Models of provider care in long-term care: A rapid scoping review

Abstract

Introduction One of the current challenges in long-term care homes (LTCH) is to identify the optimal model of care, which may include specialty physicians, nursing staff, person support workers, among others. There is currently no consensus on the complement or scope of care delivered by these providers, nor is there a repository of studies that evaluate the various models of care. We conducted a rapid scoping review to identify and map what care provider models and interventions in LTCH have been evaluated to improve quality of life, quality of care, and health outcomes of residents. Methods We conducted this review over 10-weeks of English language, peer-reviewed studies published from 2010 onward. Search strategies for databases (e.g., MEDLINE) were run on July 9, 2020. Studies that evaluated models of provider care (e.g., direct patient care), or interventions delivered to facility, staff, and residents of LTCH were included. Study selection was performed independently, in duplicate. Mapping was performed by two reviewers, and data were extracted by one reviewer, with partial verification by a second reviewer. Results A total of 7,574 citations were screened based on the title/abstract, 836 were reviewed at full text, and 366 studies were included. Studies were classified according to two main categories: healthcare service delivery (n = 92) and implementation strategies (n = 274). The condition/ focus of the intervention was used to further classify the interventions into subcategories. The complex nature of the interventions may have led to a study being classified in more than one category/subcategory. Conclusion Many healthcare service interventions have been evaluated in the literature in the last decade. Well represented interventions (e.g., dementia care, exercise/mobility, optimal/appropriate medication) may present opportunities for future systematic reviews. Areas with less research (e.g., hearing care, vision care, foot care) have the potential to have an impact on balance, falls, subsequent acute care hospitalization.

Embedded on‐site aged care pharmacists in Australia: Insights from early adopters of a new workforce model

“…[1][2][3] These new workforce models include greater multidisciplinary collaboration, including integration of pharmacists and allied healthcare professionals into the RACF care team. 4 The Australian Government announced AU$345. 7 million for national roll-out of embedded onsite pharmacists in Government-funded RACFs from 2023 to 2027.…”

“…There have been national and international calls for new workforce models to address persistent high rates of medication‐related harm and high‐risk prescribing in residential aged care facilities (RACFs) 1–3 . These new workforce models include greater multidisciplinary collaboration, including integration of pharmacists and allied health‐care professionals into the RACF care team 4 …”

Models of Care and Relationships with Care Homes: Cross-Sectional Survey of English General Practices

“…The projected increase in demand for long-term care in the next twenty years [ 23 ] requires a coherent and consistent response. It is unlikely that one model of care will be the most effective and may need to be modified to fit the local needs and structures [ 11 , 24 ]. Nevertheless, this survey demonstrates two key findings; there has been an observable shift in the organisation of primary care for this frail population but how this is achieved appears to still be arbitrary.…”

Guidance for using artificial intelligence for title and abstract screening while conducting knowledge syntheses

“…In addition to the above retrospective investigation, since adoption of DistillerSR®‘s AML features as part of the workflow within the research unit of team members CH and BH, the strategies described in this guidance were assessed in terms of their benefits and challenges in the context of recent knowledge syntheses related to the benefits of different primary care models for long-term care homes [ 39 , 40 ], interventions to manage chronic pain in those with comorbid mental health conditions [ 41 ], interventions to reduce the risk of acute pain transitioning to chronic pain [ 41 ], the health effects of cannabis consumed by older adults [ 42 ], and interventions for management of methamphetamine disorder [ 43 ]; we provide additional information regarding these reviews in Additional file 1 to provide context for readers. Authors CH and BH have overseen the implementation of AML in these reviews, monitored their benefits and challenges, and continually refined their approach.…”