Journal of general internal medicine
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Randomized Controlled Trial
Redefining and redesigning hospital discharge to enhance patient care: a randomized controlled study.
Patients are routinely ill-prepared for the transition from hospital to home. Inadequate communication between Hospitalists and primary care providers can further compromise post-discharge care. Redesigning the discharge process may improve the continuity and the quality of patient care. ⋯ A low-cost discharge-transfer intervention may improve the rates of outpatient follow-up and of completed workups after hospital discharge.
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Randomized Controlled Trial
Automatic capture of student notes to augment mentor feedback and student performance on patient write-ups.
To determine whether the integration of an automated electronic clinical portfolio into clinical clerkships can improve the quality of feedback given to students on their patient write-ups and the quality of students' write-ups. ⋯ An electronic clinical portfolio that automatically collects students' clinical notes is associated with improved teacher feedback on write-ups and similar quality of write-ups.
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Randomized Controlled Trial Multicenter Study
Stop orders to reduce inappropriate urinary catheterization in hospitalized patients: a randomized controlled trial.
Hospitalized patients frequently have urinary catheters inserted for inappropriate reasons. This can lead to urinary tract infections and other complications. ⋯ Stop orders for urinary catheterization safely reduced duration of inappropriate urinary catheterization in hospitalized patients but did not reduce urinary tract infections.
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Randomized Controlled Trial Multicenter Study
Improving HIV screening and receipt of results by nurse-initiated streamlined counseling and rapid testing.
HIV testing is cost-effective in unselected general medical populations, yet testing rates among those at risk remain low, even among those with regular primary care. HIV rapid testing is effective in many healthcare settings, but scant research has been done within primary care settings or within the US Department of Veteran's Affairs Healthcare System. ⋯ Streamlined counseling with rapid testing significantly increased testing and receipt rates over current practice without changes in risk behavior or posttest knowledge. Increased testing and receipt of results could lead to earlier disease identification, increased treatment, and reduced morbidity/mortality. Policymakers should consider streamlined counseling/rapid testing when implementing routine HIV testing into primary/urgent care.
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Randomized Controlled Trial
Caring and dominance affect participants' perceptions and behaviors during a virtual medical visit.
Physician communication style affects patients' perceptions and behaviors. Two aspects of physician communication style, caring and dominance, are often related in that a high caring physician is usually not dominant and vice versa. ⋯ Dominant and caring physicians elicit different emotional and behavioral responses from APs. Physician dominance reduces patient engagement in the medical dialog and produces submissiveness, whereas physician caring increases patient emotionality.