scholarly journals Novel Method for Identifying Care Home Residents in England: A Validation Study

2021 ◽  
Vol 5 (4) ◽  
Author(s):  
Stefano Conti ◽  
Filipe Oliveira dos Santos ◽  
Arne Wolters
Keyword(s):  
Health Care ◽  
Predictive Value ◽  
Care Home ◽  
Care Homes ◽  
Health Care Data ◽  
Patient Level ◽  
Home Address ◽  
Negative Rate ◽  
Routine Identification ◽  
Address Matching

IntroductionThe ability to identify residents of care homes in routinely collected health care data is key to informing healthcare planning decisions and delivery initiatives targeting the older and frail population. Health-care planning and delivery implications at national level concerning this population subgroup have considerably and suddenly grown in urgency following the onset of the COVID-19 pandemic, which has especially hit care homes. The range of applicability of this information has widened with the increased availability in England of retrospectively collected administrative databases, holding rich patient-level details on health and prognostic status who have made or are in contact with the National Health Service. In practice lack of a national registry of care homes residents in England complicates assessing an individual's care home residency status, which has been typically identified via manual address matching from pseudonymised patient-level healthcare databases linked with publicly availably care home address information. ObjectivesTo examine a novel methodology based on linking unique care home address identifiers with primary care patient registration data, enabling routine identification of care home residents in health-care data. MethodsThis study benchmarks the proposed strategy against the manual address matching standard approach through a diagnostic assessment of a stratified random sample of care home post codes in England. ResultsDerived estimates of diagnostic performance, albeit showing a non-insignificant false negative rate (21.98%), highlight a remarkable true negative rate (99.69%) and positive predictive value (99.35%) as well as a satisfactory negative predictive value (88.25%). ConclusionsThe validation exercise lends confidence to the reliability of the novel address matching method as a viable and general alternative to manual address matching.

A helping hand

2020 ◽  
Vol 16 (5) ◽  
pp. 248-250
Author(s):  
Amanda McLaughlin
Keyword(s):  
Health Care ◽  
Nursing Home ◽  
Oral Health ◽  
Residential Care ◽  
Care Home ◽  
The Elderly ◽  
Oral Health Care ◽  
Care Homes ◽  
Residential Care Home

Amanda McLaughlin considers the importance of oral health care in nursing and residential care homes Aim The reader should be able to understand the importance of introducing and maintaining effective oral health care in nursing and residential care home and nursing home settings. Objectives To have an overview of UK statistics. To understand the implications of poor oral health on overall wellbeing To understand ways in which teams can improve the oral health of the elderly.

scholarly journals Remote Health Care Provision in Care Homes in England: An Exploratory Mixed Methods Study of Yorkshire and the Humber

Technologies ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 24 ◽  
Author(s):  
Louise Newbould ◽  
Gail Mountain ◽  
Steven Ariss ◽  
Mark Hawley
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Urban Areas ◽  
Health Care Services ◽  
Qualitative Interviews ◽  
Care Home ◽  
Mixed Methods Study ◽  
Care Homes ◽  
Health Care Provision ◽  
Care Provision

An increasing demand for care homes in the UK, has necessitated the evaluation of innovative methods for delivering more effective health care. Videoconferencing may be one way to meet this demand. However, there is a lack of literature on the provision of videoconferencing in England. This mixed-methods study aimed to map current attitudes, knowledge and provision of videoconferencing in the Yorkshire and Humber region of England. Qualitative interviews with care home managers, a scoping review and field notes from a Special Interest Group (SIG) informed the development of a descriptive convenience survey which was sent out to care home managers in the Yorkshire and Humber region of England. The survey had a 14% (n = 124) response rate. Of those who responded, 10% (n = 12) reported using videoconferencing for health care; with over 78% (n = 97) of respondents’ care homes being based in urban areas. Approximately 62% (n = 77) of the 124 respondents had heard of videoconferencing for health care provision. Of those who reported not using videoconferencing (n = 112), 39% (n = 48) said they would consider it but would need to know more. The top ranked reason for not introducing videoconferencing was the belief that residents would not be comfortable using videoconferencing to consult with a healthcare professional. The main reason for implementation was the need for speedier access to services. Those already using videoconferencing rated videoconferencing overall as being very good (50%) (n = 6) or good (42%) (n = 5). Those who were not using it in practice appeared sceptical before implementing videoconferencing. The main driver of uptake was the home’s current access to and satisfaction with traditionally delivered health care services.

scholarly journals The positive predictive value of a hyperkalemia diagnosis in automated health care data

2010 ◽  
Vol 19 (11) ◽  
pp. 1204-1208 ◽  
Author(s):  
Marsha A. Raebel ◽  
Michael L. Smith ◽  
Gwyn Saylor ◽  
Leslie A. Wright ◽  
Craig Cheetham ◽  
...  
Keyword(s):  
Health Care ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Health Care Data

scholarly journals 139 What are the Barriers and Facilitators to Effective Advance Care Planning (ACP) in Residential Care Settings for Older People?

