scholarly journals Determining The Characteristics Of Transition-Based Interventions Most Effective In Enhancing Quality of Care For Seniors: A systematic Review

2021 ◽  
Author(s):  
Sarah Rosato
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Acute Care ◽  
Transitional Care ◽  
Descriptive Analysis ◽  
Chi Square ◽  
Effective Interventions ◽  
Hospital To Home ◽  
Additional Support

Introduction: Seniors (65 years or older) often require additional support and resources during the transition from acute care to home. A comprehensive understanding of the transition-based literature will support the development and implementation of effective interventions, possibly resulting in organizational and individual benefits. Purpose: A systematic review was conducted to identify the characteristics of transition-based interventions most effective in enhancing quality of care for seniors transitioning from hospital to home. Methods: Primary research that evaluated a transitional care intervention for seniors and measured one of more quality of care outcome were included. Chi-square test for independence, ANOVA, and descriptive analysis were used. Results: Forty-six interventions were reviewed for their specific characteristics. Multicomponent interventions which used multiple delivery methods (face-to-face/telephone), over one-to-three months (p= <0.05), were most effective in enhancing quality of care. Implications/Conclusions: Understanding the most effective intervention characteristics may support the provision of effective/efficient transitional care for seniors moving from acute care to home.

scholarly journals Determining The Characteristics Of Transition-Based Interventions Most Effective In Enhancing Quality of Care For Seniors: A systematic Review

2021 ◽  
Author(s):  
Sarah Rosato
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Acute Care ◽  
Transitional Care ◽  
Descriptive Analysis ◽  
Chi Square ◽  
Effective Interventions ◽  
Hospital To Home ◽  
Additional Support

Introduction: Seniors (65 years or older) often require additional support and resources during the transition from acute care to home. A comprehensive understanding of the transition-based literature will support the development and implementation of effective interventions, possibly resulting in organizational and individual benefits. Purpose: A systematic review was conducted to identify the characteristics of transition-based interventions most effective in enhancing quality of care for seniors transitioning from hospital to home. Methods: Primary research that evaluated a transitional care intervention for seniors and measured one of more quality of care outcome were included. Chi-square test for independence, ANOVA, and descriptive analysis were used. Results: Forty-six interventions were reviewed for their specific characteristics. Multicomponent interventions which used multiple delivery methods (face-to-face/telephone), over one-to-three months (p= <0.05), were most effective in enhancing quality of care. Implications/Conclusions: Understanding the most effective intervention characteristics may support the provision of effective/efficient transitional care for seniors moving from acute care to home.

scholarly journals Transitional care quality indicators to assess quality of care following hospitalisation for chronic obstructive pulmonary disease and heart failure: a systematic review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e032764
Author(s):  
Faith Michael ◽  
Sera Whitelaw ◽  
Harriette GC Van Spall
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Quality Indicators ◽  
Transitional Care ◽  
Care Quality ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Patient Reported ◽  
Hospital To Home

IntroductionThe period following hospitalisation for chronic obstructive pulmonary disease (COPD) or heart failure (HF)—when patients transition between settings and clinicians—is one of high risk. Transitional care services that bridge the gap from hospital to home can improve outcomes, but there are no widely accepted indicators to assess their quality.Methods and analysisIn this systematic review, we will summarise transitional care quality indicators, and describe their associations with clinical, patient-reported and cost outcomes. We will search MEDLINE, Embase, CINAHL and HealthSTAR, as well as grey literature and reference lists of included articles. We will screen all studies published between January 1990 and October 2019 that test an intervention that aims to improve the hospital-to-home transition for patients with COPD and/or HF; and measure at least one process (eg, medication errors), clinical (eg, hospital readmissions) or patient-reported (eg, health-related quality of life) outcome which will serve as a transitional care quality indicator . We will include randomised controlled trials, cohort studies, cross-sectional studies, interrupted time series studies and before–after studies. We will extract data in duplicate and classify transitional care quality indicators as structural, process-related or outcome-related. When possible, we will assess associations between transitional care quality indicators and clinical outcomes. In anticipation of conceptual and statistical heterogeneity, we will provide a qualitative synthesis and narrative review of the results.Ethics and disseminationThis review will provide a list of transitional care quality indicators and their associations with clinical outcomes. These results can be used by hospitals, administrators and clinicians for assessing the quality of transitional care provided to patients with COPD and HF. The findings can also be used by policy-makers to assess and incentivise transitional care quality. We will disseminate results through publications, social media releases and presentations.PROSPERO registration numberThis study is registered on PROSPERO.

