Journal for Healthcare Quality最新文献_第5页

Characterization of Emergency Department Quality Assurance Cases Seen Within a Midwestern United States Health System. 美国中西部医疗系统急诊科质量保证病例的特点。

IF 0.9 4区医学

Journal for Healthcare Quality Pub Date : 2024-09-01 Epub Date: 2024-06-04 DOI: 10.1097/JHQ.0000000000000447

Karli Smith, Hayden L Smith, Alex Wittry, Gabriel Conley, Jodi Leech, Nicholas Kluesner

{"title":"Characterization of Emergency Department Quality Assurance Cases Seen Within a Midwestern United States Health System.","authors":"Karli Smith, Hayden L Smith, Alex Wittry, Gabriel Conley, Jodi Leech, Nicholas Kluesner","doi":"10.1097/JHQ.0000000000000447","DOIUrl":"10.1097/JHQ.0000000000000447","url":null,"abstract":"Background: Hospital quality-assurance (QA) processes, including peer-review committees, seek to identify high-risk areas.Purpose: To characterize emergency department (ED) cases sent for QA review.Methods: A retrospective observational study was conducted of ED cases sent to a QA committee from November 2018 through July 2022 at three midwestern US hospitals. The QA records analyzed for these cases included the original incident report, case summary, and the committee determinations.Results: One hundred and forty-seven cases were reviewed by the ED QA Committee. The most frequent referrals came from physicians. Common diagnostic categories included infectious (21%), cardiac (16%), gastrointestinal (11%), and neurologic (10%) concerns. Of the cases, 51% were considered nonpreventable, 33% were potentially preventable, and 9% were preventable. Inpatient boarding in the ED was explicitly implicated as a contributing factor in 6% of case reports.Conclusions: Peer physician reporting represent the largest referral source sent for review with the most frequent diagnostic categories, including infectious, cardiac, gastrointestinal, and neurological conditions. Preventable concerns were rare.Implications: This study provides a better understanding of the referral sources, diagnostic categories, and committee determinations in ED quality concerns. These results can target future investigations into case reporting and patient safety.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"281-285"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Challenges Meeting 21st Century Cures Act Patient Identity Interoperability and Information Blocking Rules. 满足《21 世纪治愈法案》患者身份互操作性和信息屏蔽规则的挑战。

IF 0.9 4区医学

Journal for Healthcare Quality Pub Date : 2024-09-01 DOI: 10.1097/JHQ.0000000000000446

George A Gellert, Mark E Erwich, Sara Krivicky Herdman

{"title":"Challenges Meeting 21st Century Cures Act Patient Identity Interoperability and Information Blocking Rules.","authors":"George A Gellert, Mark E Erwich, Sara Krivicky Herdman","doi":"10.1097/JHQ.0000000000000446","DOIUrl":"10.1097/JHQ.0000000000000446","url":null,"abstract":"Objective: Gather insights into healthcare organization (HCO) preparedness for new 21st Century Cures Act information blocking disincentives and challenges in achieving greater accuracy /interoperability of patient identity/data.Methods: Survey of 197 U.S. healthcare executives (54.7% response rate), included 46 health systems (23.4%), 141 hospitals (71.6%), and 10 payer organizations (5.1%), evaluated organizational gaps in patient identity data management/interoperability and preparation for information deblocking.Results: Healthcare organizations are unprepared to meet information deblocking requirements and manage increased data influx/exchange. Although 61% have invested in meeting requirements, only 36% have capabilities in place. Majorities reported inability to comply with information blocking rules (59%), communicate electronic patient activity notifications to other organizations (56%), or share/receive patient-level information with patients and other HCOs (57%). Across 12 critical functionalities, 57% lacked key capabilities; 97% reported inadequate patient data/identity management/interoperability as data volume expands, adversely affecting care quality/safety and outcomes; and 57% envision patient data-matching errors precipitating a healthcare crisis in 5-10 years.Conclusions: Many HCOs are unprepared to meet new Cures Act information blocking requirements and resultant increase of internal/external patient data volumes. Next generation master data management, enterprise master patient index, and referential matching technologies can improve HCO patient identity and data management, and information interoperability.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":"46 5","pages":"306-315"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142093996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Factors Associated With Nasogastric Tube Placement-Related Complications in a Single Academic Medical Center. 单个学术医疗中心中与鼻胃管置入相关并发症有关的因素。

