Background: Several studies indicate that when patients transition from one level of care to another, errors may occur. Pharmacists can play an integral role in the transitions of care process. At Michael E. DeBakey Veteran Affairs Medical Center, the Home-Based Primary Care (HBPC) service has implemented a streamlined hospital discharge plan to improve 30-day readmission rates after 1 year of HBPC enrollment.
Methods: Our aim was to identify specific pharmacist interventions to improve the HBPC discharge process and ultimately, improve hospital readmission rates. A Plan-Do-Study-Act quality improvement project was initiated. We conducted a review of veterans enrolled in HBPC from October 2019 to March 2020.
Results: Of 175 patients assessed postdischarge, a medication reconciliation was completed by an HBPC pharmacist in 118 (67.4%) patients. Of the 118 medication reconciliations completed, 92 (78%) interventions were made by HBPC pharmacists. During the 6-month study period, 30-day hospital readmission rates decreased from 19% to 13%.
Conclusions: This study demonstrates several opportunities for interventions to lower readmission rates. Using the results from this study, education has been provided for the HBPC service and its readmission committee.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9648578 | PMC |
http://dx.doi.org/10.12788/fp.0287 | DOI Listing |
Neurosurgery
February 2025
Global Neurosciences Institute, Philadelphia , Pennsylvania , USA.
Background And Objectives: Despite growing interest in how patient frailty affects outcomes (eg, in neuro-oncology), its role after transsphenoidal surgery for Cushing disease (CD) remains unclear. We evaluated the effect of frailty on CD outcomes using the Registry of Adenomas of the Pituitary and Related Disorders (RAPID) data set from a collaboration of US academic pituitary centers.
Methods: Data on consecutive surgically treated patients with CD (2011-2023) were compiled using the 11-factor modified frailty index.
JAMA Netw Open
January 2025
Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.
Importance: There have been limited evaluations of the patients treated at academic and community hospitals. Understanding differences between academic and community hospitals has relevance for the design of clinical models of care, remuneration for clinical services, and health professional training programs.
Objective: To evaluate differences in complexity and clinical outcomes between patients admitted to general medical wards at academic and community hospitals.
J Am Coll Surg
February 2025
From the Division of Colorectal Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Antoniv, Ahmed, Bleday).
Background: Enhanced recovery after surgery (ERAS) protocols aim to improve surgical patient outcomes, although their effectiveness may vary. This study assessed the impact of multi-institutional ERAS implementation on postoperative morbidity in patients undergoing elective colorectal surgery.
Study Design: We conducted a multicenter retrospective cohort study using the American College of Surgeons NSQIP database from 2012 to 2020.
Arthroplast Today
February 2025
Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA.
Background: Peripheral nerve blocks (PNBs) may be utilized for postoperative pain control following total hip arthroplasty (THA). The purpose of this study was to evaluate the association between PNBs and postoperative complication rates, healthcare utilization, and opioid consumption following elective THA.
Methods: Opioid-naive patients who received PNBs on the same day as undergoing THA for degenerative etiologies were identified from a large national database and matched 1:5 to a control cohort using propensity scoring.
Antimicrob Steward Healthc Epidemiol
January 2025
Ascension Borgess Hospital, Kalamazoo, MI, USA.
Objective: This study aimed to evaluate appropriate antimicrobial prescribing after implementing a pneumonia order set within a community teaching hospital.
Design: Retrospective chart review study.
Setting: 450-bed community teaching hospital.
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