Patient satisfaction with a hospital-in-the-home service

Facultad, Jose; Lee, Geraldine

doi:10.12968/bjcn.2019.24.4.179

Cited by 23 publications

(44 citation statements)

References 13 publications

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“…Patients were therefore unsure whether the APN role leads to efficient results and whether the introduction of APNs in family practices could stabilise or reduce cost, as mentioned in the review of international studies by Delamaire et al [ 6 ]. The hospital at home model, in which APNs were involved, also reported positive results in terms of efficacy, costs and patient satisfaction [ 11 ]. However, Delamaire et al [ 6 ] stated that if APNs take on supplementary tasks, it often results in higher cost According to van der Biezen et al [ 5 ], the decision whether to focus on substitutive or complementary tasks depends largely on the GPs’ motives for hiring an APN.…”

Section: Discussionmentioning

confidence: 99%

Patients’ experiences with the advanced practice nurse role in Swiss family practices: a qualitative study

Schönenberger

Sottas²,

Merlo

et al. 2020

BMC Nurs

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Background Considering shortages of general practitioners (GP) and strategies for improving the quality of health care provision, many countries have implemented interprofessional care models with advanced practice nurses (APN). International evidence suggests that APN care results in high patient satisfaction. In Switzerland, the role is still new, and the patient perspective has not yet been researched. Our aim was therefore to explore patients’ experiences with the APN role in Swiss family practices. Methods We conducted 22 semi-structured interviews in four different family practices with patients aged 18 to 97 suffering from minor acute to multiple chronic diseases, and who had at least one consultation with an APN. All interviews were audiotaped, transcribed verbatim, and analysed using qualitative content analysis. Results The analysis resulted in five themes: Despite the unfamiliarity, all patients were willing to be consulted by an APN because it was recommended by their GP (1); after several encounters, most participants perceived differences between the APN and the GP consultation in terms of the length and style of the consultations as well as the complexity of their tasks (2); the interviewees emphasised coaching, guidance, care coordination, and GP-assisting tasks as APN core competencies and attributed the characteristics empathetic, trustworthy, and competent to the APN role (3); most patients especially valued home visits and the holistic approach of the APNs, but they also noticed that in certain cases GP supervision was required (4); and due to the close collaboration between the APN and the GP, patients felt safe, well cared for and experienced improvements in physical and psychological well-being as well as in daily activities (5). Conclusion Our results suggested that patients value the APNs’ competencies, despite their initial lack of role knowledge. Trust in the GP seemed to be the most important factor for patients’ receptiveness toward the APN role. Overall, patients perceived an added value due to the enlargement of the scope of practice offered by APNs. The patient perspective might provide valuable insights for further APN role implementation in Swiss family practices.

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Section: Discussionmentioning

confidence: 99%

Patients’ experiences with the advanced practice nurse role in Swiss family practices: a qualitative study

Schönenberger

Sottas²,

Merlo

et al. 2020

BMC Nurs

View full text Add to dashboard Cite

show abstract

“…Patients were therefore unsure whether the APN role leads to e cient results and whether the introduction of APNs in family practices could stabilise or reduce cost, as mentioned in the review of international studies by Delamaire et al (6). The hospital at home model, in which APNs were involved, also reported positive results in terms of e cacy, costs and patient satisfaction (11). However, Delamaire et al (6) stated that if APNs take on supplementary tasks, it often results in higher cost According to van der Biezen et al (5), the decision whether to focus on substitutive or complementary tasks depends largely on the GPs' motives for hiring an APN.…”

Section: Interpretation Of the Resultsmentioning

confidence: 99%

“…APNs tasks include the initial assessment of needs, routine follow-up care and advising patients on self-care management or life changes (3,8,9). In addition, several studies have shown that APNs, regardless of the eld of implementation (hospitals, general practice or hospital at home models) are likely to achieve higher patient satisfaction than GPs, due to longer consultations, the comprehensive provision of health information and advice, as well as their psychosocial (patient-centered) communication style (3,6,(10)(11)(12)(13). Furthermore, Jakimowicz (14) found in their review, that patients appreciated the involvement of APNs in their treatment because they displayed a focus on the patient as a person with additional concerns and not just on the disease.…”

