scholarly journals Use of the Flugelman index for identifying patients who are difficult to discharge from the hospital

2013 ◽  
pp. 103-108
Author(s):  
Chiara Bozzano ◽  
Ilario Lancini ◽  
Elena Mei ◽  
Maida Lucarini ◽  
Roberta Mastriforti ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Hospital Stay ◽  
Discharge Planning ◽  
District General Hospital ◽  
Feeding Problems ◽  
Care Needs ◽  
Socioeconomic Condition ◽  
Factors Affecting ◽  
Effective Discharge ◽  
Medical Wards

Introduction: To evaluate the use of multidimensional assessment based on the Fluegelman Index (FI) to identify internal medicine patients who are likely to be difficult to discharge from the hospital. Materials and methods: Have been evaluated all patients admitted to the medical wards of the District General Hospital of Arezzo from September 1 to October 31, 2007. We collected data on age, sex, socioeconomic condition, cause of admission, comorbidity score preadmission functional status (Barthel Index), incontinence, feeding problems, length of hospitalization, condition at discharge, and type of discharge. The FI cut off for difficult discharge was > 17. Results: Of the 413 patients (mean age 80 + 11.37 years; percentage of women, 56.1%) included in the study, 109 (26.39%) had Flugelman Index > 17. These patients were significantly older than the patients with lower FIs (85 + 9.35 vs 78 + 11.58 years, p < 0.001), more likely to be admitted for pneumonia (22% vs. 4.9% of those with lower FIs; p < 0,001). They also had more comorbidity, loss of autonomy, cognitive impairment, social frailty, and nursing care needs. The subgroup with FIs>17 had significantly higher in-hospital mortality (30.28% vs 6.25%, p < 0.001), longer hospital stay (13 vs. 10 days, p < 0.05), and higher rates of discharge to nursing homes. Conclusions: Evaluation of internal medicine patients with the Flugelman Index may be helpful for identifying more critical patients likely to require longer hospitalization and to detect factors affecting the hospital stay. This information can be useful for more effective discharge planning.

scholarly journals Evaluating Implementation of the Diabetes Perioperative Passport: A qualitative focus group study

2020 ◽  
Author(s):  
Funke Akiboye ◽  
Emma Page ◽  
Krish Nirantharakumar ◽  
Gerry Rayman ◽  
Antje Lindenmeyer
Keyword(s):  
Focus Group ◽  
Focus Groups ◽  
Elective Surgery ◽  
District General Hospital ◽  
Working Environment ◽  
Practical Implementation ◽  
Care Needs ◽  
Focus Group Study ◽  
Factors Affecting ◽  
Implementation Tool

Abstract Background and AimsA perioperative passport was developed to improve care of people with diabetes undergoing elective surgery by equipping patients with a hand-held summary of their care needs. Two surgical nursing groups were approached to be involved in developing and piloting this novel technology with contrasting results.This study aims to examine the factors affecting implementation of an empowerment tool for patients with diabetes among nursing staff in two surgical groups within a single district general hospitalDesignA qualitative study using focus groups to examine factors affecting staff engagement in implementing the diabetes perioperative passport.MethodsTwo focus group were conducted in 2017 with pre-operative assessment nurses in the departments of orthopaedics and general surgery of an NHS trust (N= 8). Audio-taped group discussions were transcribed, and the data coded and analysed to identify themesFindingsThe general surgical nurse group generally supported each other’s views and comments. They were enthused about the passport throughout. In contrast, the orthopaedic specialist nurse group had initial reservations about implementing the passport, but as the focus group unfolded, they moved from sharing individual views to finding commonalities and became more engaged and motivated to use the passport.ConclusionFocus groups are a practical and efficient tool to conduct within the usual working environment of an NHS hospital. In addition to capturing information about the challenges to implementation they may serve as a crucial implementation tool where evidence-based practice has not been adopted.ImpactThis is the first study carried out in the NHS setting highlighting the benefit of focus groups as a practical implementation tool.

scholarly journals Effect of an Intervention to Improve Team Coordination on Patients Who are Likely to be Discharged by General Internal Medicine

1970 ◽  
Vol 10 (1) ◽  
Author(s):  
Lina Pham BA ◽  
Teri Arany ◽  
William Coke MD ◽  
Vivian Lo ◽  
Robert C. Wu MD
Keyword(s):  
Internal Medicine ◽  
Emergency Department ◽  
Length Of Stay ◽  
General Internal Medicine ◽  
Discharge Planning ◽  
Teaching Hospitals ◽  
Post Discharge ◽  
General Internal ◽  
Effective Discharge ◽  
The Impact

