Exploring Discharge Outcomes and Readmission Rates of Mothers Admitted to a Psychiatric Mother and Baby Unit

Author(s):  
Nayan Soni ◽  
Susan Roberts ◽  
Grace Branjerdporn
Author(s):  
Caitlin Fette ◽  
Rachel Krallman ◽  
Colin McMahon ◽  
Daniel Montgomery ◽  
Jennifer Wang ◽  
...  

Background: Prior studies have shown that patients with diabetes mellitus (DM) have increased risk for developing cardiovascular disease. BRIdging the Discharge Gap Effectively (BRIDGE) is a nurse practitioner-delivered cardiac transitional care program for patients who have been recently discharged following a cardiac event. Previous research has shown BRIDGE to be effective in improving patient outcomes. This study sought to describe differences in outcomes 1) of heart failure (HF), acute coronary syndrome (ACS), and atrial fibrillation (AF) patients with and without concomitant DM, and 2) between diabetic patients who did and did not attend BRIDGE. Methods: Retrospective data were abstracted for HF, ACS, and AF patients from 2008-2014. Patients were divided into cohorts based on presence or absence of DM and BRIDGE attendance versus non-attendance. Outcomes (readmissions, ED visits, death) within each primary diagnosis (HF, ACS, AF) were compared between DM and non-DM patients and between those who attended BRIDGE versus those who did not for all DM patients. Results: Of 2197 patients referred to BRIDGE, 723 (32.9%) had concomitant DM. DM patients had similar outcomes to non-DM patients for most post-discharge outcomes; however, DM ACS patients had higher readmission (42.2% v 29.6%, p<0.001) and death (10.5% v. 4.5%, p=0.001) rates within 6 months, and DM AF patients had higher readmission rates within 6 months (52.1% v 37.9%, p=0.006). HF patients with DM who attended BRIDGE had lower mortality rates within 6 months of discharge than those who did not (10.3% vs. 22.1%, p=0.014). No other significant differences in outcomes were seen between BRIDGE attendees and non-attendees. Conclusions: Though not significant, patients with DM had worse post-discharge outcomes than those without DM for all primary diagnoses. In the subset of DM patients, the 30-day readmission rate for ACS patients who attended BRIDGE was half of those who did not attend. Conversely, 30-day readmission rates for HF patients were greater if they attended. This may in part explain the significantly lower mortality rate among BRIDGE attenders with HF, where patients who needed readmission were identified during their BRIDGE appointment. Due to the high prevalence of DM, efforts to tailor transitional care for this population are needed.


Author(s):  
George A. Beyer ◽  
Karan Dua ◽  
Neil V. Shah ◽  
Joseph P. Scollan ◽  
Jared M. Newman ◽  
...  

Abstract Introduction We evaluated the demographics, flap types, and 30-day complication, readmission, and reoperation rates for upper extremity free flap transfers within the National Surgical Quality Improvement Program (NSQIP) database. Materials and Methods Upper extremity free flap transfer patients in the NSQIP from 2008 to 2016 were identified. Complications, reoperations, and readmissions were queried. Chi-squared tests evaluated differences in sex, race, and insurance. The types of procedures performed, complication frequencies, reoperation rates, and readmission rates were analyzed. Results One-hundred-eleven patients were selected (mean: 36.8 years). Most common upper extremity free flaps were muscle/myocutaneous (45.9%) and other vascularized bone grafts with microanastomosis (27.9%). Thirty-day complications among all patients included superficial site infections (2.7%), intraoperative transfusions (7.2%), pneumonia (0.9%), and deep venous thrombosis (0.9%). Thirty-day reoperation and readmission rates were 4.5% and 3.6%, respectively. The mean time from discharge to readmission was 12.5 days. Conclusion Upper extremity free flap transfers could be performed with a low rate of 30-day complications, reoperations, and readmissions.


Author(s):  
Julio J. Jauregui ◽  
Jeffery J. Cherian ◽  
Todd P. Pierce ◽  
Randa K Elmallah ◽  
Michael A. Mont

2020 ◽  
pp. 1-6
Author(s):  
Paul Park ◽  
Victor Chang ◽  
Hsueh-Han Yeh ◽  
Jason M. Schwalb ◽  
David R. Nerenz ◽  
...  

