Discharge Communications for Older Patients Between Hospital Healthcare Providers and Home Healthcare Providers: An Integrative Review

2021 ◽  
pp. 108482232110520
Author(s):  
Yeonsu Kim ◽  
Mary Crandall ◽  
Ha Do Byon
Keyword(s):  
Home Care ◽  
Older Patients ◽  
Healthcare Providers ◽  
Home Care Services ◽  
Home Healthcare ◽  
Discharge Process ◽  
Care Services ◽  
Phone Calls ◽  
Discharge Communication

The increasing volume of our aging population is dramatically affecting the need for home care services. The discharge process from hospital to home can be fraught with communication challenges if critical information is not provided. The transition process can threaten patient safety and incur adverse patient health outcomes. However, little is known about how the communication occurs between hospital and home health providers. Therefore, this integrative literature review was conducted to (1) describe the discharge communication that is occurring for older patients between hospital and home healthcare providers and (2) summarize the limitations of current discharge communication. A systematic search was conducted using CINAHL, PubMed, Web of Science, and PsycINFO databases. Findings were categorized to address each aim. Seven studies were included for full reviews. Healthcare providers used a variety of communication methods, including: written information, phone calls, or in-person meetings to exchange the discharge information of older patients. Limitations in communications included excessive and incomplete discharge documents, lack of provider’s contact information, lack of trust in each other, and lack of bidirectional communications. The quality of discharge communications can improve by utilizing mediators and implementing standardized discharge documentation requirements. Overall, there was a lack of literature that described the methods and limitations of discharge communication for older patients between hospital and home care services. Further studies can be conducted to generate more evidence. Healthcare providers may improve the quality of discharge communication by addressing the suggested areas.

scholarly journals A Qualitative Study of Healthcare Experience Among Chinese Homebound Adults Receiving Home-Based Medical Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 48-48
Author(s):  
Rui Zhou ◽  
Joyce Cheng ◽  
Shuangshuang Wang ◽  
Nengliang (Aaron) Yao
Keyword(s):  
Quality Of Care ◽  
Home Care ◽  
Medical Care ◽  
Healthcare Providers ◽  
Home Care Services ◽  
Care Providers ◽  
Professional Skills ◽  
Care Services ◽  
Home Based

Abstract Home-based medical care (HBMC) is emerging in China, but research understanding the efficiency and effectiveness of this new care model is rare. In this study, researchers interviewed 17 Chinese homebound adults aged 45 and older (53% females, mean age=76) who have received HBMC, and collected detailed information regarding their experiences and attitudes toward HBMC. Participants were recruited from healthcare institutions in Shanghai, Jinan, and Zhangqiu of China. The evaluation of patients’ experiences with HBMC yielded both positive and negative aspects. Positive experiences included 1) the delivery method was convenient for homebound patients; 2) health problems could be detected timely because doctors visited patients regularly; 3) home care providers had better bedside manners and professional skills than hospital-based providers; 4) the medical insurance covered the cost of home care services. Negative experiences related to the supply and quality of care, including 1) the scope of current HBMC services was too limited to meet the needs of homebound patients; 2) the visit time was too short; 3) healthcare providers’ professional skills varied greatly. Findings from this study suggest that the HBMC model benefited Chinese older adults, primarily homebound adults, in terms of convenience and affordability. There are opportunities to expand the scope of home care services and improve the quality of care. Policymakers may consider providing more resources and incentives to enhance HBMC in China. Educational programs may be created to train more HBMC providers and improve their professional skills.

scholarly journals Using the Multidimensional Prognostic Index to Predict Clinical Outcomes of Hospitalized Older Persons: A Prospective, Multicenter, International Study

2018 ◽  
Vol 74 (10) ◽  
pp. 1643-1649 ◽  
Author(s):  
Alberto Pilotto ◽  
Nicola Veronese ◽  
Julia Daragjati ◽  
Alfonso J Cruz-Jentoft ◽  
Maria Cristina Polidori ◽  
...  
Keyword(s):  
Home Care ◽  
Older Patients ◽  
Risk Group ◽  
Prognostic Index ◽  
Home Care Services ◽  
Cognitive Status ◽  
Public Hospitals ◽  
Mortality Data ◽  
Care Services ◽  
Overall Mortality

Abstract Background Multidimensional Prognostic Index (MPI) is useful as a prognostic tool in hospitalized older patients, but our knowledge is derived from retrospective studies. We therefore aimed to evaluate in a multicenter, longitudinal, cohort study whether the MPI at hospital admission is useful to identify groups with different mortality risk and whether MPI at discharge may predict institutionalization, rehospitalization, and use of home care services during 12 months. Methods This longitudinal study, carried out between February 2015 and August 2017, included nine public hospitals in Europe and Australia. A standardized comprehensive geriatric assessment including information on functional, nutritional, cognitive status, risk of pressure sores, comorbidities, medications, and cohabitation status was used to calculate the MPI and to categorize participants in low, moderate, and severe risk of mortality. Data regarding mortality, institutionalization, rehospitalization, and use of home care services were recorded through administrative information. Results Altogether, 1,140 hospitalized patients (mean age 84.1 years, women = 60.8%) were included. In the multivariable analysis, compared to patients with low risk group at admission, patients in moderate (odds ratio [OR] = 3.32; 95% CI: 1.79–6.17; p < .001) and severe risk (OR = 10.72, 95% CI: 5.70–20.18, p < .0001) groups were at higher risk of overall mortality. Among the 984 older patients with follow-up data available, those in the severe-risk group experienced a higher risk of overall mortality, institutionalization, rehospitalization, and access to home care services. Conclusions In this cohort of hospitalized older adults, higher MPI values are associated with higher mortality and other negative outcomes. Multidimensional assessment of older people admitted to hospital may facilitate appropriate clinical and postdischarge management.

