Neurodegenerative Disease Is Associated With Increased Incidence Of Epilepsy: A Population Based Study Of Older Adults
Leah J. Blank, Emily K. Acton, Dylan Thibault, Allison W. Willis
Abstract [from journal]
Objective: To determine the incidence of epilepsy among Medicare beneficiaries with a new diagnosis of Alzheimer dementia (AD) or Parkinson disease (PD).
Methods: Retrospective cohort study of Medicare beneficiaries with an incident diagnosis of AD or PD in the year 2009. The 5-year incidence of epilepsy was examined by sociodemographic characteristics, comorbidities and neurodegenerative disease status. Cox regression models examined the association of neurodegenerative disease with incident
...The Economic Value of Hospital Investment in Nurses
Many hospitals have been slow to improve nurse staffing, even as evidence mounts that nursing resources are associated with better outcomes, including lower rates of patient mortality, avoidable complications, and readmissions. One barrier has been the cost of more and better trained nurses: are the benefits worth it?
Differences In Transitional Care Processes Among High-Performing And Low-Performing Hospital-SNF Pairs: A Rapid Ethnographic Approach
Kirstin A. Manges, Roman Ayele, Chelsea Leonard, Marcie Lee, Emily Galenbeck, Robert E. Burke
Abstract [from journal]
Background: Despite the increased focus on improving patient's postacute care outcomes, best practices for reducing readmissions from skilled nursing facilities (SNFs) are unclear. The objective of this study was to observe processes used to prepare patients for postacute care in SNFs, and to explore differences between hospital-SNF pairs with high or low 30-day readmission rates.
Design: We used a rapid ethnographic approach with intensive multiday observations and key informant interviews at
...Prognosticating Outcomes And Nudging Decisions With Electronic Records In The ICU (PONDER-ICU) Trial Protocol
Katherine R. Courtright, Erich M. Dress, Jaspal Singh, Brian A. Bayes, Marzana Chowdhury, Dylan S. Small, Timothy Hetherington, Lindsay Plickert, Michael E. Detsky, Jason N. Doctor, Michael O. Harhay, Henry L. Burke, Michael B....
Abstract [from journal]
Expert recommendations to discuss prognosis and offer palliative options for critically ill patients at high risk of death are variably heeded by intensive care unit (ICU) clinicians. How to best promote such communication to avoid potentially unwanted aggressive care is unknown. The Prognosticating Outcomes and Nudging Decisions with Electronic Records in the ICU (PONDER-ICU) study is a 33-month pragmatic, stepped-wedge, cluster randomized trial testing the effectiveness of two electronic health record (EHR) interventions designed
...Improving Emergency Care For Children With Medical Complexity: Parent & Physicians' Perspectives
Christian D. Pulcini, Zoe Belardo, Tara Ketterer, Joseph J. Zorc, Cynthia Mollen
Abstract [from journal]
Objectives: Children with medical complexity (CMC) have high rates of emergency department (ED) utilization, but little evidence exists on the perceptions of parents and pediatric emergency medicine (PEM) physicians about emergency care. We sought to explore parent and PEM physicians' perspectives about 1) ED care for CMC, and 2) how emergency care can be improved.
Methods: We performed semi-structured interviews with parents and PEM physicians at a single academic, children's hospital.
...How Context Influences Hospital Readmissions From Skilled Nursing Facilities: A Rapid Ethnographic Study
Roman Ayele, Kirstin A. Manges, Chelsea Leonard, Marcie Lee, Emily Galenbeck, Mithu Molla, Cari Levy, Robert E. Burke
Abstract [from journal]
Introduction: Improving hospital discharge processes and reducing adverse outcomes after hospital discharge to skilled nursing facilities (SNFs) are gaining national recognition. However, little is known about how the social-contextual factors of hospitals and their affiliated SNFs may influence the discharge process and drive variations in patient outcomes. We sought to categorize contextual drivers that vary between high- and low-performing hospitals in older adult transition from hospitals to SNFs.
...
