TESTING THE EFFECTIVENESS OF INTEGRATED ELDERLY CARE MODEL ON QUALITY OF CARE AND HEALTH OUTCOMES AMONG HOSPITALIZED ELDERLIES IN WEST BANK

The rapid increase in the ageing population and health conditions are imposing a higher challenge to the health care system that requires multidisciplinary teamwork utilizing coordinated care approach. This study examined the effects of integrated care model on quality of care received by older hospitalized patients in West Bank. A quantitative interrupted time series design (pretest and posttest multiple time series, quasi-experiment design) was used. The study examined the effects of integrated care model on admitted older patients (n=32) in the West Bank measuring ten dimensions of quality of care and four health indicators. There was a significant improvement in the dimensions of quality of care: dimensions: nurses’ communications with patients, physicians’ communications with patients, staff response to patients’ needs, pain management, explanations on medications, amount of information given on discharge plan, patients' area cleanliness, patients' area quietness, rating of the hospital, and willingness to recommend the hospital. Incidence of falls and incidence of pressure ulcer improved after implementing the model, while readmission rate and average length of stay did not improve. This study contributed to the limited body of knowledge related to the effect of integrated care model on hospitalized older patients’ quality of care in Palestine/ West Bank. Integrated care has the potential to improve care outcomes among hospitalized older patients.

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Theoretical Perspectives of Hospitalized Older Patients and Their Health-Related Problems and Quality of Care: Systematic Literature Review

The Open Public Health Journal ◽

10.2174/1874944501710010215 ◽

2017 ◽

Vol 10 (1) ◽

pp. 215-225 ◽

Cited By ~ 1

Author(s):

Atef Hasan Khatib ◽

Ayman M. Hamdan-Mansour ◽

Manar Ali Bani Hani

Keyword(s):

Quality Of Life ◽

Health Care ◽

Quality Of Care ◽

Elderly Patients ◽

Older Patients ◽

Older Persons ◽

Elderly Care ◽

Quality Of Healthcare ◽

Emotional Wellbeing

Introduction:The proportion of aged people is growing worldwide. Older persons are affected by a number of physical, psychological and social factors that influence their health and quality of life. These factors are usually multiple and are often masked by sensory and cognitive impairments.Purpose:The purpose of this study was to examine the available literature emphasizing older persons’ care, care-related problems, and older persons’ quality of healthcare. Also, the paper aimed at exploring the future direction of research needs.Results:Good quality older patients’ care involves safety, professional interventions, recognition and management of physical and emotional wellbeing. Care of older patients requires addressing the aging process itself, the expected decrease in functionality, and diminished cognitive ability. Little statistical data were found to address the quality of hospitalized elderly patients in particular as well as study on healthcare facilities and nursing homes. Literature does not provide much guidance to the effectiveness of care strategies.Conclusion:The results assert that elderly health care is a priority. However, health care systems are not specific about elderly patients’ needs, leading to low quality of elderly care. There is a need to use an integrated model of care to improve the quality of life and quality of care provided to hospitalized older patients.

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Effectiveness of a Technology-Enhanced Integrated Care Model for Frail Older People: A Stepped-Wedge Cluster Randomized Trial in Nursing Homes

The Gerontologist ◽

10.1093/geront/gnaa090 ◽

2020 ◽

Author(s):

Hongsoo Kim ◽

Young-il Jung ◽

Gi-Soo Kim ◽

Hyoungshim Choi ◽

Yeon-Hwan Park

Keyword(s):

