“Self-care index” and “Post-acute care discharge score” to predict discharge destination of adult medical inpatients: multicentre validation study protocol (Preprint)

“Self-care index” (SPI) and “Post-acute care discharge score” (PACD) to predict transfer of adult medical inpatients to a post-acute care facility: study protocol for a multicentre validation study (Preprint)

10.2196/preprints.21447 ◽

2020 ◽

Author(s):

Antoinette Conca ◽

Daniel Koch ◽

Katharina Regez ◽

Alexander Kutz ◽

Ciril Baechli ◽

...

Keyword(s):

Acute Care ◽

Study Protocol ◽

Negative Impact ◽

External Validation ◽

Self Care ◽

Care Facility ◽

The Self ◽

Acute Care Facility ◽

Care Index ◽

Post Acute Care

BACKGROUND Delays in patient discharge can not only lead to deterioration especially among geriatric patients, but also incorporates unnecessary resources at the hospital level. Many of these delays and their negative impact may be preventable by early focused screening to identify patients at risk for transfer to a post-acute care facility. Early interprofessional discharge planning is crucial in order to fit the appropriate individual discharge destination. As prediction of discharge to a post-acute care facility using post-acute care discharge score, the self-care index and a combination of both has been shown in a single centre pilot study, an external validation is still missing. OBJECTIVE This paper outlines the study protocol and methodology currently being used to replicate the previous pilot findings whether the post-acute care discharge score, the self-care index or the combination of both can reliably identify patients requiring transfer to post-acute care facilities. METHODS This study will use prospective data involving all phases of the quasi-experimental study “In-HospiTOOL” conducted at seven Swiss hospitals in urban and rural areas. During a 18-month period consecutive adult medical patients admitted to the hospitals through the emergency department will be included. This data will enable a prospective external validation of the prediction instruments. RESULTS We expect to gain more insight into the predictive capability of the above mentioned prediction instruments. This approach will allow us to get important information about the generalizability of the three different models. CONCLUSIONS This study will provide evidence on prognostic properties, comparative performance, reliability of scorings, and suitability of the instruments for screening purpose in order to be able to recommend application in clinical practice.

Download Full-text

Improving the post-acute care discharge score (PACD) by adding patients’ self-care abilities: A prospective cohort study

PLoS ONE ◽

10.1371/journal.pone.0214194 ◽

2019 ◽

Vol 14 (3) ◽

pp. e0214194

Author(s):

Daniel Koch ◽

Philipp Schuetz ◽

Sebastian Haubitz ◽

Alexander Kutz ◽

Beat Mueller ◽

...

Keyword(s):

Cohort Study ◽

Acute Care ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Self Care ◽

Post Acute Care

Download Full-text

Post‐Acute Care Locations: Hospital Discharge Destination Reports vs Medicare Claims

Journal of the American Geriatrics Society ◽

10.1111/jgs.16308 ◽

2019 ◽

Vol 68 (4) ◽

pp. 847-851 ◽

Cited By ~ 1

Author(s):

Ye Zhu ◽

Sally C. Stearns

Keyword(s):

Hospital Discharge ◽

Acute Care ◽

Discharge Destination ◽

Medicare Claims ◽

Post Acute Care

Download Full-text

88 Profiling Clinical Frailty in Older Adults in an Irish Post-Acute Care Ortho-Geriatric Unit

Age and Ageing ◽

10.1093/ageing/afz103.50 ◽

2019 ◽

Vol 48 (Supplement_3) ◽

pp. iii17-iii65

Author(s):

Edel McDaid ◽

Elaine Ross ◽

Lisa Cogan

Keyword(s):

Length Of Stay ◽

Acute Care ◽

Long Term Care ◽

Discharge Destination ◽

Clinical Frailty Scale ◽

Geriatric Population ◽

Term Care ◽

Geriatric Unit ◽

Post Acute Care

Abstract Background Clinical frailty upon admission to acute care has been shown to independently predict adverse discharge destination in geriatric patients (1). However, the prevalence of clinical frailty in post-acute care and its impact on length of stay and discharge destination has not been explored to date (2). The aims of this study were to measure clinical frailty upon admission and discharge to a post-acute Ortho-geriatric Unit (OGU) and identify its impact on length of stay (LOS) and discharge destination. Methods A retrospective data analysis was completed of all patients admitted and discharged within a 6-month period. All received routine Multidisciplinary team (MDT) rehabilitation care. Clinical Frailty was assessed within first week of admission and the week prior to discharge using the Clinical Frailty Scale (CFS). Data was analysed using Microsoft Excel. Results Fifty-four patients were admitted over the 6-month period. All were female, mean age 81 years and over half (55%) had a primary diagnosis of hip fracture (n=30). All were deemed frail on admission (CFS score >5). The Mild to Moderate (CFS 5 and CFS 6) Group (n=36) had a mean age 81.1 years, mean LOS 38.75 days, 96.6% independently mobile on discharge and 97.2% discharged home. The Severe (CFS 7 and CFS 8) Group (n=18) had a mean age 85.2 years, mean LOS 85.2 days, 59.4% independently mobile on discharge and 83.3%% discharged home. 75% (n=3) of patients that transitioned to long-term care were in the Severe Group. At discharge 54% of the total participants were deemed frail(CFS>5), 46% less compared to admission scores. Conclusion All admissions to OGU were frail. MDT rehabilitation reduced frailty levels for the majority of subjects’ in this study. Higher admission CFS scores resulted in increased LOS and a trend towards long-term care transition. Further research is warranted to evaluate the efficacy of CFS in post-acute geriatric population.

