Browsing by Author "Feeney, Colby"

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    Impact of a hospital service for adults with chronic childhood-onset disease: A propensity weighted analysis.
    (Journal of hospital medicine, 2023-11) Feeney, Colby; Chandler, Mark; Platt, Alyssa; Sun, Shifeng; Setji, Noppon; Ming, David Y

    Background

    Young adults with chronic childhood-onset diseases (CCOD) transitioning care from pediatrics to adult care are at high risk for readmission after hospital discharge. At our institution, we have implemented an inpatient service, the Med-Peds (MP) line, to improve transitions to adult care and reduce hospital utilization by young adults with CCOD.

    Objective

    This study aimed to assess the effect of the MP line on length of stay (LOS) and 30-day readmission rates compared to other inpatient services.

    Methods

    This was an observational, retrospective cohort analysis of patients admitted to the MP line compared to other hospital service lines over a 2-year period. To avoid potential confounding by indication for admission to the MP line, propensity score weighting methods were used.

    Results

    The MP line cared for 302 patients with CCOD from June 2019 to July 2021. Compared to other service lines, there was a 33% reduction in relative risk of 30-day readmission (26.9% compared to 40.3%, risk ratio = 0.67, 95% confidence interval [CI] 0.55-0.81). LOS was 10% longer for the MP line (event time ratio (ETR): 1.10 95% CI 1.0-1.21) with median LOS 4.8 versus 4.5 days. Patients with sickle cell disease had less of a reduction in 30-day readmissions and longer LOS.

    Conclusion

    Hospitalization for young adults with CCOD on a MP service line was associated with lower 30-day readmission rates and longer LOS than hospitalization on other services. Further research is needed to assess which components of the line most contribute to decreased utilization.
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    Success of a Resident-Led Safety Council: A Model for Satisfying CLER Pathways to Excellence Patient Safety Goals
    (Journal of Graduate Medical Education, 2019-04) Cohen, Sarah P; Pelletier, Jonathan H; Ladd, Jennifer M; Feeney, Colby; Parente, Victoria; Shaikh, Sophie K
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    Utilization of Text Messages to Supplement Rounding Communication: a Randomized Feasibility Study.
    (Journal of general internal medicine, 2022-09) Wesevich, Austin; Key-Solle, Mikelle; Kandakatla, Apoorva; Feeney, Colby; Pollak, Kathryn I; LeBlanc, Thomas W

    Background

    Fragmented communication with patients and families during hospitalizations often leaves patients confused about the daily plan.

    Objective

    To pilot a supplemental text message-based platform for improving bidirectional communication about the clinical plan and patients' goals.

    Design

    Randomized controlled trial PARTICIPANTS: Thirty adult patients, thirty caregivers of pediatric patients, and the interns caring for them on inpatient general medicine and pediatric services.

    Interventions

    Patients and caregivers were texted or emailed daily to report their personal goal and assess their understanding of the team's clinical plan. Interns were texted daily to report the team's clinical plan and to assess their understanding of the patient's personal goal.

    Main measures

    Primary outcomes were feasibility, defined as survey response rates, and acceptability. Secondary outcomes were patient comprehension of the clinical plan, trainee comprehension of the patient's goal, patient-centered communication scores, and educational satisfaction scores.

    Key results

    Thirty adult patients, thirty caregivers of pediatric patients, fourteen general medicine interns, and six general pediatric interns enrolled. Intervention feasibility was met, with survey response rates of 80% for general medicine trainees, 67% for general pediatric trainees, 58% for adult patients, and 70% for caregivers. Patients and caregivers in the intervention arm had higher understanding of medication changes (76% vs 50%, p = 0.02) and new consultations (90% vs 61%, p = 0.002). Interns had higher understanding of patients' goals in the intervention arm (93% vs 40%, p < 0.001), particularly for adult patients (97% vs 17%, p < 0.001). Caregivers rated communication higher regarding information to help make decisions (p = 0.04). Interviews demonstrated high acceptability.

    Conclusions

    Our text message-based communication intervention was feasible and acceptable to all involved participants, with preliminary signals of efficacy. The intervention may contribute to improved understanding of medication changes and new consultations, as well as help in making decisions. A large, randomized efficacy trial of this intervention is warranted. Graphical abstract.