A Scoping Review of the Evidence About the Nurses Improving Care for Healthsystem Elders (NICHE) Program

2019 ◽  
Author(s):  
Allison Squires ◽  
Komal Patel Murali ◽  
Sherry A Greenberg ◽  
Linda L Herrmann ◽  
Catherine O D’amico
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Quality Of Care ◽  
Work Environment ◽  
Older Adult ◽  
Patient Outcomes ◽  
Scoping Review ◽  
Adult Care ◽  
Program Adoption

Abstract Background and Objectives The Nurses Improving Care for Healthsystem Elders (NICHE) is a nurse-led education and consultation program designed to help health care organizations improve the quality of care for older adults. To conduct a scoping review of the evidence associated with the NICHE program to (a) understand how it influences patient outcomes through specialized care of the older adult and (b) provide an overview of implementation of the NICHE program across organizations as well as its impact on nursing professionals and the work environment. Research Design and Methods Six databases were searched to identify NICHE-related articles between January 1992 and April 2019. After critical appraisal, 43 articles were included. Results Four thematic categories were identified including specialized older adult care, geriatric resource nurse (GRN) model, work environment, and NICHE program adoption and refinement. Specialized older adult care, a key feature of NICHE programs, resulted in improved quality of care, patient safety, lower complications, and decreased length of stay. The GRN model emphasizes specialized geriatric care education and consultation. Improvements in the geriatric nurse work environment as measured by perceptions of the practice environment, quality of care, and aging-sensitive care delivery have been reported. NICHE program adoption and refinement focuses on the methods used to improve care, implementation and adoption of the NICHE program, and measuring its impact. Discussion and Implications The evidence about the NICHE program in caring for older adults is promising but more studies examining patient outcomes and the impact on health care professionals are needed.

scholarly journals EMERGING ADULT CAREGIVERS: PERCEPTIONS OF OLDER ADULT CARE RECIPIENTS, QUALITY OF CONTACT, AND AGEISM

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S952-S952
Author(s):  
Anastasia E Canell ◽  
Grace Caskie
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Social Role ◽  
Emerging Adult ◽  
Care Recipient ◽  
Adult Care ◽  
Care Recipients ◽  
Adult Caregivers ◽  
Quality Of Contact

Abstract Approximately 12-18% of family caregivers to older adults in the U.S. are 18-25 years old (i.e., emerging adulthood), yet minimal research has focused on this subgroup of caregivers (Levine, 2005; Smyth, Blaxland, & Cass, 2011). Individuals’ perceptions of an older adult’s social role relate to their attitudes toward older adults as a group (Hummert, 1999; Kite & Wagner, 2002). However, whether perceptions that emerging adult caregivers hold of older adults are specific to the social role of “care-recipient” has not been studied. A sample of 210 informal caregivers (ages 18-25) were surveyed to collect qualitative responses regarding perceptions of an older adult care-recipient (age 65+) and to assess quality of contact with the care-recipient and ageist attitudes. Participants were asked to provide five adjectives describing their older adult care-recipient. Approximately 43% provided a set of adjectives in which 80%-100% were coded as positive adjectives (e.g., “active”, “wise”); similarly, half of the sample’s adjective sets contained 0%-25% negative adjectives (e.g., “helpless”, “obnoxious”). The quality of contact with the care-recipient was significantly correlated (p<.001) with the percentage of positive (r=.47) and negative (r=-.49) adjectives. Scores on the Fraboni Scale of Ageism were also significantly correlated (p<.01) with the percentage of positive (r=-.19) and negative (r=.20) adjectives. Overall, these emerging adult caregivers had generally positive perceptions of their older adult care-recipients, and these perceptions reflected the positive quality of contact with the care-recipient. Less ageist attitudes’ relationship with more positive and less negative perceptions may have implications for experiences within a caregiving dyad.

