scholarly journals Stakeholders’ perspectives on models of care in the emergency department and the introduction of health and social care professional teams: A qualitative analysis using World Cafés and interviews

2020 ◽  
Vol 23 (5) ◽  
pp. 1065-1073
Author(s):  
Marica Cassarino ◽  
Rosie Quinn ◽  
Fiona Boland ◽  
Marie E. Ward ◽  
Rosa McNamara ◽  
...  
Keyword(s):  
Emergency Department ◽  
Qualitative Analysis ◽  
Social Care ◽  
Models Of Care ◽  
Social Care Professional ◽  
Health And Social Care

scholarly journals 66Enhancing Older Patients’ Care in the Emergency Department: A Systematic Review of Interventions by Health and Social Care Professional Teams

2018 ◽  
Vol 47 (suppl_5) ◽  
pp. v13-v60
Author(s):  
Marica Cassarino ◽  
Katie Robinson ◽  
Rosie Quinn ◽  
Breda Naddy ◽  
Andrew O’Regan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Older Patients ◽  
Social Care ◽  
Social Care Professional ◽  
Health And Social Care

scholarly journals 138 The Role of Health and Social Care Professional Teams in the Emergency Department: A Qualitative Study of Key Stakeholders’ Views

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Marica Cassarino ◽  
Katie Robinson ◽  
Rosie Quinn ◽  
Fiona Boland ◽  
Marie E Ward ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Qualitative Study ◽  
Social Care ◽  
Care Delivery ◽  
System Level ◽  
Social Care Professional ◽  
Health And Social Care ◽  
Wide Range

Abstract Background Introducing Health and Social Care Professional (HSCP) teams to the emergency department (ED) has increasingly demonstrated benefits for ED patient and process outcomes. However, there is a dearth of research exploring the views of key ED stakeholders on the role of HSCP teams in care delivery the ED. This qualitative study investigated the perspectives of a wide range of ED stakeholders about HSCPs teams working in the ED. Methods A total of 65 participants including older adults who had recently attended the ED and their carers/relatives, ED doctors and nurses, HSCPs and pre-hospital staff participated in four World Café style focus groups and individual interviews across two Irish hospital sites. Written and audio-recorded data were transcribed and thematically analysed. Results Overall, participants expressed positive views on HSCPs working in teams in the ED, with benefits for patients, staff members and the hospital (Theme 1). Having an ED-based HSCP team was described as promoting effective and timely decision-making and a more integrated approach to patient care, particularly for frail older adults with complex needs (Theme 2). Barriers and enablers for effective implementation were identified at multiple levels (Theme 3) including the ED physical environment, (e.g., space and equipment), operational factors (e.g., working hours), and relations (e.g., patient-staff or staff-staff communication); factors at system level included availability of community resources and financial pressures. Conclusion Our study indicates overall acceptability of HSCPs working in teams in the ED and positive views on their contribution to enhance the quality care of older adults. However, a number of operational and relational factors need to be considered to ensure feasibility and effectiveness. This information is crucial to inform implementation.

scholarly journals Effectiveness of early assessment and intervention by interdisciplinary teams including health and social care professionals in the emergency department: protocol for a systematic review

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e023464 ◽  
Author(s):  
Marica Cassarino ◽  
Katie Robinson ◽  
Rosie Quinn ◽  
Breda Naddy ◽  
Andrew O’Regan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Patient Care ◽  
Systematic Reviews ◽  
Social Care ◽  
Interdisciplinary Teams ◽  
Cochrane Library ◽  
Early Assessment ◽  
Health And Social Care ◽  
The Impact

IntroductionFinding cost-effective strategies to improve patient care in the emergency department (ED) is an increasing imperative given growing numbers of ED attendees. Encouraging evidence indicates that interdisciplinary teams including health and social care professionals (HSCPs) enhance patient care across a variety of healthcare settings. However, to date no systematic reviews of the effectiveness of early assessment and/or interventions carried by such teams in the ED exist. This systematic review aims to explore the impact of early assessment and/or intervention carried out by interdisciplinary teams including HSCPs in the ED on the quality, safety and cost-effectiveness of care, and to define the content of the assessment and/or intervention offered by HSCPs.Methods and analysisUsing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standardised guidelines, we will conduct a systematic review of randomised controlled trials (RCTs), non-RCTs, controlled before–after studies, interrupted time series and repeated measures studies that report the impact of early assessment and/or intervention provided to adults aged 18+ by interdisciplinary teams including HSCPs in the ED. Searches will be carried in Cumulative Index of Nursing and Allied Health Literature, Embase, Cochrane Library and MEDLINE from inception to March 2018. We will also hand-search the reference lists of relevant studies. Following a two-step screening process, two independent reviewers will extract data on the type of population, intervention, comparison, outcomes and study design. The quality of the studies will be appraised using the Cochrane Risk of Bias Tool. The findings will be synthesised in a narrative summary, and a meta-analysis will be conducted where appropriate.Ethics and disseminationEthical approval will not be sought since it is not required for systematic reviews. The results of this review will be disseminated through publication in a peer-review journal and presented at relevant conferences.Trial registration numberCRD42018091794.

