scholarly journals P129: Safer transitions in the care of the elderly: identification of essential information in transitional care

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S110-S111
Author(s):  
S. Trivedi ◽  
S. Beckett ◽  
A. Dick ◽  
R. Hartmann ◽  
C. Roberts ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Transitional Care ◽  
Transitions Of Care ◽  
Free Text ◽  
Care Providers ◽  
Cross Sectional ◽  
Term Care ◽  
Essential Information ◽  
Patient Advocates

Introduction: When presenting to the Emergency Department (ED), the care of elderly patients residing in Long Term Care (LTC) can be complicated by threats to patient safety created by ineffective transitions of care. Though standardized inpatient handover tools exist, there has yet to be a universal tool adopted for transfers to the ED. In this study, we surveyed relevant stakeholders and identified what information is essential in the transitions of care for this vulnerable population. Methods: We performed a descriptive, cross sectional electronic survey that was distributed to physicians and nurses in ED and LTC settings, paramedics, and patient advocates in two Canadian cities. The survey was kept open for a one month period with weekly formal reminders sent. Questions were generated after performing a literature review which sought to assess the current landscape of transitional care in this population. These were either multiple choice or free text entry questions aimed at identifying what information is essential in transitional periods. Results: A total of 191 health care providers (HCP) and 22 patient advocates (PA) responded to the survey. Within the HCPs, 38% were paramedics, 38% worked in the ED, and 24% were in LTC. In this group, only 41% of respondents were aware of existing handover protocols. Of the proposed informational items in transitional care, 100% of the respondents within both groups indicated that items including reason for transfer and advanced care directives were essential. Other areas identified as necessary were past medical history and baseline functional status. Furthermore, the majority of PAs identified that items such as primary language, bowel and bladder incontinence and spiritual beliefs should be included. Conclusion: This survey demonstrated that there is a need for an improved handover culture to be established when caring for LTC patients in the ED. Education needs to be provided surrounding existing protocols to ensure that health care providers are aware of their existence. Furthermore, we identified what information is essential to transitional care of these patients according to HCPs and PAs. These findings will be used to generate a simple, one page handover form. The next iteration of this project will pilot this handover form in an attempt to create safer transitions to the ED in this at-risk population.

Outside Looking In: A Pharmacist's Personal Journey With Family Elders

2019 ◽  
Vol 34 (3) ◽  
pp. 156-167
Author(s):  
Jeannette Y. Wick
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Providers ◽  
Transitions Of Care ◽  
Clinical Inertia ◽  
Older Individuals ◽  
Care Providers ◽  
Term Care ◽  
Personal Journey ◽  
Care System

Pharmacists who work in long-term care—or in any area of health care—are exposed to the health care system on a daily basis. While most of us recognize that the health care system has problems, especially at transitions of care, few of us appreciate fully how serious these problems can be. Certifying and accrediting agencies have encouraged health care providers to step out of their silos and work more collaboratively, and educators have emphasized understanding geriatric syndromes. A description of a personal journey through the health system—for both the patient and the caregiver—with two older individuals, this narrative discusses how difficult it is for patients to understand what's happening around them. It also discusses the clinical inertia in addressing geriatric issues and offers suggestions to health care providers facing similar situations.

scholarly journals Integration of Community Pharmacists in Transition of Care (TOC) Services: Current Trends and Pharmacist Perceptions

2017 ◽  
Vol 32 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Elizabeth A. Zeleznikar ◽  
Miranda E. Kroehl ◽  
Katharine M. Perica ◽  
Angela M. Thompson ◽  
Katy E. Trinkley
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Systems ◽  
Community Pharmacists ◽  
Cross Sectional Study ◽  
Transitions Of Care ◽  
Care Providers ◽  
Cross Sectional ◽  
Communication Breakdown ◽  
Discharge Medication

