scholarly journals Post-discharge telephone calls: Improving the communication gap between patients, families and healthcare providers

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Erica Bridge
Keyword(s):  
Healthcare Providers ◽  
Post Discharge ◽  
Telephone Calls ◽  
Communication Gap

scholarly journals Early prediction of diagnostic-related groups and estimation of hospital cost by processing clinical notes

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Jinghui Liu ◽  
Daniel Capurro ◽  
Anthony Nguyen ◽  
Karin Verspoor
Keyword(s):  
Language Processing ◽  
Hospital Cost ◽  
Diagnosis Related Groups ◽  
Characteristic Curve ◽  
Healthcare Providers ◽  
Post Discharge ◽  
Clinical Text ◽  
Case Mix Index ◽  
Operational Decision Making ◽  
Diagnostic Related Groups

AbstractAs healthcare providers receive fixed amounts of reimbursement for given services under DRG (Diagnosis-Related Groups) payment, DRG codes are valuable for cost monitoring and resource allocation. However, coding is typically performed retrospectively post-discharge. We seek to predict DRGs and DRG-based case mix index (CMI) at early inpatient admission using routine clinical text to estimate hospital cost in an acute setting. We examined a deep learning-based natural language processing (NLP) model to automatically predict per-episode DRGs and corresponding cost-reflecting weights on two cohorts (paid under Medicare Severity (MS) DRG or All Patient Refined (APR) DRG), without human coding efforts. It achieved macro-averaged area under the receiver operating characteristic curve (AUC) scores of 0·871 (SD 0·011) on MS-DRG and 0·884 (0·003) on APR-DRG in fivefold cross-validation experiments on the first day of ICU admission. When extended to simulated patient populations to estimate average cost-reflecting weights, the model increased its accuracy over time and obtained absolute CMI error of 2·40 (1·07%) and 12·79% (2·31%), respectively on the first day. As the model could adapt to variations in admission time, cohort size, and requires no extra manual coding efforts, it shows potential to help estimating costs for active patients to support better operational decision-making in hospitals.

scholarly journals A patient-centered system in a provider-centered world: challenges of incorporating post-discharge wound data into practice

2016 ◽  
Vol 23 (3) ◽  
pp. 514-525 ◽  
Author(s):  
Patrick C Sanger ◽  
Andrea Hartzler ◽  
Ross J Lordon ◽  
Cheryl AL Armstrong ◽  
William B Lober ◽  
...  
Keyword(s):  
Design Process ◽  
Data Transfer ◽  
Clinical Care ◽  
Healthcare Providers ◽  
Surgical Patients ◽  
Discharge Process ◽  
Post Discharge ◽  
Patient Centered ◽  
Semistructured Interviews ◽  
Present Design

Objective The proposed Meaningful Use Stage 3 recommendations require healthcare providers to accept patient-generated health data (PGHD) by 2017. Yet, we know little about the tensions that arise in supporting the needs of both patients and providers in this context. We sought to examine these tensions when designing a novel, patient-centered technology – mobile Post-Operative Wound Evaluator (mPOWEr) – that uses PGHD for post-discharge surgical wound monitoring. Materials and Methods As part of the iterative design process of mPOWEr, we conducted semistructured interviews and think-aloud sessions using mockups with surgical patients and providers. We asked participants how mPOWEr could enhance the current post-discharge process for surgical patients, then used grounded theory to develop themes related to conflicts and agreements between patients and providers. Results We identified four areas of agreement: providing contextual metadata, accessible and actionable data presentation, building on existing sociotechnical systems, and process transparency. We identified six areas of conflict, with patients preferring: more flexibility in data input, frequent data transfer, text-based communication, patient input in provider response prioritization, timely and reliable provider responses, and definitive diagnoses. Discussion We present design implications and potential solutions to the identified conflicts for each theme, illustrated using our work on mPOWEr. Our experience highlights the importance of bringing a variety of stakeholders, including patients, into the design process for PGHD applications. Conclusion We have identified critical barriers to integrating PGHD into clinical care and describe design implications to help address these barriers. Our work informs future efforts to ensure the smooth integration of essential PGHD into clinical practice.

