scholarly journals 560: USE OF CERIBELL EEG SYSTEM IN A COMMUNITY HOSPITAL: A FINANCIAL AND PATIENT OUTCOMES IMPACT STUDY

2021 ◽  
Vol 50 (1) ◽  
pp. 271-271
Author(s):  
Jared Ward ◽  
Adam Green ◽  
Stanley Dumond ◽  
Jessica Clough ◽  
Robert Cole ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Community Hospital ◽  
Impact Study

Implementation of an Acute Care Surgery Service in a Community Hospital: Impact on Hospital Efficiency and Patient Outcomes

2016 ◽  
Vol 82 (1) ◽  
pp. 79-84 ◽  
Author(s):  
Michael Kalina
Keyword(s):  
Length Of Stay ◽  
Patient Care ◽  
Acute Care ◽  
Patient Outcomes ◽  
Community Hospital ◽  
Hospital Efficiency ◽  
Hospital Charges ◽  
Acute Care Surgery ◽  
Health Evaluation ◽  
Care Surgery

A service led by acute care surgeons managing trauma, critically ill surgical, and emergency general surgery patients via an acute care surgery model of patient care improves hospital efficiency and patient outcomes at university-affiliated hospitals and American College of Surgeons–verified trauma centers. Our goal was to determine whether an acute care surgeon led service, entitled the Surgical Trauma and Acute Resuscitative Service (STARS) that implemented an acute care surgery model of patient care, could improve hospital efficiency and patient outcomes at a community hospital. A total of 492 patient charts were reviewed, which included 230 before the implementation of the STARS [pre-STARS (control)] and 262 after the implementation of the STARS [post-STARS (study)]. Demographics included age, gender, Acute Physiology and Chronic Health Evaluation 2 score, and medical comorbidities. Efficiency data included length of stay in emergency department (ED-LOS), length of stay in surgical intensive care unit (SICU-LOS), and length of stay in hospital (H-LOS), and total in hospital charges. Average age was 64.1 + 16.4 years, 255 males (51.83%) and 237 females (48.17%). Average Acute Physiology and Chronic Health Evaluation 2 score was 11.9 + 5.8. No significant differences in demographics were observed. Average decreases in ED-LOS (9.7 + 9.6 hours, pre-STARS versus 6.6 + 4.5 hours, post-STARS), SICU-LOS (5.3 + 9.6 days, pre-STARS versus 3.5 + 4.8 days, post-STARS), H-LOS (12.4 + 12.7 days, pre-STARS versus 11.4 + 11.3 days, post-STARS), and total in hospital charges ($419,602.6 + $519,523.0 pre-STARS to $374,816.7 + $411,935.8 post-STARS) post-STARS. Regression analysis revealed decreased ED-LOS—2.9 hours [ P = 0.17; 95% confidence interval (CI): -7.0, 1.2], SICU-LOS—6.3 days ( P < 0.001; 95% CI: -9.3, -3.2), H-LOS—7.6 days ( P = 0.001; 95% CI: -12.1, -3.1), and 3.4 times greater odds of survival ( P = 0.04; 95% CI: 1.1, 10.7) post-STARS. In conclusion, implementation of the STARS improved hospital efficiency and patient outcomes at a community hospital.

Phytonadione Education Program in a Community Hospital

2003 ◽  
Vol 38 (5) ◽  
pp. 458-462 ◽  
Author(s):  
Lisa M. Murphey ◽  
Debbie C. Byrd
Keyword(s):  
Patient Outcomes ◽  
Community Hospital ◽  
Medication Use ◽  
Education Session ◽  
Routes Of Administration ◽  
Baseline Group ◽  
Before And After ◽  
Post Test ◽  
The Mean

Purpose Pharmacists and physicians were educated regarding updated guidelines on phytonadione indications, dosing, and routes of administration. Study objectives were to evaluate the use of phytonadione in a community hospital, educate pharmacists and physicians about phytonadione use, and assess the value of education in terms of patient outcomes. Methods Baseline and follow-up data on phytonadione indications, dosages, and routes of administration were collected. Pretests and post-tests were administered before and after an education session. A Pharmacy and Therapeutics newsletter article highlighting the appropriate use of phytonadione was published. Results The baseline and follow-up medication use evaluations (MUEs) revealed that 53% and 62% of patients had an appropriate indication for phytonadione, respectively (P = 0.181). Among patients with an appropriate indication, 44% were administered an appropriate dose in the baseline group and 46% in the follow-up (P = 0.876). The baseline MUE revealed that 20% of phytonadione routes of administration were appropriate; 18% were considered appropriate in the follow-up (P = 0.842). Pharmacists' knowledge showed improvement after education efforts, with the mean score improving from 57% to 93.4% from pretest to post-test (P < 0.05) and the median score changing from 50% to 100%. Conclusion Improving pharmacists' knowledge is beneficial and necessary; however, it was not enough to change practice in this study. Additional steps must be taken to encourage routine application of the knowledge.

