GM-020 Seamless care: Development of a discharge communication tool for elderly patients

Background: Elderly patients in primary care often have multiple health problems,with different healthcare professionals involved. For consistency in care, it is required that communication amongst professionals and patient-systems (patient and informal-carers) be well tuned. Electronic-communication can make it easier for patient-system to be active in care.Objective: To examine whether an e-communication tool (Congredi) designed for professionals, including a care plan and secure e-mail, is usable for patient-systems and what their experiences are.Methods: In a multi-method study, home-dwelling elderly patients with two or more professionals were invited to use Congredi; data were gathered from the system after 42 weeks. Also semi-structured interviews were undertaken with patient-systems with topics retrieved from literature. Analysis took place by two researchers independently; the themes were extracted together by consensus.Results: Data about actual use of the tool were gathered from 22 patients. Four profiles of Congredi-users were distinguished, varying in intensity of use. Data from interviews with members of patient-systems (n = 7) showed that they were motivated and able to use Congredi. Barriers in daily use were limited participation of professionals, unanswered e-mail and not being alerted about actions. Despite limitations, patient-systems retained their motivation.Conclusion: Congredi was usable for patient-systems. The barriers found seem not to be tool-related but primarily user-related. An important barrier for daily use was limited active participation of involved professionals in a complete feedback loop. Potential for future implementation was found, as patient-systems were intrinsically motivated for better feedback with the professionals, even though in this study it only partly met their expectations.

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The challenge of involving elderly patients in primary care by using an electronic communication tool with their professionals: a mixed methods study

International Journal of Integrated Care ◽

10.5334/ijic.icic20213 ◽

2021 ◽

Vol 21 (S1) ◽

pp. 319

Author(s):

Rolien De Jong

Keyword(s):

Primary Care ◽

Mixed Methods ◽

Elderly Patients ◽

Electronic Communication ◽

Mixed Methods Study ◽

Communication Tool

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A randomised controlled trial assessing the efficacy of an electronic discharge communication tool for preventing death or hospital readmission

BMJ Quality & Safety ◽

10.1136/bmjqs-2017-006635 ◽

2017 ◽

Vol 26 (12) ◽

pp. 993-1003 ◽

Cited By ~ 4

Author(s):

Maria J Santana ◽

Jayna Holroyd-Leduc ◽

Danielle A Southern ◽

Ward W Flemons ◽

Maeve O’Beirne ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Hospital Readmission ◽

Controlled Trial ◽

Communication Tool ◽

Randomised Controlled ◽

Discharge Communication

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Evaluation and Implementation of ListeningTime: A Web-Based Preparatory Communication Tool for Elderly Patients With Cancer and Their Health Care Providers

JMIR Cancer ◽

10.2196/11556 ◽

2019 ◽

Vol 5 (1) ◽

pp. e11556 ◽

Cited By ~ 1

Author(s):

Janneke Noordman ◽

Jeanine A Driesenaar ◽

Inge R van Bruinessen ◽

Johanneke EA Portielje ◽

Sandra van Dulmen

Keyword(s):

Health Care ◽

Elderly Patients ◽

Health Care Providers ◽

Care Providers ◽

Communication Tool ◽

Web Based ◽

Patients With Cancer

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Prospective economic evaluation of an electronic discharge communication tool: analysis of a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2017-019139 ◽

2017 ◽

Vol 7 (12) ◽

pp. e019139 ◽

Cited By ~ 3

Author(s):

Laura K Sevick ◽

Maria-Jose Santana ◽

William A Ghali ◽

Fiona Clement

Keyword(s):

