Journal of general internal medicine
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Randomized Controlled Trial
Delayed Visits for Contraception Due to Concerns Regarding Pelvic Examination Among Women with History of Intimate Partner Violence.
Concern regarding pelvic examinations may be more common among women experiencing intimate partner violence. ⋯ History of pressured sex from an intimate partner is common. Among women who have experienced pressured sex, concern regarding pelvic examinations is a potential barrier to contraception. Communicating that routine pelvic examinations are no longer recommended by professional societies could potentially reduce barriers and increase preventive healthcare visits.
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Randomized Controlled Trial
Comparison of Two Methods for Implementing Comfort Care Order Sets in the Inpatient Setting: a Cluster Randomized Trial.
There is an ongoing need for interventions to improve quality of end-of-life care for patients in inpatient settings. ⋯ Findings suggest the clinical effectiveness of palliative care educational intervention was not dependent on which of the two implementation methods was used.
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Randomized Controlled Trial
Hospital-Level Care at Home for Acutely Ill Adults: a Qualitative Evaluation of a Randomized Controlled Trial.
Substitutive hospital-level care in a patient's home ("home hospital") has been shown to lower cost, utilization, and readmission compared to traditional hospital care. However, patients' perspectives to help explain how and why interventions like home hospital accomplish many of these results are lacking. ⋯ Compared to control patients, home patients had better experiences with their care team, had more experiences promoting healing such as better sleep and physical activity, and had better experiences with systems factors such as the admission processes. Potential explanations include continuity of care, the power and familiarity of the home, and streamlined logistics. Future improvements include enhanced care transitions and ensuring digital interfaces are usable.
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According to the American Association of Medical Colleges, women comprise 26% of full professors and 19% of medical school department chairs. African American and Latino faculty comprise 4.6% of full professors and 6.9% of department chairs. ⋯ We found that participant gender and race/ethnicity shaped perspectives of medical school faculty advancement in distinct ways.
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High-cost/high-need (HCHN) adults and the healthcare systems that provide their care may benefit from a new patient-centered model of care involving a dedicated physician and nurse team who coordinate both clinical and social services for a small patient panel. ⋯ The KPMAS CCP was associated with significantly reduced short-term mortality risk for eligible patients who volunteered to participate in this intervention.