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Access to heart failure care post emergency department visit: do we meet established benchmarks and does it matter?

https://arctichealth.org/en/permalink/ahliterature114344
Source
Am Heart J. 2013 May;165(5):725-32
Publication Type
Article
Date
May-2013
Author
Debbie Ehrmann Feldman
Thao Huynh
Julie Des Lauriers
Nadia Giannetti
Marc Frenette
François Grondin
Caroline Michel
Richard Sheppard
Martine Montigny
Serge Lepage
Viviane Nguyen
Hassan Behlouli
Louise Pilote
Author Affiliation
Université de Montréal, Montreal, Quebec, Canada. debbie.feldman@umontreal.ca
Source
Am Heart J. 2013 May;165(5):725-32
Date
May-2013
Language
English
Publication Type
Article
Keywords
Aged
Benchmarking
Continuity of Patient Care - standards
Emergencies
Emergency Service, Hospital - organization & administration
Female
Heart Failure - therapy
Humans
Male
Office Visits - utilization
Quebec
Abstract
The Canadian Cardiology Society recommends that patients should be seen within 2 weeks after an emergency department (ED) visit for heart failure (HF). We sought to investigate whether patients who had an ED visit for HF subsequently consult a physician within the current established benchmark, to explore factors related to physician consultation, and to examine whether delay in consultation is associated with adverse events (AEs) (death, hospitalization, or repeat ED visit).
Patients were recruited by nurses at 8 hospital EDs in Québec, Canada, and interviewed by telephone within 6 weeks of discharge and subsequently at 3 and 6 months. Clinical variables were extracted from medical charts by nurses. We used Cox regression in the analysis.
We enrolled 410 patients (mean age 74.9 ± 11.1 years, 53% males) with a confirmed primary diagnosis of HF. Only 30% consulted with a physician within 2 weeks post-ED visit. By 4 weeks, 51% consulted a physician. Over the 6-month follow-up, 26% returned to the ED, 25% were hospitalized, and 9% died. Patients who were followed up within 4 weeks were more likely to be older and have higher education and a worse quality of life. Patients who consulted a physician within 4 weeks of ED discharge had a lower risk of AEs (hazard ratio 0.59, 95% CI 0.35-0.99).
Prompt follow-up post-ED visit for HF is associated with lower risk for major AEs. Therefore, adherence to current HF guideline benchmarks for timely follow-up post-ED visit is crucial.
PubMed ID
23622909 View in PubMed
Less detail

Adverse events following an emergency department visit.

https://arctichealth.org/en/permalink/ahliterature165144
Source
Qual Saf Health Care. 2007 Feb;16(1):17-22
Publication Type
Article
Date
Feb-2007
Author
Alan J Forster
Nicholas G W Rose
Carl van Walraven
Ian Stiell
Author Affiliation
Ottawa Health Research Institute--Clinical Epidemiology Program, Ottawa, Ontario, Canada. aforster@ohri.ca
Source
Qual Saf Health Care. 2007 Feb;16(1):17-22
Date
Feb-2007
Language
English
Publication Type
Article
Keywords
Academic Medical Centers
Adult
Age Factors
Aged
Confidence Intervals
Continuity of Patient Care - standards - trends
Disease Progression
Emergency Service, Hospital - standards
Female
Follow-Up Studies
Humans
Male
Medical Errors
Middle Aged
Ontario
Patient Discharge - trends
Probability
Risk assessment
Safety Management
Sex Factors
Triage
Abstract
Many studies demonstrate a high rate of treatment-related adverse outcomes or adverse events. No studies have prospectively evaluated adverse events in patients discharged home from the emergency department (ED).
To describe the types of adverse events in patients discharged home from an ED.
PATIENTS who were sent home directly from the ED of an urban, academic teaching hospital in Ottawa, Canada.
Patient records were reviewed to identify demographic and medical history information. Two weeks following the ED visit, patients completed a standard telephone interview to record post ED visit outcomes. Two physicians reviewed outcomes to identify all adverse events and their cause.
