scholarly journals Following Up on Clinical Recommendations in Transitions from Hospital to Nursing Home

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Lisa B. Caruso ◽  
Soe Soe Thwin ◽  
Gary H. Brandeis
Keyword(s):  
Nursing Home ◽  
Patient Outcomes ◽  
Hospital Readmission ◽  
Medical Center ◽  
Academic Medical Center ◽  
National Data ◽  
Home Setting ◽  
Hospital Readmission Rate ◽  
Academic Medical ◽  
Nursing Home Setting

Following up on recommendations made at the time of a hospital discharge is important to patient safety. While data is lacking, specifically around the transition of patient to nursing home, it has been postulated that missed items such as laboratory tests may result in adverse patient outcomes. To determine the extent of this problem, a retrospective cohort study of subjects discharged from an academic medical center and admitted to nursing homes (NH) was followed to determine the type of discharge recommendations and the rate of completion. In addition, for the purpose of generalizability, the 30-day hospital readmission rate was calculated. 152 recommendations were made on 51 subjects. Almost a quarter of the recommendations made by the hospital discharging team were not acted upon. Furthermore, for the majority of those recommendations that were not acted upon, a reason could not be determined. In concert with national data, 20% of the subjects returned to the hospital within 30 days. Further investigation is warranted to determine if an association exists between missed recommendations and hospital readmission from the nursing home setting.

scholarly journals Patient Centered Medical Home transformation at an academic medical center

2015 ◽  
Vol 5 (1) ◽  
pp. 34
Author(s):  
Randy Wexler ◽  
Jennifer Lehman ◽  
Mary Jo Welker
Keyword(s):  
Family Medicine ◽  
Patient Outcomes ◽  
Medical Home ◽  
Medical Center ◽  
Academic Medical Center ◽  
Lessons Learned ◽  
Patient Centered Medical Home ◽  
Model Of Care ◽  
Patient Centered ◽  
Academic Medical

Background: Primary care is playing an ever increasing role in the design and implementation of new models of healthcare focused on achieving policy ends as put forth by government at both the state and federal level. The Patient Centered Medical Home (PCMH) model is a leading design in this endeavor.Objective: We sought to transform family medicine offices at an academic medical center into the PCMH model of care with improvements in patient outcomes as the end result.Results: Transformation to the PCMH model of care resulted in improved rates of control of diabetes and hypertension and improved prevention measures such as smoking cessation, mammograms, Pneumovax administration, and Tdap vaccination. Readmission rates also improved using a care coordination model.Conclusions: It is possible to transform family medicine offices at academic medical centers in methods consistent with newer models of care such as the PCMH model and to improve patient outcomes. Lessons learned along the way are useful to any practice or system seeking to undertake such transformation.

Abstract 16125: Impact of COVID-19 on Echocardiography Volume at a Large Academic Medical Center

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Merilyn S Varghese ◽  
Jordan B Strom ◽  
Sarah Fostello ◽  
Warren J Manning
Keyword(s):  
Patient Outcomes ◽  
Hospital Admissions ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical ◽  
Hospital Systems ◽  
The Impact ◽  
At Home

Introduction: COVID-19 has significantly impacted hospital systems worldwide. The impact of statewide stay-at-home mandates on echocardiography volumes is unclear. Methods: We queried our institutional echocardiography database from 6/1/2018 to 6/13/2020 to examine rates of transthoracic (TTE), stress (SE), and transesophageal echocardiograms (TEE) prior to and following the COVID-19 Massachusetts stay-at-home order on March 15, 2020. Results: Among 36,377 total studies performed during the study period, mean weekly study volume dropped from 332 + 3 TTEs/week, 30 + 1 SEs/week, and 21 + 1 TEEs/week prior to the stay-at-home order (6/1/2018-3/15/2020) to 158 + 13 TTEs/week, 8 + 2 SEs/week, and 8 + 1 TEEs/week after (% change, -52%, -73%, and -62% respectively, all p < 0.001 when comparing volume prior to March 15 versus after). Weekly TTEs correlated strongly with hospital admissions throughout the study period (r = 0.93, 95% CI 0.89-0.95, p < 0.001) ( Figure ). Outpatient TTEs declined more than inpatient TTEs (% change, -74% vs. -39%, p <0.001). As of 3 weeks following the cessation of the stay-at-home order, TTE, SE, and TEE weekly volumes have increased to 73%, 66%, and 81% of pre-pandemic levels, respectively. Conclusions: Echocardiography volumes fell precipitously following the Massachusetts stay-at-home order, strongly paralleling declines in overall hospitalizations. Outpatient TTEs declined more than inpatient TTEs. Despite lifting of the order, echocardiography volumes remain substantially below pre-pandemic levels. The impact of the decreased use of echocardiographic services on patient outcomes remains to be determined.

