Cameron J Gettel, Nathan Pertsch, Elizabeth M Goldberg
{"title":"A Systematic Review of Interventions to Improve Nursing Home to Emergency Department Care Transitions.","authors":"Cameron J Gettel, Nathan Pertsch, Elizabeth M Goldberg","doi":"","DOIUrl":null,"url":null,"abstract":"<p><p>This study aimed to identify interventions that are effective in improving the transitions of care for patients from nursing homes (NHs) to emergency departments (EDs). A total of 607 studies were identified, from which 19 studies were included for full-text review. Nine pre-post intervention studies and two retrospective cohort studies met all criteria for inclusion. In the quality assessment, two (18.2%) were assessed as good quality; seven (63.6%) were fair; and two (18.2%) were poor. Nine studies (81.2%) had a severe risk of bias, primarily due to confounding and deviation from the intended intervention. Pre-post intervention studies utilized transfer checklists/forms, web-based communication networks, and multimodal approaches to improve transitions of care. Eight studies reported significant improvement in critical NH-ED transfer information completeness after intervention implementation. Three studies assessed health care utilization after intervention implementation with two studies reporting no reduction in utilization and one study reporting decreased 30-day hospital readmission and ED revisit rates. Studies evaluating patient-centered outcomes, such as whether interventions reduced harm to patients by decreasing medical errors, hospital length of stay, or the overall number of facility transfers, are needed.</p>","PeriodicalId":87367,"journal":{"name":"The annals of long-term care : the official journal of the American Medical Directors Association","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7295263/pdf/nihms-1557210.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"The annals of long-term care : the official journal of the American Medical Directors Association","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2020/1/22 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
This study aimed to identify interventions that are effective in improving the transitions of care for patients from nursing homes (NHs) to emergency departments (EDs). A total of 607 studies were identified, from which 19 studies were included for full-text review. Nine pre-post intervention studies and two retrospective cohort studies met all criteria for inclusion. In the quality assessment, two (18.2%) were assessed as good quality; seven (63.6%) were fair; and two (18.2%) were poor. Nine studies (81.2%) had a severe risk of bias, primarily due to confounding and deviation from the intended intervention. Pre-post intervention studies utilized transfer checklists/forms, web-based communication networks, and multimodal approaches to improve transitions of care. Eight studies reported significant improvement in critical NH-ED transfer information completeness after intervention implementation. Three studies assessed health care utilization after intervention implementation with two studies reporting no reduction in utilization and one study reporting decreased 30-day hospital readmission and ED revisit rates. Studies evaluating patient-centered outcomes, such as whether interventions reduced harm to patients by decreasing medical errors, hospital length of stay, or the overall number of facility transfers, are needed.