An interdisciplinary symposium on dementia care improves student attitudes toward health care teams

2009 ◽  
Vol 22 (2) ◽  
pp. 312-320 ◽  
Author(s):  
Renée A. Zucchero ◽  
Edmond Hooker ◽  
Shelagh Larkin
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Quality Of Care ◽  
Student Attitudes ◽  
Care Process ◽  
Health Care Teams ◽  
Educational Approach ◽  
International Consensus ◽  
Health Care Students

ABSTRACTBackground: Interdisciplinary teams are sometimes used in the provision of health care to populations who present with complicated needs, such as older adults experiencing dementia. Moreover, there is an international consensus that health care students should receive training in interdisciplinary care.Methods: 157 health care students from Xavier University's College of Social Sciences, Health, and Education in Cincinnati, U.S.A. participated in a five-hour symposium on an interdisciplinary approach to treating older adults with dementia. The Attitudes Toward Health Care Teams Scale (ATHCTS; Heinemann et al., 1999) was used to assess student attitudes before and after the symposium.Results: A paired-sample t-test was conducted to compare pre and post-test ATHCTS overall and subscale scores. There was a statistically significant increase in the overall pre-post ATHCTS scores and Quality of Care/Process Subscale scores. There was a significant decrease in the Physician Centrality Subscale scores.Conclusions: The findings suggest that, after the symposium, participants reported more positive overall attitudes about health care teams, and about the quality of care provided by such teams and the teamwork to achieve good patient care. Participants also displayed a decrease in their beliefs about how essential physicians are as leaders of health care teams. These results affirm the use of a brief interdisciplinary educational approach in changing student attitudes about the use of health care teams. Students who develop more positive attitudes about working on an interdisciplinary health care team recognize the team's value and therefore may be more receptive to and effective in working as professional team members in the future.

Relational Climate and Health Care Costs: Evidence From Diabetes Care

2018 ◽  
Vol 77 (2) ◽  
pp. 131-142 ◽  
Author(s):  
Marina Soley-Bori ◽  
Theodore Stefos ◽  
James F. Burgess ◽  
Justin K. Benzer
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Work Environment ◽  
Health Care Costs ◽  
Care Delivery ◽  
Positive Association ◽  
Diabetic Patients ◽  
Care Costs ◽  
Relational Climate

Quality of care worries and rising costs have resulted in a widespread interest in enhancing the efficiency of health care delivery. One area of increasing interest is in promoting teamwork as a way of coordinating efforts to reduce costs and improve quality, and identifying the characteristics of the work environment that support teamwork. Relational climate is a measure of the work environment that captures shared employee perceptions of teamwork, conflict resolution, and diversity acceptance. Previous research has found a positive association between relational climate and quality of care, yet its relationship with costs remains unexplored. We examined the influence of primary care relational climate on health care costs incurred by diabetic patients at the U.S. Department of Veterans Affairs between 2008 and 2012. We found that better relational climate is significantly related to lower costs. Clinics with the strongest relational climate saved $334 in outpatient costs per patient compared with facilities with the weakest score in 2010. The total outpatient cost saving if all clinics achieved the top 5% relational climate score was $20 million. Relational climate may contribute to lower costs by enhancing diabetic treatment work processes, especially in outpatient settings.

scholarly journals Examining the Relationship between Cost and Quality of Care in the Neonatal Intensive Care Unit and Beyond

Children ◽  
2020 ◽  
Vol 7 (11) ◽  
pp. 238
Author(s):  
Lauren Culbertson ◽  
Dmitry Dukhovny ◽  
Wannasiri Lapcharoensap
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Of Care ◽  
Neonatal Intensive Care Unit ◽  
Patient Outcomes ◽  
Neonatal Intensive Care ◽  
Future Research ◽  
The Relationship

