The Effectiveness of the Nurse Care Coordinator Role on Patient-Reported and Health Service Outcomes: A Systematic Review

2017 ◽  
Vol 42 (3) ◽  
pp. 263-296 ◽  
Author(s):  
Aaron Conway ◽  
Chris O’Donnell ◽  
Patsy Yates
Keyword(s):  
Systematic Review ◽  
Health Service ◽  
Care Coordination ◽  
Evaluation System ◽  
The United States ◽  
Care Coordinator ◽  
Nurse Care ◽  
Patient Reported ◽  
Service Outcomes ◽  
The Impact

This systematic review examined the effectiveness of nurse care coordinator (CC) roles on patient-reported and health service outcomes. Multiple electronic databases (Medline, CINAHL, and EMBASE) were searched and the Cochrane Risk of Bias Assessment Tool was applied by two independent reviewers. The Grades of Recommendation, Assessment, Development, and Evaluation system was used to assess the quality of evidence. A total of 45 articles (reporting on 36 studies) were included. The majority of studies ( n = 28, 78%) were conducted in the United States and published after 2009 ( n = 24, 67%). Thirteen studies (36%) used a randomized controlled trial design. A total of 17 studies evaluated patient-reported outcomes and 29 studies reported health service outcomes. The individual components of nurse CC roles that were evaluated ranged considerably. The impact of nurse care coordination on patient-reported and health service outcomes was inconsistent. There was an indication from higher quality studies that nurse care coordination roles were more likely to result in improved patient and health service outcomes where they involved frequent, in-person interactions, had ongoing follow-up with monitoring of disease status, and involved transition care and the application of behavior change principles.

The patient-centered medical home as an intervention strategy for diabetes mellitus: A systematic review of the literature

2020 ◽  
Vol 16 ◽  
Author(s):  
Lisa S. McManus ◽  
Karen A. Dominguez-Cancino ◽  
Michele K. Stanek ◽  
Juan. M. LeyvaMoral ◽  
Carola E. Bravo-Tare ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Care Coordination ◽  
Medical Home ◽  
Health Care Expenditures ◽  
The United States ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Team Based Care ◽  
The Impact

Background: Poorly managed diabetes mellitus increases health care expenditures and negatively impact health outcomes. There are 34 million people living with diabetes in the United States with a direct annual medical cost of $237 billion. The patient-centered medical home (PCMH) was introduced to transform primary care by offering teambased care that is accessible, coordinated, and comprehensive. Although the PCMH is believed to address multiple gaps in delivering care to people living with chronic diseases, the research has not yet reported clear benefits for managing diabetes. Objective: To review the scientific literature about diabetes mellitus outcomes reported by PCMHs, and understand the impact of team-based care, interdisciplinary communication, and care coordination strategies on the clinical, financial, and health related outcomes. Method: The systematic review was performed according to the Cochrane method and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Eight databases were systematically searched for articles. The Oxford Centre for Evidence-based Medicine levels of evidence and the Critical Appraisal Skills Programme systematic review checklist were used to evaluate the studies. Results: The search resulted in 596 articles, of which 24 met all the inclusion criteria. Care management resulted in more screenings and better preventive care. Pharmacy-led interventions and technology were associated with positive clinical outcomes, decreased utilization, and cost savings. Most studies reported decreased emergency room visits and less inpatient admissions. Conclusion : The quality and strength of the outcomes were largely inconclusive about the overall effectiveness of the PCMH. Defining and comparing concepts across studies was difficult as universal definitions specific to the PCMH were not often applied. More research is needed to unpack the care model of the PCMH to further understand how the individual key components, such as care bundles, contribute to improved outcomes. Further evaluations are needed for team-based care, communication, and care coordination with comparisons to patient, clinical, health, and financial outcomes.

scholarly journals What Is the Value of the Routine Use of Patient-Reported Outcome Measures Toward Improvement of Patient Outcomes, Processes of Care, and Health Service Outcomes in Cancer Care? A Systematic Review of Controlled Trials