Experience with an Enhanced Recovery After Spine Surgery protocol at an academic community hospital

2020 ◽  
pp. 1-8
Author(s):  
Robert Young ◽  
Ethan Cottrill ◽  
Zach Pennington ◽  
Jeff Ehresman ◽  
A. Karim Ahmed ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Spine Surgery ◽  
Community Hospital ◽  
Enhanced Recovery ◽  
Academic Community ◽  
Control Group ◽  
Opiate Use ◽  
Secondary Outcomes ◽  
Improve Patient ◽  
Historic Cohort

OBJECTIVEEnhanced Recovery After Surgery (ERAS) protocols have rapidly gained popularity in multiple surgical specialties and are recognized for their potential to improve patient outcomes and decrease hospitalization costs. However, they have only recently been applied to spinal surgery. The goal in the present work was to describe the development, implementation, and impact of an Enhanced Recovery After Spine Surgery (ERASS) protocol for patients undergoing elective spine procedures at an academic community hospital.METHODSA multidisciplinary team, drawing on prior publications and spine surgery best practices, collaborated to develop an ERASS protocol. Patients undergoing elective cervical or lumbar procedures were prospectively enrolled at a single tertiary care center; interventions were standardized across the cohort for pre-, intra-, and postoperative care using standardized order sets in the electronic medical record. Protocol efficacy was evaluated by comparing enrolled patients to a historic cohort of age- and procedure-matched controls. The primary study outcomes were quantity of opiate use in morphine milligram equivalents (MMEs) on postoperative day (POD) 1 and length of stay. Secondary outcomes included frequency and duration of indwelling urinary catheter use, discharge disposition, 30-day readmission and reoperation rates, and complication rates. Multivariable linear regression was used to determine whether ERASS protocol use was independently predictive of opiate use on POD 1.RESULTSIn total, 97 patients were included in the study cohort and were compared with a historic cohort of 146 patients. The patients in the ERASS group had lower POD 1 opiate use than the control group (26 ± 33 vs 42 ± 40 MMEs, p < 0.001), driven largely by differences in opiate-naive patients (16 ± 21 vs 38 ± 36 MMEs, p < 0.001). Additionally, patients in the ERASS group had shorter hospitalizations than patients in the control group (51 ± 30 vs 62 ± 49 hours, p = 0.047). On multivariable regression, implementation of the ERASS protocol was independently predictive of lower POD 1 opiate consumption (β = −7.32, p < 0.001). There were no significant differences in any of the secondary outcomes.CONCLUSIONSThe authors found that the development and implementation of a comprehensive ERASS protocol led to a modest reduction in postoperative opiate consumption and hospital length of stay in patients undergoing elective cervical or lumbar procedures. As suggested by these results and those of other groups, the implementation of ERASS protocols may reduce care costs and improve patient outcomes after spine surgery.

scholarly journals Impact of Stroke Care Unit on Patient Outcomes in a Community Hospital

Stroke ◽  
2014 ◽  
Vol 45 (1) ◽  
pp. 211-216 ◽  
Author(s):  
Alexander Tamm ◽  
Muzaffar Siddiqui ◽  
Ashfaq Shuaib ◽  
Ken Butcher ◽  
Rajive Jassal ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Community Hospital ◽  
Stroke Care

IMPACT OF RECOMBINANT HUMAN ACTIVATED PROTEIN C (RHAPC) IN TREATMENT OF SEPTIC SHOCK IN A COMMUNITY HOSPITAL: IMPACT STUDY

CHEST Journal ◽  
2009 ◽  
Vol 136 (4) ◽  
pp. 44S
Author(s):  
Narinder S. Gill ◽  
Linda Hamidjaja ◽  
Bing Shen ◽  
Vijay P. Balasubramanian
Keyword(s):  
Septic Shock ◽  
Protein C ◽  
Community Hospital ◽  
Activated Protein C ◽  
Impact Study

Didactic and Simulation Nontechnical Skills Team Training to Improve Perinatal Patient Outcomes in a Community Hospital

2011 ◽  
Vol 37 (8) ◽  
pp. 357-364 ◽  
Author(s):  
William Riley ◽  
Stanley Davis ◽  
Kristi Miller ◽  
Helen Hansen ◽  
Francois Sainfort ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Community Hospital ◽  
Team Training ◽  
Nontechnical Skills

Clinical Pharmacist Management of Bacteremia in a Community Hospital Emergency Department

2017 ◽  
Vol 51 (6) ◽  
pp. 465-472 ◽  
Author(s):  
C. Dustin Waters ◽  
Bryce J. Bitton ◽  
Annie Torosyan ◽  
Kevin P. Myers
Keyword(s):  
Infectious Disease ◽  
Emergency Department ◽  
Patient Outcomes ◽  
Primary Outcome ◽  
Community Hospital ◽  
Mortality Data ◽  
High Morbidity ◽  
Hospital Emergency ◽  
Appropriate Treatment ◽  
Secondary Outcomes

Background: Bacteremia is a serious condition that leads to high morbidity and mortality. Data describing pharmacist involvement in the management of bacteremia in the emergency department are lacking. Objective: To determine if pharmacist involvement in the management of bacteremia in the emergency department (ED) led to an increase in appropriate treatment of bacteremia as well as improvements in patient outcomes. Methods: The primary outcome of this retrospective cohort study was the rate of appropriate treatment of bacteremia. Secondary outcomes included the rate of unplanned, infectious disease–related 90-day admission or readmission to the ED or hospital as well as infectious disease–related 90-day mortality. All patients seen in the ED and subsequently discharged who had a positive blood culture determined not to be a contaminant were included in the study. Patients were analyzed in 2 cohorts: those that were physician managed (107 patients) and those that were pharmacist managed (138 patients). Results: In the physician-managed cohort, 50 of 107 (47%) patients were treated appropriately compared with 131 of 138 (95%) patients in the pharmacist-managed cohort ( P < 0.0001). There was also a decrease in attributable 90-day admission or readmission in pharmacist-managed patients, which occurred in 4 of 138 patients (2.9%) versus the physician-managed patient cohort in which 13 of 107 patients (12.1%) were readmitted ( P = 0.01). There was no difference in mortality between the groups ( P = 0.8337). Conclusion: Pharmacist involvement in the management of bacteremia in the ED was associated with higher rates of appropriate treatment and a corresponding decrease in the rates of attributable 90-day admission or readmission to the hospital or ED.

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