Journal articles: 'Discharge calls'

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Schuller, Kristin A., Szu-Hsuan Lin, Larry D. Gamm, and Nicholas Edwardson. "Discharge Phone Calls." Journal for Healthcare Quality 37, no. 3 (2015): 163–72. http://dx.doi.org/10.1111/jhq.12051.

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Cave, Lucinda A. "Follow-up Phone Calls after Discharge." American Journal of Nursing 89, no. 7 (July 1989): 942. http://dx.doi.org/10.2307/3426370.

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CAVE, LUCINDA A. "FOLLOW–UP PHONE CALLS AFTER DISCHARGE." AJN, American Journal of Nursing 89, no. 7 (July 1989): 942–43. http://dx.doi.org/10.1097/00000446-198907000-00015.

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O’Neill, S. E., and J. Newman. "Discharge follow-up phone calls for BMT patients." Biology of Blood and Marrow Transplantation 12, no. 2 (February 2006): 150. http://dx.doi.org/10.1016/j.bbmt.2005.11.464.

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Morse, Lucy, Linda Xiong, Vanessa Ramirez-Zohfeld, Scott Dresden, and Lee Lindquist. "Tele-Follow-Up of Older Adult Patients from the Geriatric Emergency Department Innovation (GEDI) Program." Geriatrics 4, no. 1 (January 29, 2019): 18. http://dx.doi.org/10.3390/geriatrics4010018.

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The objective of this study was to characterize the content and interventions performed during follow-up phone calls made to patients discharged from the Geriatrics Emergency Department Innovation (GEDI) Program and to demonstrate the benefit of these calls in the care of older adults discharged from the emergency department (ED). This study utilizes retrospective chart review with qualitative analysis. It was set in a large, urban, academic hospital emergency department utilizing the Geriatric Emergency Department Innovations (GEDI) Program. The subjects were adults aged 65 and over who visited the emergency department for acute care. Follow-up telephone calls were made by geriatric nurse liaisons (GNLs) at 24–72 h and 10–14 days post-discharge from the ED. The GNLs documented the content of the phone calls, and these notes were analyzed through a constant comparative method to identify emergent themes. The results showed that the most commonly arising themes in the patients’ questions and nurses’ responses across time-points included symptom management, medications, and care coordination (physician appointments, social services, therapy, and medical equipment). Early follow-up presented the opportunity for nurses to address needs in symptom management and care coordination that directly related to the ED admission; later follow-up presented a unique opportunity to resolve sub-acute issues that were not addressed by the initial discharge plan and to manage newly arising symptoms and patient needs. Thus, telephone follow-up after emergency department discharge presents an opportunity to better connect older adults with appropriate outpatient care and to address needs arising shortly after discharge that may not have otherwise been detected. By following up at two discrete time-points, this intervention identifies and addresses distinct patient needs.

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Ng, Y. H., D. V. Pilcher, M. Bailey, C. A. Bain, C. MacManus, and T. K. Bucknall. "Predicting Medical Emergency Team Calls, Cardiac Arrest Calls and Re-Admission after Intensive Care Discharge: Creation of a Tool to Identify At-Risk Patients." Anaesthesia and Intensive Care 46, no. 1 (January 2018): 88–96. http://dx.doi.org/10.1177/0310057x1804600113.

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We aimed to develop a predictive model for intensive care unit (ICU)–discharged patients at risk of post-ICU deterioration. We performed a retrospective, single-centre cohort observational study by linking the hospital admission, patient pathology, ICU, and medical emergency team (MET) databases. All patients discharged from the Alfred Hospital ICU to wards between July 2012 and June 2014 were included. The primary outcome was a composite endpoint of any MET call, cardiac arrest call or ICU re-admission. Multivariable logistic regression analysis was used to identify predictors of outcome and develop a risk-stratification model. Four thousand, six hundred and thirty-two patients were included in the study. Of these, 878 (19%) patients had a MET call, 51 (1.1%) patients had cardiac arrest calls, 304 (6.5%) were re-admitted to ICU during the same hospital stay, and 964 (21%) had MET calls, cardiac arrest calls or ICU re-admission. A discriminatory predictive model was developed (area under the receiver operating characteristic curve 0.72 [95% confidence intervals {CI} 0.70 to 0.73]) which identified the following factors: increasing age (odds ratio [OR] 1.012 [95% CI 1.007 to 1.017] P <0.001), ICU admission with subarachnoid haemorrhage (OR 2.26 [95% CI 1.22 to 4.16] P=0.009), admission to ICU from a ward (OR 1.67 [95% CI 1.31 to 2.13] P <0.001), Acute Physiology and Chronic Health Evaluation (APACHE) III score without the age component (OR 1.005 [95% CI 1.001 to 1.010] P=0.025), tracheostomy on ICU discharge (OR 4.32 [95% CI 2.9 to 6.42] P <0.001) and discharge to cardiothoracic (OR 2.43 [95%CI 1.49 to 3.96] P <0.001) or oncology wards (OR 2.27 [95% CI 1.05 to 4.89] P=0.036). Over the two-year period, 361 patients were identified as having a greater than 50% chance of having post-ICU deterioration. Factors are identifiable to predict patients at risk of post-ICU deterioration. This knowledge could be used to guide patient follow-up after ICU discharge, optimise healthcare resources, and improve patient outcomes and service delivery.

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Plakogiannis, Roda, Ana Mola, Shreya Sinha, Abraham Stefanidis, Hannah Oh, and Stuart Katz. "Impact of Pharmacy Student–Driven Postdischarge Telephone Calls on Heart Failure Hospital Readmission Rates: A Pilot Program." Hospital Pharmacy 54, no. 2 (April 18, 2018): 100–104. http://dx.doi.org/10.1177/0018578718769243.

