Improving Transitions to Postacute Care for Elderly Patients Using a Novel Video-Conferencing Program: ECHO-Care Transitions

Moore, Amber; Krupp, J. Elyse; Dufour, Alyssa B.; Sircar, Mousumi; Travison, Thomas G.; Abrams, Alan; Farris, Grace E.; Mattison, Melissa L. P.; Lipsitz, Lewis A.

doi:10.1016/j.amjmed.2017.04.041

Cited by 43 publications

(66 citation statements)

References 9 publications

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“…Moore et al . conducted a prospective cohort study comparing outcomes of usual care ( n = 148) with care involving post‐discharge videoconferences ( n = 214).…”

Section: Resultsmentioning

confidence: 99%

“…Discrepancies between the discharge medication summary and prescription have also been reported in 80% of cases . The risk of inadequate handover of information during this transition is also increased by patients often being unable to participate in the discharge process . Poor‐quality transitions of care, including inconsistencies with medications, have been linked to adverse health outcomes .…”

Section: Introductionmentioning

confidence: 99%

“…The risk of inadequate handover of information during this transition is also increased by patients often being unable to participate in the discharge process . Poor‐quality transitions of care, including inconsistencies with medications, have been linked to adverse health outcomes . The present systematic review was performed to investigate interventions to improve continuity of medication management when discharging a patient from hospital to an RACF.…”

Section: Introductionmentioning

confidence: 99%

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Interventions to improve the continuity of medication management upon discharge of patients from hospital to residential aged care facilities

Fredrickson

Burkett

2019

Pharmacy Practice and Res

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Aim: The aim of this study was to undertake a systematic review of the literature and evaluate interventions used to improve continuity of medication management upon transition of care from an acute hospital setting to a residential aged care facility (RACF). Data sources: Embase, PubMed, The Cochrane Database of Systematic Reviews, Google Scholar, Informit Health Collection, grey literature and reference mining of included studies (from inception to March 2018). Study selection: Interventions aimed at improving the continuity of medication management upon discharge of patients from hospital to an RACF or similar facility were included. Interventions were defined as a communication tool or a service initiated by any healthcare professional. Studies were excluded if they were not available in English, had certain study designs (i.e. qualitative, observational and systematic review) and if no abstract and full-text article could be obtained. Results: Seven studies met the inclusion criteria. All interventions involved a multidisciplinary approach to discharge facilitation including the provision of discharge medication information. Six studies included pharmacist-led medication reconciliation. Two studies used an RACF-specific medication chart. Although positive findings were shown for most interventions, critical analysis of the studies included identified many limitations. Conclusion: Interventions involving a multidisciplinary team, pharmacist-led medication reconciliation and the provision of accurate discharge information have been identified as improving continuity of medication management during transitions of care from hospital to RACF. Importantly, this systematic review has identified an ongoing need for development of a comprehensive intervention that addresses all barriers to optimal continuity of medications encountered during this high-risk transition.

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“…Moore et al . conducted a prospective cohort study comparing outcomes of usual care ( n = 148) with care involving post‐discharge videoconferences ( n = 214).…”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Interventions to improve the continuity of medication management upon discharge of patients from hospital to residential aged care facilities

Fredrickson

Burkett

2019

Pharmacy Practice and Res

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“…According to Atwal et al [55], a home assessment may be perceived as demoralizing, daunting, or may even increase anxiety. Measuring the effects of alternative discharge planning options, such as mobile videoconferencing [56] or virtual home assessments should be considered with these patients, as they may reduce their fatigue while giving access to home environmental cues.…”

