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https://www.readbyqxmd.com/read/28650872/barriers-and-facilitators-to-implementing-a-change-initiative-in-long-term-care-using-the-interact%C3%A2-quality-improvement-program
#1
Ruth M Tappen, David G Wolf, Zahra Rahemi, Gabriella Engstrom, Carolina Rojido, Jill M Shutes, Joseph G Ouslander
Implementation of major organizational change initiatives presents a challenge for long-term care leadership. Implementation of the INTERACT® (Interventions to Reduce Acute Care Transfers) quality improvement program, designed to improve the management of acute changes in condition and reduce unnecessary emergency department visits and hospitalizations of nursing home residents, serves as an example to illustrate the facilitators and barriers to major change in long-term care. As part of a larger study of the impact of INTERACT® on rates of emergency department visits and hospitalizations, staff of 71 nursing homes were called monthly to follow-up on their progress and discuss successful facilitating strategies and any challenges and barriers they encountered during the yearlong implementation period...
June 23, 2017: Health Care Manager
https://www.readbyqxmd.com/read/28649454/methods-guiding-stakeholder-engagement-in-planning-a-pragmatic-study-on-changing-stroke-systems-of-care
#2
Sabina B Gesell, Karen Potvin Klein, Jacqueline Halladay, Janet Prvu Bettger, Janet Freburger, Doyle M Cummings, Barbara J Lutz, Sylvia Coleman, Cheryl Bushnell, Wayne Rosamond, Pamela W Duncan
BACKGROUND: The Comprehensive Post-Acute Stroke Services (COMPASS) Study is one of the first large pragmatic randomized-controlled clinical trials using comparative effectiveness research methods, funded by the Patient-Centered Outcomes Research Institute. In the COMPASS Study, we compare the effectiveness of a patient-centered, transitional care intervention versus usual care for stroke patients discharged home from acute care. Outcomes include stroke patient post-discharge functional status and caregiver strain 90 days after discharge, and hospital readmissions...
April 2017: Journal of clinical and translational science
https://www.readbyqxmd.com/read/28648218/innovative-information-technology-powered-population-health-care-management-improves-outcomes-and-reduces-hospital-readmissions-and-emergency-department-visits
#3
Sharon Anderson, Michele Campbell, Donna Mahoney, Ann Kathryn Muther, Janice Nevin, Patricia Resnik, Tabassum Salam, Terri Steinberg
BACKGROUND: Patients with chronic conditions are often the most frequent users of health care. Moreover, adapting to developments in one's illness, understanding how to self-manage a chronic illness, and sharing information between primary care and specialty providers, can be a full-time job for someone with a chronic illness. In response to these challenges, Christiana Care Health System (Wilmington, Delaware) developed Care Link, an information technology (IT)-enhanced care management support to enable populations of patients to achieve better clinical outcomes at lower cost...
July 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28647727/patients-as-partners-in-enhanced-recovery-after-surgery-a-qualitative-patient-led-study
#4
Chelsia Gillis, Marlyn Gill, Nancy Marlett, Gail MacKean, Kathy GermAnn, Loreen Gilmour, Gregg Nelson, Tracy Wasylak, Susan Nguyen, Edamil Araujo, Sandra Zelinsky, Leah Gramlich
OBJECTIVES: Explore the experience of patients undergoing colorectal surgery within an Enhanced Recovery After Surgery (ERAS) programme. Use these experiential data to inform the development of a framework to support ongoing, meaningful patient engagement in ERAS. DESIGN: Qualitative patient-led study using focus groups and narrative interviews. Data were analysed iteratively using a Participatory Grounded Theory approach. SETTING: Five tertiary care centres in Alberta, Canada, following the ERAS programme...
June 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28644300/breathlessness-in-the-primary-care-setting
#5
Noel Baxter
PURPOSE OF REVIEW: Breathlessness is a high-volume problem with 10% of adults experiencing the symptom daily placing a heavy burden on the health and wider economy. As it worsens, they enter the specialist and hospital-based symptom services where costs quickly escalate and people may find themselves in a place not of their choosing. For many, their care will be delivered by a disease or organ specialist and can find themselves passing between physicians without coordination for symptom support...
