Outcomes of Care by Hospitalists

2021 ◽  
Author(s):  
James S. Goodwin
Keyword(s):  
Outcomes Of Care

Framework for Biosignal Interpretation in Intensive Care and Anesthesia

1997 ◽  
Vol 36 (04/05) ◽  
pp. 340-344 ◽  
Author(s):  
I. Korhonen ◽  
M. van Gils ◽  
A. Kari ◽  
N. Saranummi
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Data Management ◽  
Clinical Evaluation ◽  
Patient Monitoring ◽  
Research Community ◽  
Clinical Routine ◽  
The Poor ◽  
Outcomes Of Care

Abstract:Improved monitoring improves outcomes of care. As critical care is “critical”, everything that can be done to detect and prevent complications as early as possible benefits the patients. In spite of major efforts by the research community to develop and apply sophisticated biosignal interpretation methods (BSI), the uptake of the results by industry has been poor. Consequently, the BSI methods used in clinical routine are fairly simple. This paper postulates that the main reason for the poor uptake is the insufficient bridging between the actors (i.e., clinicians, industry and research). This makes it difficult for the BSI developers to understand what can be implemented into commercial systems and what will be accepted by clinicians as routine tools. A framework is suggested that enables improved interaction and cooperation between the actors. This framework is based on the emerging commercial patient monitoring and data management platforms which can be shared and utilized by all concerned, from research to development and finally to clinical evaluation.

Public Reporting of Cardiovascular Data: Benefits, Pitfalls, and Vision for the Future

2016 ◽  
Vol 10 (1) ◽  
pp. 36
Author(s):  
Gregory J Dehmer ◽  
Keyword(s):  
Clinical Data ◽  
Clinical Status ◽  
Public Reporting ◽  
Professional Organizations ◽  
Healthcare Data ◽  
Outcomes Of Care ◽  
The Future ◽  
Policy Statements ◽  
Quality And Outcomes ◽  
Reporting Programs

Public reporting of healthcare data is not a new concept. This initiative continues to proliferate as consumers and other stakeholders seek information on the quality and outcomes of care. Furthermore, mandates for the development of additional public reporting efforts are included in several new healthcare legislations such as the Affordable Care Act. Many current reporting programs rely heavily on administrative data as a surrogate for true clinical data, but this approach has well-defined limitations. Clinical data are traditionally more difficult and costly to collect, but more accurately reflect the clinical status of the patient, thus enhancing validity of the quality metrics and the reporting program. Several professional organizations have published policy statements articulating the main principles that should establish the foundation for public reporting programs in the future.

scholarly journals 77 National Audit of Care At the End of Life (NACEL)—Round Two Findings

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
D Hibbert
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Care Service ◽  
Palliative Care Service ◽  
Care Plan ◽  
Specialist Palliative Care ◽  
Experience Of Care ◽  
Outcomes Of Care ◽  
Specialist Palliative Care Service ◽  
The Right

Abstract   NACEL is a national comparative audit of the quality and outcomes of care experienced by the dying person and those important to them during the final admission in acute and community hospitals in England and Wales. Mental health inpatient providers participated in the first round but excluded from the second round. NACEL round two, undertaken during 2019/20, comprised: Data was collected between June and October 2019. 175 trusts in England and 8 Welsh organisations took part in at least one element of NACEL (97% of eligible organisations). Key findings include Recognising the possibility of imminent death: The possibility that the patient may die was documented in 88% of cases. The median time from recognition of dying to death was 41 hours (36 hours in the first round). Individual plan of care: 71% of patients, where it had been recognised that the patient was dying (Category 1 deaths), had an individualised end of life care plan. Of the patients who did not have an individualised plan of care, in 45% of these cases, the time from recognition of dying to death was more than 24 hours. Families’ and others’ experience of care: 80% of Quality Survey respondents rated the quality of care delivered to the patient as outstanding/excellent/good and 75% rated the care provided to families/others as outstanding/excellent/good. However, one-fifth of responses reported that the families’/others’ needs were not asked about. Individual plan of care: 80% of Quality Survey respondents believed that hospital was the “right” place to die; however, 20% reported there was a lack of peace and privacy. Workforce Most hospitals (99%) have access to a specialist palliative care service. 36% of hospitals have a face-to-face specialist palliative care service (doctor and/or nurse) available 8 hours a day, 7 days a week. NACEL round three will start in 2021.

scholarly journals Patient and family views of team functioning in primary healthcare teams with nurse practitioners: a survey of patient-reported experience and outcomes

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kelley Kilpatrick ◽  
Eric Tchouaket ◽  
Nicolas Fernandez ◽  
Mira Jabbour ◽  
Carl-Ardy Dubois ◽  
...  
Keyword(s):  
Urban Area ◽  
Nurse Practitioners ◽  
Primary Healthcare ◽  
Organizational Characteristics ◽  
Role Clarity ◽  
Team Processes ◽  
Healthcare Teams ◽  
Outcomes Of Care ◽  
Patient Reported ◽  
Team Functioning