2014 ◽  
Vol 32 (14) ◽  
pp. 1480-1501 ◽  
Author(s):  
Grigorios Kotronoulas ◽  
Nora Kearney ◽  
Roma Maguire ◽  
Alison Harrow ◽  
David Di Domenico ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Service ◽  
Supportive Care ◽  
Patient Outcomes ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Controlled Trials ◽  
Patient Reported ◽  
Service Outcomes ◽  
Anticancer Treatment

Purpose The systematic use of patient-reported outcome measures (PROMs) has been advocated as an effective way to standardize cancer practice. Yet, the question of whether PROMs can lead to actual improvements in the quality of patient care remains under debate. This review examined whether inclusion of PROM in routine clinical practice is associated with improvements in patient outcomes, processes of care, and health service outcomes during active anticancer treatment. Methods A systematic review of five electronic databases (Medline, EMBASE, CINAHL [Cumulative Index to Nursing and Allied Health Literature], PsycINFO, and Psychology and Behavioral Sciences Collection [PBSC]) was conducted from database inception to May 2012 to locate randomized and nonrandomized controlled trials of patients receiving active anticancer treatment or supportive care irrespective of type of cancer. Results Based on prespecified eligibility criteria, we included 26 articles that reported on 24 unique controlled trials. Wide variability in the design and use of interventions delivered, outcomes evaluated, and cancer- and modality-specific context was apparent. Health service outcomes were only scarcely included as end points. Overall, the number of statistically significant findings were limited and PROMs' intervention effect sizes were predominantly small-to-moderate. Conclusion The routine use of PROMs increases the frequency of discussion of patient outcomes during consultations. In some studies, PROMs are associated with improved symptom control, increased supportive care measures, and patient satisfaction. Additional effort is required to ensure patient adherence, as well as additional support to clinicians who will respond to patient concerns and issues, with clear system guidelines in place to guide their responses. More research is required to support PROM cost-benefit in terms of patient safety, clinician burden, and health services usage.

scholarly journals Efficacy of hydrofibre dressing following total joint arthroplasty: a meta-analysis of randomised controlled trials

2021 ◽  
pp. 112070002110126
Author(s):  
Raman Mundi ◽  
Harman Chaudhry ◽  
Seper Ekhtiari ◽  
Prabjit Ajrawat ◽  
Daniel M Tushinski ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Joint Arthroplasty ◽  
Meta Analysis ◽  
Joint Infection ◽  
The United States ◽  
Joint Arthroplasty ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Observable Effect ◽  
The Impact

Introduction: In the United States, over 1,000,000 total joint arthroplasty (TJA) surgeries are performed annually and has been forecasted that this number will exceed 4,000,000 by the year 2030. Many different types of dressing exist for use in TJA surgery, and it is unclear if any of the newer, hydrofibre dressings are superior to traditional dressings at reducing rates of infections or improving wound healing. Thus, the aim of this systematic review and meta-analysis was to assess the impact of hydrofiber dressings on reducing complications. Methods: A systematic review and meta-analysis was performed using the online databases MEDLINE and the Cochrane Library. Randomized controlled trials (RCTs) comparing hydrofibre dressings to a standard dressing were included. Summary measures are reported as odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs). Our primary outcome was prosthetic joint infection (PJI). Secondary outcomes included blisters, dressing changes and wound irritation. Results: 5 RCTs were included. Hydrofibre dressing had no observable effect on PJI or wound irritation (OR 0.53; 95% CI, 0.14–1.98; p = 0.35). Hydrofibre dressings reduced the rate of blisters (OR 0.36; 95% CI, 0.14–0.90; p = 0.03) and number of dressing changes (MD -1.89; 95% CI, -2.68 to -1.11). Conclusions: In conclusion, evidence suggests hydrofibre dressings have no observable effect on PJI and wound irritation. Evidence for reduction in blisters and number of dressings is modest given wide CIs and biased trial methodologies. Use of hydrofibre dressings should be considered inconclusive for mitigating major complications in light of current best evidence.

