Patient Inclusion criteria
Item
patient inclusion criteria will be:
boolean
C0030705 (UMLS CUI [1,1])
C1512693 (UMLS CUI [1,2])
Age
Item
18 years of age or greater
boolean
C0001779 (UMLS CUI [1])
Admission Internal medicine clinic | Admission Cardiology Hospital Services
Item
admission to the internal medical or cardiology services at lac/usc medical center
boolean
C0030673 (UMLS CUI [1,1])
C3838887 (UMLS CUI [1,2])
C0030673 (UMLS CUI [2,1])
C0085107 (UMLS CUI [2,2])
Discharge to home Directly
Item
discharge directly from the medical service to home
boolean
C0184713 (UMLS CUI [1,1])
C1947931 (UMLS CUI [1,2])
Evaluation Congestive heart failure | Evaluation Coronary Artery Disease | Congestive heart failure Treated | Coronary Artery Disease Treated
Item
during admission, being evaluated or treated for congestive heart failure or coronary artery disease.
boolean
C1261322 (UMLS CUI [1,1])
C0018802 (UMLS CUI [1,2])
C1261322 (UMLS CUI [2,1])
C1956346 (UMLS CUI [2,2])
C0018802 (UMLS CUI [3,1])
C1522326 (UMLS CUI [3,2])
C1956346 (UMLS CUI [4,1])
C1522326 (UMLS CUI [4,2])
Patient Exclusion Criteria
Item
patient exclusion criteria :
boolean
C0030705 (UMLS CUI [1,1])
C0680251 (UMLS CUI [1,2])
Impaired cognition Moderate | Impaired cognition Severe
Item
moderate or severe cognitive dysfunction
boolean
C0338656 (UMLS CUI [1,1])
C0205081 (UMLS CUI [1,2])
C0338656 (UMLS CUI [2,1])
C0205082 (UMLS CUI [2,2])
Mental disability Severe | Mental disorder Associated with Psychotic symptom
Item
severe psychiatric disability such that the patient has, or there is an application for, a conservator, or any psychiatric illness with current psychotic features
boolean
C1306341 (UMLS CUI [1,1])
C0205082 (UMLS CUI [1,2])
C0004936 (UMLS CUI [2,1])
C0332281 (UMLS CUI [2,2])
C0871189 (UMLS CUI [2,3])
Lacking Able to speak English Language | Lacking Able to speak Spanish Language
Item
not having speaking proficiency in either english or spanish language.
boolean
C0332268 (UMLS CUI [1,1])
C0564215 (UMLS CUI [1,2])
C0376245 (UMLS CUI [1,3])
C0332268 (UMLS CUI [2,1])
C0564215 (UMLS CUI [2,2])
C0037750 (UMLS CUI [2,3])
Study Subject Participation Status | Previous hospitalization
Item
if the patient was previously enrolled in the study on a prior hospitalization, he or she will also be excluded.
boolean
C2348568 (UMLS CUI [1])
C2114455 (UMLS CUI [2])
Nurse Inclusion criteria
Item
nurse inclusion criteria:
boolean
C0028661 (UMLS CUI [1,1])
C1512693 (UMLS CUI [1,2])
Patient education Hospital discharge
Item
performing the patient education at hospital discharge for a patient enrolled in the study
boolean
C0030688 (UMLS CUI [1,1])
C0586003 (UMLS CUI [1,2])