Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Little is known about the contribution of psychiatric illness to medical 30-day readmission risk. ⋯ Our data suggest that patients treated during a hospitalization for depression and for schizophrenia are at higher risk for potentially avoidable 30-day readmissions, whereas those prescribed more psychiatric medications as outpatients are at increased risk for all-cause readmissions. These populations may represent fruitful targets for interventions to reduce readmission risk.
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Multicenter Study
Project BOOST: effectiveness of a multihospital effort to reduce rehospitalization.
Rehospitalization is a prominent target for healthcare quality improvement and performance-based reimbursement. The generalizability of existing evidence on best practices is unknown. ⋯ Participation in Project BOOST appeared to be associated with a decrease in readmission rates.
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Discharge summaries are essential for safe transitions from hospital to home. ⋯ Discharge summary quality is inadequate in many domains. This may explain why individual aspects of summary quality such as timeliness or content have not been associated with improved patient outcomes. However, improving discharge summary timeliness may also improve content and transmission.
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Changes in the clinical learning environment under resident duty hours restrictions have introduced a number of challenges on today's wards. Additionally, the current group of medical trainees is largely represented by the Millennial Generation, a generation characterized by an affinity for technology, interaction, and group-based learning. Special attention must be paid to take into account the learning needs of a generation that has only ever known life with duty hours. ⋯ Hospitalists serving as teaching attendings should consider these possible strategies as ways to enhance teaching in the post-duty hours era. These techniques appeal to the preferences of today's learners in an environment often limited by time constraints. Hospitalists are well positioned to champion innovative approaches to teaching in a dynamic and evolving clinical learning environment.
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Randomized Controlled Trial
Bacterial contamination of healthcare workers' uniforms: a randomized controlled trial of antimicrobial scrubs.
Healthcare workers' (HCWs) uniforms become contaminated with bacteria during normal use, and this may contribute to hospital-acquired infections. Antimicrobial uniforms are currently marketed as a means of reducing this contamination. ⋯ We found no evidence that either antimicrobial scrub product decreased bacterial contamination of HCWs' uniforms or skin after an 8-hour workday.