scholarly journals Rapid evaluation for health and social care innovations: challenges for “quick wins” using interrupted time series

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Andrew McCarthy ◽  
Peter McMeekin ◽  
Shona Haining ◽  
Lesley Bainbridge ◽  
Claire Laing ◽  
...  
Keyword(s):  
Social Care ◽  
Interrupted Time Series ◽  
Models Of Care ◽  
Short Term ◽  
Data Set ◽  
Monthly Cost ◽  
Cost Increase ◽  
Term Model ◽  
Health And Social Care ◽  
Quasi Experimental

Abstract Background Rapid evaluation was at the heart of National Health Service England’s evaluation strategy of the new models of care vanguard programme. This was to facilitate the scale and spread of successful models of care throughout the health & social care system. The aim of this paper is to compare the findings of the two evaluations of the Enhanced health in Care Homes (EHCH) vanguard in Gateshead, one using a smaller data set for rapidity and one using a larger longitudinal data set and to investigate the implications of the use of rapid evaluations using interrupted time series (ITS) methods. Methods A quasi-experimental design study in the form of an ITS was used to evaluate the impact of the vanguard on secondary care use. Two different models are presented differing by timeframes only. The short-term model consisted of data for 11 months data pre and 20 months post vanguard. The long-term model consisted of data for 23 months pre and 34 months post vanguard. Results The cost consequences, including the cost of running the EHCH vanguard, were estimated using both a single tariff non-elective admissions methodology and a tariff per bed day methodology. The short-term model estimated a monthly cost increase of £73,408 using a single tariff methodology. When using a tariff per bed day, there was an estimated monthly cost increase of £14,315. The long-term model had, using a single tariff for non-elective admissions, an overall cost increase of £7576 per month. However, when using a tariff per bed-days, there was an estimated monthly cost reduction of £57,168. Conclusions Although it is acknowledged that there is often a need for rapid evaluations in order to identify “quick wins” and to expedite learning within health and social care systems, we conclude that this may not be appropriate for quasi-experimental designs estimating effect using ITS for complex interventions. Our analyses suggests that care must be taken when conducting and interpreting the results of short-term evaluations using ITS methods, as they may produce misleading results and may lead to a misallocation of resources.

Seniors' narratives of asking (and not asking) for help after a fall: implications for identity

2014 ◽  
Vol 36 (2) ◽  
pp. 240-258 ◽  
Author(s):  
PATRICIA A. MILLER ◽  
CHRISTINA SINDING ◽  
LAUREN E. GRIFFITH ◽  
HARRY S. SHANNON ◽  
PARMINDER RAINA
Keyword(s):  
Public Health ◽  
Emergency Department ◽  
Social Care ◽  
Work And Family ◽  
Community Dwelling ◽  
The Other ◽  
Health Concern ◽  
Public Health Concern ◽  
Policy Makers ◽  
Health And Social Care

ABSTRACTFalls among community-dwelling seniors constitute a major public health concern because of the potential morbidity and mortality associated with the fall. This study examined the informal care networks accessed by Canadian seniors who had visited the Emergency Department as a result of a fall, and considered the implications of the processes of asking for and receiving help on the senior's identity. Four themes were identified. The first was valuing independence. The remaining three themes concerned threats to the participants' identities linked to the need to ask for or receive help from family and friends. They were: becoming indebted, feeling devalued and becoming a burden to others. Seniors were noted to excuse family members from the expectation of helping because of work and family commitments, and illness. Participants described a mutually beneficial relationship with friends wherein both parties valued their independence and provided assistance to the other when needed. Their comments suggested that assistance was viewed as a good to be traded among peers. Our findings indicate that seniors value their independence and may not seek help even when it appears to be available, if asking threatens valued identities. Health and social care practitioners and policy makers responsible for planning and delivery of services should take this into account in order to ensure the best possible care for injured community-dwelling seniors.

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