Articles: hospitals.
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Multicenter Study
Variation in length of stay and outcomes among hospitalized patients attributable to hospitals and hospitalists.
There have been no prior population-based studies of variation in performance of hospitalists. ⋯ There is significant variation among hospitalists in length of stay and discharge destination of their patients, but much of the variation is attributable to the hospitals where they practice. The very low variation among hospitalists in 30-day readmission rates suggests that hospitalists are not important contributors to variations in those rates among hospitals.
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Int J Occup Med Environ Health · Mar 2013
Multicenter Study Comparative StudyObservance of hand washing procedures performed by the medical personnel before patient contact. Part I.
According to the Centers for Disease Control and Prevention (CDC) as well as the World Health Organization (WHO) recommendations, medical staff are obliged to decontaminate the skin of the hands before every single patient contact. ⋯ The level of observance of hand washing procedures among the medical staff prior to the patient contact appears to be alarmingly below the expectations.
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Randomized Controlled Trial Multicenter Study
A multilevel intervention to increase community hospital use of alteplase for acute stroke (INSTINCT): a cluster-randomised controlled trial.
Use of alteplase improves outcome in some patients with stroke. Several types of barrier frequently prevent its use. We assessed whether a standardised, barrier-assessment, multicomponent intervention could increase alteplase use in community hospitals in Michigan, USA. ⋯ National Institutes of Health National Institute of Neurological Disorders and Stroke.
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Multicenter Study Comparative Study
Inpatient growth and resource use in 28 children's hospitals: a longitudinal, multi-institutional study.
To compare inpatient resource use trends for healthy children and children with chronic health conditions of varying degrees of medical complexity. ⋯ Patients with a chronic condition increasingly used more resources in a group of children's hospitals than patients without a chronic condition. The greatest growth was observed in hospitalized children with chronic conditions affecting 2 or more body systems. Children's hospitals must ensure that their inpatient care systems and payment structures are equipped to meet the protean needs of this important population of children.
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Multicenter Study Clinical Trial
Thrombolysis in acute ischemic stroke: a simulation study to improve pre- and in-hospital delays in community hospitals.
Various studies demonstrate better patient outcome and higher thrombolysis rates achieved by centralized stroke care compared to decentralized care, i.e. community hospitals. It remains largely unclear how to improve thrombolysis rate in decentralized care. The aim of this simulation study was to assess the impact of previously identified success factors in a central model on thrombolysis rates and patient outcome when implemented for a decentral model. ⋯ Simulation technique may target opportunities for improving thrombolysis rates in acute stroke. Pre-hospital factors proved to be the most promising for improving thrombolysis rates in an implementation study.