There is tremendous variation in costs of delivering health care, whether by country, hospital, or patient. However, the questions remain: what costs are reasonable? How does spending affect patient outcomes? We look to explore the relationship between cost and quality of care in adult, pediatric and neonatal literature. Health care stewardship initiatives attempt to address the issue of lowering costs while maintaining the same quality of care; but how do we define and deliver high value care to our patients? Ultimately, these questions remain challenging to tackle due to the heterogeneous definitions of cost and quality. Further standardization of these terms, as well as studying the variations of both costs and quality, may benefit future research on value in health care.

scholarly journals Using Living Labs to Explore Needs and Solutions for Older Adults With Dementia: Scoping Review (Preprint)

2021 ◽  
Author(s):  
Henk Verloo ◽  
Adrien Lorette ◽  
Joëlle Rosselet Amoussou ◽  
Estelle Gillès de Pélichy ◽  
Alcina Matos Queirós ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Scoping Review ◽  
Independent Living ◽  
Cognitive Disorders ◽  
Health Care Facilities ◽  
Community Or ◽  
Scoping Reviews ◽  
Living Labs

BACKGROUND Numerous living labs have established a new approach for studying the health, independent living, and well-being of older adults with dementia. Living labs interact with a broad set of stakeholders, including students, academic institutions, private companies, health care organizations, and patient representative bodies and even with other living labs. Hence, it is crucial to identify the types of cocreations that should be attempted and how they can be facilitated through living labs. OBJECTIVE This study aims to scope publications that examine all types of living lab activities, exploring the needs and expectations of older adults with dementia and seeking solutions, whether they live in the community or long-term health care facilities (LTHFs). METHODS This scoping review was reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) recommendations for the extension of scoping reviews. We searched six bibliographic databases for publications up to March 2020, and a forward-backward citation chasing was performed. Additional searches were conducted using Google Scholar. The quality of the selected papers was assessed. RESULTS Of the 5609 articles identified, we read 58 (1.03%) articles and retained 12 (0.21%) articles for inclusion and final analysis. All 12 articles presented an innovative product, developed in 4 main living labs, to assist older adults with cognitive disorders or dementia living in the community or LTHFs. The objectives of these studies were to optimize health, quality of life, independent living, home care, and safety of older adults with cognitive disorders or dementia, as well as to support professional and family caregivers or reduce their burdens. The overall methodological quality of the studies ranged from poor to moderate. CONCLUSIONS This scoping review identified several living labs playing a pivotal role in research aimed at older adults with dementia living in the community or LTHFs. However, it also revealed that living labs should conduct more better-quality interventional research to prove the effectiveness of their technological products or service solutions. INTERNATIONAL REGISTERED REPORT RR2-10.2147/SHTT.S233130

scholarly journals How can leadership influence the quality of care in a health-care organization?

2020 ◽  
Vol 7 (1) ◽  
pp. 19-22
Author(s):  
Li-Yuan Xing ◽  
Jing-Hui Song ◽  
Fan Yan
Keyword(s):  
Health Care ◽  
Organizational Culture ◽  
Quality Of Care ◽  
Work Environment ◽  
Effective Leadership ◽  
Health Care Organization ◽  
Care Organization ◽  
Leadership Influence

AbstractObjectiveThis study focuses on how leadership could influence the quality of care in a health-care organization.MethodsThe concept of leadership and quality are analyzed. In addition, issues concerning how leadership can influence quality of care through the effect on the organizational culture and the engagement of both nurses and patients are discussed.ResultsLeadership is the pivotal factor in the improvement of quality through the effect on the organizational culture and the engagement of both nurses and patients.ConclusionsLeadership can influence the quality of care directly and indirectly. The organization and the leaders should know the importance of effective leadership to a better work environment, facilitate the implementation of the new mode of nursing, and provide best services to the patients.