scholarly journals A Causal Relationship of Home Care Services on the Quality of Life among Survivors of Stroke in Thailand

2021 ◽  
Vol 18 (5) ◽  
Author(s):  
Patoomthip ADUNWATANASIRI ◽  
Siriorn SINDHU ◽  
Napaporn WANITKUN ◽  
Chukiat VIWATWONGKASEM
Keyword(s):  
Quality Of Life ◽  
Home Care ◽  
Functional Status ◽  
Home Care Services ◽  
Self Management ◽  
Stroke Survivors ◽  
Management Support ◽  
Policy Makers ◽  
Care Services

Survivors of stroke suffer impairments associated with a complex need of care from healthcare services after being discharged from hospital and returning home, and these impairments affect the quality of their lives. This cross-sectional study, aimed at evaluating the pathways linking home care services, patient factors, and quality of life (QOL), was carried out by conducting interviews and questionnaires with stroke survivors at their homes. Simple random sampling was used to select the settings for data collection, and multi-stage sampling was used to select the samples. In all, 317 stroke survivors admitted to 13 hospitals in rural and urban setting were selected for participation in the study. The data obtained were analyzed by using Structural Equation Modeling (SEM). The hypothetical model demonstrated a good fit (chi-square = 15.299, df = 9, p = 0.083, GFI = 0.98, CFI = 0.98, RMSEA = 0.047). Statistically significant explanatory variables for the home care service had a direct effect on perceived self-management support, functional status, and QOL (β = 0.39, 0.12 and 0.11, respectively), while number of community supporters had a significant positive indirect effect on QOL through functional status (β = 0.13). The variables accounted for 56 % of the variance in QOL. This finding could be used by policy makers to make important policy development in home care services and help improve health outcomes. In particular, it is also recommended that policy makers push for policies that encompass self-management support and community support groups among stroke survivors in community settings.

scholarly journals Interprofessional Stroke Rehabilitation for Stroke Survivors Using Home Care

2011 ◽  
Vol 38 (2) ◽  
pp. 317-334 ◽  
Author(s):  
Maureen Markle-Reid ◽  
Camille Orridge ◽  
Robin Weir ◽  
Gina Browne ◽  
Amiram Gafni ◽  
...  
Keyword(s):  
Home Care ◽  
Stroke Rehabilitation ◽  
Intervention Group ◽  
Home Care Services ◽  
Stroke Survivors ◽  
Interprofessional Team ◽  
Care Services ◽  
Sf 36

Objective:To compare a specialized interprofessional team approach to community-based stroke rehabilitation with usual home care for stroke survivors using home care services.Methods:Randomized controlled trial of 101 community-living stroke survivors (<18 months post-stroke) using home care services. Subjects were randomized to intervention (n=52) or control (n=49) groups. The intervention was a 12-month specialized, evidence-based rehabilitation strategy involving an interprofessional team. The primary outcome was change in health-related quality of life and functioning (SF-36) from baseline to 12 months. Secondary outcomes were number of strokes during the 12-month follow-up, and changes in community reintegration (RNLI), perceived social support (PRQ85-Part 2), anxiety and depressive symptoms (Kessler-10), cognitive function (SPMSQ), and costs of use of health services from baseline to 12 months.Results:A total of 82 subjects completed the 12-month follow-up. Compared with the usual care group, stroke survivors in the intervention group showed clinically important (although not statistically significant) greater improvements from baseline in mean SF-36 physical functioning score (5.87, 95% CI -3.98 to 15.7; p=0.24) and social functioning score (9.03, CI-7.50 to 25.6; p=0.28). The groups did not differ for any of the secondary effectiveness outcomes. There was a higher total per-person costs of use of health services in the intervention group compared to usual home care although the difference was not statistically significant (p = 0.76).Conclusions:A 12-month specialized, interprofessional team is a feasible and acceptable approach to community-based stroke rehabilitation that produced greater improvements in quality of life compared to usual home care. Clinicaltrials.gov identifier: NCT00463229

scholarly journals The Impact of Urinary Incontinence on Quality of Life in Those Receiving Home Care Services

2018 ◽  
Vol 31 (1) ◽  
pp. 30-34
Author(s):  
Mahcube Cubukcu
Keyword(s):  
Quality Of Life ◽  
Urinary Incontinence ◽  
Home Care ◽  
Chronic Diseases ◽  
Short Form ◽  
Home Care Services ◽  
Care Services ◽  
The Mean ◽  
The Impact

This study aims to evaluate the impact of urinary incontinence on the quality of life in those receiving home care services and the factors that influence this. This cross-descriptive study was performed in 180 patients who were served from Home Care Services between 01 and 28 February 2018. An International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF) was implemented in person to those who gave their informed consent with orientation and cooperation. The mean age of a 180 patients was 74.40 ± 7.80 years (min = 18, max = 104), of which 55.2% were women. The mean ICIQ-SF score was found to be 12.42 ± 4.83 (min = 0, max = 21). The lowest points were given as responses to the question, “In your opinion, what amount of leakage do you experience?” The highest points, however, were given to the question of “How much does urinary leakage interfere with your everyday life?” It was seen that when quality of life is assessed with a visual analog scale within the ICIQ-SF, the quality of life for 66.6% of elderly individuals was affected moderately or significantly. The mean ICIQ-SF scores were higher in those with chronic diseases ( p < .005). Urinary Incontinence negatively affects quality of life to a moderate and significant degree in those receiving home care. The quality of life for those who have chronic diseases was worse. In this respect, there is a need to support patients in those receiving home care services.

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