scholarly journals Continuity of care in heart failure patients

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
K Olsen ◽  
NF Falun ◽  
HK Keilegavlen
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Health Care ◽  
Continuity Of Care ◽  
Secondary Care ◽  
Health Care Services ◽  
Care Services ◽  
Discharge From Hospital ◽  
Patients Experience

Abstract Funding Acknowledgements Type of funding sources: None. Background  Heart failure (HF) requires follow-up over time and by several different health services. The positive effects of follow-up care in secondary care services is well known. However, there is a lack of knowledge in how HF patients experience continuity of care a through various health care services in secondary and primary care. Purpose To explore how HF patients experience continuity of care through secondary and primary health care services. Methods The study used an inductive design by performing four semi-structured focus group interviews. Overall, 17 patients, mean age of 71 years (range 42-95), 11 men and 6 women, All patients were receiving regular and individual follow-up by cardiac nurses in primary care after hospital discharge The interviews were analysed through qualitative content analysis. Results Gaps in continuity of care were described as challenging. Information about HF at the time of discharge from hospital were not always fully comprehended. Patients experienced physical strain of being lost and abandoned after discharge from hospital. They did not know whom to contact for follow-up.  Appointments with the GP was not agreed or scheduled weeks ahead. Patients appreciated home visit by a cardiac nurse in primary care who provided the patients with knowledge in self-care administration. When experiencing deterioration they could call the cardiac nurse, who could facilitate fast track to the hospital. Self-care was difficult to comprehend, especially for those experiencing comorbidities. Patients also  described the importance of sharing knowledge and experience of living with HF with other patients in a secondary care setting, organized by specialised cardiac nurses. Conclusions There are gaps in continuity in patients’ pathways, throughout both secondary and primary healthcare. Even though patients receive information at discharge from hospital, they felt insecure when returning home. Health care services in the primary care provided the patients with both knowledge and confidence as they regularly met the patients, both at home and in organized primary care meetings.

scholarly journals Stroke follow-up in primary care: a discourse study on the discharge summary as a tool for knowledge transfer and collaboration

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rune Aakvik Pedersen ◽  
Halfdan Petursson ◽  
Irene Hetlevik ◽  
Henriette Thune
Keyword(s):  
Primary Care ◽  
Health Care ◽  
General Practice ◽  
Discourse Analysis ◽  
Knowledge Transfer ◽  
Health Care Services ◽  
Discharge Summary ◽  
Care Services ◽  
Discharge Summaries

Abstract Background The acute treatment for stroke takes place in hospitals and in Norway follow-up of stroke survivors residing in the communities largely takes place in general practice. In order to provide continuous post stroke care, these two levels of care must collaborate, and information and knowledge must be transferred between them. The discharge summary, a written report from the hospital, is central to this communication. Norwegian national guidelines for treatment of stroke, issued in 2010, therefore give recommendations on the content of the discharge summaries. One ambition is to achieve collaboration and knowledge transfer, contributing to integration of the health care services. However, studies suggest that adherence to guidelines in general practice is weak, that collaboration within the health care services does not work the way the authorities intend, and that health care services are fragmented. This study aims to assess to what degree the discharge summaries adhere to the guideline recommendations on content and to what degree they are used as tools for knowledge transfer and collaboration between secondary and primary care. Methods The study was an analysis of 54 discharge summaries for home-dwelling stroke patients. The patients had been discharged from two Norwegian local hospitals in 2011 and 2012 and followed up in primary care. We examined whether content was according to guidelines’ recommendations and performed a descriptive and interpretative discourse analysis, using tools adapted from an established integrated approach to discourse analysis.  Results We found a varying degree of adherence to the different advice for the contents of the discharge summaries. One tendency was clear: topics relevant here and now, i.e. at the hospital, were included, while topics most relevant for the later follow-up in primary care were to a larger degree omitted. In most discharge summaries, we did not find anything indicating that the doctors at the hospital made themselves available for collaboration with primary care after dischargeof the patient. Conclusions The discharge summaries did not fulfill their potential to serve as tools for collaboration, knowledge transfer, and guideline implementation. Instead, they may contribute to sustain the gap between hospital medicine and general practice.

scholarly journals Nurse liaison: a strategy for counter-referral

2018 ◽  
Vol 71 (suppl 1) ◽  
pp. 546-553 ◽  
Author(s):  
Ester do Nascimento Ribas ◽  
Elizabeth Bernardino ◽  
Liliana Muller Larocca ◽  
Paulo Poli Neto ◽  
Gisele Knop Aued ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Continuity Of Care ◽  
Emergency Care ◽  
Health Care Services ◽  
Health Care Data ◽  
Project Method ◽  
Care Services ◽  
Primary Health

