Introduction Children born with neonatal abstinence syndrome (NAS) have lower rates of preventive care utilization than children born without NAS, a pattern which is only partially explained by differences in social determinants of health (SDH). We sought to determine whether SDH and clinical characteristics were associated with well-child visit (WCV) attendance among children born with NAS in a rural academic health system. Methods Infants born at a single hospital in 2016–2018 were retrospectively included if they were diagnosed with non-iatrogenic NAS attributable to in utero opioid exposure and established care with an affiliated primary care clinic by 6 months of age. Healthcare utilization was tracked through the first 12 months of life. Independent variables included demographics, prenatal risk factors, insurance coverage, and SDH such as housing problems and food insecurity. Ages and Stages Questionnaire (ASQ) scores were extracted from the latest completed WCV during the first year of life. Results We identified 182 patients with NAS, of whom 80 established care with the primary care clinic, with a median of four WCVs (interquartile range: 2, 5) completed by 12 months of age. On unadjusted Poisson regression, none of the demographic, clinical, or SDH characteristics were associated with the number of completed WCVs. Among 44 patients with available ASQ data, the number of WCVs was not associated with ASQ scores at the latest WCV. Conclusions Within an academic rural health system, SDH and other infant or family characteristics did not predict WCV attendance among infants with NAS.
{"title":"Primary care follow-up among children born with neonatal abstinence syndrome in a rural region in the United States","authors":"Stephiya Sabu, Abby Hodges, Cierra Buckman, Dmitry Tumin, Shaundreal Jamison","doi":"10.1177/20534345231213729","DOIUrl":"https://doi.org/10.1177/20534345231213729","url":null,"abstract":"Introduction Children born with neonatal abstinence syndrome (NAS) have lower rates of preventive care utilization than children born without NAS, a pattern which is only partially explained by differences in social determinants of health (SDH). We sought to determine whether SDH and clinical characteristics were associated with well-child visit (WCV) attendance among children born with NAS in a rural academic health system. Methods Infants born at a single hospital in 2016–2018 were retrospectively included if they were diagnosed with non-iatrogenic NAS attributable to in utero opioid exposure and established care with an affiliated primary care clinic by 6 months of age. Healthcare utilization was tracked through the first 12 months of life. Independent variables included demographics, prenatal risk factors, insurance coverage, and SDH such as housing problems and food insecurity. Ages and Stages Questionnaire (ASQ) scores were extracted from the latest completed WCV during the first year of life. Results We identified 182 patients with NAS, of whom 80 established care with the primary care clinic, with a median of four WCVs (interquartile range: 2, 5) completed by 12 months of age. On unadjusted Poisson regression, none of the demographic, clinical, or SDH characteristics were associated with the number of completed WCVs. Among 44 patients with available ASQ data, the number of WCVs was not associated with ASQ scores at the latest WCV. Conclusions Within an academic rural health system, SDH and other infant or family characteristics did not predict WCV attendance among infants with NAS.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"29 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136282198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-24DOI: 10.1177/20534345231208295
Makiko Ozaki, Shinji Matsumura, Seiji Bito
Introduction Challenges are often observed during care transitions from home to hospital among frail elderly individuals who tend to be treated by different providers. This study evaluated the effectiveness of early care information transfer on the quality of care transitions among home-dwelling elderly patients in Japan who needed acute hospitalization. Methods A cluster randomized controlled trial with a clinic as a clustering unit was conducted with patients aged 65 years and older who had home-visit care and then needed to be hospitalized for acute care. The main outcomes were the quality of care transition perceived by the patient, measured by a self-administered questionnaire, and patient satisfaction, measured by the Hospital Patient Satisfaction Questionnaire. Multilevel regression analysis was used to adjust for clustering and covariates. Results Among 177 patients (78 patients in the intervention group vs. 99 patients in the control group) from 17 clinics (8 vs. 9 clinics) who were admitted to hospitals during the study period, 112 patients with main outcomes were included in the analysis (45 patients vs. 67 patients). Quality of care transition was not statistically significantly different between groups (understanding of home care situations: 58.8 vs. 58.2, p = 0.88; preference on where to be cared for: 58.1 vs. 59.6, p = 0.67; goal for discharge: 71.9 vs. 70.9, p = 0.79; care coordination: 66.3 vs. 63.8, p = 0.56). Discussion Early care referral in care transition did not show effectiveness in the quality of care transition and patient satisfaction. Studies on information-sharing in the care transition from home to hospitals are needed.
