scholarly journals Impact of Home Care Services on Patient and Economic Outcomes: A Targeted Review

2021 ◽  
pp. 108482232110383
Author(s):  
Irene Lizano-Díez ◽  
Sonia Amaral-Rohter ◽  
Lucía Pérez-Carbonell ◽  
Susana Aceituno
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Positive Impact ◽  
Patient Empowerment ◽  
Home Care Services ◽  
Care Services ◽  
Adherence To Medication ◽  
Home Based ◽  
Patient Reported ◽  
Home Based Care

Patient Support Programs (PSPs) reinforce patients’ care provided by health care professionals with the aim to improve adherence and patient empowerment. PSPs may include interventions such as home-based care, individualized medication counseling, support, training, and home delivery of medicines and/or devices. This study described these services and its impact on patient-reported outcomes and health care savings. We conducted an integrative literature review which was limited to publications from the last 10 years (2009-2019) and focused on diseases that require special support and/or parenteral administration. From 7040 total citations, we identified 64 home-based care services performed worldwide. Among the home-based care services, most were provided by nurses (n = 47/64; 73.4%) and addressed to cancer patients (n = 22/64; 34.4%); 23 out of 64 services (35.9%) incorporated telepharmacy. In general, home-based services and PSPs showed a positive impact on patients’ adherence to medication, patient satisfaction, and health-related quality of life. In addition, 14 (21.9%) services reported economic results, most of which showed that home therapy led to substantial cost savings.

scholarly journals Challenges Facing Home-Based Caregivers in the Management of Health Care Risk Waste

2018 ◽  
Vol 15 (12) ◽  
pp. 2700
Author(s):  
Thobile Zikhathile ◽  
Harrison Atagana
Keyword(s):  
Health Care ◽  
Quantitative Methods ◽  
Management Practices ◽  
Early Discharge ◽  
Policy Framework ◽  
Research Approach ◽  
Running Water ◽  
Care Services ◽  
Home Based ◽  
Home Based Care

The quadruple burden of diseases, early discharge from hospital and hospital at home have resulted in home-based care services becoming a requirement in South Africa. These home-based care services generate a significant amount of health care risk waste that is mismanaged. More attention is given to the health care risk waste generated in hospitals and clinics than to health care risk waste generated by home-based caregivers. Therefore, this study investigates the health care risk waste management practices by home-based caregivers. The study adopted a mixed research approach, qualitative and quantitative methods, using a literature review, interviews, and questionnaires as means of data collection. Results show that there are different types of health care risk waste generated as a result of different activities performed by home-based caregivers, but that the waste was found to be managed in an unsafe manner. The majority of households receiving home-based care did not have basic sanitation facilities such as toilets, running water and waste removal services, aggravating the issue of health care risk waste mismanagement. The study recommends a new policy framework that will lead to safe management practices of generated health care risk waste to be adopted by home-based caregivers.

scholarly journals National Home Care Initiative in Jordan: A Demonstration Project

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 242s-242s
Author(s):  
O. Shamieh ◽  
A. Mansour ◽  
R. Harding ◽  
M. Tarawneh ◽  
S. Payne
Keyword(s):  
Health Care ◽  
Home Care ◽  
Home Health Care ◽  
Health Care Professionals ◽  
Home Care Services ◽  
Home Health ◽  
Demonstration Project ◽  
Strategic Framework ◽  
Care Services ◽  
Effective Partnership

Background and context: The home healthcare market in Jordan is nascent with little service offered. It suffers from a highly fragmented and underregulated landscape. The limited access to qualified trustworthy home care services, lack of professional home care training, and lack of home health care insurance coverage have added to the heavy in-patient bed demand and delayed hospital discharges especially for disabled or terminally ill patients. Aim: To establish a comprehensive national home care program to improve the delivery of palliative and home care services in Jordan, and to conduct a situational analysis and generate policy recommendations. Strategy/Tactics: We used multiple strategies to reach our objectives. 1. Expansion of home care services at King Hussein Cancer Center (KHCC) to create a local demonstration project. 2. Building health care professional capacity by offering variety of educational programs. 3. Improving quality of service delivery by generating clinical practice guidelines, such as standards operating procedures and patient and family educational materials. 4. Use the pilot operational and financial data to generate an economic model to inform the development of similar home health care units in hospitals across Jordan. 5. National advocacy and building effective partnership with all related stakeholders to advance national policy. Program/Policy process: Between May 2016 and May 2017, 7818 home care visits were conducted by KHCC. For capacity building; 678 health care professionals were trained in palliative and home care, out of which 366 participants were females (54%). Palliative care was successfully recognized as a specialty by the Jordan Nursing Council and recognized as a subspecialty by the Jordan Medical Council. The palliative and home care standards of practice were included in the health care accreditation council. The analysis of economic evaluation data suggested that home care services decreased in-patient utilization and costs which is advantageous to a country with limited resources. As a result of the advocacy stream and a collaborative network, the national palliative and home care strategic framework was generated, and endorsed by the Ministry of Health. Outcomes: The NHCI resulted in a very successful pilot project and achieved specialty and subspecialty recognition. Furthermore, we were able to build the capacity of health care professionals and policy makers in the palliative and home care sector from public, private and academic institutions. In the advocacy and policy dimension, the Minister of Health officially approved and adapted the palliative and home care strategic framework that was developed by this initiative. What was learned: Cross-sector collaboration and effective partnership resulted in system change and policy advancement. Developing effective economic systems is essential in low resourced countries. The initiative was supported by a joint grant from the USAID and KHCC.