ABSTRACT Objective: to identify the profile of the counter-referred patients by the “nurse liaison” and to describe the experience of the professionals who participated in the project. Method: intervention research, with twelve nursing nurses from a hospital and an Emergency Care Unit, and 26 nurses from Primary Health Care. Data were obtained through questionnaires and counter-referral forms. Results: Out of 43 counter-referred individuals, 62.8% are over sixty years, 53.5% are men with multi-pathologies. Among the positive aspects, the nurses highlighted the dialogue between health care services, agility in the acquisition of inputs for the continuity of care in primary care, benefiting patients after hospital discharge. The greatest challenge was the lack of time and the deficit of nurses to perform the function. Final considerations: the presence of the “nurse liaison” has proved to be an important strategy to improve integration between services and to promote continuity of care.

scholarly journals Chronic disease in childhood and adolescence: continuity of care in the Health Care Network

2017 ◽  
Vol 51 (0) ◽  
Author(s):  
Vanessa Medeiros da Nóbrega ◽  
Maria Elizabete de Amorim Silva ◽  
Leiliane Teixeira Bento Fernandes ◽  
Claudia Silveira Viera ◽  
Altamira Pereira da Silva Reichert ◽  
...  
Keyword(s):  
Health Care ◽  
Continuity Of Care ◽  
Health Care Services ◽  
Childhood And Adolescence ◽  
Structured Interviews ◽  
Care Network ◽  
Care Services ◽  
Network Methods ◽  
Health Care Network

abstract OBJECTIVE To evaluate the continuity of care for children and adolescents with chronic diseases in the health care network. METHODS This qualitative study was conducted between February and October 2013 with 12 families, six health managers, and 14 health professionals from different health care services in a municipality of the state of Paraíba, Brazil, using focal groups, semi-structured interviews, and medical record consultation. The data were analyzed by triangulation and thematic analysis. RESULTS Two categories were created: “health care management” and “(dis)continuity of care.” We found gaps in the system, including poor data recording aimed to facilitate follow-up and guide the planning actions as well as sporadic and discoordinate services with a limited flow of information, which hinders follow-up over time. CONCLUSION Continuity of care in the health care network is limited and creates the need to develop strategies to improve these services.

scholarly journals Profile of Children Referred to Primary Health Care Physiotherapy: A Longitudinal Observational Study in Norway

2020 ◽  
Author(s):  
Kari Anne I Evensen ◽  
Siw Sellæg ◽  
Anne-Cath Stræte ◽  
Anne E. Hansen ◽  
Ingebrigt Meisingset
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Services ◽  
Daily Activities ◽  
Care Services ◽  
Longitudinal Observational Study ◽  
Primary Health ◽  
Primary Health Care Services

Abstract Background: Physiotherapy services are an important part of the primary health care services for children, serving a broad spectrum of children referred from different sources and for a variety of reasons. There is limited knowledge about their characteristics and outcome. The aim of this study was to describe the profile, i.e. referral patterns, baseline demographical and clinical characteristics, as well as treatment outcome at follow-up six months after baseline in children receiving physiotherapy in primary care. Methods: Children referred to primary care physiotherapy in a municipality in Norway were invited to participate in this longitudinal observational study. The children’s demographics, referral source, causes of referral, functional diagnoses, influence on their daily activities, main goals and planned treatments were registered at baseline. Goal attainment and treatment compliance were registered at follow-up maximum six months after baseline. Results: The physiotherapists registered baseline characteristics for 148 children. Parent-reported data at baseline were available for 101 (68.2%) of these children. Children were mainly referred from child health care centres (n=74; 50.0%), hospital (n=25; 16.9%) and kindergarten (n=22; 14.9%). The most frequent causes of referral were concerns for motor development (n=50; 33.8%), asymmetry (n=40; 27.0%) and orthopaedic conditions (n=25; 16.9%). Eighty-one (54.7%) children were below the age of one year. There was partly agreement between causes of referral and the physiotherapists’ functional diagnoses. Parents of 69 (71.1%) children reported that their child’s daily activities were little to not at all influenced by the problem or complaint for which they were referred. Follow-up data was registered for 64 children. The main treatment goal was achieved in 37 (57.8%) and partly achieved in 26 (40.6%) children and the treatment was carried out as planned in 55 (87.3%) children. Conclusions: The large variation in the profile of children receiving primary health care physiotherapy in Norway shows how primary health care PT’s can contribute to fulfil the broad purpose of the primary health care services.Trial registration: ClinicalTrials.gov Identifier: NCT03626389. Registered on August 13th 2018 (retrospectively registered).

scholarly journals Continuity of care experienced by patients in a multi-institutional pancreatic care network: a pilot study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
J. S. Hopstaken ◽  
D. van Dalen ◽  
B. M. van der Kolk ◽  
E. J. M. van Geenen ◽  
J. J. Hermans ◽  
...  
Keyword(s):  
Health Care ◽  
Pilot Study ◽  
Continuity Of Care ◽  
Health Care Services ◽  
Pancreatic Surgery ◽  
Tertiary Hospital ◽  
Tumor Board ◽  
Pancreatic Tumors ◽  
Care Network ◽  
Care Services

