Barriers to Post-Discharge Monitoring and Patient-Clinician Communication: A Qualitative Study

2021 ◽  
Vol 268 ◽  
pp. 1-8
Author(s):  
Brian C. Brajcich ◽  
Meagan L. Shallcross ◽  
Julie K. Johnson ◽  
Rachel Hae-Soo Joung ◽  
Cassandra B. Iroz ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Post Discharge ◽  
Discharge Monitoring ◽  
Clinician Communication

scholarly journals Disconnection in Information Exchange During Pediatric Trauma Transfers: A Qualitative Study

2021 ◽  
Vol 8 ◽  
pp. 237437352110565
Author(s):  
Hadley S Sauers-Ford ◽  
James B Aboagye ◽  
Stuart Henderson ◽  
James P Marcin ◽  
Jennifer L Rosenthal
Keyword(s):  
Qualitative Study ◽  
Information Exchange ◽  
Pediatric Patients ◽  
Traumatic Injury ◽  
Pediatric Trauma ◽  
Structured Interviews ◽  
Theoretical Concepts ◽  
Qualitative Thematic Analysis ◽  
Clinician Communication ◽  
Flow Of Information

Pediatric patients experiencing an emergency department (ED) visit for a traumatic injury often transfer from the referring ED to a pediatric trauma center. This qualitative study sought to evaluate the experience of information exchange during pediatric trauma visits to referring EDs from the perspectives of parents and referring and accepting clinicians through semi-structured interviews. Twenty-five interviews were conducted (10 parents and 15 clinicians) and analyzed through qualitative thematic analysis. A 4-person team collaboratively identified codes, wrote memos, developed major themes, and discussed theoretical concepts. Three interdependent themes emerged: (1) Parents’ and clinicians’ distinct experiences result in a disconnect of information exchange needs; (2) systems factors inhibit effective information exchange and amplify the disconnect; and (3) situational context disrupts the flow of information contributing to the disconnect. Individual-, situational-, and systems-level factors contribute to disconnects in the information exchanged between parents and clinicians. Understanding how these factors’ influence information disconnect may offer avenues for improving patient–clinician communication in trauma transfers.

Patient and therapist experiences of using affordable feedback-based technology in rehabilitation: a qualitative study nested in a randomized controlled trial

2018 ◽  
Vol 32 (9) ◽  
pp. 1258-1270 ◽  
Author(s):  
Caitlin Hamilton ◽  
Annie McCluskey ◽  
Leanne Hassett ◽  
Maggie Killington ◽  
Meryl Lovarini
Keyword(s):  
Randomized Controlled Trial ◽  
Qualitative Study ◽  
Patient Engagement ◽  
Controlled Trial ◽  
Aged Care ◽  
Theory Approach ◽  
Post Discharge ◽  
Randomized Controlled ◽  
The Right ◽  
Two Stages

Objective: To explore how technologies are used and experienced in rehabilitation. Design: A qualitative study using a grounded theory approach within a randomized controlled trial investigating the effectiveness of tailored, affordable technologies to improve mobility and physical activity. Settings: Aged care and neurological rehabilitation wards with community follow-up. Participants: Twenty patients undergoing rehabilitation and randomized to the experimental arm of a trial (mean age 64 years (SD 23)) were recruited for interviews, plus 11 physiotherapists involved in technology prescription as part of the trial. Method: Two interviews per patient (one in hospital, one post-discharge) and four focus groups with physiotherapists were conducted. Transcribed data were coded and synthesized. Memo-writing and constant comparison methods guided data analysis. Results: A process of patient engagement with technology involving two stages: (1) initial patient engagement and (2) maintaining patient engagement was identified. Therapists used a series of steps and strategies to gain and maintain patient engagement. A positive first experience and continued input into patient programmes was needed. The level of patient engagement was not consistent across the duration of the trial, increasing or decreasing due to changes in the technologies prescribed or setting of use. Two conditions were key to optimizing patient engagement: sufficient support and perceived benefit from using technology. Conclusions: Patients can engage with technology during rehabilitation when prescription is tailored by a therapist. Perceiving benefit from using technology, in addition to receiving the right support to enable use appears to influence the level of patient engagement.

