Journal of the American Geriatrics Society
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Multicenter Study
Patterns of surgical care and complications in elderly adults.
To determine whether procedures, hospitals visited, and complications would differ according to decade in elderly adults and from those of younger adults. ⋯ This article reports the pattern of surgical procedures, complications, and mortality found in NACOR, which is one of the few data sets that contains data from community hospitals and individuals with all types of insurance. Because the outcomes portion of the data set is under development, it is not possible to investigate the relationship between hospital type and complications or mortality, but this study underscores the magnitude of geriatric surgery that occurs in community hospitals as an area for future outcomes studies.
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Randomized Controlled Trial Multicenter Study
A standardized, bundled approach to providing geriatric-focused acute care.
To determine whether a bundled intervention can increase detection of delirium and facilitate safer use of high-risk medications. ⋯ An intervention focused on delirium prevention and recognition by bedside staff combined with computerized decision support facilitates safer prescribing of high-risk medications and possibly results in less need for extended care.
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Randomized Controlled Trial Multicenter Study
Successfully reducing antibiotic prescribing in nursing homes.
To determine whether antibiotic prescribing can be reduced in nursing homes using a quality improvement (QI) program that involves providers, staff, residents, and families. ⋯ This magnitude of effect is unusual in efforts to reduce antibiotic use in nursing homes. Outcomes could be attributed to the commitment of the providers; outreach to providers and staff; and a focus on common clinical situations in which antibiotics are generally not indicated; and suggest that similar results can be achieved on a wider scale if similar commitment is obtained and education provided.
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Randomized Controlled Trial
An electronic health record-based intervention to increase follow-up office visits and decrease rehospitalization in older adults.
To assess the effect of an electronic health record-based transitional care intervention involving automated alerts to primary care providers and staff when older adults were discharged from the hospital. ⋯ This electronic health record-based intervention did not have a significant effect on the timeliness of office visits to primary care providers after hospitalization or risk of rehospitalization.