Clinical

Establishing a Role for Polysomnography in Hospitalized Children

Clinical question: What is the role for inpatient polysomnograms for children with medical complexity? Background: Sleep-disordered breathing is more common in certain pediatric populations. Children with neuromuscular disease, craniofacial or tracheobronchial malformations, or developmental delay have up to 10 times the rate of sleep-disordered breathing as compared to the general pediatric population, with a prevalence… [Read More]

Physicians, Residents, Students Can Learn High-Value, Cost-Conscious Care

Clinical question: What are the factors that promote education in delivering high-value, cost-conscious care? Background: Healthcare costs are increasing, with most recent numbers showing U.S. expenditures on healthcare of more than $3 trillion, almost 18% of the gross domestic product. High-value care focuses on understanding the benefits, risks, and costs of care and promoting interventions… [Read More]

Data Show Patients Are More Likely to Die at Night, on Weekends

Clinical question: Is there a clinical difference in rates of return of spontaneous circulation (ROSC) and survival to discharge in patients with in-hospital cardiac arrest (IHCA) depending on time of day and day of the week? Background: Current U.S. data from the American Hospital Association’s “Get with the Guidelines-Resuscitation” (AHA GWTG-R) show hospital survival is… [Read More]

Medicare ‘Hospital Star Rating’ May Correspond to Patient Outcomes

The Centers for Medicare and Medicaid Services has been letting patients grade their hospital experiences, and those “patient experience scores” may give some insight into a hospital’s health outcomes, a new study suggests. Some people have been concerned that patient experience isn’t the most important factor to measure, said coauthor Dr. Ashish K. Jha, of… [Read More]

“Nonurgent” Patients Might Still End up Being Hospitalized

(Reuters Health) – Patients assigned a “nonurgent” status on arrival in the emergency room might still be sick enough to be hospitalized, a new study shows. Patients deemed by triage nurses to be “nonurgent” often receive diagnostic services and procedures, and some are even admitted to critical care units, researchers found. Triage was never intended… [Read More]

Prior clopidogrel tied to more events in medically treated ACS patients

NEW YORK (Reuters Health) – Among medically treated patients with acute coronary syndrome (ACS), prior clopidogrel therapy appears to be associated with more cardiovascular events, researchers have found. As Dr. Chee Tang Chin told Reuters Health by email, “We found that among patients who were admitted for an acute coronary syndrome and did not undergo… [Read More]

Stigma Keeps Some Cancer Patients from getting Palliative Care

(Reuters Health) – Some cancer patients may turn down care that could ease their pain and improve their quality of life because they think this type of “palliative” treatment amounts to giving up and simply waiting to die, a small Canadian study suggests. Even though the World Health Organization recommends early palliative care for patients… [Read More]

Engaging Your Patients in Decision-Making Processes Yields Better Outcomes

Editor’s note: “Everything We Say and Do” is an informational series developed by SHM’s Patient Experience Committee to provide readers with thoughtful and actionable communication tactics that have great potential to positively impact patients’ experience of care. Each column will focus on how the contributor applies one of the “Key Communication” areas in practice. View… [Read More]

Long-Term Βeta-Blocker Use May Cause More Harm in Patients Undergoing Surgery

Clinical question: What is the harm associated with long-term beta-blocker therapy in patients with uncomplicated hypertension undergoing non-cardiac surgery? Background: Given the recent concerns over the validity of prior studies, there is uncertainty about which patients benefit most from perioperative beta-blockade. Current guidelines suggest continuing beta-blockers in the perioperative period. More data are needed to… [Read More]

Depression Common among Physicians in Training

Clinical question: What is the prevalence of depression or depressive symptoms in resident physicians? Background: Depression in resident physicians can lead to poor-quality medical care, increased errors, and long-term morbidity. Prevalence of depression or depressive symptoms has varied in prior studies, and more data are needed to better understand the true prevalence. Study design: Systematic… [Read More]