Impact of discharge planning decision support on time to readmission among older adult medical patients.

Purpose Of The Study: Hospital clinicians are overwhelmed with the volume of patients churning through the health care systems. The study purpose was to determine whether alerting case managers about high-risk patients by supplying decision support results in better discharge plans as evidenced by time to first hospital readmission.

Primary Practice Setting: Four medical units at one urban, university medical center.

Implementation and testing of interdisciplinary decision support tools to standardize discharge planning.

Improving transitions in care is an international priority. In acute care, this complex process starts upon admission and requires multiple interventions to appropriately transition patients from one setting to the next. Within this multi-step process are two important decision points that warrant standardization and support.

Risk factors for lymphedema after breast cancer treatment.

Background: As cancer treatments evolve, it is important to reevaluate their effect on lymphedema risk in breast cancer survivors.

Methods: A population-based random sample of 631 women from metropolitan Philadelphia, Pennsylvania, diagnosed with incident breast cancer in 1999 to 2001, was followed for 5 years. Risk factor information was obtained by questionnaire and medical record review.

Lymphedema in breast cancer survivors: incidence, degree, time course, treatment, and symptoms.

Purpose: To examine the incidence, degree, time course, treatment, and symptoms of lymphedema in breast cancer survivors.

Methods: We conducted a 5-year, population-based prospective study of 631 randomly selected Philadelphia and Delaware County, Pennsylvania female residents with incident breast cancer who were diagnosed from 1999 to 2001. Using a questionnaire previously validated against physical therapists' measurement-based clinical criteria, we assigned a score indicating the degree of lymphedema (none, mild, or moderate/severe) to each month of follow-up based on the respondent's perceived differences in hand/arm size.

Modifiable risk factors for breast cancer recurrence: what can we tell survivors?

The potential for recurrence causes considerable distress for breast cancer survivors. Major information sources for survivors and providers offer few clear recommendations for postdiagnosis lifestyle change related to recurrence. To design interventions to improve long-term survivors' care and quality of life, we must know what survivors are doing to prevent recurrence in the absence of solid evidence, whether survivors' perceptions and behaviors correspond to hypothesized modifiable risk factors for recurrence, and whether survivors are adopting behaviors that could otherwise be harmful to their health.