Abstract Background Over the past decades, health care services for pancreatic surgery were reorganized. Volume norms were applied with the result that only a limited number of expert centers perform pancreatic surgery. As a result of this centralization of pancreatic surgery, the patient journey of patients with pancreatic tumors has become multi-institutional. To illustrate, patients are referred to a center of expertise for pancreatic surgery whereas other parts of pancreatic care, such as chemotherapy, take place in local hospitals. This fragmentation of health care services could affect continuity of care (COC). The aim of this study was to assess COC perceived by patients in a pancreatic care network and investigate correlations with patient-and care-related characteristics. Methods This is a pilot study in which patients with (pre) malignant pancreatic tumors discussed in a multidisciplinary tumor board in a Dutch tertiary hospital were asked to participate. Patients were asked to fill out the Nijmegen Continuity of Care-questionnaire (NCQ) (5-point Likert scale). Additionally, their patient-and care-related data were retrieved from medical records. Correlations of NCQ score and patient-and care-related characteristics were calculated with Spearman’s correlation coefficient. Results In total, 44 patients were included (92% response rate). Pancreatic cancer was the predominant diagnosis (32%). Forty percent received a repetition of diagnostic investigations in the tertiary hospital. Mean scores for personal continuity were 3.55 ± 0.74 for GP, 3.29 ± 0.91 for the specialist and 3.43 ± 0.65 for collaboration between GPs and specialists. Overall COC was scored with a mean 3.38 ± 0.72. No significant correlations were observed between NCQ score and certain patient-or care-related characteristics. Conclusion Continuity of care perceived by patients with pancreatic tumors was scored as moderate. This outcome supports the need to improve continuity of care within multi-institutional pancreatic care networks.

scholarly journals Factors related to perceived continuity of care in hospitalized cardiac patients

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Safstrom ◽  
T.J Jaarsma ◽  
L.N Nordgren ◽  
M.L Liljeroos ◽  
A.S Stomberg
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Health Care ◽  
Continuity Of Care ◽  
Perceived Control ◽  
Care Utilization ◽  
Funding Source ◽  
Patient Reported

Abstract Background Since healthcare systems are increasingly complex and often fragmented, continuity of care after hospitalization is a priority to increase patient safety and satisfaction. Aim Describe factors related to continuity of care in patients hospitalized due to cardiac conditions. Methods This cross-sectional multicenter study enrolled patients 6 weeks after hospitalization due to cardiac conditions. A total of 993 patients were included (mean age 72.2 (SD 10.4), males 66%) with AMI (35%), AF (25%), angina (21%) and HF (17.3%). Patients completed the Patient Continuity of Care Questionnaire, a questionnaire based on the definition that continuity of care is “the extent to which a series of health care services is experienced as connected and coherent and is consistent with a patient's health needs and personal circumstances”. The total score of the questionnaire ranges from 6 to 30, higher score indicating higher continuity and a score <24 indicating insufficient continuity. Cronbach's alpha on the total PCCQ was 0.94. Correlations between PCCQ and quality of life, depression, anxiety, perceived control and health care utilization were estimated using spearman rang correlation. Results Insufficient continuity of care ranged between 47% to 59% in the different diagnosis groups, which the highest continuity in the AMI group and lowest in patients with atrial fibrillation. In patients hospitalized due to AMI (n=355, mean age 71 (± 11), 70% men), continuity of care was related to higher perceived control, higher quality of life, a good financial situation, being a man, no symptoms of anxiety or depression (ᚹ range 0.17–0.26 p≤0.002). A low score on the PCCQ were associated with follow-up visit to a nurse in primary care after hospitalization (ᚹ −0.12 p=0.033). In patients hospitalized due to angina (n=210, mean age 73 (± 9), 74% men), continuity of care was related to higher perceived control, higher quality of life and no depressive symptoms (ᚹ range between 0.20 and 0.26 p=0.005). In patients with AF, (n=255, mean age 71 (± 10.), 58% men), continuity of care was related to having had contact by telephone with a nurse-led AF clinic, higher perceived control, higher quality of life and not being depressed (ᚹ range between 0.14–0.25 p=0.03). In patients with HF, (n=173, mean age 77 (±8) 59% men), continuity was related to male ender, younger age, follow-up in a nurse-led HF clinic and not being anxious (ᚹ range between 0.16 and 0.22 p=0.004–0.047). Low total score on PCCQ correlated to having had telephone contact with nurse in primary care (ᚹ −0.24 p=0.002). Conclusion Almost half of all patient reported insufficient continuity of care. Perceived control, quality of life, and symptoms of depression were related to higher continuity of care in all diagnose groups except heart failure. Further, there was a correlation between continuity and follow-up visits or contact by telephone with nurse-led clinics in all diagnose groups except angina. Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Medical Research Council of Southeast Sweden, Centre for Clinical Research Sörmland

scholarly journals Health care services and costs after hip fracture, comparing conventional versus standardised care: A retrospective study with 12-month follow-up

Injury ◽  
2021 ◽  
Author(s):  
Kristin Haugan ◽  
Vidar Halsteinli ◽  
Øystein Døhl ◽  
Trude Basso ◽  
Lars G. Johnsen ◽  
...  
Keyword(s):  
Health Care ◽  
Retrospective Study ◽  
Hip Fracture ◽  
Health Care Services ◽  
Care Services
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