scholarly journals Continuity of Care Assessment Within a Vertically Integrated Care Management Organization Before and After COPD-Related Exacerbations

2021 ◽  
Vol Volume 16 ◽  
pp. 2755-2767
Author(s):  
Morgan Justice Fuoco ◽  
Richard A Mularski ◽  
Benjamin Wu ◽  
Chad Moretz ◽  
Mary Ann McBurnie ◽  
...  
Keyword(s):  
Integrated Care ◽  
Continuity Of Care ◽  
Care Management ◽  
Care Assessment ◽  
Before And After ◽  
Management Organization

The Cardinal Needs Schedule – a modified version of the MRC Needs for Care Assessment Schedule

1995 ◽  
Vol 25 (3) ◽  
pp. 605-617 ◽  
Author(s):  
M. Marshall ◽  
L. I. Hogg ◽  
D. H. Gath ◽  
A. Lockwood
Keyword(s):  
Social Services ◽  
Care Management ◽  
Social Care ◽  
Community Care ◽  
Reliability And Validity ◽  
Systematic Account ◽  
Needs For Care ◽  
Care Assessment ◽  
Modified Schedule ◽  
Assessment Of Need

SYNOPSISThis paper describes a modified version of the MRC Needs for Care Schedule (the Cardinal Needs Schedule), for measuring needs for psychiatric and social care amongst patients with severe psychiatric disorders. The modified schedule has three new features: (i) it is quick and easy to use; (ii) it takes systematic account of the views of patients and their carers; (iii) it defines and identifies need in a way that is concise and easy to interpret. The paper describes why the three new features were considered necessary, and then gives an overview of the structure of the Cardinal Needs Schedule, together with a description of how the three new features were developed. During a study of social services care management the practicality of the modified schedule was investigated and further data were obtained on the reliability and validity of the standardized approach to measuring need, in domains not previously investigated. Because of its speed and simplicity, the Cardinal Needs Schedule offers a new choice to researchers who wish to use a standardized and practical assessment of need in evaluative studies of community care. Examples of the usage of the modified schedule are given in an Appendix.

Improved Population-Based Clinical Outcomes of Patients with Atrial Fibrillation by Compliance with the Simple ABC (Atrial Fibrillation Better Care) Pathway for Integrated Care Management: A Nationwide Cohort Study

2019 ◽  
Vol 119 (10) ◽  
pp. 1695-1703 ◽  
Author(s):  
Minjae Yoon ◽  
Pil-Sung Yang ◽  
Eunsun Jang ◽  
Hee Tae Yu ◽  
Tae-Hoon Kim ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Integrated Care ◽  
Clinical Outcomes ◽  
Care Management ◽  
Care Pathway ◽  
Holistic Approach ◽  
Population Based ◽  
Composite Outcome ◽  
Care Approach ◽  
Multivariable Regression

Background An integrated care approach might be of benefit for clinical outcomes of patients with atrial fibrillation (AF). This study evaluated whether compliance with the Atrial fibrillation Better Care (ABC) pathway for integrated care management (“A” Avoid stroke; “B” Better symptom management; “C” Cardiovascular risk and Comorbidity optimization) would improve population-based clinical outcomes in a nationwide AF cohort. Methods and Results From the Korea National Health Insurance Service database, a total of 204,842 nonvalvular AF patients were enrolled between January 1, 2005 and December 31, 2015. Patients that fulfilled all criteria of the ABC pathway were defined as the “ABC” group, and those who did not were the “Non-ABC” group.Over a mean follow-up of 6.2 ± 3.5 years, the ABC pathway compliant group had lower rates of all-cause death (0.80 vs. 2.72 per 100 person-years, p < 0.001) and the composite outcome of “death, ischemic stroke, major bleeding, and myocardial infarction” (2.34 vs. 5.92 per 100 person-years, p < 0.001) compared with the Non-ABC compliant group. Adjusted Cox multivariable regression showed that the ABC group had a significantly lower risk of all-cause death (adjusted hazard ratio [HR] 0.82; 95% confidence interval [CI], 0.78–0.86) and the composite outcome (adjusted HR 0.86; 95% CI, 0.83–0.89). With the increasing numbers of ABC pathway criteria fulfilled, the risk of all-cause death and composite outcome were progressively lowered. Conclusion In the first study of a nationwide population cohort, we show that compliance with the simple ABC pathway is associated with improved clinically relevant outcomes of patients with AF. Given the high health care burden associated with AF, such a streamlined holistic approach to AF management should be implemented, to improve the care of such patients.

scholarly journals Diabetes care management patterns before and after a cancer diagnosis: A SEER‐Medicare matched cohort study

