This month we have begun reviewing the top mistakes hospitals make within their case management department's infrastructure. As discussed, the biggest mistake is to not clearly and prospectively define the roles of the RN case manager and the social worker to optimize each discipline's skill sets. Associated with this mistake is to have inadequate patient ratios assigned to each discipline. These mistakes are related and when roles are not clearly defined, it becomes almost impossible to understand or advocate for appropriate staffing ratios. If it appears that nurses and social workers can all do the same things equally well, then the organization will likely choose to go with the professional group that will cost the organization the least amount of money. In the end, this logic is penny-wise and pound foolish. We do both disciplines a disservice when we don't apply their skill sets adequately and don't have each group functioning at the "top of their license!" Next month, we will continue to discuss the top mistakes hospitals make in their acute care management departments' design. We will discuss the use of clerical support staff, assessments, and days of coverage.
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JA Clin Rep
January 2025
Department of Anesthesiology and Pain Medicine, Gifu University Hospital, 1-1 Yanagido, Gifu, 501-1194, Japan.
Background: Cold agglutinin disease (CAD) is an autoimmune hemolytic anemia that induces blood coagulation and hemolysis upon exposure to cold temperatures. Strict temperature control is essential to mitigate these effects, especially during surgical procedures where hypothermia is possible.
Case Presentation: A 57-year-old male, 165 cm and 72 kg, diagnosed with CAD, underwent cerebral vascular anastomosis.
Int J Qual Health Care
January 2025
Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Background: Hospitals face mounting pressure to reduce unplanned utilization amid rising healthcare demands from an aging population. The Case management for At-Risk patients in the Emergency Department (CARED) program is among the first ED transitional care strategies to focus on both frail older adults and Emergency Department (ED) re-attenders to reduce acute hospital utilization. This study aims to evaluate the effectiveness of the CARED program in reducing hospital (re)admissions and ED re-attendances within 30- and 60-days post-discharge.
View Article and Find Full Text PDFBlood Adv
January 2025
The Ohio State University, Columbus, Ohio, United States.
Hemophagocytic lymphohistiocytosis (HLH) is a rare but aggressive and potentially lethal hyperinflammatory syndrome characterized by pathologic immune activation and excessive production of proinflammatory cytokines leading to tissue damage and multisystem organ failure. There is an urgent need for the discovery of novel targets and development of therapeutic strategies to treat this rare but deadly syndrome. Protein Arginine Methyltransferase 5 (PRMT5) mediates T cell-based inflammatory responses, making it a potential actionable target for the treatment of HLH.
View Article and Find Full Text PDFRev Gastroenterol Peru
January 2025
Hospital Nacional Dos de Mayo, Lima, Perú.
We report the case of a 68-year-old female patient who had a gastrointestinal stromal tumor involving muscularis propria of the gastric body that was removed through submucosal tunneling endoscopic resection, with favorable follow-up after 5 years, with no signs of recurrence.
View Article and Find Full Text PDFRev Gastroenterol Peru
January 2025
Universidad de Caldas, Manizales, Colombia.
Esophago-jejunal anastomoses fistula could be mortal. Currently there is a wide therapeutic measure ranging from conservative management, endoscopic therapy and surgery. Endoscopic management has been positioned above other strategies due to minimal invasion which improves survival and reduces mortality.
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