The Evolving Role of Academia During the COVID-19 Pandemic
Colorado’s response to the COVID-19 pandemic has been informed by an evolving partnership between academia and public health practitioners that can serve as a model for other states.
Case For Hospital Nurse-To-Patient Ratio Legislation In Queensland, Australia, Hospitals: An Observational Study
Matthew D. McHugh, Linda H. Aiken, Carol Windsor, Clint Douglas, Patsy Yates
Abstract [from journal]
Objectives: To determine whether there was variation in nurse staffing across hospitals in Queensland prior to implementation of nurse-to-patient ratio legislation targeting medical-surgical wards, and if so, the extent to which nurse staffing variation was associated with poor outcomes for patients and nurses.
Design: Analysis of cross-sectional data derived from nurse surveys linked with admitted patient outcomes data.
Setting: Public hospitals in Queensland.
...LDI Launches New Dissemination Training Program for Its Senior Fellows
Long-Term Care, Residential Facilities, And COVID-19: An Overview Of Federal And State Policy Responses
Angela T. Chen, Kira L. Ryskina, Hye-Young Jung
Abstract [from journal]
The COVID-19 pandemic has disproportionately affected residents and staff at long-term care (LTC) and other residential facilities in the United States. The high morbidity and mortality at these facilities has been attributed to a combination of a particularly vulnerable population and a lack of resources to mitigate the risk. During the first wave of the pandemic, the federal and state governments received urgent calls for help from LTC and residential care facilities; between March and early June of 2020, policymakers responded
...Care Management for Medicaid Patients
Five percent of Medicaid enrollees account for nearly 50% of Medicaid spending, making this high-cost group a promising target for care management programs.
Perspectives Of Urban Adolescent Black Males And Their Parents On Well Care
George Dalembert, Ima Samba, Victoria A. Miller, Carol A. Ford, Alexander G. Fiks
Abstract [from journal]
Objective: Adolescents have fewer well-care visits than all other age groups. Males and ethnic minorities are seen least often. We elicited, from Black adolescent males and their parents, key drivers of teen well-care seeking.
Methods: We conducted separate semi-structured interviews with Black adolescent males and their parents. We recruited parent-teen dyads from West Philadelphia. Eligible teens were age 13-18, with no complex chronic health conditions. We purposively sampled teens who had
...Patterns Of Postpartum Ambulatory Care Follow-Up Care Among Women With Hypertensive Disorders Of Pregnancy
Jennifer Lewey, Lisa D. Levine, Lin Yang, Jourdan E. Triebwasser, Peter W. Groeneveld
Abstract [from journal]
Background Preeclampsia and gestational hypertension are hypertensive disorders of pregnancy (HDP) that identify an increased risk of developing chronic hypertension and cardiovascular disease later in life. Postpartum follow-up may facilitate early screening and treatment of cardiovascular risk factors. Our objective is to describe patterns of postpartum visits with primary care and women's health providers (eg, family medicine and obstetrics) among women with and without HDP in a nationally representative sample of commercially
...Chronic Hospital Nurse Understaffing Meets COVID-19
A study of hospitals in New York and Illinois at the start of the COVID-19 pandemic found that most did not meet benchmark patient-to-nurse staffing ratios for medical-surgical or intensive care units. New York City hospitals had especially low staffing ratios. Understaffed hospitals were associated with less job satisfaction among nurses, unfavorable grades for patient safety and quality of care, and hesitance by nurses and patients to recommend their hospitals.
Intersectionality and Health Inequities For Gender Minority Blacks In The U.S.
Elle Lett, Nadia L. Dowshen, Kellan E. Baker
Abstract [from journal]
Introduction: Gender minority blacks represent the intersection of multiply marginalized populations that experience severe health inequities in the U.S. However, few studies focus on the unique health experiences of this multiply disadvantaged population. This study quantifies the health inequities experienced by gender minority blacks in the U.S. using an intersectional framework.
Methods: This cross-sectional study analyzed data in 2018/2019 from the Behavioral Risk Factor Surveillance System, including all...