Hospital practice (1995)最新文献

{"title":"The impact of interprofessional collaboration on hospital wait times and length of stays: insights from the National Hospital Ambulatory Medical Care Survey (NHAMCS).","authors":"Emmanuel Temitope Adaranijo, Cassandra R Marshall, Crispin Rakibu Mbamba","doi":"10.1080/21548331.2025.2591023","DOIUrl":"10.1080/21548331.2025.2591023","url":null,"abstract":"<p><strong>Introduction: </strong>Interprofessional collaboration (IPC), involving multidisciplinary teams of physicians, nurses, pharmacists, and other allied healthcare professionals, has been recognized as a strategy to streamline patient management and reduce systemic inefficiencies. IPC may help reduce hospital wait times (HWT), patients' length of stay (LOS) while enhancing overall quality of care.</p><p><strong>Objective: </strong>This study explores how IPC, patient demographics, and admission characteristics influence HWT and LOS.</p><p><strong>Methods: </strong>Data were drawn from the 2022 National Hospital Ambulatory Medical Care Survey (NHAMCS), <i>n</i> = 2,121 admitted patients in the United States. Multiple linear regression models were used to analyze the associations between IPC, patient demographics, urgency of admission, admission characteristics, and hospital wait times and length of stay.</p><p><strong>Results: </strong>Increased IPC was significantly associated with shorter HWT (<i>p</i> < 0.05) but a marginal increase in LOS (<i>p</i> < 0.05). High-urgency admission was associated with reduced HWT (<i>p</i> < 0.05). Older patients experienced modestly shorter waits (<i>p</i> < 0.001) but longer stays (<i>p</i> < 0.001). Admission to a stepdown unit correlated with longer wait times (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Strengthening IPC and effectively managing high-urgency admissions may help reduce HWT. Further research is needed to explore why IPC is linked to longer hospital stays and how to optimize resource allocation in stepdown units. These insights hold prospects to guide strategies for improving hospital efficiency and patient experiences.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2591023"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The promise of difference-in-differences for evaluating interprofessional collaboration in hospital settings.","authors":"Emmanuel Adaranijo","doi":"10.1080/21548331.2025.2593812","DOIUrl":"10.1080/21548331.2025.2593812","url":null,"abstract":"","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2593812"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum cystatin C and serum adenosine deaminase level in patients with stable and exacerbated chronic obstructive pulmonary disease: a cross-sectional comparative study.","authors":"Sandeep Appunni, Safreena Mohamed, Pradeep Kumar, Rebecca James, Ashwathy Muraleedharan Saraswathy, Muni Rubens","doi":"10.1080/21548331.2025.2591597","DOIUrl":"10.1080/21548331.2025.2591597","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to measure and compare the serum levels of cystatin C and ADA between stable and exacerbated COPD.</p><p><strong>Methods: </strong>The study was designed as a cross-sectional comparative study. Cases were defined as subjects who presented in the outpatient and inpatient departments with COPD and were stratified to stable COPD and acute exacerbation of COPD. Controls were healthy age-matched subjects who are not on any drugs and were nonsmokers. Association between cystatin C and ADA between stable and exacerbated COPD was assessed using logistic regression.</p><p><strong>Results: </strong>There were a total of 182 subjects included in the study, of which, 63 had acute exacerbated COPD, 60 had stable COPD, and 59 were heathy controls. Logistic regression analysis showed that cystatin C (OR, 1.33, 95% CI: 1.16-2.56) and CRP (OR, 2.26, 95% CI: 1.59-2.69) levels were significantly higher, while ADA (OR, 0.82, 95% CI: 0.59-0.91) levels were significantly lower among those with stable COPD, compared to healthy controls. Similarly, cystatin C (OR, 1.48, 95% CI: 1.12-2.12) and CRP (OR, 3.39, 95% CI: 2.34-3.89) levels were significantly higher, while ADA (OR, 0.62, 95% CI: 0.41-0.87) levels were significantly lower among those with acute exacerbated COPD, compared to healthy controls.</p><p><strong>Conclusion: </strong>Cystatin C and c-reactive protein (CRP) were significantly elevated, while ADA was significantly reduced in both stable and acute exacerbated COPD. Future large-scale studies should further explore the value of these markers in predicting the severity of COPD.