scholarly journals Challenges Facing Home-Based Caregivers in the Management of Health Care Risk Waste

2018 ◽  
Author(s):  
Thobile Zikhathile ◽  
Harrison Atagana
Keyword(s):  
Health Care ◽  
Quantitative Methods ◽  
Management Practices ◽  
Early Discharge ◽  
Policy Framework ◽  
Research Approach ◽  
Running Water ◽  
Care Services ◽  
Home Based ◽  
Home Based Care

The quadruple burden of diseases, early discharge from hospital and hospital at home have resulted in home-based care services becoming a requirement in South Africa. The home-based care services generate a significant amount of health care risk waste that is mismanaged. However, more attention is given to the health care risk waste generated in hospitals and clinics than to health care risk waste generated by home-based caregivers. Therefore, this study investigates the health care risk waste management practices by home-based caregivers. The study adopted a mixed research approach, qualitative and quantitative methods, using a literature review, interviews, and questionnaires as means of data collection. Results show that there are different types of health care risk waste generated as a result of different activities performed by home-based caregivers, but that the waste was found to be managed in an unsafe manner. The majority of households receiving home-based care did not have basic sanitation facilities such as toilets, running water and waste removal services, aggravating the issue of health care risk waste mismanagement. The study recommends a new policy framework that will lead to safe management practices of generated health care risk waste to be adopted by home-based caregivers.

scholarly journals Excellence in elective hip and knee surgery: what does it look like? A positive deviance approach

2019 ◽  
Vol 25 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Lesley Hughes ◽  
Laura Sheard ◽  
Lisa Pinkney ◽  
Rebecca L Lawton
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
High Performance ◽  
Elective Surgery ◽  
Local Population ◽  
Patient Empowerment ◽  
Positive Deviance ◽  
Replacement Surgery ◽  
Distributed Approach ◽  
Patient Reported

Objectives Positive deviance is a way of examining variation across health care settings to understand how and why high-performing clinical teams or organizations achieve their results despite facing the same constraints as others. This study explores how exceptional performance is delivered within enhanced hip and knee elective surgery in England. We were particularly interested in non-clinical factors that may influence patient outcomes. Methods We used 28-day emergency readmissions and patient-reported outcomes to identify two hospitals providing enhanced elective hip and knee replacement surgery and who presented different levels of performance. We used ethnographic observations, in-depth interviews, focus groups and documentary analysis, conducted over eight months. The study involved 54 health care professionals from multiple professional backgrounds. Results Five key themes were identified, which may underpin the high performance in the site identified as a positive deviant: (i) leadership and engagement that adopts a distributed approach to sustain progress and engage team members; (ii) autonomy, in particular the ability for all clinical staff to make decisions about patient care; (iii) relationships and communication, which promote clear lines of communication and a climate of shared decision making within and across teams; (iv) patient empowerment, which supports patients in managing their behaviour before and after surgery; and (v) resilience, which enables the workforce to respond to threats to maintain high performance such as those that could reduce capacity and flow, or interfere with provision and coordination. Conclusions Our study demonstrates that it is possible to build an excellent service that meets the needs of the local population and the wider organization agenda despite constraints and rising demands. The findings can inform orthopaedic and other surgical departments on ways in which they can achieve high performance within existing resources.

scholarly journals A Summary of Researches on the Quality of Home-based Care Services in China

2021 ◽  
Vol 10 (1) ◽  
pp. 41
Author(s):  
Yi-Luo Wang ◽  
Ying Duan ◽  
Ying Zhang
Keyword(s):  
Service Quality ◽  
Home Care ◽  
Care Service ◽  
Elderly Care ◽  
The Elderly ◽  
Home Care Services ◽  
Care Services ◽  
Home Based ◽  
Home Based Care