IF 0.9 4区医学

Journal for Healthcare Quality Pub Date : 2024-09-01 DOI: 10.1097/JHQ.0000000000000448

Whitney Pickel, Elizabeth Talbott, Justine Abram, Richard Bernardi, DaWanda Forester, Joshua Hawkins, Jennifer Henry, Danielle Nesbitt, Candice Smith, Keith Gray

{"title":"Factors Associated With Nasogastric Tube Placement-Related Complications in a Single Academic Medical Center.","authors":"Whitney Pickel, Elizabeth Talbott, Justine Abram, Richard Bernardi, DaWanda Forester, Joshua Hawkins, Jennifer Henry, Danielle Nesbitt, Candice Smith, Keith Gray","doi":"10.1097/JHQ.0000000000000448","DOIUrl":"10.1097/JHQ.0000000000000448","url":null,"abstract":"Objective: At our 710-bed academic medical center, nine (9) patients sustained injuries during nasogastric (NG) tube insertion attempts over a 16-month period (March 2021-July 2022). No injuries were reported during the comparable period before these events. This increase in reported events prompted an in-depth analysis to determine the root causes and implement a process improvement plan.Methods: Root cause analysis (RCA) of these events failed to identify risk factors or actionable themes. The RCAs demonstrated wide variation in the number of insertion attempts and techniques.Results: A standard process was created to provide team members with guidance for escalation when NG tube placement was difficult.Conclusions: Although the complication rate for NG tube insertion was comparable with the criterion standard for large tertiary care institutions, we focused on minimizing risk and improving outcomes by creating a standard process for NG tube placement.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":"46 5","pages":"316-323"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142093998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multimodal Quality Initiatives in Sepsis Care: Assessing Impact on Core Measures and Outcomes. 败血症护理中的多模式质量倡议：评估对核心指标和结果的影响。

IF 0.9 4区医学

Journal for Healthcare Quality Pub Date : 2024-07-01 Epub Date: 2024-05-17 DOI: 10.1097/JHQ.0000000000000440

Marcos Garcia, Mohammed Al-Jaghbeer, James Morrison, Antoine Boustany, Bindesh Ghimire, Neel Tapryal, Komal Mushtaq, Kelly Orlosky, Amy Flowers-Surovi, Christopher Murphy, Palak Rath, Muhaimen Rahman, Corrine Kickel, Yu-Che Lee, Ko-Yun Chang, Francois Abi Fadel

{"title":"Multimodal Quality Initiatives in Sepsis Care: Assessing Impact on Core Measures and Outcomes.","authors":"Marcos Garcia, Mohammed Al-Jaghbeer, James Morrison, Antoine Boustany, Bindesh Ghimire, Neel Tapryal, Komal Mushtaq, Kelly Orlosky, Amy Flowers-Surovi, Christopher Murphy, Palak Rath, Muhaimen Rahman, Corrine Kickel, Yu-Che Lee, Ko-Yun Chang, Francois Abi Fadel","doi":"10.1097/JHQ.0000000000000440","DOIUrl":"10.1097/JHQ.0000000000000440","url":null,"abstract":"Abstract: Providing timely and effective care for patients with sepsis is challenging due to delays in recognition and intervention. The Surviving Sepsis Campaign has developed bundles that have been shown to reduce sepsis mortality. However, hospitals have not consistently adhered to these bundles, resulting in suboptimal outcomes. To address this, a multimodal quality improvement sepsis program was implemented from 2017 to 2022 in a large urban tertiary hospital. The aim of this program was to enhance the Severe Sepsis and Septic Shock Management Bundle compliance and reduce sepsis mortality. At baseline, the Severe Sepsis and Septic Shock Management Bundle compliance rates were low, at 25%, with a sepsis observed/expected mortality ratio of 1.14. Our interventions included the formation of a multidisciplinary committee, the appointment of sepsis champions, the implementation of sepsis alerts and order sets, the formation of a Code Sepsis team, real-time audits, and peer-to-peer education. By 2022, compliance rose to 62%, and the observed/expected mortality ratio decreased to 0.73. Our approach led to improved outcomes and hospital rankings. These findings underscore the efficacy of a comprehensive sepsis care initiative, emphasizing the importance of interdisciplinary collaboration. A multimodal hospital-wide sepsis performance program is feasible and can contribute to improved outcomes. However, further research is necessary to determine the specific impact of individual strategies on sepsis outcomes.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"245-250"},"PeriodicalIF":0.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quality and Safety in Nursing: Recommendations From a Systematic Review. 护理质量与安全：系统综述提出的建议。