Abstract Background Nurse practitioners (NPs) have been added to primary healthcare teams to improve access to care. Team processes, including communication and decision-making, explicate how patients and families view team functioning. Yet, important gaps exist in our understanding of patient-reported experience and outcomes at the level of the healthcare team. We aimed to examine the influence of individual, team, and organizational characteristics, and role clarity on outcomes of care mediated by team processes in primary healthcare teams that include NPs. Methods A cross-sectional survey across six sites representing practices with NPs in Québec, Canada, was conducted between March 2018 and April 2019 as part of a multiple-case study. Patients and families (n = 485; response rate: 53%) completed a validated questionnaire, which included a patient-reported experience measure (PREM) and a patient-reported outcome measure (PROM) of team functioning (Cronbach alpha: 0.771 (PROM) to 0.877 (PREM)). We performed logistic regression and mediation analyses to examine relationships between the individual, team, and organizational characteristics, role clarity, and outcomes of care mediated by team processes. Results Patients and families expressed positive perceptions of team functioning (mean 4.97/6 [SD 0.68]) and outcomes of care (5.08/6 [0.74]). Also, high team processes (adjusted odds ratio [AOR] 14.92 [95% CI 8.11 to 27.44]) was a significant predictor of high outcomes of care. Role clarity (indirect effect coefficient ab = 6.48 [95% CI 3.79 to 9.56]), living in an urban area (-1.32 [-2.59 to -0.13]), patient as respondent (-1.43 [-2.80 to -0.14]), and income (1.73 [0.14 to 3.45]) were significant predictors of outcomes of care mediated by team processes. Conclusions This study provides key insights on how primary healthcare teams with NPs contribute to team functioning, using a validated instrument consistent with a conceptual framework. Results highlight that high role clarity, living in a non urban area, family as respondent, and adequate income were significant predictors of high outcomes of care mediated by high team processes. Additional research is needed to compare teams with and without NPs in different settings, to further explicate the relationships identified in our study.

scholarly journals Digital Tools to Enhance Caregiver-Centered Communication

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 571-571
Author(s):  
Debra Parker Oliver
Keyword(s):  
Family Caregivers ◽  
Randomized Clinical Trials ◽  
Video Conferencing ◽  
Geographic Distance ◽  
Interdisciplinary Teams ◽  
Digital Tools ◽  
Team Members ◽  
Outcomes Of Care ◽  
Challenges And Opportunities ◽  
Episodes Of Care

Abstract While it is recognized that caregiver engagement can improve processes and outcomes of care in gerontology, there are barriers to caregiver centered communication, including limited resources for health systems to devote services specifically to families, geographic distance and lack of time. Digital tools such as social media platforms and video-conferencing introduce opportunities for remote and often asynchronous communication. In this presentation, we discuss findings from two randomized clinical trials that explored digital tools to empower family caregivers. In the first we examined ways to use video-conferencing to enable family caregivers to become virtual team members during hospice interdisciplinary teams, and in the second trial we examine the use of secret Facebook groups to meet informational and emotional needs of family caregivers during episodes of care that are often linked to increased social isolation and loneliness. We discuss challenges and opportunities in designing digital tools to facilitate caregiver engagement and empowerment.

scholarly journals How Assisted Living Staff Conceive of Dementia Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 676-677
Author(s):  
Debra Dobbs ◽  
Sheryl Zimmerman ◽  
Stephanie Miller ◽  
Paula Carder ◽  
Anna Beeber ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Assisted Living ◽  
Medication Management ◽  
Mixed Methods Study ◽  
Organizational Characteristics ◽  
Medical Interventions ◽  
Person Centered Care ◽  
Outcomes Of Care ◽  
Centered Care ◽  
Care Practices

Abstract For those who provide care to the more than 40% of persons with dementia in assisted living (AL) communities, behavioral expressions (BEs) can be challenging. The objective of this mixed-methods study was to understand how AL staff conceive of BEs and what strategies they use to address them. Staff from 250 AL communities in seven states were asked to describe one successful and unsuccessful case of care. A conceptual model related to antecedents, behaviors, and consequences was developed and expanded to include staff strategies and outcomes of care; organizational characteristics associated with care practices were examined. Anxiety/restlessness, combativeness and resistance to care were the most prevalent BEs. Medical interventions (e.g., inpatient psychiatric assessment, medication management) were used in two-thirds of cases. Person-centered care was used more often in successful cases. Respondents in dementia-only communities identified antecedents to BEs more often than those in other communities.

Telehealth in pediatric rehabilitation medicine: A survey of clinician reported utilization and experience

2020 ◽  
Vol 13 (3) ◽  
pp. 281-288
Author(s):  
Anton Dietzen ◽  
William Ide ◽  
Larissa Pavone
Keyword(s):  
Rehabilitation Medicine ◽  
Pediatric Care ◽  
Pediatric Rehabilitation ◽  
Medical Specialties ◽  
Outcomes Of Care ◽  
Perceived Satisfaction ◽  
Barriers To Implementation ◽  
Family Perceptions

PURPOSE: Telehealth services have been touted to improve access to specialty pediatric care. COVID-19 accelerated the adoption of telehealth across many medical specialties. The purpose of this study was to examine telehealth utilization and satisfaction among pediatric physiatrists. METHODS: Using Google Forms, a voluntary survey was created and administered to pediatric physiatrists. The survey collected information on practice setting, telehealth utilization, provider satisfaction, perceived satisfaction of patients and families, and the anticipated role of telehealth in pediatric rehabilitation going forward. RESULTS: Seventy-eight respondents completed the survey. There was a significant reported increase in telehealth utilization since COVID-19 from 14.5% to 97.4%. Eighty-two percent of participants reported feeling comfortable utilizing telehealth, 77% felt confident in the quality of the care provided, and 91% believed patients were satisfied with telehealth visits. Responses indicate that telehealth is expected to play a role in future pediatric physiatry and interest in telehealth continuing medical education is prevalent. Most pediatric physiatrists plan to continue or expand telehealth offerings after COVID-19. CONCLUSION: Telehealth adoption has been expedited by COVID-19. Physician interest in and satisfaction with telehealth is high. Patient and family perceptions, outcomes of care, and barriers to implementation limiting program expansion deserve further study.

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