Nursing Home ◽

Quality Of Care ◽

Nursing Homes ◽

Integrated Care ◽

Information And Communication Technologies ◽

Assessment System ◽

Stepped Wedge ◽

Care Model ◽

The Impact

Abstract Background and Objectives The objective of this study was to evaluate the impact of an information and communication technologies (ICT)-enhanced, multidisciplinary integrated care model, called Systems for Person-centered Elder Care (SPEC), on frail older adults at nursing homes. Research Design and Methods SPEC was implemented at 10 nursing homes in South Korea in random order using a stepped-wedge design. Data were collected on all participating older residents in the homes before the first implementation and until 6 months after the last implementation. The 21-month SPEC intervention guided by the chronic care model (CCM) consists of 5 strategies: comprehensive geriatric assessment, care planning, optional interdisciplinary case conferences, care coordination, and a cloud-based ICT tool along with a free messaging app. The primary outcome was quality of care measured by a composite quality indicator (QI) from the interRAI assessment system. Usual care continued over the control periods. Nursing home staff were not blinded to the intervention. Results There were a total of 482 older nursing home residents included in the analysis. Overall quality of care measured by the composite QI was significantly improved (adjusted mean difference: −0.025 [95% CI: −0.037 to −0.014, p < .0001]). The intervention effect was consistent in the subgroup analysis by cognition and activities of daily living. There were no important adverse events or side effects. Discussion and Implications The SPEC, a CCM-guided, ICT-supported, multidisciplinary integrated care management intervention, can improve the quality of care measured by health and functional outcomes for frail older persons residing in nursing homes with limited health care provision. Clinical Trials Registration Number ISRCTN11972147

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Does community size or commute time affect severity of illness at diagnosis or quality of care in a centralized care model of pulmonary hypertension?

International Journal of Cardiology ◽

10.1016/j.ijcard.2021.03.035 ◽

2021 ◽

Author(s):

Nathan W. Brunner ◽

Lena Legkaia ◽

Fayez Al-Ahmadi ◽

Lisa Lee ◽

Monica Norena ◽

...

Keyword(s):

Pulmonary Hypertension ◽

Quality Of Care ◽

Severity Of Illness ◽

Care Model ◽

Community Size ◽

Commute Time ◽

Centralized Care

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PCV12: QUALITY OF CARE IN OLDER PATIENTS ADMITTED TO HOSPITAL WITH HEART FAILURE

Value in Health ◽

10.1046/j.1524-4733.2001.40202-86.x ◽

2001 ◽

Vol 4 (2) ◽

pp. 99-100

Author(s):

AH Abdelhafiz ◽

N Wheeldon

Keyword(s):

Heart Failure ◽

Quality Of Care ◽

Older Patients

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Mental Disorders, Quality of Care, and Outcomes Among Older Patients Hospitalized With Heart Failure

Archives of General Psychiatry ◽

10.1001/archpsyc.65.12.1402 ◽

2008 ◽

Vol 65 (12) ◽

pp. 1402 ◽

Cited By ~ 29

Author(s):

Saif S. Rathore ◽

Yongfei Wang ◽

Benjamin G. Druss ◽

Frederick A. Masoudi ◽

Harlan M. Krumholz

Keyword(s):

Heart Failure ◽

Quality Of Care ◽

Mental Disorders ◽

Older Patients

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Effect of a health system payment and quality improvement programme for tonsillectomy in Ontario, Canada: an interrupted time series analysis

BMJ Quality & Safety ◽

10.1136/bmjqs-2021-013110 ◽

2021 ◽

pp. bmjqs-2021-013110

Author(s):

Sanjay Mahant ◽

Jun Guan ◽

Jessie Zhang ◽

Sima Gandhi ◽

Evan Jon Propst ◽

...

Keyword(s):

Time Series ◽

Quality Improvement ◽

Quality Of Care ◽

Health System ◽

Interrupted Time Series ◽

Improve Quality ◽

Interrupted Time Series Analysis ◽

Quality Improvement Programme ◽

Improvement Programme

BackgroundTonsillectomy is among the most common and cumulatively expensive surgical procedures in children, with known variations in quality of care. However, evidence on health system interventions to improve quality of care is limited. The Quality-Based Procedures (QBP) programme in Ontario, Canada, introduced fixed episode hospital payment per tonsillectomy and disseminated a perioperative care pathway. We determined the association of this payment and quality improvement programme with tonsillectomy quality of care.MethodsInterrupted time series analysis of children undergoing elective tonsillectomy at community and children’s hospitals in Ontario in the QBP period (1 April 2014 to 31 December 2018) and the pre-QBP period (1 January 2009 to 31 January 2014) using health administrative data. We compared the age-standardised and sex-standardised rates for all-cause tonsillectomy-related revisits within 30 days, opioid prescription fills within 30 days and index tonsillectomy inpatient admission.Results111 411 children underwent tonsillectomy: 51 967 in the QBP period and 59 444 in the pre-QBP period (annual median number of hospitals, 86 (range 77–93)). Following QBP programme implementation, revisit rates decreased for all-cause tonsillectomy-related revisits (0.48 to −0.18 revisits per 1000 tonsillectomies per month; difference −0.66 revisits per 1000 tonsillectomies per month (95% CI −0.97 to −0.34); p<0.0001). Codeine prescription fill rate continued to decrease but at a slower rate (−4.81 to −0.11 prescriptions per 1000 tonsillectomies per month; difference 4.69 (95% CI 3.60 to 5.79) prescriptions per 1000 tonsillectomies per month; p<0.0001). The index tonsillectomy inpatient admission rate decreased (1.12 to 0.23 admissions per 1000 tonsillectomies per month; difference −0.89 (95% CI −1.33 to −0.44) admissions per 1000 tonsillectomies per month; p<0.0001).ConclusionsThe payment and quality improvement programme was associated with several improvements in quality of care. These findings may inform jurisdictions planning health system interventions to improve quality of care for tonsillectomy and other paediatric procedures.

