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Joseph S, Tomaschek R, Hug BL, Beeler PE. Enhancing communication and care coordination: A scoping review of encounter notification systems between emergency departments and primary care providers. Int J Med Inform 2024; 191:105579. [PMID: 39127014 DOI: 10.1016/j.ijmedinf.2024.105579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 07/20/2024] [Accepted: 07/27/2024] [Indexed: 08/12/2024]
Abstract
OBJECTIVE This scoping review aims to explore the current state of encounter notification systems (ENS) between emergency departments (EDs) and primary care providers (PCPs), focusing on their mechanisms, effectiveness, impacts, and challenges in healthcare settings. METHODS A systematic search was conducted using PubMed/MEDLINE and Google Scholar to identify relevant literature on ENS between EDs and PCPs. Eligible studies were selected based on predefined criteria, and data were synthesized narratively. RESULTS The initial search yielded 1,396 articles, with 29 included in the review. Studies highlighted the significance of encounter notifications in improving communication and care coordination between EDs and PCPs, leading to enhanced patient outcomes. However, challenges such as technological barriers, privacy concerns, and variations in healthcare settings were identified. CONCLUSION ENS play a crucial role in enhancing communication and care coordination between EDs and PCPs. Despite challenges, these systems offer substantial benefits and opportunities for improving patient care in the ED-primary care continuum. Future research should focus on addressing implementation barriers and evaluating long-term impacts to optimize the effectiveness of ENS in this context.
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Affiliation(s)
- Staria Joseph
- Faculty of Health Sciences and Medicine, University of Lucerne, Switzerland
| | - Rebecca Tomaschek
- Center for Primary and Community Care, Faculty of Health Sciences and Medicine, University of Lucerne, Switzerland
| | - Balthasar L Hug
- Center for Primary and Community Care, Faculty of Health Sciences and Medicine, University of Lucerne, Switzerland; Department of General Internal Medicine, Cantonal Hospital Lucerne, Switzerland
| | - Patrick E Beeler
- Center for Primary and Community Care, Faculty of Health Sciences and Medicine, University of Lucerne, Switzerland.
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Azmi H, Walter BL, Brooks A, Richard IH, Amodeo K, Okun MS. Editorial: Hospitalization and Parkinson's disease: safety, quality and outcomes. Front Aging Neurosci 2024; 16:1398947. [PMID: 38638192 PMCID: PMC11024459 DOI: 10.3389/fnagi.2024.1398947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 03/14/2024] [Indexed: 04/20/2024] Open
Affiliation(s)
- Hooman Azmi
- Department of Neurosurgery, Hackensack University Medical Center, Hackensack, NJ, United States
- Hackensack Meridian School of Medicine, Nutley, NJ, United States
| | | | - Annie Brooks
- Parkinson's Foundation, New York, NY, United States
| | - Irene Hegeman Richard
- Department of Neurology, University of Rochester Medical Center, Rochester, NY, United States
| | - Katherine Amodeo
- Westchester Medical Center Health Network, Valhalla, NY, United States
| | - Michael S. Okun
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
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Azmi H, Cocoziello L, Ruzicka F, Clar E, Pederson JM, Jacob B, Thomas J, Rocco A, Bobek M, Pereira-Argenziano L, Roth P, Thomas FP. Custom order entry for Parkinson's medications in the hospital improves timely administration: an analysis of over 31,000 medication doses. Front Aging Neurosci 2023; 15:1267067. [PMID: 38187358 PMCID: PMC10768191 DOI: 10.3389/fnagi.2023.1267067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/28/2023] [Indexed: 01/09/2024] Open
Abstract
Background Patients with Parkinson's disease (PD) are at increased risk for hospital acquired complications. Deviations from home medication schedules and delays in administration are major contributing factors. We had previously developed a protocol to ensure adherence to home medication schedules using "custom" ordering. In this study we are assessing the impact this order type may have on reducing delays in PD medication administration in the hospital. Material and methods We reviewed 31,404 orders placed for PD medications from January 2, 2016 to April 30 2021. We evaluated the orders to determine if they were placed in a Custom format or using a default non-custom order entry. We further evaluated all orders to determine if there was a relationship with the order type and timely administration of medications. We compared medications that were administered within 1 min, 15 min, 30 min and 60 min of due times across custom orders vs. non-custom default orders. We also evaluated the relationship between ordering providers and type of orders placed as well as hospital unit and type of orders placed. Results 14,204 (45.23%) orders were placed using a custom schedule and 17,200 (54.77%) orders were placed using non-custom defaults. The custom group showed a significantly lower median delay of 3.06 minutes compared to the non-custom group (p<.001). Custom orders had a significantly more recent median date than non-custom default orders (2019-10-07 vs. 2018-01-06, p<0.001). In additional analyses, medication administration delays were significantly improved for custom orders compared to non-custom orders, with likelihoods 1.64 times higher within 1 minute, 1.40 times higher within 15 minutes, and 1.33 times higher within 30 minutes of the due time (p<0.001 for all comparisons). Conclusion This is the largest study to date examining the effects of order entry type on timely administration of PD medications in the hospital. Orders placed using a custom schedule may help reduce delays in administration of PD medications.