Follow-up was complete for 399 of 408 enrolled patients. The median age was 49 years (interquartile range 36-68) and 50% were male. The most common diagnosis was "chest pain", occurring in 74 patients (18%), followed by "bone and joint disorders" in 55 patients (14%). 24 patients experienced an adverse event (incidence 6% (95% CI 4% to 9%)), of which 17 were preventable (incidence 4% (95% CI 3% to 7%)). Five of the unpreventable adverse events were medication side effects and two were minor, procedure-related complications. Of all 24 adverse events, 15 (63%; 95% CI 43 to 79%) led to an additional ED visit or a hospitalisation. Preventable adverse events occurred in 5 of 78 chest pain patients (incidence 6% (95% CI 3% to 14%)).
Most adverse events occurring following an ED visit are preventable and often relate to diagnostic or management errors.
Notes
Cites: Ann Emerg Med. 1999 Aug;34(2):155-910424915
Cites: Ann Intern Med. 1999 Dec 21;131(12):909-1810610641
Cites: Med Care. 2000 Mar;38(3):261-7110718351
Cites: Acad Emerg Med. 2000 Nov;7(11):1173-411073459
Cites: Acad Emerg Med. 2000 Nov;7(11):1239-4311073472
Cites: BMJ. 2001 Mar 3;322(7285):517-911230064
Cites: MedGenMed. 2001 Mar 5;3(2):211549951
Cites: Acad Emerg Med. 2002 Nov;9(11):1184-20412414468
Cites: Ann Intern Med. 2003 Feb 4;138(3):161-712558354
Cites: Ann Emerg Med. 2003 Sep;42(3):324-3312944883
Cites: CMAJ. 2003 Nov 11;169(10):1023-814609971
Cites: CMAJ. 2004 Feb 3;170(3):345-914757670
Cites: N Engl J Med. 1991 Feb 7;324(6):370-61987460
Cites: N Engl J Med. 1991 Feb 7;324(6):377-841824793
Cites: Ann Emerg Med. 1991 Sep;20(9):980-61877784
Cites: Ann Emerg Med. 1993 Mar;22(3):553-98442544
Cites: CMAJ. 1995 May 1;152(9):1437-427728692
Cites: Med J Aust. 1995 Nov 6;163(9):458-717476634
Cites: Ann Intern Med. 1997 Dec 1;127(11):996-10059412306
Cites: Stat Med. 1998 Apr 30;17(8):857-729595616
Cites: N Engl J Med. 1998 Dec 24;339(26):1882-89862943
PubMed ID
17301197 View in PubMed
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An evaluation of data quality in Canada's Continuing Care Reporting System (CCRS): secondary analyses of Ontario data submitted between 1996 and 2011.

https://arctichealth.org/en/permalink/ahliterature116025
Source
BMC Med Inform Decis Mak. 2013;13:27
Publication Type
Article
Date
2013
Author
John P Hirdes
Jeff W Poss
Hilary Caldarelli
Brant E Fries
John N Morris
Gary F Teare
Kristen Reidel
Norma Jutan
Author Affiliation
School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, N2L 3G1, Waterloo, ON, Canada. hirdes@uwaterloo.ca
Source
BMC Med Inform Decis Mak. 2013;13:27
Date
2013
Language
English
Publication Type
Article
Keywords
Aged
Canada
Continuity of Patient Care - standards
Databases, Factual
Diagnosis-Related Groups
Humans
Nursing Homes - standards
Ontario
Psychometrics
Selection Bias
Skilled Nursing Facilities - standards
Abstract
Evidence informed decision making in health policy development and clinical practice depends on the availability of valid and reliable data. The introduction of interRAI assessment systems in many countries has provided valuable new information that can be used to support case mix based payment systems, quality monitoring, outcome measurement and care planning. The Continuing Care Reporting System (CCRS) managed by the Canadian Institute for Health Information has served as a data repository supporting national implementation of the Resident Assessment Instrument (RAI 2.0) in Canada for more than 15 years. The present paper aims to evaluate data quality for the CCRS using an approach that may be generalizable to comparable data holdings internationally.
Data from the RAI 2.0 implementation in Complex Continuing Care (CCC) hospitals/units and Long Term Care (LTC) homes in Ontario were analyzed using various statistical techniques that provide evidence for trends in validity, reliability, and population attributes. Time series comparisons included evaluations of scale reliability, patterns of associations between items and scales that provide evidence about convergent validity, and measures of changes in population characteristics over time.
Data quality with respect to reliability, validity, completeness and freedom from logical coding errors was consistently high for the CCRS in both CCC and LTC settings. The addition of logic checks further improved data quality in both settings. The only notable change of concern was a substantial inflation in the percentage of long term care home residents qualifying for the Special Rehabilitation level of the Resource Utilization Groups (RUG-III) case mix system after the adoption of that system as part of the payment system for LTC.
