Hospital practice (1995)
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Hospital practice (1995) · Dec 2016
Hospitalist-vascular surgery comanagement: effects on complications and mortality.
Hospitalized vascular surgery patients have multiple severe comorbidities, poor functional status, and high perioperative cardiac risk. Thus they may be ideal patients for a collaborative care model. However, there is little evidence for a comanagement model on clinical outcomes. ⋯ After two years of implementation, our comanagement service reduced complications, mortality, and pain scores among high-risk vascular surgery patients.
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Dual anti-platelet therapy denotes a regimen of aspirin plus a P2Y12 receptor inhibitor, clopidogrel, prasugrel, or ticagrelor. Such therapy is a cornerstone of medical management following acute coronary syndromes and is imperative following percutaneous coronary interventions. ⋯ There may be latitude for earlier discontinuation in appropriately selected patients; extended dual antiplatelet therapy beyond one year may be beneficial in others. Herein, we describe current guidelines and evidence supporting if and when dual antiplatelet therapy should be interrupted for surgery for patients who have undergone percutaneous coronary intervention.
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Hospital practice (1995) · Dec 2016
Lean intervention improves patient discharge times, improves emergency department throughput and reduces congestion.
To determine if a lean intervention improved emergency department (ED) throughput and reduced ED boarding by improving patient discharge efficiency from a tertiary care children's hospital. ⋯ Lean principles implemented by one hospital service line improved patient discharge times enhanced patient ED throughput, and reduced ED boarding times.