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2591597"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145542865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency nurses' and paramedics' perspectives on interprofessional communication and handover in Palestinian emergency care.","authors":"Mohammed Jallad, Imad Abu Khader, Asef Mohammad, Haitham Khatatbeh, Mohammed ALBashtawy, Moawiah Khatatbeh, Omar Al Omari, Mohammad Hamdi Abuadas, Saad ALBashtawy","doi":"10.1080/21548331.2025.2594394","DOIUrl":"10.1080/21548331.2025.2594394","url":null,"abstract":"<p><strong>Objectives: </strong>Clinical handover is a major part of everyday work in healthcare settings. Clinical handover plays a great role between emergency medical services (EMS) and emergency nurses in providing safe and quality EMS. This study aims to assess the communication and handover mechanism between EMS and the emergency departments (ED) in Palestinian hospitals, to identify opportunities for improvement, and to make recommendations to improve the handover.</p><p><strong>Methods: </strong>A descriptive, quantitative cross-sectional approach was used in this study. A sample of 220 emergency nurses working in governmental hospital and 130 paramedics working in the Palestine Red Crescent Society were conveniently selected from the West Bank, including Jerusalem.</p><p><strong>Results: </strong>Our study showed that effective EMS-ED communication was perceived to have a high-degree impact on patient outcomes and patient waiting time in EDs, and a medium-degree impact on the readiness of healthcare providers. One-sample t-tests confirmed that perceived patient outcomes, readiness of healthcare providers, and patient waiting time in EDs were all perceived to be significantly influenced by EMS-ED communication.</p><p><strong>Conclusion: </strong>Our findings demonstrate that effective EMS-ED communication, as perceived by healthcare providers, significantly influences patient outcomes, healthcare provider readiness, and patient waiting times. The availability of communication tools and the accuracy/adequacy of information are also perceived to significantly impact patient handover effectiveness and patient health/medical procedures, collectively enhancing the perceived quality and efficiency of emergency healthcare services.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2594394"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors leading to escalations in hospital-at-home: a scoping review.","authors":"Cesar A Gomez-Cabello, Sahar Borna, Syed Ali Haider, Ariana Genovese, Srinivagasam Prabha, Antonio J Forte, Jennifer B Cowart, Michael J Maniaci","doi":"10.1080/21548331.2025.2520741","DOIUrl":"10.1080/21548331.2025.2520741","url":null,"abstract":"<p><strong>Objective: </strong>Hospital-at-Home (H@H) models are safe and cost-effective alternatives for patients with acute or subacute conditions, offering care in the comfort and familiarity of their homes. Escalations, where patients are transferred back to traditional inpatient settings, are key performance metrics but represent significant challenges for H@H programs by interrupting the continuity and advantages of home-based treatment. This scoping review analyzes the factors leading to escalations across H@H programs.</p><p><strong>Methods: </strong>We searched 5 databases: Embase, Google Scholar, PubMed, Scopus, and Web of Science. Our search focused on papers reporting the reasons why patients needed further escalations to Brick and Mortar (B&M) and the sociodemographic characteristics of these patients from 2005 to date. Besides factors leading to escalations, we charted the H@H program's objective, diseases treated, type of visit and personnel visiting, and predictors of escalation.</p><p><strong>Results: </strong>Our search yielded 2932 papers, with 23 meeting our inclusion criteria. Common reasons for escalation included falling, lack of treatment response, exacerbation of the primary disease, cardiac symptoms, and medication adverse effects. Among our studies, higher escalation rates were observed in patients with infectious diseases (16%) and heart failure (9%). Significant predictors included older age, higher Charlson Comorbidity Index (CCI), and comorbidities such as diabetes and chronic kidney disease.</p><p><strong>Conclusion: </strong>Escalations in H@H settings are influenced by primary underlying conditions, patient comorbidities, and care complexity. The novelty and ambiguity of the term 'escalation' and the diverse patient populations and H@H protocols limit statistical analysis. Standardizing definitions and consistent documentation of the number of patients needing care escalations and the reasons behind them is pivotal for proper analysis, nuanced understanding, and plausible prevention.