Section: Introductionmentioning

confidence: 99%

Patients’ experiences with the advanced practice nurse role in Swiss family practices: a qualitative study

Schönenberger

Sottas²,

Merlo

et al. 2020

Preprint

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Background: Considering shortages of general practitioners (GP) and strategies for improving the quality of health care provision, many countries have implemented interprofessional care models with advanced practice nurses (APN). International evidence suggests that APN care results in high patient satisfaction. In Switzerland, the role is still new, and the patient perspective has not yet been researched. Our aim was therefore to explore patients’ experiences with the APN role in Swiss family practices.Methods: We conducted 22 semi-structured interviews in four different family practices with patients aged 18 to 97 suffering from minor acute to multiple chronic diseases, and who had at least one consultation with an APN. All interviews were audiotaped, transcribed verbatim, and analysed using qualitative content analysis.Results: The analysis resulted in five themes: Despite the unfamiliarity, all patients were willing to be consulted by an APN because it was recommended by their GP (1); after several encounters, most participants perceived differences between the APN and the GP consultation in terms of the length and approach of the consultations as well as the complexity of their tasks (2); the interviewees emphasised coaching, guidance, care coordination, and GP-assisting tasks as APN core competencies and attributed the characteristics empathetic, trustworthy, and competent to the APN role (3); most patients especially valued home visits and the holistic approach of the APNs, but they also noticed that in certain cases GP supervision was required (4); and due to the close collaboration between the APN and the GP, patients felt safe, well cared for and experienced improvements in physical and psychological well-being as well as in daily activities (5). Conclusion: Our results suggest that patients value the APNs’ competencies, despite their initial lack of role knowledge. Trust in the GP seems to be the most important factor for patients’ receptiveness toward the APN role. Overall, patients perceived an added value due to the enlargement of the scope of practice offered by APNs. The patient perspective might provide valuable insights for further APN role implementation in Swiss family practices.

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“…This limits our interpretation of the impact of therapists on the function of the MDT in terms of cost‐effectiveness and patient satisfaction. These are important concepts and will need exploration in further work.…”

Section: Discussionmentioning

confidence: 99%

What are physiotherapists and occupational therapists doing in services that replace acute hospital admission? A systematic review

2019

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Background: Alternatives to acute hospital admission are required to accommodate the increasing pressures on health services. Since physiotherapists and occupational therapists are integral to inpatient teams, they may also be integral to admission replacement services, and thus their roles in these services merit investigation.Aims: Primarily to determine the presence and roles of physiotherapists and occupational therapists in services replacing acute hospital admission. The secondary outcome is to determine the impact of therapists in such services.Methods: Five electronic databases were searched, with keywords related to therapy, discharge, and admission replacement. Inclusion criteria were that studies explicitly described at least one therapist role within a service replacing acute hospital admissions. Two authors independently reviewed all potentially eligible studies. Two reviewers independently assessed data extracted from included studies into a standardized data extraction form.Results: Fifteen studies (3 Hospital at Home, 12 Early Supported Discharge) were included. Both clinical (eg, exercise prescription) and non-clinical (eg, organization and study outcome assessments) therapist roles were described in different admission substitution services. Some roles were only reported among teams, not individually ascribed to therapists. Conclusions:The roles of therapists in services that replace hospital admission are rarely described in detail, with wide variation in reported roles, including across service types and patient populations. This review could not determine the impact of individual therapists on patient or service-level outcomes. Future studies need to more clearly define therapist roles and impact.

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Patient satisfaction with a hospital-in-the-home service

Cited by 23 publications

References 13 publications

Patients’ experiences with the advanced practice nurse role in Swiss family practices: a qualitative study

Patients’ experiences with the advanced practice nurse role in Swiss family practices: a qualitative study

Patients’ experiences with the advanced practice nurse role in Swiss family practices: a qualitative study

What are physiotherapists and occupational therapists doing in services that replace acute hospital admission? A systematic review

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