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
K Chumbley
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Palliative Care ◽  
Health Care Professionals ◽  
Care Home ◽  
Skills Training ◽  
Care Homes ◽  
Technological Support ◽  
Care Home Staff ◽  
North East

Abstract Introduction ACP is recommended for all people approaching the end of life but there is an inequality in access to ACP for care home residents. In North East Essex there has been an Electronic Palliative Care Coordination system (EPaCCS) in place for 6 years, currently without care home staff access capability. The aim of this study was to investigate ACP within care homes within this context. Method A qualitative study, with semi-structured interviews with fourteen senior care home staff from ten care homes across North East Essex. The interview transcripts underwent thematic analysis regarding facilitators and inhibitors to effective ACP. Results Four overarching themes were identified. These were relationships, communication, healthcare systems and attitudes. Care home staff considered ACP to be part of their role but perceived their work in this area to be separate from that performed by other health care professionals. The care home staff awareness of ACP done by other health care professionals was limited. Care home staff were aware of the EPaCCS, but only a minority perceived it to impact on residents care. All interviewees were keen to have access to the EPaCCS. Many of the facilitators and barriers to effective ACP in this locality are consistent with those found in prior literature. Having an EPaCCS within the area did not alleviate a perceived barrier of poor communication. Relationships between staff, residents, families and health care professionals remain the most common facilitators to ACP, with continuity of care from primary care, specialist palliative care and paperwork tools remaining important. Conclusion To overcome the inequity of access to ACP for residents in care homes interventions could be commissioned to address current barriers. These could include communication skills training, aligned primary care and community services as well as technological support for communication with family and access to EPaCCS.

scholarly journals A validation study of the identification of haemophagocytic lymphohistiocytosis in England using population-based health data

2021 ◽  
Author(s):  
Mark John Bishton ◽  
Peter Stilwell ◽  
Tim Card ◽  
Peter Lanyon ◽  
Lu Ban ◽  
...  
Keyword(s):  
Health Care ◽  
Predictive Value ◽  
Population Based ◽  
Future Research ◽  
Mortality Data ◽  
Free Text ◽  
Active Case Finding ◽  
Haemophagocytic Lymphohistiocytosis ◽  
Health Care Data ◽  
Icd 10

We assessed the validity of coded health care data to identify cases of haemophagocytic lymphohistiocytosis (HLH). Hospital Episode Statistics (HES) identified 127 cases within five hospital Trusts 2013-2018 using ICD-10 codes D76.1, D76.2 and D76.3. Hospital records were reviewed to validate diagnoses. 73/74 patients with confirmed/probable HLH were coded D76.1 or D76.2 (positive predictive value 89.0% [95% CI 80.2-94.9%]). For cases considered not HLH, 44/53 were coded D76.3 (negative predictive value 97.8% [95% CI 88.2%-99.9%]). D76.1 or D76.2 had 68% sensitivity in detecting HLH compared to an established active case finding HLH register in Sheffield. Office for National Statistics (ONS) mortality data (2003-2018) identified 698 patients coded D76.1, D76.2 and D76.3 on death certificates. 541 were coded D76.1 or D76.2 of whom 524(96.9%) had HLH in the free text cause of death. Of 157 coded D76.3, 66(42.0%) had HLH in free text. D76.1 and D76.2 codes reliably identify HLH cases, and provide a lower bound on incidence. Non-concordance between D76.3 and HLH excludes D76.3 as an ascertainment source from HES. Our results suggest electronic health care data in England can enable population wide registration and analysis of HLH for future research.

scholarly journals A multifaceted intervention to reduce antimicrobial prescribing in care homes: a non-randomised feasibility study and process evaluation

2020 ◽  
Vol 8 (8) ◽  
pp. 1-150
Author(s):  
Carmel Hughes ◽  
David Ellard ◽  
Anne Campbell ◽  
Rachel Potter ◽  
Catherine Shaw ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Data Collection ◽  
Health Services ◽  
Focus Groups ◽  
Care Home ◽  
Training Programme ◽  
Care Homes ◽  
Care Home Staff ◽  
Antimicrobial Prescribing