The CCRS provides a robust, high quality data source that may be used to inform policy, clinical practice and service delivery in Ontario. Only one area of concern was noted, and the statistical techniques employed here may be readily used to target organizations with data quality problems in that (or any other) area. There was also evidence that data quality was good in both CCC and LTC settings from the outset of implementation, meaning data may be used from the entire time series. The methods employed here may continue to be used to monitor data quality in this province over time and they provide a benchmark for comparisons with other jurisdictions implementing the RAI 2.0 in similar populations.
Notes
Cites: Can J Aging. 2011 Sep;30(3):371-9021851753
Cites: BMC Health Serv Res. 2011;11:8621507213
Cites: Med Care. 2012 Jul;50 Suppl:S21-922692254
Cites: BMC Health Serv Res. 2012;12:11622583552
Cites: BMC Health Serv Res. 2013;13:1523305286
Cites: J Gerontol A Biol Sci Med Sci. 1999 Nov;54(11):M546-5310619316
Cites: Age Ageing. 2000 Mar;29(2):165-7210791452
Cites: Gerontologist. 2001 Jun;41(3):401-511405438
Cites: Pain Res Manag. 2001 Fall;6(3):119-2511854774
Cites: J Aging Soc Policy. 2001;13(2-3):69-8112216363
Cites: J Behav Health Serv Res. 2002 Nov;29(4):419-3212404936
Cites: Age Ageing. 2003 Jul;32(4):435-812851189
Cites: Med Care. 2004 Apr;42(4 Suppl):III50-915026672
Cites: BMC Health Serv Res. 2003 Nov 4;3(1):2014596684
Cites: Gerontologist. 1990 Jun;30(3):293-3072354790
Cites: Gerontologist. 1992 Apr;32(2):148-91577305
Cites: Gerontologist. 1992 Aug;32(4):563-41427264
Cites: J Gerontol. 1994 Jul;49(4):M174-828014392
Cites: Med Care. 1994 Jul;32(7):668-858028403
Cites: Gerontologist. 1995 Apr;35(2):172-87750773
Cites: Health Care Financ Rev. 1995 Summer;16(4):107-2710151883
Cites: J Am Geriatr Soc. 1995 Dec;43(12):1363-97490387
Cites: Healthc Manage Forum. 1996 Spring;9(1):40-610157047
Cites: J Am Geriatr Soc. 1997 Aug;45(8):1011-69256856
Cites: J Am Geriatr Soc. 1997 Aug;45(8):1017-249256857
Cites: Alzheimer Dis Assoc Disord. 1997;11 Suppl 6:162-79437461
Cites: Age Ageing. 1997 Sep;26 Suppl 2:27-309464551
Cites: Med Care. 1998 Feb;36(2):167-799475471
Cites: Scand J Public Health. 1999 Sep;27(3):228-3410482083
Cites: Am J Med Qual. 2004 Nov-Dec;19(6):242-715620075
Cites: BMC Geriatr. 2005;5:115627403
Cites: Milbank Q. 2005;83(3):333-6416201996
Cites: Nurs Res. 2006 Mar-Apr;55(2 Suppl):S75-8116601638
Cites: Age Ageing. 2006 Jul;35(4):329-3116788076
Cites: J Am Geriatr Soc. 2007 Jul;55(7):1139-4017608893
Cites: Inform Prim Care. 2007;15(2):121-717877874
Cites: Age Ageing. 2008 Jan;37(1):51-618033777
Cites: Healthc Manage Forum. 2008 Spring;21(1):33-918814426
Cites: J Am Geriatr Soc. 2008 Dec;56(12):2298-30319093929
Cites: BMC Health Serv Res. 2008;8:27719115991
Cites: BMC Health Serv Res. 2009;9:7119402891
Cites: BMC Health Serv Res. 2010;10:9620398304
Cites: Community Ment Health J. 2010 Dec;46(6):621-720449657
Cites: BMC Health Serv Res. 2011;11:7821496257
Cites: BMC Health Serv Res. 2012;12:522230771
PubMed ID
23442258 View in PubMed
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An integrated medical and psychosocial treatment program for psychotic disorders: patient characteristics and outcome.

