scholarly journals Understanding geographic variations in psychiatric inpatient admission rates: width of the variations and associations with the supply of health and social care in France

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Coralie Gandré ◽  
Jeanne Gervaix ◽  
Julien Thillard ◽  
Jean-Marc Macé ◽  
Jean-Luc Roelandt ◽  
...  
Keyword(s):  
Social Care ◽  
Psychiatric Inpatient ◽  
Inpatient Admission ◽  
Geographic Variations ◽  
Admission Rates ◽  
Health And Social Care

scholarly journals Understanding variation in unplanned admissions of people aged 85 and over: a systems-based approach

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e026405 ◽  
Author(s):  
Andrew Wilson ◽  
Richard Baker ◽  
John Bankart ◽  
Jay Banerjee ◽  
Ran Bhamra ◽  
...  
Keyword(s):  
Primary Care ◽  
Social Care ◽  
Primary Care Trust ◽  
Community Health Services ◽  
Shared Vision ◽  
Admission Rates ◽  
Care Services ◽  
Health And Social Care ◽  
Study Sites ◽  
Unplanned Admissions

AimTo examine system characteristics associated with variations in unplanned admission rates in those aged 85+.DesignMixed methods.SettingPrimary care trusts in England were ranked according to changes in admission rates for people aged 85+ between 2007 and 2009, and study sites selected from each end of the distribution: three ‘improving’ sites where rates had declined by more than 4% and three ‘deteriorating’ sites where rates had increased by more than 20%. Each site comprised an acute hospital trust, its linked primary care trust/clinical commissioning group, the provider of community health services and adult social care.ParticipantsA total of 142 representatives from these organisations were interviewed to understand how policies had been developed and implemented. McKinsey’s 7S framework was used as a structure for investigation and analysis.ResultsIn general, improving sites provided more evidence of comprehensive system focused strategies backed by strong leadership, enabling the development and implementation of policies and procedures to avoid unnecessary admissions of older people. In these sites, primary and intermediate care services appeared more comprehensive and better integrated with other parts of the system, and policies in emergency departments were more focused on providing alternatives to admission.ConclusionsHealth and social care communities which have attenuated admissions of people aged 85+ prioritised developing a shared vision and strategy, with sustained implementation of a suite of interventions.

scholarly journals 106 Optimising Early Assessment and Intervention by Health and Social Care Professions in the ED: Preliminary Findings from the OPTIMEND RCT

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Íde O'Shaughnessy ◽  
Stephan White ◽  
Eimear Smalle ◽  
Marica Cassarino ◽  
Katie Robinson ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Care ◽  
Healthcare Utilisation ◽  
Adverse Outcomes ◽  
Control Group ◽  
Early Assessment ◽  
Admission Rates ◽  
Health And Social Care

Abstract Background Older adults are frequent users of emergency services and demonstrate high rates of adverse outcomes following emergency care. There is some evidence to suggest that Health and Social Care Professions (HSCP) teams working in the emergency department (ED) can enhance the care of older adults but the quality of these studies is mixed. This randomised controlled trial (Trial registration: NCT03739515) explores the impact of early assessment and intervention by an ED-based HSCP team on the quality, safety and cost-effectiveness of care of older adults. Methods Consecutive ED attendees aged ≥65 years were considered eligible for inclusion to the trial and were screened for eligibility based on pre-defined inclusion criteria. Participants were randomised to either early assessment/intervention by interdisciplinary team comprising a senior occupational therapist, senior physiotherapist and senior medical social worker or usual care. Primary outcomes included: ED length of stay and hospital admission rates. Secondary outcomes included: patient satisfaction, function, quality of life, incidence of ED re-visits, hospital admissions, nursing home admission, healthcare utilisation and mortality at 30-day and 6-month follow-up Results Considering the first 140 participants, the intervention group spent significantly shorter time in the ED than the control group (7.5 vs. 15.2 median hours, p<0.001) and experienced lower admission rates (18.6% vs. 64.3%). At 30-day follow up, healthcare utilisation rates were higher in the intervention than control group (77.2% vs. 61.4%, p=0.04). There were no significant differences between the groups regarding satisfaction with their ED visit, function, quality of life of incidence of adverse outcomes at 30 days. Our cost-effectiveness analysis is ongoing. Conclusion Preliminary findings from our trial indicates that HSCPs working in the ED can contribute to improved older patients’ care by reducing their duration of stay in the ED and increasing rates of discharge home. Participant recruitment and six month follow-up is continuing.