Background: Barriers exist for patients transitioning from one health-care setting to another, or to home, and health-care systems are falling short of meeting patient needs during this time. Community pharmacist incorporation poses a solution to the current communication breakdown and high rates of medication errors during transitions of care (TOC). The purpose of this study was to determine community pharmacists’ involvement in and perceptions of TOC services. Methods: Cross-sectional study using electronic surveys nationwide to pharmacists employed by a community pharmacy chain. Results: Of 7236 pharmacists surveyed, 546 (7.5%) responded. Only 33 (6%) pharmacists reported their pharmacy participates in TOC services. Most pharmacists (81.5%) reported receiving discharge medication lists. The most common reported barrier to TOC participation is lack of electronic integration with surrounding hospitals (51.1%). Most pharmacists agreed that (1) it is valuable to receive discharge medication lists (83.3%), (2) receiving discharge medication lists is beneficial for patients’ health (89.1%), (3) discharge medication list receipt improves medication safety (88.8%). Conclusions: Most pharmacists reported receiving discharge medication lists and reported discharge medication lists are beneficial, but less than half purposefully used medication lists. To close TOC gaps, health-care providers must collaborate to overcome barriers for successful TOC services.

Patient Flow or the Patient’s Journey? Exploring Health Care Providers’ Experiences and Understandings of Implementing a Care Pathway to Improve the Quality of Transitional Care for Older People

2021 ◽  
pp. 104973232110038
Author(s):  
Cecilie Fromholt Olsen ◽  
Astrid Bergland ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Anne Gudrun Langaas
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Care Providers ◽  
Transitional Care ◽  
Care Pathway ◽  
Patient Flow ◽  
Care Pathways ◽  
Care Providers ◽  
Patient Centered ◽  
Care For Older People

Internationally, the implementation of care pathways is a common strategy for making transitional care for older people more effective and patient-centered. Previous research highlights inherent tensions in care pathways, particularly in relation to their patient-centered aspects, which may cause dilemmas for health care providers. Health care providers’ understandings and experiences of this, however, remain unclear. Our aim was to explore health care providers’ experiences and understandings of implementing a care pathway to improve transitional care for older people. We conducted semistructured interviews with 20 health care providers and three key persons, along with participant observations of 22 meetings, in a Norwegian quality improvement collaborative. Through a thematic analysis, we identified an understanding of the care pathway as both patient flow and the patient’s journey and a dilemma between the two, and we discuss how the negotiation of conflicting institutional logics is a central part of care pathway implementation.

A survey of Cambodian health-care providers' HIV knowledge, attitudes and intentions to take a sexual history

2009 ◽  
Vol 20 (5) ◽  
pp. 346-350 ◽  
Author(s):  
G Webber ◽  
N Edwards ◽  
I D Graham ◽  
C Amaratunga ◽  
I Gaboury ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Theory Of Planned Behaviour ◽  
Sexual History ◽  
People Living With Hiv ◽  
Care Providers ◽  
Hiv Knowledge ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Planned Behaviour

Cambodia has one of the highest prevalence rates of HIV in Asia and is scaling up HIV testing. We conducted a cross-sectional survey with 358 health care providers in Phnom Penh, Cambodia to assess readiness for voluntary testing and counselling for HIV. We measured HIV knowledge and attitudes, and predictors of intentions to take a sexual history using the Theory of Planned Behaviour. Over 90% of health care providers correctly answered knowledge questions about HIV transmission, but their attitudes were often not positive towards people living with HIV. The Theory of Planned Behaviour constructs explained 56% of the variance in intention to take a sexual history: the control providers perceive they have over taking a sexual history was the strongest contributor (51%), while social pressure explained a further 3%. Attitudes about taking a sexual history did not contribute to intention. Interventions with Cambodian health care providers should focus on improving skills in sexual history-taking.

scholarly journals Assessing Knowledge on Clubfoot Among Parents Having Children with Clubfoot Deformity

2015 ◽  
Vol 14 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Zobaer Alam ◽  
Md Monoarul Haque ◽  
Md Rijwan Bhuiyan ◽  
Md Shahinoor Islam ◽  
Monirul Haque ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Public Health Problem ◽  
Educational Status ◽  
Cross Sectional Study ◽  
Childhood Disability ◽  
Care Providers ◽  
Cross Sectional ◽  
Middle Income ◽  
Level Of Knowledge