July 20, 2017: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/28638844/predictors-of-unplanned-hospitalization-in-patients-receiving-outpatient-parenteral-antimicrobial-therapy-across-a-large-integrated-healthcare-network
#6
Monica Schmidt, Bevin Hearn, Michael Gabriel, Melanie D Spencer, Lewis McCurdy
BACKGROUND: Outpatient parenteral antimicrobial therapy (OPAT) prescribing has increased along with the trend toward early discharge of hospitalized patients who have infections. There is limited literature that assesses unplanned hospitalizations during OPAT. This study aims to elucidate the predictors of unplanned hospitalization in OPAT patients after discharge from acute-care facilities within Carolinas HealthCare System (CHS). Understanding these predictors may inform future interventions to improve treatment efficacy and patient outcomes...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28637576/antimicrobial-use-and-resistance-in-australia-aura-surveillance-system-coordinating-national-data-on-antimicrobial-use-and-resistance-for-australia
#7
John D Turnidge, Kathy T Meleady
Objective The aim of the present study was to describe the process of establishment and coordination of the national Antimicrobial Use and Resistance in Australia (AURA) surveillance system.Methods Existing surveillance programs conducted by health organisations at state or multi-jurisdictional levels were reviewed, and gaps and opportunities identified for the development of a national system. In view of the time frame available as part of the Australian Government Department of Health funding agreement, the strategy used by the Australian Commission on Safety and Quality in Health Care was to commence work with existing surveillance programs, expanding and enhancing them and developing new systems where gaps were identified...
June 22, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28627006/parents-perceptions-during-the-transition-to-home-for-their-child-with-a-congenital-heart-defect-how-can-we-support-families-of-children-with-hypoplastic-left-heart-syndrome
#8
Sarita March
PURPOSE: The aim of the study was to explore the literature related to transitions in healthcare between the hospital and home that caregivers experience with a child who has a congenital heart defect (CHD), specifically related to hypoplastic left heart syndrome (HLHS). DESIGN AND METHODS: A systematic literature review was conducted searching OVID Medline, CINAHL, and PubMed to discover the caregivers' perceptions on their transitions between hospital care and home care of their child with a CHD...
June 18, 2017: Journal for Specialists in Pediatric Nursing: JSPN
https://www.readbyqxmd.com/read/28623892/improving-transitions-in-acute-stroke-patients-discharged-to-home-the-michigan-stroke-transitions-trial-mistt-protocol
#9
Mathew J Reeves, Anne K Hughes, Amanda T Woodward, Paul P Freddolino, Constantinos K Coursaris, Sarah J Swierenga, Lee H Schwamm, Michele C Fritz
BACKGROUND: For some stroke patients and caregivers, navigating the transition between hospital discharge and returning home is associated with substantial psychosocial and health-related challenges. Currently, no evidence-based standard of care exists that addresses the concerns of stroke patients and caregivers during the transition period. Objectives of the Michigan Stroke Transitions Trial (MISTT) are to test the impact of a social worker home-based case management program, as well as an online information and support resource, on patient and caregiver outcomes after returning home...
June 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28621011/yoga-for-the-management-of-pain-and-sleep-in-rheumatoid-arthritis-a-pilot-randomized-controlled-trial
#10
Lesley Ward, Simon Stebbings, Josie Athens, Daniel Cherkin, G David Baxter
OBJECTIVE: The aim of the present study was to determine the feasibility of a relaxation-based yoga intervention for rheumatoid arthritis, designed and reported in accordance with Delphi recommendations for yoga interventions for musculoskeletal conditions. METHODS: Participants were recruited from a hospital database, and randomized to either eight weekly 75-min yoga classes or a usual care control. Feasibility was determined by recruitment rates, retention, protocol adherence, participant satisfaction and adverse events...
