the client. Early recognition of new or worsening symptoms will result in practitioner management of the condition, with decreased need for readmission. Keywords: readmission, adverse events, discharge, discharge planning, care transition. ." -- Abstract
Author: Denise Romney
Publisher:
ISBN:
Category :
Languages : en
Pages : 90
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Book Description
Hospital readmission is a severe problem, costing the United States $12 billion to $17.4 billion annually, with Medicare beneficiaries 65 years and older accounting for a disproportionate share of the cost. For 30 days post-discharge from hospitalization or an emergency department (ED) visit, the highest rates of readmission and ED revisits occur among patients suffering from a chronic obstructive pulmonary disease (COPD), heart failure, hypertension, or diabetes. In New York City, the problem of chronic illness and hospital readmissions is acute. For example, at a local hospital, the chronic disease population exceeds 20,000, the readmission rate is higher than 40%, and it takes 40 days to gain access to follow-up care. Research shows the Transitional Care Model Program (TCM) decreases readmission 30 days after the discharge of patients with chronic diseases, thereby reducing healthcare cost and improving health outcomes. Evidence-Based Framework: Rosswurm and Larrabee's Model for Change to Evidence-Based Practice and Meleis' Transitions Theory Model Framework guided the quality improvement practice change. Methods: The primary objective of the study was to determine whether transitional telephone follow-up (TFU) calls to patients with chronic diseases at primary adult care clinic reduce avoidable readmission and ED revisits 30 days post discharge. The TFU call intervention was implemented by a nurse practitioner using the Re-Engineered Discharge Project (RED) toolkit telephone script. TFU calls were conducted 1-14 days post-discharge from hospital stays or emergency department visits. The study employed a sample of 60 patients randomly assigned to one of two groups of 30 patients each. The treatmet group received TFU intervention, while the control group, was not subjected to intervention. Using the IBM SPSS program, the study employed Chi-square and Unpaired T-test statistics to compare the readmission and ED revisits of the control and treatment groups. Findings: The results show that TFU call intervention had a significant association with ED revisits. ED revisits among the treatment group were 30% less than that of the control group. In terms of number of visits, ED revists among the treatment group were 0.4 revisits less than that of the control group. By contrast, the results failed to establish a significant associatiion between the intervention and readmissions. Other results showed that the intervention reduced healthcare cost by ad estimated $554 per patient. Recommendations: The study recommends that the Transitional TFU call intervention is implemented as standard practice in the primary adult clinic at Kings County Medical Clinic for patients with chronic diseases.
Author: Ronda Hughes
Publisher: Department of Health and Human Services
ISBN:
Category : Medical
Languages : en
Pages : 592
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Book Description
"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
Author: Kerm Henriksen
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 526
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Book Description
v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.
Author: Sharon E. Straus
Publisher: John Wiley & Sons
ISBN: 1444357255
Category : Medical
Languages : en
Pages : 213
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Book Description
Health care systems worldwide are faced with the challenge of improving the quality of care. Providing evidence from health research is necessary but not sufficient for the provision of optimal care and so knowledge translation (KT), the scientific study of methods for closing the knowledge-to-action gap and of the barriers and facilitators inherent in the process, is gaining significance. Knowledge Translation in Health Care explains how to use research findings to improve health care in real life, everyday situations. The authors define and describe knowledge translation, and outline strategies for successful knowledge translation in practice and policy making. The book is full of examples of how knowledge translation models work in closing the gap between evidence and action. Written by a team of authors closely involved in the development of knowledge translation this unique book aims to extend understanding and implementation worldwide. It is an introductory guide to an emerging hot topic in evidence-based care and essential for health policy makers, researchers, managers, clinicians and trainees.
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309131529
Category : Medical
Languages : en
Pages : 427
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Book Description
Medical residents in hospitals are often required to be on duty for long hours. In 2003 the organization overseeing graduate medical education adopted common program requirements to restrict resident workweeks, including limits to an average of 80 hours over 4 weeks and the longest consecutive period of work to 30 hours in order to protect patients and residents from unsafe conditions resulting from excessive fatigue. Resident Duty Hours provides a timely examination of how those requirements were implemented and their impact on safety, education, and the training institutions. An in-depth review of the evidence on sleep and human performance indicated a need to increase opportunities for sleep during residency training to prevent acute and chronic sleep deprivation and minimize the risk of fatigue-related errors. In addition to recommending opportunities for on-duty sleep during long duty periods and breaks for sleep of appropriate lengths between work periods, the committee also recommends enhancements of supervision, appropriate workload, and changes in the work environment to improve conditions for safety and learning. All residents, medical educators, those involved with academic training institutions, specialty societies, professional groups, and consumer/patient safety organizations will find this book useful to advocate for an improved culture of safety.
