期刊论文详细信息
BMC Health Services Research
The Older Persons’ Transitions in Care (OPTIC) study: pilot testing of the transition tracking tool
Greta G Cummings4  Mike Ertel5  Peter G Norton1  Adrian Wagg6  Brian H Rowe3  Carole A Estabrooks4  Laura J Bissell2  Stephanie L Abel4  Sarah L Cooper4  Garnet E Cummings3  Robert Colin Reid2 
[1] Department of Family Medicine, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada;School of Health and Exercise Sciences, University of British Columbia’s Okanagan campus, 3333 University Way, ART, Kelowna, British Columbia V1V 1V7, Canada;Department of Emergency Medicine, Faculty of Medicine and Dentistry and School of Public Health, University of Alberta, Edmonton, Alberta, Canada;Faculty of Nursing, University of Alberta, 5-110 Edmonton Clinical Health Academy, 11405 87 Avenue, Edmonton, Alberta T6G 1C9, Canada;Kelowna General Hospital, Interior Health Authority, Kelowna, British Columbia, Canada;Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
关键词: Emergency department;    Nursing home;    Transition tracking;    Transitional care;    Transfers;   
Others  :  1134475
DOI  :  10.1186/1472-6963-13-515
 received in 2013-05-31, accepted in 2013-12-09,  发布年份 2013
PDF
【 摘 要 】

Background

OPTIC is a mixed method Partnership for Health System Improvement (http://www.cihr-irsc.gc.ca/e/34348.html webcite) study focused on improving care for nursing home (NH) residents who are transferred to and from emergency departments (EDs) via emergency medical services (EMS). In the pilot study we tested feasibility of concurrently collecting individual resident data during transitions across settings using the Transition Tracking Tool (T3).

Methods

The pilot study tracked 54 residents transferred from NHs to one of two EDs in two western Canadian provinces over a three month period. The T3 is an electronic data collection tool developed for this study to record data relevant to describing and determining success of transitions in care. It comprises 800+ data elements including resident characteristics, reasons and precipitating factors for transfer, advance directives, family involvement, healthcare services provided, disposition decisions, and dates/times and timing.

Results

Residents were elderly (mean age = 87.1 years) and the majority were female (61.8%). Feasibility of collecting data from multiple sources across two research sites was established. We identified resources and requirements to access and retrieve specific data elements in various settings to manage data collection processes and allocate research staff resources. We present preliminary data from NH, EMS, and ED settings.

Conclusions

While most research in this area has focused on a unidirectional process of patient progression from one care setting to another, this study established feasibility of collecting detailed data from beginning to end of a transition across multiple settings and in multiple directions.