https://arctichealth.org/en/permalink/ahliterature204302
Source
Can J Psychiatry. 1998 Sep;43(7):698-705
Publication Type
Article
Date
Sep-1998
Author
A K Malla
R M Norman
T S McLean
S. Cheng
A. Rickwood
E. McIntosh
L. Cortese
K. Diaz
L P Voruganti
Author Affiliation
Department of Psychiatry, University of Western Ontario, London. akmalla@julian.uwo.ca
Source
Can J Psychiatry. 1998 Sep;43(7):698-705
Date
Sep-1998
Language
English
Publication Type
Article
Keywords
Adult
Canada
Case Management - standards
Chronic Disease
Continuity of Patient Care - standards
Female
Humans
Interinstitutional Relations
Male
Models, Psychological
Outcome and Process Assessment (Health Care)
Patient Readmission - statistics & numerical data
Patient satisfaction
Program Evaluation
Psychotic Disorders - therapy
Recurrence
Retrospective Studies
Schizophrenia - therapy
Abstract
To provide an overview of a comprehensive and integrated case-management program that incorporates principles of assertive community treatment and combines effective medical and psychosocial interventions and to present the results of a process and outcome evaluation of the program, with particular emphasis on its impact on service utilization and consumer satisfaction.
Data on demographic, clinical, and several outcome measures were collected on all patients who received care in the program for a minimum of 6 months. For process evaluation we assessed the extent to which the program adhered to its goals and satisfied the patients, their families, and community-service agencies. Outcome-evaluation data on the number and length of hospital admissions were compared for each subject with individual historical data for a period equal to the time spent in the program. In addition, relapses of psychotic symptoms that did not result in hospital admissions were calculated for each patient while in the program.
Demographic, clinical, and treatment characteristics of clients show that the program has succeeded in maintaining its focus on providing services to relatively chronically ill patients with psychotic disorders over a mean period of 3 years. The process-evaluation data indicated a high level of satisfaction by patients, families, and other service agencies with the services received. Information on outcome variable showed that the program achieved significantly lower rates of hospital admissions and relapse of psychosis than expected. There was a highly significant reduction achieved in the utilization of inpatient hospital resources for patients receiving care in the program. Most of the inpatient service utilization was attributed to patients either who were resistant to treatment with antipsychotic agents or who refused to accept or comply with medication.
It is possible to provide effective continuity of care from inpatient treatment to community adjustment for most individuals with psychotic disorders across the spectrum by blending hospital and community resources within an integrated case-management model of care.
PubMed ID
9773219 View in PubMed
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Association between continuity of care in Swedish primary care and emergency services utilisation: a population-based cross-sectional study.

https://arctichealth.org/en/permalink/ahliterature290683
Source
Scand J Prim Health Care. 2017 Jun; 35(2):113-119
Publication Type
Journal Article
Date
Jun-2017
Author
Hannes Kohnke
Andrzej Zielinski
Author Affiliation
a Ronneby Primary Health Care Centre and Blekinge Centre of Competence , Ronneby , Sweden.
Source
Scand J Prim Health Care. 2017 Jun; 35(2):113-119
Date
Jun-2017
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Aged
Continuity of Patient Care - standards
Cross-Sectional Studies
Emergency Medical Services - utilization
Female
Humans
Longitudinal Studies
Male
Middle Aged
Regression Analysis
Sweden
Young Adult
Abstract
The primary objective of this study was to determine the association between longitudinal continuity of care (CoC) in Swedish primary care (PC) and emergency services (ES) utilisation.
A cross-sectional analysis of longitudinal population data.
PC centres, out-of-hours PC facilities and emergency departments (EDs) in Blekinge County in southern Sweden.
People of all ages who lived in Blekinge County and who had made two or more visits per year to a general practitioner (GP) during office hours from 1 January 2012 to 31 December 2014.
ES utilisation.
Eight-thousand one-hundred and eighty-five people were included in the study. CoC was quantified using three different indices-Usual Provider of Care index (UPC), Continuity of Care index (CoCI), and Sequential Continuity index (SECON). The CoC that the PC centres could offer their enrolled patients varied significantly between the different centres, ranging from 0.23-0.57 for UPC, 0.12-0.43 for CoCI, and 0.25-0.52 for SECON. Association between the three CoC indices and ES utilisation was computed as an incidence rate ratio which ranged between 0.50 and 0.59.
