Measuring Client Satisfaction in Residential Aged Care Settings: A Narrative Review of Instruments

Medication management in residential aged care facilities (RACFs) is complex and often sub-optimal. Pharmacist practice models and services have emerged internationally to address medication-related issues in RACFs. This narrative review aimed to explore pharmacist practice models in aged care in Australia, England and the USA, and identify key activities and characteristics within each model. A search strategy using key terms was performed in peer-reviewed databases, as well as the grey literature. Additionally, experts from the selected countries were consulted to obtain further information about the practice models in their respective countries. Thirty-six documents met the inclusion criteria and were included in the review. Four major pharmacist practice models were identified and formed the focus of the review: (1) the NHS’s Medicine Optimisation in Care Homes (MOCH) program from England; (2) the Australian model utilising visiting accredited pharmacists; (3) the Centers for Medicare and Medicaid (CMS) pharmacy services in long-term care from the USA; and (4) the Medication Therapy Management (MTM) program from the USA. Medication reviews were key activities in all models, but each had distinct characteristics in relation to the comprehensiveness, who is eligible, and how frequently residents receive medication review activity. There was heterogeneity in the types of facility-level activities offered by pharmacists, and further research is needed to determine the effectiveness of these activities in improving quality use of medicines in the aged care setting. This review found that in some models, pharmacists have a limited level of collaboration with other healthcare professionals, emphasising the need to trial innovative models with integrated services and increased collaboration to achieve a holistic patient-centred approach to medication management.

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Fact Sheet: How to Support a Restraint-free Environment in Residential Aged Care

PsycEXTRA Dataset ◽

10.1037/e680372012-001 ◽

2012 ◽

Keyword(s):

Aged Care ◽

Residential Aged Care ◽

Fact Sheet ◽

Free Environment

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“Consideration of patients as networked units to identify opportunities and motivation to enhance capability”: A mixed methods study to explore a personalised Digital Health Hub Model of Care for hip fractures in South Australia (Preprint)

10.2196/preprints.26886 ◽

2021 ◽

Author(s):

Lalit Yadav ◽

Tiffany K Gill ◽

Anita Taylor ◽

Jen DeYoung ◽

Mellick J Chehade

Keyword(s):

Hip Fractures ◽

Digital Health ◽

Family Members ◽

South Australia ◽

Aged Care ◽

Mixed Methods Study ◽

Residential Aged Care ◽

Model Of Care ◽

Factors Influencing

UNSTRUCTURED Introduction Majority of older people with hip fractures once admitted to acute hospital care are unable to return to their pre-fracture level of independence and a significant number are either newly admitted or return to residential aged care. Patient education involves family members and/or residential aged care staff as networked units, crucial for empowerment through improving health literacy. Advancement of digital technology has led to evolving solutions around optimising health care including self-management of chronic disease conditions and telerehabilitation. The aim of this study is to understand perspectives of older patients with hip fractures, their family members and residential aged carers, to inform the development of a digitally enabled model of care using a personalised digital health hub (pDHH). Methods A mixed methods study was conducted at a public tertiary care hospital in South Australia involving patients aged 50 years and above along with their family members and residential aged carers. Quantitative data, including basic demographic characteristics, access to computers and Internet were analysed using descriptive statistics. Spearman’s Rank Order Correlation was used to examine correlations between the perceived role of a pDHH in improving health and likelihood of subsequent usage. Whereas qualitative data included series of open-ended questions and findings were interpreted using constructs of capability, opportunity and motivation to help understand the factors influencing the likelihood of potential pDHH use Results Overall, 100 people were recruited in the study, representing 55 patients, 13 family members and 32 residential aged carers. The mean age of patients was 76.4 years (SD-8.4, age range 54-88) and females represented 60% of patients. Although a moderate negative correlation existed with increasing age and likelihood of pDHH usage (ρ= -0.50, p<0.001) the perceived role of the DHH in improving health had a strong positive correlation with the likelihood of pDHH usage by self (ρ=0.71, p<0.001) and by society, including friends and family members (ρ=0.75, p<0.001). Of particular note, almost all the patients (98%) believed they had a family member or friend /carer who would be able to help them to use a digital health platform. Whereas our qualitative findings suggest emphasising on complex interplay of capability, opportunity and motivation as crucial factors while designing a pDHH enabled model of care for hip fractures at a local context level. Conclusion Findings from this study contributed to understand the dynamics around capabilities, motivation and opportunities of patients, family members and formal carers as a “patient networked unit”. Future research recommendation must involve co-creation guided by iterative processes through improving understanding of factors influencing development and successful integration of complex digital healthcare interventions in real-world scenarios.

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