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2520741"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rocking biologic prosthetic valve: <i>Cutibacterium acnes</i> prosthetic valve endocarditis.","authors":"Edward Dababneh, Sylvio Carvalho Junior Provenzano, Matthew S Yong, Eric Jacombs, Rowena Solayar, Vijay Kapadia, Maria Gabriela Matta","doi":"10.1080/21548331.2026.2628523","DOIUrl":"10.1080/21548331.2026.2628523","url":null,"abstract":"<p><p><i>Cutibacterium acnes</i> is a low-virulence pathogen that can cause prosthetic valve endocarditis (PVE), presenting significant diagnostic challenges due to its slow growth and indolent clinical course. We report a case of a 57-year-old male with a history of tissue aortic valve replacement, who presented with 6 months of intermittent fever and a nonproductive cough. Initial tests showed elevated inflammatory markers and moderate aortic regurgitation, but no vegetations were identified on transthoracic or transoesophageal echocardiography. After 13 months of symptoms, a PET scan showed significant FDG uptake around the bioprosthetic valve, and a single blood culture grew <i>C. acnes</i>. Transoesophageal echocardiography revealed abnormal rocking motion of the valve and severe paravalvular regurgitation, suggesting near-complete valve dehiscence. The patient underwent redo surgery for aortic root and valve replacement, and intraoperative cultures confirmed <i>C. acnes</i> infection. This case highlights the importance of considering low-virulence pathogens like <i>C. acnes</i> in patients with prolonged, nonspecific symptoms and initially negative cultures. Advanced imaging, particularly PET/CT, is crucial for early diagnosis and intervention. Early recognition and appropriate treatment are vital for preventing severe complications such as valve dehiscence and tissue destruction.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2628523"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in effective communication for end-of-life decision making in clinical practice.","authors":"Anish Bhardwaj","doi":"10.1080/21548331.2025.2537618","DOIUrl":"10.1080/21548331.2025.2537618","url":null,"abstract":"<p><p>Decisions on end-of-life (EOL) care are a complex process that involves multiple stakeholders including patients, their families, and healthcare providers. Myriad factors play a role in making these decisions, such as desires of the patient and surrogates, advance directives, the patient's health condition, expectations about the disease course and prognosis, metaphysical beliefs about life and death, spiritual and socio-cultural backgrounds and views, quality of life considerations, legal connotations, costs of care, and nuances surrounding organ donation and procurement. This treatise utilizes three real-life examples to highlight the complexity and debate surrounding these decisions, especially in terms of interface of medicine and legal process, particularly when a patient is in coma or a vegetative state and decisions transfer to surrogates. This descriptive exposition underscores the need for dialogic and effective communication among healthcare providers, patients, and their families during this challenging EOL decision-making process.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2537618"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global strategies to reduce elective surgery waiting times for sustainable health outcomes: a systematic review.","authors":"Dimuthu Rathnayake, Mike Clarke, Viraj Jayasinghe","doi":"10.1080/21548331.2024.2435802","DOIUrl":"10.1080/21548331.2024.2435802","url":null,"abstract":"<p><strong>Objective: </strong>Long waiting times for elective surgery reflect not just backlog issues but systemic inefficiencies that disrupt the smooth flow of patients through the surgical care pathway. This systematic review adopts a holistic approach to summarize global policies, strategies, and interventions aimed at reducing elective surgery wait times.</p><p><strong>Method: </strong>A comprehensive electronic search was performed in PubMed, EMBASE, SCOPUS, Web of Science, and Cochrane Library from December 2019 to January 2020 and updated in April 2022. Eligible studies, published after 2013, focused on waiting lists for major elective surgeries in adults, excluding cancer-related surgeries. Both randomized and non-randomized studies and systematic reviews were included. Study quality was assessed using ROBINS-I, AMSTAR 2, and CASP tools, as appropriate. The review was registered in PROSPERO (CRD42019158455) and reported using a PRISMA flow diagram.</p><p><strong>Results: </strong>From 7543 records, 92 articles met the inclusion criteria. Evidence was categorized into seven strategic areas: referral management, patient prioritization, preventing scheduled surgery cancellations, perioperative time management, quality improvement methods for surgical care pathways, and waiting time targets for hospitals. Strategies such as referral management, patient prioritization, and preventing cancellations had the most significant impact on reducing waiting times, while perioperative time management and waiting time targets proved less effective.