在从家庭到医院的护理过渡过程中，往往观察到由不同提供者治疗的体弱老年人面临的挑战。本研究评估早期照护资讯传递对日本急症住院的居家长者照护转换品质的影响。方法采用以门诊为聚类单位的聚类随机对照试验，选取65岁及以上家访护理后需住院急症护理的患者。主要结果是患者感知到的护理过渡质量(通过自我管理问卷测量)和患者满意度(通过医院患者满意度问卷测量)。采用多水平回归分析对聚类和协变量进行调整。结果在研究期间住院的17家诊所(8家对9家)177例患者(干预组78例对对照组99例)中，有主要结局的112例患者(45例对67例)被纳入分析。两组间护理过渡质量差异无统计学意义(对家庭护理情况的理解:58.8比58.2,p = 0.88;对护理地点的偏好:58.1比59.6,p = 0.67;出院目标:71.9 vs. 70.9, p = 0.79;护理协调:66.3比63.8,p = 0.56)。早期转诊对转诊质量和患者满意度没有显著影响。需要对从家庭到医院的护理过渡中的信息共享进行研究。
{"title":"Effectiveness of early care information transfer among home-dwelling frail elderly patients in Japan: A cluster randomized trial","authors":"Makiko Ozaki, Shinji Matsumura, Seiji Bito","doi":"10.1177/20534345231208295","DOIUrl":"https://doi.org/10.1177/20534345231208295","url":null,"abstract":"Introduction Challenges are often observed during care transitions from home to hospital among frail elderly individuals who tend to be treated by different providers. This study evaluated the effectiveness of early care information transfer on the quality of care transitions among home-dwelling elderly patients in Japan who needed acute hospitalization. Methods A cluster randomized controlled trial with a clinic as a clustering unit was conducted with patients aged 65 years and older who had home-visit care and then needed to be hospitalized for acute care. The main outcomes were the quality of care transition perceived by the patient, measured by a self-administered questionnaire, and patient satisfaction, measured by the Hospital Patient Satisfaction Questionnaire. Multilevel regression analysis was used to adjust for clustering and covariates. Results Among 177 patients (78 patients in the intervention group vs. 99 patients in the control group) from 17 clinics (8 vs. 9 clinics) who were admitted to hospitals during the study period, 112 patients with main outcomes were included in the analysis (45 patients vs. 67 patients). Quality of care transition was not statistically significantly different between groups (understanding of home care situations: 58.8 vs. 58.2, p = 0.88; preference on where to be cared for: 58.1 vs. 59.6, p = 0.67; goal for discharge: 71.9 vs. 70.9, p = 0.79; care coordination: 66.3 vs. 63.8, p = 0.56). Discussion Early care referral in care transition did not show effectiveness in the quality of care transition and patient satisfaction. Studies on information-sharing in the care transition from home to hospitals are needed.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"22 8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135322853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-17DOI: 10.1177/20534345231207527
Ysanne de Graaf, Ber Oomen, Enrique Castro-Sanchéz, Jeannette Geelhoed, Hubertus Johannes Maria Vrijhoef
Introduction Nurses play a crucial part in responding to pandemics. Not only are they often in direct contact with patients but nurses also can inform and educate the general public regarding vaccination. Mapping nurses’ preferences and knowledge on the value of vaccination can contribute to shaping policy, generate support for policy measures and help address vaccination hesitancy. Methods The present exploratory study was based on an electronic survey distributed amongst nurses working in Europe. Analysis included descriptive statistics to summarize knowledge levels, attitudes and demographics and tests for associations. Results Of 103 respondents, most assessed their knowledge about vaccines, the immune system and pathogens on a medium level. Most respondents agreed that the best policy is to leave influenza vaccination voluntary for healthcare workers and vulnerable groups, but to make COVID-19 vaccination mandatory. Country of employment of respondents was associated with their preferred policy of influenza- and COVID-19 vaccination. Most needed by nurses in the current study to increase their involvement in vaccination programs were improved perceptions amongst patients and society at large. To perform better in responding to future pandemics, the most needed type of institutional support was continuous free nursing education. Discussion This study emphasizes a need for more nurse-generated data regarding the value of vaccination. Complexity of vaccine-related decision-making was highlighted by findings that opinions of nurses on (vaccination-) policy differ between influenza- and COVID vaccines and appear to be influenced by the policy environment in their country of employment.
