MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'discharge'. Sat, 03 Sep 2011 02:10:47 +0100 http://www.medworm.com/index.php?rid=5158857&cid=t_127586_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F08%2F23%2Fhow-to-guide-improving-transitions-from-the-hospital-to-post-acute-care-settings-to-reduce-avoidable-rehospitalizations%2F Scan or click to download 'How-to Guide Improving Transitions from the Hospital to Post-Acute Care Settings to Reduce Avoidable Rehospitalizations' Title: How-to Guide Improving Transitions from the Hospital to Post-Acute Care Settings to Reduce Avoidable Rehospitalizations The Skinny: Guide from Institute for Health Improvement on avoiding avoidable rehospitalisations as a result of poor co-ordination of care settings. Avoiding this is a key step toward achieving broader delivery system transformation. Based on the healthcare system of the USA this guide is of use to those looking at intermediate care/rehabilitation settings. Publisher: Institute for Health Improvement Published: August 2011 Size: 144p. Filed under: Ooops Missed Category! Tagged: Clinical Governance, finance, Gr... Fade Library blogs http://www.medworm.com/rss/comments.php?id=5158857 Tue, 23 Aug 2011 08:27:37 +0100 5158857 http://www.medworm.com/index.php?rid=5069471&cid=t_127586_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhen-physicians-fail-to-take-responsibility-for-their-own-orders%2F2011.07.27 A physician asked me a question regarding what should be the role of hospitalists in carrying out discharge orders written by other physicians. I have been following your blog since I was a resident and recommend it to a lot of people.  Thank you so much for enlightening me on so many day to day hospital issues.  I wanted to know your opinion about something that puzzles me.  When a specialist changes a medication or requires a lab to be done as outpatient after a discharge order is written (for example you write: okay to D/C if okay with cardiology, and they change a dose or request stress test out-pt) who is required to write the new scripts and arrange that test? Is it the hospitalist’s responsibility to do it? Or is the specialist who changed the dose after you rounded require... Better Health blogs http://www.medworm.com/rss/comments.php?id=5069471 Wed, 27 Jul 2011 21:00:00 +0100 5069471 http://www.medworm.com/index.php?rid=4968491&cid=t_127586_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhospitalization-vs-discharge-when-is-one-the-preferred-option%2F2011.06.25 I received a call recently from an emergency room (ER) physician about a patient who presented there with rectal bleeding. Does this sound blogworthy? Hardly. We gastro physicians get this call routinely. Here’s the twist. The emergency room physician presented the case and recommended that the patient be discharged home. He was calling me to verify that our office would provide this patient with an office appointment in the near term, which we would. We had an actual dialogue. This was a refreshing experience since the typical emergency room conversation of a rectal bleeder ends differently. Here’s what usually occurs. We are contacted and are notified that the patient has been admitted to the hospital and our in-patient consultative services are being requested. In other words, we ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4968491 Sat, 25 Jun 2011 16:00:00 +0100 4968491 http://www.medworm.com/index.php?rid=4600489&cid=t_127586_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F03%2F15%2Fnursing-times-2011-vol-107-no-9%2F Fade Fave: Surveillance of surgical sites in primary care Fade Skinny: A trust set up a programme to monitor surgical site infection that had developed after patient discharge to identify the risk factors and assess compliance with best practice. Contact the Library for a copy of this article.   Filed under: Current Awareness, Journals Tagged: Post Discharge, Surgical Site Infection, Surveillance (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4600489 Tue, 15 Mar 2011 11:11:25 +0100 4600489 http://www.medworm.com/index.php?rid=4477761&cid=t_127586_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmeasuring-the-patient-experience%2F2011.02.15 There’s a growing recognition within the medical-industrial complex that the patient is a key element of the enterprise, and that patient satisfaction, patient experience, patient engagement, patient activation, and patient-centeredness are very important. Some research shows that patient activation yields better patient outcomes, and that patient activation