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[PMID]:29183058
[Ti] Título:Diagnostic Problems: Guest Editorial.
[So] Source:JAMA;318(20):2050, 2017 11 28.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Patologia Clínica/história
Visitas com Preceptor/história
[Mh] Termos MeSH secundário: Diagnóstico
História do Século XX
Seres Humanos
[Pt] Tipo de publicação:CLASSICAL ARTICLE; HISTORICAL ARTICLE; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171213
[Lr] Data última revisão:
171213
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.10496


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[PMID]:28771651
[Au] Autor:Merchant NB; Federman DG
[Ad] Endereço:From the Department of Medicine, Yale University School of Medicine, New Haven, and the VA CT Health Care System, West Haven, Connecticut.
[Ti] Título:Bedside Rounds Valued But Not Preferred: Perceptions of Internal Medicine Residents and Attending Physicians in a Diverse Academic Training Program.
[So] Source:South Med J;110(8):531-537, 2017 Aug.
[Is] ISSN:1541-8243
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Bedside rounds/rounding (BDR) is an important tool for patient-centered care and trainee education. This study aimed at understanding the attitudes toward BDR among residents and attending physicians. METHODS: A survey was conducted using the Qualtrics survey tool. Responses were measured using a five-point Likert scale. RESULTS: The survey was sent to 301 attending physicians and 195 residents. Attending physicians conducted BDR 19% of the time. The preferred mode of rounding for residents was hallway and/or conference room rounding (67%). The major barriers to BDR were concern for causing confusion in or alarm to patients (attending physicians 49%, residents 77%) and prolongation of rounds (attending physicians 47%, residents 72%). The major advantages to BDR were increased likelihood of using patient-friendly language (attending physicians 84%, residents 69%) and the potential to improve trainees' oral presentations and physical examination skills (attending physicians 71%, residents 54%). Attending physicians reported having adequate skills to conduct BDR (95%) and potential opportunity to be better teachers with this mode of rounding (69%). Residents reported having some previous experience with BDR (46%) and agreed that BDR is an important skill for residents (62%). Only 34% of residents agreed that BDR allowed them to learn more about patient care compared with other modes of rounding, however. CONCLUSIONS: Our study showed that our participants perceive BDR positively. Endorsed benefits include the ability to use patient-friendly language, the potential to improve trainees' clinical skills, and an opportunity to become better teachers. The reported major barriers to BDR were potential concern for patient confusion and prolongation of rounds. Despite some prior exposure reported by residents and adequate attending skills, the frequency and preference for BDR remains low and the residents remain uncertain about the educational value of BDR. The evaluation of other factors that contribute to the low frequency of BDR needs further consideration. Furthermore, each residency program may differ in the patterns of perception toward BDR and these should be formally assessed before implementing this patient-centered mode of rounding.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Medicina Interna/educação
Internato e Residência
Corpo Clínico Hospitalar
Visitas com Preceptor
[Mh] Termos MeSH secundário: Seres Humanos
Autorrelato
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170831
[Lr] Data última revisão:
170831
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170804
[St] Status:MEDLINE
[do] DOI:10.14423/SMJ.0000000000000689