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Background: Heart failure (HF) hospitalization rates have remained high in the past 10 years. Numerous studies have shown significant improvement in HF readmission rates when pharmacists or pharmacy residents conduct postdischarge telephone calls. Objective: The purpose of this retrospective review of a pilot program was to evaluate the impact of pharmacy student–driven postdischarge phone calls on 30- and 90-day hospital readmission rates in patients recently discharged with HF. Methods: A retrospective manual chart review was conducted for all patients who received a telephone call from the pharmacy students. The primary endpoint compared historical readmissions, 30 and 90 days prior to hospital discharge, with 30 and 90 days post discharge readmissions. For the secondary endpoints, historical and postdischarge 30-day and 90-day readmission rates were compared for patients with a primary diagnosis of HF and for patients with a secondary diagnosis of HF. Descriptive statistics were calculated in the form of means and standard deviations for continuous variables and frequencies and percentages for categorical variables. Results: Statistically significant decrease was observed for both the 30-day ( P = .006) and 90-day ( P = .007) readmission periods. Prior to the pharmacy students’ phone calls, the overall group of 131 patients had historical readmission rates of 24.43% within 30 days and 38.17% within 90 days after hospital discharge. After the postdischarge phone calls, the readmission rates decreased to 11.45%, for 30 days, and 22.90%, for 90 days. Conclusion: Postdischarge phone calls, specifically made by pharmacy students, demonstrated a positive impact on reducing HF-associated hospital readmissions, adding to the growing body of evidence of different methods of pharmacy interventions and highlighting the clinical impact pharmacy students may have in transition of care services.

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Bauer, Eric E., Achim Klug, and George D. Pollak. "Spectral Determination of Responses to Species-Specific Calls in the Dorsal Nucleus of the Lateral Lemniscus." Journal of Neurophysiology 88, no. 4 (October 1, 2002): 1955–67. http://dx.doi.org/10.1152/jn.2002.88.4.1955.

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This study evaluated how neurons in the dorsal nucleus of the lateral lemniscus (DNLL) in Mexican free-tailed bats respond to both tone bursts and species-specific calls. Up to 20 calls were presented to each neuron, of which 18 were social communication and 2 were echolocation calls. We also measured excitatory response regions (ERRs): the range of tone burst frequencies that evoked discharges at a fixed intensity. Neurons were unselective for one or another call in that each neuron responded to any call so long as the call had energy that encroached on its ERR. Additionally, responses were evoked by the same set of calls, and with similar spike counts, when they were presented normally or reversed. By convolving activity in the ERRs with the spectrogram of each call, we showed that responses to tones accurately predicted discharge patterns evoked by species-specific calls. DNLL cells are remarkably homogeneous in that neurons having similar BFs responded to each of the species-specific calls with similar response profiles. The homogeneity was further illustrated by the ability to accurately predict the response profiles of a particular DNLL cell to species-specific calls from the ERR of another similarly tuned DNLL cell. Thus DNLL neurons tuned to the same or similar frequencies responded to species-specific calls with latencies and temporal discharge patterns that were so similar as to be virtually interchangeable. What this suggests is that DNLL responses evoked by complex sounds can be largely explained by a simple summation of the excitation in each neuron's ERR. Finally, superimposing the spectrograms of each call on the responses evoked by that call revealed that the DNLL population response re-creates both the spectral and the temporal features of each signal.

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Darcy, Ann Marie, Gina A. Murphy, and Susan DeSanto-Madeya. "Evaluation of Discharge Telephone Calls Following Total Joint Replacement Surgery." Orthopaedic Nursing 33, no. 4 (2014): 188–95. http://dx.doi.org/10.1097/nor.0000000000000062.

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&NA;. "Evaluation of Discharge Telephone Calls Following Total Joint Replacement Surgery." Orthopaedic Nursing 33, no. 4 (2014): 196–97. http://dx.doi.org/10.1097/nor.0000000000000070.

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Setia, Nina, and Christine Meade. "Bundling the Value of Discharge Telephone Calls and Leader Rounding." JONA: The Journal of Nursing Administration 39, no. 3 (March 2009): 138–41. http://dx.doi.org/10.1097/nna.0b013e31819894f1.

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Eggenberger, Terry, Heather Garrison, Nancy Hilton, and Karen Giovengo. "Discharge phone calls: using person-centred communication to improve outcomes." Journal of Nursing Management 21, no. 5 (July 2013): 733–39. http://dx.doi.org/10.1111/jonm.12100.

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Salmany, Sewar S., Lujeen Ratrout, Abdallah Amireh, Randa Agha, Noor Nassar, Nour Mahmoud, Dalia Rimawi, and Lama Nazer. "The impact of pharmacist telephone calls after discharge on satisfaction of oncology patients: A randomized controlled study." Journal of Oncology Pharmacy Practice 24, no. 5 (May 16, 2017): 359–64. http://dx.doi.org/10.1177/1078155217709616.

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Purpose The aim of the study was to determine the impact of telephone follow-up calls on satisfaction in oncology patients after hospital discharge. Method A randomized controlled study, in which patients were randomized into two groups: The experimental group with the telephone follow-up (TFU) calls (intervention) and the control group (no intervention). The telephone follow-up call was conducted within 72 h after discharge. During the call, patients were asked about their medications, namely, whether they received them, understood how to take them, and whether they developed any medication-related adverse effect. Both groups were contacted by phone two weeks later to assess their satisfaction with the discharge medication instructions and the provided pharmaceutical services, using the 5-point Likert scale. In addition, hospital records were reviewed for emergency room visits and hospital readmissions within 30 days after discharge. Results There was no difference in the percentage of patients who reported being very satisfied between both the intervention and the control groups (45% intervention vs. 48% control, P = 0.68). The mean time of the intervention phone call was 3 ± 1.7 (SD) min. During the telephone follow-up call, medication-related problems were identified in 20% of the patients. There was no significant difference in emergency room visits and hospital readmissions in the intervention group vs. control (44% vs. 53%, P = 0.123) and (37% vs. 43%, P = 0.317), respectively. Conclusion Telephone follow-up calls conducted by a pharmacist to discharged oncology patients did not improve patients' satisfaction, emergency room visits or hospital readmissions; however, they helped to identify medication-related adverse effects in the oncology patients.

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Zuckerman, Scott L., Clinton J. Devin, Vincent Rossi, Silky Chotai, E. Hunter Dyer, John J. Knightly, Eric A. Potts, et al. "The Institute for Healthcare Improvement–NeuroPoint Alliance collaboration to decrease length of stay and readmission after lumbar spine fusion: using national registries to design quality improvement protocols." Journal of Neurosurgery: Spine 33, no. 6 (December 2020): 812–21. http://dx.doi.org/10.3171/2020.5.spine20457.

