Hospital-Level Care at Home for Acutely Ill Adults in Rural Settings: Proof of Concept.

Residents in rural areas face barriers to accessing acute care. Rural home hospital (RHH) or delivery of acute care at home could represent an important clinical care model. This study assessed the feasibility and acceptability of RHH as a substitute to traditional hospital care.

Modified early warning score-based clinical decision support: cost impact and clinical outcomes in sepsis.

Objective: The objective of this study was to assess the clinical and financial impact of a quality improvement project that utilized a modified Early Warning Score (mEWS)-based clinical decision support intervention targeting early recognition of sepsis decompensation.

Materials And Methods: We conducted a retrospective, interrupted time series study on all adult patients who received a diagnosis of sepsis and were exposed to an acute care floor with the intervention. Primary outcomes (total direct cost, length of stay [LOS], and mortality) were aggregated for each study month for the post-intervention period (March 1, 2016-February 28, 2017,  = 2118 visits) and compared to the pre-intervention period (November 1, 2014-October 31, 2015,  = 1546 visits).

Improving Physician Communication With Patients as Measured by HCAHPS Using a Standardized Communication Model.

Physicians often fail to communicate well with patients. The objective of this retrospective controlled interrupted time series study was to evaluate the impact of a standardized communication intervention to improve physician communication. All patients ages 18 years or older (N = 7739 visits) admitted to University of Utah Health Care in Salt Lake City, Utah, from July 1, 2012, to June 31, 2014, were included.

Implementation of a Value-Driven Outcomes Program to Identify High Variability in Clinical Costs and Outcomes and Association With Reduced Cost and Improved Quality.

Importance: Transformation of US health care from volume to value requires meaningful quantification of costs and outcomes at the level of individual patients.

Objective: To measure the association of a value-driven outcomes tool that allocates costs of care and quality measures to individual patient encounters with cost reduction and health outcome optimization.

Design, Setting, And Participants: Uncontrolled, pre-post, longitudinal, observational study measuring quality and outcomes relative to cost from 2012 to 2016 at University of Utah Health Care.

Rivaroxaban for the Long-term Treatment of Spontaneous Ovarian Vein Thrombosis Caused by Factor V Leiden Homozygosity.

Objective: To report a case where rivaroxaban was used in the management of an ovarian vein thrombosis and to briefly review the literature, pathophysiology, and clinical implications therein.

Case Summary: A 30-year-old previously healthy woman was diagnosed with acute, spontaneous, left-ovarian vein thrombosis (OVT) with proximal extension into the renal vein. After initial catheter-directed thrombolysis with tPA, angioplasty of the left renal vein, and heparinoid treatment, rivaroxaban was begun for long-term anticoagulation.