172. Use of an EMR-Based Care Path for Nutritional Insufficiency: How Quickly Can We Safely Stabilize Them?

2015 ◽  
Vol 56 (2) ◽  
pp. S88-S89
Author(s):  
Erin H. Sieke ◽  
Sarah Strandjord ◽  
Miranda Richmond ◽  
Sarah Worley ◽  
Ellen S. Rome
Keyword(s):  
Care Path ◽  
Nutritional Insufficiency

Medical stabilization of adolescents with nutritional insufficiency: a clinical care path

2015 ◽  
Vol 21 (3) ◽  
pp. 403-410 ◽  
Author(s):  
Sarah E. Strandjord ◽  
Erin H. Sieke ◽  
Miranda Richmond ◽  
Arjun Khadilkar ◽  
Ellen S. Rome
Keyword(s):  
Clinical Care ◽  
Medical Stabilization ◽  
Care Path ◽  
Nutritional Insufficiency

scholarly journals DETECTING MITRAL REGURGITATION AND TRACKING CARE PATH COMPLIANCE USING A NOVEL DIGITAL PLATFORM

2021 ◽  
Vol 77 (18) ◽  
pp. 3238
Author(s):  
Daniel O’Hair ◽  
Janet Kimmel ◽  
Moly Ware ◽  
Miguel Sotelo ◽  
Loren Wagner ◽  
...  
Keyword(s):  
Mitral Regurgitation ◽  
Digital Platform ◽  
Care Path

scholarly journals Systemic inflammation and nutritional insufficiency in palliative cancer patients

2021 ◽  
Vol 102 (4) ◽  
pp. 446-452
Author(s):  
O V Kurchenkova ◽  
U V Kharlamova ◽  
A V Vazhenin ◽  
A O Abdalov
Keyword(s):  
Cancer Patients ◽  
Body Mass ◽  
Systemic Inflammation ◽  
Risk Index ◽  
Nutritional Risk ◽  
Albumin Concentration ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Nutritional Risk Index ◽  
Nutritional Insufficiency

Aim. To study the relationship between the symptoms of nutritional insufficiency and systemic inflammation in cancer palliative patients. Methods. 106 palliative cancer patients were examined at Chelyabinsk Regional Clinical Center of Oncology and Nuclear Medicine: 54 (50.9%) men and 52 (49.1%) women aged 61 [54; 67] years. All patients underwent laboratory and instrumental examination within the approved standards of specialized medical care. Systemic inflammation was assessed by the levels of acute phase proteins (C-reactive protein, fibrinogen). The study of integrated clinical and laboratory, somatometric parameters was carried out. The nutritional risk index was assessed. Results. Palliative cancer patients showed a statistically significant decrease in the concentration of hemoglobin, lymphocytes, and albumin. The activation of systemic inflammation that manifested by hyperfibrinogenemia and an increase in the level of C-reactive protein was revealed. The study of somatometric parameters revealed a statistically significant decrease in body mass index, shoulder circumference, subscapular skinfold thickness, and a tendency to reduce lean body mass. The nutritional risk index assessment showed mild nutritional insufficiency in 22 (20.8%) of the examined patients and severe nutritional insufficiency in 28 (26.4%) patients. The maximum diagnostic significance of the level of C-reactive protein for prediction the nutritional insufficiency was achieved at 80.4% sensitivity and 52.7% specificity (AUC=0.671, 95% confidence interval [0.573; 0.759], p=0.001), which corresponded to a C-reactive protein threshold of 31 mg/l. Conclusion. 50 (47.2%) of the examined patients showed signs of nutritional insufficiency, a statistically significant decrease in hemoglobin and albumin concentration, as well as lymphocyte count, activation of systemic inflammation, manifested by hyperfibrinogenemia, and an increase in the level of C-reactive protein; it was revealed a statistically significant relationship between C-reactive protein level and malnutrition.

scholarly journals Value-Based HIV Care: A Method to Improve Quality of HIV Care.