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ORBITS

Proceedings of the VLDB Endowment ◽

10.14778/3430915.3430920 ◽

2020 ◽

Vol 14 (3) ◽

pp. 294-306

Author(s):

Mourad Khayati ◽

Ines Arous ◽

Zakhar Tymchenko ◽

Philippe Cudré-Mauroux

Keyword(s):

Time Series ◽

Linear Time ◽

Multiple Time ◽

Multiple Time Series ◽

Online Data ◽

Incremental Computation ◽

Online Recovery ◽

Recovery Technique ◽

Centroid Decomposition

With the emergence of the Internet of Things (IoT), time series streams have become ubiquitous in our daily life. Recording such data is rarely a perfect process, as sensor failures frequently occur, yielding occasional blocks of data that go missing in multiple time series. These missing blocks do not only affect real-time monitoring but also compromise the quality of online data analyses. Effective streaming recovery (imputation) techniques either have a quadratic runtime complexity, which is infeasible for any moderately sized data, or cannot recover more than one time series at a time. In this paper, we introduce a new online recovery technique to recover multiple time series streams in linear time. Our recovery technique implements a novel incremental version of the Centroid Decomposition technique and reduces its complexity from quadratic to linear. Using this incremental technique, missing blocks are efficiently recovered in a continuous manner based on previous recoveries. We formally prove the correctness of our new incremental computation, which yields an accurate recovery. Our experimental results on real-world time series show that our recovery technique is, on average, 30% more accurate than the state of the art while being vastly more efficient.

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Quality of Care in Chronic Kidney Disease and Incidence of End-Stage Renal Disease in Older Patients

Medical Care ◽

10.1097/mlr.0000000000001301 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Shingo Fukuma ◽

Tatsuyoshi Ikenoue ◽

Sayaka Shimizu ◽

Edward C. Norton ◽

Rajiv Saran ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Quality Of Care ◽

Kidney Disease ◽

Renal Disease ◽

End Stage Renal Disease ◽

Older Patients ◽

Stage Renal Disease ◽

End Stage

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Exploring caregivers' perspectives on improving care for older people at the end of life in Thailand

International Journal of Palliative Nursing ◽

10.12968/ijpn.2019.25.7.326 ◽

2019 ◽

Vol 25 (7) ◽

pp. 326-332

Author(s):

Kanyanat Supaporn ◽

Sang-arun Isaramalai ◽

Wandee Suttharangsee

Keyword(s):

Quality Of Care ◽

Older People ◽

End Of Life ◽

Care Quality ◽

Ageing Population ◽

Home Setting ◽

Experience Of Care ◽

Care Recipients ◽

Care For Older People

Background: Older people in Thailand receive general medical and social care at the end of life, and many rarely access palliative services. In light of this, improving the quality of care for the ageing population relies on addressing the needs of family caregivers, who provide the majority of care in a home setting. Understanding caregivers' perspectives when caring for a friend or relative will help to improve the quality of care that they provide. Aim: To explore caregivers' perspectives on improving care for older people in Thailand in the palliative stage. Methods: A qualitative study using in-depth interviews and observation of 10 older people in the palliative stage and their caregivers was undertaken. Data were analysed using content analysis. Findings: Data analysis revealed three themes: caregivers cared to repay the older person's previous kindness, caregivers cared and changed their caregiving behaviour to minimise the older person's perception of being abandoned or being a burden, and to follow Thai ancestral traditions, so that the older person could die peacefully. Conclusion: This study provides specific instructions for those who provide care for older Thai people in the palliative stage. Finding ways to address caregivers' perspectives on improving care quality could enhance the experience of care recipients.

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