Longitudinal CoC was shown to have a negative association with ES utilisation. The association was significant and of a magnitude that implies clinical relevance. Computed incidence rate ratios suggest that patients with the lowest CoC had twice as many ES visits compared to patients with the highest CoC.
Notes
Cites: Isr J Health Policy Res. 2012 May 23;1(1):21 PMID 22913949
Cites: CMAJ. 2007 Nov 20;177(11):1362-8 PMID 18025427
Cites: Br J Gen Pract. 2001 Sep;51(470):712-8 PMID 11593831
Cites: Am J Public Health. 1980 Feb;70(2):122-7 PMID 7352605
Cites: Popul Health Manag. 2009 Apr;12(2):81-6 PMID 19361251
Cites: Ann Fam Med. 2005 Mar-Apr;3(2):159-66 PMID 15798043
Cites: Scand J Prim Health Care. 2010 Sep;28(3):185-90 PMID 20642396
Cites: Am J Manag Care. 2011 Jun;17(6):420-7 PMID 21756012
Cites: Ont Health Technol Assess Ser. 2013 Sep 01;13(6):1-41 PMID 24167540
Cites: Med Care Res Rev. 2006 Apr;63(2):158-88 PMID 16595410
Cites: Ann Fam Med. 2003 Sep-Oct;1(3):134-43 PMID 15043374
Cites: J Korean Med Sci. 2010 Sep;25(9):1259-71 PMID 20808667
Cites: Pediatrics. 2004 Apr;113(4):738-41 PMID 15060221
Cites: Scand J Prim Health Care. 2012 Dec;30(4):214-21 PMID 23113798
Cites: Am J Public Health. 1980 Feb;70(2):117-9 PMID 7352602
Cites: CMAJ. 2012 Apr 3;184(6):E307-16 PMID 22353588
Cites: JAMA Intern Med. 2014 May;174(5):742-8 PMID 24638880
Cites: J Fam Pract. 1981 Oct;13(5):655-64 PMID 7024464
Cites: Health Policy Plan. 2011 Mar;26(2):157-62 PMID 20699348
Cites: Br J Gen Pract. 2009 Apr;59(561):e134-41 PMID 19341548
Cites: Health Serv Res. 2005 Apr;40(2):389-400 PMID 15762898
Cites: Arch Intern Med. 2010 Oct 11;170(18):1671-7 PMID 20937927
Cites: BMJ. 2003 Nov 22;327(7425):1219-21 PMID 14630762
PubMed ID
28598752 View in PubMed
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Beliefs and experiences can influence patient participation in handover between primary and secondary care--a qualitative study of patient perspectives.

https://arctichealth.org/en/permalink/ahliterature259773
Source
BMJ Qual Saf. 2012 Dec;21 Suppl 1:i76-83
Publication Type
Article
Date
Dec-2012
Author
Maria Flink
Gunnar Öhlén
Helen Hansagi
Paul Barach
Mariann Olsson
Source
BMJ Qual Saf. 2012 Dec;21 Suppl 1:i76-83
Date
Dec-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Chronic Disease - therapy
Communication
Continuity of Patient Care - standards
Emergency Service, Hospital - statistics & numerical data
Female
Hospitalization - statistics & numerical data
Hospitals, University
Humans
Interviews as Topic
Length of Stay
Male
Middle Aged
Outcome Assessment (Health Care)
Patient Handoff
Patient Participation - psychology
Primary Health Care - standards
Qualitative Research
Secondary Care - standards
Sweden
Systems Analysis
Abstract
Communication between healthcare settings at patient transfers between primary and secondary care, 'handover', is a critical and risky process for patients. Patients' views on their roles in these processes are often lacking despite the knowledge that patient participation contributes to enhanced safety and wellbeing.
This study aims to improve the knowledge and understanding of patients' perspectives about their participation in handover.
Twenty-three Swedish patients with chronic diseases were individually interviewed about their experiences with handovers between three clinical microsystems: emergency room, emergency ward and primary healthcare centres. Data were analysed using inductive qualitative content analysis.
Patients participated within the microsystems by exchanging information, and between microsystems by making contact with and conveying information to their next healthcare provider. Enablers for participation included positive encounters with providers, patient empowerment and beliefs about organisational factors. Patients' trust in their providers, and providers' attitudes were important factors in patients' willingness to communicate. Patients who thought medical records access was shared across microsystems volunteered less information to their providers. Patients with experiences of non-effective handovers took more responsibility in the handover to ensure continuity of care.
