Southern medical journal
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Southern medical journal · Sep 2022
Utilization of an Internal Medicine Triaging Resident in the Emergency Department Reduces Preventable Admissions and Improves Trainee Experiences.
Increasing patient care requirements and suboptimal communication between emergency department (ED) and Internal Medicine (IM) services may lead to inefficient hospital utilization, lapses in transitions of care, and reduced trainee satisfaction in the inpatient setting. Furthermore, a lack of triaging roles for IM trainees has been a common limitation in graduate medical education. We aimed to demonstrate that the addition of an IM triaging resident (TR) in the ED may represent an innovative solution to these problems. ⋯ Expansion of this model in select integrated health systems may improve graduate medical education and healthcare system performance. Future iterations of this study can aim to improve transitions of care between ambulatory and inpatient providers and limit the overuse of antimicrobial agents, radiography, and consultative services.
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Southern medical journal · Sep 2022
Exploring the Patient Experience with Patient-Reported Outcomes: A Qualitative, Multistakeholder Study.
Although the literature provides guidance regarding patient-reported outcome (PRO) implementation barriers, patients' perspectives are underreported. This study aimed to improve the understanding of patient experiences with PRO tools through examining perceptions of and attitudes toward PROs and expectations of data use after collection. ⋯ Design and implementation of PRO assessments into patient care should include the patients as key end users. Transparency of the purpose for data collection is critical for broader patient adoption. Ensuring that only necessary and sufficient data are collected for clinical action, and associated research may help minimize burden and maximize patient participation.
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Southern medical journal · Sep 2022
Factors Affecting Neurological Presentation and Severity in Pediatric Off-Highway Vehicle Accidents in Texas.
The purpose was to evaluate the characteristics of off-highway vehicle (OHV) crashes correlated with neurological injury and accident severity in the pediatric population in El Paso, Texas. ⋯ OHVs are associated with both TBIs and severe injuries. Stricter laws requiring helmets and forbidding children younger than 6 to ride are required, as modifying these factors could reduce the incidence of OHV crashes and their complications.
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Southern medical journal · Sep 2022
Impact of a Hemoglobin Trigger Communication Tool on Perioperative Transfusion in Cardiac Surgery.
Blood transfusion represents an important and potentially modifiable risk in the daily practice of cardiac surgery. The risk profile and increasing cost of transfusion led us to study the effect of different maneuvers, interventions, or surgical techniques to minimize transfusion while maintaining patient safety. This study compares postoperative outcomes before and after incorporating a verbal hemoglobin (Hb) trigger during the surgical timeout in which the surgeon and anesthesiologist preemptively agree on a threshold for packed red blood cell (PRBC) administration in the perioperative period. ⋯ Implementation of a verbal Hb trigger during the surgical timeout was associated with a reduction in FP administration and duration of mechanical ventilation, but not a decrease in PRBC transfusion and mortality.
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Southern medical journal · Sep 2022
Fetal Maturation and Intrauterine Survival in Asian American Women by Ethnicity.
Although there are multiple ethnic subgroups of the Asian race, this population is usually treated as homogenous in public health research and practice. There is a dearth of information on fetal maturation and perinatal outcomes among Asian American women compared with their non-Hispanic (NH) White counterparts. This study aimed to determine whether fetal maturation, as captured by gestational age periods, influences the risk of stillbirth in Asian American fetuses, in general, as well as within different ethnic subgroups: Asian Indian, Korean, Chinese, Vietnamese, Japanese, and Filipino, using NH Whites as referent. ⋯ Our study suggests the existence of differential maturation of the fetoplacental unit as explanation for the decline in intrauterine survival advantage with advancing gestational age among Asian American subgroups.