scholarly journals Geographic variations in involuntary care and associations with the supply of health and social care: results from a nationwide study

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Coralie Gandré ◽  
Jeanne Gervaix ◽  
Julien Thillard ◽  
Jean-Marc Macé ◽  
Jean-Luc Roelandt ◽  
...  
Keyword(s):  
Social Care ◽  
Geographic Variations ◽  
Nationwide Study ◽  
Health And Social Care ◽  
Involuntary Care

Practices of inclusion for carers who are higher education students

2020 ◽  
Author(s):  
Jordan Taylor ◽  
Paula Gleeson ◽  
Tania Teague ◽  
Michelle DiGiacomo
Keyword(s):  
Higher Education ◽  
Social Care ◽  
Higher Education Institutions ◽  
Education Students ◽  
Institutional Settings ◽  
Policies And Procedures ◽  
Health And Social Care ◽  
Students With A Disability ◽  
Crucial Part

The role of unpaid and informal care is a crucial part of the health and social care system in Australia and internationally. As carers in Australia have received statutory recognition, concerted efforts to foster engagement in carer participation in work and education has followed. However, little is known about the strategies and policies that higher education institutions have implemented to support the inclusion of carers. This study has three components: first, it employs a review of evidence for interventions to support to support carers; second, it reviews existing higher education institutions’ policies to gauge the extent of inclusive support made available to student carers, and; third it conducts interviews with staff from five higher education institutions with concerted carer policies in Australia were held to discuss their institutions’ policies, and experiences as practitioners of carer inclusion and support. Results indicate difficulty in identifying carers to offer support services, the relatively recent measures taken to accommodate carers in higher education, extending similar measures which are in place for students with a disability, and difficulties accommodating flexibility in rigid institutional settings. A synthesis of these findings were used to produce a framework of strategies, policies and procedures of inclusion to support carers in higher education.

A case study evaluation of a community multidisciplinary team in South East England using a mixed-method approach

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711569
Author(s):  
Jessica Wyatt Muscat
Keyword(s):  
Mental Health ◽  
Mixed Method ◽  
Social Care ◽  
Free Form ◽  
Normalisation Process Theory ◽  
Multidisciplinary Teams ◽  
Mixed Method Approach ◽  
Health And Social Care ◽  
Method Approach

BackgroundCommunity multidisciplinary teams (MDTs) represent a model of integrated care comprising health, social care, and the voluntary sector where members work collaboratively to coordinate care for those patients most at risk.AimThe evaluation will answer the question, ‘What are the enablers and what are the restrictors to the embedding of the case study MDT into the routine practice of the health and social care teams involved in the project?’MethodThe MDT was evaluated using a mixed-method approach with normalisation process theory as a methodological tool. Both quantitative and qualitative data were gathered through a questionnaire consisting of the NoMAD survey followed by free-form questions.ResultsThe concepts of the MDT were generally clear, and participants could see the potential benefits of the programme, though this was found to be lower in GPs. Certain professionals, particularly mental health and nursing professionals, found it difficult to integrate the MDT into normal working patterns because of a lack of resources. Participants also felt there was a lack of training for MDT working. A lack of awareness of evidence supporting the programme was shown particularly within management, GP, and nursing roles.ConclusionSpecific recommendations have been made in order to improve the MDT under evaluation. These include adjustments to IT systems and meeting documentation, continued education as to the purpose of the MDT, and the engagement of GPs to enable better buy-in. Recommendations were made to focus the agenda with specialist attendance when necessary, and to expand the MDT remit, particularly in mental health and geriatrics.

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