J Am Board Fam Med
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The purpose of this study was to identify data available at the time of hospital admission that predict readmission risk. ⋯ Polypharmacy and higher Charlson score at admission predict readmission risk as well as or better than published risk prediction models. The model could help to conserve limited resources and to target interventions for reducing readmission among the highest-risk patients.
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Observational Study
Translating New Lung Cancer Screening Guidelines into Practice: The Experience of One Community Hospital.
In December 2013 the US Preventive Services Task Force issued a recommendation for lung cancer screening with annual low-dose computed tomography (LDCT). As screening guidelines emerge and change, this creates an environment for studying the translation of these guidelines into practice. This study assessed how these guidelines were implemented in a community hospital setting and the resulting radiologic findings. ⋯ This study shows that new lung cancer screening guidelines, as implemented at a community hospital, resulted in radiologic findings that required follow-up in more than half of patients. Clinicians must be aware of these potential incidental findings when talking to patients about the decision to order screenings.
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Many primary care practices have created a team structure in which a clinician and medical assistant "teamlet" form the core of a larger team. The larger team comprises a few teamlets supported by other clinical personnel. ⋯ Clinicians working in stable teamlets, with the same medical assistant every day, have less burnout than clinicians working with different medical assistants on different days. The teamlet model can thus create positive experiences for clinicians and patients alike.
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The objective of this study was to examine the impact of the transition from International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), to Interactional Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), on family medicine and to identify areas where additional training might be required. ⋯ The transition to ICD-10-CM is simple for 70% or more of diagnosis codes, visits, and reimbursement for a family medicine physician. However, some frequently used codes for disease management are convoluted and incorrect, and for which additional resources need to be invested to ensure a successful transition to ICD-10-CM.
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Although routine medication reviews in primary care practice are recommended to identify drug therapy problems, it is often difficult to get patients to bring all their medications to office visits. The objective of this study was to determine whether the medication review tool in the Agency for Healthcare Research and Quality Health Literacy Universal Precautions Toolkit can help to improve medication reviews in primary care practices. ⋯ Use of the Health Literacy Universal Precautions Toolkit can help to identify drug therapy problems.