</p><p><strong>Conclusion: </strong>The review highlights that targeted interventions at different stages of the surgical care pathway yield variable impacts on overall waiting times. While individual measures had limited effects, combining multiple short-term strategies may be more beneficial, particularly for health systems recovering from the COVID-19 pandemic.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2435802"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Acute Care Mobility Assessment is a promising tool for evaluating day-to-day mobility in clinical settings: linguistic and convergent-validity in Danish geriatric patients.","authors":"Britt Stævnsbo Pedersen, Lea Kromann Johansen, Thomas Kallemose, Thomas Bandholm, Cynthia J Brown, Mette Merete Pedersen","doi":"10.1080/21548331.2025.2520742","DOIUrl":"10.1080/21548331.2025.2520742","url":null,"abstract":"<p><strong>Objective: </strong>Low in-hospital mobility is highly prevalent and can cause hospital-associated-disability. In both research and clinical care, valid and reliable outcome measures of in-hospital mobility are necessary. The Acute Care Mobility Assessment (ACMA) provides a single measure of hospital out-of-bed mobility and may be a promising tool. The purpose of this study was to perform a cross-cultural validation to facilitate international uptake.</p><p><strong>Methods: </strong>We performed a linguistic validation (translation, cognitive interviewing, cultural adaptation) of the ACMA in Denmark and investigated the convergent-validity of the Danish version (ACMA-DK) in older hospitalized (+65) Danish adults by evaluating the correlation between the ACMA-DK and 24-hour mobility assessed as number of steps, time spent walking, and upright time by SENS motion® activity monitors.</p><p><strong>Results: </strong>The linguistic validation showed ACMA-DK to be well understood and accepted by the respondents. We found a moderate positive correlation between the ACMA-DK and both steps and time spent walking (<i>r</i> > 0.5). Linear regression analyses suggested that for every 1-point increase in the ACMA-DK, steps increased by 363 and time spent walking by 0.14 hours.</p><p><strong>Conclusion: </strong>The ACMA-DK was cross-culturally adapted and was positively associated with out-of-bed mobility (steps taken and time spent walking). The ACMA is a potential tool for evaluating day-to-day out-of-bed mobility in clinical settings.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2520742"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct costs of severe hypoglycemia events in individuals with diabetes mellitus: a perspective from the Colombian health system - a single-center study.","authors":"Natalia A Rojas-Henao, Michael Garcia-Rivera, Ana C Hernandez-Herrera, Juliana Díaz-Giraldo, Carlos E Builes-Montaño","doi":"10.1080/21548331.2024.2439775","DOIUrl":"10.1080/21548331.2024.2439775","url":null,"abstract":"<p><strong>Background and aims: </strong>Diabetes mellitus is one of the more prevalent chronic diseases globally, and healthcare expenditures for diabetes care are on the rise. Intensive diabetes treatment has been associated with reducing the risk of chronic complications. However, hypoglycemia, the most common adverse effect, poses a significant risk to individuals' lives and is linked to high costs for healthcare systems.</p><p><strong>Methods: </strong>We conducted a retrospective cross-sectional study to determine direct costs by identifying emergency room visits due to hypoglycemia events using diagnostic codes during January 2017 to June 2019. Direct costs were calculated using billed data from the payer and information on outpatient treatment regimens. Differences in median costs were estimated based on length of stay and type of outpatient treatment.</p><p><strong>Results: </strong>Data from 101 patients and the same number of events were included. Women represented (62.4%) of the patients, the median age was 70 (IQR 59.5-80). Blood glucose levels at admission ranged from 12 mg/dL to 67 mg/dL. Most patients were on insulin for outpatient treatment. The median cost of care per hypoglycemia episode was US $345.35 (IQR US $202-727.8), and the cost per episode was higher in patients treated with regimens that included sulfonylureas.</p><p><strong>Conclusions: </strong>The management of patients admitted to the emergency department with a diagnosis of hypoglycemia places a significant burden on the Colombian healthcare system, primarily due to the associated hospitalization costs. Patients treated with regimens that included sulfonylureas incurred higher costs per episode. Prevention, patient education, and individualized treatment approaches could help alleviate the burden of hypoglycemia on both patients and the healthcare system.</p>","PeriodicalId":35045,"journal":{"name":"Hospital practice (1995)","volume":" ","pages":"2439775"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142796182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}