Focal Concerns and Police Decision Making in Sexual Assault Cases: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 152483802199128
Author(s):  
David S. Lapsey ◽  
Bradley A. Campbell ◽  
Bryant T. Plumlee
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Sexual Assault ◽  
Meta Analysis ◽  
The United States ◽  
Empirical Literature ◽  
Campbell Collaboration ◽  
Focal Concerns ◽  
Police Decision Making ◽  
The Impact

Sexual assault and case attrition at the arrest stage are serious problems in the United States. Focal concerns have increasingly been used to explain police decision making in sexual assault cases. Because of the popularity of the focal concerns perspective and potential to inform evidence-based training, a systematic review and meta-analysis are needed to condense the literature. In this study, we assess the overall strength of the relationship between focal concerns variables and police decisions to arrest in cases of sexual assault. Our assessment of the effects of focal concerns variables on arrest decision making in sexual assault cases followed the systematic review protocols provided by the Campbell Collaboration of Systematic Reviews. Specifically, we used the Campbell Collaboration recommendations to search empirical literature and used meta-analysis to evaluate the size, direction, and strength of the impact of focal concerns variables on arrest decisions. Our search strategy detected 14 eligible studies and 79 effect sizes. The meta-analysis found several robust and statistically significant correlates of arrest. In fact, each focal concerns concept produced at least one robust arrest correlate. Overall, focal concerns offers a strong approach for explaining police decisions in sexual assault cases. Although practical concerns and resource constraints produced the strongest arrest correlates, results show the importance of additional case characteristics in officers’ decision to arrest.

scholarly journals The health and relationship dynamics of late-life couples: a systematic review of the literature

2009 ◽  
Vol 29 (3) ◽  
pp. 455-480 ◽  
Author(s):  
RUTH B. WALKER ◽  
MARY A. LUSZCZ
Keyword(s):  
Systematic Review ◽  
Marital Quality ◽  
Late Life ◽  
The United States ◽  
Health It ◽  
Social Emotional ◽  
Marital Relations ◽  
The Impact ◽  
The Relationship ◽  
Adequate Communication

ABSTRACTLate-life husband and wife relationships are increasingly recognised as an important factor in promoting wellbeing, particularly in terms of the health, social, emotional, financial and practical needs of older people. Knowledge of marital dynamics and how they affect both members of a couple remains scarce. This systematic review aimed to identify and appraise research that has focused explicitly on the dynamics of the relationship, as evinced by data frombothspouses. Implementing rigorous identification strategies, 45 articles were identified and reviewed. These studies were grouped into three broad thematic areas: marital relations and satisfaction; concordance in emotional state or physical health; and the interplay between marital quality and wellbeing. The issues found to affect marital relations and satisfaction in late life included equality of roles, having adequate communication, and transitions to living apart. There is strong evidence for couple concordance in depression, that marital relationships affect ill-health, longevity and recovery from illness, and reciprocally that ill-health impacts on the marriage itself. The research also suggests important gender differences in the impact of marital dynamics on health. It has led to the conclusion that there is a need for more diverse studies of late-life marriages, particularly ones that examine the dynamics of non-traditional elderly couples and that extend beyond a predominant focus on the Caucasian population of the United States.

Neighborhood Socioeconomic Status and Stroke Incidence: A Systematic Review

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011892
Author(s):  
Yeonwoo Kim ◽  
Erica Twardzik ◽  
Suzanne E. Judd ◽  
Natalie Colabianchi
Keyword(s):  
United States ◽  
Systematic Review ◽  
Socioeconomic Status ◽  
Stroke Risk ◽  
Keyword Search ◽  
The United States ◽  
Stroke Incidence ◽  
Neighborhood Socioeconomic Status ◽  
Modifiable Factors ◽  
The Impact