IF 0.9 4区医学

Journal for Healthcare Quality Pub Date : 2024-07-01 Epub Date: 2024-05-08 DOI: 10.1097/JHQ.0000000000000430

Patricia A Patrician, Caitlin M Campbell, Mariyam Javed, Kathy M Williams, Lozay Foots, Wendy M Hamilton, Sherita House, Pauline A Swiger

{"title":"Quality and Safety in Nursing: Recommendations From a Systematic Review.","authors":"Patricia A Patrician, Caitlin M Campbell, Mariyam Javed, Kathy M Williams, Lozay Foots, Wendy M Hamilton, Sherita House, Pauline A Swiger","doi":"10.1097/JHQ.0000000000000430","DOIUrl":"10.1097/JHQ.0000000000000430","url":null,"abstract":"Abstract: As a consistent 24-hour presence in hospitals, nurses play a pivotal role in ensuring the quality and safety (Q&S) of patient care. However, a comprehensive review of evidence-based recommendations to guide nursing interventions that enhance the Q&S of patient care is lacking. Therefore, the purpose of our systematic review was to create evidence-based recommendations for the Q&S component of a nursing professional practice model for military hospitals. To accomplish this, a triservice military nursing team used Covidence software to conduct a systematic review of the literature across five databases. Two hundred forty-nine articles met inclusion criteria. From these articles, we created 94 recommendations for practice and identified eight focus areas from the literature: (1) communication; (2) adverse events; (3) leadership; (4) patient experience; (5) quality improvement; (6) safety culture/committees; (7) staffing/workload/work environment; and (8) technology/electronic health record. These findings provide suggestions for implementing Q&S practices that could be adapted to many healthcare delivery systems.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"203-219"},"PeriodicalIF":0.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11198958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implementation of a Patient-Reported Outcome Measure: A Quality Improvement Project. 实施患者报告结果衡量标准：质量改进项目。

IF 0.9 4区医学

Journal for Healthcare Quality Pub Date : 2024-07-01 Epub Date: 2024-04-30 DOI: 10.1097/JHQ.0000000000000434

Shana McGrath, Mequeil Howard, Kristen Webber, Lisa Juckett

{"title":"Implementation of a Patient-Reported Outcome Measure: A Quality Improvement Project.","authors":"Shana McGrath, Mequeil Howard, Kristen Webber, Lisa Juckett","doi":"10.1097/JHQ.0000000000000434","DOIUrl":"10.1097/JHQ.0000000000000434","url":null,"abstract":"Abstract: Patient-reported outcome measures (PROMs) are seen as increasingly beneficial to patient-centered clinical practice, but implementation of routine collection and utilization into clinical care can be challenging. Our interdisciplinary quality improvement (QI) team used the Institute for Health Care Improvement Model for Improvement methodology to address this problem in our outpatient neurorehabilitation program. We used a participatory approach to identify the PROM rehabilitation stakeholders found to be most appropriate to implement in the outpatient settings; chart audits were conducted to determine the extent to which clinicians implemented the PROM and documented a PROM-related goal. Opportunistic clinician feedback was collected to determine single PROM usefulness and acceptability. Our 4-month initiative demonstrated increased collection of a PROM, the Patient-Specific Functional Scale (PSFS), and incorporation into patient-centered goal. Use of QI methodology was beneficial when planning and executing our initiative. Future work is needed to examine factors to sustain PSFS use, incorporation into patient-centered goal setting, and maximize meaningful patient outcomes.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"e20-e25"},"PeriodicalIF":0.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quality Coordinators' Perspectives on Quality Improvement in Primary Healthcare in Kosovo: A Qualitative Study. 质量协调员对科索沃初级医疗质量改进的看法：定性研究。