OBJECTIVEIn 2017, Michigan passed new legislation designed to reduce opioid abuse. This study evaluated the impact of these new restrictive laws on preoperative narcotic use, short-term outcomes, and readmission rates after spinal surgery.METHODSPatient data from 1 year before and 1 year after initiation of the new opioid laws (beginning July 1, 2018) were queried from the Michigan Spine Surgery Improvement Collaborative database. Before and after implementation of the major elements of the new laws, 12,325 and 11,988 patients, respectively, were treated.RESULTSPatients before and after passage of the opioid laws had generally similar demographic and surgical characteristics. Notably, after passage of the opioid laws, the number of patients taking daily narcotics preoperatively decreased from 3783 (48.7%) to 2698 (39.7%; p < 0.0001). Three months postoperatively, there were no differences in minimum clinically important difference (56.0% vs 58.0%, p = 0.1068), numeric rating scale (NRS) score of back pain (3.5 vs 3.4, p = 0.1156), NRS score of leg pain (2.7 vs 2.7, p = 0.3595), satisfaction (84.4% vs 84.7%, p = 0.6852), or 90-day readmission rate (5.8% vs 6.2%, p = 0.3202) between groups. Although there was no difference in readmission rates, pain as a reason for readmission was marginally more common (0.86% vs 1.22%, p = 0.0323).CONCLUSIONSThere was a meaningful decrease in preoperative narcotic use, but notably there was no apparent negative impact on postoperative recovery, patient satisfaction, or short-term outcomes after spinal surgery despite more restrictive opioid prescribing. Although the readmission rate did not significantly increase, pain as a reason for readmission was marginally more frequently observed.


Author(s):  
Marat Fudim ◽  
Toi Spates ◽  
Jie-Lena Sun ◽  
Veraprapas Kittipibul ◽  
Jeffrey M. Testani ◽  
...  

2021 ◽  
Vol 11 (15) ◽  
pp. 6853
Author(s):  
Filippo Migliorini ◽  
Lucio Cipollaro ◽  
Francesco Cuozzo ◽  
Francesco Oliva ◽  
Andrea Valerio Marino ◽  
...  

Introduction: Outpatient total hip arthroplasty (THA) is increasingly popular. This meta-analysis investigated the potential advantages of outpatient regimes for THA. Methods: This study followed the PRISMA guidelines. PubMed, Web of Science, Google Scholar, Embase, and Scopus databases were accessed in June 2021. All clinical studies investigating outpatient THA were considered. The outcomes of interest were pain, infection, mortality, revision, dislocation, readmission rates, and deep vein thrombosis (DVT). Results: Data from 102,839 patients were included. A total of 52% (153,168 of 102,839 patients) were women. The mean age of patients was 62.6 ± 4.6 years, the mean BMI was 29.1 ± 1.8 kg/m2. Good comparability was found in age, BMI, and gender (p > 0.1). No difference was found in pain (p = 0.4), infections (p = 0.9), mortality (p = 0.9), rate of revision (p = 0.1), dislocation (p = 0.9), and readmission (p = 0.8). The outpatient group demonstrated a greater rate of DVT (OR 3.57; 95% CI 2.47 to 5.18; p < 0.0001). Conclusions: In selected patients, outpatient THA can be performed safely with optimal outcomes comparable with inpatient THA. Clear and comprehensive pre-operative planning should involve a multi-disciplinary group composed of orthopaedic surgeons, anaesthesia and rehabilitation specialists, and physiotherapists. Each centre performing outpatient THA should implement continuous homecoming welfare activity, to supervise physiotherapy and monitor anticoagulant therapy.


2021 ◽  
Vol 40 (4) ◽  
pp. S122-S123
Author(s):  
D.S. Burstein ◽  
C. Connelly ◽  
C.S. Almond ◽  
R.A. Niebler ◽  
J.A. Godown ◽  
...  

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 160-161
Author(s):  
Ellen Schneider ◽  
Maureen Dale ◽  
Krista Wells ◽  
John Gotelli ◽  
Carol Julian ◽  
...  

Abstract Alzheimer’s disease is the 4th leading cause of death in North Carolina for people 65 and older. People with dementia are hospitalized more often and have prolonged stays, poorer outcomes, higher costs, and increased readmission rates. Hospital employees have expressed the desire to have specialized training to learn how to more effectively communicate with and provide better care to patients with dementia. To address identified patient and hospital employee needs, the University of North Carolina (UNC) Center for Aging and Health is disseminating hospital-specific dementia-friendly training at five hospitals within the UNC Health System. The training is being delivered via online modules and follow-up didactic sessions over a three-year period to clinical and non-clinical staff who interact with patients. To date, 1,948 employees at three of the five hospitals have launched the online training; 1,102 have completed the training. The pilot training took place at the UNC Hospitals--Hillsborough Campus (“Hillsborough Hospital”) in 2019. Hillsborough Hospital staff (n=195) who participated in the dementia friendly training completed a survey to assess their ability to recognize symptoms and provide appropriate care to dementia patients pre- and post-training. Clinical staff answered 23 Likert scale self-efficacy questions; non-clinical staff answered the first 12 of these questions. Positive change in self-efficacy ratings from pre- to post-training was significant for every question (p &lt; .0001). Additional results will be included in the poster. The dementia-friendly hospital initiative is preparing employees to provide better care for people with dementia and is effective in increasing employee self-efficacy.


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