Reduing Hospital Readmissions: IDEAL Discharge Planning for Heart Failure Management

Abstract The objectives during this project were to achieve by the end of 2018 an overall reduction of 25% in HF readmissions within 30 days. By identifying root causes of readmissions and using needs assessment within the microsystem, literature highlights the elements defining interventions that can be used to improve transitions of care and reduce avoidable HF hospital readmissions. A plan was developed for integrating an evidence-based practice, IDEAL Discharge Planning, along with engaging patients and families at bedside from the first day of admission until discharge to more effectively assist staff in providing patient-centered education and self-care skills. The results were a better care transition experience and prevention of avoidable readmissions in HF patient populations. The microsystem consists of twenty-six telemetry beds and specializes in managing patients with a primary diagnosis of cardiovascular disease. Fifty patients’ charts were reviewed for 2 months prior to initiation of the project, and again 2 months later to collect data specific to HF patient 30-day readmission rates. The CNL strives to identify quality measures that need improvement, incorporate new evidence into practice, implement new guidelines for patient care, track data on the project, and is able to show improved clinical outcomes that are immensely cost effective within the microsystem. Ultimately, this project should gain support and spread to other microsystems and other patient populations within the hospital organization

Thermodynamic properties and bulk viscosity near phase transition in the Z(2) and O(4) models

We investigate the thermodynamic properties including equation of state, the trace anomaly, the sound velocity and the specific heat, as well as transport properties like bulk viscosity in the Z(2) and O(4) models in the Hartree approximation of Cornwall-Jackiw-Tomboulis (CJT) formalism. We study these properties in different cases, e.g. first order phase transition, second order phase transition, crossover and the case without phase transition, and discuss the correlation between the bulk viscosity and the thermodynamic properties of the system. We find that the bulk viscosity over entropy density ratio exhibits an upward cusp at the second order phase transition, and a sharp peak at the 1st order phase transition. However, this peak becomes smooth or disappears in the case of crossover. This indicates that at RHIC, where there is no real phase transition and the system experiences a crossover, the bulk viscosity over entropy density might be small, and it will not affect too much on hadronization. We also suggest that the bulk viscosity over entropy density ratio is a better quantity than the shear viscosity over entropy density ratio to locate the critical endpoint.Comment: 19 pages, 30 figures, 1 tabl

The global hydrology education resource

This article is a selective overview of a range of contemporary teaching resources currently available globally for university hydrology educators, with an emphasis on web-based resources. Major governmental and scientific organizations relevant to the promotion of hydrology teaching are briefly introduced. Selected online teaching materials are then overviewed, i.e. PowerPoint presentations, course materials, and multimedia. A range of websites offering free basic hydrology modelling software are mentioned, together with some data file sources which could be used for teaching. Websites offering a considerable range of general hydrology links are also noted, as are websites providing international and national data sets which might be incorporated into teaching exercises. Finally, some discussion is given on reference material for different modes of hydrology teaching, including laboratory and field exercises

Convergence of the Ginzburg-Landau approximation for the Ericksen-Leslie system

We establish the local well-posedness of the general Ericksen-Leslie system in liquid crystals with the initial velocity and director field in $H^1 \times H_b^2$. In particular, we prove that the solutions of the Ginzburg-Landau approximation system converge smoothly to the solution of the Ericksen-Leslie system for any $t \in (0,T^\ast)$ with a maximal existence time $T^\ast$ of the Ericksen- Leslie system