Transitional care pathway for diabetes at Darent Valley Hospital, Dartford

2017 ◽  
Author(s):  
Mohamed Khonji ◽  
Naveed Khan ◽  
Kevin McEwan ◽  
Kishani Wijewarden ◽  
Alok Gupta
Keyword(s):  
Transitional Care ◽  
Care Pathway

Patient Flow or the Patient’s Journey? Exploring Health Care Providers’ Experiences and Understandings of Implementing a Care Pathway to Improve the Quality of Transitional Care for Older People

2021 ◽  
pp. 104973232110038
Author(s):  
Cecilie Fromholt Olsen ◽  
Astrid Bergland ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Anne Gudrun Langaas
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Care Providers ◽  
Transitional Care ◽  
Care Pathway ◽  
Patient Flow ◽  
Care Pathways ◽  
Care Providers ◽  
Patient Centered ◽  
Care For Older People

Internationally, the implementation of care pathways is a common strategy for making transitional care for older people more effective and patient-centered. Previous research highlights inherent tensions in care pathways, particularly in relation to their patient-centered aspects, which may cause dilemmas for health care providers. Health care providers’ understandings and experiences of this, however, remain unclear. Our aim was to explore health care providers’ experiences and understandings of implementing a care pathway to improve transitional care for older people. We conducted semistructured interviews with 20 health care providers and three key persons, along with participant observations of 22 meetings, in a Norwegian quality improvement collaborative. Through a thematic analysis, we identified an understanding of the care pathway as both patient flow and the patient’s journey and a dilemma between the two, and we discuss how the negotiation of conflicting institutional logics is a central part of care pathway implementation.

scholarly journals Implementation and impact analysis of a transitional care pathway for patients presenting to the emergency department with cardiac-related complaints

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Gabriel E. Soto ◽  
Elizabeth A. Huenefeldt ◽  
Masey N. Hengst ◽  
Arlo J. Reimer ◽  
Shawn K. Samuel ◽  
...  
Keyword(s):  
Emergency Department ◽  
Impact Analysis ◽  
Transitional Care ◽  
Care Pathway

scholarly journals Feasibility of the PalliSupport care pathway: results from a mixed-method study in acutely hospitalized older patients at the end of life

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Isabelle Flierman ◽  
Marjon van Rijn ◽  
Marike de Meij ◽  
Marjolein Poels ◽  
Dorende M. Niezink ◽  
...  
Keyword(s):  
Palliative Care ◽  
Data Collection ◽  
End Of Life ◽  
Feasibility Study ◽  
Mixed Method ◽  
Older Patients ◽  
Transitional Care ◽  
Care Pathway ◽  
Controlled Trial ◽  
Protocol Adherence

Abstract Background A transitional care pathway (TCP) could improve care for older patients in the last months of life. However, barriers exist such as unidentified palliative care needs and suboptimal collaboration between care settings. The aim of this study was to determine the feasibility of a TCP, named PalliSupport, for older patients at the end of life, prior to a stepped-wedge randomized controlled trial. Methods A mixed-method feasibility study was conducted at one hospital with affiliated primary care. Patients were ≥ 60 years and acutely hospitalized. The intervention consisted of (1) training on early identification of the palliative phase and end of life conversations, (2) involvement of a transitional palliative care team during admission and post-discharge and (3) intensified collaboration between care settings. Outcomes were feasibility of recruitment, data collection, patient burden and protocol adherence. Experiences of 14 professionals were assessed through qualitative interviews. Results Only 16% of anticipated participants were included which resulted in difficulty assessing other feasibility criteria. The qualitative analysis identified misunderstandings about palliative care, uncertainty about professionals’ roles and difficulties in initiating end of life conversations as barriers. The training program was well received and professionals found the intensified collaboration beneficial for patient care. The patients that participated experienced low burden and data collection on primary outcomes and protocol adherence seems feasible. Discussion This study highlights the importance of performing a feasibility study prior to embarking on effectiveness studies. Moving forward, the PalliSupport care pathway will be adjusted to incorporate a more active recruitment approach, additional training on identification and palliative care, and further improvement on data collection.

scholarly journals Impact of transitional care on endocrine and anthropometric parameters in Prader–Willi syndrome

2018 ◽  
Vol 7 (5) ◽  
pp. 663-672 ◽  
Author(s):  
A C Paepegaey ◽  
M Coupaye ◽  
A Jaziri ◽  
F Ménesguen ◽  
B Dubern ◽  
...  
Keyword(s):  
Transitional Care ◽  
Care Pathway ◽  
Adult Life ◽  
Stimulation Test ◽  
Metabolic Parameters ◽  
Pediatric Care ◽  
Prader Willi Syndrome ◽  
Anthropometric Parameters ◽  
Gh Treatment ◽  
Structured Care

Context The transition of patients with Prader–Willi syndrome (PWS) to adult life for medical care is challenging because of multiple comorbidities, including hormone deficiencies, obesity and cognitive and behavioral disabilities. Objective To assess endocrine management, and metabolic and anthropometric parameters of PWS adults who received (n = 31) or not (n = 64) transitional care, defined as specialized pediatric care followed by a structured care pathway to a multidisciplinary adult team. Patients and study design Hormonal and metabolic parameters were retrospectively recorded in 95 adults with PWS (mean ± s.d. age 24.7 ± 8.2 years, BMI: 39.8 ± 12.1 kg/m²) referred to our Reference Center and compared according to transition. Results Among the entire cohort, 35.8% received growth hormone (GH) during childhood and 16.8% had a GH stimulation test after completion of growth. In adulthood, 14.7% were treated with GH, 56.8% received sex-hormone therapy, whereas 91.1% were hypogonadic and 37.9% had undergone valid screening of the corticotropic axis. The main reason for suboptimal endocrine management was marked behavioral disorders. Patients receiving transitional care were more likely to have had a GH stimulation test and hormonal substitutions in childhood. They also had a lower BMI, percentage of fat mass, improved metabolic parameters and fewer antidepressant treatments. Transitional care remained significantly associated with these parameters in multivariate analysis when adjusted on GH treatment. Conclusion A coordinated care pathway with specialized pediatric care and transition to a multidisciplinary adult team accustomed to managing complex disability including psychiatric troubles are associated with a better health status in adults with PWS.

New CPT Codes Boost Pay for Transitional Care Services

2012 ◽  
Vol 42 (20) ◽  
pp. 1-2
Author(s):  
MARY ELLEN SCHNEIDER
Keyword(s):  
Transitional Care ◽  
Care Services
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