ObjectiveTo summarize overall patterns of the impact of neighborhood socioeconomic status (nSES) on incidence stroke and uncover potential gaps in the literature, we conducted a systematic review of studies examining the association between nSES and incident stroke, independent of individual socioeconomic status (SES).MethodsFour electronic databases and reference lists of included articles were searched, and corresponding authors were contacted to locate additional studies. A keyword search strategy included the three broad domains of neighborhood, SES, and stroke. Eight studies met our inclusion criteria (e.g., nSES as an exposure, individual SES as a covariate, and incident stroke as an outcome). We coded study methodology and findings across the eight studies.ResultsThe results provide evidence for the overall nSES and incident stroke association in Sweden and Japan, but not within the United States. Findings were inconclusive when examining the nSES-incident stroke association stratified by race. We found evidence for the mediating role of biological factors in the nSES-incident stroke association.ConclusionsHigher neighborhood disadvantage was found to be associated with higher stroke risk, but it was not significant in all the studies. The relationship between nSES and stroke risk within different racial groups in the United States was inconclusive. Inconsistencies may be driven by differences in covariate adjustment (e.g., individual-level sociodemographic characteristics, neighborhood-level racial composition). Additional research is needed to investigate potential intermediate and modifiable factors of the nSES and incident stroke association, which could serve as intervention points.

The Impact of Race/Ethnicity on the Outcomes of Burn Patients: A Systematic Review of the Literature

2021 ◽  
Author(s):  
Jasmine Peters ◽  
Mariel S Bello ◽  
Leigh Spera ◽  
T Justin Gillenwater ◽  
Haig A Yenikomshian
Keyword(s):  
Systematic Review ◽  
Native American ◽  
The United States ◽  
Current Status ◽  
Surgical Trauma ◽  
Insurance Status ◽  
Inclusion Criteria ◽  
Burn Care ◽  
Race Ethnicity ◽  
The Impact

Abstract Racial and ethnic disparities are endemic to the United States and are only beginning to attract the attention of researchers. With an increasingly diverse population, focused and tailored medicine to provide more equitable care is needed. For surgical trauma populations, this topic is a small but expanding field and still rarely mentioned in burn medicine. Disparities in prevention, treatment, and recovery outcomes between different racial and ethnic minorities who are burned are rarely discussed. The purpose of this study is to determine the current status of identified disparities of care in the burn population literature and areas of future research. A systematic review was conducted of literature utilizing PubMed for articles published between 2000-2020. Searches were used to identify articles that crossed the burn term (burn patient OR burn recovery OR burn survivor OR burn care) and a race/ethnicity and insurance status-related term (race/ethnicity OR African-American OR Black OR Asian OR Hispanic OR Latino OR Native American OR Indigenous OR Mixed race OR 2 or more races OR socioeconomic status OR insurance status). Inclusion criteria were English studies in the US that discussed disparities in burn injury outcomes or risk factors associated with race/ethnicity. 1,169 papers were populated, 55 were reviewed, and 36 articles met inclusion criteria. Most studies showed minorities had poorer inpatient and outpatient outcomes. While this is a concerning trend, there is a paucity of literature in this field and more research is needed to create culturally-tailored medical care and address the needs of disadvantaged burn survivors.

scholarly journals For Better or for Worse? A Systematic Review of the Evidence on Social Media Use and Depression Among Lesbian, Gay, and Bisexual Minorities (Preprint)

2018 ◽  
Author(s):  
César G Escobar-Viera ◽  
Darren L Whitfield ◽  
Charles B Wessel ◽  
Ariel Shensa ◽  
Jaime E Sidani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Social Media ◽  
Risk Factor ◽  
Media Use ◽  
The United States ◽  
Qualitative Studies ◽  
Social Media Use ◽  
Patterns Of Use ◽  
And Bisexual ◽  
The Impact