scholarly journals Effectiveness of Transitional Care from Hospital to Home in Frail Older Adults: A Systematic Review

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 821-821
Author(s):  
Ji Yeon Lee ◽  
Yong Sook Yang ◽  
Eunhee Cho
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Older Adults ◽  
Health Status ◽  
Transitional Care ◽  
Frail Older Adults ◽  
Self Rated Health ◽  
Hospital To Home

Abstract Frail older adults are at high risk of negative consequences from hospitalization and are discharged without completely returning to their pre-existing health status. Transitional care is needed to maintain care continuity from hospital to home. This systematic review aimed to examine transitional care for frail older adults and its effectiveness. The Cochrane guidelines were followed, and search terms were determined by PICO: (P) frail older adults, not disease-specified; (I) transitional care initiated before discharge; (C) usual care; and (O) all health outcomes. Four databases were searched for English-written randomized controlled trials (inception to 2020), and eight trials were ultimately included. Frail older adults in eight trials (1996–2019) totaled 2,785, with a mean sample size of 310. The intervention components varied from hospital care (e.g., geriatric assessment, discharge planning, rehabilitation) to follow-up care after discharge (e.g., home visit, phone follow-up, community service). Most measured outcomes were readmission (n = 7), function (n = 4), quality of life (n = 4), self-rated health (n = 3), and mortality (n = 3). Statistical significance was reported in the following number of trials: readmission (n = 2), function (n = 2), quality of life (n = 1), self-rated health (n = 3), and mortality (n = 0). The effectiveness of the intervention on each outcome was inconsistent across the trials. Varied transitional care between hospital and home was implemented to improve health status; however, its effectiveness was controversial. A novel, yet evidence-based approach is needed to develop transitional care interventions for these vulnerable populations.

scholarly journals The quality of intervention reporting in trials of therapeutic exercise for hip osteoarthritis: a secondary analysis of a systematic review

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Louise C. Burgess ◽  
Thomas W. Wainwright ◽  
Khara A. James ◽  
Johan von Heideken ◽  
Maura D. Iversen
Keyword(s):  
Systematic Review ◽  
Secondary Analysis ◽  
Internal Validity ◽  
Hip Osteoarthritis ◽  
Therapeutic Exercise ◽  
Quality Of Reporting ◽  
Effective Interventions ◽  
Randomised Controlled ◽  
Intervention Reporting

Abstract Background Therapeutic exercise is recommended as a core treatment for hip osteoarthritis (HOA). Whilst it is widely accepted that exercise can improve pain and disability, optimal type and dose of exercise are yet to be agreed upon. This may, in part, be attributed to the wide variation and inadequate reporting of interventions within the literature. This study evaluates the quality of intervention reporting among trials of therapeutic exercise in HOA. Methods Randomised controlled trials (RCTs) were sourced in a systematic review, completed in August 2020. Two raters independently used the Template for Intervention Description and Replication (TIDieR) and Consensus on Exercise Reporting Template (CERT) to evaluate intervention reporting. Correlations between quality assessment scores and CERT and TIDieR scores evaluated the relationship between internal validity and external applicability. The year of publication was compared to the quality of reporting scores. Results Fourteen RCTs were included in the analysis. On average, studies were awarded 9.43 ± 1.95 out of 12 points for the TIDieR checklist (range 4–12) and 13.57 ± 4.01 out of 19 points for the CERT (range 5–19). Pearson’s correlation coefficient suggested that the quality of reporting had improved over time and that there was a fair, positive relationship between internal validity and external applicability. Discussion Whilst the quality of intervention reporting is improving, many RCTs of therapeutic exercise in HOA lack the detail necessary to allow accurate evaluation and replication. Researchers are encouraged to utilise the standardised reporting guidelines to increase the translation of effective interventions into clinical practice.