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OBJECTIVENational databases collect large amounts of clinical information, yet application of these data can be challenging. The authors present the NeuroPoint Alliance and Institute for Healthcare Improvement (NPA-IHI) program as a novel attempt to create a quality improvement (QI) tool informed through registry data to improve the quality of care delivered. Reducing the length of stay (LOS) and readmission after elective lumbar fusion was chosen as the pilot module.METHODSThe NPA-IHI program prospectively enrolled patients undergoing elective 1- to 3-level lumbar fusions across 8 institutions. A three-pronged approach was taken that included the following phases: 1) Research Phase, 2) Development Phase, and 3) Implementation Phase. Primary outcomes were LOS and readmission. From January to June 2017, a learning system was created utilizing monthly conference calls, weekly data submission, and continuous refinement of the proposed QI tool. Nonparametric tests were used to assess the impact of the QI intervention.RESULTSThe novel QI tool included the following three areas of intervention: 1) preoperative discharge assessment (location, date, and instructions), 2) inpatient changes (LOS rounding checklist, daily huddle, and pain assessments), and 3) postdischarge calls (pain, primary care follow-up, and satisfaction). A total of 209 patients were enrolled, and the most common procedure was a posterior laminectomy/fusion (60.2%). Seven patients (3.3%) were readmitted during the study period. Preoperative discharge planning was completed for 129 patients (61.7%). A shorter median LOS was seen in those with a known preoperative discharge date (67 vs 80 hours, p = 0.018) and clear discharge instructions (71 vs 81 hours, p = 0.030). Patients with a known preoperative discharge plan also reported significantly increased satisfaction (8.0 vs 7.0, p = 0.028), and patients with increased discharge readiness (scale 0–10) also reported higher satisfaction (r = 0.474, p < 0.001). Those receiving postdischarge calls (76%) had a significantly shorter LOS than those without postdischarge calls (75 vs 99 hours, p = 0.020), although no significant relationship was seen between postdischarge calls and readmission (p = 0.342).CONCLUSIONSThe NPA-IHI program showed that preoperative discharge planning and postdischarge calls have the potential to reduce LOS and improve satisfaction after elective lumbar fusion. It is our hope that neurosurgical providers can recognize how registries can be used to both develop and implement a QI tool and appreciate the importance of QI implementation as a separate process from data collection/analysis.

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Klug, Achim, Eric E. Bauer, Joshua T. Hanson, Laura Hurley, John Meitzen, and George D. Pollak. "Response Selectivity for Species-Specific Calls in the Inferior Colliculus of Mexican Free-Tailed Bats is Generated by Inhibition." Journal of Neurophysiology 88, no. 4 (October 1, 2002): 1941–54. http://dx.doi.org/10.1152/jn.2002.88.4.1941.

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Here we show that inhibition shapes diverse responses to species-specific calls in the inferior colliculus (IC) of Mexican free-tailed bats. We presented 10 calls to each neuron of which 8 were social communication and 2 were echolocation calls. We also measured excitatory response regions: the range of tone burst frequencies that evoked discharges at a fixed intensity. The calls evoked highly selective responses in that IC neurons responded to some calls but not others even though those calls swept through their excitatory response regions. By convolving activity in the response regions with the spectrogram of each call, we evaluated whether responses to tone bursts could predict discharge patterns evoked by species-specific calls. The convolutions often predicted responses to calls that evoked no responses and thus were inaccurate. Blocking inhibition at the IC reduced or eliminated selectivity and greatly improved the predictive accuracy of the convolutions. By comparing the responses evoked by two calls with similar spectra, we show that each call evoked a unique spatiotemporal pattern of activity distributed across and within isofrequency contours and that the disparity in the population response was greatly reduced by blocking inhibition. Thus the inhibition evoked by each call can shape a unique pattern of activity in the IC population and that pattern may be important for both the identification of a particular call and for discriminating it from other calls and other signals.

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Felipe, Alfeil, Anu Vats, Andressa Sleiman, Brian Tran, Miis Akel, Omri Chia, Jeannette M. Hester, Daniel J. Hoh, Katharina M. Busl, and Jacqueline Baron-Lee. "Using Intern-Led Quality Improvement to Reduce Readmissions for Specialty Service Patients Within an Academic Medical Center." Global Journal on Quality and Safety in Healthcare 4, no. 2 (May 1, 2021): 70–76. http://dx.doi.org/10.36401/jqsh-20-38.

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ABSTRACT Introduction Postdischarge patient calls are an effective intervention to decrease unplanned readmissions. Despite its efficacy, calls are time consuming and compete with other clinical obligations. The purpose of this study was to evaluate the viability of intern-led quality improvement (QI) on conducting initial postdischarge calls to filter patients who require clinical or nurse follow-up. Methods QI interns from an academic medical center's QI program completed postdischarge patient calls within 72 hours of patient discharge from a neurosurgery service between June 2018 and July 2019. QI interns filtered patients who required follow-up calls from a clinical service or nurse department. The departments called patients within 48 hours of requests. Unplanned readmission rate was compared between the cohort of patients who requested and received a follow-up call versus a cohort of patients who requested and did not receive a follow-up call (control). Results QI interns completed 83.8% postdischarge patient calls within 72 hours of discharge. Reasons for unsuccessful calls included patient unresponsiveness (74.6%), wrong phone number on file (13.9%), and request to be called at a different time (11.5%). Nurses completed 57.2% follow-up requests within the targeted 48 hours and completed remaining requests within 7 days. QI intern postdischarge follow-up calls, in conjunction with nurse follow-up intervention, showed a significant (risk ratio = −3.31, p = 0.012) preventive effect on unplanned readmission rate. Conclusions QI interns are a viable alternative to nurses to conduct the first contact of postdischarge patient follow-up calls. This system of QI interns filtering calls to the correct clinical service or nurse department increased postdischarge patient follow-up calls success rate and decreased readmission rates.

