The rising cost of health care has increased the call for cost control. The pressing need to control cost, coupled with the increase in managed care and prospective payment, has placed new urgency on administrators and clinicians to work collaboratively in providing efficient and effective care. We have developed the Integrated Inpatient Management Model (IIMM) to assist in this collaborative effort. We describe the IIMM's clinical information system that provides decision support to both administrators and clinicians. This clinical information system is the information backbone for the development and monitoring of practice guidelines or critical pathways. An integrated information system of this type is essential if hospitals are to prosper during the next decade.
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J Glob Health
December 2024
Amsterdam UMC, location University of Amsterdam, Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands.
Background: Risk prediction tools for acutely ill children have been developed in high- and low-income settings, but few are validated or incorporated into clinical guidelines. We aimed to assess the performance of existing paediatric early warning scores for use in low- and middle-income countries using clinical data from a recent large multi-country study in Africa and South-Asia.
Methods: We used data (children across three nutritional strata) from the Childhood Acute Illness and Nutrition (CHAIN) Network cohort study (n = 3101).
Can J Anaesth
January 2025
Outcomes Research Consortium, Houston, TX, USA.
Purpose: Residual neuromuscular blockade can impair postoperative respiratory mechanics, promoting hypoxemia and pulmonary complications. Sugammadex, with its unique mechanism of action, may offer a more effective reversal of neuromuscular blockade and respiratory function than neostigmine. We sought to test the primary hypothesis that children undergoing noncardiac surgery exhibit better initial recovery oxygenation when administered sugammadex than those administered neostigmine.
View Article and Find Full Text PDFBMC Palliat Care
January 2025
Department of Nursing, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, No. 599 Dayang East Road, Linhai, Zhejiang, 317000, China.
Background: Delirium frequently occurs in palliative care settings, yet its screening, identification, and management remain suboptimal in clinical practice. This review aims to elucidate the barriers preventing healthcare professionals from effectively screening, recognizing, and managing delirium in adult patients receiving specialist palliative care, with the goal of developing strategies to enhance clinical practice.
Methods: A mixed-methods systematic review was conducted (PROSPERO: CRD42024563666).
Am J Hosp Palliat Care
January 2025
Department of Pediatrics, University of Chicago, Comer Children's Hospital, Chicago, IL, USA.
Pediatric neuro-oncology patients have one of the highest mortality rates among all children with cancer. Our study examines the potential relationship between palliative care consultation and intensity of in-hospital care and determines if racial and ethnic differences are associated with palliative care consultations during their terminal admission. Retrospective observational study using the Pediatric Health Information System (PHIS) database with data from U.
View Article and Find Full Text PDFChirurgie (Heidelb)
January 2025
Klinik für Allgemein- und Viszeralchirurgie, SRH Zentralklinikum Suhl, Albert-Schweitzer-Straße 2, 98527, Suhl, Deutschland.
Colorectal surgery in multimorbid patients requires a comprehensive interdisciplinary planning of the treatment approach, from preoperative to posthospital care, in order to minimize complications and improve the patient's outcome. Therefore, the integration of the outpatient and inpatient sectors is essential as is a perioperative interdisciplinary coordinated approach. Preoperatively, all possible risks of concomitant diseases must be considered and optimized if necessary.
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