Everyday Ethical Challenges and Informal Ethics Support Structures of Migrant Caregivers in Older Adult Care in England

2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 32-32
Author(s):  
Kumeri Bandara ◽  
◽  
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Support Systems ◽  
Ethical Challenges ◽  
Adult Care ◽  
Ethics Support ◽  
Unexplored Area ◽  
Anthropological Fieldwork ◽  
The Uk

"This paper builds on anthropological fieldwork I conducted in 2019 while living for over two months with migrant caregivers of older adults in Epsom, England. Caregivers’ experiences resonated with existing literature on everyday ethical challenges in caregiving: navigating divergent perspectives on good care, negotiating professional disagreements on treatments, dealing with older adults’ verbal and physical abuse appropriately, and telling older adults ‘white lies’ to avoid mental distress. Caregivers also faced unique ethical challenges because of their migrant identities: dealing with racism, conscientious objecting of certain requests made by older adults, struggling with language when following training and defending themselves against exploitative managers, and carrying the burden of being a translator to fellow migrant colleagues. Based on insight into ethical challenges unique to migrant caregivers, this paper focuses on informal ethics support systems on which migrants relied ‒ an unexplored area in the literature on ethics support within social care ‒ and explores formal ethics support systems that could support migrant caregivers in the future. Existing literature shows that the UK in general lacks ethics support systems to help caregivers recognize and appropriately address ethical challenges. The literature goes on to explore kinds of formal ethics support systems that could address ethical challenges. However, the literature completely overlooks needs and challenges unique to migrant caregivers who increasingly constitute the older adult care workforce in the UK. Understanding everyday ethical challenges and informal support systems of migrant caregivers are important steps in ensuring wellbeing of caregivers, and thus, quality of care. "

scholarly journals Homebound older adults: Prevalence, characteristics, health care utilization and quality of care

2015 ◽  
Vol 36 (6) ◽  
pp. 445-450 ◽  
Author(s):  
Shirley Musich ◽  
Shaohung S. Wang ◽  
Kevin Hawkins ◽  
Charlotte S. Yeh
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Quality Of Care ◽  
Health Care Utilization ◽  
Care Utilization ◽  
Homebound Older Adults

scholarly journals Current developments in delivering customized care: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Etienne Minvielle ◽  
Aude Fourcade ◽  
Thomas Ricketts ◽  
Mathias Waelli
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Delivery ◽  
Scoping Review ◽  
Care Delivery ◽  
Patient Characteristics ◽  
Delivery Systems ◽  
Segmentation Analysis ◽  
Health Care Delivery Systems

Abstract Background In recent years, there has been a growing interest in health care personalization and customization (i.e. personalized medicine and patient-centered care). While some positive impacts of these approaches have been reported, there has been a dearth of research on how these approaches are implemented and combined for health care delivery systems. The present study undertakes a scoping review of articles on customized care to describe which patient characteristics are used for segmenting care, and to identify the challenges face to implement customized intervention in routine care. Methods Article searches were initially conducted in November 2018, and updated in January 2019 and March 2019, according to Prisma guidelines. Two investigators independently searched MEDLINE, PubMed, PsycINFO, Web of Science, Science Direct and JSTOR, The search was focused on articles that included “care customization”, “personalized service and health care”, individualized care” and “targeting population” in the title or abstract. Inclusion and exclusion criteria were defined. Disagreements on study selection and data extraction were resolved by consensus and discussion between two reviewers. Results We identified 70 articles published between 2008 and 2019. Most of the articles (n = 43) were published from 2016 to 2019. Four categories of patient characteristics used for segmentation analysis emerged: clinical, psychosocial, service and costs. We observed these characteristics often coexisted with the most commonly described combinations, namely clinical, psychosocial and service. A small number of articles (n = 18) reported assessments on quality of care, experiences and costs. Finally, few articles (n = 6) formally defined a conceptual basis related to mass customization, whereas only half of articles used existing theories to guide their analysis or interpretation. Conclusions There is no common theory based strategy for providing customized care. In response, we have highlighted three areas for researchers and managers to advance the customization in health care delivery systems: better define the content of the segmentation analysis and the intervention steps, demonstrate its added value, in particular its economic viability, and align the logics of action that underpin current efforts of customization. These steps would allow them to use customization to reduce costs and improve quality of care.

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