  3 / 644 MEDLINE  
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[PMID]:28705913
[Au] Autor:Anttila A; Rappaport DI; Tijerino J; Zaman N; Sharif I
[Ad] Endereço:General Pediatrics, Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware; and ashley.anttila@nemours.org.
[Ti] Título:Interpretation Modalities Used on Family-Centered Rounds: Perspectives of Spanish-Speaking Families.
[So] Source:Hosp Pediatr;7(8):492-498, 2017 08.
[Is] ISSN:2154-1663
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVES: Limited-English-proficient (LEP) patients and families are at risk for worse hospital outcomes due to impaired communication. Family-centered rounds (FCR) have become the preferred format for information sharing among providers and families at pediatric institutions. However, there are limited data on FCR among LEP families, particularly regarding interpretation type. We sought to examine the relationships between interpretation type and FCR satisfaction and efficacy among Spanish-speaking families, the fastest growing LEP population in pediatric hospitals. METHODS: Spanish speakers admitted to general pediatrics units over a period of 16 months were identified on admission. A bilingual research assistant observed FCR and completed an observation tool, including interpreter type. After FCR, the research assistant interviewed families, collecting parent demographics, FCR experience, and interpreter satisfaction. Associations between interpretation type and satisfaction as well as interpretation type and understanding were tested by using χ analyses. RESULTS: We studied 124 families over 16 months. Most respondents were patients' mothers (84%), born in Mexico (76%), had grade school education (56%), and spoke limited English (96%). Overall, 83 (73%) reported the interpreter services improved their understanding of their child's medical condition. Interpreter type was significantly associated with family satisfaction with FCR; specifically, an in-person hospital interpreter or video interpreter was associated with complete caregiver satisfaction ( = .005). CONCLUSIONS: Spanish speakers report higher satisfaction with face-to-face interpreters during FCR, including in-person and video, compared with telephonic interpreters. Video interpretation via iPad during FCR may be a valuable and accessible approach to improve communication in the care of hospitalized children.
[Mh] Termos MeSH primário: Barreiras de Comunicação
Família
Hispano-Americanos
Visitas com Preceptor
Tradução
[Mh] Termos MeSH secundário: Adulto
Pré-Escolar
Feminino
Seres Humanos
Masculino
Satisfação do Paciente
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170715
[St] Status:MEDLINE
[do] DOI:10.1542/hpeds.2016-0209


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[PMID]:28614674
[Au] Autor:Singh S
[Ad] Endereço:From Stanford Health Care, Los Gatos, CA.
[Ti] Título:Morning Report.
[So] Source:N Engl J Med;376(24):2316-2317, 2017 Jun 15.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Internato e Residência
Relações Médico-Paciente
Visitas com Preceptor
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; PERSONAL NARRATIVES
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170629
[Lr] Data última revisão:
170629
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170615
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMp1701939


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[PMID]:28594673
[Au] Autor:Hendricks S; LaMothe VJ; Kara A; Miller J
[Ad] Endereço:Author Affiliations: Associate Professor and Associate Dean (Dr Hendricks), Undergraduate Programs, and Project Manager (Dr LaMothe), School of Nursing, Indiana University; and IC Hospitalist (Dr Kara), and Clinical Nurse Specialist (Ms Miller), Indiana University Health Methodist Hospital, Bloomington.
[Ti] Título:Facilitators and Barriers for Interprofessional Rounding: A Qualitative Study.
[So] Source:Clin Nurse Spec;31(4):219-228, 2017 Jul/Aug.
[Is] ISSN:1538-9782
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The purpose of this qualitative study was to describe the barriers and facilitators for interprofessional patient-centered rounding across 4 acute care units in a large urban hospital. DESIGN: A qualitative descriptive method that included data gathered over an 18-month period was used. METHODS: Three data sources were included: participant observation of rounding activities, focused meetings related to interprofessional practice, and exit interviews with key informants representing multiple professions and roles. The data were analyzed, and the findings were developed through an extensive transcription, coding, and discussion process. RESULTS: The facilitators and barriers related to the team included high versus low turnover of team membership, structured versus unstructured rounding, valuing versus skepticism about interprofessional practice, and confidence versus hesitancy about skills. Facilitator/barrier pairs related to the environment included rounding aligned versus mismatched with hospital's mission, time for rounding versus competing demands, geographically cohorted versus distributed teams, and readiness for change and innovation versus saturation. CONCLUSION: Factors associated with the members of the interprofessional team were important in successful implementation of interprofessional rounding. The organizational context and structure were also important. Leaders who anticipate implementing interprofessional rounding may incorporate knowledge of these facilitators and barriers into their planning process.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Relações Interprofissionais
Corpo Clínico Hospitalar/psicologia
Equipe de Assistência ao Paciente/organização & administração
Visitas com Preceptor/organização & administração
[Mh] Termos MeSH secundário: Competência Clínica
Meio Ambiente
Hospitais Urbanos
Seres Humanos
Unidades de Terapia Intensiva
Reorganização de Recursos Humanos/estatística & dados numéricos
Pesquisa Qualitativa
Autoeficácia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170609
[St] Status:MEDLINE
[do] DOI:10.1097/NUR.0000000000000310