Background: The burden of childhood disability as a public health problem in developing countries remains relatively unrecognized. One out of 750 children born in the world suffer from club foot among them 80% are in low and middle income countries. Most of these babies have limited access to receive effective treatment for their clubfoot due to lack o knowledge, awareness and some barriers. We actually don’t know the level of knowledge of parents who have child with clubfoot deformity. The purpose of this study was to assess the level of knowledge of parents who have children with clubfoot during clubfoot treatment. Materials and Methods: This cross sectional study was conducted among 102 parents who have children with clubfoot deformity during its treatment in a selected clinic. The samples were selected purposively from the clinics where clubfoot treatment was given and face to face interview was done by using semi-structured questionnaire. Results: The mean (±SD) age of the respondents were 24.7 (±6.0) years where 87.3% (n=89) respondents ware female and 59.8 %(n=61) respondent’s educational status ware up to primary level. About 44.1% respondents started treatment of their child within 6 months of birth and 33% within 6 to 12 months where 57% (n=58) respondents are referred by health care professional to this clinics. About 93.1% of parents (n=95) said that they knew nothing about clubfoot deformity before their child was diagnosed where 97% are aware after diagnosis of their child. About 93.1% respondents knew the best time for treatment initiation where 59.8% respondents know the correct follow up time of clubfoot management. In case of knowledge of parents’ roles in the treatment of clubfoot about 91.2%, parents have knowledge weekly visit for treatment and 86.3% know the plaster care where 52.9% (n=54) parents have lack of knowledge about how to use the brace Conclusion: There is need to improve the communication skills of clinicians/health care providers offering treatment to children with clubfoot at the Clinics. Need to share information with the parents about the condition. Finally, there is need to emphasize of educating parents about plaster care and how to use brace. DOI: http://dx.doi.org/10.3329/cmoshmcj.v14i1.22882 Chatt Maa Shi Hosp Med Coll J; Vol.14 (1); Jan 2015; Page 42-46

scholarly journals SERVICES AND PRACTICES OF HEALTH CARE PROVIDERS IN A RURAL AREA OF FAISALABAD.

2011 ◽  
Vol 18 (03) ◽  
pp. 518-524
Author(s):  
GHULAM SARWAR ◽  
FARIDA MANZUR ◽  
IMTIAZ HAMID
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Medical Assistants ◽  
The Public ◽  
Union Council ◽  
Proper Training ◽  
Socio Demographic Factors

Objectives: (1) To determine the mode of services being rendered and practices done by the health care providers of the study area. (2) To identify various socio-demographic factors about the health care providers. A health care provider provides preventive, curative, rehabilitative and spiritual health services to the community. Health care is being provided by not only the registered and qualified doctors, but also by non-qualified non-registered and inexperienced persons in Pakistan. Methodology: A total of 57 health care providers from the union council 42 area in district Faisalabad were included. A pre-tested questionnaire to know about the services and practices of the individuals was served upon them to collect the relevant data. Design: Cross-sectional study. Setting: Union council 42 area in district Faisalabad. Period: 2008. Results: Out of 57, 30 (52.63%) were males and 27 (47.37%) were females. Most of them, 18 (31.6%) were above 49 years of age. 51 (89.47%) were practicing in the private; whereas, only 2(3.51%) in the public sector. Most of the individuals, 21 (36.8%) were LHW and only 2(3.5%) were doctors or medical assistants; 3(5.3%) were dispensers, 9(15.8%) were hakeems and 7 (12.3%) homeopaths. Most of them, 40(70.2%) were matriculates and 14(24.6%) graduates. Only 20 (35.1%) were having certificates and 11(19.3%) were diploma holders. Further, only 2(11.76%) out of 57 were registered with PM&DC and Punjab Medical Faculty. 30 (52.6%) individuals were rendering curative and only 5 (8.8%) preventive services. None of the health care providers was rendering laboratory, x-ray or ultrasound services. Most of the individuals, 36 (63.2%) were practicing allopathy and 7(12.3%) homeopathy way of treatment. Further, most of the professionals, 45 (78.95%) were not doing any surgery. As regards sterilization, the most 8(66.7%) were practicing boiling of instruments. Most of them 47 (82.45%) were giving injections to the patients, however, using disposable syringes, and 27(57.4%) were disposing of the syringes by cutting the needles to dump. 20 (42.55%) were referring their patients to DHQ Hospital and 47 (82.46%) were keeping the record. Conclusions: Qualified medical professionals were scarce in the locality. However, allopathic system of medicine was being widely practiced. Only LHWs were providing curative services with proper training to deliver first aid services.