June 16, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28614637/renal-telemedicine-through-video-as-a-service-delivered-to-patients-on-home-dialysis-a-qualitative-study-on-the-renal-care-team-members-experience
#11
Jae-Llane Ditchburn, Alison Marshall
BACKGROUND: The Lancashire Teaching Hospitals NHS Trust in the UK has been providing renal care through video-as-a-service (VAAS) to patients since 2013, with support from the North West NHS Shared Infrastructure Service, a collaborative team that supports information and communication technology use in the UK National Health Service. INTRODUCTION: Renal telemedicine offered remotely to patients on home dialysis supports renal care through the provision of a live high-quality video link directly to unsupported patients undergoing haemodialysis at home...
June 14, 2017: Journal of Renal Care
https://www.readbyqxmd.com/read/28613119/relatives-level-of-satisfaction-with-advanced-cancer-care-in-greenland-a-mixed-methods-study
#12
Mikaela Augustussen, Lise Hounsgaard, Michael Lynge Pedersen, Per Sjøgren, Helle Timm
Palliative cancer care in Greenland is provided by health professionals at local level, the national Queen Ingrid's Hospital and at Rigshospitalet in Denmark. To improve and develop care for relatives of patients with advanced cancer, we conducted a mixed method study examining relatives' level of satisfaction with care and treatment and their current main concerns. The aim was to investigate relatives' level of satisfaction with advanced cancer care and bring to light their current main concerns. The FAMCARE-20 questionnaire was translated to Greenlandic and pilot tested...
2017: International Journal of Circumpolar Health
https://www.readbyqxmd.com/read/28611875/patient-perspectives-on-accessing-acute-illness-care
#13
Mary K Finta, Amy Borkenhagen, Nicole E Werner, Joyce Duckles, Craig R Sellers, Sandhya Seshadri, Denise Lampo, Manish N Shah
INTRODUCTION: Older adults use the emergency department (ED) at high rates, including for illnesses that could be managed by their primary care providers (PCP). Policymakers have implemented barriers and incentives, often financial, to try to modify use patterns but with limited success. This study aims to understand the factors that influence older adults' decision to obtain acute illness care from the ED rather than from their PCPs. METHODS: We performed a qualitative study using a directed content analysis approach from February to October 2013...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28610431/palliative-care-experience-in-the-last-3-months-of-life-a-quantitative-comparison-of-care-provided-in-residential-hospices-hospitals-and-the-home-from-the-perspectives-of-bereaved-caregivers
#14
Daryl Bainbridge, Hsien Seow
OBJECTIVE: This study captured the end-of-life care experiences across various settings from bereaved caregivers of individuals who died in residential hospice. METHODS: A retrospective, observational design using the CaregiverVoice survey with bereaved caregivers of patients in 22 hospices in Ontario, Canada. The survey assessed various dimensions of the patient's care experiences across multiple care settings in the last 3 months of life. RESULTS: A total of 1153 caregivers responded to the survey (44% response rate)...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28606028/an-investigation-of-perspectives-of-respite-admission-among-people-living-with-amyotrophic-lateral-sclerosis-and-the-hospitals-that-support-them
#15
Michiko Nakai, Yugo Narita, Hidekazu Tomimoto
BACKGROUND: Amyotrophic lateral sclerosis is a progressive disease with rapid degeneration. Respite care is an essential service for improving the well-being of both patients with this disease and their family caregivers, but accessibility of respite services is limited. This study investigates perspectives on respite admission among people living with amyotrophic lateral sclerosis and the hospitals supporting them. METHOD: We conducted semistructured interviews among 3 patients with amyotrophic lateral sclerosis and 12 family members, exploring demographic information and their awareness and experience of respite admission...
July 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28599601/effect-of-pharmacy-supported-transition-of-care-interventions-on-30-day-readmissions-a-systematic-review-and-meta-analysis
#16
Claire R Rodrigues, Amanda R Harrington, Nicole Murdock, John T Holmes, Eliza Z Borzadek, Kristin Calabro, Jennifer Martin, Marion K Slack
OBJECTIVE: To describe pharmacy-supported transition-of-care (TOC) interventions and determine their effect on 30-day all-cause readmissions. DATA SOURCES: MEDLINE/PubMed, EMBASE, International Pharmaceutical Abstracts, ABI Inform Complete, PsychINFO, Web of Science, Academic Search Complete, CINHAL, Cochrane library, OIASTER, ProQuest Dissertations & Theses, ClinicalTrials.gov , and relevant websites were searched from January 1, 1995, to December 31, 2015. STUDY SELECTION AND DATA EXTRACTION: PICOS+E criteria were utilized...
