Topic
Admission note
About: Admission note is a research topic. Over the lifetime, 22 publications have been published within this topic receiving 280 citations.
Papers
TL;DR: The purposes of this study were to evaluate the occurrence of discrepancies between home medications listed in hospital admission notes and patients' reported medical conditions and to describe the types of medications most often identified as not having a corresponding indication.
Abstract: Background: One of the Joint Commission on Accreditation of Healthcare Organization's National Patient Safety Goals is for hospitals to accurately and completely reconcile patients' medications. Unfortunately, medication histories in charts might bc inaccurate and incomplete. In a thorough medication history, each medication should match a particular reported medical condition. The use of medications without a clear reported indication is of particular concern and has bccn associated with inappropriate use and polypharmacy. Objectives: The purposes of this study were to evaluate the occurrence of discrepancies between home medications listed in hospital admission notes and patients' reported medical conditions and to describe the types of medications most often identified as not having a corresponding indication. Methods: In this retrospective observational study, data were included from adult patients (≥18 years of age) who were receiving ≥3 home medications on admission to medical wards at a university hospital during a 6-month period. Each home medication listed in the admission note, together with any preadmission paperwork, was matched with an indication listed in the note. Medications were deemed unspecified if an indicated disease state or condition for the medication was not reported. Results: Data from 121 patients were included. The majority (91.7%) of the patients were admitted to an internal medicine service. Eighty-four patients (69.4%) had ≥1 unspecified medication listed in the admission note. Patients with ≥1 unspecified home medication reported taking a signifcantly higher number of home medications (10.2 [4.5] vs 7.5 [3.5] in those without unspecified medications; P = 0.007). Thirty-two patients (26.4%) were receiving proton pump inhibitors or histamine type 2 antagonists without a reported indication. Seventeen patients (14.0%) were receiving selective scrotonin rcuptakc inhibitors without a reported indication. Conclusions: Nearly 70% of patients admitted to a medical ward had ≥1 unspecified medication listed in the admission note. Based on these results, health care professionals must bc careful to obtain and document complete medication histories with matching indications.
26 citations
TL;DR: The goal of this study was to determine attitudes and practices of physicians in training with respect to the evaluation and treatment of obesity.
Abstract: Objective The goal of this study was to determine attitudes and practices of physicians in training with respect to the evaluation and treatment of obesity. Methods Resident-generated admission and discharge notes of all 1,765 general medicine hospital admissions during 4 nonconsecutive months were analyzed, and any references to weight, obesity, BMI, adiposity, and body fat were identified. The full general resident cohort was then surveyed for perceptions and behaviors related to obesity. Results Obesity was considered a highly important medical issue by 98.5% of residents; 90% correctly identified a class II obesity Stunkard phenotype, and 80% accurately calculated a BMI given height and weight in metric units. Residents overestimated inpatient obesity prevalence (estimate = 75%; actual = 35%) and the rate of obesity recording in the hospital admission note (estimate = 94%; actual = 49.5%). A BMI or current weight in the admission note or discharge summary was reported in none of the 1,765 patient records, and only 6% of the patients with obesity had obesity noted in either the inpatient admission or discharge assessment or plan. Conclusions Though residents recognize obesity and its clinical implications, it is underreported in the assessment of inpatients. This low level of documenting obesity and its impact on clinical care planning underscores a missed opportunity to establish appropriate referrals and initiate treatment at a clinically opportune time.
17 citations
TL;DR: The humble culprit is the portable data-crunching COW, affectionately short for “computer on wheels,” which helps streamline and improve medical care, including electronic patient charting and documentation, increasingly onerous tasks.
Abstract: * Abbreviations:
COW — : computer on wheels
How did I find myself leading family-centered rounds a while ago in the NICU, yet unable to actually see any of my team members, not to mention my patient’s parents sitting just several feet away? I looked up while listening to a summary of the infant’s overnight events, and suddenly it hit me, something was amiss. My entire team was hidden, our views obstructed, from each other and the patient’s family. No one was fully focused or making eye contact during the presentation. I could not see to whom the presenting voice belonged. One resident was fixated on the computer screen, while another was obliviously typing away, nose to keyboard. This hardly looked the picture of family-centered rounding, or the epitome of good communication, things I strived for. The humbling culprit, aside from me? COWs. No, not the grass-eating, milk-producing kind of cow, but rather the portable data-crunching COW, affectionately short for “computer on wheels.”
These mobile computing machines have now become permanent features of many hospitals and clinics, and for good reason. COWs help streamline and improve medical care, including electronic patient charting and documentation, increasingly onerous tasks. They allow physicians to, for example, quickly check on a laboratory result or write an admission note, while watching over a critical patient. COWs also help expedite clinic notes during back-to-back patient encounters. The COW certainly facilitates on-the-go charting, the new fast food of medical documentation for the multitasking physician. But, as I struggled with my …
Address for correspondence to Christy L. Cummings, MD, Division of Newborn Medicine, Boston Children’s Hospital, 300 Longwood Ave, Hunnewell 437, Boston, MA 02115. E-mail: christy.cummings{at}childrens.harvard.edu
12 citations
Posted Content•
TL;DR: A convolutional neural network is built which takes an admission note as input and predicts the medications placed on the patient at discharge time and is able to distill semantic patterns from unstructured and noisy texts, and is capable of capturing the pharmacological correlations among medications.
Abstract: Predicting discharge medications right after a patient being admitted is an important clinical decision, which provides physicians with guidance on what type of medication regimen to plan for and what possible changes on initial medication may occur during an inpatient stay. It also facilitates medication reconciliation process with easy detection of medication discrepancy at discharge time to improve patient safety. However, since the information available upon admission is limited and patients' condition may evolve during an inpatient stay, these predictions could be a difficult decision for physicians to make. In this work, we investigate how to leverage deep learning technologies to assist physicians in predicting discharge medications based on information documented in the admission note. We build a convolutional neural network which takes an admission note as input and predicts the medications placed on the patient at discharge time. Our method is able to distill semantic patterns from unstructured and noisy texts, and is capable of capturing the pharmacological correlations among medications. We evaluate our method on 25K patient visits and compare with 4 strong baselines. Our methods demonstrate a 20% increase in macro-averaged F1 score than the best baseline.
8 citations
TL;DR: Views on priorities in public psoriasis care and visions of a future care among politicians, administrators and professionals in the county of Västerbottten in northern Sweden are described and methods with fairness in economic planning and priority setting are suggested.
5 citations
Related Topics (5)
Performance Metrics
| Year | Papers |
|---|---|
| 2021 | 2 |
| 2020 | 1 |
| 2019 | 1 |
| 2018 | 2 |
| 2017 | 1 |
| 2013 | 4 |