Background The most frequent acute health-care intervention that care home residents receive is the prescribing of medications. There are serious concerns about prescribing generally, and about antimicrobial prescribing in particular, with facilities such as care homes being described as an important ‘reservoir’ of antimicrobial resistance. Objectives To evaluate the feasibility and acceptability of a multifaceted intervention on the prescribing of antimicrobials for the treatment of infections. Design This was a non-randomised feasibility study, using a mixed-methods design with normalization process theory as the underpinning theoretical framework and consisting of a number of interlinked strands: (1) recruitment of care homes; (2) adaptation of a Canadian intervention (a decision-making algorithm and an associated training programme) for implementation in UK care homes through rapid reviews of the literature, focus groups/interviews with care home staff, family members of residents and general practitioners (GPs), a consensus group with health-care professionals and development of a training programme; (3) implementation of the intervention; (4) a process evaluation consisting of observations of practice and focus groups with staff post implementation; and (5) a survey of a sample of care homes to ascertain interest in a larger study. Setting Six care homes – three in Northern Ireland and three in the West Midlands. Participants Care home staff, GPs associated with the care homes and family members of residents. Interventions A training programme for care home staff in the use of the decision-making algorithm, and implementation of the decision-making algorithm over a 6-month period in the six participating care homes. REACH (REduce Antimicrobial prescribing in Care Homes) Champions were appointed in each care home to support intervention implementation and the training of staff. Main outcome measures The acceptability of the intervention in terms of recruitment, delivery of training, feasibility of data collection from a variety of sources, implementation, practicality of use and the feasibility of measuring the appropriateness of prescribing. Results Six care homes from two jurisdictions were recruited, and the intervention was adapted and implemented. The intervention appeared to be broadly acceptable and was implemented largely as intended, although staff were concerned about the workload associated with study documentation. It was feasible to collect data from community pharmacies and care homes, but hospitalisation data from administrative sources could not be obtained. The survey indicated that there was interest in participating in a larger study. Conclusions The adapted and implemented intervention was largely acceptable to care home staff. Approaches to minimising the data-collection burden on staff will be examined, together with access to a range of data sources, with a view to conducting a larger randomised study. Trial registration Current Controlled Trials ISRCTN10441831. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 8. See the NIHR Journals Library website for further project information. Queen’s University Belfast acted as sponsor.

scholarly journals PS1-24: The Positive Predictive Value of a Hyperkalemia Diagnosis in Automated Health Care Data

2010 ◽  
Vol 8 (3-4) ◽  
pp. 185-185
Author(s):  
M. Raebel ◽  
C. Ross ◽  
M. Smith ◽  
G. Saylor ◽  
L. Wright ◽  
...  
Keyword(s):  
Health Care ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Health Care Data

scholarly journals Optimal NHS service delivery to care homes: a realist evaluation of the features and mechanisms that support effective working for the continuing care of older people in residential settings

2017 ◽  
Vol 5 (29) ◽  
pp. 1-204 ◽  
Author(s):  
Claire Goodman ◽  
Sue L Davies ◽  
Adam L Gordon ◽  
Tom Dening ◽  
Heather Gage ◽  
...  
Keyword(s):  
Health Care ◽  
Older People ◽  
Phase 1 ◽  
Care Home ◽  
Care Homes ◽  
Health Care Provision ◽  
Care Provision ◽  
Phase 2 ◽  
Care Home Staff ◽  
Health Related

BackgroundCare homes are the institutional providers of long-term care for older people. The OPTIMAL study argued that it is probable that there are key activities within different models of health-care provision that are important for residents’ health care.ObjectivesTo understand ‘what works, for whom, why and in what circumstances?’. Study questions focused on how different mechanisms within the various models of service delivery act as the ‘active ingredients’ associated with positive health-related outcomes for care home residents.MethodsUsing realist methods we focused on five outcomes: (1) medication use and review; (2) use of out-of-hours services; (3) hospital admissions, including emergency department attendances and length of hospital stay; (4) resource use; and (5) user satisfaction. Phase 1: interviewed stakeholders and reviewed the evidence to develop an explanatory theory of what supported good health-care provision for further testing in phase 2. Phase 2 developed a minimum data set of resident characteristics and tracked their care for 12 months. We also interviewed residents, family and staff receiving and providing health care to residents. The 12 study care homes were located on the south coast, the Midlands and the east of England. Health-care provision to care homes was distinctive in each site.FindingsPhase 1 found that health-care provision to care homes is reactive and inequitable. The realist review argued that incentives or sanctions, agreed protocols, clinical expertise and structured approaches to assessment and care planning could support improved health-related outcomes; however, to achieve change NHS professionals and care home staff needed to work together from the outset to identify, co-design and implement agreed approaches to health care. Phase 2 tested this further and found that, although there were few differences between the sites in residents’ use of resources, the differences in service integration between the NHS and care homes did reflect how these institutions approached activities that supported relational working. Key to this was how much time NHS staff and care home staff had had to learn how to work together and if the work was seen as legitimate, requiring ongoing investment by commissioners and engagement from practitioners. Residents appreciated the general practitioner (GP) input and, when supported by other care home-specific NHS services, GPs reported that it was sustainable and valued work. Access to dementia expertise, ongoing training and support was essential to ensure that both NHS and care home staff were equipped to provide appropriate care.LimitationsFindings were constrained by the numbers of residents recruited and retained in phase 2 for the 12 months of data collection.ConclusionsNHS services work well with care homes when payments and role specification endorse the importance of this work at an institutional level as well as with individual residents. GP involvement is important but needs additional support from other services to be sustainable. A focus on strategies that promote co-design-based approaches between the NHS and care homes has the potential to improve residents’ access to and experience of health care.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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