Implementation of Milestones-Based Assessment for a Safe and Effective Discharge.
Creator
Suddarth Kathleen Heist; Jones Ronald R; O'Malley Cheryl W; Paje David; Yamazaki Kenji; Zaas Aimee K; Meade Lauren B
Publisher
The American journal of medicine
Date
2016
2016-06
Subject
Documentation; Female; Health Care Surveys; Humans; Male; Patient Discharge – Standards; Patient Discharge/*standards; Patient Safety; Practice Guidelines; Practice Guidelines as Topic; Records; Surveys
OBJECTIVES: To evaluate paramedics' ability to identify elderly at risk and refer them for assessment and service. DESIGN: A prospective nonrandomized open trial. SETTING: Akron, Ohio, a midsize city with a well-developed advanced life support emergency medical services system. TYPE OF PARTICIPANTS: One hundred thirty firefighter paramedics evaluated 6,000 elderly patients. Assessments were performed by trained geriatric assessors. INTERVENTION: Regardless of the reason for the call, paramedics screened all emergency medical services users age 60 and older for medical, mental health, social, and environmental problems. Identified cases were referred to the Area Agency on Aging for assessment and follow-up. MAIN RESULTS: Paramedics identified 197 people with possible problems, 124 of whom received an assessment. The remainder could not be assessed due to death, moving, referral, or transfer to a long-term care facility. Assessors confirmed the presence of a problem in 121 of 124 assessed cases, a positive predictive value of 98%. The program was useful for 94 people, 48% of those identified and assessed. CONCLUSION: Paramedics can serve as case finders for at-risk elderly, and effective linkage to service agencies can occur.
Subject
*Emergency Medical Technicians; *Geriatric Assessment; Aged; Female; Humans; Male; Ohio; Predictive Value of Tests; Prospective Studies; Records; Risk Factors
Making The Case For A Qualitative Study Of Medical Errors In Primary Care
Creator
Kuzel A J; Woolf S H; Engel J D; Gilchrist V J; Frankel R M; LaVeist T A; Vincent C
Publisher
Qualitative Health Research
Date
2003
2003-07
Description
In the interest of publicizing examples of funded qualitative health research, the authors share a proposal to the Ageney for Healthcare Research and Quality in Washington, D.C., in which they sought to elicit patient stories of preventable problems in their primary health care that were associated with psychological or physical harms. These stories would allow for the construction of a tentative typology of errors and harms as experienced by patients and the contrasting of this with errors and harms reported by primary care physicians in the United States and other countries. The authors make explicit the anticipated concerns of reviewers more accustomed to quantitative research proposals and the arguments and strategies employed to address them.
Subject
adverse events; australian health-care; aviation; Biomedical Social Sciences; doctor; harm; hospitalized-patients; Information Science & Library Science; lessons; medical error; needs; patient harms; patient perspectives; preferences; qualitative methods; records; Social Sciences - Other Topics