scholarly journals Parent and Clinician Communication During Paediatric Burn Wound Care: A Qualitative Study

2020 ◽  
Vol 55 ◽  
pp. 147-154
Author(s):  
Erin A. Brown ◽  
Marthe Egberts ◽  
Rachmania Wardhani ◽  
Alexandra De Young ◽  
Roy Kimble ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Wound Care ◽  
Burn Wound ◽  
Clinician Communication

scholarly journals Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness Approach

Life ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 171
Author(s):  
Giovanni Prezioso ◽  
Serafina Perrone ◽  
Giacomo Biasucci ◽  
Giovanna Pisi ◽  
Valentina Fainardi ◽  
...  
Keyword(s):  
Skin Color ◽  
Color Change ◽  
Educational Interventions ◽  
Admission Criteria ◽  
Post Discharge ◽  
Life Threatening ◽  
Discharge Monitoring ◽  
Work Up ◽  
Primary Care Pediatricians

Unexpected events of breath, tone, and skin color change in infants are a cause of considerable distress to the caregiver and there is still debate on their appropriate management. The aim of this study is to survey the trend in prevention, decision-making, and management of brief resolved unexplained events (BRUE)/apparent life-threatening events (ALTE) and to develop a shared protocol among hospitals and primary care pediatricians regarding hospital admission criteria, work-up and post-discharge monitoring of patients with BRUE/ALTE. For the study purpose, a panel of 54 experts was selected to achieve consensus using the RAND/UCLA appropriateness method. Twelve scenarios were developed: one addressed to primary prevention of ALTE and BRUE, and 11 focused on hospital management of BRUE and ALTE. For each scenario, participants were asked to rank each option from ‘1’ (extremely inappropriate) to ‘9’ (extremely appropriate). Results derived from panel meeting and discussion showed several points of agreement but also disagreement with different opinion emerged and the need of focused education on some areas. However, by combining previous recommendations with expert opinion, the application of the RAND/UCLA appropriateness permitted us to drive pediatricians to reasoned and informed decisions in term of evaluation, treatment and follow-up of infants with BRUE/ALTE, reducing inappropriate exams and hospitalisation and highlighting priorities for educational interventions.

scholarly journals Experiences of frail older cardiac patients with a nurse-coordinated transitional care intervention - a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Patricia Jepma ◽  
Corine H. M. Latour ◽  
Iris H. J. ten Barge ◽  
Lotte Verweij ◽  
Ron J. G. Peters ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Transitional Care ◽  
Living Arrangement ◽  
Intervention Group ◽  
Adverse Outcomes ◽  
Cardiac Patients ◽  
Added Value ◽  
Structured Interviews ◽  
Post Discharge ◽  
Care Intervention

Abstract Background Older cardiac patients are at high risk of readmission and mortality. Transitional care interventions (TCIs) might contribute to the prevention of adverse outcomes. The Cardiac Care Bridge program was a randomized nurse-coordinated TCI combining case management, disease management and home-based rehabilitation for hospitalized frail older cardiac patients. This qualitative study explored the experiences of patients’ participating in this study, as part of a larger process evaluation as this might support interpretation of the neutral study outcomes. In addition, understanding these experiences could contribute to the design and application of future transitional care interventions for frail older cardiac patients. Methods A generic qualitative approach was used. Semi-structured interviews were performed with 16 patients ≥70 years who participated in the intervention group. Participants were selected by gender, diagnosis, living arrangement and hospital of inclusion. Data were analysed using thematic analysis. In addition, quantitative data about intervention delivery were analysed. Results Three themes emerged from the data: 1) appreciation of care continuity; 2) varying experiences with recovery and, 3) the influence of an existing care network. Participants felt supported by the transitional care intervention as they experienced post-discharge support and continuity of care. The perceived contribution of the program in participants’ recovery varied. Some participants reported physical improvements while others felt impeded by comorbidities or frailty. The home visits by the community nurse were appreciated, although some participants did not recognize the added value. Participants with an existing healthcare provider network preferred to consult these providers instead of the providers who were involved in the transitional care intervention. Conclusion Our results contribute to an explanation of the neutral study of a nurse-coordinated transitional care intervention. For future purpose, it is important to identify which patients might benefit most from TCIs. Furthermore, the intensity and content of TCIs could be more personalized by tailoring interventions to older cardiac patients’ needs, considering their frailty, self-management skills and existing formal and informal caregiver networks.