2020 ◽  
Author(s):  
Guido van den berk ◽  
Daoud Ait Moha ◽  
Janneke Stalenhoef ◽  
Marie-Jose Kleene ◽  
Narda van der Meche ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Care Delivery ◽  
Population Level ◽  
Care Quality ◽  
Hiv Care ◽  
First Year ◽  
Outcome Indicators ◽  
Number Of Patients ◽  
Care Path

Abstract Background : To support our goal of providing optimal HIV care to our patients, we started applying the value-based health care principle to the HIV care that we offer in our HIV center, measuring relevant health outcomes and costs to allow continuous implementation of improvements (Value-Based HIV Care; VBHiC). Methods : In line with the principles of Michael Porter, our approach consisted of the following steps: 1) Organizing into integrated practice units / describing the HIV care path; 2) Defining an HIV outcome indicator set; 3) Building an enabling information technology platform; 4) Integrating care delivery across separate facilities; 5) Moving to bundled payments for care cycles and 6) Expanding excellent services and interventions for improvement across geographic boundaries. Results : The following set of 9 outcome indicators was developed: undetectable HIV load within the first year of care; quality of life within the first year of care; mortality within the first year of care; retention in care; therapy effectiveness; therapy tolerance; cardiovascular risk; quality of life for every subsequent year and overall annual mortality. These indicators, which were evaluated retrospectively, are shown in figures 1-5. Collection of the underlying data started in January 2016. The HIV care path was also integrated into the electronic file system. Creation of the ability to monitor outcome indicators at patient level, population level and process level allowed us to implement a quality cycle (plan-do-study-act). Conclusion : Our Value-Based HIV Care approach facilitated structured evaluation of parameters that are of value to the patient. It also boosted the quality of the HIV care that we provide and allowed us to increase the number of patients to whom we can offer high quality HIV care.

scholarly journals Fragmentation of patient safety research: a critical reflection of current human factors approaches to patient handover

2013 ◽  
Vol 2 (3) ◽  
pp. 33 ◽  
Author(s):  
Tanja Manser
Keyword(s):  
Patient Safety ◽  
Human Factors ◽  
Critical Reflection ◽  
Research Strategy ◽  
Safety Research ◽  
Communication Practices ◽  
Patient Handover ◽  
Fragmentation Of Care ◽  
Care Path

The integration of human factors science in research and interventions aimed at increased patient safety has led to considerable improvements. However, some challenges to patient safety persist and may require human factors experts to critically reflect upon their predominant approaches to research and improvement. This paper is a call to start a discussion of these issues in the area of patient handover. Briefly reviewing recent handover research shows that while these studies have provided valuable insights into the communication practices for a range of handover situations, the predominant research strategy of studying isolated handover episodes replicates the very problem of fragmentation of care that the studies aim to overcome. Thus, there seems to be a need for a patient-centred approach to handover research that aims to investigate the interdependencies of handover episodes during a series of transitions occurring along the care path. Such an approach may contribute to novel insights and help to increase the effectiveness and sustainability of interventions to improve handover.

Abstract P145: Outcomes of an EMR-Enabled Acute Ischemic Stroke Care Path in a Primary Stroke Center

Circulation ◽  
2019 ◽  
Vol 139 (Suppl_1) ◽  
Author(s):  
Aaron Dunn ◽  
Selena Pasadyn ◽  
Francis May ◽  
Dolora Wisco
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Stroke Care ◽  
Primary Stroke Center ◽  
Stroke Center ◽  
Care Path

Improving the Quality of Care across All Settings

2019 ◽  
pp. 573-605
Author(s):  
Marilyn Bookbinder ◽  
Romina Arceo ◽  
James T. McDaniel
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
The United States ◽  
Healthcare Settings ◽  
National Priority ◽  
Hospice And Palliative Care ◽  
Eol Care ◽  
Clinician Assessment ◽  
Care Path

This chapter provides perspectives on quality-based initiatives in the United States across healthcare settings and populations and describes their impact on patient, professional, and system outcomes. The authors discuss the need for quality improvement (QI) at end of life, QI principles, and the models, methods, and tools most frequently used. Also described are areas of national priority for improving end-of-life (EOL) care. A care-path for the end of life is used to illustrate a QI effort and the FOCUS_PDSA method and to encourage use of specific tools for improving EOL care, including respiratory distress, and a clinician assessment of EOL care using The Joint Commission (TJC) tracer methodology. The authors review the linkages between QI and practice changes in hospitals and hospices that ultimately lead to improved EOL care and close with examples of how nurses are providing leadership in the field of quality hospice and palliative care.

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