With the increase of the aging of the population in china, the demand of the elderly continues to increase, which has brought great challenges to the elderly care service industry. As a new type of elderly care service, home-based care services directly affect the quality of the elderly’s health and daily life in their later years. Therefore, improving the product and quality of elderly care services has become the goal and purpose of the development of home-based care service for aged. This article uses Cite Space software to perform visual analysis of keyword clustering on existing literature, and concludes that scholars focus on the integration of medical care, social elderly care service system, service quality, and influencing factors, but the impact of service quality models and indicator systems is low. Then through the integration and induction of scholars’ research progress on home care services, existing problems in service quality, and service quality evaluation index systems, in order to continue to innovate on the basis of existing knowledge, improve the service quality index system, and focus on combing process indicators with outcome indicators effectively, thereby improving the quality of community home care services.

scholarly journals Coaxing as a Strategy to Deal with Ethical Issues in Community Home Care: An Ethnographic Study

2020 ◽  
Author(s):  
Dara Rasoal
Keyword(s):  
Health Care ◽  
Home Care ◽  
Health Care Professionals ◽  
Ethical Issues ◽  
Participant Observation ◽  
Home Care Services ◽  
Ethnographic Study ◽  
Western Society ◽  
Care Services ◽  
Difficult Situations

Introduction: The provision of home health care services increases as a desirable option in western society. Previous studies indicate that health care professionals encounter ethically difficult situations when providing home care services. There is a lack of studies describing ethically difficult situations through observation. This study aimed to explore ethical issues experienced by healthcare staff when providing community home care services.  Methods: Qualitative design, using the ethnographical approach. Data gathered as fieldwork in terms of memos, non-participant observation and informal interview with registered nurses (n=8), and nurse-assistants (n=4) during three weeks (in total 148 hours, 7am -5pm) . Results: The result generated two main categories: 1) To balance stakeholders’ requirements, and, 2) Strategy to deal with ethical issues. Coxing was used as a strategy to deal with ethically difficult situations in patient care. The results showed that the complexity of the ethical issues is often related to personal values and organisational impact. The staff experienced need for a structured approach to assist them in identifying, analysing, and resolving ethical issues that arise in clinical practice. Health care organisations, personnel and patients are disagreed about values and choices that could lead to the best course of actions. Conclusion: This study reveals that the ethically difficult situations in the context of community home care services are complex and are influencing the provision of care. The personnel enforced to find a balance between different expectations and from different stakeholders. To deal with these situations coaxing was used as a strategy for managing ethical issues.

Telemedicine in Cancer Care

2018 ◽  
pp. 540-545 ◽  
Author(s):  
S. Joseph Sirintrapun ◽  
Ana Maria Lopez
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Cancer Care ◽  
Symptom Management ◽  
Lifestyle Modification ◽  
Clinical Settings ◽  
Home Based ◽  
Home Based Care ◽  
Care Costs ◽  
Improve Access

Telemedicine uses telecommunications technology as a tool to deliver health care to populations with limited access to care. Telemedicine has been tested in multiple clinical settings, demonstrating at least equivalency to in-person care and high levels of patient and health professional satisfaction. Teleoncology has been demonstrated to improve access to care and decrease health care costs. Teleconsultations may take place in a synchronous, asynchronous, or blended format. Examples of successful teleoncology applications include cancer telegenetics, bundling of cancer-related teleapplications, remote chemotherapy supervision, symptom management, survivorship care, palliative care, and approaches to increase access to cancer clinical trials. Telepathology is critical to cancer care and may be accomplished synchronously and asynchronously for both cytology and tissue diagnoses. Mobile applications support symptom management, lifestyle modification, and medication adherence as a tool for home-based care. Telemedicine can support the oncologist with access to interactive tele-education. Teleoncology practice should maintain in-person professional standards, including documentation integrated into the patient’s electronic health record. Telemedicine training is essential to facilitate rapport, maximize engagement, and conduct an accurate virtual exam. With the appropriate attachments, the only limitation to the virtual exam is palpation. The national telehealth resource centers can provide interested clinicians with the latest information on telemedicine reimbursement, parity, and practice. To experience the gains of teleoncology, appropriate training, education, as well as paying close attention to gaps, such as those inherent in the digital divide, are essential.

