Journal of evaluation in clinical practice
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Evidence from the literature suggests that social determinants of health (SDOH) account for 80% of health outcomes and are associated with hospital readmissions. Readmissions negatively impact the quality of life of patients and increase healthcare costs. The Agency for Healthcare Research and Quality reports that there were 3.8 million 30-day adult hospital readmissions in 2018 with an average readmission cost of $15,000. ⋯ The findings provide strong evidence of the effectiveness of a bundled discharge approach in reducing hospital readmissions and improving patient outcomes.
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At present, there is no specific teaching method for doctor-patient communication for oncology residents. This study combined BOPPPS (bridge-in, learning objective, pretest, participatory learning, posttest, and summary) teaching model and SBAR (situation-background-assessment-recommendation) communication model to try a new teaching and assessment model of doctor-patient communication, aiming to explore and improve the teaching method of doctor-patient communication for oncology residents. ⋯ The application of the BOPPPS combined with the SBAR can effectively enhance residents' doctor-patient communication ability and improve teaching satisfaction and patient satisfaction. This new model can effectively improve resident physician‒patient communication ability, which is worth actively promoting in clinical teaching work.
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Allied Health Primary Contact Clinic (AHPCC) models of care are increasingly used to manage growing demands on health service capacity. There is a critical need for new models of care to demonstrate value, however comprehensive evaluation of AHPCCs, including use of metrics frameworks like the Moretto framework, have been slow to uptake, and the reasons for this are unclear. ⋯ For health services to fully understand the value of their AHPCC services and direct their limited resources appropriately, evaluation activity needs to be better valued and enabled at a local, statewide and national level. Strategies should include protected time, funding, administrative support, leadership support, access to mentorship, development of structures which enable collaborative evaluation at a state-wide (or broader) level, and a shared understanding of value and core areas for measurement across stakeholders.
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Exercise capacity declines with age. However, the effect of common geriatric symptoms, that are related to physical performance, on exercise capacity is unclear. ⋯ This study indicates that changes in exercise capacity are more influenced by the presence of sarcopenia, and that poor TUG performance is the greatest risk factor for the impaired exercise capacity.
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To explore the clinical effect of a nurse-centred multidisciplinary collaborative hospice care model in patients with advanced malignant tumours. ⋯ The nurse-led multidisciplinary collaborative hospice care model substantially alleviated negative emotions among patients, effectively improved their quality of life and happiness, and garnered positive evaluations of nursing satisfaction.