966 results match your criteria Palliative Care in the Acute Care Setting


A Comparison of Caregiver Burden of Patients with Advanced Cancer in Different Palliative Cancer Care Settings.

J Palliat Med 2021 Apr 28. Epub 2021 Apr 28.

Department of Palliative, Rehabilitation, and Integrative Medicine and The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Informal caregivers may experience a significant burden while caring for cancer patients. Little is known about how caregiver burden varies across different palliative cancer care settings and the factors influencing it. We compared the severity of caregiver subjective stress burden (emotional impact) among caregivers of patients seen in the outpatient supportive care center (SCC) with those being cared for in the acute palliative care unit (PCU). Read More

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Successful Use of Multidisciplinary Palliative Care in the Outpatient Treatment of Disseminated Histoplasmosis in an HIV Positive Child.

Children (Basel) 2021 Apr 2;8(4). Epub 2021 Apr 2.

Baylor College of Medicine International Pediatric AIDS Initiative at Texas Children's Hospital, Houston, TX 77030, USA.

Histoplasmosis is an uncommon opportunistic infection in human immunodeficiency virus (HIV) positive children. The most common form is primary disseminated histoplasmosis, characterized by persistent fever and failure to thrive. A 10-year-old HIV positive girl presented to the Baylor College of Medicine Children's Foundation-Tanzania Mbeya Center of Excellence (COE) with ulcerated skin lesions and a violaceous facial rash. Read More

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The Impact of COVID-19 on Palliative Care for People with Parkinson's and Response to Future Pandemics.

Expert Rev Neurother 2021 Apr 27. Epub 2021 Apr 27.

Parkinson and Movement Disorders Program and the Complex Neurologic Symptoms Clinic (Neuropalliative Care), University of Alberta, Alberta, Canada.

Introduction: Although in some countries, palliative care (PC) still remains poorly implemented, its importance throughout the course of Parkinson's disease (PD) is increasingly being acknowledged. With an emergence of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pandemic, growing emphasis has been placed on the palliative needs of people with Parkinson's (PwP), particularly elderly, frail, and with comorbidities.

Areas Covered: The ongoing COVID-19 pandemic poses an enormous challenge on aspects of daily living in PwP and might interact negatively with a range of motor and non-motor symptoms (NMS), both directly and indirectly - as a consequence of pandemic-related social and health care restrictions. Read More

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Impact of physician-based palliative care delivery models on health care utilization outcomes: A population-based retrospective cohort study.

Palliat Med 2021 Apr 22:2692163211009440. Epub 2021 Apr 22.

Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, ON, Canada.

Background: Increasing involvement of palliative care generalists may improve access to palliative care. It is unknown, however, if their involvement with and without palliative care specialists are associated with different outcomes.

Aim: To describe physician-based models of palliative care and their association with healthcare utilization outcomes including: emergency department visits, acute hospitalizations and intensive care unit (ICU) admissions in last 30 days of life; and, place of death. Read More

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A Core Outcome Set for Research Evaluating Interventions to Prevent and/or Treat Delirium in Critically Ill Adults: An International Consensus Study (Del-COrS).

Crit Care Med 2021 Apr 19. Epub 2021 Apr 19.

Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom. Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada. Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada. Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia. College of Pharmacy, Purdue University, West Lafayette, IN. School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland Inaugural Research Chair in Geriatric Emergency Medicine, Schwartz/Reisman Emergency Medicine Institute, Sinai Health System, Toronto, ON, Canada. St Michael's Hospital and Li Ka Shing Research Institute, Toronto, ON, Canada. School of Pharmacy, Northeastern University, Boston, MA. Wellcome-Wolfson Institute of Experimental Medicine, Queen's University Belfast, Belfast, Northern Ireland. School of Medicine, Johns Hopkins University, Baltimore, MD. Hull York Medical School, University of York, York, United Kingdom. Watford General Hospital, Watford, United Kingdom.

