Extension for Community Healthcare Outcomes—Care Transitions: Enhancing Geriatric Care Transitions Through a Multidisciplinary Videoconference

Farris, Grace E.; Sircar, Mousumi; Bortinger, Jonathan; Moore, Amber; Krupp, J. Elyse; Marshall, John; Abrams, Alan; Lipsitz, Lewis A.; Mattison, Melissa L. P.

doi:10.1111/jgs.14690

Cited by 39 publications

(34 citation statements)

References 14 publications

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“…While teleconferences are not new to CMC, to our knowledge, this is the first study of a multidisciplinary discharge videoconference for children. Our findings are consistent with a previous study utilizing a multidisciplinary videoconference during geriatric hospital to postacute care transition, which demonstrated improvements in communication, post-acute provider access to hospital staff, and medication errors [9]. Our intervention differed in its inclusion of the patient and caregiver in the handoff, a practice in keeping with principles of familycentered care [22].…”

Section: Discussionsupporting

confidence: 87%

“…Prior work by Solan et al described numerous problems with hospitalist-primary care provider (PCP) communication at the time of hospital discharge, including perceived devaluation of the PCP and unclear post-discharge responsibilities, and identified videoconferences as a potential solution [8]. Multidisciplinary discharge videoconferences have been shown to improve communication, increase access to hospital staff and information, and decrease medication errors during geriatric hospital to post-acute care transitions [9]. However, this approach has not been studied in children.…”

Section: Introductionmentioning

confidence: 99%

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Implementation of a multidisciplinary discharge videoconference for children with medical complexity: a pilot study

Ravid

Zamora

Rehm³

et al. 2020

Pilot Feasibility Stud

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Background: The hospital to home transition for children with medical complexity (CMC) poses many challenges, including suboptimal communication between the hospital and medical home. Our objective was to evaluate the implementation of a discharge videoconference incorporating the patient, caregiver, primary care provider (PCP), hospitalist physician, and case manager. Methods:We evaluated implementation of this pilot intervention at a freestanding tertiary care children's hospital using mixed methods. A discharge videoconference was conducted for hospitalized children (< 18 years old) meeting complex chronic disease (C-CD) criteria. We collected field notes and conducted surveys and semistructured interviews. Outcomes included adoption, cost, acceptability, feasibility, and appropriateness. Adoption, cost, and acceptability were analyzed using descriptive statistics. Acceptability, feasibility, and appropriateness were summarized using thematic content analysis.Results: Adoption: A total of 4 CMC (9% of the 44 eligible children) had discharge videoconferences conducted. Cost (in provider time): On average, videoconferences took 5 min to schedule and lasted 21.5 min. Acceptability: All hospitalists involved (n = 4) were very likely to participate again. Interviews with caregivers (n = 4) and PCPs (n = 5) demonstrated that for those participating, videoconferences were acceptable and appropriate due to benefits including development of a shared understanding, remote physical assessment by the PCP, transparency, and humanization of the care handoff, and increased PCP comfort with care of CMC. Feasibility: Barriers included internet connection quality and scheduling constraints. Conclusions: This novel, visual approach to discharge communication for CMC had low adoption, possibly related to recruitment strategy. The videoconference posed low time burdens, and participating physicians and caregivers found them acceptable due to a variety of benefits. We identified several feasibility barriers that could be targeted in future implementation efforts.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Implementation of a multidisciplinary discharge videoconference for children with medical complexity: a pilot study

Ravid

Zamora

Rehm³

et al. 2020

Pilot Feasibility Stud

View full text Add to dashboard Cite

show abstract

“…Enabling multiple modes of communication, such as face-to-face communication and agreement about guidelines and treatment plans have been identified as facilitators for effective transitions [40]. Technology, such as video-communication tools could be used to facilitate cross-organizational communication and learning [41]. This could contribute to a common understanding of the transition process and increased trust between healthcare professionals at hospitals and the neuro-rehabilitation teams in primary care [42,43].…”

Section: Discussionmentioning

confidence: 99%

Perceptive Dialogue for Linking Stakeholders and Units During Care Transitions – A Qualitative Study of People with Stroke, Significant Others and Healthcare Professionals in Sweden

et al. 2020

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Introduction: Care transitions are a complex set of actions that risk poor quality outcomes for patients and their significant others. This study explored the transition process between hospital and continued rehabilitation in the home. The process is explored from the perspectives of people with stroke, significant others and healthcare professionals in Stockholm, Sweden. Method: Focus group interviews (n = 10), semi-structured individual interviews (n = 23) and interviews in dyad (n = 4) were conducted with healthcare professionals, people with stroke and significant others, altogether 71 participants. Data was collected and analyzed using Grounded Theory. Results: One core category "Perceptive dialogue for a coordinated transition", and two categories "Synthesis of parallel processes for common understanding" and "The forced transformation from passive attendant to uninformed agent" emerged from the analysis. The transition consisted of several parallel processes which made it difficult for the stakeholders to get a common understanding of the transition as a whole. Enabling a perceptive dialogue was as a prerequisite for the creation of a common understanding of the care transition. Conclusion: This study elucidates that a perceptive dialogue with patients/significant others as well as within and across organizations is part of a coordinated and person-centred transition. There is an extensive need for increased involvement of patients and significant others regarding dialogue about health conditions, procedures at the hospital and preparation for self-management after discharge.

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“…Improving communication between healthcare facilities has been identified as an important mechanism to reduce gaps when transitioning individuals with dementia (Chenoweth et al 2015). Although models of transitional care have been developed for other chronic health conditions, they rely on the patient to be an active participant in the process (Chenoweth et al 2015;Farris et al 2017). With the limited cognitive capacity of individuals with more severe dementia, this is not possible and often the responsibility to inform care transitions falls to the family (Chenoweth et al 2015;Grealish et al 2013).…”

Section: Discussionmentioning

confidence: 99%

Mending the Cracks: A Case Study in Using Technology to Assist with Transitional Care for Persons with Dementia

Ritchie¹,

Duff-Woskosky²,

Kipping³

2019

whp

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Extension for Community Healthcare Outcomes—Care Transitions: Enhancing Geriatric Care Transitions Through a Multidisciplinary Videoconference

Cited by 39 publications

References 14 publications

Implementation of a multidisciplinary discharge videoconference for children with medical complexity: a pilot study

Implementation of a multidisciplinary discharge videoconference for children with medical complexity: a pilot study

Perceptive Dialogue for Linking Stakeholders and Units During Care Transitions – A Qualitative Study of People with Stroke, Significant Others and Healthcare Professionals in Sweden

Mending the Cracks: A Case Study in Using Technology to Assist with Transitional Care for Persons with Dementia

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