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Zafar, Waleed, Irum Ghafoor, Arif Jamshed, Sabika Gul, and Haroon Hafeez. "Outcomes of In-Hospital Cardiopulmonary Resuscitation Among Patients With Cancer." American Journal of Hospice and Palliative Medicine® 34, no. 3 (July 10, 2016): 212–16. http://dx.doi.org/10.1177/1049909115617934.

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Objective: To review all episodes where an emergency code was called in a cancer-specialized hospital in Pakistan and to assess survival to discharge among patients who received a cardiopulmonary resuscitation (CPR). Methods: We reviewed demographic and clinical data related to all “code blue” calls over 3 years. Multivariate logistic regression analyses were used to test the association of clinical characteristics with the primary outcome of survival to discharge. Results: A total of 646 code blue calls were included in the analysis. The CPR was performed in 388 (60%) of these calls. For every 20 episodes of CPR among patients with cancer of all ages, only 1 resulted in a patient’s survival to discharge, even though in 52.2% episodes there was a return of spontaneous circulation. No association was found between the type of rhythm at initiation of CPR and likelihood of survival to discharge. Conclusions: The proportion of patients with advanced cancer surviving to discharge after in-hospital CPR in a low-income country was in line with the reported international experience. Most patients with cancer who received in-hospital CPR did not survive to discharge and did not appear to benefit from resuscitation. Advance directives by patients with cancer limiting aggressive interventions at end of life and proper documentation of these directives will help in provision of care that is humane and consonant with patients’ wishes for a dignified death. Patients’ early appreciation of the limited benefits of CPR in advanced cancer is likely to help them formulate such advance directives.

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LeBlanc, Lynn. "Using Discharge Phone Calls to Measure Patient Satisfaction and Quality Improvement Initiatives." Journal of Radiology Nursing 26, no. 2 (June 2007): 61. http://dx.doi.org/10.1016/j.jradnu.2007.03.013.

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Bunch, Linda. "The Role of Post Discharge Phone Calls in the Radiation Therapy Department." Journal of Medical Imaging and Radiation Sciences 47, no. 1 (March 2016): S2. http://dx.doi.org/10.1016/j.jmir.2015.12.007.

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Soong, Christine, Bochra Kurabi, David Wells, Lesley Caines, Matthew W. Morgan, Rebecca Ramsden, and Chaim M. Bell. "Do Post Discharge Phone Calls Improve Care Transitions? A Cluster-Randomized Trial." PLoS ONE 9, no. 11 (November 11, 2014): e112230. http://dx.doi.org/10.1371/journal.pone.0112230.

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Wong, F. K. Y., C. So, J. Chau, A. K. P. Law, S. K. F. Tam, and S. McGhee. "Economic evaluation of the differential benefits of home visits with telephone calls and telephone calls only in transitional discharge support." Age and Ageing 44, no. 1 (October 29, 2014): 143–47. http://dx.doi.org/10.1093/ageing/afu166.

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Wong, Frances Kam Yuet, Susan Ka Yee Chow, Tony Moon Fai Chan, and Stanley Kui Fu Tam. "Comparison of effects between home visits with telephone calls and telephone calls only for transitional discharge support: a randomised controlled trial." Age and Ageing 43, no. 1 (August 26, 2013): 91–97. http://dx.doi.org/10.1093/ageing/aft123.

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Tan, M., and D. Lang. "Effectiveness of nurse leader rounding and post-discharge telephone calls on patient satisfaction." International Journal of Evidence-Based Healthcare 14, no. 4 (December 2016): 195–96. http://dx.doi.org/10.1097/01.xeb.0000511338.43833.68.

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Faraone, E., R. Smith, and J. Santamaria. "Survival after hospital discharge for patients that had in-hospital medical emergency calls." Australian Critical Care 26, no. 2 (May 2013): 91. http://dx.doi.org/10.1016/j.aucc.2013.02.033.

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Masoner, Jason R., Dana W. Kolpin, Isabelle M. Cozzarelli, Kelly L. Smalling, Stephanie C. Bolyard, Jennifer A. Field, Edward T. Furlong, et al. "Landfill leachate contributes per-/poly-fluoroalkyl substances (PFAS) and pharmaceuticals to municipal wastewater." Environmental Science: Water Research & Technology 6, no. 5 (2020): 1300–1311. http://dx.doi.org/10.1039/d0ew00045k.

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Widespread disposal of landfill leachate to municipal sewer in the US calls for improved understanding of the relative organic-chemical contributions to the WWTP waste stream and associated surface-water discharge to receptors in the environment.

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Schofield, Toni, R. Sacha Bhatia, Cindy Yin, Shoshana Hahn-Goldberg, and Karen Okrainec. "Patient experiences using a novel tool to improve care transitions in patients with heart failure: a qualitative analysis." BMJ Open 9, no. 6 (June 2019): e026822. http://dx.doi.org/10.1136/bmjopen-2018-026822.

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ObjectiveTo evaluate the utility of a novel discharge tool adapted for heart failure (HF) on patient experience.DesignSemistructured interviews assessed the utility of a novel discharge tool adapted for HF; patient-oriented discharge summary (PODS-HF) at 72 hours and 30 days after leaving hospital. Interviews were recorded and transcribed verbatim. Three investigators used directed content analysis to determine themes and subthemes from the narrative data.SettingThe cardiology ward of an urban academic institution in Canada.Participants13 patients and caregivers completed 24 interviews. Eligible patients were >18 years and admitted with a diagnosis of HF.ResultsAnalysis revealed six interconnected themes: (1) Utility of discharge instructions: how patients perceive and use written and verbal instructions. Patients receiving PODS-HF identified value in the patient-centred summarised content. (2) Adherence: strategies used by patients to enhance adherence to medications, diet and lifestyle changes. PODS-HF provides a strong visual reminder, particularly early postdischarge. (3) Adaptation: how patients incorporate changes into ‘new norms’. This was more evident by 30 days, and those using PODS-HF had less unscheduled visits and readmissions. (4) Relationships with healthcare providers: patients’ perceptions of the roles of family physicians and specialists in follow-up care. (5) Role of family and caregivers: the pivotal role of caregivers in supporting adherence and adaptation. (6) Follow-up phone calls: the utility of follow-up calls, particularly early after discharge as a means of providing clarification, reassurance and education.ConclusionPODS-HF is a useful tool that increases patients’ confidence to self-manage and facilitates adherence by providing relevant written information to reference after discharge.

