Physician Office (Home)

MedlinePlus. Interactive Health Tutorials. [Web site]. http://www.nlm.nih.gov/medlineplus/tutorial.html . Updated April 18, 2012. Accessed July 30, 2015. MedlinePlus presents interactive health tutorials from the Patient Education Institute. Learn about the symptoms, diagnosis and treatment for a variety of diseases and conditions. Also learn about surgeries, prevention and wellness. Each tutorial includes animated graphics, audio and easy-to-read language.

August 7, 2019

MedLine Plus: Interactive Health Tutorials

MedlinePlus. Interactive Health Tutorials. [Web site]. http://www.nlm.nih.gov/medlineplus/tutorial.html . Updated April 18, 2012. Accessed July 30, 2015. MedlinePlus presents interactive health tutorials from the Patient Education Institute. Learn about the symptoms, diagnosis and treatment for a variety of diseases and conditions. Also learn about surgeries, prevention and wellness. Each tutorial includes […]
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MedlinePlus. Interactive Health Tutorials. [Web site]. http://www.nlm.nih.gov/medlineplus/tutorial.html . Updated April 18, 2012. Accessed July 30, 2015. MedlinePlus presents interactive health tutorials from the Patient Education Institute. Learn about the symptoms, diagnosis and treatment for a variety of diseases and conditions. Also learn about surgeries, prevention and wellness. Each tutorial includes animated graphics, audio and easy-to-read language.
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http://www.nlm.nih.gov/medlineplus/tutorial.html

August 7, 2019

AHRQ. Navigating the Health Care System: Advice columns from Dr. Carolyn Clancy

AHRQ. Navigating the Health Care System. [Web site]. http://www.ahrq.gov/news/columns/navigating-the-health-care-system/070709.html . Published July 7, 2009. Accessed July 30, 2014. Former AHRQ Director Carolyn Clancy, M.D., prepared brief, easy-to-understand advice columns for consumers to help navigate the health care system. They address important issues such as how to recognize high-quality health care, […]
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AHRQ. Navigating the Health Care System. [Web site]. http://www.ahrq.gov/news/columns/navigating-the-health-care-system/070709.html . Published July 7, 2009. Accessed July 30, 2014. Former AHRQ Director Carolyn Clancy, M.D., prepared brief, easy-to-understand advice columns for consumers to help navigate the health care system. They address important issues such as how to recognize high-quality health care, how to be an informed health care consumer, and how to choose a hospital, doctor, and health plan.
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http://www.ahrq.gov/consumer/cc/cc070709.htm

August 7, 2019

AHRQ Patient Fact Sheet: 20 Tips to Help Prevent Medical Errors

AHRQ Patient Fact Sheet: 20 Tips to Help Prevent Medical Errors. [Web site]. Http://www.ahrq.gov/patients-consumers/care-planning/errors/20tips/index.html . Updated September 2011. Accessed July 30, 2014. Medical errors can occur anywhere in the health care system: In hospitals, clinics, surgery centers, doctors’ offices, nursing homes, pharmacies, and patients’ homes. Errors can involve medicines, surgery, […]
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AHRQ Patient Fact Sheet: 20 Tips to Help Prevent Medical Errors. [Web site]. Http://www.ahrq.gov/patients-consumers/care-planning/errors/20tips/index.html . Updated September 2011. Accessed July 30, 2014. Medical errors can occur anywhere in the health care system: In hospitals, clinics, surgery centers, doctors' offices, nursing homes, pharmacies, and patients' homes. Errors can involve medicines, surgery, diagnosis, equipment, or lab reports. These tips tell what you can do to get safer care.
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http://www.ahrq.gov/consumer/20tips.htm

August 7, 2019

End of Life Issues

U.S. National Library of Medicine, U.S. Department of Health and Human Services, National Institutes of Health. End of Life Issues. Medline Plus. http://www.nlm.nih.gov/medlineplus/endoflifeissues.html. Updated July 8, 2014. Accessed July 25, 2014. Planning for the end of life can be difficult. But by deciding what end-of-life care best suits your needs […]
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U.S. National Library of Medicine, U.S. Department of Health and Human Services, National Institutes of Health. End of Life Issues. Medline Plus. http://www.nlm.nih.gov/medlineplus/endoflifeissues.html. Updated July 8, 2014. Accessed July 25, 2014. Planning for the end of life can be difficult. But by deciding what end-of-life care best suits your needs when you are healthy, you can help those close to you make the right choices when the time comes. This comprehensive resource page contains links to many useful materials for both patients or caregivers faced with planning end-of-life of care.
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http://www.nlm.nih.gov/medlineplus/endoflifeissues.html