BACKGROUND Over 90% of adults in the United States have at least one social media account, and lesbian, gay, and bisexual (LGB) persons are more socially active on social media than heterosexuals. Rates of depression among LGB persons are between 1.5- and 2-fold higher than those among their heterosexual counterparts. Social media allows users to connect, interact, and express ideas, emotions, feelings, and thoughts. Thus, social media use might represent both a protective and a risk factor for depression among LGB persons. Studying the nature of the relationship between social media use and depression among LGB individuals is a necessary step to inform public health interventions for this population. OBJECTIVE The objective of this systematic review was to synthesize and critique the evidence on social media use and depression among LGB populations. METHODS We conducted a literature search for quantitative and qualitative studies published between January 2003 and June 2017 using 3 electronic databases. Articles were included if they were peer-reviewed, were in English, assessed social media use either quantitatively or qualitatively, measured depression, and focused on LGB populations. A minimum of two authors independently extracted data from each study using an a priori developed abstraction form. We assessed appropriate reporting of studies using the Strengthening the Reporting of Observational Studies in Epidemiology and the Consolidated Criteria for Reporting Qualitative Research for quantitative and qualitative studies, respectively. RESULTS We included 11 articles in the review; 9 studies were quantitative and cross-sectional and 2 were qualitative. Appropriate reporting of results varied greatly. Across quantitative studies, we found heterogeneity in how social media use was defined and measured. Cyberbullying was the most studied social media experience and was associated with depression and suicidality. Qualitative studies found that while social media provides a space to disclose minority experiences and share ways to cope and get support, constant surveillance of one’s social media profile can become a stressor, potentially leading to depression. In most studies, sexual minority participants were identified inconsistently. CONCLUSIONS This review supports the need for research on the role of social media use on depression outcomes among LBG persons. Using social media may be both a protective and a risk factor for depression among LGB individuals. Support gained via social media may buffer the impact of geographic isolation and loneliness. Negative experiences such as cyberbullying and other patterns of use may be associated with depression. Future research would benefit from more consistent definitions of both social media use and study populations. Moreover, use of larger samples and accounting for patterns of use and individuals’ experiences on social media may help better understand the factors that impact LGB mental health disparities.

scholarly journals Impact of care coordination on oral anticoagulant therapy among patients with atrial fibrillation in routine clinical practice in Japan: a prospective, observational study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Fumiko Ono ◽  
◽  
Sayako Akiyama ◽  
Akifumi Suzuki ◽  
Yoshinobu Ikeda ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Anticoagulant Therapy ◽  
Care Coordination ◽  
Oral Anticoagulant ◽  
Oral Anticoagulant Therapy ◽  
Critical Issue ◽  
Newly Diagnosed ◽  
Clinical Practices ◽  
Patient Reported ◽  
The Impact

Abstract Background Care coordination between general practitioners (GPs) and cardiovascular specialists is expected to play a key role in establishing appropriate oral anticoagulant (OAC) treatment in atrial fibrillation (AF) patients. The aim of this study was to assess the impact of care coordination on oral anticoagulant therapy in the management of AF in Japan. Methods This study was a multi-center, single-arm, prospective cohort study with retrospective chart and claims data review for historical controls. The study included three study periods: a 12-month pre-campaign period; a 12-month campaign period for AF screening and care coordination; and a 3-month post-campaign period for follow-up of care coordination. During the campaign period, patients aged ≥65 years who attended participating GP clinics underwent opportunistic AF screening by GPs under the campaign. At the discretion of the GP, newly diagnosed AF patients after the screening were referred to a cardiovascular specialist for care coordination. To assess the impact of care coordination and evaluate the effects of the campaign, implementation of care coordination, antithrombotic therapies, and patient-reported outcomes were compared between patients with and without care coordination, and between patients during the pre-campaign and campaign periods. Results There were 86 newly diagnosed AF patients during the pre-campaign period and 90 during the campaign period. The percentage of patients with care coordination increased from 3.5% (3/86) in the pre-campaign period to 14.4% (n = 13/90) during the campaign period. The percentage of patients who received OAC therapies, according to the definition from the Japanese AF medication guideline, increased from 55.8% (48/86) to 71.1% (64/90) during the campaign period regardless of care coordination. Younger patients were referred to cardiovascular specialists for care coordination. Implementation of OAC therapy did not differ between patients with and without care coordination. Adherence to OAC therapy was low regardless of care coordination. Conclusions This GP-targeted campaign was effective at raising awareness regarding the implementation of care coordination and appropriate OAC therapy at local clinical practices in Japan. Improvement of adherence to OAC therapy in elderly patients is a critical issue, and measures such as education programs targeted to patients and healthcare professionals should be undertaken.

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