scholarly journals Validation and psychometric evaluation of the Dutch person-centred care of older people with cognitive impairment in acute care (POPAC) scale

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Annette Keuning-Plantinga ◽  
Evelyn J. Finnema ◽  
Wim Krijnen ◽  
David Edvardsson ◽  
Petrie F. Roodbol
Keyword(s):  
Factor Analysis ◽  
Cognitive Impairment ◽  
Quality Of Care ◽  
Confirmatory Factor Analysis ◽  
Older People ◽  
Root Mean Square ◽  
Acute Care ◽  
Mean Square ◽  
Confirmatory Factor

Abstract Background Person-centred care is the preferred model for caring for people with dementia. Knowledge of the level of person-centred care is essential for improving the quality of care for patients with dementia. The person-centred care of older people with cognitive impairment in acute care (POPAC) scale is a tool to determine the level of person-centred care. This study aimed to translate and validate the Dutch POPAC scale and evaluate its psychometric properties to enable international comparison of data and outcomes. Methods After double-blinded forward and backward translations, a total of 159 nurses recruited from six hospitals (n=114) and via social media (n=45) completed the POPAC scale. By performing confirmatory factor analysis, construct validity was tested. Cronbach’s alpha scale was utilized to establish internal consistency. Results The confirmatory factor analysis showed that the comparative fit index (0.89) was slightly lower than 0.9. The root mean square error of approximation (0.075, p=0.012, CI 0.057–0.092) and the standardized root mean square residual (0.063) were acceptable, with values less than 0.08. The findings revealed a three-dimensional structure. The factor loadings (0.69–0.77) indicated the items to be strongly associated with their respective factors. The results also indicated that deleting Item 5 improved the Cronbach’s alpha of the instrument as well as of the subscale ‘using cognitive assessments and care interventions’. Instead of deleting this item, we suggest rephrasing it into a positively worded item. Conclusions Our findings suggest that the Dutch POPAC scale is sufficiently valid and reliable and can be utilized for assessing person-centred care in acute care hospitals. The study enables nurses to interpret and compare person-centred care levels in wards and hospital levels nationally and internationally. The results form an important basis for improving the quality of care and nurse-sensitive outcomes, such as preventing complications and hospital stay length.

scholarly journals The impact of asynchronous e-visits on clinical outcomes and healthcare delivery: A systematic review (Preprint)

2021 ◽  
Author(s):  
Oliver T. Nguyen ◽  
Amir Alishahi Tabriz ◽  
Jinhai Huo ◽  
Karim Hanna ◽  
Christopher M. Shea ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Clinical Outcomes ◽  
Healthcare Costs ◽  
Healthcare Delivery ◽  
Healthcare Quality ◽  
Antibiotic Prescribing ◽  
Infection Management ◽  
The Impact

BACKGROUND E-visits involve asynchronous communication between providers and patients through a secure web-based platform, such as a patient portal, to elicit symptoms and determine a diagnosis and treatment plan. E-visits are now reimbursable through Medicare due to the COVID-19 pandemic. The state of the evidence regarding e-visits, such as the impact on clinical outcomes and healthcare delivery, is unclear. OBJECTIVE To address this gap, this systematic review examines how e-visits have impacted clinical outcomes and healthcare quality, access, utilization, and costs. METHODS MEDLINE, Embase, and Web of Science were searched from January 2000 through October 2020 for peer-reviewed studies that assessed e-visits’ impact on clinical and healthcare delivery outcomes. RESULTS Out of 1,858 papers, 19 studies met the inclusion criteria. E-visit usage was associated with improved or comparable clinical outcomes, especially for chronic disease management (e.g., diabetes care, blood pressure management). The impact on quality of care varied across conditions. Quality of care was equivalent or better for chronic conditions but variable quality was observed in infection management (e.g., appropriate antibiotic prescribing). Similarly, the impact on healthcare utilization varied across conditions (e.g., lower utilization for dermatology) but mixed impact in primary care. Healthcare costs were lower for e-visits for a wide-range of conditions (e.g., dermatology and acute visits). No studies examined the impact of e-visits on healthcare access. Available studies are observational in nature and it is difficult to draw firm conclusions about effectiveness or impact on care delivery. CONCLUSIONS Overall, the evidence suggests e-visits may provide comparable clinical outcomes to in-person care and reduce healthcare costs for certain healthcare conditions. At the same time, there is mixed evidence on healthcare quality, especially regarding infection management (e.g., sinusitis, urinary tract infections, conjunctivitis). Further studies are needed to test implementation strategies that might improve delivery (e.g., clinical decision support for antibiotic prescribing) and to assess which conditions are amenable to e-visits and which conditions require in-person or face-to-face care (e.g., virtual visit). CLINICALTRIAL not applicable