can be measured. Patient-centeredness and patient engagement are two of the key metrics to be used by the feds in describing Accountable Care Organizations (ACOs), if the internecine battles within government are resolved soon enough to actually release draft ACO regulations in time to allow for sufficient advance planning for the January 2012 go-live date. (Wearing one of my many hats, I’ve had the opportunity to submit ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4477761 Tue, 15 Feb 2011 14:00:44 +0100 4477761 http://www.medworm.com/index.php?rid=4399465&cid=t_127586_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F01%2F26%2Fnursing-times-2010-vol-107-no-1%2F Fade Fave: What is the effect of discharge planning? Fade Skinny: This Cochrane Review investigates whether discharge planning improved the use of acute care and patient outcomes. It also looked at whether discharge planning reduced overall costs of healthcare. Follow this link to access the full Cochrane Review report or contact the Library for a copy of the Nursing Times summary of the review. Filed under: Journals Tagged: Cost Effectiveness, Discharge Planning, Health Economics, Health Outcomes (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4399465 Wed, 26 Jan 2011 11:35:38 +0100 4399465 http://www.medworm.com/index.php?rid=4151658&cid=t_127586_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2010%2F11%2Fwatery-discharge-nose-head-trauma%2F Patients that have watery discharge from the nose several hours after significant head trauma (e.g., head striking the windshield or dashboard in a motor vehicle accident) is likely secondary to a cribiform plate fracture. The initial management of this is raising the head of the bed to 30 degrees if no contraindications exist such as spine fractures. (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=4151658 Wed, 10 Nov 2010 06:50:11 +0100 4151658 http://www.medworm.com/index.php?rid=3858154&cid=t_127586_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Freducing-hospital-bouncebacks-how%2F2010.08.11 In their most recent piece at Slate, emergency physicians Zachary F. Meisel and Jesse M. Pines tackle the issue of bouncebacks — that is, the re-admission of recently-discharged hospitalized patients. They bring up good some good points, and point out that until recently hospitals really didn’t have any incentive to reduce bouncebacks: …hospitals have never had a compelling reason to try to prevent bouncebacks. Hospitals are typically paid a flat sum for each inpatient stay — shorter stays equal higher profits. When patients bounce back, hospitals can charge the insurance company twice for the same patient with the same problem. Many hospitals also view bouncebacks as out of their control: If a patient boomerangs back because she doesn’t follow doctor’s orders, it’s not t... Better Health blogs http://www.medworm.com/rss/comments.php?id=3858154 Wed, 11 Aug 2010 22:00:33 +0100 3858154 http://www.medworm.com/index.php?rid=3718336&cid=t_127586_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F07%2F01%2Fnursing-times-2010-vol-106-no-25%2F Fade Fave: Why do patients with complex palliative care needs experience delayed hospital discharge? Fade Skinny: The Palliative Care Team of the North Middlesex University Hospital Trust have carried out a clinical audit of the case notes of 40 patients to examine why patients with complex palliative care needs experience delays in hospital discharge. Recommendations were made and implemented and a repeat audit will assess their effectiveness. Contact the Library for a copy of this article Filed under: Current Awareness, Journals Tagged: Discharge, Hospitals, Palliative Care, Patient Discharge (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3718336 Thu, 01 Jul 2010 09:41:01 +0100 3718336 http://www.medworm.com/index.php?rid=3577343&cid=t_127586_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F05%2F19%2Fready-to-go-planning-the-discharge-and-the-transfer-of-patients-from-hospital-and-intermediate-care%2F Title: Ready to go? Planning the discharge and the transfer of patients from hospital and intermediate care Skinny: Good practice professionals guide for health and social care, it provides a practical resource for practitioners and organisations with advice to support improvements in how they manage the discharge of individuals and transfer of care between settings. Publisher: DH Size of Publication:36p. Published: 12/03/2010 Filed under: Grey Literature, Hospitals, Local Authorities, NHS, Primary Care, Social Services Tagged: Good Practice, Grey