August 7, 2019

ABA: Commission on Law and Aging

American Bar Association. Commission on Law and Aging. [Web site]. http://www.americanbar.org/groups/law_aging.html . Updated 2014. Accessed July 31, 2014. The ABA Commission on Law and Aging examines a wide range of legal issues affecting older persons. This work results in: •Policy and practice research and development •Coordination and collaboration •Education (professional […]
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American Bar Association. Commission on Law and Aging. [Web site]. http://www.americanbar.org/groups/law_aging.html . Updated 2014. Accessed July 31, 2014. The ABA Commission on Law and Aging examines a wide range of legal issues affecting older persons. This work results in: •Policy and practice research and development •Coordination and collaboration •Education (professional and public) •Technical assistance Read more about the Commission’s current work in: Capacity Assessment, Elder Abuse, Guardianship Law and Practice, Health Care Decision Making, International Rights of Older Persons, Medicare, and Voting and Cognitive Impairment.
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http://www.americanbar.org/groups/law_aging.html

August 7, 2019

Connected Care: How a Health Science Centre Is Using Evidence to Improve Patient Transitions from Primary to Secondary Care

The department of emergency medicine at Queen Elizabeth II Health Sciences Centre in Nova Scotia’s Capital Health District is developing pathways to strengthen the ability of family physicians to manage their patients and improve the primary-secondary care transition. This diagnostic pathway initiative improves patient and caregiver satisfaction and also provides […]
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The department of emergency medicine at Queen Elizabeth II Health Sciences Centre in Nova Scotia's Capital Health District is developing pathways to strengthen the ability of family physicians to manage their patients and improve the primary-secondary care transition. This diagnostic pathway initiative improves patient and caregiver satisfaction and also provides system benefits. This innovative initiative was recently featured in Promising Practices in Research Use, a series produced by the Canadian Health Services Research Foundation highlighting organizations that have invested their time, energy and resources to improve their ability to use research in the delivery of health services. Tell the Foundation your own stories and visit the Promising Practices in Research Use inventory at http://www.chsrf.ca/promising/index_e.php.
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http://www.chsrf.ca/publicationsandresources/pastseries/PromisingPracticesinResearchUse/article/08-04-01/5a22d864-cab6-4678-a375-009a1accf6e9.aspx

August 7, 2019

“But I am not moving”: residents’ perspectives on transitions within a continuing care retirement community

PURPOSE This article investigates how continuing care retirement community (CCRC) residents define transitions between levels of care. Although older adults move to CCRCs to “age in place,” moving between levels of care is often stressful. More than half a million older adults live in CCRCs, with numbers continually increasing; yet, […]
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PURPOSE This article investigates how continuing care retirement community (CCRC) residents define transitions between levels of care. Although older adults move to CCRCs to "age in place," moving between levels of care is often stressful. More than half a million older adults live in CCRCs, with numbers continually increasing; yet, no studies address transitions between levels of care in these communities. DESIGN AND METHODS I completed 23 months of live-in observation and conducted 35 face-to-face in-depth interviews with CCRC residents across 3 levels of care. I performed a thematic analysis of observation notes and interview transcripts. RESULTS Residents perceived transitions as both disempowering and final. They discussed decreases in social networks that occurred after such moves. Resident-maintained social boundaries exacerbated these challenges. IMPLICATIONS Although the transition to institutional living is one of the most important events in older persons' lives, transitions within CCRCs also are consequential especially because they are coupled with declining functional ability. These findings may inform policy for retirement facilities on topics such as increasing privacy, challenging social boundaries, and educating residents to prepare them for transitions.
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http://gerontologist.oxfordjournals.org/content/49/3/418.abstract

August 7, 2019

Continuity of Outpatient and Inpatient Care by Primary Care Physicians for Hospitalized Older Adults