scholarly journals Optimalisasi peran & fungsi manajemen kepala ruangan dalam supervisi dokumentasi asuhan keperawatan di rumah sakit x Jakarta

2021 ◽  
Vol 14 (4) ◽  
pp. 536-544
Author(s):  
Teresa Teresa ◽  
Tuti Afrianti ◽  
Tini Suminarti
Keyword(s):  
Quality Of Care ◽  
Nursing Care ◽  
Health Care Quality ◽  
Descriptive Analysis ◽  
Pilot Project ◽  
Poor Quality ◽  
Care Quality ◽  
Nursing Documentation ◽  
Head Nurse

The role of a head nurse in optimizing of management function in supervision of nursing care documentation at X hospital in JakartaBackground: Nursing documentation is important thing that  is indicator quality of care. Since the nursing documentation is still a poor quality, it requires a supervision by the head nurse.Purpose: The head of nursing is responsible for the direction, organization and strategic planning collaborate with nursing staffs in ensuring the quality of nursing care to achieve accurate, effective and efficient documentation and to complete supervision.Method: A pilot project using questionnaire and observation methods was conducted at difference times on two hospital units in Jakarta.Results: The descriptive analysis results showed that among 18 nurses, 4 nurses believed that nursing documentation is an important, effective and clear way to  ease their job. Hence, supervision is continuity needed to support the improvement of health care quality. The innovative projects will be applied in health care.Conclusion:  Nursing documentation must show continuity and quality of  care nursing under the control and supervision of the head nurse and EMR is used as the instrument for documentation.Keywords :  The role; Head nurse; Management; Supervision; Nursing care; DocumentationPendahuluan: Dokumentasi asuhan keperawatan adalah hal yang penting karena menjadi indikator kualitas perawatan. Penerapan dokumentasi asuhan keperawatan saat ini belum optimal sehingga membutuhkan arahan dan supervisi dari Kepala Ruang/Kepala Unit.Tujuan: Tercapainya supervisi dan keberhasilan pelaksanaan dokumentasi asuhan keperawatan yang komprehensif, berkesinambungan, efektif dan  efisien.Metode: Metode pilot project di salah satu Rumah Sakit di Jakarta dengan pengambilan data melalui  observasi dan kuestioner. Instrumen diujikan pada dua ruangan dalam  waktu yang berbeda.Hasil: Analisis deskripsi pada  sejumlah 18 perawat, 4 orang menyatakan bermanfaat, penting dan mudah dalam penerapannya. Supervisi dilakukan untuk memberikan support terhadap kelangsungan pendokumentasian asuhan keperawatan yang berkesinambungan. Proyek inovasi akan ditindaklanjuti dan diaplikasikan dalam program kerja bidang pelayanan keperawatan.Simpulan: Asuhan keperawatan yang berkualitas memerlukan adanya supervisi. Sarannya penggunaan Instrumen Supervise Dokumentasi Asuhan Keperawatan akan disesuaikan dengan penggunaan pencatatan asuhan keperawatan Elektronic Medical Record/EMR

QUALITY-OF-CARE INDICATORS FOR WOMEN WITH OVERACTIVE BLADDER: A SYSTEMATIC REVIEW OF THE LITERATURE

2009 ◽  
Vol 181 (4S) ◽  
pp. 5-5
Author(s):  
Aviva E. Weinberg ◽  
Jennifer T Anger ◽  
Ja-Hong Kim ◽  
Paul Shekelle ◽  
Shlomo Raz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Of Care ◽  
Overactive Bladder ◽  
Review Of The Literature
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