scholarly journals Pharmacy professionals’ views regarding the future of NHS patient medicines helpline services: A multimethod qualitative study

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i27-i28
Author(s):  
M Williams ◽  
A Jordan ◽  
J Scott ◽  
M Jones
Keyword(s):  
Qualitative Study ◽  
Evaluation Framework ◽  
National Standards ◽  
Survey Study ◽  
Service Improvement ◽  
Community Pharmacies ◽  
Service Users ◽  
Post Discharge ◽  
Access Methods ◽  
The Future

Abstract Introduction Patient medicines helpline services (PMHS) have been established at some National Health Service (NHS) hospitals in England, to provide medicines-related support to recently discharged hospital patients and carers. However, findings suggest that, due to a lack of resources, considerable variation exists in the operation of PMHS, and that their access, availability, and promotion do not meet national standards regarding helpline provision (1, 2). To develop recommendations for service improvement, this qualitative study sought to examine pharmacy professionals’ views regarding the future of PMHS. Aim To examine pharmacy professionals’ perceptions of the future of PMHS, and develop recommendations for service improvement. Methods University ethics and Health Research Authority approval were obtained before commencement. Participants comprised pharmacy professionals from acute, mental health, specialist, and community NHS Trusts that provided a PMHS. Invitations to participate in an online qualitative survey and subsequent semi-structured telephone interview were sent via email to pharmacy services at all Trusts that provided a PMHS. Within the survey and the interview schedule was one question “How do you see patient medicines helplines at NHS Trusts developing in the future?” and only the data generated from this open-ended question were analysed for this study. Survey data were collected via SurveyMonkey (n=100). Individuals interested in participating in an interview contacted the research team, resulting in 34 interviews. Interviews were conducted from May-October 2018, and ranged from 16 to 53 minutes. Braun and Clarke’s inductive reflexive thematic analysis was used to analyse the data. Guidelines for enhancing the validity and trustworthiness of qualitative research were used. Results Two themes were generated from the survey and interviews. Enhancing value for service users identifies suggestions for improving the value of PMHS for service users. These include providing access methods beyond the telephone, and providing patients/carers with post-discharge follow-up calls from a pharmacist. Improving efficiency identifies that, in the future, and in line with NHS plans for efficiency and shared resources, PMHS may become centralised or provided by community pharmacies. Centralised services were considered to likely have more resources available to provide a patient medicines information service compared to hospital pharmacies. Participants often referred to the Carter report and sustainability and transformation plans, which promote the sharing of resources within regions. However, such a change was perceived to only increase efficiency if patient information can be shared between relevant healthcare settings. Conclusion PMHS are perceived by pharmacy professionals as likely to become centralised in the future (i.e., provided regionally or nationally) or provided by community pharmacies. This is dependent upon patients’ information being shared between hospitals and the centralised PMHS or pharmacies. To enhance the value of PMHS for service users, providers could establish other methods of access, such as email and video consultation. A limitation of this study is that it did not seek the perspectives of pharmacy professionals who do not provide a PMHS, other healthcare professionals, nor patients and carers. Considering the uncertainty around the future of PMHS, research should establish the best way to support all patients and carers regarding medicines following hospital discharge. References 1. Williams MJ, Jones MD, Jordan AL, Scott JA. Operating a patient medicines helpline. A survey study exploring current practice in England using the RE-AIM evaluation framework. BMC Health Serv Res. 2018; doi:10.1186/s12913-018-3690-9 2. Williams M, Jordan A, Scott J, Jones MD. Pharmacy professionals’ experiences and perceptions of providing NHS patient medicines helpline services: a qualitative study. BMC Health Serv Res. 2020; doi.org/10.1186/s12913-020-05182-w.

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