Objectives: Delirium in critically ill adults is highly prevalent and has multiple negative consequences. To-date, trials of interventions to prevent or treat delirium report heterogenous outcomes. To develop international consensus among key stakeholders for a core outcome set for future trials of interventions to prevent and/or treat delirium in critically ill adults. Read More

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Interfacility transfer communication of multidrug-resistant organism colonization or infection status: Practices and barriers in the acute-care setting.

Infect Control Hosp Epidemiol 2021 Apr 16:1-6. Epub 2021 Apr 16.

Department of Pharmacy Practice, Oregon State University College of Pharmacy, Portland, Oregon.

Objective: To describe interfacility transfer communication (IFTC) methods for notification of multidrug-resistant organism (MDRO) status in a diverse sample of acute-care hospitals.

Design: Cross-sectional survey.

Participants: Hospitals within the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN). Read More

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Variation in Initial U.S. Hospital Responses to the Coronavirus Disease 2019 Pandemic.

Crit Care Med 2021 Apr 8. Epub 2021 Apr 8.

Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY. Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY. Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Vanderbilt University, Nashville, TN. Health Services Research & Development, VA Portland Health Care System, Portland, OR. Division of Pulmonary and Critical Care, Department of Medicine, Oregon Health & Science University, Portland, OR. Palliative and Advanced Illness Research (PAIR) Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Department of Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, OH. Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI. Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI. Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, MI. Department of Geography, University of Washington, Seattle, WA. Department of Emergency Medicine, University of Washington, Seattle, WA. Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Division of Pulmonary and Critical Care Medicine, Department of Medicine, David Geffen School of Medicine at UCLA, Ronald Reagan-UCLA Medical Center, Los Angeles, CA.

Objectives: The coronavirus disease 2019 pandemic has strained many healthcare systems. In response, U.S. Read More

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Hospital at Home services: An inventory of fee-for-service payments to inform Medicare reimbursement.

J Am Geriatr Soc 2021 Apr 2. Epub 2021 Apr 2.

Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Background: Hospital at Home (HaH) is a growing model of care with proven patient benefits. However, for the types of services required to provide an episode of HaH, full Medicare reimbursement is traditionally paid only if care is provided in inpatient facilities.

Design: This project identifies HaH services that could be reimbursable under Medicare to inform episodic care within fee-for-service (FFS) Medicare. Read More

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Adapting a Traumatic Brain Injury Goals-of-Care Decision Aid for Critically Ill Patients to Intracerebral Hemorrhage and Hemispheric Acute Ischemic Stroke.

Crit Care Explor 2021 Mar 9;3(3):e0357. Epub 2021 Mar 9.

Department of Neurology, University of Massachusetts Medical School, Worcester, MA.

Objectives: Families in the neurologic ICU urgently request goals-of-care decision support and shared decision-making tools. We recently developed a goals-of-care decision aid for surrogates of critically ill traumatic brain injury patients using a systematic development process adherent to the International Patient Decision Aid Standards. To widen its applicability, we adapted this decision aid to critically ill patients with intracerebral hemorrhage and large hemispheric acute ischemic stroke. Read More

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Hospital-based acute care in the last 30 days of life among patients with chronic disease that received early, late or no specialist palliative care: a retrospective cohort study of eight chronic disease groups.

BMJ Open 2021 Mar 24;11(3):e044196. Epub 2021 Mar 24.

Division of Palliative Medicine, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

Objective: For eight chronic diseases, evaluate the association of specialist palliative care (PC) exposure and timing with hospital-based acute care in the last 30 days of life.

Design: Retrospective cohort study using administrative data.

Setting: Alberta, Canada between 2007 and 2016. Read More

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Management and outcomes of a COVID-19 outbreak in a nursing home with predominantly Black residents.

J Am Geriatr Soc 2021 Mar 19. Epub 2021 Mar 19.

Department of Medicine, Section of Geriatrics and Palliative Medicine, University of Chicago, Chicago, Illinois, USA.

Background/objectives: Few studies present clinical management approaches and outcomes of coronavirus disease 2019 (COVID-19) outbreaks in skilled nursing facilities (SNFs). We describe outcomes of a clinical management pathway for a large COVID-19 outbreak in an urban SNF with predominantly racial minority (>90% black), medically complex, older residents.

