Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Hospital at Home (HaH) programs are used throughout the United States and are beneficial in both providing patients care in environments most comfortable to them and freeing up inpatient beds. Better informing patients about HaH programs, while promoting shared decision-making (SDM), should be prioritized by health systems. SDM apps may promote increased patient agency and understanding of complex HaH care decisions. We previously developed, usability tested, and refined a HaH SDM app. ⋯ SDM apps may better inform patients' HaH care decisions, allowing patients self-directed access to information and engagement with visual content, which may address challenges related to health literacy and navigating complex, time-sensitive decisions.
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Text messaging has emerged as a popular strategy to engage patients after hospital discharge. Little is known about how patients use these programs and what types of needs are addressed through this approach. ⋯ The needs identified via an automated texting program were concentrated in three areas relevant to primary care practice and within nursing scope of practice. This program can serve as a model for health systems looking to support transitions through an operationally efficient approach, and the findings of this analysis can inform future iterations of this type of program.
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Hospital readmission rates are used for quality and pay-for-performance initiatives. To identify readmissions from administrative data, two commonly employed methods are focusing either on unplanned readmissions (used by the Centers for Medicare & Medicaid Services, CMS) or potentially avoidable readmissions (used by commercial vendors such as SQLape or 3 M). However, it is not known which of these methods has higher criterion validity and can more accurately identify actually avoidable readmissions. ⋯ Thus, the CMS method has both higher criterion validity and greater sensitivity for identifying actually avoidable readmissions, compared with the SQLape method. Consequently, the CMS method should primarily be used for quality initiatives.