IF 0.9 4区医学

Journal for Healthcare Quality Pub Date : 2024-07-01 Epub Date: 2024-04-30 DOI: 10.1097/JHQ.0000000000000431

Ardita Baraku, Gordana Pavleković

{"title":"Quality Coordinators' Perspectives on Quality Improvement in Primary Healthcare in Kosovo: A Qualitative Study.","authors":"Ardita Baraku, Gordana Pavleković","doi":"10.1097/JHQ.0000000000000431","DOIUrl":"10.1097/JHQ.0000000000000431","url":null,"abstract":"Aims: This qualitative descriptive study provides insights into the experiences of quality coordinators (QCs) in primary healthcare to inform policy and practice actions and empower QCs to enhance healthcare quality.Methods: We conducted focus group discussions with purposefully selected QCs to understand their motivations, job experiences, factors influencing healthcare quality, and suggestions for quality improvement. Content analysis and deductive coding were used to scrutinize the responses and answer the research questions.Results: The QCs thought highly about their job performance and were motivated by both extrinsic and intrinsic factors. Clinical audits, collegial reviews, and managerial support positively affected QCs' performance. In contrast, a lack of managerial support, limited working hours, and changes in organizing work caused the opposite. Empowerment and external support positively influenced healthcare quality, whereas lack of resources, managerial support, or training had a negative influence. Suggestions to improve quality include the role of QCs, external supervision, and centralization of the QCs' network.Conclusion: Appointing QCs alone does not guarantee quality improvement. It is essential to ensure that QCs have the appropriate skills, tools, management support, and open communication channels. Further research is required to evaluate the effects of sex and age on QCs' performance.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"e49-e55"},"PeriodicalIF":0.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Differential Mortality Among Heart Failure Patients Across Different COVID-19 Surges in New York City. 纽约市不同 COVID-19 高峰期心衰患者的死亡率差异。

IF 0.9 4区医学

Journal for Healthcare Quality Pub Date : 2024-07-01 Epub Date: 2024-01-12 DOI: 10.1097/JHQ.0000000000000421

Sheetal Vasundara Mathai, Samuel J Apple, Xiaobao Xu, Li Pang, Elie Flatow, Ari Friedman, Saul Rios, Cesar Joel Benites Moya, Majd Al Deen Alhuarrat, Matthew Parker, Seth I Sokol, Robert T Faillace

{"title":"Differential Mortality Among Heart Failure Patients Across Different COVID-19 Surges in New York City.","authors":"Sheetal Vasundara Mathai, Samuel J Apple, Xiaobao Xu, Li Pang, Elie Flatow, Ari Friedman, Saul Rios, Cesar Joel Benites Moya, Majd Al Deen Alhuarrat, Matthew Parker, Seth I Sokol, Robert T Faillace","doi":"10.1097/JHQ.0000000000000421","DOIUrl":"10.1097/JHQ.0000000000000421","url":null,"abstract":"Abstract: Learning from the healthcare system's response to the COVID-19 pandemic is essential to better prepare for potential future crises. We sought to assess mortality rates for patients admitted for acute decompensated heart failure (HF) and to analyze which factors demonstrated a statistically significant correlation with this primary endpoint. We performed a retrospective analysis of patients hospitalized with a primary diagnosis of acute decompensated HF within the New York City Health and Hospitals 11-hospital system across the different COVID surge periods. Mortality information was collected in 4,405 participants (mean [SD] age 70.54 [14.44] years, 1885 [42.87%] female).The highest mortality existed in the first surge (9.02%), then improved to near prepandemic levels (3.65%) in the second (3.91%) and third surges (5.94%, p < 0.0001). In-hospital mortality inversely correlated with receipt of a COVID-19 vaccination, but had no correlation with left ventricular ejection fraction or the number of vaccination doses. Mortality for acute decompensated HF patients improved after the first surge, suggesting that hospitals adequately adapted to provide quality care. As future infectious outbreaks may occur, emergency preparedness must ensure that adequate focus and resources remain for other clinical entities, such as HF, to ensure optimal care is delivered across all areas of illness.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"197-202"},"PeriodicalIF":0.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Iron Deficiency Among Hospitalized Patients With Congestive Heart Failure. 充血性心力衰竭住院患者的铁缺乏症。

