[Take a seat when talking with a patient].

The quality of communication influences the patient-doctor relationship. Patient satisfaction and compliance improve when a healthcare professional shows empathy and compassion. A substantial part of communication is non-verbal, especially in more complex conversations.

[A woman with a pituitary stone].

A 78-year-old female patient was presented with acute onset nystagmus and vertigo. A magnetic resonance imaging (MRI) was performed that revealed a pituitary stone. Metabolic imbalances have been described as their cause.

Understanding what matters most to patients in acute care in seven countries, using the flash mob study design.

Background: Truly patient-centred care needs to be aligned with what patients consider important, and is highly desirable in the first 24 h of an acute admission, as many decisions are made during this period. However, there is limited knowledge on what matters most to patients in this phase of their hospital stay. The objective of this study was to identify what mattered most to patients in acute care and to assess the patient perspective as to whether their treating doctors were aware of this.

PreAnaesThesia computerized health (PATCH) assessment: development and validation.

Background: Technological advances in healthcare have enabled patients to participate in digital self-assessment, with reported benefits of enhanced healthcare efficiency and self-efficacy. This report describes the design and validation of a patient-administered preanaesthesia health assessment digital application for gathering medical history relevant to preanaesthesia assessment. Effective preoperative evaluation allows for timely optimization of medical conditions and reduces case cancellations on day of surgery.

Competency-Based Training for Entrustment in Telehealth Consultations.

Doctors need to acquire telehealth consultation skills to thrive in the increasingly pressurized health system of delivering high-quality, high-volume health care with a shrinking health care workforce. Telehealth consultations require the same degree of thoroughness and careful clinical judgment as face-to-face consultations. The distinct differences between telehealth and face-to-face consultations warrant training in telehealth, which should be incorporated into core curricula of medical schools and continuing medical education.

Factors influencing quality of life in children with atopic dermatitis and their caregivers: a cross-sectional study.

Better understanding of atopic dermatitis' effect on quality of life could enhance current management and therapeutic strategies. Studies investigating factors related to the health-related quality of life (HRQOL) of children with atopic dermatitis and their caregivers are limited. This cross-sectional study included 559 children (<16 years) with atopic dermatitis and their caregivers.

Health Professions Digital Education on Antibiotic Management: Systematic Review and Meta-Analysis by the Digital Health Education Collaboration.

Background: Inappropriate antibiotic prescription is one of the key contributors to antibiotic resistance, which is managed with a range of interventions including education.

Objective: We aimed to summarize evidence on the effectiveness of digital education of antibiotic management compared to traditional education for improving health care professionals' knowledge, skills, attitudes, and clinical practice.

Methods: Seven electronic databases and two trial registries were searched for randomized controlled trials (RCTs) and cluster RCTs published between January 1, 1990, and September 20, 2018.

Different Perspectives on Predictability and Preventability of Surgical Readmissions.

Background: Although unscheduled readmissions are increasingly being used as a quality indicator, only few readmission studies have focused on surgical patient populations.

Methods: An observational study "CURIOS@" was performed at three centers in the Netherlands. Readmitted patients and treating doctors were surveyed to assess the discharge process during index admission and their opinion on predictability and preventability of the readmission.

Patients' and providers' perceptions of the preventability of hospital readmission: a prospective, observational study in four European countries.

Objectives: Because of fundamental differences in healthcare systems, US readmission data cannot be extrapolated to the European setting: To investigate the opinions of readmitted patients, their carers, nurses and physicians on predictability and preventability of readmissions and using majority consensus to determine contributing factors that could potentially foresee (preventable) readmissions.

Design: Prospective observational study. Readmitted patients, their carers, and treating professionals were surveyed during readmission to assess the discharge process and the predictability and preventability of the readmission.

Cruising through the journey without getting drowned: The saga of a PhD student in the Netherlands.

Young medical trainees all over the world are encouraged to investigate unknown areas of medicine that need clarification. This often leads them to undertake a PhD (Doctor of Philosophy). Being curious, critical, and creative are necessary competences which enable us to engender scientific research within acute (internal) medicine.

Hospital Readmissions - Independent Predictors of 30-day Readmissions derived from a 10 year Database.

Unplanned medical 30 day readmissions place a burden on the provision of acute hospital services and are increasingly used as quality indicators to assess quality of care in hospitals. Multivariable logistic regression of a 10 year database showed that four factors were most strongly associated with early readmission: Charlson comorbidity index >=1, respiratory disease as a principal diagnosis, liver disease and alcohol-related illness as an additional diagnosis, and the number of previous readmissions. Disease and patient-related factors beyond control of the hospital are the factors most strongly associated with 30 day readmission to hospital, suggesting that this may not be an appropriate quality indicator.

Delayed Recognition of Deterioration of Patients in General Wards Is Mostly Caused by Human Related Monitoring Failures: A Root Cause Analysis of Unplanned ICU Admissions.

Background: An unplanned ICU admission of an inpatient is a serious adverse event (SAE). So far, no in depth-study has been performed to systematically analyse the root causes of unplanned ICU-admissions. The primary aim of this study was to identify the healthcare worker-, organisational-, technical,- disease- and patient- related causes that contribute to acute unplanned ICU admissions from general wards using a Root-Cause Analysis Tool called PRISMA-medical.

A Protocolised Once a Day Modified Early Warning Score (MEWS) Measurement Is an Appropriate Screening Tool for Major Adverse Events in a General Hospital Population.

Background: The Modified Early Warning Score (MEWS) was developed to timely recognise clinically deteriorating hospitalised patients. However, the ability of the MEWS in predicting serious adverse events (SAEs) in a general hospital population has not been examined prospectively. The aims were to (1) analyse protocol adherence to a MEWS protocol in a real-life setting and (2) to determine the predictive value of protocolised daily MEWS measurement on SAEs: death, cardiac arrests, ICU-admissions and readmissions.

[Hospital readmissions: A reliable quality indicator?].

The percentage of readmissions within 30 days after discharge is an official quality indicator for Dutch hospitals in 2016. In this commentary the authors argue why readmissions cannot be regarded as a reliable way of assessing quality of healthcare in a hospital. To date, policy makers have been struggling with its precise definition and the indicator has not been properly formulated yet.

Budesonide-related adrenal insufficiency.

Iatrogenic adrenal insufficiency is a potential harmful side effect of treatment with corticosteroids. It manifests itself when an insufficient cortisol response to biological stress leads to an Addisonian crisis: a life-threatening situation. We describe a case of a patient who developed an Addisonian crisis after inappropriate discontinuation of budesonide (a topical steroid used in Crohn's disease) treatment.