August 7, 2019

Safer Transitions, Fewer Re-Hospitalizations with PAH: An Interdisciplinary Guide

PAH White Paper is a transitions of care white paper that was developed by NTOCC and Case Management Society of America (CMSA) for system leaders and interprofessional clinical team members who treat and manage patients with Pulmonary Arterial Hypertension (PAH).
PAH White Paper is a transitions of care white paper that was developed by NTOCC and Case Management Society of America (CMSA) for system leaders and interprofessional clinical team members who treat and manage patients with Pulmonary Arterial Hypertension (PAH).
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https://primeinc.org/cme/monograph/1248/Safer_Transitions,_Fewer_Re-Hospitalizations_with_PAH:_An_Interdisciplinary_Guide

August 7, 2019

Information exchange among physicians caring for the same patient in the community (CMAJ|November 4, 2008; 179 (10). doi:10.1503/cmaj.080430)

Background: The exchange of information is an integral component of continuity of health care and may limit or prevent costly duplication of tests and treatments. This study determined the probability that patient information from previous visits with other physicians was available for a current physician visit. Methods: We conducted a […]
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Background: The exchange of information is an integral component of continuity of health care and may limit or prevent costly duplication of tests and treatments. This study determined the probability that patient information from previous visits with other physicians was available for a current physician visit. Methods: We conducted a multicentre prospective cohort study including patients discharged from the medical or surgical services of 11 community and academic hospitals in Ontario. Patients included in the study saw at least 2 different physicians during the 6 months after discharge. The primary outcome was whether information from a previous visit with another physician was available at the current visit. We determined the availability of previous information using surveys of or interviews with the physicians seen during current visits. Results: A total of 3250 patients, with a total of 39 469 previous–current visit combinations, met the inclusion criteria. Overall, information about the previous visit was available 22.0% of the time. Information was more likely to be available if the current doctor was a family physician (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.54–1.98) or a physician who had treated the patient before the hospital admission (OR 1.33, 95% CI 1.21–1.46). Conversely, information was less likely to be available if the previous doctor was a family physician (OR 0.38, 95% CI 0.32–0.44) or a physician who had treated the patient before the admission (OR 0.72, 95% CI 0.60–0.86). The strongest predictor of information exchange was the current physician having previously received information about the patient from the previous physician (OR 7.72, 95% CI 6.92–8.63).
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http://www.cmaj.ca/cgi/content/abstract/179/10/1013

August 7, 2019

Reengineering hospital discharge: a protocol to improve patient safety, reduce costs, and boost patient satisfaction. Clancy CM. Am J Med Qual. 2009;24:344-346.

In this commentary, AHRQ Director Carolyn Clancy discusses effective patient discharge as an important factor in patient safety. Specifically, she highlights elements of an AHRQ-funded implementation program for engaging patients along with their clinical team to enable smooth discharge.
In this commentary, AHRQ Director Carolyn Clancy discusses effective patient discharge as an important factor in patient safety. Specifically, she highlights elements of an AHRQ-funded implementation program for engaging patients along with their clinical team to enable smooth discharge.
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http://ajm.sagepub.com/content/24/4/344

August 7, 2019

Safety in numbers: Physicians joining forces to seal the cracks during transitions (Journal of Hospital Medicine, Volume 4, Issue 6, pages 329–330, July/August 2009)

A lack of communication and accountability among healthcare professionals in general and physicians in particular, jeopardizes quality and safety for our patients who are transitioning across sites of care. Our patients, their family caregivers, and our health care professional colleagues on the receiving end of these transfers are often left […]
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A lack of communication and accountability among healthcare professionals in general and physicians in particular, jeopardizes quality and safety for our patients who are transitioning across sites of care. Our patients, their family caregivers, and our health care professional colleagues on the receiving end of these transfers are often left “flying blind” without adequate information or direction to make sound clinical decisions.
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http://onlinelibrary.wiley.com/doi/10.1002/jhm.548/abstract

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

August 7, 2019

The University of Kansas Hospital Corporate Policy Manual. Subject: Medication Reconciliation.

The University of Kansas Hospital Corporate Policy Manual. Subject: Medication Reconciliation. Formulated 5/1/2007. Accessed 7/9/2014. http://www.learningace.com/doc/2126652/d79631db906484626d18f77f4d4945bd/medication-reconciliation-hospital-policy. This short Policy from the University of Kansas Hospital includes definitions, policy, and procedures.
The University of Kansas Hospital Corporate Policy Manual. Subject: Medication Reconciliation. Formulated 5/1/2007. Accessed 7/9/2014. http://www.learningace.com/doc/2126652/d79631db906484626d18f77f4d4945bd/medication-reconciliation-hospital-policy. This short Policy from the University of Kansas Hospital includes definitions, policy, and procedures.
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http://www.learningace.com/doc/2126652/d79631db906484626d18f77f4d4945bd/medication-reconciliation-hospital-policy

August 7, 2019

NTOCC Policy Considerations: Improving Transitions of Care

Learn which policy considerations NTOCC believes are important to better transitions of care.
Learn which policy considerations NTOCC believes are important to better transitions of care.
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http://www.ntocc.org/Portals/0/PolicyConsiderations.pdf

August 7, 2019

NTOCC My Medicine List (Spanish)

(Spanish Version) This form helps you gather important information about your medications. Filling this list out prior to visiting your doctor or entering the hospital will help ensure your health care providers know what medications you are already taking. When your doctor writes you a new prescription or changes your […]
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(Spanish Version) This form helps you gather important information about your medications. Filling this list out prior to visiting your doctor or entering the hospital will help ensure your health care providers know what medications you are already taking. When your doctor writes you a new prescription or changes your medication ask them to update your My Medicine List. Working with your doctors to fill out the form will help you better understand what medications you should be taking.
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http://www.ntocc.org/Portals/0/My_Medicine_List_Spanish.pdf

August 7, 2019

On the same page: making transitions between EMS & urgent care centers smooth

Medic 25 is called to a local urgent care center to a chief complaint of a possible heart attack at 8:45 p.m. On their way there, one of the medics tells his partner they’ve been getting multiple calls to this facility at about the same time each evening, so they […]
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Medic 25 is called to a local urgent care center to a chief complaint of a possible heart attack at 8:45 p.m. On their way there, one of the medics tells his partner they've been getting multiple calls to this facility at about the same time each evening, so they can "unload" their patients before it closes at 9 p.m. He says it's usually for minor complaints and seems to be more for the convenience of the urgent care center staff than for any true emergencies.
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http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=20708144

August 7, 2019

CAPS: Talking to Your Doctor or Nurse

A handy list that gives patients and their advocates advice and tips for making the most of their conversations with their doctor or nurse, wherever such conversations occur.
A handy list that gives patients and their advocates advice and tips for making the most of their conversations with their doctor or nurse, wherever such conversations occur.
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http://www.patientsafety.org/file_depot/0-10000000/20000-30000/24986/folder/85204/Talking_to_Your_Doctor.pdf