Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Randomized Controlled Trial
Strategies to engage stakeholders in research to improve acute care delivery.
Many families involved in research are well versed in the care system due to chronic conditions. Engagement of families of children with serious acute illnesses is infrequent, and no studies have documented the feasibility or acceptability of different methods of family engagement. We describe a model used in the Hospital-to-Home Outcomes study, which utilized a novel approach of short-term focused engagement of families and other stakeholders to incorporate the unique viewpoints of families whose care experience is primarily focused around the period surrounding their child's hospitalization for acute illness.
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Randomized Controlled Trial
Impact of pharmacist involvement in the transitional care of high-risk patients through medication reconciliation, medication education, and postdischarge call-backs (IPITCH Study).
Previous data suggest that direct pharmacist interaction with patients through medication reconciliation, discharge counseling, and postdischarge phone calls decreases the number of adverse drug events (ADEs) and plays an overall positive role in transitional care. Previous studies have evaluated pharmacist involvement in improving transitional care, but these studies did not include multiple postdischarge follow-up phone calls. ⋯ This study demonstrated that pharmacist involvement in hospital discharge transitions of care had a positive impact on decreasing composite inpatient readmissions and ED visits. Statistically significant difference in medication-related events and HCAHPS scores were not observed. Patients with moderately complex medication regimens benefited from a continuity of care involving a pharmacy team during transitions in care.
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Randomized Controlled Trial
Smarter hospital communication: secure smartphone text messaging improves provider satisfaction and perception of efficacy, workflow.
Though current hospital paging systems are neither efficient (callbacks disrupt workflow), nor secure (pagers are not Health Insurance Portability and Accountability Act [HIPAA]-compliant), they are routinely used to communicate patient information. Smartphone-based text messaging is a potentially more convenient and efficient mobile alternative; however, commercial cellular networks are also not secure. ⋯ Smartphone-based, HIPAA-compliant group messaging applications improve provider perception of in-hospital communication, while providing the information security that paging and commercial cellular networks do not.
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Randomized Controlled Trial
A randomized trial of real-time automated clinical deterioration alerts sent to a rapid response team.
Episodes of patient deterioration on hospital units are expected to increasingly contribute to morbidity and healthcare costs. ⋯ Real-time alerts sent to the RRT did not reduce ICU transfers, hospital mortality, or the need for subsequent long term care. However, hospital length of stay was modestly reduced.
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Randomized Controlled Trial
Hospital cardiac arrest resuscitation practice in the United States: a nationally representative survey.
In-hospital cardiac arrest (IHCA) outcomes vary widely between hospitals, even after adjusting for patient characteristics, suggesting variations in practice as a potential etiology. However, little is known about the standards of IHCA resuscitation practice among US hospitals. ⋯ There is wide variability among hospitals and within practices for resuscitation care in the United States with opportunities for improvement.