Integrating person-centered, outcome-driven long-term care planning and quality assurance: The PEONIES approach

2009 ◽  
Vol 2 (1) ◽  
pp. e11-e12
Author(s):  
Sarita L. Karon ◽  
Barbara Bowers
2019 ◽  
Vol 34 (3) ◽  
pp. 206-214
Author(s):  
Edward L. Schneider ◽  
Jung Ki Kim ◽  
Diana Hyun ◽  
Anjali Lobana ◽  
Rick Smith ◽  
...  

AIM: The most frequent use of medications in the geriatric population occurs in skilled nursing facilities. This quality assurance study prospectively examines the high number of prescriptions ordered for long-term nursing facility residents throughout their first year after admission. METHODS: The investigators prospectively followed 101 consecutive long-term-stay older adult residents at the Joyce Eisenberg Keefer Medical Center, a nursing facility of Los Angeles Jewish Home for the Aging (LAJH) over a 12-month period. Preadmission prescriptions were obtained for 91 residents, as well as prescriptions at 1 week, 1 month, 3 months, 6 months, and 1 year after admission. The number of prescriptions by staff physicians and outside physicians was examined. RESULTS: Over the 12 months following admission, the mean number of scheduled prescriptions increased significantly from 11.1 prior to admission to 13.0 by 6 months and to 13.3 by 12 months (P-value < 0.05). The residents who were hospitalized during the 12 months of observation received significantly more scheduled, as needed, and total prescriptions than those not hospitalized. Physicians employed full time by LAJH ordered significantly fewer additional prescriptions than physicians with outside practices. The patients of the staff physicians also had fewer hospitalizations than those of the outside physicians. CONCLUSION: This quality assurance study reveals a statistically significant increase in the number of prescriptions made in a long-term care setting over a 12-month prospective study. Patients of staff physicians received fewer prescriptions and were hospitalized less frequently than patients of physicians who practiced outside LAJH.


2019 ◽  
Vol 33 (9) ◽  
pp. 1176-1188 ◽  
Author(s):  
Maud ten Koppel ◽  
Bregje D Onwuteaka-Philipsen ◽  
Lieve Van den Block ◽  
Luc Deliens ◽  
Giovanni Gambassi ◽  
...  

Background: While the need for palliative care in long-term care facilities is growing, it is unknown whether palliative care in this setting is sufficiently developed. Aim: To describe and compare in six European countries palliative care provision in long-term care facilities and to assess associations between patient, facility and advance care planning factors and receipt and timing of palliative care. Design: Cross-sectional after-death survey regarding care provided to long-term care residents in Belgium, England, Finland, Italy, the Netherlands and Poland. Generalized estimating equations were used for analyses. Setting/participants: Nurses or care assistants who are most involved in care for the resident. Results: We included 1298 residents in 300 facilities, of whom a majority received palliative care in most countries (England: 72.6%–Belgium: 77.9%), except in Poland (14.0%) and Italy (32.1%). Palliative care typically started within 2 weeks before death and was often provided by the treating physician (England: 75%–the Netherlands: 98.8%). A palliative care specialist was frequently involved in Belgium and Poland (57.1% and 86.7%). Residents with cancer, dementia or a contact person in their record more often received palliative care, and it started earlier for residents with whom the nurse had spoken about treatments or the preferred course of care at the end of life. Conclusion: The late initiation of palliative care (especially when advance care planning is lacking) and palliative care for residents without cancer, dementia or closely involved relatives deserve attention in all countries. Diversity in palliative care organization might be related to different levels of its development.


2004 ◽  
Vol 16 (2) ◽  
pp. 35-48 ◽  
Author(s):  
Patricia M. San Antonio ◽  
Robert L. Rubinstein

1989 ◽  
Vol 15 (5) ◽  
pp. 156-162 ◽  
Author(s):  
Paul D. Phillips ◽  
Robert A. Applebaum ◽  
Sheila J. Atchley ◽  
Rosalie McGinnis

Medical Care ◽  
1978 ◽  
Vol 16 (9) ◽  
pp. 796-797
Author(s):  
Sidney Katz

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