Design: Single-center, retrospective, and observational cohort study (March 1, 2020-May 31, 2020). Read More

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Adapting to a New Normal After Severe Acute Brain Injury: An Observational Cohort Using a Sequential Explanatory Design.

Crit Care Med 2021 Mar 17. Epub 2021 Mar 17.

Department of Neurology, Harborview Medical Center, University of Washington, Seattle, WA. Palliative and Supportive Care Service, Department of Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA. Cambia Palliative Care Center of Excellence, University of Washington, Seattle, WA. Institute of Humanities in Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Objectives: Treatment decisions following severe acute brain injury need to consider patients' goals-of-care and long-term outcomes. Using family members as respondents, we aimed to assess patients' goals-of-care in the ICU and explore the impact of adaptation on survivors who did not reach the level of recovery initially considered acceptable.

Design: Prospective, observational, mixed-methods cohort study. Read More

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Clinical impact of a sub-epidermal moisture scanner: what is the real-world use?

J Wound Care 2021 Mar;30(3):198-208

St. Helens Medical Centre, Isle of Wight, UK.

Objective: The presence of sub-epidermal moisture (SEM) over a bony prominence is indicative of incipient pressure ulcer (pressure injury/decubitus/bedsore) (PU). Early identification of patients at increased risk of PU can prompt interventions that reduce the incidence and severity of hospital (or community)-acquired PUs (HAPUs). This study evaluated the clinical utility of a SEM Scanner device in HAPU management. Read More

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COVID-19 in an Acute Care Setting: Perspectives from an Oncology and a Palliative Medicine Social Worker.

J Soc Work End Life Palliat Care 2021 Mar 15:1-4. Epub 2021 Mar 15.

Department of Palliative and Supportive Care, Cleveland Clinic's Taussig Cancer Institute, Cleveland, Ohio, USA.

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Parent Perspectives after the PRISM-P Randomized Trial: A Mixed-Methods Analysis.

J Palliat Med 2021 Mar 15. Epub 2021 Mar 15.

Palliative Care and Resilience Research Laboratory, Center for Clinical and Translational Research, Epidemiology, and Analytics in Research Program, Seattle Children's Research Institute, Seattle, Washington, USA.

Parents experience high distress following their child's diagnosis of cancer. We previously tested two delivery models (group and one-on-one) of the "Promoting Resilience in Stress Management for Parents" (PRISM-P) intervention in a randomized trial: one-on-one delivery improved resilience and benefit finding at three months when compared to usual care (UC). The objective of this analysis was to evaluate quantitative and qualitative outcomes at six months. Read More

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Conventional supportive cancer care services in Australia: A national service mapping study (The CIA study).

Asia Pac J Clin Oncol 2021 Mar 13. Epub 2021 Mar 13.

Physiotherapy Department and Division of Cancer Services, Princess Alexandra Hospital, Metro South Health, Brisbane, Queensland, Australia.

Aim: Cancer and its treatment produce significant acute and long-term adverse effects in cancer survivors, resulting in a range of supportive cancer care needs across the disease trajectory. To enhance supportive cancer care in Australia, this study sought to understand and describe conventional services offered nationwide, specific to their structure (ownership, setting, duration), process (participants, delivery mode, referral pathways), and outcomes (evaluation).

Methods: A survey canvassing 13 conventional supportive cancer care interventions was electronically distributed to 265 cancer organizations in all Australian states and territories over 2019 and 2020. Read More

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High-flow therapy: physiological effects and clinical applications.

Breathe (Sheff) 2020 Dec;16(4):200224

Lane Fox Clinical Respiratory Physiology Research Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK.

Humidified high-flow therapy (HFT) is a noninvasive respiratory therapy, typically delivered through a nasal cannula interface, which delivers a stable fraction of inspired oxygen ( ) at flow rates of up to 60 L·min. It is well-tolerated, simple to set up and ideally applied at 37°C to permit optimal humidification of inspired gas. Flow rate and should be selected based on patients' inspiratory effort and severity of hypoxaemia. Read More

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December 2020

Convergent Validity of In-Person Assessment of Inpatients With Traumatic Brain Injury Using the Brief Test of Adult Cognition by Telephone (BTACT).