【 授权许可】

   
2013 Reid et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Boling PA: Care transitions and home health care. Clin Geriat Med 2009, 25(1):135-148.
  • [2]Scott IA: Preventing the rebound: Improving care transition in hospital discharge processes. Aust. Health Rev 2010, 34(4):445-451.
  • [3]Mor V, Besdine RW: Policy options to improve discharge planning and reduce rehospitalization. JAMA 2011, 305(3):302-303.
  • [4]Gruneir A, Bronskill S, Bell C, Gill S, Schull M, Ma X, Anderson G, Rochon PA: Recent health care transitions and emergency department use by chronic long term care residents: A population-based cohort study. J Am Med Dir Assoc 2012, 13(3):202-206.
  • [5]Tsilimingras D, Bates DW: Addressing postdischarge adverse events: a neglected area. J Qual Patient Saf 2008, 34(2):85-97.
  • [6]Hastings SN, Oddone EZ, Fillenbaum G, Sloane RJ, Schmader KE: Frequency and predictors of adverse health outcomes in older medicare beneficiaries discharged from the emergency department. Med Care 2008, 46(8):771-777.
  • [7]Coleman EA, Smith JD, Frank JC, Eilertsen TB, Thiare JN, Kramer AM: Development and testing of a measure designed to assess the quality of care transitions. Int J Integr Care 2002, 2:e02.
  • [8]Parry C, Mahoney E, Chalmers SA, Coleman EA: Assessing the quality of transitional care: further applications of the care transitions measure. Med Care 2008, 46(3):317-322.
  • [9]Canadian Institute for Health Information: Patient pathways: Transfers from continuing care to acute care. Ottawa, Ontario: CIHI; 2009.
  • [10]McCloskey R, van den Hoonaard D: Nursing home residents in emergency departments: A Foucauldian analysis. J Adv Nurs 2007, 59(2):186-194.
  • [11]Gruneir A, Bell CM, Bronskill SE, Schull M, Anderson GM, Rochon PA: Frequency and pattern of emergency department visits by long-term care residents–a population-based study. J Am Geriat Soc 2010, 58(3):510-517.
  • [12]McCloskey R: Use of one ER by nursing home residents in New Brunswick. Geriat Today 2004, 7:53-58.
  • [13]Castle NG, Mor V: Hospitalization of nursing home residents: A review of the literature, 1980–1995. Med Care Res Rev 1996, 53(2):123-148.
  • [14]Malone M, Danto-Nocton E: Improving the hospital care of nursing home residents. Ann of Long-Term Care 2004, 12:42-49.
  • [15]Callahan CM, Arling G, Tu W, Rosenman MB, Counsell SR, Stump TE, Hendrie HC: Transitions in care for older adults with and without dementia. J Am Geriat Soc 2012, 60(5):813-820.
  • [16]McCloskey RM: A qualitative study on the transfer of residents between a nursing home and an emergency department. J Am Geriat Soc 2011, 59(4):717-724.
  • [17]Coleman EA: Falling through the cracks: Challenges and opportunities for improving transitional care for persons with continuous complex care needs. J Am Geriatr Soc 2003, 51(4):549-555.
  • [18]Crilly J, Chaboyer W, Wallis M: Continuity of care for acutely unwell older adults from nursing homes. Scand J Caring Sci 2006, 20(2):122-134.
  • [19]Naylor MD: Transitional care of older adults. Ann Rev Nurs Res 2002, 20:127-147.
  • [20]Kelly NA, Mahoney DF, Bonner A, O’Malley T: Use of a Transitional Minimum Data Set (TMDS) to improve communication between nursing home and emergency department providers. J Am Med Dir Assoc 2012, 13(1):85-89.
  • [21]Cummings GG, Reid RC, Estabrooks CA, Norton PG, Cummings GE, Rowe BH, Abel SL, Bissell L, Bottorff JL, Robinson CA, et al.: Older Persons’ Transitions in Care (OPTIC): A study protocol. BMC Geriatr 2012, 12:75. BioMed Central Full Text
  • [22]Robinson CA, Bottorff JL, Lilly MB, Reid C, Abel S, Lo M, Cummings GG: Stakeholder perspectives on transitions of nursing home residents to hospital emergency departments and back in two Canadian provinces. J. Aging Stud 2012, 26:419-427.
  • [23]Statistics Canada: Edmonton, Alberta (Code 4811061), Canada (Code 01) and Kelowna, British Columbia (Code 5935010) (table). Census Profile, 2011 Census. 2012. http://www12.statcan.gc.ca/census-recensement/2011/dp-pd/prof/index.cfm?Lang=E webcite
  • [24]Alzheimer Society of Canada: Rising Tide: The impact of dementia on Canadian society. Toronto, ON; 2010. http://www.alzheimer.ca/en/Get-involved/Raise-your-voice/Rising-Tide webcite
  • [25]Morris JN, Fries BE, Mehr DR, Hawes C, Phillips C, Mor V, Lipsitz LA: MDS Cognitive Performance Scale. J Gerontol 1994, 49(4):M174-M182.
  • [26]Gillespie SM, Gleason LJ, Karuza J, Shah MN: Health care providers’ opinions on communication between nursing homes and emergency departments. J Am Med Dir Assoc 2010, 11(3):204-210.
  • [27]Beveridge R: CAEP issues. The Canadian Triage and Acuity Scale: A new and critical element in health care reform. Canadian Association of Emergency Physicians. J Emerg Med 1998, 16(3):507-511.
  • [28]Coleman EA, Berenson RA: Lost in transition: Challenges and opportunities for improving the quality of transitional care. Ann Intern Med 2004, 141(7):533-536.
  • [29]Davis MM, Devoe M, Kansagara D, Nicolaidis C, Englander H: “Did I do as best as the system would let me?” Healthcare professional views on hospital to home care transitions. J Gen Intern Med 2012, 27(12):1649-1656.
  • [30]McCloskey RM: A conceptual framework for understanding interorganizational relationships between nursing homes and emergency departments: Examples from the Canadian setting. Policy, Polit Nurs Pract 2009, 10(4):285-294.
  • [31]American Medical Directors Association: Transitions of care in the long-term care continuum clinical practice guideline. Columbia, MD: AMDA; 2010.
  • [32]Cwinn MA, Forster AA, Cwinn AJ, Hebert G, Calder L, Stiell IG: Prevalence of information gaps for seniors transferred from nursing homes to the emergency department. J Emerg Med 2009, 11(5):462-471.
  • [33]Gaddis GM: Elder care transfer forms. Acad Emerg Med 2005, 12(2):160-161.
  • [34]Stiell A, Forster AJ, Stiell IG, van Walraven C: Prevalence of information gaps in the emergency department and the effect on patient outcomes. CMAJ 2003, 169(10):1023-1028.
  • [35]Hinkin T, Holtom BC, Klag M: Collaborative research: Developing mutually beneficial relationships between researchers and organizations. Organ Dyn 2007, 36(1):105-118.
  • [36]Lomas J: Connecting research and policy. J Policy Res 2000, 1(1):140-144.
  • [37]Hammel J, Southall K, Jutai J, Finlayson M, Kashindi G, Fok D: Evaluating use and outcomes of mobility technology: A multiple stakeholder analysis. Disabil Rehabil Assist Technol J 2012, 00:1-11.
  • [38]VanderVeen L, Ritz M: Customer satisfaction: A practical approach for hospitals. J Healthc Qual 1996, 18(2):10-15.
  • [39]Field TS, Mazor KM, Briesacher B, Debellis KR, Gurwitz JH: Adverse drug events resulting from patient errors in older adults. J Am Geriat Soc 2007, 55(2):271-276.
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