Economic Evaluation ◽

Randomised Controlled Trial ◽

Usual Care ◽

Controlled Trial ◽

Secondary Outcome ◽

Control Group ◽

Communication Tool ◽

Randomised Controlled ◽

The Cost ◽

Discharge Communication

ObjectiveTo complete an economic evaluation within a randomised controlled trial (RCT) comparing the use of an electronic discharge communication tool (eDCT) compared with usual care.SettingPatients being discharged from a single tertiary care centre’s internal medicine Medical Teaching Units.ParticipantsBetween January 2012 and December 2013, 1399 patients were randomised to a discharge mechanism. Forty-five patients were excluded from the economic evaluation as they did not have data for the index hospitalisation cost; 1354 patients contributed to the economic evaluation.InterventioneDCT generated at discharge containing structured content on reason for admission, details of the hospital stay, treatments received and follow-up care required. The control group was discharged via traditional dictation methods.Primary and secondary outcome measuresThe primary economic outcome was the cost per quality-adjusted life year (QALY) gained. Secondary outcomes included the cost per death avoided and the cost per readmission avoided.ResultsThe average transcription cost was $C22.28 per patient, whereas the estimated cost of the eDCT was $C13.33 per patient. The cost per QALY gained was $C239 933 in the eDCT arm compared with usual care due to the very small gains in effectiveness and approximately $C800difference in resource utilisation costs. The bootstrap analyses resulted in eDCT being more effective and more costly in 29.2% of samples, less costly and more effective in 29.2% of samples, less effective and more costly in 23.9% of samples and finally, less costly and less effective in 17.7% of samples.ConclusionsThe eDCT reduced per patient costs of the generation of discharge summaries. The bootstrap estimates demonstrate considerable uncertainty supporting the finding of neutrality reported in the clinical component of the RCT. The immediate transcription cost savings and previously documented provider and patient satisfaction may increase the impetus for organisations to invest in such systems, provided they have a foundation of eHealth infrastructure and readiness.Trial registration numberNCT01402609.

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Does a Standardized Discharge Communication Tool Improve Resident Performance and Overall Patient Satisfaction?

Western Journal of Emergency Medicine ◽

10.5811/westjem.2020.9.48604 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Michael Dalley ◽

Mauricio Baca ◽

Chandelle Raza ◽

Laurie Boge ◽

David Edwards ◽

...

Keyword(s):

Patient Satisfaction ◽

Communication Tool ◽

Resident Performance ◽

Discharge Communication

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Evaluation and Implementation of ListeningTime: A Web-Based Preparatory Communication Tool for Elderly Patients With Cancer and Their Health Care Providers (Preprint)

10.2196/preprints.11556 ◽

2018 ◽

Author(s):

Janneke Noordman ◽

Jeanine A Driesenaar ◽

Inge R. van Bruinessen ◽

Johanneke E.A. Portielje ◽

Sandra van Dulmen

Keyword(s):

Health Care ◽

Elderly Patients ◽

Cancer Survivors ◽

Health Care Providers ◽

Real Life ◽

Perceived Usefulness ◽

Care Providers ◽

Communication Tool ◽

Web Based ◽

Patients With Cancer

BACKGROUND Effective patient-provider communication is an important condition to deliver optimal care and it supports patients in coping with their disease. The complex and emotionally loaded setting of oncology care challenges both health care providers (HCPs) and patients in reaching effective communication. ListeningTime is developed for elderly patients with cancer and their oncological HCPs to help them (better) prepare the clinical encounter and overcome communication barriers. ListeningTime is a Web-based preparatory communication tool including modeling videos and has an audio-facility to listen back to recorded encounters. OBJECTIVE This study aims to evaluate the usability, perceived usefulness, and actual use of ListeningTime, through the eyes of elderly patients with cancer and their oncological HCPs. If highly rated, the ultimate goal is to make ListeningTime publicly available. METHODS First, members of a panel of elderly cancer survivors and patients (age ≥65 years) were approached to evaluate ListeningTime through a Web-based questionnaire. The usability and perceived usefulness were assessed. Second, ListeningTime was evaluated in real-life practice through a pilot study in 3 Dutch hospitals. In these hospitals, elderly patients with cancer and their oncological HCPs were approached to evaluate ListeningTime through a similar Web-based questionnaire, measuring the perceived usefulness. In addition, we examined log files and user statistics to get insight into how the program was used. RESULTS A total of 30 cancer survivors or patients from the patient panel, and 17 patients and 8 HCPs from the hospitals, evaluated ListeningTime. Overall, both panel members and hospital patients were positive about the ListeningTime website, audio-facility, and video fragments. Some patients suggested improvements with respect to the actors’ performances in the video fragments and believed that ListeningTime is mainly suitable for non experienced patients. HCPs were also positive about ListeningTime; they valued the video fragments for patients and the audio-facility for patients and themselves. However, providers did not relisten their own recorded encounters. Patients did use the audio-facility to relisten their encounters. CONCLUSIONS ListeningTime was highly rated, both by patients and their oncological HCPs. As a result, the video fragments of ListeningTime are now made publicly available for elderly patients with cancer through the Dutch website “kanker.nl.”

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