Southern medical journal
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Southern medical journal · Jul 2015
Streptococcus bovis Bacteremia: Association with Gastrointestinal and Liver Disease in a Predominantly Hispanic Population.
Streptococcus bovis bacteremia has been associated with gastrointestinal diseases, especially colon cancer, neoplastic colon polyps, and other malignancies of the gastrointestinal tract. Studies have suggested an association with chronic liver parenchymal and biliary tract disorders. We report a series of patients with S. bovis bacteremia in a county hospital in a US city on the border of Mexico to examine the demographic and clinical associations. ⋯ Our finding in a series of predominantly Hispanic patients with S. bovis bacteremia in a county hospital setting was consistent with the previously reported association with gastrointestinal disease. Findings on colonoscopy included colonic polyps and colitis, although no cases of colon cancer were found. Chronic liver disease was a common concurrent illness and cholangitis also occurred. There was a significant mortality rate in adults.
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Southern medical journal · Jun 2015
Feedback on Bounce Backs: Real-Time Notification of Readmissions and the Impact on Readmission Rates and Physician Perceptions.
Readmissions are an increasing area of focus for quality improvement initiatives. Widely variable estimates exist on preventability and impact of multipronged readmission interventions. Given the rotating nature of attending physicians in academic centers, physicians often are unaware of readmissions. We present a before-and-after (uncontrolled) trial evaluating timely feedback of readmissions to hospitalist physicians. ⋯ Our intervention of real-time feedback regarding readmissions and enforced chart review led to a modest reduction in readmission rates without significant changes in length of stay. Physicians continued to believe that a readmission event was multifactorial and largely not preventable. Real-time notification did increase physician involvement in prevention initiatives, in particular with high-use patients.
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Patient satisfaction scores are increasing in importance. Although the influence of selected patient and physician characteristics on satisfaction scores has been identified, the impact of different pediatric diagnoses is unknown. The purpose of this study was to compare patient satisfaction scores in visits for mechanical back pain with visits for clubfoot or scoliosis. ⋯ Satisfaction scores in pediatric patients with back pain were not lower than visits for scoliosis or clubfoot. Future research can be directed toward identifying common goals in visits for pediatric mechanical back pain to further improve the patient experience.
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Southern medical journal · Jun 2015
Developing a Communication Curriculum and Workshop for an Internal Medicine Residency Program.
Learning effective communication is essential for physicians. Effective communication has been shown to affect healthcare outcomes, including patient safety, adherence rates, patient satisfaction, and enhanced teamwork. The importance of these skills has become even more apparent in recent years, with value-based purchasing programs and federal measures of patient satisfaction in the form of Hospital Consumer Assessment of Healthcare Providers and Systems scores becoming an important part of measuring the performance of a healthcare facility. ⋯ Our findings demonstrate a needs gap and an area of potential improvement in medical education. We anticipate that with the growing understanding of the importance of communication skills in the healthcare setting, there will be an enhanced role for teaching these skills at all levels of medical education. More studies are needed to further elucidate the specific areas of communication in health care where additional training is necessary.
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Southern medical journal · May 2015
Impact of trainees on length of stay in the emergency department at an Academic Medical Center.
Emergency department (ED) overcrowding remains a growing concern despite continued efforts by hospitals to improve efficiency while also maintaining quality of care and medical education. The purpose of this study was to examine whether the total number of trainees rotating in the ED affects length of stay (LOS). ⋯ Findings from this study suggest that ED LOS is unaffected by the presence or total number of trainees (medical students, postgraduate year-1 students/interns, and nurse practitioners) rotating in the ED. Further research is needed to examine what, if any, adjustments are being made to accommodate trainees and whether the quality of education suffers when the trainee-to-attending ratio is high.