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Lee, A., G. Bishop, K. M. Hillman, and K. Daffurn. "The Medical Emergency Team." Anaesthesia and Intensive Care 23, no. 2 (April 1995): 183–86. http://dx.doi.org/10.1177/0310057x9502300210.

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The concept of a Medical Emergency Team was developed in order to rapidly identify and manage seriously ill patients at risk of cardiopulmonary arrest and other high-risk conditions. The aim of this study was to describe the utilization and outcome of Medical Emergency Team interventions over a one-year period at a teaching hospital in South Western Sydney. Data was collected prospectively using a standardized form. Cardiopulmonary resuscitation occurred in 148/522 (28%) calls. Alerting the team using the specific condition criteria occurred in 253/522 (48%) calls and on physiological/pathological abnormality criteria in 121/522 (23%) calls. Survival rate to hospital discharge following cardiopulmonary arrest was low (29%), compared with other medical emergencies (76%).

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Rush, Sandra Kay. "Discharge Calls: How One Call Can Make the Difference for Patients, Families, and Reimbursement." Nurse Leader 10, no. 2 (April 2012): 45–52. http://dx.doi.org/10.1016/j.mnl.2011.07.014.

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Choudhry, Asad J., Moustafa Younis, Mohamed D. Ray-Zack, Amy Glasgow, Elizabeth B. Habermann, Stephanie Heller, Henry J. Schiller, Martin D. Zielinski, and Nadeem N. Haddad. "Enhanced Readability of Discharge Summaries Decreases Provider Phone Calls in the Post-Hospital Setting." Journal of the American College of Surgeons 225, no. 4 (October 2017): S115—S116. http://dx.doi.org/10.1016/j.jamcollsurg.2017.07.255.

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Kaufman, Laurie, Gina Aranzamendez, Beverly A. Hayes, Kavita Pathak, Duke Rohe, and Valerie Haywood. "Optimizing discharge teaching process to increase the efficiency and effectiveness of the follow-up call." Journal of Clinical Oncology 34, no. 7_suppl (March 1, 2016): 226. http://dx.doi.org/10.1200/jco.2016.34.7_suppl.226.

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226 Background: Patients undergoing complex oncologic operations are at high risk for perioperative complications associated with adverse effects on quality of life, costs and overall outcomes. Complications within 30 days of discharge are most commonly identified during first 48-72 hours post-discharge. Telephone follow-up can provide a safety net and is part of a larger discharge teaching process. Initial review of the current follow up processes underscored many variations. An interdisciplinary team was tasked to optimize discharge processes across the continuum of care which leads to a more efficient follow-up call encounter. Methods: Working with in and outpatient frontline staff from focus group teams, pre and post implementation work flow processes were captured. Inefficiencies were used for a redesign session to develop a standard discharge teaching guide and patient checklist. A database was used for data collection of measures for issues and complications encountered by patients. Storyboards were used to communicate the project progression to those working within the processes being redesigned. Results: A 42% reduction in inefficiencies of overall discharge teaching process was obtained with the largest decrease during the post discharge phase. The number of patients contacted during follow-up calls increased by 12%: discussions were longer and documentation took less time (excluding outliers). 46% of the issues were handled by the Clinical Nurse Leaders: all other medium/high issues were handed off to primary team. The time spent for follow-up calls increased, therefore, increasing direct labor cost. The rate of complications and severity decreased during the implementation phase. Effects on the readmission rates remains to be seen and patient satisfaction scores are showing a positive trend. Conclusions: Involving content experts to assess the discharge teaching process identified a worklist of inefficiencies. Using these to optimize the process, a discharge teaching guide and patient checklist were developed. Inefficiencies were reduced and process made more effective with an increased percent of patients contacted during the follow-up call.

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Pařílková, Jana, Jaromír Říha, and Zbyněk Zachoval. "The Influence of Roughness on the Discharge Coefficient of a Broad-Crested Weir." Journal of Hydrology and Hydromechanics 60, no. 2 (June 1, 2012): 101–14. http://dx.doi.org/10.2478/v10098-012-0009-0.

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The Influence of Roughness on the Discharge Coefficient of a Broad-Crested Weir The use of environmentally-friendly materials in hydraulic engineering (e.g. the stone lining of weirs at levees) calls for the more accurate estimation of the discharge coefficient for broad-crested weirs with a rough crest surface. However, in the available literature sources the discharge coefficient of broad-crested weirs is usually expressed for a smooth crest. The authors of this paper have summarized the theoretical knowledge related to the effect of weir crest surface roughness on the discharge coefficient. The method of determination of the head-discharge relation for broad-crested weirs with a rough crest surface is proposed based on known discharge coefficient values for smooth surfaces and on the roughness parameters of the weir. For selected scenarios the theoretical results were compared with experimental research carried out at the Laboratory of Water Management Research, Faculty of Civil Engineering (FCE), Brno University of Technology (BUT).

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Schofield, Toni, Heather Ross, R. Sacha Bhatia, and Karen Okrainec. "Feasibility and performance of a patient-oriented discharge instruction tool for heart failure." BMJ Open Quality 8, no. 3 (August 2019): e000489. http://dx.doi.org/10.1136/bmjoq-2018-000489.