Patients participate actively in handovers when they feel a need for involvement to ensure continuity of care, and are less active when they perceive that their contribution is unnecessary or not valued. In acute care settings with short hospital stays and less time to establish a trusting relationship between patients and their providers, discharge encounters may be important enablers for patient engagement in handovers. The advantages of a redundant handover process need to be considered.
Notes
Cites: J Gen Intern Med. 2010 May;25(5):441-720180158
Cites: Ann Intern Med. 2003 Feb 4;138(3):161-712558354
Cites: Mayo Clin Proc. 2010 Jan;85(1):53-6220042562
Cites: Patient Educ Couns. 2009 Apr;75(1):58-6619013047
Cites: Ann Intern Med. 2009 Feb 3;150(3):178-8719189907
Cites: Int Emerg Nurs. 2009 Jan;17(1):15-2219135011
Cites: J Clin Nurs. 2009 Jan;18(2):199-20918702620
Cites: Mayo Clin Proc. 2008 May;83(5):554-818452685
Cites: Nurs Forum. 2008 Jan-Mar;43(1):2-1118269439
Cites: Eur J Emerg Med. 2008 Feb;15(1):34-918180664
Cites: Int J Qual Health Care. 2007 Dec;19(6):349-5717872937
Cites: Br J Nurs. 2007 Jul 26-Aug 8;16(14):882-617851351
Cites: Scand J Caring Sci. 2007 Sep;21(3):313-2017727543
Cites: Health Expect. 2007 Sep;10(3):259-6717678514
Cites: JAMA. 2007 Feb 28;297(8):831-4117327525
Cites: J Hosp Med. 2006 Nov;1(6):354-6017219528
Cites: Qual Saf Health Care. 2006 Dec;15 Suppl 1:i10-617142602
Cites: Arch Intern Med. 2006 Sep 25;166(17):1822-817000937
Cites: J Clin Nurs. 2006 Oct;15(10):1299-30716968434
Cites: Ann Fam Med. 2006 Mar-Apr;4(2):124-3116569715
Cites: Qual Health Res. 2005 Nov;15(9):1277-8816204405
Cites: CMAJ. 2005 Aug 30;173(5):510-516129874
Cites: Ann Fam Med. 2004 Jul-Aug;2(4):317-2615335130
Cites: J Clin Nurs. 2004 Jul;13(5):562-7015189409
Cites: J Gen Intern Med. 2003 Aug;18(8):646-5112911647
Cites: Eur J Emerg Med. 2013 Oct;20(5):327-3422960802
Cites: Int J Nurs Terminol Classif. 2010 Jan-Mar;21(1):21-3220132355
PubMed ID
23112289 View in PubMed
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Best practice and needs for improvement in the chain of care for persons with dementia in Sweden: a qualitative study based on focus group interviews.

https://arctichealth.org/en/permalink/ahliterature271366
Source
BMC Health Serv Res. 2014;14:596
Publication Type
Article
Date
2014
Author
Christina Bökberg
Gerd Ahlström
Staffan Karlsson
Ingalill Rahm Hallberg
Ann-Christin Janlöv
Source
BMC Health Serv Res. 2014;14:596
Date
2014
Language
English
Publication Type
Article
Keywords
Adult
Continuity of Patient Care - standards
Cooperative Behavior
Dementia - nursing
Female
Focus Groups
Home Care Services
Humans
Male
Middle Aged
Nursing Homes
Qualitative Research
Quality Improvement
Sweden
Abstract
Persons with dementia receive health care and social services from a wide range of professional care providers during the disease trajectory, presenting risks of miscommunication, duplication and/or missed nursing interventions. Accordingly, the aim of this study was to investigate professional care providers' views on conditions for best practice in terms of collaboration and improvement needs in the chain of care from early to end-of-life stage for persons with dementia in Sweden.
The study had a qualitative design based on three focus group interviews. A strategic sample of 23 professional care providers was included. Data were subjected to content analysis based on the three stages of dementia (early, moderate, end-of-life).