{"title":"Nurses’ roles, views and knowledge regarding vaccines and vaccination: A pan-European survey","authors":"Ysanne de Graaf, Ber Oomen, Enrique Castro-Sanchéz, Jeannette Geelhoed, Hubertus Johannes Maria Vrijhoef","doi":"10.1177/20534345231207527","DOIUrl":"https://doi.org/10.1177/20534345231207527","url":null,"abstract":"Introduction Nurses play a crucial part in responding to pandemics. Not only are they often in direct contact with patients but nurses also can inform and educate the general public regarding vaccination. Mapping nurses’ preferences and knowledge on the value of vaccination can contribute to shaping policy, generate support for policy measures and help address vaccination hesitancy. Methods The present exploratory study was based on an electronic survey distributed amongst nurses working in Europe. Analysis included descriptive statistics to summarize knowledge levels, attitudes and demographics and tests for associations. Results Of 103 respondents, most assessed their knowledge about vaccines, the immune system and pathogens on a medium level. Most respondents agreed that the best policy is to leave influenza vaccination voluntary for healthcare workers and vulnerable groups, but to make COVID-19 vaccination mandatory. Country of employment of respondents was associated with their preferred policy of influenza- and COVID-19 vaccination. Most needed by nurses in the current study to increase their involvement in vaccination programs were improved perceptions amongst patients and society at large. To perform better in responding to future pandemics, the most needed type of institutional support was continuous free nursing education. Discussion This study emphasizes a need for more nurse-generated data regarding the value of vaccination. Complexity of vaccine-related decision-making was highlighted by findings that opinions of nurses on (vaccination-) policy differ between influenza- and COVID vaccines and appear to be influenced by the policy environment in their country of employment.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135993811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1177/20534345231214403
H. Vrijhoef
{"title":"Without unpaid carers the system would collapse","authors":"H. Vrijhoef","doi":"10.1177/20534345231214403","DOIUrl":"https://doi.org/10.1177/20534345231214403","url":null,"abstract":"","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"130 1","pages":"95 - 96"},"PeriodicalIF":1.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139343599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-29DOI: 10.1177/20534345231198146
J. Kornelsen, Nancy Humber, Sean Ebert, T. Skinner
In many jurisdictions internationally, distributed networks of clinical care have emerged as a planning principle to meet the needs of rural communities. Such networks rely on productive relationships between small rural sites and larger regional centres as the mechanism for training and backup and as the pathways for transfer when triage to a higher level of care is required. This paper explores the impact of the Rural Surgical Obstetrical Network (RSON) initiative on regional relationships between networked sites in order to provide data on the efficacy of networked models of healthcare. Implementation of networked care may ultimately lead to better patient care. This qualitative study involved interviews and focus groups over 4 years with 169 rural healthcare workers and hospital administrators at different RSON sites. Data was analysed inductively using thematic analysis. Findings revealed three primary areas considered in the context of RSON funding: improved relationships (primarily through clinical coaching and the consequent building of reciprocal trust) and increased regional coordination of patient care through more efficient triage pathways and increased involvement of specialists through outreach care in rural communities. Continued lack of engagement with regional specialists was reported by a minority of participants. RSON provided a supportive infrastructure that benefitted both rural and regional services namely through funding for clinical coaching and quality improvement initiatives which enabled overall improved provider relationships between sites. This strengthened a regional approach to optimal patient care that should be supported on an ongoing basis.
