ASKING THE PEOPLE WHO MATTER THE MOST: DESIGNING A VALUE-BASED DEMENTIA SPECIALTY CLINIC

Abstract This presentation will highlight our research which uses a qualitative methodology to incorporate the voices and experiences of people impacted by dementia into the value-based health model. This model is characterized by a team-based approach as well as the measurement of outcomes. The aim of value-based care is to provide individuals meaningful and compassionate care that helps them achieve the health outcomes that matter most to them. Foundational to creating this person-centered model is the incorporation of the perspectives of individuals with dementia and their care partners. Experience Groups offer an opportunity for those affected by dementia to share their expertise and describe their daily challenges and successes so we are able to learn from their experiences and better understand unmet and unarticulated needs. The findings of this research—consisting of 41 patients and 11 care partners—enabled the development of outcome measurement tools implemented at the clinical level, and the design of a care delivery model that addresses unmet needs. Some of the key findings from the research that have been implemented at the Cognitive Disorders Clinic and that will be highlighted in this poster are: 1. Care partners would like more emotional support from their medical team; 2. Individuals want more information about the trajectory of the disease and an actionable “roadmap-of-care”; 3. Care partners and those with early stage memory loss desire counseling and team-based care versus strictly physician-provided care.

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Designing a Value-Based Care Delivery Model for Complex Older Adults Based on Geriatric and Palliative Care Principles (FR461B)

Journal of Pain and Symptom Management ◽

10.1016/j.jpainsymman.2016.12.150 ◽

2017 ◽

Vol 53 (2) ◽

pp. 378

Author(s):

Ankur Bharija ◽

Astrid Block

Keyword(s):

Older Adults ◽

Palliative Care ◽

Care Delivery ◽

Delivery Model ◽

A Value ◽

Care Delivery Model ◽

Value Based Care

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Translating a Group-Based Dyadic Intervention for Early-Stage People and Their Care Partners for Spanish Speakers

Innovation in Aging ◽

10.1093/geroni/igaa057.2136 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 626-626

Author(s):

David Coon ◽

Marielysse Cortes ◽

Abigail Gomez ◽

Berta Carbajal ◽

Maria Gonzalez ◽

...

Keyword(s):

Early Stage ◽

Memory Loss ◽

Skills Training ◽

Spanish Language ◽

Spanish Speakers ◽

Entire Group ◽

Language Version ◽

Care Partners ◽

The Impact ◽

Psychoeducational Interventions

Abstract This presentation focuses on the development of and recruitment for a Spanish language version of EPIC, a group-based dyadic intervention for people with early-stage dementia (EPs) and their care partners (CPs). EPIC involves activities for the entire group together, separate EP or CP groups, and one individualized session for each dyad. EPIC builds on components of SHARE combined with strategies from other psychoeducational interventions (e.g., skills-training, care values clarification, care planning). Findings from 6 focus groups with Latino participants were used to help with cultural responsiveness such as fluent Spanish/bilingual staff, testimonials from Latino families affected by dementia, and minimization of “threatening” language for memory loss. Participants also provided suggestions for recruitment for Spanish speakers such as engaging promotores, using social media across generations, recruiting through Spanish language health classes, and recognizing the impact of the political environment. The presentation will review both recruitment successes and challenges using these approaches.

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Value-Based Care

Oxford Textbook of Palliative Nursing ◽

10.1093/med/9780190862374.003.0057 ◽

2019 ◽

pp. 690-696

Author(s):

Finly Zachariah ◽

William Dale

Keyword(s):

Palliative Care ◽

Healthcare Costs ◽

Care Delivery ◽

Healthcare Delivery ◽

Healthcare Team ◽

Institute Of Medicine ◽

A Value ◽

Care Delivery Model ◽

Value Based Care ◽

Evidence Based Care

The unsustainable growth of healthcare costs has precipitated the need for significant reforms in healthcare with a focus on shifting from volume to value. Value-based care is evidence-based care that helps patients improve their health, reduce the effects from chronic diseases, and live healthier lives. The Institute of Medicine (IOM) report, Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life, detailed several recommendations to improve care through the provision of palliative care. Palliative care is conducted by an interdisciplinary team and, in addition to addressing bio-psycho-socio-spiritual concerns, facilitates the alignment of patient preferences with healthcare delivery and minimizes under- and overtreatment. This chapter explores key opportunities aligned with the IOM’s report that recommend nurses and the healthcare team facilitate the incorporation of palliative care and execution and the adoption of a value-based care delivery model.