Optimization of Provider Ecosystem Through Actor-Resource Integration

2020 ◽  
pp. 103-115
Author(s):  
Mohan Tanniru
Keyword(s):  
Information Technology ◽  
Social Media ◽  
Continuity Of Care ◽  
Healthcare Providers ◽  
Care Transition ◽  
The Internet ◽  
Post Discharge ◽  
Discharge Care ◽  
Internal Operations ◽  
Insight Into

Information technology has enabled healthcare providers such as hospitals to extend their internal operations into external facilities such as urgent and ambulatory care centers and optimizeresources in support of patient care. With the development of the internet, social media, wearables, and telehealth technologies, the potential for patient engagement in preventive and post-discharge care transition has increased. Unlike other organizations where the provider has limited insight into the customer ecosystem, hospitals, for example, have an opportunity to gain insight into the patient ecosystem and influence patient behavior while the patients are within the provider ecosystem. This chapter looks at hospital engagement with patients in two settings—the emergency room (ER) and the patient room (PR)—to illustrate both the opportunities and the strategies that can help hospitals use patient touchpoints to improve continuity of care inside and outside hospital walls.

scholarly journals WORKING BACK TO NORMAL FUNCTION FOLLOWING HOSPITALIZATION: A GROUNDED THEORY STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S445-S445
Author(s):  
Daniel Liebzeit ◽  
Lisa Bratzke ◽  
Barbara King
Keyword(s):  
Older Adults ◽  
Grounded Theory ◽  
Hospital Stay ◽  
Functional Status ◽  
Healthcare Providers ◽  
Physical Space ◽  
Normal Function ◽  
Ability To Work ◽  
Post Discharge ◽  
Grounded Theory Study

Abstract Transitions older adults experience post hospital discharge have primarily focused on the process of moving care from one setting to another (e.g. hospital to home). Older adults often experience a significant transition in terms of losing functional status after a hospital stay. Little is known about how older adults regain their functional ability, the type of work they engage in to recover, and conditions that influence their ability to work after a hospital stay. The objective of this Grounded Theory study was to understand strategies older adults use post discharge as they work to regain their functional status and what conditions facilitate or limit their ability to work toward returning to normal. A qualitative study was conducted. Adults aged 65 and older discharged from a large Midwestern teaching hospital (N = 14) were interviewed using in-depth one-on-one interviews. Data were analyzed using open, axial, and selective coding. Participants described key strategies they employed to regain their normal function following hospitalization and illness: doing exercises, expanding physical space, resuming prior activities and daily cares, and tracking improvement with benchmarks. Several conditions such as, presence of informal (family, friends) and formal (healthcare providers) support, perceived threats (relocation), and having poor physical or physiologic function, acted as barriers and facilitators to participants ability to work back to normal function. This study provides empirical data on work older adults engage in to transition back to normal function during the post discharge period. It presents opportunities for better supporting their work of regaining function.

scholarly journals Post-discharge surveillance of wound infections by telephone calls method in a Sudanese Teaching Hospital

2013 ◽  
Vol 6 (5) ◽  
pp. 339-346 ◽  
Author(s):  
Abubaker Ibrahim Elbur ◽  
Yousif MA ◽  
Ahmed S.A. ElSayed ◽  
Manar E. Abdel-Rahman
Keyword(s):  
Teaching Hospital ◽  
Wound Infections ◽  
Post Discharge ◽  
Telephone Calls

Malpractice claims regarding calls to Swedish telephone advice nursing: what went wrong and why?

2012 ◽  
Vol 18 (7) ◽  
pp. 379-383 ◽  
Author(s):  
Annica Ernesäter ◽  
Ulrika Winblad ◽  
Maria Engström ◽  
Inger K Holmström
Keyword(s):  
Interaction Analysis ◽  
Work Group ◽  
Qualitative Content Analysis ◽  
Group Discussion ◽  
Healthcare Providers ◽  
Third Party ◽  
National Board ◽  
Malpractice Claims ◽  
Telephone Calls ◽  
Analysis System

We analysed the characteristics of all malpractice claims arising out of telephone calls to Swedish Healthcare Direct (SHD) during 2003–2010 ( n = 33). The National Board of Health and Welfare's (NBHW) investigations describing the causes of the malpractice claims and the healthcare providers' reported measures were analysed using Qualitative Content Analysis. The original telephone calls themselves, which had been recorded, were analysed using the Roter Interaction Analysis System (RIAS). Among the 33 cases, 13 patients died and 12 were admitted to intensive care. Failure to listen to the caller ( n = 12) was the most common reason for malpractice claims, and work-group discussion ( n = 13) was the most common measure taken to prevent future re-occurrence. Male patients ( n = 19) were in the majority, and females ( n = 24) were the most common callers. The most common symptoms were abdominal ( n = 11) and chest pain ( n = 6). Telenurses followed up on caller understanding in six calls, and mainly used closed-ended questions. Despite the severity of these malpractice claims, the measures taken mainly addressed active failure, rather than the latent conditions. Third-party communication should be regarded as a risk. When callers make repeated contacts, telenurses need to re-evaluate their need for care.

