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When patients are admitted through the emergency department (ED) and multiple clinicians are involved with competing priorities in their care, discharge planning can be challenging.
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While hospitalists can provide consistency in the care of hospitalized patients, there can be drawbacks when it comes to transitions in care.
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Pharmacist involvement in medication reconciliation is so crucial to patient safety that one 450-plus-bed Wisconsin hospital invested considerable staff resources to make this a smooth process from admission through discharge.
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A new survey, conducted by a worldwide company that provides private, in-home care for older adults, suggests that older Americans and their adult children do a poor job of planning for their future needs as health begins to fail.
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The recently passed health care reform legislation may have generated controversy in political circles, but there appears to be a consensus among health care quality observers that it will strengthen the position of hospital quality managers and give their roles even greater importance.
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While Brigham and Women's Hospital in Boston has been successful in reducing the incidents of venous thromboembolism (VTE), it has taken an ongoing effort and a combination of successful interventions, says Sylvia McKean, MD, SFHM, FACP, a senior hospitalist. "National and international registries have shown that prophylaxis is still underutilized," she says.
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The Society of Hospital Medicine (SHM) developed a web-based educational resource for hospitalists, a VTE "resource room" (http://www.hospitalmedicine.org/ResourceRoomRedesign/RR_LandingPage.cfm). "The overarching goal of SHM was to bridge the gap between the best evidence in terms of medical prophylaxis and actual practice," Sylvia McKean, MD, SFHM, FACP, a senior hospitalist at Brigham and Women's Hospital, notes.
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About six years ago, Cooley Dickinson Hospital in Northampton, MA, had the highest rate of pressure ulcers in the state; including Stage I patients, it was in the 20%-30% range. Today, the facility can boast 10 quarters of 0%, beginning in December 2005.
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