Background: Modern acute care surgery (ACS) programs depend on consistent patient hand-offs to facilitate care, as most programs have transitioned to shift-based coverage. We sought to determine the impact of implementing a morning report (MR) model on patient outcomes in the trauma service of a tertiary care center.
Methods: The University of Arkansas for Medical Sciences (UAMS) Division of ACS implemented MR in October 2015, which consists of the trauma day team, the emergency general surgery day team, and a combined night float team. This study queried the UAMS Trauma Registry and the Arkansas Clinical Data Repository for all patients meeting the National Trauma Data Bank inclusion criteria from January 1, 2011 to April 30, 2018. Bivariate frequency statistics and generalized linear model were run using STATA V.14.2.
Results: A total of 11 253 patients (pre-MR, n=6556; post-MR, n=4697) were analyzed in this study. The generalized linear model indicates that implementation of MR resulted in a significant decrease in length of stay (LOS) in trauma patients.
Discussion: This study describes an approach to improving patient outcomes in a trauma surgery service of a tertiary care center. The data show how an MR session can allow for patients to get out of the hospital faster; however, broader implications of these sessions have yet to be studied. Further work is needed to describe the decisions being made that allow for a decreased LOS, what dynamics exist between the attendings and the residents in these sessions, and if these sessions can show some of the same benefits in other surgical services.
Level Of Evidence: Level 4, Care Management.
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http://dx.doi.org/10.1136/tsaco-2018-000185 | DOI Listing |
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Department of Physiology, University of Louisville School of Medicine, Louisville, KY 40202, USA.
Background/objectives: Chronic gut dysbiosis due to a high-fat diet (HFD) instigates cardiac remodeling and heart failure with preserved ejection fraction (HFpEF), in particular, kidney/volume-dependent HFpEF. Studies report that although mitochondrial ATP citrate lyase (ACLY) supports cardiac function, it decreases more in human HFpEF than HFrEF. Interestingly, ACLY synthesizes lipids and creates hyperlipidemia.
View Article and Find Full Text PDFHealthcare (Basel)
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Department of Medicine, Division of Geriatrics and Palliative Medicine, Glennan Center for Geriatrics and Gerontology, Eastern Virginia Medical School at Old Dominion University, Norfolk, VA 23508, USA.
Serious illness conversation (SIC) in an important skillset for clinicians. A review of mortality meetings from an urban academic hospital highlighted the need for early engagement in SICs and advance care planning (ACP) to align medical treatments with patient-centered outcomes. The aim of this study was to increase SICs and their documentation in patients with low one-year survival probability identified by updated Charlson Comorbidity Index (CCI) scores.
View Article and Find Full Text PDFRes Child Adolesc Psychopathol
January 2025
Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA.
Developmental changes in youth sleep preferences (chronotype) and pubertal development are consequential for youth risk for depression. Previous research has identified individual differences in chronotype in risk for psychopathology. However, little is known regarding how the timing of chronotype may confer risk in youth.
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Department of Paediatric Surgery and Urology, Southampton Children's Hospital, Southampton, UK.
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Method: Retrospective review (April 2018-2024) of all primary gastrostomy insertions.
J Med Case Rep
January 2025
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