Effective discharge planning is important to ensuring a high quality of patient care and operational efficiency. The general internal medicine (GIM) environment is very complex and fluid, with multiple health professions providing care for patients. This makes coordination of discharges difficult, even with structured daily interprofessional rounds.The purpose of this case-control study was to evaluate a discharge notification form that predicts next-day discharges. The main measures of the study, which took place in GIM wards at two academic teaching hospitals, were the completion and accuracy of the discharge forms, length of stay, discharge times, post-discharge admissions, and emergency department visits.Seventy-six of 200 patients studied had information completed on the discharge notification form. The overall effect appeared to move discharges earlier in the day, while having no effect on length of stay.Patients whose information was completed on the discharge notification form were less likely to have an emergency department visit within 30 days post-discharge.The use of a discharge notification form appears to move discharges earlier in the day, without increasing length of stay. Further refinement and evaluation is necessary to increase usage and assess the impact onoutcomes of care.

scholarly journals Evaluating Implementation of The Diabetes Perioperative Passport: A Qualitative Focus Group Study

2020 ◽  
Author(s):  
Funke Akiboye ◽  
Emma Page ◽  
Krish Nirantharakumar ◽  
Gerry Rayman ◽  
Antje Lindenmeyer
Keyword(s):  
Focus Group ◽  
Focus Groups ◽  
Elective Surgery ◽  
District General Hospital ◽  
Working Environment ◽  
Practical Implementation ◽  
Care Needs ◽  
Focus Group Study ◽  
Factors Affecting ◽  
Implementation Tool

Abstract Aims To examine the factors affecting implementation of an empowerment tool for patients with diabetes in two surgical groups within a single district general hospitalBackground A perioperative passport was developed to improve care of people with diabetes undergoing elective surgery by equipping patients with a hand-held summary of their care needs. Two surgical groups were approached to be involved in developing and piloting this novel technology with contrasting results. Design A qualitative study using focus groups to examine factors affecting staff engagement in implementing the diabetes perioperative passport.Methods Two focus group were conducted in 2017 with pre-operative nurses in the departments of orthopaedics and general surgery of an NHS trust (N= 8). Audio-taped group discussions were transcribed, and the data coded and analysed to identify themes.Results The general surgical nurse group generally supported each other’s views and comments. They were enthused about the passport throughout. In contrast, the orthopaedic specialist nurse group had initial reservations about implementing the passport, but as the focus group unfolded, they moved from sharing individual views to finding commonalities and became more engaged and motivated to use the passport. Conclusion Focus groups are a practical and efficient tool to conduct within the usual working environment of an NHS hospital. In addition to capturing information about the challenges to implementation they may serve as a crucial implementation tool where evidence-based practice has not been adopted. Impact This is the first study carried out in the NHS setting highlighting the benefit of focus groups as a practical implementation tool.

Predictors of clinical events occurring during hospital stay among elderly patients admitted to medical wards in Italy

2016 ◽  
Vol 32 ◽  
pp. 38-42 ◽  
Author(s):  
Paolo Dionigi Rossi ◽  
Claudio Bilotta ◽  
Dario Consonni ◽  
Alessandro Nobili ◽  
Sarah Damanti ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Hospital Stay ◽  
Clinical Events ◽  
Medical Wards

scholarly journals Pattern and Clinical Profile of Congenital Heart Disease in A Teaching Hospital

1970 ◽  
Vol 21 (1) ◽  
pp. 58-62 ◽  
Author(s):  
L Shamima Sharmin ◽  
M Azizul Haque ◽  
M Iqbal Bari ◽  
M Ayub Ali
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Hospital Stay ◽  
Congenital Heart ◽  
Growth Failure ◽  
Female Child ◽  
Feeding Problems ◽  
Medical College ◽  
One Year ◽  
A Prospective Study

Objectives: To see the (a) type of congenital heart disease, (b) Clinical presentation of the cases, (c) association with extra-cardiac anomalies and disease, (d) complications of different CHD, (e) outcome of patients during hospital stay. Methodology: it was a prospective study conducted in the department of pediatrics of Rajshahi Medical College & Hospital over a period of one year.115 children from birth to 12 years of age who had congenital heart disease confirmed by echocardiography were included. All patients were treated conservatively and observed for immediate out come during the hospital stay. Result: major types of CHD were VSD (42.6%), TOF (18.3%), ASD (14.8%), PDA (7.8%). Male outnumbers female child. Common symptoms were breathlessness (60%), fatigue (54.8%), cough (43.5%), poor weight gain (41.7%), recurrent chest infection (34.8%), fever (28.7%), feeding problems (26.1%), palpitation (21.7%) and bluish discoloration of lips and fingertips (20%). Murmur with or without thrill and cardiomegaly was the most important cardiac finding. Frequently observed complications were heart failure, pulmonary hypertension and growth failure.   doi: 10.3329/taj.v21i1.3221 TAJ 2008; 21(1): 58-62

Prevalence of anemia in hospitalized internal medicine patients: Correlations with comorbidities and length of hospital stay

