Articles: hospitals.
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Multicenter Study
Ranking and rankability of hospital postoperative mortality rates in colorectal cancer surgery.
To examine to what extent random variation and variation in case-mix influence hospital rankings on the basis of mortality rates and to determine the suitability of mortality for ranking hospitals in colorectal surgery. ⋯ Hospital ranks changed after case-mix adjustment and random-effects models, compared with unadjusted analysis. A large proportion of hospital variation in mortality was due to chance. Caution should be warranted when interpreting hospital rankings on the basis of postoperative mortality. Percentiles of expected ranks may help identify hospitals with exceptional performance.
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Multicenter Study
Benefit in regionalisation of care for patients treated with radical cystectomy: a nationwide inpatient sample analysis.
To quantify in absolute terms the potential benefit of regionalisation of care from low- to high-volume hospitals. ⋯ This is the first report to quantify the potential benefit of regionalisation of RC for muscle-invasive bladder cancer to high-volume hospitals.
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Multicenter Study Comparative Study Clinical Trial
Geriatric Syndromes Predict Postdischarge Outcomes Among Older Emergency Department Patients: Findings From the interRAI Multinational Emergency Department Study.
Identifying older emergency department (ED) patients with clinical features associated with adverse postdischarge outcomes may lead to improved clinical reasoning and better targeting for preventative interventions. Previous studies have used single-country samples to identify limited sets of determinants for a limited number of proxy outcomes. The objective of this study was to identify and compare geriatric syndromes that influence the probability of postdischarge outcomes among older ED patients from a multinational context. ⋯ Despite markedly different health care systems, the probability of long hospital lengths of stay and repeat hospital use among older ED patients is detectable at the multinational level with moderate accuracy. This study demonstrates the potential utility of incorporating common geriatric clinical features in routine clinical examination and disposition planning for older patients in EDs.
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Randomized Controlled Trial Multicenter Study
"Don't get weak in your compassion": bereaved next of kin's suggestions for improving end-of-life care in Veterans Affairs Medical Centers.
To analyze bereaved next of kin's suggestions for improving end-of-life (EOL) care in Veterans Affairs (VA) Medical Centers (VAMCs). ⋯ Interventions that support staff's ability to convey compassion, communicate information to families and other staff, listen to patients and families, prepare families for the individual's death, and provide consistent, coordinated information regarding after-death activities may optimize EOL hospital care for veterans.
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Multicenter Study
Knowing what to expect, forecasting monthly emergency department visits: A time-series analysis.
To evaluate an automatic forecasting algorithm in order to predict the number of monthly emergency department (ED) visits one year ahead. ⋯ The applied automated exponential smoothing approach provided useful predictions of the number of monthly visits a year in advance.