Download Full-text

Post-Acute Care Facility as a Discharge Destination for Patients in Need of Palliative Care in Brazil

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909117691280 ◽

2017 ◽

Vol 35 (2) ◽

pp. 198-202

Author(s):

Luiz Guilherme L. Soares ◽

André M. Japiassu ◽

Lucia C. Gomes ◽

Rogéria Pereira

Keyword(s):

Palliative Care ◽

Acute Care ◽

Care Facility ◽

Discharge Destination ◽

Care Needs ◽

Care Services ◽

Lengths Of Stay ◽

Hospital Stays ◽

Acute Care Facilities ◽

Post Acute Care

Patients with complex palliative care needs can experience delayed discharge, which causes an inappropriate occupancy of hospital beds. Post-acute care facilities (PACFs) have emerged as an alternative discharge destination for some of these patients. The aim of this study was to investigate the frequency of admissions and characteristics of palliative care patients discharged from hospitals to a PACF. We conducted a retrospective analysis of PACF admissions between 2014 and 2016 that were linked to hospital discharge reports and electronic health records, to gather information about hospital-to-PACF transitions. In total, 205 consecutive patients were discharged from 6 different hospitals to our PACF. Palliative care patients were involved in 32% (n = 67) of these discharges. The most common conditions were terminal cancer (n = 42, 63%), advanced dementia (n = 17, 25%), and stroke (n = 5, 8%). During acute hospital stays, patients with cancer had significant shorter lengths of stay (13 vs 99 days, P = .004), a lower use of intensive care services (2% vs 64%, P < .001) and mechanical ventilation (2% vs 40%, P < .001), when compared to noncancer patients. Approximately one-third of discharges from hospitals to a PACF involved a heterogeneous group of patients in need of palliative care. Further studies are necessary to understand the trajectory of posthospitalized patients with life-limiting illnesses and what factors influence their decision to choose a PACF as a discharge destination and place of death. We advocate that palliative care should be integrated into the portfolio of post-acute services.

Download Full-text

Rise of Post–Acute Care Facilities as a Discharge Destination of US Hospitalizations

JAMA Internal Medicine ◽

10.1001/jamainternmed.2014.6383 ◽

2015 ◽

Vol 175 (2) ◽

pp. 295 ◽

Cited By ~ 60

Author(s):

Robert E. Burke ◽

Elizabeth Juarez-Colunga ◽

Cari Levy ◽

Allan V. Prochazka ◽

Eric A. Coleman ◽

...

Keyword(s):

Acute Care ◽

Discharge Destination ◽

Care Facilities ◽

Acute Care Facilities ◽

Post Acute Care

Download Full-text

Person-Centred Dermatology Self-care Index: a translation and validation study

Journal of Wound Care ◽

10.12968/jowc.2019.28.9.566 ◽

2019 ◽

Vol 28 (9) ◽

pp. 566-575

Author(s):

Jan Kottner ◽

Oliver Ludwig ◽

Thomas Bode ◽

Fiona Cowdell ◽

Steven Ersser ◽

...

Keyword(s):

Validation Study ◽

Skin Diseases ◽

Life Quality ◽

Self Care ◽

Support Needs ◽

Significant Difference ◽

German Speaking ◽

Chronic Skin ◽

Skin Conditions ◽

Care Index

Objective: Self-management is important to successfully managing chronic skin diseases. The Person-Centred Dermatology Self-care Index (PeDeSI) is a self-efficacy theory-based questionnaire tool to measure education and support needs of adults with long-term skin conditions. The aim of this research was to translate the PeDeSI into German (PeDeSI-G) and to explore the validity of this tool. Methods: The instrument was translated by five translators working independently. User understanding and relevance were evaluated by nurses, patients and physicians. The translated version was modified and applied in a subsequent validation study. Demographic and other variables, PeDeSI-G and Dermatology Life Quality Index (DLQI) scores of dermatological patients were obtained. Results: PeDeSi-G and DLQI scores were obtained from 100 patients. A conceptually and semantically equivalent German translation of the PeDeSI was developed. There was a statistically significant difference between in- and outpatients (p<0.001). PeDeSI-G scores were most strongly correlated with disease duration and DLQI scores. Conclusions: Validation results indicate that the PeDeSI-G is able to discriminate between patients with different educational and support needs for this patient group. Newly diagnosed patients and patients admitted to the hospital for the first time might benefit most from the PeDeSI-G assessment. The PeDeSI-G is a valid tool for assessing and evaluating the support needs of German-speaking patients with chronic skin disease.

Download Full-text