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BackgroundThe provision of patient-centred discharge instructions is a pivotal goal for improving quality of care for patients with heart failure (HF) during care transitions. We tested the feasibility and performance of a novel discharge instruction tool co-designed with patients and adapted for HF; the patient-oriented discharge summary (PODS-HF) with the aim of improving communication, comprehension and adherence to discharge instructions.MethodsAn iterative process was used to adapt and implement an existing patient instruction tool for patients with HF (PODS-HF). A mixed methods approach was then used to explore patient experience, feasibility and performance using a pre–post study design among eligible patients admitted for HF over a 6-month period. Outcome measures included: the documentation of patient-centred instructions, a locally derived Average Discharge Score (ADS) based on the inclusion of instructions in nine key areas, patient satisfaction and understanding and adherence to instructions at 72 hours and 30 days determined using follow-up phone calls.Results19 patients were enrolled. The ADS increased by 68% with more consistent documentation. Patient satisfaction remained high. Patients provided PODS-HF reported receiving written information about HF related signs and symptoms to watch for (two out of five patients in the usual care group vs seven out of seven patients in the PODS-HF group; p=0.045). Patients also felt more confident to manage their own health and 30-day adherence to diet and exercise instructions improved while reducing the need for unscheduled visits. Quantitative results were supported by themes identified during follow-up calls, namely, the utility of written instructions and the importance of a follow-up call.ConclusionPODS-HF is a feasible tool for the delivery of patient-centred discharge instructions for patients with HF. The individual benefits of clarification and reinforcement made during follow-up calls among patients receiving this tool remains to be clarified.

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Christy, Shannon, Billy Sin, and Suzanna Gim. "Impact of an Integrated Pharmacy Transitions of Care Pilot Program in an Urban Hospital." Journal of Pharmacy Practice 29, no. 5 (July 9, 2016): 490–94. http://dx.doi.org/10.1177/0897190014568674.

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Purpose: To evaluate the effectiveness of an integrated Pharmacy Transitions of Care (PTC) pilot program on reducing hospital readmissions and improving patient satisfaction. Methods: This prospective observational cohort study compares patients who participated in the PTC program to a control of usual hospital discharged patients during January through April 2014. The PTC program provided discharge medication review, medication counseling, delivery of medications to bedside, clinic scheduling, and follow-up phone calls. The primary outcome measure was 30-day readmissions. Secondary outcomes included emergency department (ED) visits, pharmacist interventions, and patient satisfaction. Results: Seventy patients participated in the PTC program. Compared to the control (n = 725), the study group had decreased 30-day all-cause readmissions (5.7% vs 13.8%, P = .08), 30-day readmissions for the same diagnosis (2.9% vs 8.1%, P = .18), and ED visits (18.6% vs 25%, P = .82). Twenty-five interventions during discharge medication review included discontinuation of unnecessary medications and correction of medication dose or frequency. The majority of patients were satisfied with the medication education provided (94%) and the timely delivery of prescriptions to bedside (96%). Conclusion: There was no significant difference in 30-day readmission rates. However, pharmacists were able to make a positive impact on patient satisfaction and improve understanding of medications during discharge.

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Renda, William, and Charlie H. Zhang. "Comparative Analysis of Firearm Discharge Recorded by Gunshot Detection Technology and Calls for Service in Louisville, Kentucky." ISPRS International Journal of Geo-Information 8, no. 6 (June 13, 2019): 275. http://dx.doi.org/10.3390/ijgi8060275.

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Gunshot detection technology (GDT) has been increasingly adopted by law enforcement agencies to tackle the problem of underreporting of crime via 911 calls for service, which undoubtedly affects the quality of crime mapping and spatial analysis. This article investigates the spatial and temporal patterns of gun violence by comparing data collected from GDT and 911 calls in Louisville, Kentucky. We applied hot spot mapping, near repeat diagnosis, and spatial regression approaches to the analysis of gunshot incidents and their associated neighborhood characteristics. We observed significant discrepancies between GDT data and 911 calls for service, which indicate possible underreporting of firearm discharge in 911 call data. The near repeat analysis suggests an increased risk of gunshots in nearby locations following an initial event. Results of spatial regression models validate the hypothesis of spatial dependence in frequencies of gunshot incidents and crime underreporting across neighborhoods in the study area, both of which are positively associated with proportions of African American residents, who are less likely to report a gunshot. This article adds to a growing body of research on GDT and its benefits for law enforcement activity. Findings from this research not only provide new insights into the spatiotemporal aspects of gun violence in urban areas but also shed light on the issue of underreporting of gun violence.

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Rao, Boloor S., Gail O. Lowe, and Andrew J. Hughes. "Reduced emergency calls and improved weekend discharge after introduction of a new electronic handover system." Medical Journal of Australia 197, no. 10 (November 2012): 569–73. http://dx.doi.org/10.5694/mja11.11048.

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Kates, FrederickR, DorothyM Mwachiro, and Jacqueline Baron-Lee. "The impact of post-discharge follow-up calls on 30-day hospital readmissions in neurosurgery." Global Journal on Quality and Safety in Healthcare 2, no. 2 (2019): 46. http://dx.doi.org/10.4103/jqsh.jqsh_29_18.

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Elbur, Abubaker Ibrahim, Yousif MA, Ahmed S. A. ElSayed, and Manar E. Abdel-Rahman. "Post-discharge surveillance of wound infections by telephone calls method in a Sudanese Teaching Hospital." Journal of Infection and Public Health 6, no. 5 (October 2013): 339–46. http://dx.doi.org/10.1016/j.jiph.2013.04.005.

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Harrison, James D., Andrew D. Auerbach, Kathryn Quinn, Ellen Kynoch, and Michelle Mourad. "Assessing the Impact of Nurse Post-Discharge Telephone Calls on 30-Day Hospital Readmission Rates." Journal of General Internal Medicine 29, no. 11 (August 8, 2014): 1519–25. http://dx.doi.org/10.1007/s11606-014-2954-2.

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Kimmel, Lara A., Anne E. Holland, Melissa J. Hart, Elton R. Edwards, Richard S. Page, Raphael Hau, Andrew Bucknill, and Belinda J. Gabbe. "Discharge from the acute hospital: trauma patients’ perceptions of care." Australian Health Review 40, no. 6 (2016): 625. http://dx.doi.org/10.1071/ah15148.

