Versorgung optimieren, vermeidbare Krankenhaustransporte reduzieren

Kada, Olivia; Janig, Herbert; Likar, Rudolf; Pinter, Georg

doi:10.1007/978-3-7091-1581-7_15

Cited by 10 publications

(9 citation statements)

References 33 publications

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“…In a retrospective secondary data analysis, a ratio of 3.4 transfers per NH bed in a 12-month period could be observed in Carinthia ( Kada et al, 2011 ). In the present study, the transfer to resident ratio was 1.18 and, hence, lower and well comparable with the results of the intervention study the present project builds upon ( M = 2.3, SD = 2.4 transfers in 91 transferred residents in 6 months; transfer to occupied NH bed ratio = 0.83; control group only, ratio = 1.05; Kada et al, 2013 ). Interpreting the differences in transfer rates, it has to be kept in mind that a strong Hawthorne effect can be expected whenever NHs are participating in projects investigating transfer rates; the comparison of the results with data from a secondary data analysis is certainly limited thereby.…”

Section: Discussionsupporting

confidence: 86%

“…Even if a rather small amount of transfers were rated potentially avoidable (cf. Kada & Janig, 2016 ; Kada et al, 2013 ; Lamb et al, 2011 ), most of them could have been prevented by specialist consultations on site or the GP seeing the resident. These results indicate the potential for reducing transfers by increasing physician presence and diagnostic resources in NHs.…”

Section: Discussionmentioning

confidence: 99%

“…An intervention study conducted in Austria (province of Carinthia) tested the effectiveness of interventions comprising geriatric training for nurses, workshops improving nurse–physician cooperation, information on advance directives for residents and family, and polypharmacy checks ( Kada, Janig, Likar, Pinter, & Cernic, 2013 ). The interventions were implemented in two NHs for 6 months, and two comparable NHs without interventions served as control group.…”

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confidence: 99%

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Reducing Avoidable Hospital Transfers From Nursing Homes in Austria

Kada

Janig

Likar

et al. 2017

Gerontology and Geriatric Medicine

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Hospital transfers from nursing homes (NHs) are frequent, burdensome for residents, and often avoidable. The evidence regarding the effectiveness of interventions to reduce avoidable transfers is limited, and most projects focus on nurses’ knowledge and skills. In the present project, interventions focusing on nurses and physicians are integrated, elaborated, and implemented in 17 NHs. Results of the 6 months preintervention period are reported. Hospital transfer rates (N = 1,520) and basic data on all residents (N = 1,238) were collected prospectively. Nurses’ preintervention knowledge and self-efficacy were assessed using standardized questionnaires (N = 330). Many hospital transfers were initiated by nurses without physician involvement, polypharmacy was common, and a high potential for reducing transfers by increasing physician presence was observed. Nurses showed rather low knowledge but high self-efficacy. The results are discussed against the background of the interventions including enhancement of physician presence and geriatric quality circles.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Reducing Avoidable Hospital Transfers From Nursing Homes in Austria

Kada

Janig

Likar

et al. 2017

Gerontology and Geriatric Medicine

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“…With demographic aging in full force, an increasing number of elderly people are being cared for in nursing homes (NHs). Recent reports have indicated an alarming lack of primary on-site care provided in such facilities [1–4], the result of which can be unnecessary, costly and burdensome hospitalizations for residents [2, 5–10]. Previous studies have assessed that a fair amount of hospitalizations could be avoided by expanding on-site primary care [3–5, 11–13].…”

Section: Introductionmentioning

confidence: 99%

“…This situation presents an increasing challenge to German physicians as they struggle to coordinate with one another [3, 13] and NH staff [3–5, 7, 13], hence establishing the need for a more systematic basis for cooperation. Interventions that might improve teamwork within groups of multidisciplinary NH care providers include advancing communication, regularly scheduled physicians’ NH visits (that are more appropriately compensated), after-hours availability and reducing administrative workload [10, 14–16]. Some of these have been proven to be effective in pilot projects [1, 2, 7].…”

Section: Introductionmentioning

confidence: 99%

A complex health services intervention to improve medical care in long-term care homes: study protocol of the controlled coordinated medical care (CoCare) study

Brühmann

Reese

Kaier

et al. 2019

BMC Health Serv Res

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Background Deficits in general and specialized on-site medical care are a common problem in nursing homes and can lead to unnecessary, costly and burdensome hospitalizations for residents. Reasons for this are often organizational obstacles (such as lack of infrastructure or communication channels) and unfavorable compensation structures, which impede the implementation of adequate medical care. The purpose of this study is to evaluate a complex intervention aiming to improve the coordination of medical care in long-term care nursing homes in Germany. The project aims to optimize the collaboration of nurses and physicians in order to reduce avoidable hospital admissions and ambulance transportations. Methods/design In a prospective controlled trial, nursing home residents receiving a complex on-site intervention are compared to residents receiving care/treatment as usual. The study will include a total of around 4000 residents in approximately 80 nursing homes split equally between the intervention group and the control group. Recruitment will take place in all administrative districts of Baden-Wuerttemberg, Germany. The control group focuses on the administrative district of Tuebingen. The intervention includes on-site visits by physicians joined by nursing staff, the formation of teams of physicians, a computerized documentation system (CoCare Cockpit), joint trainings and audits, the introduction of structured treatment paths and after-hours availability of medical care. The project evaluation will be comprised of both a formative process evaluation and a summative evaluation. Discussion This study will provide evidence regarding the efficacy of a complex intervention to positively influence the quality of medical care and supply efficiency as well as provide cost-saving effects. Its feasibility will be evaluated in a controlled inter-regional design. Trial registration WHO UTN: U1111–1196-6611 ; DRKS-ID: DRKS00012703 (Date of Registration in DRKS: 2017/08/23). Electronic supplementary material The online version of this article (10.1186/s12913-019-4156-4) contains supplementary material, which is available to authorized users.

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„Neues Altern“ und integrierte Gesundheitsversorgung

Janig

2021

Das Ganze Leben Leben

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Versorgung optimieren, vermeidbare Krankenhaustransporte reduzieren

Cited by 10 publications

References 33 publications

Reducing Avoidable Hospital Transfers From Nursing Homes in Austria

Reducing Avoidable Hospital Transfers From Nursing Homes in Austria

A complex health services intervention to improve medical care in long-term care homes: study protocol of the controlled coordinated medical care (CoCare) study

„Neues Altern“ und integrierte Gesundheitsversorgung

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