Author: Ronnie Ann Rosenthal
Publisher: Springer Science & Business Media
ISBN: 1441969993
Category : Medical
Languages : en
Pages : 1364
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Book Description
"In the preface to this impressive and well-produced book, the editors state that their aim is not to describe a new surgical specialty, since most surgeons will soon need to be "geriatric surgeons," but to assemble a comprehensive account that will allow "all providers of healthcare to the elderly to understand the issues involved in choosing surgery as a treatment option for their patients." This is a useful book that deserves to do well. I hope that the editors and their publisher will have the stamina to make this the first of several editions, as it is clear that updated information about surgery in the elderly will be required to keep pace with this important field." NEJM Book Review
Author: Marlaine C. Smith, PhD, RN, NEA-BC, FAAN
Publisher: Springer Publishing Company
ISBN: 0826171125
Category : Medical
Languages : en
Pages : 550
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Book Description
"This very interesting book provides a good overview of the evolution of the art and practice of nursing...Recommended."--Choice: Current Reviews for Academic Libraries “This collected work by scholars Smith, Turkel, and Wolf stands as a classic indeed. It offers nursing and related fields a repository and living history of the evolution of nursing within a caring science paradigm over a 40-year span from foundational ideas and developments, to current work in education, research, and institutional/community practices of caring...[The work] sustains and advances knowledge of human caring to serve humanity.” From the Foreword by Jean Watson, PhD, RN, AHN- BC, FAAN Founder, Watson Caring Science Institute This is a core resource for nursing educators and students at all levels who seek fundamental perspectives on the art and science of caring. The text comprises 37 classic book chapters and journal articles written by leaders in the field and illuminate the evolution of the caring paradigm--from its beginnings as a philosophical/ethical/theoretical guide to nursing, to implications for the future development of caring science. Co-published with the Watson Caring Science Institute (WCSI), it will also be a primary resource for students attending WCSI programs and for in-service education programs, especially in hospitals with, or seeking, Magnet status. Each section features an introductory essay illuminating important concepts, followed by reflective questions appropriate for baccalaureate, master’s, and doctoral levels. Also included are multiple-choice questions, a variety of case studies, a digital teacher and student resource with PowerPoints for key ideas, and more. The book is organized into nine sections providing an in-depth analysis of the evolution of caring scholarship; systematic reviews of the concept of caring; theoretical perspectives, including conceptual orientations, middle-range theories, and grand theories; seminal research studies; research designs and methods; practice models for the integration of caring within contemporary hospital-based practice environments; caring in communities and for the environment; leadership and administrative issues with a focus on caring and economics; and the future of caring science. Key Features: Presents the seminal literature on caring Co-published with the Watson Caring Science Institute Provides reflective/critical thinking questions tailored to academic levels For use in baccalaureate, graduate, doctoral, and in-service education, and as a core resource for WCSI programs Is accompanied by a digital teacher and student guide (please contact
[email protected] to request this content)
Author: Jennifer R. Gray
Publisher: Elsevier Health Sciences
ISBN: 0323779255
Category : Medical
Languages : en
Pages : 883
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Book Description
NEW! Extensively updated content reflects the most current quantitative and qualitative approaches to nursing research, as well as the most current research tools and techniques used in the digital era. NEW! Updated research examples throughout incorporate the best examples of current literature, with increased emphasis on international examples to reflect the increasingly global nature of nursing research. NEW! Increased use of visuals includes the addition of more illustrations, tables, and boxes to help break up long passages of text for today’s more visually oriented learners of all levels. NEW! Revised chapters offer improved clarity and usability in the areas of research problems and purpose, quantitative research design, quantitative methodology, and qualitative methodology. NEW! Increased emphasis on hospital magnet status reflects the effect this status has on improving nursing competency and quality outcomes. UPDATED! Coverage of certain qualitative research content has been de-emphasized to reflect the decreased use of certain methodologies (e.g., historical research) and to allow the introduction of additional methodologies that are growing in use.
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309391970
Category : Medical
Languages : en
Pages : 95
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Book Description
The Centers for Medicare & Medicaid Services (CMS) have been moving from volume-based, fee-for-service payment to value-based payment (VBP), which aims to improve health care quality, health outcomes, and patient care experiences, while also controlling costs. Since the passage of the Patient Protection and Affordable Care Act of 2010, CMS has implemented a variety of VBP strategies, including incentive programs and risk-based alternative payment models. Early evidence from these programs raised concerns about potential unintended consequences for health equity. Specifically, emerging evidence suggests that providers disproportionately serving patients with social risk factors for poor health outcomes (e.g., individuals with low socioeconomic position, racial and ethnic minorities, gender and sexual minorities, socially isolated persons, and individuals residing in disadvantaged neighborhoods) may be more likely to fare poorly on quality rankings and to receive financial penalties, and less likely to receive financial rewards. The drivers of these disparities are poorly understood, and differences in interpretation have led to divergent concerns about the potential effect of VBP on health equity. Some suggest that underlying differences in patient characteristics that are out of the control of providers lead to differences in health outcomes. At the same time, others are concerned that differences in outcomes between providers serving socially at-risk populations and providers serving the general population reflect disparities in the provision of health care. Systems Practices for the Care of Socially At-Risk Populations seeks to better distinguish the drivers of variations in performance among providers disproportionately serving socially at-risk populations and identifies methods to account for social risk factors in Medicare payment programs. This report identifies best practices of high-performing hospitals, health plans, and other providers that serve disproportionately higher shares of socioeconomically disadvantaged populations and compares those best practices of low-performing providers serving similar patient populations. It is the second in a series of five brief reports that aim to inform the Office of the Assistant Secretary of Planning and Evaluation (ASPE) analyses that account for social risk factors in Medicare payment programs mandated through the Improving Medicare Post-Acute Care Transformation (IMPACT) Act.