Assessment of Short-Term Patient Outcomes Following Overlapping Orthopaedic Surgery at a Large Academic Medical Center

2020 ◽  
Vol 102 (8) ◽  
pp. 654-663
Author(s):  
Gregory Glauser ◽  
Benjamin Osiemo ◽  
Stephen Goodrich ◽  
Scott D. McClintock ◽  
Kristy L. Weber ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Orthopaedic Surgery ◽  
Medical Center ◽  
Academic Medical Center ◽  
Short Term ◽  
Academic Medical

Risk Factors and Effects of Care Management on Hospital Readmissions Among High Users at an Academic Medical Center

2016 ◽  
Vol 17 (3) ◽  
pp. 134-139 ◽  
Author(s):  
Quang H. Pham ◽  
Sara X. Li ◽  
Brent C. Williams
Keyword(s):  
Hospital Readmission ◽  
Care Management ◽  
Medical Center ◽  
Academic Medical Center ◽  
Management Program ◽  
Complex Care ◽  
Intensive Care Management ◽  
Academic Medical ◽  
Care Management Program ◽  
The Mean

Few studies have examined predictors of hospital readmission among high-using patients enrolled in a behaviorally oriented intensive care management program. The purpose of this case control study was to describe risk factors and the effectiveness of a complex care management program for hospital readmission among vulnerable patients at a large academic medical center. One hundred sixty-three patients enrolled in the University of Michigan Complex Care Management Program (UM CCMP) were hospitalized between January 2014 and March 2015. Sixty were readmitted within 30 days of discharge. Among all patients, the mean age was 51.1 years, 38.7% were non-White, 81.5% had Medicaid and/or Medicare, 50.3% were without stable housing, and 27.6% had significant psychiatric illnesses. Although mostly not statistically significant, multivariable risk of readmission was increased by having twice the mean number of hospitalizations in the last 6 months (odds ratio [OR] = 1.44, 95% CI [1.00, 2.06]), having chronic pain on a scheduled narcotic (OR = 1.49, 95% CI [0.67, 3.35]), and going to a primary care physician within 30 days of discharge (OR = 1.35, 95% CI [0.63, 2.89]). Risk was decreased by going to a specialist (OR = 0.54, 95% CI [0.23, 1.27]) and receiving moderate-intensity CCMP intervention (OR = 0.48, 95% CI [0.20, 1.19]). Among hospitalized high-using patients enrolled in the UM intensive care management program, readmission is likely significantly influenced by medical, behavioral, and social challenges. Care management appears most effective in preventing readmission among patients with mid- rather than high- or low-level needs. These findings at a single program should be explored in further, larger studies.

Impact of Pharmacist-Managed Warfarin on Patient Outcomes in an Academic Medical Center

2015 ◽  
Vol 72 (11_Supplement_1) ◽  
pp. S31-S31
Author(s):  
Christina Y. Martin ◽  
Staci A. Hermann ◽  
Rick J. Couldry
Keyword(s):  
Patient Outcomes ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical

scholarly journals In Reply: Association of Overlapping Neurosurgery With Patient Outcomes at a Large Academic Medical Center

Neurosurgery ◽  
2020 ◽  
Vol 86 (6) ◽  
pp. E586-E586
Author(s):  
Prateek Agarwal ◽  
Gregory Glauser ◽  
Neil R Malhotra
Keyword(s):  
Patient Outcomes ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical

scholarly journals Letter: Association of Overlapping Neurosurgery With Patient Outcomes at a Large Academic Medical Center

Neurosurgery ◽  
2020 ◽  
Author(s):  
Feng Zheng ◽  
Xintong Zhang ◽  
Weipeng Hu ◽  
Jinzhong Huang ◽  
Cui'e Wang ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical
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