The results were divided into five categories: Diagnosis is a prerequisite for specialized dementia care, Creating routines in the chain of care, Competent staff a prerequisite for high-quality care, Day care facilitates transition in the chain of care and Next-of-kin participation is a prerequisite for continuity in the chain of care. It was clear that, according to the participants, best practice in dementia care in Sweden is not achieved in every respect. It appeared that transitions of care between different organizations are critical events which need to be improved. The further the disease progresses, the less collaboration there seems to be among professional care providers, which is when the next of kin are usually called upon to maintain continuity in the chain of care.
The results indicate that, according to the care providers, best practice in terms of collaboration is achieved to a higher degree during the early stage of dementia compared with the moderate and end-of-life stages. Lack of best practice strategies during these stages makes it difficult to meet the needs of persons with dementia and reduce the burden for next of kin. These are experiences to be taken into account to improve the quality of dementia care. Implementation research is needed to develop strategies for best practice on the basis of national knowledge-based guidelines and to apply these strategies in the moderate and end-of-life stages.
Notes
Cites: J Am Geriatr Soc. 2001 Dec;49(12):1714-2111844008
Cites: Br J Nurs. 2001 Jun 14-27;10(11):710-412048486
Cites: Nurse Educ Today. 2004 Feb;24(2):105-1214769454
Cites: Image J Nurs Sch. 1994 Summer;26(2):119-278063317
Cites: Lancet. 2005 Dec 17;366(9503):2112-716360788
Cites: Int J Geriatr Psychiatry. 2007 Jan;22(1):47-5417044135
Cites: Int Psychogeriatr. 2008 Dec;20(6):1177-9218606052
Cites: J Clin Nurs. 2010 Sep;19(17-18):2611-820586833
Cites: J Aging Soc Policy. 2011 Oct;23(4):335-5321985063
Cites: BMC Public Health. 2012;12:6822269343
Cites: J Am Geriatr Soc. 2012 May;60(5):813-2022587849
Cites: Online J Issues Nurs. 2012 May;17(2):422686112
Cites: BMC Health Serv Res. 2012;12:39523151143
Cites: Patient Educ Couns. 2014 May;95(2):175-8424525223
PubMed ID
25433673 View in PubMed
Less detail

[Cancer patients need a local coordinator--is the general practitioner prepared?]

https://arctichealth.org/en/permalink/ahliterature17872
Source
Tidsskr Nor Laegeforen. 2004 Mar 4;124(5):659-61
Publication Type
Article
Date
Mar-4-2004

Cardiac surgery patients' evaluation of the quality of theatre nurse postoperative follow-up visit.

https://arctichealth.org/en/permalink/ahliterature92251
Source
Eur J Cardiovasc Nurs. 2009 Jun;8(2):105-11
Publication Type
Article
Date
Jun-2009
Author
Falk-Brynhildsen Karin
Nilsson Ulrica
Author Affiliation
Department of Cardiothoracic Surgery, Orebro University Hospital, Sweden.
Source
Eur J Cardiovasc Nurs. 2009 Jun;8(2):105-11
Date
Jun-2009
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Cardiac Surgical Procedures - nursing
Continuity of Patient Care - standards
Female
Follow-Up Studies
Humans
Male
Middle Aged
Patient satisfaction
Perioperative Nursing - methods - standards
Postoperative Care - standards
Prospective Studies
Quality of Health Care
Questionnaires
Retrospective Studies
Abstract
Theatre nurses at the Department of Cardiothoracic Surgery in Orebro, Sweden, have since 2001 routinely conducted a follow-up visit to postoperative cardiac patients. A model with a standardized information part and an individual-caring conversation including both a retrospective and a prospective part designed the visit. The purpose of this study was to evaluate the quality of the postoperative follow-up visit conducted by the theatre nurses and find out if the quality was related to gender or type of admission. The method was prospective and explorative, including 74 cardiac surgery patients who had had a postoperative follow-up visit by a theatre nurse in Sweden. The instrument measuring quality, from the patient's perspective, measured the quality of the visit, and consisted of 16 items modified to suit the study. The results showed an overall high quality rating, with statistically significant higher scores for six items between patients who had undergone emergency surgery, in comparison with elective patients. When comparing gender, women had statistically significant higher scores in two items. In conclusion, this postoperative follow-up visit by the theatre nurse was a valuable and useful tool especially for the patients who had undergone emergency surgery. In the follow-up visit the theatre nurse creates a caring relationship by meeting the patient as an individual with his/her own experience and needs for information about the surgery, intra and postoperative care, and recovery.
PubMed ID
18760675 View in PubMed
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