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Affiliation(s)
- Hooman Azmi
- Department of Neurosurgery, Hackensack University Medical Center, Hackensack, NJ, United States
- New Jersey Brain and Spine Center, Hackensack, NJ, United States
- Hackensack Meridian School of Medicine, Nutley, NJ, United States
| | - Lisa Cocoziello
- Department of Neurosurgery, Hackensack University Medical Center, Hackensack, NJ, United States
| | - Francis Ruzicka
- Hackensack Meridian School of Medicine, Nutley, NJ, United States
| | - Elana Clar
- New Jersey Brain and Spine Center, Hackensack, NJ, United States
- Hackensack Meridian School of Medicine, Nutley, NJ, United States
- Department of Neurology, Hackensack University Medical Center, Hackensack, NJ, United States
| | | | - Blessy Jacob
- Department of Pharmacy, Hackensack University Medical Center, Hackensack, NJ, United States
| | - Jewell Thomas
- Department of Pharmacy, Hackensack University Medical Center, Hackensack, NJ, United States
| | - Anthony Rocco
- Department of Patient Safety and Quality, Hackensack University Medical Center, Hackensack, NJ, United States
| | - Mary Bobek
- Department of Nursing Clinical Education, Hackensack University Medical Center, Hackensack, NJ, United States
| | - Lucy Pereira-Argenziano
- Department of Patient Safety and Quality, Hackensack University Medical Center, Hackensack, NJ, United States
| | - Patrick Roth
- Department of Neurosurgery, Hackensack University Medical Center, Hackensack, NJ, United States
- New Jersey Brain and Spine Center, Hackensack, NJ, United States
- Hackensack Meridian School of Medicine, Nutley, NJ, United States
| | - Florian P. Thomas
- Hackensack Meridian School of Medicine, Nutley, NJ, United States
- Department of Neurology, Hackensack University Medical Center, Hackensack, NJ, United States
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Shurer J, Golden SLS, Mihas P, Browner N. More than medications: a patient-centered assessment of Parkinson's disease care needs during hospitalization. Front Aging Neurosci 2023; 15:1255428. [PMID: 37842122 PMCID: PMC10569176 DOI: 10.3389/fnagi.2023.1255428] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
Background Parkinson's disease (PD) increases the risk of hospitalization and complications while in the hospital. Patient-centered care emphasizes active participation of patients in decision-making and has been found to improve satisfaction with care. Engaging in discussion and capturing hospitalization experience of a person with PD (PwP) and their family care partner (CP) is a critical step toward the development of quality improvement initiatives tailored to the unique hospitalization needs of PD population. Objectives This qualitative study aimed to identify the challenges and opportunities for PD patient-centered care in hospital setting. Methods Focus groups were held with PwPs and CPs to capture first-hand perspectives and generate consensus themes on PD care during hospitalization. A semi-structured guide for focus group discussions included questions about inpatient experiences and interactions with the health system and the clinical team. The data were analyzed using inductive thematic analysis. Results A total of 12 PwPs and 13 CPs participated in seven focus groups. Participants were 52% female and 28% non-white; 84% discussed unplanned hospitalizations. This paper focuses on two specific categories that emerged from the data analysis. The first category explored the impact of PD diagnosis on the hospital experience, specifically during planned and unplanned hospitalizations. The second category delves into the unique needs of PwPs and CPs during hospitalization, which included the importance of proper PD medication management, the need for improved hospital ambulation protocols, and the creation of disability informed hospital environment specific for PD. Conclusion PD diagnosis impacts the care experience, regardless of the reason for hospitalization. While provision of PD medications was a challenge during hospitalization, participants also desired flexibility in ambulation protocols and an environment that accommodated their disability. These findings highlight the importance of integrating the perspectives of PwPs and CPs when targeting patient-centered interventions to improve hospital experiences and outcomes.
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Affiliation(s)
| | | | - Paul Mihas
- Odum Institute for Research in Social Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Nina Browner
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Okunoye O, Kojima G, Marston L, Walters K, Schrag A. Factors associated with hospitalisation among people with Parkinson's disease - A systematic review and meta-analysis. Parkinsonism Relat Disord 2020; 71:66-72. [PMID: 32156461 DOI: 10.1016/j.parkreldis.2020.02.018] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/21/2020] [Accepted: 02/25/2020] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Parkinson's disease (PD) is associated with an increased risk of admission to hospital; however data on the main reasons for admission are lacking. Our objective was to determine the pooled prevalence of the most common factors leading to admission among people with Parkinson's disease. METHODOLOGY A systematic literature search was conducted in 11 electronic databases. We included all studies providing reasons for admissions among PD patients without restrictions to diagnostic criteria of PD, language or year of study. In the included studies, methodological quality, publication bias and heterogeneity were assessed. Meta-analysis was performed using random-effects models to calculate the pooled estimates of the identified top factors that lead to admission among people with PD. RESULTS A total of 7283 studies were identified of which nine studies including 7162 people with PD were included in this review. There was a high degree of heterogeneity between studies regarding reasons for hospitalisation. The pooled prevalence of the topmost reasons for hospitalisation among people with PD was 22% (95%CI 16.0%–30.0%) for infections (mainly urinary tract infections and pneumonia); 19% (95%CI 13.0%–27.0%) for worsening motor manifestations of PD; 18% (95%CI 14.0%–21.0%) for falls/fractures; 13% (95%CI 9.0%–18%) for cardiovascular co-morbidities; 8% (95%CI 4.0%–13.0%) for neuropsychiatric and 7% (95%CI 4.0%–11.0%) for gastrointestinal complications. CONCLUSION The main reasons for hospitalisation among people with PD are infections, worsening motor features, falls/fractures, cardiovascular co-morbidities, neuropsychiatric and gastrointestinal complications. Further research is needed on targeting and implementing preventative strategies.
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Affiliation(s)
- Olaitan Okunoye
- Department of Clinical and Movement Neurosciences, University College London, UK.
| | - Gotaro Kojima
- Department of Primary Care and Population Health, University College London, UK
| | - Louise Marston
- Department of Primary Care and Population Health, University College London, UK
| | - Kate Walters
- Department of Primary Care and Population Health, University College London, UK
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences, University College London, UK
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