scholarly journals Potential Benefits and Drawbacks of Virtual Clinics in General Surgery: Pilot Cross-Sectional Questionnaire Study (Preprint)

2018 ◽  
Author(s):  
Emily Rutherford ◽  
Roghinio Noray ◽  
Caolán Ó HEarráin ◽  
Kevin Quinlan ◽  
Aisling Hegarty ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Health Care Providers ◽  
Care Delivery ◽  
Day Surgery ◽  
Care Providers ◽  
Cross Sectional ◽  
Tertiary Center ◽  
Specialist Health Care ◽  
Outpatient Settings

BACKGROUND Escalating demand for specialist health care puts considerable demand on hospital services. Technology offers a means by which health care providers may increase the efficiency of health care delivery. OBJECTIVE The aim of this study was to conduct a pilot study of the feasibility, benefits, and drawbacks of a virtual clinic (VC) in the general surgical service of a busy tertiary center. METHODS Patient satisfaction with current care and attitudes to VC were surveyed prospectively in the general surgical outpatient department (OPD; n=223). A subset of patients who had undergone endoscopy and day surgery were recruited to follow-up in a VC and subsequently surveyed with regard to their satisfaction (20/243). Other outcomes measured included a comparison of consultation times in traditional and virtual outpatient settings and financial cost to both patients and the institution. RESULTS Almost half of the patients reported barriers to prospective use of VCs. However, within the cohort who had been followed-up in the VC, satisfaction was higher than the traditional OPD (100% as compared with 187/223, 83.9%). Significant savings in both time (<italic>P</italic>=.003) and financial costs to patients and the institution were found. CONCLUSIONS For an appropriately selected group of patients, VCs offer a viable alternative to traditional OPD. This alternative can improve both patient satisfaction and efficiency of patient care.

scholarly journals Community awareness of which seizure type should present to healthcare providers; a potential risk factor of the epilepsy treatment gap

2021 ◽  
Author(s):  
Ismat Babiker ◽  
Mohamed K. Elnaeim ◽  
Awab K.Elnaeim
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Demographic Data ◽  
Healthcare Providers ◽  
Seizure Type ◽  
Absence Seizure ◽  
Care Providers ◽  
Treatment Gap ◽  
Cross Sectional ◽  
Epilepsy Treatment

Abstract Objective: the objective of this study was to assess the awareness of the community in Sudan of which seizure type(s) should present to health care providers.Methods: This is a cross-sectional descriptive internet-based survey that was conducted in Sudan during the period from January to April 2018, using google forms. The survey consisted of demographic data (age, gender, educational level), a statement evaluating participants’ sources of obtaining information regarding epilepsy, a statement assessing awareness about the primary care provider for people with epilepsy (PWE), and a statement describing the symptomatology of different seizure types in simple Arabic, asking what description(s) participants thought should present to health care providers. We included participants residing in Sudan, and those with a college degree or higher education. Four hundred sixty-seven participants completed the survey.Results: 467 participants were included, of whom, 279 (60%) were females. The mean age of participants was 28 years. Two-thirds of participants obtained their information from non-scientific sources. 84% of the participants were aware that doctors are the primary health care providers for people with epilepsy.The majority (92.%) of participants were aware that patients with symptoms corresponding to the generalized tonic-clonic seizure description should present to doctors, compared with two-thirds of participants for focal seizure symptom description, and only 30.6 % of participants for absence seizure symptom description.Conclusion: This study demonstrated poor awareness about the necessity of presentation for focal and absence seizures. We hypothesize that this lack of awareness may contribute to the epilepsy treatment gap, and we recommend further studies to examine this hypothesis.

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