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Objective The involvement of orthopaedic trauma patients in the decision-making regarding discharge destination from the acute hospital and their perceptions of the care following discharge are poorly understood. The aim of the present study was to investigate orthopaedic trauma patient experiences of discharge from the acute hospital and transition back into the community. Methods The present qualitative study performed in-depth interviews, between October 2012 and November 2013, with patients aged 18–64 years with lower limb trauma. Thematic analysis was used to derive important themes. Results Ninety-four patients were interviewed, including 35 discharged to in-patient rehabilitation. Key themes that emerged include variable involvement in decision-making regarding discharge, lack of information and follow-up care on discharge and varying opinions regarding in-patient rehabilitation. Readiness for discharge from in-patient rehabilitation also differed widely among patients, with patients often reporting being ready for discharge before the planned discharge date and feeling frustration at the need to stay in in-patient care. There was also a difference in patients’ perception of the factors leading to recovery, with patients discharged to rehabilitation more commonly reporting external factors, such as rehabilitation providers and physiotherapy. Conclusion The insights provided by the participants in the present study will help us improve our discharge practice, especially the need to address the concerns of inadequate information provision regarding discharge and the role of in-patient rehabilitation. What is known about the topic? There is no current literature describing trauma patient involvement in decision-making regarding discharge from the acute hospital and the perception of how this decision (and destination choice; e.g. home or in-patient rehabilitation) affects their outcome. What does this paper add? The present large qualitative study provides information on patients’ opinion of discharge from the acute hospital following trauma and how this could be improved from their perception. Patients are especially concerned with the lack of information provided to them on discharge, their lack of involvement and understanding of the choices made with regard to their discharge and describe concerns regarding their follow-up care. There is also a feeling from the patients that they are ready to leave rehabilitation before their actual planned discharge date, a concept that needs further investigation. What are the implications for practitioners? The patient insights gained by the present study will lead to a change in discharge practice, including increased involvement of the patient in the decision-making in terms of discharge from both the acute and rehabilitation hospitals and a raised awareness of the need to provide written information and follow-up telephone calls to patients following discharge. Further research into many aspects of patient discharge from the acute hospital should be considered, including the use of rehabilitation prediction tools to ensure patient involvement in decision-making and a discharge and/or follow-up coordinator to ensure patients are aware of how to access information after discharge.

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Rohatgi, Nidhi, Yingjie Weng, and Neera Ahuja. "Surgical Comanagement by Hospitalists: Continued Improvement Over 5 Years." Journal of Hospital Medicine, Volume 15, Issue 04 (February 19, 2020): 232–35. http://dx.doi.org/10.12788/jhm.3363.

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Neurosurgery services in which the same Internal Medicine hospitalists are dedicated year round to each of these surgical services to proactively prevent and manage medical conditions. In this article, we evaluate if SCM was associated with continued improvement in patient outcomes between 2012 and 2018 in Orthopedic and Neurosurgery services at our institution. We conducted regression analysis on 26,380 discharges to assess yearly change in our outcomes. Since 2012, the odds of patients with ≥1 medical complication decreased by 3.8% per year (P = .01), the estimated length of stay decreased by 0.3 days per year (P < .0001), and the odds of rapid response team calls decreased by 12.2% per year (P = .001). Estimated average direct cost savings were $3,424 per discharge.

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Kogon, Brian, Kim Woodall, Kirk Kanter, Bahaaldin Alsoufi, and Matt Oster. "Reducing readmissions following paediatric cardiothoracic surgery: a quality improvement initiative." Cardiology in the Young 25, no. 5 (August 13, 2014): 935–40. http://dx.doi.org/10.1017/s1047951114001437.

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AbstractBackground: We have previously identified risk factors for readmission following congenital heart surgery – Hispanic ethnicity, failure to thrive, and original hospital stay more than 10 days. As part of a quality initiative, changes were made to the discharge process in hopes of reducing the impact. All discharges were carried out with an interpreter, medications were delivered to the hospital before discharge, and phone calls were made to families within 72 hours following discharge. We hypothesised that these changes would decrease readmissions. Methods: The current cohort of 635 patients underwent surgery in 2012. Demographic, preoperative, operative, and postoperative variables were evaluated. Univariate and multivariate risk factor analyses were performed. Comparisons were made between the initial (2009) and the current (2012) cohorts. Results: There were 86 readmissions of 77 patients during 2012. Multivariate risk factors for readmission were risk adjustment for congenital heart surgery score and initial hospital stay >10 days. In comparing 2009 with 2012, the overall readmission rate was similar (10 versus 12%, p=0.27). Although there were slight decreases in the 2012 readmissions for those patients with Hispanic ethnicity (18 versus 16%, p=0.79), failure to thrive (23 versus 17%, p=0.49), and initial hospital stay >10 days (22 versus 20%, p=0.63), they were not statistically significant. Conclusions: Potential risk factors for readmission following paediatric cardiothoracic surgery have been identified. Although targeted modifications in discharge processes can be made, they may not reduce readmissions. Efforts should continue to identify modifiable factors that can reduce the negative impact of hospital readmissions.

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Record, Janet D., Ashwini Niranjan-Azadi, Colleen Christmas, Laura A. Hanyok, Cynthia S. Rand, David B. Hellmann, and Roy C. Ziegelstein. "Telephone calls to patients after discharge from the hospital: an important part of transitions of care." Medical Education Online 20, no. 1 (January 2015): 26701. http://dx.doi.org/10.3402/meo.v20.26701.

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Choudhry, Asad J., Moustafa Younis, Mohamed D. Ray-Zack, Amy E. Glasgow, Nadeem N. Haddad, Elizabeth B. Habermann, Donald H. Jenkins, Stephanie F. Heller, Henry J. Schiller, and Martin D. Zielinski. "Enhanced readability of discharge summaries decreases provider telephone calls and patient readmissions in the posthospital setting." Surgery 165, no. 4 (April 2019): 789–94. http://dx.doi.org/10.1016/j.surg.2018.10.014.

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Yang, Chen, and Chung-Ming Chen. "Effects of post-discharge telephone calls on the rate of emergency department visits in paediatric patients." Journal of Paediatrics and Child Health 48, no. 10 (August 16, 2012): 931–35. http://dx.doi.org/10.1111/j.1440-1754.2012.02519.x.

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Tan, Mary, and Dora Lang. "Effectiveness of nurse leader rounding and post-discharge telephone calls in patient satisfaction: a systematic review." JBI Database of Systematic Reviews and Implementation Reports 13, no. 7 (July 2015): 154–76. http://dx.doi.org/10.11124/01938924-201513070-00015.