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Co-designing an Integrated Care Network With People Living With Parkinson’s Disease: From Patients’ Narratives to Trajectory Analysis

Qualitative Health Research ◽

10.1177/10497323211042605 ◽

2021 ◽

pp. 104973232110426

Author(s):

Grosjean Sylvie ◽

Jordi Farré Coma ◽

Gal Ota ◽

Laffan Aoife ◽

Sendra Anna ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Integrated Care ◽

Care Delivery ◽

Care Needs ◽

Care Network ◽

Care Delivery Model ◽

Care Partners ◽

Narrative Interview ◽

Complex Care Needs

An integrated care model for people living with Parkinson’s disease (PD) offers the promise of meeting complex care needs in a person-centered way that addresses fragmentation and improves quality of life. The purpose of our research was to co-design a care delivery model that supports both social and medical care from the perspective of patients and care partners. In the first step of our co-design approach, participants from five countries were invited to share their experiences of living with PD during a narrative interview. A qualitative analysis of these narrative interviews based on the Corbin and Strauss model was done to map out patients’ trajectories. Three typical trajectories were identified: (a) the “unpredictable” trajectory, (b) the “situated” trajectory, and (c) the “demanding” trajectory. Based on the analysis of these trajectories, we were able to integrate various patient experiences into the design of an integrated care network.

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Effect of COVID-19 on Thoracic Oncology Surgery in Spain: A Spanish Thoracic Surgery Society (SECT) Survey

Cancers ◽

10.3390/cancers13122897 ◽

2021 ◽

Vol 13 (12) ◽

pp. 2897

Author(s):

Néstor Martínez-Hernández ◽

Usue Caballero Silva ◽

Alberto Cabañero Sánchez ◽

José Luis Campo-Cañaveral de la Cruz ◽

Andrés Obeso Carillo ◽

...

Keyword(s):

Overall Response Rate ◽

Early Stage ◽

Care Delivery ◽

Public Hospitals ◽

Clinical Activity ◽

Spanish Society ◽

Lung Cancer Patients ◽

Oncological Patients ◽

Multiple Choice Questionnaire ◽

The Impact

After the first wave of COVID-19, the Spanish Society of Thoracic Surgeons (SECT) surveyed its members to assess the impact of the pandemic on thoracic oncology surgery in Spain. In May 2020, all SECT members were invited to complete an online, 40-item, multiple choice questionnaire. The questionnaire was developed by the SECT Scientific Committee and sent via email. The overall response rate was 19.2%. The respondents answered at least 91.5% of the items, with only one exception (a question about residents). Most respondents (89.3%) worked in public hospitals. The reported impact of the pandemic on routine clinical activity was considered extreme or severe by 75.5% of respondents (25.5% and 50%, respectively). Multidisciplinary tumour boards were held either with fewer members attending or through electronic platforms (44.6% and 35.9%, respectively). Surgical activity decreased by 95.7%, with 41.5% of centers performing surgery only on oncological patients and 11.7% only in emergencies. Nearly 60% of respondents reported modifying standard protocols for early-stage cancer and in the preoperative workup. Most centers (≈80%) reported using full personal protective equipment when operating on COVID-19 positive patients. The COVID-19 pandemic severely affected thoracic oncology surgery in Spain. The lack of common protocols led to a variable care delivery to lung cancer patients.

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Effectiveness of a Care Delivery Model for High-Need Older Adults in Communities

Research on Social Work Practice ◽

10.1177/1049731520982355 ◽

2020 ◽

pp. 104973152098235

Author(s):

Kuei-Min Chen ◽

Hui-Fen Hsu ◽

Li-Yen Yang ◽

Chiang-Ching Chang ◽

Yu-Ming Chen ◽

...