Literature, Intermediate Care, NHS, Patient Discharge, Primary Care, Social Care (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3577343 Wed, 19 May 2010 09:19:53 +0100 3577343 http://www.medworm.com/index.php?rid=3556096&cid=t_127586_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-helpful-guide-for-discharge-planning%2F2010.05.11 Medicare has a handy guide to help patients and their caregivers take control of the discharge planning process. It might be good for hospitals to have a stack of these at the ready and a plan to make sure every patient gets one: Planning for your discharge: A checklist for patients and caregivers preparing to leave a hospital, nursing home, or other health care setting *This blog post was originally published at ACP Hospitalist* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3556096 Tue, 11 May 2010 20:00:00 +0100 3556096 http://www.medworm.com/index.php?rid=3366140&cid=t_127586_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F03%2F15%2Farchives-of-internal-medicine-2010-vol-170-no-4%2F contents page Fade Fave: Hospital Cost of Care, Quality of Care, and Readmission Rates: Penny Wise and Pound Foolish? Fade Skinny: Hospitals face increasing pressure to lower cost of care while improving quality of care. It is unclear if efforts to reduce hospital cost of care will adversely affect quality of care or increase downstream inpatient cost of care. Finds the associations are inconsistent between hospitals’ cost of care and quality of care and between hospitals’ cost of care and mortality rates. Most evidence did not support the “penny wise and pound foolish” hypothesis that low-cost hospitals discharge patients earlier but have higher readmission rates and greater downstream inpatient cost of care. (NHS Athens is required to access this article online) ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3366140 Mon, 15 Mar 2010 07:47:48 +0100 3366140 http://www.medworm.com/index.php?rid=3212250&cid=t_127586_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2010%2F01%2Fcandidiasis%2F Pathophysiology 1) infection with Candida 2) all species that cause disease in humans can exist as commensals in mouth, vagina, and stool 3) manifestations depend on invasion site Signs and Symptoms oral – 1) thrush (whitish, adherent plaques), fissuring at corners of the mouth 2) cutaneous – reddish, macerated intertriginous lesions on wet skin (diaper rash, under pendulous breasts) 3) vulvovaginal – inflamed mucosa with “cottage-cheese” discharge (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=3212250 Wed, 27 Jan 2010 01:39:45 +0100 3212250 http://www.medworm.com/index.php?rid=2963300&cid=t_127586_136_f&fid=39016&url=http%3A%2F%2Fturquoisegates.blogspot.com%2F2009%2F11%2Fflying-coop.html We just got word we are going home today! Amy is smiling non-stop and I must admit I am, too! It has been 10 long days and we miss home horribly. There is some concern about discharging her so soon after stopping the antiviral medication, but "since both parents are nurses with ICU experience"...oh, how I hate it when they drop that big ball of responsibility squarely into our court! Most of the various specialists agree that the changes in her brain are not inflammatory but demyelinating. This means that the virus or the inflammation it caused resulted in a loss of protective fatty covering on the coils of the brain in the area that was most affected. It can also be an early sign of a long-term congenital condition. Amy will be required to have multiple MRI's over the next month to year, ... Turquoise Gates blogs http://www.medworm.com/rss/comments.php?id=2963300 Thu, 05 Nov 2009 15:46:00 +0100 2963300 http://www.medworm.com/index.php?rid=2930908&cid=t_127586_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F10%2F27%2Fmanaging-patients%25e2%2580%2599-medicines-after-discharge-from-hospital%2F Title: Managing patients’ medicines after discharge from hospital Skinny: Report that raises concerns that : GPs and hospitals do not always exchange enough information about medicines, and don’t share it on time. In a minority of GP practices (17%), administrative staff rather than clinical staff update records, and they don’t have the clinical skills to check whether medications are right. There’s not enough being done to talk to patients themselves about their medications, either when they’re discharged from hospital or in the longer term. Monitoring and learning from serious incidents is patchy. Publisher: Care Quality Commission Size of Publication: 56p Published: 27/10/2009 Tool: Managing patients’ medicine after discharge – self-assessment tool North West Report: Stu... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2930908 Tue, 27 Oct 2009 13:00:00 +0100 2930908 http://www.medworm.com/index.php?rid=2846312&cid=t_127586_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F09%2F30%2Fthe-delayed-discharges-continuing-care-directions-2009%2F Title: The Delayed Discharges (Continuing Care) Directions 2009 The Skinny: Amendment to current regulations relating to delayed discharges. Publisher: DH Size of Publication: 4p Published: 29/09/2009 Posted in Acute Services, Hospitals, Legislation, Local Authorities, NHS, Social Services Tagged: Legislation, Patient Discharge, Reglulations (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2846312 Wed, 30 Sep 2009 16:21:23 +0100 2846312 http://www.medworm.com/index.php?rid=2823921&cid=t_127586_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F09%2F23%2Fbritish-journal-of-healthcare-management-2009-volume-15-issue-9%2F This article analyses the implicit relationship between Payment by Results (PbR) and the Delayed Discharges Act (DDA), and highlights some of its most relevant features. (Print copy held at the Fade Library) Posted in Current Awareness, Health Economics, Journals, Local Authorities, NHS, Payment by Results, Social Care, Social Services Tagged: Current Awareness, Financial Management, Health Economics, Journals, Legislation, Local Authorities, NHS, Patient Discharge, Payment by Results, Social Services (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2823921 Wed, 23 Sep 2009 09:00:06 +0100 2823921 http://www.medworm.com/index.php?rid=2671094&cid=t_127586_150_f&fid=38374&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FePharmaSummit%2F%7E3%2FJl3Mf2vW2Yw%2Fonline-hospital-ratings.html (Source: ePharma Summit) ePharma Summit blogs http://www.medworm.com/rss/comments.php?id=2671094 Tue, 04 Aug 2009 14:38:00 +0100 2671094 http://www.medworm.com/index.php?rid=2452329&cid=t_127586_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F06%2F03%2Fhealthy-mind-healthy-body%2F Title: Healthy mind, healthy body The Skinny: NHS Confederation briefing that looks at opportunities to improve quality and efficiency in acute services by focusing on the needs of the significant number of patients who also have mental health problems complicating their care and discharge. Key points: One quarter of acute inpatients have mental health problems. Identifying and treating the mental health needs of acute inpatients early has a direct impact on the recovery of their physical health. Liaison services can improve care and bring costs savings as patients can be discharged earlier if their mental health needs are addressed. Services can also bring savings for primary care trusts (PCTs) by reducing re-attendances. Publisher: NHS Confederation Size of Document: 6p. Published: 07... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2452329 Wed, 03 Jun 2009 19:00:21 +0100 2452329 http://www.medworm.com/index.php?rid=2258171&cid=t_127586_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F03%2F10%2Ftexas-state-hospital-heres-the-bus-station-see-ya%2F Just as you believe that maybe, perhaps, the tide is turning and the government that is charged with the responsibility and care of those most in need — the severely mentally ill who are hospitalized — actually “gets” it, you read a story like this one. Raquel Padilla was discharged from a state inpatient psychiatric hospital in San Antonio, Texas and dropped off at the bus station. That and a phone call to a sibling who also suffers from schizophrenia was apparently the extent of her discharge planning. Raquel suffered from schizophrenia herself and also apparently had mild mental retardation. Needless to say, bad things soon followed and three days later, she was found dead in a concrete ditch. She never made it on the bus. The family is rightfully outraged: &#8... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2258171 Tue, 10 Mar 2009 12:22:52 +0100 2258171 http://www.medworm.com/index.php?rid=2175376&cid=t_127586_88_f&fid=38203&url=http%3A%2F%2Fprecordialthump.medbrains.net%2F2009%2F02%2F10%2Fto-the-night-shift-ae-doctor%2F It’s four in the morning. It’s been a long night… I know, believe me. But before you discharge the 60 year-old man who came in gasping for air a few hours earlier, take the time to consider a few things. Listen to the history, the patient may tell you the diagnosis. Having to get out of bed at night to stand up and breathe, and frequently passing urine at night,  might bring to mind the simple equation: paroxysmal nocturnal dyspnoea + orthopnea + nocturia = heart failure. Yes, he smokes like a chimney, but less than a quarter of smokers develop clinically significant chronic obstructive airways disease. It seems that many people are resistant to the ravages of cigarette smoke on their lungs. “Not all that wheezes is asthma” - remember that old chestnut? Hold... AEQUANIMITAS blogs http://www.medworm.com/rss/comments.php?id=2175376 Tue, 10 Feb 2009 17:39:26 +0100 2175376 http://www.medworm.com/index.php?rid=1833374&cid=t_127586_113_f&fid=35744&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F403257588%2F Pay them to do it, take money away when they don’t — make hospitals accountable for their role in avoiding unnecessary readmissions. Mark E. Miller, Ph.D., Executive Director, Medicare Payment Advisory Commission testified recently in front of the U.S. Senate Committee on Finance. He opened his remarks by stating: The health care delivery system we see today is not a true system: care coordination is rare, specialist care is favored over primary care, quality of care is often poor, and costs are high and increasing at an unsustainable rate. About a quarter of Mr. Miller’s testimony focused on an issue that hasn’t received much attention: avoidable hospital readmissions . Here are some key excerpts: (more…) (Source: e-CareManagement) e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=1833374 Thu, 25 Sep 2008 23:49:28 +0100 1833374 http://www.medworm.com/index.php?rid=1211994&cid=t_127586_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2008%2F02%2F06%2F368%2F To use this journal you’ll need your NHS Athens password from Liverpool PCT (You can register here to get one if you work for the PCT.  If you need any training for this or any other electronic resources and you work for the PCT use the contact form at the bottom of this post to request it. Quality Lines David P Stevens Qual Saf Health Care 2008; 17: 1. [Extract] [Full text] [PDF] Handovers and Debussy D P Stevens Qual Saf Health Care 2008; 17: 2-3. doi:10.1136/qshc.2007.025916 [Extract] [Full text] [PDF] Structuring flexibility: the potential good, bad and ugly in standardisation of handovers E S Patterson Qual Saf Health Care 2008; 17: 4-5. doi:10.1136/qshc.2007.022772 [Extract] [Full text] ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=1211994 Wed, 06 Feb 2008 13:49:23 +0100 1211994 http://www.medworm.com/index.php?rid=949713&cid=t_127586_111_f&fid=36048&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FAHeartyLife%2F%7E3%2F169572792%2F This is a tricky one. I think that so many different outside factors could also cloud the findings in this racially based study. Is seems that if you are African American or Hispanic, you don’t want to be hypertensive in Florida, USA. Yes, there was actually a study done on this. I don’t know how it came about or if it stemmed from a wrongful treatment or malpractice case or just plain old curiosity. Over 55% of all emergent, as well as non emergent, patients that were hospital for hypertension in the state of Florida were whites. African American were in a distant second at just over 25% and Hispanic patients brought up the rear at just under 15%. Like I said above, I can personally think of many reasons that would lead to this conclusion but here is what the persons conductin... A Hearty Life blogs http://www.medworm.com/rss/comments.php?id=949713 Sun, 14 Oct 2007 01:21:06 +0100 949713 http://www.medworm.com/index.php?rid=865789&cid=t_127586_158_f&fid=36018&url=http%3A%2F%2Fcaregiversbeacon.blogspot.com%2F2007%2F09%2Fhospital-discharge-planners-explained.html The AAHSA, American Association of Homes and Services for Aging, at aahsa.org, offers Consumer Information that explains that hospital discharge planners operate under "tight restrictions...arrange discharges at a rapid pace...and how Medicare reimbursements stop when a doctor clears someone to leave" so the hospital is motivated to fill the bed with a paying patient.The AAHSA provides consumer information under "How to Choose" on the page titled "Crises Planning, When You Need Aging Services Now" and says "you may want to seek advice from someone other than the hurried discharge planner" and discusses the option of also using a private care coordinator.The AAHSA says that for a fee you can hire a private care coordinator who can provide you with additional assistance. Contacting friends, ... The Caregiver's Beacon - Resources, Links, Ideas, News blogs http://www.medworm.com/rss/comments.php?id=865789 Wed, 12 Sep 2007 01:47:00 +0100 865789