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Tan, Mary, and Dora Lang. "Effectiveness of nurse leader rounding and post-discharge telephone calls in patient satisfaction: a systematic review." JBI Database of Systematic Reviews and Implementation Reports 13, no. 7 (July 2015): 154–76. http://dx.doi.org/10.11124/jbisrir-2015-2013.

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Price, R. J., and M. A. Garrioch. "Prospective Observational Survey of the Utilisation of Anaesthetists and the Outcome following Cardiac Arrest Calls." Scottish Medical Journal 50, no. 1 (February 2005): 13–14. http://dx.doi.org/10.1177/003693300505000105.

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Background and Aims: We wanted to determine whether the practice of routinely sending an anaesthetist to cardiac arrests is common within Scotland. We also wished to evaluate the interventions performed by our intensive care anaesthetist when responding to cardiac arrest calls. Methods: We performed a telephone survey of the 26 Scottish hospitals with an intensive care unit. We conducted a prospective observational survey over a period of six months in one Scottish teaching hospital. Structured interviews with the anaesthetist who responded to the cardiac arrest call were undertaken. Results: Routine attendance of an anaesthetist at cardiac arrests occurs in 25 of the 26 hospitals surveyed. We analysed 68 of 73 arrest calls. In 28 calls (41%) there was no requirement for anaesthetic intervention. In 40 (59%) the anaesthetist intervened. The interventions were for cardiac arrest procedures in 33 cases and ventilatory failure in the remaining 7 cases. One patient survived to hospital discharge: a mortality of 98%. Conclusions: Patients who remain in cardiac arrest upon the arrival of the anaesthetist have a very high mortality. The practice of routinely sending an anaesthetist to cardiac arrest calls is not justified.

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Saba, Alexander Martin. "The Constitutional Role of Judicial Service Commission in Protecting Independence of the Judiciary." KAS African Law Study Library - Librairie Africaine d’Etudes Juridiques 6, no. 1 (2019): 105–13. http://dx.doi.org/10.5771/2363-6262-2019-1-105.

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The judiciary is constitutionally vested with power to dispense justice to the citizens without fear, favor, ill-will or affection. This sacred function can only be effectively discharge if the judiciary exercises independence without any iota of interference from any person, body or organ. If that is the case it calls for the judiciary to defend its independence whenever interference is done or is likely to be done to it. This role, at any rate, is not intended to be discharged by individual judges. The appropriate organ to discharge this function is the Judicial Service Commission (JSC) which is mandated to ensure self-regulation of the judiciary. Judiciary is therefore expected to be at the frontline to always defend and promote the independence of the judiciary. This article, therefore, seeks to unveil whether or not the JSC of Tanzania is capable of protecting independence of our judiciary to enable the judges to perform their duty without reprisals or intimidations from any quarter. The author is of the view that a lot has to be done in terms of structure and mandates to realize rebirth of vibrant and independent JSC.

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Paula, Ivie Braga de, and Adriene Moraes Campos. "Breast imaging in patients with nipple discharge." Radiologia Brasileira 50, no. 6 (November 9, 2017): 383–88. http://dx.doi.org/10.1590/0100-3984.2016.0103.

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Abstract Nipple discharge is a common symptom in clinical practice, representing the third leading breast complaint, after pain and lumps. It is usually limited and has a benign etiology. The risk of malignancy is higher when the discharge is uniductal, unilateral, spontaneous, persistent, bloody, or serous, as well as when it is accompanied by a breast mass. The most common causes of pathologic nipple discharge are papilloma and ductal ectasia. However, there is a 5% risk of malignancy, mainly ductal carcinoma in situ. The clinical examination is an essential part of the patient evaluation, allowing benign nipple discharge to be distinguished from suspicious nipple discharge, which calls for imaging. Mammography and ultrasound should be used together as first-line imaging methods. However, mammography has low sensitivity in cases of nipple discharge, because, typically, the lesions are small, are retroareolar, and contain no calcifications. Because the reported sensitivity and specificity of ultrasound, it is important to use the correct technique to search for intraductal lesions in the retroareolar region. Recent studies recommend the use of magnetic resonance imaging in cases of suspicious nipple discharge in which the mammography and ultrasound findings are normal. The most common magnetic resonance imaging finding is non-mass enhancement. Surgery is no longer the only solution for patients with suspicious nipple discharge, because short-time follow-up can be safely proposed.

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Ploeg, Karlijn, Fabian Seemann, Ann-Kathrin Wild, and Qiong Zhang. "Glacio-Nival Regime Creates Complex Relationships between Discharge and Climatic Trends of Zackenberg River, Greenland (1996–2019)." Climate 9, no. 4 (April 8, 2021): 59. http://dx.doi.org/10.3390/cli9040059.

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Arctic environments experience rapid climatic changes as air temperatures are rising and precipitation is increasing. Rivers are key elements in these regions since they drain vast land areas and thereby reflect various climatic signals. Zackenberg River in northeast Greenland provides a unique opportunity to study climatic influences on discharge, as the river is not connected to the Greenland ice sheet. The study aims to explain discharge patterns between 1996 and 2019 and analyse the discharge for correlations to variations in air temperature and both solid and liquid precipitation. The results reveal no trend in the annual discharge. A lengthening of the discharge period is characterised by a later freeze-up and extreme discharge peaks are observed almost yearly between 2005 and 2017. A positive correlation exists between the length of the discharge period and the Thawing Degree Days (r=0.52,p<0.01), and between the total annual discharge and the annual maximum snow depth (r=0.48,p=0.02). Thereby, snowmelt provides the main source of discharge in the first part of the runoff season. However, the influence of precipitation on discharge could not be fully identified, because of uncertainties in the data and possible delays in the hydrological system. This calls for further studies on the relationship between discharge and precipitation. The discharge patterns are also influenced by meltwater from the A.P. Olsen ice cap and an adjacent glacier-dammed lake which releases outburst floods. Hence, this mixed hydrological regime causes different relationships between the discharge and climatic trends when compared to most Arctic rivers.

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Journal articles on the topic 'Discharge calls'

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