Keyword(s):

Older Adults ◽

Repeated Measures ◽

Comparison Group ◽

Care Delivery ◽

Intervention Group ◽

Community Dwelling ◽

Delivery Model ◽

Positive Effects ◽

Repeated Measures Design ◽

Care Delivery Model

Purpose: This study aimed to test the effectiveness of High-Need Community-Dwelling Older Adults Care Delivery Model (HCOACDM) in Taiwan. Methods: A cluster randomized controlled trial with repeated measures design was conducted in eight community care centers, involving 145 high-need older adults who were assigned to the intervention group or comparison group. The HCOACDM was provided over 6 months. Functional ability, quality of life, depressive symptoms, and health care and social service utilizations were measured at baseline, at 3 months, and 6 months into the intervention. The participants’ satisfaction was measured at the end of 6-month intervention. Results: Positive effects were shown on all variables in the intervention group at both the 3-month and 6-month intervals (all p < .05). The intervention group had a higher satisfaction with care delivery than the comparison group ( p < .05). Discussion: The promising findings supported a long-term implementation of the HCOACDM as applicable and beneficial.

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Physician requirements for adoption of telehealth following the SARS-CoV-2 pandemic

npj Digital Medicine ◽

10.1038/s41746-021-00390-y ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Michael Hodgkins ◽

Meg Barron ◽

Shireesha Jevaji ◽

Stacy Lloyd

Keyword(s):

Care Delivery ◽

Virtual Technology ◽

Privacy Concerns ◽

Face To Face ◽

House Calls ◽

Care Delivery Model ◽

Virtual Visits ◽

Similar Survey ◽

Remote Care

AbstractIt took the advent of SARS-CoV-2, a “black swan event”, to widely introduce telehealth, remote care, and virtual house calls. Prior to the epidemic (2019), the American Medical Association (AMA) conducted a routine study to compare physicians’ adoption of emerging technologies to a similar survey in 2016. Most notable was a doubling in the adoption of telehealth/virtual technology to 28% and increases in the use of remote monitoring and management for improved care (13–22%). These results may now seem insignificant when compared to the unprecedented surge in telehealth visits because of SARS-CoV-2. Even as this surge levels off and begins to decline, many observers believe we will continue to see a persistent increase in the use of virtual visits compared to face-to-face care. The requirements for adoption communicated by physicians in both the 2016 and 2019 surveys are now more relevant than ever: Is remote care as effective as in-person care and how best to determine when to use these modalities? How do I safeguard my patients and my practice from liability and privacy concerns? How do I optimize using these technologies in my practice and, especially integration with my EHR and workflows to improve efficiency? And how will a mix of virtual and in-person visits affect practice revenue and sustainability? Consumers have also expressed concerns about payment for virtual visits as well as privacy and quality of care. If telehealth and remote care are here to stay, continuing to track their impact during the current public health emergency is critically important to address so that policymakers and insurers will take necessary steps to ensure that the “new normal” will reflect a health care delivery model that can provide comparable or improved results today and into the future.

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Effectiveness of a Care Delivery Model for High-Need Community-Dwelling Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.893 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 279-279

Author(s):

Kuei-Min Chen ◽

Hui-Fen Hsu

Keyword(s):

Older Adults ◽

Comparison Group ◽

Care Delivery ◽

Care Service ◽

Intervention Group ◽

Community Dwelling ◽

Delivery Model ◽

Care Services ◽

Care Delivery Model ◽

Community Dwelling Older Adults

Abstract The effectiveness of sufficient care coordination for high-need community-dwelling older adults has not been discussed. This study aimed to examine the effectiveness of a newly-developed care delivery model for high-need community-dwelling older adults. A cluster randomized controlled trial with repeated measures design was employed. A total of 145 high-need older adults participated in the study and were randomly assigned to either the intervention group or comparison group. A categorized list of care services based on the types of high-need older adults as the intervention allowed care coordinators to make adequate care service linkages. The intervention period ranged over 6 months with regulated home visits and assesssments. Functional ability, quality of life, depressive symptoms, and healthcare and social service utilizations were measured at baseline, and at 3 and 6 months into the intervention. The participants’ satisfaction with care delivery was measured at the end of 6-month intervention. Results showed that the intervention group had a better functional ability, a higher quality of life, reduced depressive symptoms, and more efficient healthcare and social service utilizations than the comparison group at both the 3-month and 6-month intervals (all p < .05). By the end of the 6-month study, the intervention group were more satisfied with the care service linkages than the comparison group (p < .05). The positive effects of providing a categorized list of care services for care coordinators to make service linkages have been evidenced by the outcomes. The promising findings supported a further longer-term implementation of the care delivery model.

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