J Head Trauma Rehabil 2021 Feb 22. Epub 2021 Feb 22.

Department of Psychology (Ms DiBlasio and Dr Cook), Department of Physical Medicine and Rehabilitation (Dr Novack), and Division of Gerontology, Geriatrics, and Palliative Care (Dr Kennedy), University of Alabama at Birmingham, Birmingham, Alabama; Departments of Rehabilitation and Human Performance and Neurology, Icahn School of Medicine at Mount Sinai, New York City, New York (Dr Dams-O'Connor).

Objective: To examine convergent validity of the Brief Test of Adult Cognition by Telephone (BTACT) by determining correlation with established neuropsychological tests, administered an average of 4.4 days apart, in an inpatient traumatic brain injury (TBI) population.

Setting: Acute inpatient rehabilitation hospital. Read More

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February 2021

First steps to integrate general palliative care into a cardiac hospital setting - using dialogue-based workshops.

Scand J Caring Sci 2021 Mar 3. Epub 2021 Mar 3.

Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.

Background: Heart failure is a chronic, life-threatening illness with multiple acute events. Palliative care alongside standard treatment is recommended for these patients. There is a lack of knowledge and research literature on how to integrate palliative care interventions for heart failure patients in a general hospital setting. Read More

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Implementation and evaluation of a palliative and end-of-life care peer-learning initiative.

Authors:
Michelle Buono

Br J Nurs 2021 Feb;30(4):244-249

Nurse Prescriber and Macmillan End of Life Education Nurse/Clinical Nurse Specialist, Palliative Care Team, West Suffolk NHS Foundation Trust, Bury St Edmunds.

Background: Palliative and end-of-life care skills for nurses in acute care are dependent on the level of training received. Hospices are seen as fountains of knowledge in end-of-life and complex care issues.

Aim: This study evaluated peer learning between registered nurses (RNs) at West Suffolk Foundation Trust and St Nicholas Hospice Care. Read More

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February 2021

Long-term outcomes in children with absent pulmonary valve syndrome: it is not just fixing the heart.

Arch Dis Child 2021 Feb 25. Epub 2021 Feb 25.

Department of Cardiology and Cardiovascular Surgery, Birmingham Women's and Children's Hospitals NHS Foundation Trust, Birmingham, UK

Objective: Absent pulmonary valve syndrome (APV) is a rare condition usually associated with tetralogy of Fallot (TOF). Some infants develop respiratory failure from bronchial compression and the long-term neurodevelopmental outcome is unknown. We aimed to investigate the outcomes of APV and the need for long-term ventilation (LTV). Read More

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February 2021

Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology.

Eur J Prev Cardiol 2020 Apr 7. Epub 2020 Apr 7.

REHPA-Danish Knowledge Centre for Rehabilitation and Palliative Care, University of Southern Denmark, Odense University Hospital, Denmark.

Secondary prevention through comprehensive cardiac rehabilitation has been recognized as the most cost-effective intervention to ensure favourable outcomes across a wide spectrum of cardiovascular disease, reducing cardiovascular mortality, morbidity and disability, and to increase quality of life. The delivery of a comprehensive and 'modern' cardiac rehabilitation programme is mandatory both in the residential and the out-patient setting to ensure expected outcomes. The present position paper aims to update the practical recommendations on the core components and goals of cardiac rehabilitation intervention in different cardiovascular conditions, in order to assist the whole cardiac rehabilitation staff in the design and development of the programmes, and to support healthcare providers, insurers, policy makers and patients in the recognition of the positive nature of cardiac rehabilitation. Read More

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Palliative sedation outside a palliative care unit.

BMJ Support Palliat Care 2021 Feb 17. Epub 2021 Feb 17.

Anesthesia, Private Hospital La Maddalena, Palermo, Sicilia, Italy.

Purpose: The need of acute transition from an intensive care setting to an end-of-life setting requires collaboration and experience. Variable information exists on palliative sedation in traditional palliative care settings, including home care, hospices or palliative care units.