Cancer ◽  
2020 ◽  
Vol 126 (8) ◽  
pp. 1727-1735 ◽  
Author(s):  
Laura C. Pinheiro ◽  
Orysya Soroka ◽  
Lisa M. Kern ◽  
John P. Leonard ◽  
Monika M. Safford
Keyword(s):  
Cohort Study ◽  
Cancer Diagnosis ◽  
Diabetes Care ◽  
Care Management ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
Before And After

Testing the Integrative Quality Care Assessment Tool (INQUAT)

2019 ◽  
Vol 33 (1) ◽  
pp. 120-144
Author(s):  
Rebecca Amati ◽  
Tommaso Bellandi ◽  
Amer A. Kaissi ◽  
Annegret F. Hannawa
Keyword(s):  
Quality Improvement ◽  
Continuity Of Care ◽  
Assessment Tool ◽  
Small Sample Size ◽  
Quality Care ◽  
Small Sample ◽  
Content Type ◽  
Care Assessment ◽  
Quality Aspects ◽  
The Us

Purpose Identifying the factors that contribute or hinder the provision of good quality care within healthcare institutions, from the managers’ perspective, is important for the success of quality improvement initiatives. The purpose of this paper is to test the Integrative Quality Care Assessment Tool (INQUAT) that was previously developed with a sample of healthcare managers in the USA. Design/methodology/approach Written narratives of 69 good and poor quality care episodes were collected from 37 managers in Italy. A quantitative content analysis was conducted using the INQUAT coding scheme, to compare the results of the US-based study to the new Italian sample. Findings The core frame of the INQUAT was replicated and the meta-categories showed similar distributions compared to the US data. Structure (i.e. organizational, staff and facility resources) covered 8 percent of all the coded units related to quality aspects; context (i.e. clinical factors and patient factors) 10 percent; process (i.e. communication, professional diligence, timeliness, errors and continuity of care) 49 percent; and outcome (i.e. process- and short-term outcomes) 32 percent. However, compared to the US results, Italian managers attributed more importance to different categories’ subcomponents, possibly due to the specificity of each sample. For example, professional diligence, errors and continuity of care acquired more weight, to the detriment of communication. Furthermore, the data showed that process subcomponents were associated to perceived quality more than outcomes. Research limitations/implications The major limitation of this investigation was the small sample size. Further studies are needed to test the reliability and validity of the INQUAT. Originality/value The INQUAT is proposed as a tool to systematically conduct in depth analyses of successful and unsuccessful healthcare events, allowing to better understand the factors that contribute to good quality and to identify specific areas that may need to be targeted in quality improvement initiatives.

Audit of the use of Seclusion in an Approved Centre following introduction of an Integrated Care Pathway

2018 ◽  
Vol 6 (2) ◽  
pp. 204
Author(s):  
Sorcha McManus ◽  
Patrick McLaughlin ◽  
Olwyn Cranny ◽  
Peter Whitty
Keyword(s):  
Integrated Care ◽  
Care Pathway ◽  
Retrospective Chart Review ◽  
Medical Practitioner ◽  
Next Of Kin ◽  
Codes Of Practice ◽  
Before And After ◽  
Integrated Care Pathway ◽  
Clinical File ◽  
Full Adherence

Introduction: The Mental Health Commission (MHC) has published guidelines on the rules governing the use of seclusion. These must be followed and the use of seclusion recorded in the patient’s clinical file during each seclusion episode. We devised a Seclusion Integrated Care Pathway (ICP) for use in the Approved Centre in Tallaght Hospital, Dublin, Republic of Ireland. This document was developed in conjunction with the MHC guidelines to assist in the recording and monitoring of each seclusion episode.Methods: The MHC has listed 13 rules governing the use of seclusion. These include the responsibility of the registered medical practitioner (RMP), nursing staff and the levels of observations and frequency of reviews that must take place during each seclusion episode. Using the seclusion register we identified a total of 60 seclusion episodes; 30 prior to the introduction of the ICP and 30 following the introduction of the ICP. We conducted a retrospective chart review to assess the documentation of each seclusion episode. The purpose of this audit was to compare adherence to MHC codes of practice on the use of seclusion before and after the introduction of our ICP.Results: There was overall improvement in adherence following the introduction of the ICP. Areas of improvement included consultant notification, informing the patient of the reasons for and likely duration of seclusion, informing the next of kin, 15 minute nursing observations and 2-hourly nursing review. Medical reviews within 4 hours, documentation of whether seclusion could be discontinued and subsequent medical assessment disimproved following introduction of the ICP.Conclusion: While an ICP is a robust document and ensures that many of the rules in relation to seclusion are explicitly stated adjustments to the document and regular staff training are needed to ensure full adherence to MHC guidelines.

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