Refining Patient-Centered Measures of End-of-Life Care Quality for Children With Cancer

2021 ◽  
Author(s):  
Prasanna Ananth ◽  
Sophia Mun ◽  
Noora Reffat ◽  
Soo Jung Kang ◽  
Sarah Pitafi ◽  
...  
Keyword(s):  
Health Care ◽  
End Of Life ◽  
Health Care Professionals ◽  
End Of Life Care ◽  
Care Quality ◽  
Life Care ◽  
Children With Cancer ◽  
Symptom Screening ◽  
Palliative Care Consultation ◽  
Patient Reported

PURPOSE: There are no existing quality measures (QMs) to optimize end-of-life care for children with cancer. Previously, we developed a set of 26 candidate QMs. Our primary objective in this study was to achieve stakeholder consensus on priority measures. METHODS: We conducted an iterative, cross-sectional electronic survey, using a modified Delphi method to build consensus among clinician and family stakeholders. In each of the two rounds of surveys, stakeholders were asked to rate QMs on a 9-point Likert scale, on the basis of perceived importance. Health care professionals were additionally asked to rate measures on perceived feasibility. After each round, we computed median scores on importance and feasibility of measurement, retaining QMs with median importance scores ≥ 8. RESULTS: Twenty-five participants completed both rounds of the survey. In round 1, participants were asked to rate 26 QMs; nine QMs, including QMs pertaining to health care use, were removed because of median importance scores < 8. Two new measures were proposed for consideration in round 2, on the basis of participant feedback. Following round 2, 17 QMs were ultimately retained. QMs related to symptom screening and palliative care consultation were rated highly in importance and feasibility. QMs related to communication were rated highly important, yet less feasible. Measuring whether a patient's needs were heard by their health care team was rated among the least feasible. CONCLUSION: Childhood cancer stakeholders prioritized QMs pertaining to patient-reported outcomes, deeming measures of health care resource use less important. Future research should seek to develop novel tools for quality assessment to enhance feasibility of implementing priority measures.

Promoting Healthy Medication Use Through Indigenous Knowledge Sharing: A Coyote Story

2021 ◽  
Vol 16 (2) ◽  
Author(s):  
Gina Gaspard ◽  
Carrie Gadsby ◽  
Cindy Preston
Keyword(s):  
Health Care ◽  
Knowledge Sharing ◽  
First Nations ◽  
Indigenous People ◽  
Health Authority ◽  
Health Care Professionals ◽  
Claims Data ◽  
Medication Management ◽  
Medication Use ◽  
Care Services

Polypharmacy is the administration of more medications than clinically required or appropriate, and it can negatively impact wellness. Prescribers, pharmacists, nurses, and those receiving care services all have an important role to play in promoting healthy medication use and minimizing the risk related to polypharmacy. Medication management involves health care professionals regularly reviewing drug therapies with patients for any needed changes. This strategy is a key way to reduce the harms of polypharmacy. A review of the First Nations Health Authority Health Benefits Claims data in 2015 confirmed that polypharmacy is an issue for First Nations in British Columbia, Canada. This was further validated in a series of meetings held in four First Nations communities. The learnings from these meetings were that many people do not know the names of their medications, the reasons for taking them, or how to advocate for themselves during health care interactions. A unique strategy was needed to both encourage and empower First Nations and Indigenous people to discuss managing their medications, and to support health care professionals to better understand how to engage First Nations patients about their medications.

scholarly journals Assessing the Capital Efficiency of Healthcare Information Technologies Investments: An Econometric Perspective

2008 ◽  
Vol 17 (01) ◽  
pp. 114-127 ◽  
Author(s):  
Rodolphe Meyer ◽  
Patrice Degoulet
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Information Technologies ◽  
Positive Impact ◽  
Health Care Sector ◽  
Added Value ◽  
It Investment ◽  
Econometric Methods ◽  
General Business ◽  
Economic Tools

Summary Objectives To examine the different methods that can be used in the quantification of the added value of information technologies (IT) in the health care sector. This quantification represents a major issue for decision-makers and health care professionals when they have to plan an IT investment. MethodsArticles were chosen via Medline, internet and the University of Geneva bibliographic portal. Some of the papers were obtained directly from their authors. We examine the most current methods used to evaluate IT return on investment (ROI) in the general business and in the health care sector, drawing attention on methods traditionally used in macro economic studies that could reveal themselves disruptive for IT ROI impact evaluation in hospitals. Results Financial and accounting methods can provide interesting data on a specific IT project but are usually incomplete for revealing the global IT investment influence. Econometric methods tend to demonstrate the positive impact of health care IT (HIT) on hospital production and productivity. Hospitals having higher levels of IT investment tend to deliver a higher level of clinical quality and show improved hospital cost performances. Conclusions Information technologies are so intermingled with people and processes that the identification of specific IT benefit remains questionable. Using macro economic tools could be the best way to analyze and compute IT ROI in health care. Econometric tools take into account all types investments (inputs) and all the returns (outputs) enabling the precise measurement of IT investments impact, breakeven points, and possible threshold levels, thus providing helpful intelligence to reach the higher levels of IT governance in hospitals.

Sign in / Sign up

Export Citation Format

Share Document