June 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28596445/development-of-a-new-care-model-for-hospitalized-children-with-medical-complexity
#17
Christine M White, Joanna E Thomson, Angela M Statile, Katherine A Auger, Ndidi Unaka, Matthew Carroll, Karen Tucker, Derek Fletcher, David E Hall, Jeffrey M Simmons, Patrick W Brady
Children with medical complexity are a rapidly growing inpatient population with frequent, lengthy, and costly hospitalizations. During hospitalization, these patients require care coordination among multiple subspecialties and their outpatient medical homes. At a large freestanding children's hospital, a new inpatient model of care was developed in an effort to consistently provide coordinated, family-centered, and efficient care. In addition to expanding the multidisciplinary team to include a pharmacist, dietician, and social worker, the team redesign included: (1) medication reconciliation rounds, (2) care coordination rounds, and (3) multidisciplinary weekly handoff with outpatient providers...
June 8, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28592313/impact-of-community-initiated-kangaroo-mother-care-on-survival-of-low-birth-weight-infants-study-protocol-for-a-randomized-controlled-trial
#18
Sarmila Mazumder, Sunita Taneja, Suresh Kumar Dalpath, Rakesh Gupta, Brinda Dube, Bireshwar Sinha, Kiran Bhatia, Sachiyo Yoshida, Ole Frithjof Norheim, Rajiv Bahl, Halvor Sommerfelt, Nita Bhandari, Jose Martines
BACKGROUND: Around 70% neonatal deaths occur in low birth weight (LBW) babies. Globally, 15% of babies are born with LBW. Kangaroo Mother Care (KMC) appears to be an effective way to reduce mortality and morbidity among LBW babies. KMC comprises of early and continuous skin-to-skin contact between mother and baby as well as exclusive breastfeeding. Evidence derived from hospital-based studies shows that KMC results in a 40% relative reduction in mortality, a 58% relative reduction in the risk of nosocomial infections or sepsis, shorter hospital stay, and a lower risk of lower respiratory tract infections in babies with birth weight <2000 g...
June 7, 2017: Trials
https://www.readbyqxmd.com/read/28591975/an-overview-of-home-based-primary-care-learning-from-the-field
#19
Sarah Klein, Martha Hostetter, Douglas McCarthy
ISSUE: Homebound and functionally limited individuals are often unable to access office-based primary care, leading to unmet needs and increased health care spending. GOAL: Show how home-based primary care affects outcomes and costs for Medicare and Medicaid beneficiaries with complex care needs. METHODS: Qualitative synthesis of expert perspectives and the experiences of six case-study sites. FINDINGS AND CONCLUSIONS: Successful home-based primary care practices optimize care by: fielding interdisciplinary teams, incorporating behavioral care and social supports into primary care, responding rapidly to urgent and acute care needs, offering palliative care, and supporting family members and caregivers...
June 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28591172/multi-state-modelling-of-heart-failure-care-path-a-population-based-investigation-from-italy
#20
Francesca Gasperoni, Francesca Ieva, Giulia Barbati, Arjuna Scagnetto, Annamaria Iorio, Gianfranco Sinagra, Andrea Di Lenarda
BACKGROUND: How different risk profiles of heart failure (HF) patients can influence multiple readmissions and outpatient management is largely unknown. We propose the application of two multi-state models in real world setting to jointly evaluate the impact of different risk factors on multiple hospital admissions, Integrated Home Care (IHC) activations, Intermediate Care Unit (ICU) admissions and death. METHODS AND FINDINGS: The first model (model 1) concerns only hospitalizations as possible events and aims at detecting the determinants of repeated hospitalizations...
2017: PloS One
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