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[PMID]:28566045
[Au] Autor:Sokoya M; Judge PD; Cabrera-Muffly C; Vila PM
[Ad] Endereço:1 Department of Otolaryngology, School of Medicine, University of Colorado, Aurora, Colorado, USA.
[Ti] Título:Inpatient Rounding Practices in Otolaryngology Residency Programs.
[So] Source:Otolaryngol Head Neck Surg;156(6):1032-1034, 2017 Jun.
[Is] ISSN:1097-6817
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Inpatient rounding is an agelong tradition in the field of medicine. Among recent changes in health care, rounding is understudied as an area of research. The purpose of this study was to assess current methods of inpatient rounding in otolaryngology residency programs and assess satisfaction with current practices. Survey questions were designed by members of the resident committee of the Society of University Otolaryngologists. Surveys were sent to all 450 members, and we obtained a 32% response rate. Sixty-four percent of attendings perform bedside rounds; 44% of subjects reported that attending physicians participate in rounds at least once a week; and 21% reported daily participation. When asked if attending participation in rounding is adequate, attendings did not have a strong opinion (mean = 3.8). There is a paucity of research on inpatient rounding, and future studies should examine specific practices with the goal of maximizing patient safety and resident education.
[Mh] Termos MeSH primário: Otolaringologia/educação
Padrões de Prática Médica/estatística & dados numéricos
Visitas com Preceptor
[Mh] Termos MeSH secundário: Educação de Pós-Graduação em Medicina
Seres Humanos
Internato e Residência
Satisfação no Emprego
Corpo Clínico Hospitalar
Inquéritos e Questionários
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170822
[Lr] Data última revisão:
170822
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170602
[St] Status:MEDLINE
[do] DOI:10.1177/0194599817696295


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[PMID]:28557720
[Au] Autor:Cox ED; Jacobsohn GC; Rajamanickam VP; Carayon P; Kelly MM; Wetterneck TB; Rathouz PJ; Brown RL
[Ad] Endereço:Departments of Pediatrics, ecox@pediatrics.wisc.edu.
[Ti] Título:A Family-Centered Rounds Checklist, Family Engagement, and Patient Safety: A Randomized Trial.
[So] Source:Pediatrics;139(5), 2017 May.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVES: Family-centered rounds (FCRs) have become standard of care, despite the limited evaluation of FCRs' benefits or interventions to support high-quality FCR delivery. This work examines the impact of the FCR checklist intervention, a checklist and associated provider training, on performance of FCR elements, family engagement, and patient safety. METHODS: This cluster randomized trial involved 298 families. Two hospital services were randomized to use the checklist; 2 others delivered usual care. We evaluated the performance of 8 FCR checklist elements and family engagement from 673 pre- and postintervention FCR videos and assessed the safety climate with the Children's Hospital Safety Climate Questionnaire. Random effects regression models were used to assess intervention impact. RESULTS: The intervention significantly increased the number of FCR checklist elements performed (ß = 1.2, < .001). Intervention rounds were significantly more likely to include asking the family (odds ratio [OR] = 2.43, < .05) or health care team (OR = 4.28, = .002) for questions and reading back orders (OR = 12.43, < .001). Intervention families' engagement and reports of safety climate were no different from usual care. However, performance of specific checklist elements was associated with changes in these outcomes. For example, order read-back was associated with significantly more family engagement. Asking families for questions was associated with significantly better ratings of staff's communication openness and safety of handoffs and transitions. CONCLUSIONS: The performance of FCR checklist elements was enhanced by checklist implementation and associated with changes in family engagement and more positive perceptions of safety climate. Implementing the checklist improves delivery of FCRs, impacting quality and safety of care.
[Mh] Termos MeSH primário: Lista de Checagem/métodos
Segurança do Paciente
Relações Profissional-Família
Visitas com Preceptor/métodos
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Família
Feminino
Hospitais Pediátricos
Seres Humanos
Masculino
Equipe de Assistência ao Paciente
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170810
[Lr] Data última revisão:
170810
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170531
[St] Status:MEDLINE


