The patient care circle: A descriptive framework for understanding care transitions

Lee, Jennifer I.; Cutugno, Christine; Pickering, Sean P.; Press, Matthew J.; Richardson, Joshua E.; Unterbrink, Michelle; Kelser, Mary Elizabeth; Evans, Arthur T.

doi:10.1002/jhm.2084

Cited by 11 publications

(33 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is up to all of us in the health community to make improving health literacy part of our calling. It is therefore necessary to better understand actors' perceptions before implementing shared roles and responsibilities between professional groups [39][40][41][42][43][44][45].…”

Section: R E T R a C T E Dmentioning

confidence: 99%

Framework for Patient Safety

Mohiuddin

2019

Innov Pharm

View full text Add to dashboard Cite

A commitment on quality objectives is a crucial element of quality policy in HROs, such as hospitals and other healthcare institutions. The quality of care includes objectives related to effectiveness, efficiency, and a patient’s experience. Healthcare organizations are also aware of the importance of promoting safety practices and the resiliency analysis of the clinical practice in order to improve quality. Patient Safety Culture has been defined as the product of individual and group values, attitudes, competencies, and patterns of behavior that determines their commitment, style, and proficiency with the organization’s health and safety programs. The safety culture of a health center offers an indirect means for its involvement in quality. Poor involvement of professionals in safety has negative consequences for patients. Envisioning the future of patient safety is more than an academic exercise. Appealing visions can help channel human energies, set new directions, and open the doors to alternative approaches. An outside observer is struck by three characteristics that are very different from the culture of the early 21st century: a deep sense of individual and institutional accountability for safety, an emphasis on fairness and transparency, and pervasive collaboration and teamwork based on mutual respect. Speaking up is important for patient safety, but healthcare professionals often hesitate to voice their concerns. Direct supervisors have an important role in influencing speaking up. However, good insight into the relationship between managers' behavior and employees' perceptions about whether speaking up is safe and worthwhile is still lacking. The evaluation should cover the following areas in both instruments: strategy (inquiry on their commitment to the quality and safety strategy, indicators’ feedback, and risks maps), support systems for clinical decisions (digital record algorithms to make decisions and for accessibility to patient clinical information), equipment (adequacy), follow-up (availability of tests when needed), person-centered care (respect of patients’ values and preferences), evidence-based practice (practices in accordance with guidelines), delays (on scheduled tests, surgery, and outpatient care), and cost-effective treatments (adequacy). Article Type: Commentary

show abstract

Section: R E T R a C T E Dmentioning

confidence: 99%

Framework for Patient Safety

Mohiuddin

2019

Innov Pharm

View full text Add to dashboard Cite

show abstract

“…In high-resource settings the event of acute hospitalization and care transitions have been well studied for a variety of disease states [8–14]. These events have been associated with poor outcomes [15,16], and a diverse set of interventions has been developed to increase support during this time, including multi-disciplinary care coordination and discharge planning, home visits, follow-up phone calls, and health systems interventions like increased access to specialty clinics or a packaging of services offered at one clinic visit [8–14]. In resource-limited settings, these types of interventions have not yet been implemented on a large scale and data are needed to characterize the needs of hospitalized patients and to develop effective evidenced-based interventions for follow-up care.…”

Section: Introductionmentioning

confidence: 99%

Hospitalization and post-discharge care in South Africa: A critical event in the continuum of care

Cichowitz¹,

Pellegrino²,

Motlhaoleng

et al. 2018

PLoS ONE

View full text Add to dashboard Cite

ObjectivesThe purpose of this prospective cohort study is to characterize the event of acute hospitalization for people living with and without HIV and describe its impact on the care continuum. This study describes care-seeking behavior prior to an index hospitalization, inpatient HIV testing and diagnosis, discharge instructions, and follow-up care for patients for patients being discharged from a single hospital in South Africa.MethodsA convenience sample of adult patients was recruited from the medical wards of a tertiary care facility. Baseline information at the time of hospital admission, subsequent diagnoses, and discharge instructions were recorded. Participants were prospectively followed with phone calls for six months after hospital discharge. Descriptive analyses were performed.ResultsA total of 293 participants were enrolled in the study. Just under half (46%) of the participants were known to be living with HIV at the time of hospital admission. Most participants (97%) were given a referral for follow-up care; often that appointment was scheduled within two weeks of discharge (64%). Only 36% of participants returned to care within the first month, 50% returned after at least one month had elapsed, and 14% of participants did not return for any follow up.ConclusionsLarge discrepancies were found between the type of post-discharge follow-up care recommended by providers and what patients were able to achieve. The period of time following hospital discharge represents a key transition in care. Additional research is needed to characterize patients’ risk following hospitalization and to develop patient-centered interventions.

show abstract

“…The care transition after a hospitalization is particularly perilous. Communication breakdowns during this time can lead to adverse events, including hospital readmission, an outcome that has recently become the focus of several national policies …”

mentioning

confidence: 99%

“…Communication breakdowns during this time can lead to adverse events, including hospital readmission, an outcome that has recently become the focus of several national policies. [3][4][5][6][7] Many patients discharged from the hospital receive home healthcare services provided by home health nurses. 8 Care coordination is one of the key roles home health nurses can play for their patients.…”

mentioning

confidence: 99%