Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Children with complex chronic conditions (CCCs) are at risk for adverse events (AEs) during hospitalizations. ⋯ In multivariable analysis, the adjusted incidence rate ratiofor AEs in children with CCCs was 0.5 (95% CI = 0.3-0.9, p = .01) with PFC I-PASS exposure; there was no statistically significant change in AEs for children without CCCs [IRR 0.6 (95% CI = 0.3-1.2; p = .1)].
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Randomized Controlled Trial
Discharge in the a.m.: A randomized controlled trial of physician rounding styles to improve hospital throughput and length of stay.
To relieve hospital capacity strain, hospitals often encourage clinicians to prioritize early morning discharges which may have unintended consequences. ⋯ Prioritizing discharging patients first did not result in significantly earlier discharges or reduced LOS.
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Randomized Controlled Trial
Early intervention model of inpatient diabetes care improves glycemia following hospitalization.
Admission to hospital provides an opportunity to optimize long-term diabetes management, but clinical inertia is common. We previously reported the randomized study of a proactive inpatient diabetes service (RAPIDS), investigating an early intervention model of care and demonstrated improved in-hospital glycemia and clinical outcomes. ⋯ There was a greater change in HbA1c in the early intervention group (mean -0.9% [95% CI -1.3 to -0.4]) versus the usual care group (-0.3% [-0.6 to -0.1]), p = .029. The value of acute care by dedicated inpatient diabetes teams can extend beyond improving inpatient clinical outcomes and can lead to sustained improvement in glycemia.
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Characterizing patients hospitalized without an acute care indication: A retrospective cohort study.
Hospitalizations by patients who do not meet acute inpatient criteria are common and overburden healthcare systems. Studies have characterized these alternate levels of care (ALC) but have not delineated prolonged (pALC) versus short ALC (sALC) stays. ⋯ Patients with prolonged ALC stays were more likely to be admitted for acute care, had greater psychosocial complexity, significantly longer lengths of stay, and unique discharge needs. Given the complexity and needs for hospitalizations with pALC days, intensive interdisciplinary coordination and resource mobilization are necessary.