IF 0.9 4区医学

Journal for Healthcare Quality Pub Date : 2024-07-01 Epub Date: 2024-06-04 DOI: 10.1097/JHQ.0000000000000432

Rick Foust, Stephen Clarkson, Megan Nordberg, Joanna Joly, Russell Griffin, Jori May

{"title":"Iron Deficiency Among Hospitalized Patients With Congestive Heart Failure.","authors":"Rick Foust, Stephen Clarkson, Megan Nordberg, Joanna Joly, Russell Griffin, Jori May","doi":"10.1097/JHQ.0000000000000432","DOIUrl":"10.1097/JHQ.0000000000000432","url":null,"abstract":"Introduction: Studies have demonstrated the efficacy of intravenous (IV) iron when administered to patients with congestive heart failure (CHF) and iron deficiency (ID). We aimed to better understand the adherence of treatment for ID among a population with CHF, with particular interest in high-risk groups not often studied due to inadequate recruitment.Methods: A retrospective chart review at our institution was conducted from January 1, 2012, to July 7, 2021. Analysis included hospitalized patients with CHF and ID and dividing these patients into two time periods based on changes in iron treatment patterns and treatment between sexes.Results: Four thousand eight hundred thirteen patients were included in this study. During the \"early era,\" 7.0% of patients with CHF and ID received IV iron compared with 20.9% of \"late-era\" patients. Female patients with ID were statistically less likely to receive IV iron when compared with male patients, both unadjusted (0.66, confidence interval [CI] 0.55-0.79, p < .0001) and adjusted (0.72, CI 0.59-0.87, p < .0001) for covariates.Conclusion: This study illustrates improved adherence to treatment for ID among hospitalized population with CHF and ID over time but persistent undertreatment remains. Future studies will need to identify the barriers to treating female patients with CHF and ID to reduce these disparities.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"220-227"},"PeriodicalIF":0.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pilot Process Evaluation of the Supporting Older Adults at Risk Model: A RE-AIM Approach. 支持处于风险中的老年人模式的试点过程评估：RE-AIM 方法。

IF 0.9 4区医学

Journal for Healthcare Quality Pub Date : 2024-07-01 Epub Date: 2024-05-14 DOI: 10.1097/JHQ.0000000000000435

Rebecca L Trotta, Anne E Shoemaker, S Ryan Greysen, Marie Boltz

{"title":"Pilot Process Evaluation of the Supporting Older Adults at Risk Model: A RE-AIM Approach.","authors":"Rebecca L Trotta, Anne E Shoemaker, S Ryan Greysen, Marie Boltz","doi":"10.1097/JHQ.0000000000000435","DOIUrl":"10.1097/JHQ.0000000000000435","url":null,"abstract":"Abstract: Despite evidence supporting transitional care models, hospitals report challenges implementing and sustaining them. The Discharge to Assess (D2A) Model is an innovative solution to this problem but required translation from a national health system context to an U.S.-based context. We translated the central tenets of the D2A model to establish the Supporting Older Adults at Risk (SOAR) Model, which unfolds in three phases: Prepare, Transition, and Support. The purpose of this project was to conduct a process evaluation of the SOAR Model in practice using the RE-AIM Framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance). Forty patients completed all SOAR Model components for a Reach of 21%. Patients averaged 80 years of age, 53% were female, and 64% Black/AA. SOAR significantly improved discharge before noon, time to first home visit, and use of the in-house pharmacy. SOAR also improved length of hospital stay, emergency department visits, and readmissions. Twenty-one of the 26 Implementation measures unfolded with 75% or greater fidelity. Sixteen of the 24 Adoption measures unfolded with 75% or greater fidelity. COVID-19 limited Maintenance. Given the model unfolds across settings over time, requiring adoption from interprofessional team members, patients, and families, future work should focus on improving reach and adoption.","PeriodicalId":48801,"journal":{"name":"Journal for Healthcare Quality","volume":" ","pages":"e26-e39"},"PeriodicalIF":0.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140922095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0