Section: Discussionmentioning

confidence: 99%

Supporting at-risk older adults transitioning from hospital to home: who benefits from an evidence-based patient-centered discharge planning intervention? Post-hoc analysis from a randomized trial

et al. 2020

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Background: Subgroups of older patients experience difficulty performing activities of daily living (ADL) following hospital discharge, as well as unplanned hospital readmissions and emergency department (ED) presentations. We examine whether these subgroups of "at-risk" older patients benefit more than their counterparts from an evidence-based discharge planning intervention, on the following outcomes: (1) independence in ADL, (2) participation in life roles, (3) unplanned re-hospitalizations, and (4) ED presentations. Trial design and methods: This study used data from a randomized control trial involving 400 hospitalized older patients with acute and medical conditions, recruited through 5 sites in Australia. Participants receive either HOME, a patient-centered discharge planning intervention led by an occupational therapist; or a structured in-hospital consultation. HOME uses a collaborative approach for goal setting and includes pre and post-discharge home visits as well as telephone follow-up. Characteristics associated with higher risks of adverse outcomes were recorded and at-risk subgroups were created (mild cognitive impairment, walking difficulty, comorbidity, living alone and no support from family). Independence in ADL and participation in life roles were assessed with validated questionnaires. The number of unplanned re-hospitalizations and ED presentations were extracted from medical files. Linear regression models were conducted to detect variation in response to the intervention at 3-months, according to patients' characteristics.

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“…The self-efficacy data reported here show that regular participation in Bone Health TeleECHO improves self-confidence in caring for patients with osteoporosis. The ECHO model of learning has been demonstrated to improve clinical outcomes and be cost-effective for the care of patients with chronic hepatitis C [ 15 ] and other conditions [ 16 ], providing reassurance that Bone Health TeleECHO can improve the care of their osteoporosis patients and contribute to reducing the osteoporosis treatment gap. Health care providers who attain an advanced level of knowledge can take better care of their own patients and patients of other providers in the community, providing better care, closer to home, at lower cost than referral to a specialty center that may be located far from the patient who needs care.…”

Section: Discussionmentioning

confidence: 99%

Leveraging Scarce Resources With Bone Health TeleECHO to Improve the Care of Osteoporosis

Lewiecki

Rochelle

Bouchonville

et al. 2017

Journal of the Endocrine Society

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Osteoporosis is a common condition with serious consequences because of fractures. Despite availability of treatments to reduce fracture risk, there is a large osteoporosis treatment gap that has reached crisis proportions. There are too few specialists to provide services for patients who need them. Bone Health Extension for Community Health Care Outcomes (TeleECHO) is a strategy using real-time ongoing videoconferencing technology to mentor health care professionals in rural and underserved communities to achieve an advanced level of knowledge for the care of patients with skeletal diseases. Over the first 21 months of weekly Bone Health TeleECHO programs, there were 263 registered health care professionals in the United States and several other countries, with 221 attending at least 1 online clinic and typically 35 to 40 attendees at each session at the end of the reported period. Assessment of self-confidence in 20 domains of osteoporosis care showed substantial improvement with the ECHO intervention (P = 0.005). Bone Health TeleECHO can contribute to mitigating the crisis in osteoporosis care by leveraging scarce resources, providing motivated practitioners with skills to provide better skeletal health care, closer to home, with greater convenience, and lower cost than referral to a specialty center. Bone Health TeleECHO can be replicated in any location worldwide to reach anyone with Internet access, allowing access in local time zones and languages. The ECHO model of learning can be applied to other aspects of bone care, including the education of fracture liaison service coordinators, residents and fellows, and physicians with an interest in rare bone diseases.

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Improving Transitions to Postacute Care for Elderly Patients Using a Novel Video-Conferencing Program: ECHO-Care Transitions

Cited by 43 publications

References 9 publications

Interventions to improve the continuity of medication management upon discharge of patients from hospital to residential aged care facilities

Interventions to improve the continuity of medication management upon discharge of patients from hospital to residential aged care facilities

Supporting at-risk older adults transitioning from hospital to home: who benefits from an evidence-based patient-centered discharge planning intervention? Post-hoc analysis from a randomized trial

Leveraging Scarce Resources With Bone Health TeleECHO to Improve the Care of Osteoporosis

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