A Proposed Architecture to Sustain Public-Private Partnership

2020 ◽  
pp. 185-199
Author(s):  
Mohan Tanniru ◽  
Mark Martz
Keyword(s):  
Service Delivery ◽  
Health Care Providers ◽  
Healthcare Providers ◽  
Transition Services ◽  
Care Providers ◽  
Post Discharge ◽  
Care Services ◽  
Discharge Care ◽  
Quality Of Patient Care

Information technology has enabled tertiary health care providers to improve patient access to preventive and post-discharge care transition services. When such services are supported by facilities that are under the control of the hospital, hospitals can still influence the delivery and overall quality of patient care services. However, for a variety of reasons, many hospitals rely on external care providers who operate relatively independently from the hospital to deliver these services. As such, service delivery intended to create efficiency and value to patients can become complex, challenging to deliver, and resource intensive—especially if the service delivery spans a prolonged time horizon. This chapter discusses one case of an intermediary who helps hospitals address the smoking cessation needs of patients. Using service dominant logic research, the service exchanges among three different ecosystems (healthcare providers, intermediary, and patients) are modeled and intelligence needed to align their goals using blockchain architecture is highlighted.

Pain and behaviour changes in children following surgery

2012 ◽  
Vol 97 (10) ◽  
pp. 879-884 ◽  
Author(s):  
Nina Mary Power ◽  
Richard F Howard ◽  
Angie M Wade ◽  
Linda S Franck
Keyword(s):  
Elective Surgery ◽  
Child Anxiety ◽  
Healthcare Providers ◽  
Self Report ◽  
Post Discharge ◽  
Factors Associated ◽  
Modifiable Factors ◽  
High Incidence ◽  
Outcomes For Children ◽  
Behaviour Changes

ObjectivesTo quantify postoperative pain and problematic behaviour (PB) in children at home following day-case (same day admission and discharge) or inpatient (≥1 night in hospital) surgery, to identify factors associated with PB at 2 and 4 weeks after discharge and to determine whether pain is associated with PB after adjustment for other factors.Patients and methodsChildren scheduled for elective surgery were recruited to a descriptive study involving direct observation and self-report questionnaires. The principal outcomes were pain and PB on the 2nd post-discharge day and after the 1st, 2nd and 4th weeks.Results131 parents and their children (aged 2–12years) participated in the study. 93% of children had pain and 73% exhibited PB on day 2 after discharge. The incidence of pain and PB decreased over time, but 25% of children still had pain and 32% PB at week 4. Factors associated with PB were child's previous pain experience, parent and child anxiety and parent's level of education.ConclusionsThere was a high incidence of pain and PB persisting for several weeks after surgery in this cohort of children. Previous painful medical experiences and anxiety were important modifiable factors that require further attention from healthcare providers and researchers to potentially improve health and social outcomes for children after surgery.

scholarly journals Care transition from rehabilitation to home: A QI project using the RED Toolkit to decrease readmission rates

2021 ◽  
Vol 10 (1) ◽  
pp. 46
Author(s):  
Jennifer R. Bernard ◽  
Eileen L. Creel ◽  
Rhonda K Pecoraro
Keyword(s):  
Quality Improvement ◽  
Hip Fracture ◽  
Healthcare Providers ◽  
Inpatient Rehabilitation ◽  
Care Plan ◽  
Quality Improvement Initiative ◽  
Evidence Based ◽  
Discharge Process ◽  
Post Discharge ◽  
Post Intervention

Objective: This quality improvement (QI) project’s aim was to lower 30-day healthcare reutilization for patients aged 50 or older with hip fracture using an evidence-based discharge process method, the Re-Engineered Discharge (RED) Toolkit.Methods: The QI project of a revised patient discharge process to lower healthcare reutilization of Baton Rouge Rehabilitation Hospital (BRRH) hip fracture patients was implemented as an evidence-based quality improvement initiative. Inpatient and outpatient discharge process revisions were implemented at an inpatient rehabilitation facility (IRF) based on Re-Engineered Discharge (RED) Toolkit recommendations. Inpatient revisions included patient barrier identification with associated documentation changes to the IRF interdisciplinary team form. Outpatient modifications consisted of an After-Hospital Care Plan (AHCP), and two post-discharge Telephone Follow-Up (TFU) calls.Results: Healthcare reutilization and thirty-day hospital readmission for this project were measured at 8.5% and 5.7%, respectively. A decrease in healthcare reutilization of at least 1.6% was observed for the IRF. Most participants scored at a high level (88.6%) of “patient knowledge of self-management” post intervention. Out of participants who did not attend their first Primary Care Provider (PCP) appointment, 33.3% experienced healthcare reutilization. This result emphasized the importance of seeing one’s PCP post-discharge. Patient satisfaction increased by 5% and 6.73%, measured by Hospital Consumer Assessment of HealthCare Providers and Systems (HCAHP) scores for nursing care and physician care, respectively.Conclusions: Implementation of a RED Toolkit-based discharge process at an IRF positively impacted all three study outcomes and associated healthcare costs in lowering preventable readmissions.

Sign in / Sign up

Export Citation Format

Share Document