Modelling a Typical Patient Journey Through the Geriatric Evaluation and Management Ward to Better Understand Discharge Planning Processes

2021 ◽  
pp. 81-100
Author(s):  
Elizabeth Buikstra ◽  
Robyn Clay-Williams ◽  
Edward Strivens
Author(s):  
Karen Grimmer ◽  
John Moss ◽  
Julie Falco

Objective: To describe the perceptions of people taking on a new or expanded caring role for an elderly patient recently hospitalised with a new or intensified health problem. Design: Observational study collecting qualitative data monthly for six months following patients’ discharge from hospital and attempted return to independent living in the community. Setting: Four South Australian acute hospitals (one metropolitan, three country). Subjects: 34 unpaid carers were nominated by 100 patients. 24 carers participated (17 elderly spouses, 3 younger family members, 4 neighbours and/ or friends). Results: The study highlighted carers’ perceptions of being unprepared for their new tasks, and their frustrations at the long-term and frequently significant changes to their lives brought about by assuming a caring role. Many carers felt their role had been imposed upon them without real choice, and that their own physical and emotional fitness for their new role had not been considered during discharge planning. Carers claimed to have been provided with little information about how to care for the patient, particularly when community services were seldom provided in the first week after discharge. Stresses developed in many of the carer-patient relationships, and patient and carer morale was often low for months post-discharge. Discussion: Carers indicated that their tasks could have been made easier by more timely, targeted education about their patient’s condition and their role in managing it. They would have liked greater inclusion in discharge planning processes whilst the patient was in hospital, and more timely and appropriate provision of post-discharge services that were patient- and carer-focused, and which addressed their ability to live independently in the community. Conclusion: Discharge planning systems should take greater account of the motivation and needs of carers, especially when this role is new or becoming expanded, and of the barriers they face in undertaking their role.


2020 ◽  
Vol 121 ◽  
pp. 137-146
Author(s):  
Elizabeth Buikstra ◽  
Edward Strivens ◽  
Robyn Clay-Williams

2017 ◽  
Vol 70 (2) ◽  
pp. 415-423
Author(s):  
Henrique José Mendes Nunes ◽  
Paulo Joaquim Pina Queirós

ABSTRACT Stroke still causes high levels of human inability and suffering, and it is one of the main causes of death in developed countries, including Portugal. Objective: analyze the strategies of hospital discharge planning for these patients, increasing the knowledge related to hospitalhome transition, discharge planning processes and the main impact on the quality of life and functionality. Method: integrative literature review using the PICOD criteria, with database research. Results: 19 articles were obtained, using several approaches and contexts. For quality of life, the factors related to the patient satisfaction with care and the psychoemotional aspects linked with functionality are the most significant. Conclusion: during the hospitalization period, a careful hospital discharge planning and comprehensive care to patients and caregivers - in particular the functional and psychoemotional aspects - tend to have an impact on the quality of life of patients.


2021 ◽  
Vol 16 (9) ◽  
pp. 1-8
Author(s):  
Angela Frame ◽  
Gurdeep Kainth ◽  
Einat Kammerling

The COVID-19 pandemic has had a major impact on NHS resources, causing disruption to all elective procedures and affecting each stage of the patient journey. For patients with severe symptomatic aortic stenosis, there is a significant risk of clinical deterioration if left untreated. The risk of delay needs to be weighed against the risk of acquiring COVID-19 during an admission for a procedure. This has presented many challenges for the transcatheter aortic valve implantation team. When offering any procedures during 2020, NHS trusts had a responsibility to protect patients from exposure to COVID-19 through infection control measures and adapting to COVID-19 secure pathways. The aim was to prevent the spread of COVID-19, while performing planned care to high-risk patients where possible, to prevent clinical harm caused by delays. The authors' practice needed to set realistic targets for the care that could be safely delivered at each phase of the pandemic. Therefore, new considerations and methods needed to be applied at every stage of the patient journey, from the patient referrals on the waiting list to post-procedure discharge planning. This required a team-based approach throughout. Transcatheter aortic valve implantation clinical nurse specialists have played a fundamental role in the coordination of the ever-changing situation, implementing the new pathways and monitoring the patients on the waiting list. Nurses in this role are also often the first point of contact for patients and family. This experience presented an opportunity for innovation and learning from change. This article will discuss the challenges faced by the transcatheter aortic valve implantation team, the strategies used during the pandemic and the lessons that can be applied to future practice from the authors' experiences in one centre in London.


2001 ◽  
Vol 24 (1) ◽  
pp. 100 ◽  
Author(s):  
Jenni Ham

Critical pathways, developed for utilisation in the health sector, are tools that are increasingly being used toimplement co-ordinated patient care. The introduction of critical pathways results in planned progress throughan episode of care, whilst optimising health outcomes and minimising resource utilisation. The advantages ofimplementing critical pathways are increasingly evident, with reports of increased co-ordination of activities,minimum delays in the provision of care, enhanced interdisciplinary communication, enhancedcommunication with clients, improved discharge planning processes and the implementation of a continuousquality improvement process (Pearson et al, 1995, p941-948).Hospitals in rural areas have not been excluded from the issue of providing quality care whilst containing costs.Distance, sparse population density and decreased resources intensify the need for co-ordinated care systems inrural areas. Co-ordinated care planning to date has centred on metropolitan, acute care hospitals, althoughinterest in the design and implementation of critical pathways has been demonstrated by many health agenciesin rural areas wanting to share in the advantages of implementing critical pathways (Spath, 1999, p45-48;Bertram, 1996 p54-66; Rawskey, 1996, p49-51; Ely, 1995, p66-64).


2019 ◽  
Vol 24 (11) ◽  
pp. 105-107
Author(s):  
Oliver Heinze ◽  
Gerd Schneider

Die am Universitätsklinikum Heidelberg entwickelte Persönliche Gesundheits- und Patientenakte (PEPA) ermöglicht den einrichtungsübergreifenden, elektronischen Datenaustausch des Universitätsklinikums mit seinen Partner-Krankenhäusern, mit niedergelassenen Ärzten und den Patienten in der Metropol-region Rhein-Neckar.


Sign in / Sign up

Export Citation Format

Share Document