Sharma G, Fletcher K, Zhang D, et.al. JAMA. 2009;301(16):1671-1680. http://jama.jamanetwork.com/article.aspx?articleid=183797 . Accessed August 1, 2014. Continuity of Outpatient and Inpatient Care by Primary Care Physicians for Hospitalized Older Adults. Context Little is known about the extent of continuity of care across the transition from outpatient care to hospitalization. Objectives To […]
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Sharma G, Fletcher K, Zhang D, et.al. JAMA. 2009;301(16):1671-1680. http://jama.jamanetwork.com/article.aspx?articleid=183797 . Accessed August 1, 2014. Continuity of Outpatient and Inpatient Care by Primary Care Physicians for Hospitalized Older Adults. Context Little is known about the extent of continuity of care across the transition from outpatient care to hospitalization. Objectives To describe continuity of care in older hospitalized patients, change in continuity over time, and factors associated with discontinuity.
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http://jama.ama-assn.org/cgi/content/abstract/301/16/1671

August 7, 2019

Redefining and Redesigning Hospital Discharge to Enhance Patient Care: A Randomized Controlled Study

BACKGROUND: Patients are routinely ill-prepared for the transition from hospital to home. Inadequate communication between Hospitalists and primary care providers can further compromise post-discharge care. Redesigning the discharge processmay improve the continuity and the quality of patient care. OBJECTIVES: To evaluate a low-cost intervention designed to promptly reconnect patients to […]
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BACKGROUND: Patients are routinely ill-prepared for the transition from hospital to home. Inadequate communication between Hospitalists and primary care providers can further compromise post-discharge care. Redesigning the discharge processmay improve the continuity and the quality of patient care. OBJECTIVES: To evaluate a low-cost intervention designed to promptly reconnect patients to their “medical home” after hospital discharge. DESIGN: Randomized controlled study. Intervention patients received a “user-friendly” Patient Discharge Form, and upon arrival at home, a telephone outreach from a nurse at their primary care site. PARTICIPANTS: A culturally and linguistically diverse group of patients admitted to a small community teaching hospital. MEASUREMENTS: Four undesirable outcomes were measured after hospital discharge: (1) no outpatient follow-up within 21 days; (2) readmission within 31 days; (3) emergency department visit within 31 days; and (4) failure by the primary care provider to complete an outpatient workup recommended by the hospital doctors. Outcomes of the intervention group were compared to concurrent and historical controls. RESULTS: Only 25.5% of intervention patients had 1 or more undesirable outcomes compared to 55.1% of the concurrent and 55.0% of the historical controls. Notably, only 14.9% of the intervention patients failed to follow-up within 21 days compared to 40.8% of the concurrent and 35.0% of the historical controls. Only 11.5% of recommended outpatient workups in the intervention group were incomplete versus 31.3% in the concurrent and 31.0% in the historical controls. CONCLUSIONS: A low-cost discharge–transfer intervention may improve the rates of outpatient follow-up and of completed workups after hospital discharge.
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http://www.springerlink.com/content/j81085h6634x2665/fulltext.pdf

August 7, 2019

Defragmenting Care: Stephen F. Jencks, MD, MPH

Rehospitalizations that occur soon after hospital discharge are drawing increasing attention. About 2.5 million Medicare beneficiaries and about 2 million other patients are rehospitalized within 30 days of discharge, with total hospital costs (not including physician services) of about $44 billion (1; Steiner C, Jiang J. Personal communication). From the […]
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Rehospitalizations that occur soon after hospital discharge are drawing increasing attention. About 2.5 million Medicare beneficiaries and about 2 million other patients are rehospitalized within 30 days of discharge, with total hospital costs (not including physician services) of about $44 billion (1; Steiner C, Jiang J. Personal communication). From the perspectives of payers, purchasers, and policymakers, avoidable rehospitalizations represent massive and remediable waste. However, most rehospitalization is the result of clinical deterioration, occurs emergently, and is often necessary by the time the patient reaches the emergency department. Some emergency department visits might be prevented from turning into hospitalizations. However, compelling evidence from a series of controlled studies (2–4), in which interventions to improve the transition from hospital to posthospital care have reduced rehospitalizations by 30% to 50%, suggests that the rehospitalization problem represents a failure of those transitions rather than willful overuse of hospital services. It is a symptom of fragmented care
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http://www.annals.org/content/153/11/757.extract