2018 ◽  
Vol 51 ◽  
pp. 11-17 ◽  
Author(s):  
Carlo Zaninetti ◽  
Catherine Klersy ◽  
Concetta Scavariello ◽  
Raffaella Bastia ◽  
Carlo L. Balduini ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Prevalence Of Anemia

scholarly journals What are the Most Effective Factors in Determining Future Exacerbations, Morbidity Weight and Mortality In Patients Hospitalized wıth COPD Attack? A Prospective Study

2021 ◽  
Author(s):  
Çağla Koç ◽  
Füsun Şahin
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Blood Gases ◽  
Distribution Width ◽  
Factors Affecting ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Arterial Blood ◽  
Gold Stage ◽  
A Prospective Study

INTRODUCTION: The aim of this study was to investigate the important factors affecting the COPD prognosis. MATERIAL AND METHODS: We included 160 hospitalized patients with COPD exacerbation in the study. Hemoglobin-HB, hematocrit-HCT, leukocyte, red cell distribution width- RDW, mean platelet volume, platelet distribution width, plateletcrit, platelet, neutrophil / lymphocyte ratio, platelet / lymphocyte ratio, eosinophil, uric acid, albumin, CRP, procalcitonin, arterial blood gases (PO2, PCO2) pulmonary function test (FEV1, FVC), echocardiography (ejection fraction-EF) GOLD stage, MMRC and BORG scales, Charlson comorbidity index, body mass index-BMI, length of hospital stay were examined on the first day of hospitalization. Admission to the hospital with a new attack, hospitalization in the intensive care unit-ICU, and mortality during the 6 months after discharge were evaluated. RESULTS: High CRP and procalcitonin values were observed in the group with long hospital stay. In mortality group, HB, HCT, BMI and PO2 values were significantly lower than the group without mortality while age and GOLD stage were higher. The age, BORG and MMRC scores, number of exacerbations experienced in the previous 1 year, RDW, eosinophil count, PCO2 were significantly higher in the ICU group than without ICU. HCT, EF values were lower in the ICU group than without ICU. FEV1, FVC values were significantly lower in follow-up attack group than without attack; the duration of COPD and the number of experienced in the previous 1 year were high. CONCLUSION: It has been concluded that the scoring combining selected biomarkers and other factors will be stronger in determining the prognosis.

scholarly journals 49. Effects of Maternal SARS-CoV-2 Infection on Neonatal Discharge Planning and Care: Exacerbation of Racial and Ethnic Healthcare Disparities

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S35-S35
Author(s):  
Jennifer Jubulis ◽  
Amanda Goddard ◽  
Sarah Dibrigida ◽  
Carol A McCarthy
Keyword(s):  
Healthcare Disparities ◽  
Discharge Planning ◽  
Medical Center ◽  
Newborn Care ◽  
Well Being ◽  
Racial Minorities ◽  
Foreign Born ◽  
Factors Affecting ◽  
Exposed Infant

Abstract Background SARS-CoV-2 has exacerbated healthcare disparities. Maine’s population of 1.3 million is comprised of only 6% Black, Indigenous, People of Color (BIPOC); however, statewide 18% of SARS-CoV-2 infections have occurred in this group. This study examines newborn care inequities for infants born to mothers with SARS-CoV-2. Methods This study was conducted at Maine Medical Center in Portland, the largest hospital in Maine. Maternal SARS-CoV-2 infections from March 15, 2020 through April 1, 2021 were identified by PCR near time of delivery. Cases were matched to uninfected women by date of delivery. Chart review was conducted assessing demographic and clinical characteristics, comparing SARS-CoV-2 exposed and unexposed infants. The subset of SARS-CoV-2 exposed infants was further analyzed for trends in care by race. Protocol was exempt by MaineHealth IRB. Results Twenty four women and their infants were identified with maternal positive SARS-CoV-2 PCR just prior to delivery. An additional 24 unexposed infants were enrolled. When compared to unexposed infants, SARS-CoV-2 exposed were more likely to be racial minorities (63% vs 21%, p = 0.003), to have foreign-born mothers (58% vs 0.4%, p&lt; 0.05) or to receive health care in a language other than English (29% vs 0.4%, p =0.02). For infants born to SARS-CoV-2 infected mothers, only 29% had initial follow up visit in person with their primary care provider (13% of BIPOC infants vs 56% of non-BIPOC infants, p = 0.03). Time to in-person follow up for exposed infants varied by race, with median time of 21 days (range 2-53 days) for racial minorities and 7.5 days (range 2-30 days) for non minorities. All families were discharged with a thermometer and scale for home management. No infants required re-admission during the month after discharge. One exposed infant tested positive for SARS-CoV-2. Conclusion The American Academy of Pediatrics recommends evaluation of newborns 3-5 days after discharge to identify maternal and child health factors affecting newborn well-being. The SARS-CoV-2 pandemic has made this challenging for patients, particularly for racial minorities. BIPOC pediatric patients were disproportionately affected by the pandemic in Maine, and were disproportionately affected by care discrepancies even when the infant was uninfected. Disclosures All Authors: No reported disclosures

Sign in / Sign up

Export Citation Format

Share Document