  8 / 644 MEDLINE  
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[PMID]:28363361
[Au] Autor:Yager PH; Clark M; Cummings BM; Noviski N
[Ad] Endereço:Department of Pediatrics, Division of Pediatric Critical Care, Massachusetts General Hospital, Boston, MA.
[Ti] Título:Parent Participation in Pediatric Intensive Care Unit Rounds via Telemedicine: Feasibility and Impact.
[So] Source:J Pediatr;185:181-186.e3, 2017 Jun.
[Is] ISSN:1097-6833
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To evaluate feasibility and impact of telemedicine for remote parent participation in pediatric intensive care unit (PICU) rounds when parents are unable to be present at their child's bedside. STUDY DESIGN: Parents of patients admitted to a 14-bed PICU were approached, and those unable to attend rounds were eligible subjects. Nurse and physician caregivers were also surveyed. Parents received an iPad (Apple Inc, Cupertino, California) with an application enabling audio-video connectivity with the care team. At a predetermined time for bedside rounds with the PICU team, parents entered a virtual meeting room to participate. Following each telemedicine encounter, participants (parent, physician, nurse) completed a brief survey rating satisfaction (0?=?not satisfied, 10?=?completely satisfied) and disruption (0?=?no disruption at all, 10?=?very disruptive). RESULTS: A total of 153 surveys were completed following 51 telemedicine encounters involving 13 patients. Parents of enrolled patients cited work demands (62%), care for other dependents (46%), and transportation difficulties (31%) as reasons for study participation. The median levels of satisfaction and disruption were 10 (range 5-10) and 0 (range 0-5), respectively. All parents reported that telemedicine encounters had a positive effect on their level of reassurance regarding their child's care and improved communication with the care team. CONCLUSIONS: This proof-of-concept study indicates that remote parent participation in PICU rounds is feasible, enhances parent-provider communication, and offers parents reassurance. Providers reported a high level of satisfaction with minimal disruption. Technological advancements to streamline teleconferencing workflow are needed to ensure program sustainability.
[Mh] Termos MeSH primário: Unidades de Terapia Intensiva Pediátrica
Pais
Visitas com Preceptor
Telemedicina
Videoconferência
[Mh] Termos MeSH secundário: Adolescente
Boston
Criança
Pré-Escolar
Comunicação
Estudos de Viabilidade
Feminino
Seres Humanos
Lactente
Masculino
Equipe de Assistência ao Paciente
Satisfação do Paciente
Projetos Piloto
Relações Profissional-Família
Estudos Prospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170402
[St] Status:MEDLINE