Materials: Four cases which required a rapid decision-making to alleviate suffering in patients close to death are described. Read More

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February 2021

Improving racial disparities in unmet palliative care needs among intensive care unit family members with a needs-targeted app intervention: The ICUconnect randomized clinical trial.

Contemp Clin Trials 2021 04 13;103:106319. Epub 2021 Feb 13.

School of Nursing, Duke University, Durham, NC, United States of America. Electronic address:

Introduction: The technologies used to treat the millions who receive care in intensive care unit (ICUs) each year have steadily advanced. However, the quality of ICU-based communication has remained suboptimal, particularly concerning for Black patients and their family members. Therefore we developed a mobile app intervention for ICU clinicians and family members called ICUconnect that assists with delivering need-based care. Read More

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Safety and Efficacy of Human Chorionic Gonadotropin Hormone-Derivative EA-230 in Cardiac Surgery Patients: A Randomized Double-Blind Placebo-Controlled Study.

Crit Care Med 2021 May;49(5):790-803

Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.

Objectives: To determine the safety and efficacy of human chorionic gonadotropin hormone-derivative EA-230 in cardiac surgery patients. Cardiac surgery induces systemic inflammation and may impair renal function, affecting patient outcome. EA-230 exerted immunomodulatory and renoprotective effects in preclinical models and was safe and showed efficacy in phase I and II human studies. Read More

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A consensus process to agree best practice for managing physical wellbeing in people with a prolonged disorder of consciousness.

Eur J Phys Rehabil Med 2021 Feb 10. Epub 2021 Feb 10.

School of Allied Health Professions, Keele University, Keele, UK.

Background: Current practice for physical wellbeing of people in a Prolonged Disorder of Consciousness (PDOC) is variable. A scoping literature review identified no agreed standard of care for physical management of those in a PDOC. This study addressed this deficit using a consensus process applied using nominal group technique. Read More

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February 2021

Challenges in Measuring Applied Cognition: Measurement Properties and Equivalence of the Functional Assessment in Acute Care Multidimensional Computerized Adaptive Test (FAMCAT) Applied Cognition Item Bank.

Arch Phys Med Rehabil 2021 Feb 5. Epub 2021 Feb 5.

Division of Geriatrics and Palliative Medicine, Weill Cornell Medical Center, New York, NY; Research Division, Hebrew Home at Riverdale, RiverSpring Health, Bronx, NY.

Objective: To present challenges in assessment of applied cognition and the results of differential item functioning (DIF) analyses used to inform the development of a computerized adaptive test (CAT).

Design: Measurement evaluation cohort study. DIF analyses of 107 items were conducted across educational, age, and sex groups. Read More

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February 2021

Outcomes of Patients With Coronavirus Disease 2019 Receiving Organ Support Therapies: The International Viral Infection and Respiratory Illness Universal Study Registry.

Crit Care Med 2021 03;49(3):437-448

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN.

Objectives: To describe the outcomes of hospitalized patients in a multicenter, international coronavirus disease 2019 registry.

Design: Cross-sectional observational study including coronavirus disease 2019 patients hospitalized with laboratory-confirmed severe acute respiratory syndrome coronavirus-2 infection between February 15, 2020, and November 30, 2020, according to age and type of organ support therapies.

Setting: About 168 hospitals in 16 countries within the Society of Critical Care Medicine's Discovery Viral Infection and Respiratory Illness University Study coronavirus disease 2019 registry. Read More

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Transitional care from skilled nursing facilities to home: study protocol for a stepped wedge cluster randomized trial.

Trials 2021 Feb 5;22(1):120. Epub 2021 Feb 5.

Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA.

Background: Skilled nursing facility (SNF) patients are medically complex with multiple, advanced chronic conditions. They are dependent on caregivers and have experienced recent acute illnesses. Among SNF patients, the rate of mortality or acute care use is over 50% within 90 days of discharge, yet these patients and their caregivers often do not receive the quality of transitional care that prepares them to manage serious illnesses at home. Read More

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February 2021