Following the status of visual cortex over time in patients with macular degeneration reveals atrophy of visually deprived brain regions.
Postdischarge phone calls have been shown to improve communications between patients and health care providers, potentially reducing readmission rates, medication errors, and emergency department (ED) visits. Given the complexity of social and medical issues associated with trauma, we studied the utility of an automated phone call system as a method of identifying gaps in trauma care. The Trauma Program and the Health Management and Education Department at a Level 1 academic trauma center engaged in a collaborative quality improvement effort using the CipherHealth LLC platform to provide automated phone calls to trauma patients 2–3 days after discharge. Automated questions to patients focused upon symptoms, equipment and medications, discharge instruction comprehension, and follow-up needs. When indicated, the automated system sent an alert and prompted the timely return phone call to the patient from a registered nurse with the intent of addressing the specified issue. During the 4-month study period, 1,382 patients were discharged from the trauma service. Three hundred thirty-two calls were attempted, with 186 completed. Twenty-seven percent of the completed calls prompted a nurse to make a personalized callback to the patient. Most calls were for symptoms (26%), follow-up appointments (22%), medication issues (21%), and discharge instruction clarification (15%). Just over 25% of trauma patients requested further clarification after discharge from the hospital. The results of this pilot indicate that further follow-up is warranted to determine whether outpatient follow-up calls in the trauma population have any impact upon mitigating complications and quality measures such as reduced ED visits, readmission, and patient safety and satisfaction.
Introduction:Antibiotics have been shown to be an essential component in the treatment of open extremity fractures. The American College of Surgeons' Trauma Quality Improvement Program, based on a committee of physician leaders including orthopaedic trauma surgeons, publishes best-practice guidelines for the management of open fractures. Accordingly, it established the tracking of antibiotic timing as a metric with a plan to use that metric before trauma center site reviews. Our hypothesis was that this physician-led effort at the national level would provide the necessary incentive to effect change within our institution.Methods: A retrospective review of all patients treated at our institution for open extremity fractures was performed over 3 periods separated by 2 quality initiatives. The first initiative was an institution-driven effort to increase awareness and educate specific departments about the importance of prompt antibiotic administration. The second initiative was the tracking of antibiotic order and administration times with quarterly audits following newly published guidelines.Results: Neither antibiotic order placement within 1 hour nor administration within 1 hour improved after our first institutionspecific initiative. Both outcome measures significantly improved after the second quality initiative, as did median times from arrival to antibiotic order and administration.Conclusions: Metrics developed and measured by a physicianled national organization led to practice changes at our hospital. Tracking of antibiotic timing for open fracture treatment was more effective than institutional education of healthcare providers alone. This study suggests that nationally published guidelines, developed and measured by physician leaders, will be found to be relevant by other physicians and can be a powerful tool to drive change.
Patients subjected to common trauma resuscitation practices can have varied emotional responses to certain aspects of their initial evaluation and care. Thirty-four patients admitted to the hospital after blunt traumatic injury were randomly selected to complete a self-reported questionnaire regarding their comfort levels with certain aspects of their initial trauma care and resuscitation. Most patients reported higher levels of comfort with procedures generally expected by the lay public and lower levels of comfort with those procedures less well known or for which they were not prepared. Analysis of survey data showed a larger percentage of discomfort with the digital rectal examination than with other aspects of trauma care. Notably, data analysis also showed a significant percentage of patients who were reluctant to disclose receiving a digital rectal examination. Additional investigation into the validity and reproducibility of these trends is warranted; however, there is legitimate evidence that there is room to improve a patient's perception of comfort during a trauma resuscitation and initial workup through improved communication and procedure disclosure.
Our unfunded trauma patients often lack the access to adequate health care services and equipment after hospital discharge. We have developed and implemented a pilot program to provide reclaimed durable medical equipment to medically indigent trauma patients. Our program includes the reuse of items such as front-wheeled walkers, bedside commodes, shower chairs, crutches, and canes.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.