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[PMID]:28351066
[Au] Autor:Bennett NL; Flesch JD; Cronholm P; Reilly JB; Ende J
[Ad] Endereço:N.L. Bennett is codirector, Internal Medicine Clerkship, and assistant professor of clinical medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.J.D. Flesch is associate program director, Internal Medicine Residency, and assistant professor of clinical medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.P. Cronholm is associate professor of family medicine and community health, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.J.B. Reilly is internal medicine residency program director, Allegheny Health Network, Pittsburgh, Pennsylvania, and assistant professor of medicine, Temple University School of Medicine, Philadelphia, Pennsylvania.J. Ende is Schaeffer Professor of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
[Ti] Título:Bringing Rounds Back to the Patient: A One-Year Evaluation of the Chiefs' Service Model for Inpatient Teaching.
[So] Source:Acad Med;92(4):528-536, 2017 Apr.
[Is] ISSN:1938-808X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The Chiefs' Service (CS), a structured approach to inpatient teaching rounds, focuses on resident education and patient-centered care without disrupting patient census sizes or admitting cycles. It has five key elements: morning huddles; bedside rounds; diagnostic "time-outs"; day-of-discharge rounds; and postdischarge follow-up rounds. The authors hypothesized the CS model would be well received by residents and considered more effective than more-traditional rounds. METHOD: The CS was implemented on Penn Presbyterian Medical Center's general medicine inpatient service using a quasi-experimental design. Its first year (January 2013-January 2014) was evaluated with a mixed-methods approach. Residents completed end-of-rotation evaluation questionnaires; 20 CS and 10 traditional service (TS) residents were interviewed. Measures of resident agreement on questionnaire items were compared across groups using independent sample t testing. A modified grounded theory approach was used to assess CS residents' perspectives on the CS elements and identify emergent themes. RESULTS: The questionnaires were completed by 183/188 residents (response rate 97%). Compared with TS residents, CS residents reported significantly greater satisfaction in the domains of resident education and patient care, and they rated the overall value of the rotation significantly higher. The majority of CS residents found the CS elements to be effective. CS residents described the CS as focused on resident education, patient-centered care, and collaboration with an interdisciplinary team. CONCLUSIONS: The CS approach to inpatient rounding is seen by residents as valuable and is associated with positive outcomes in terms of residents' perceptions of learning, interdisciplinary communication, and patient care.
[Mh] Termos MeSH primário: Educação de Pós-Graduação em Medicina/métodos
Medicina Interna/educação
Modelos Educacionais
Visitas com Preceptor/métodos
[Mh] Termos MeSH secundário: Atitude do Pessoal de Saúde
Seres Humanos
Internato e Residência
Assistência Centrada no Paciente
Pesquisa Qualitativa
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170731
[Lr] Data última revisão:
170731
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170329
[St] Status:MEDLINE
[do] DOI:10.1097/ACM.0000000000001459


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[PMID]:28277232
[Au] Autor:Lin JA; Farrow N; Lindeman BM; Lidor AO
[Ad] Endereço:Department of Surgery, Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD 21287, USA; Department of Surgery, University of California San Francisco, 513 Parnassus Ave, San Francisco, CA 94143, USA. Electronic address: joseph.lin@ucsf.edu.
[Ti] Título:Impact of near-peer teaching rounds on student satisfaction in the basic surgical clerkship.
[So] Source:Am J Surg;213(6):1163-1165, 2017 Jun.
[Is] ISSN:1879-1883
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Teaching rounds are rarely featured in the surgery clerkship. Senior students interested in surgery are suited to precept teaching rounds. Near-peer teaching can provide benefits to both learners and preceptors. METHODS: Near-peer teaching rounds consisted of senior student-precetors leading groups of 3 clerkship students on teaching rounds once during the clerkship. We prospectively surveyed student satisfaction before and after instituting near-peer teaching rounds. We retrospectively gathered qualitative narratives from student-preceptors. RESULTS: The survey response rate was 93% before near-peer teaching rounds were instituted and 85% after. Satisfaction with the learning environment and the quality and amount of small-group teaching were significantly higher after the institution of near-peer teaching rounds (P ≤ .001 for all 3). Satisfaction with the overall clerkship and baseline interest in surgery were not significantly different. Student-preceptors reported gaining valuable experience for future roles in academia as residents and attending surgeons. CONCLUSIONS: Student satisfaction with small-group teaching and the learning environment increased after the institution of near-peer teaching rounds in the surgery clerkship. Student-preceptors gained early experience for careers in academic surgery.
[Mh] Termos MeSH primário: Estágio Clínico
Cirurgia Geral/educação
Internato e Residência
Grupo Associado
Satisfação Pessoal
Visitas com Preceptor
[Mh] Termos MeSH secundário: Atitude do Pessoal de Saúde
Seres Humanos
Estudantes de Medicina
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170310
[St] Status:MEDLINE



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