Development and field testing of a standardised goal setting package for person-centred discharge care planning in stroke

The development of expert systems in agriculture consists of many steps such as problem definition, selection of experts, audience considerations, knowledge representation, coding, testing, and feedback. The problem definition and selection of experts for the problem domain are the foundation of a working system. Audience definition, economics and goal setting are areas that must be documented before knowledge engineering. Knowledge representation methods and system conceptual layout are the next level of development. The use of the user feedback and field testing data to improve the system are often overlooked. Benefits of expert systems for on farm decision making include education, efficiency, and adaption to changing regulations. Many aspects of agricultural expert systems are similar to traditional expert systems; yet special problem inherent in agriculture make the development interesting and challenging.

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Goal-Based Care Planning in Regional Geriatric Services for Older Persons Living with Frailty

Canadian Geriatrics Journal ◽

10.5770/cgj.21.318 ◽

2018 ◽

Vol 21 (4) ◽

pp. 297-302 ◽

Cited By ~ 1

Author(s):

Laura I.L. Poulin ◽

Mary E. Blinkhorn ◽

Stacey A. Hawkins ◽

Kelly A. Kay ◽

Mark W. Skinner

Keyword(s):

Older Adults ◽

Goal Setting ◽

Older Persons ◽

Theoretical Knowledge ◽

Care Planning ◽

Interprofessional Care ◽

Industry Standard ◽

Practical Education ◽

Open Coding

BackgroundOlder adults living with frailty represent a complex group who are increasingly accessing regional geriatric services. Goal-based care planning is the industry standard in the care of older adults, yet few studies illustrate how goal-based care planning is being conducted with this population. Understand-ing how frailty impacts goal-based care planning in regional geriatric services is key to improving patient care.Methods In this “Go-Along” method of data collection, nine observa-tional experiences were conducted, nine responses from the Interprofessional Role Shadowing Tool were obtained, and eight responses to follow-up questions were received. Open coding of the data was performed retrospectively, and indexed themes were identified.ResultsAlthough the Geriatric Clinicians indicated that goal-based care planning and frailty were central to practice, the observa-tions indicated no clear process to patient-centred goal-setting or frailty identification in practice. The results infer a gap between theoretical knowledge and practical application.ConclusionsA clear process to goal-based care planning in interprofessional geriatric services is needed. This objective requires practical education that emphasizes the skills necessary to implement goal-setting within unique, interprofessional care environments. Further research is necessary to establish if frailty identification is necessary in goal-based care planning, or if a patient-centred approach is more advantageous in practice.

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Personalised discharge care planning for postmyocardial infarction patients through the use of the Personalised Patient Education Protocol - implementing theory into practice

Journal of Clinical Nursing ◽

10.1111/jocn.13177 ◽

2016 ◽

Vol 25 (9-10) ◽

pp. 1292-1300 ◽

Cited By ~ 3

Author(s):

Margaret Lau-Walker ◽

Anne Landy ◽

Trevor Murrells

Keyword(s):

Patient Education ◽

Care Planning ◽

Postmyocardial Infarction ◽

Discharge Care

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Post-Discharge Care Planning and Rehabilitation of the Elderly Surgical Patient

Clinics in Geriatric Medicine ◽

10.1016/s0749-0690(18)30610-4 ◽

1990 ◽

Vol 6 (3) ◽

pp. 669-683 ◽

Cited By ~ 7

Author(s):

Doris Suter-Gut ◽

Amanda M. Metcalf ◽

Margaret A. Donnelly ◽

Ian M. Smith

Keyword(s):

The Elderly ◽

Surgical Patient ◽

Care Planning ◽

Post Discharge ◽

Discharge Care

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Effect of Behavior Change Techniques Targeting Clinicians to Improve Advance Care Planning in Heart Failure: A Systematic Review and Meta-Analysis

Annals of Behavioral Medicine ◽

10.1093/abm/kaaa075 ◽

2020 ◽

Author(s):

Markus Schichtel ◽

Bee Wee ◽

Rafael Perera ◽

Igho Onakpoya ◽

Charlotte Albury

Keyword(s):

Heart Failure ◽

Systematic Review ◽

Behavior Change ◽

Goal Setting ◽

Meta Analysis ◽

Risk Of Bias ◽

Controlled Trials ◽

Care Planning ◽

Behavior Change Techniques ◽

Advance Care

Abstract Background National and international guidelines recommend advance care planning (ACP) for patients with heart failure. But clinicians seem hesitant to engage with ACP. Purpose Our aim was to identify behavioral interventions with the greatest potential to engage clinicians with ACP in heart failure. Methods A systematic review and meta-analysis. We searched CINAHL, Cochrane Central Register of Controlled Trials, Database of Systematic Reviews, Embase, ERIC, Ovid MEDLINE, Science Citation Index, and PsycINFO for randomized controlled trials (RCTs) from inception to August 2018. Three reviewers independently extracted data, assessed risk of bias (Cochrane risk of bias tool), the quality of evidence (Grading of Recommendation Assessment, Development, and Evaluation), and intervention synergy according to the behavior change wheel and behavior change techniques (BCTs). Odds ratios (ORs) were calculated for pooled effects. Results Of 14,483 articles screened, we assessed the full text of 131 studies. Thirteen RCTs including 3,709 participants met all of the inclusion criteria. The BCTs of prompts/cues (OR: 4.18; 95% confidence interval [CI]: 2.03–8.59), credible source (OR: 3.24; 95% CI: 1.44–7.28), goal setting (outcome; OR: 2.67; 95% CI: 1.56–4.57), behavioral practice/rehearsal (OR: 2.64; 95% CI: 1.50–4.67), instruction on behavior performance (OR: 2.49; 95% CI: 1.63–3.79), goal setting (behavior; OR: 2.12; 95% CI: 1.57–2.87), and information about consequences (OR: 2.06; 95% CI: 1.40–3.05) showed statistically significant effects to engage clinicians with ACP. Conclusion Certain BCTs seem to improve clinicians’ practice with ACP in heart failure and merit consideration for implementation into routine clinical practice.

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