{"title":"Supporting rural health services through regional networks: Observations of a formalized model","authors":"J. Kornelsen, Nancy Humber, Sean Ebert, T. Skinner","doi":"10.1177/20534345231198146","DOIUrl":"https://doi.org/10.1177/20534345231198146","url":null,"abstract":"In many jurisdictions internationally, distributed networks of clinical care have emerged as a planning principle to meet the needs of rural communities. Such networks rely on productive relationships between small rural sites and larger regional centres as the mechanism for training and backup and as the pathways for transfer when triage to a higher level of care is required. This paper explores the impact of the Rural Surgical Obstetrical Network (RSON) initiative on regional relationships between networked sites in order to provide data on the efficacy of networked models of healthcare. Implementation of networked care may ultimately lead to better patient care. This qualitative study involved interviews and focus groups over 4 years with 169 rural healthcare workers and hospital administrators at different RSON sites. Data was analysed inductively using thematic analysis. Findings revealed three primary areas considered in the context of RSON funding: improved relationships (primarily through clinical coaching and the consequent building of reciprocal trust) and increased regional coordination of patient care through more efficient triage pathways and increased involvement of specialists through outreach care in rural communities. Continued lack of engagement with regional specialists was reported by a minority of participants. RSON provided a supportive infrastructure that benefitted both rural and regional services namely through funding for clinical coaching and quality improvement initiatives which enabled overall improved provider relationships between sites. This strengthened a regional approach to optimal patient care that should be supported on an ongoing basis.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48876567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-07DOI: 10.1177/20534345231193082
An N T Ho, Ann Robinson, S. Brandis
Osteoporosis remains unrecognised and untreated in patients with fragility fractures, which leads to higher mortality rate, increasing social and economic burden related to subsequent fractures. However, the presence of a coordinated and centralised care pathway for fragility fractures is lacking. The purpose of this paper is to explore the perspectives of health professionals regarding the current management for distal radius fragility fractures, how the care pathway can be optimised for patients with distal radius fragility fractures, and where occupational therapists can contribute. This paper uses a phenomenological qualitative methodology with selective and purposeful sampling, consisting of health professionals from an Australian Health Service ( N = 20). Online surveys ( N = 18) and semi-structured interviews ( N = 16) were conducted. Content analysis was applied, followed by thematic analysis to identify emerging themes. Eighteen health professionals participated in the presurvey of which 16 were interviewed. The identified themes presented the gaps in the knowledge and awareness of fragility fractures and osteoporosis, as well as a lack of coordination in the system, especially the referral process. These findings are consistent with previous studies which also highlight the importance of communication, coordination, collaboration, cooperation, responsibility, and a population approach in achieving integrated care. This study contributes to the global call for a centralised and coordinated care pathway for fragility fractures. The study explores personal experiences of health professionals who expressed interest in fragility fractures management. Exploring patients’ perspectives on their journey of fragility fractures management provides opportunity for future research.
{"title":"A call for a fragility fractures centralised care pathway in Australia: A qualitative study among healthcare professionals","authors":"An N T Ho, Ann Robinson, S. Brandis","doi":"10.1177/20534345231193082","DOIUrl":"https://doi.org/10.1177/20534345231193082","url":null,"abstract":"Osteoporosis remains unrecognised and untreated in patients with fragility fractures, which leads to higher mortality rate, increasing social and economic burden related to subsequent fractures. However, the presence of a coordinated and centralised care pathway for fragility fractures is lacking. The purpose of this paper is to explore the perspectives of health professionals regarding the current management for distal radius fragility fractures, how the care pathway can be optimised for patients with distal radius fragility fractures, and where occupational therapists can contribute. This paper uses a phenomenological qualitative methodology with selective and purposeful sampling, consisting of health professionals from an Australian Health Service ( N = 20). Online surveys ( N = 18) and semi-structured interviews ( N = 16) were conducted. Content analysis was applied, followed by thematic analysis to identify emerging themes. Eighteen health professionals participated in the presurvey of which 16 were interviewed. The identified themes presented the gaps in the knowledge and awareness of fragility fractures and osteoporosis, as well as a lack of coordination in the system, especially the referral process. These findings are consistent with previous studies which also highlight the importance of communication, coordination, collaboration, cooperation, responsibility, and a population approach in achieving integrated care. This study contributes to the global call for a centralised and coordinated care pathway for fragility fractures. The study explores personal experiences of health professionals who expressed interest in fragility fractures management. Exploring patients’ perspectives on their journey of fragility fractures management provides opportunity for future research.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"1 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44284456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-30DOI: 10.1177/20534345231191037
N. Araújo, Ana Maria Reis, A. Borges, J. Neves, Á. Rosa
Decision-makers are constantly confronted with the need of balancing limited resources while establishing rationing criteria in health care system. However, there is an emerging trend in involving citizens in rationing debates as mechanism to assuring legitimacy in the decision-making process. This paper aims to explore citizens’ opinions on priority setting in health care access in comparison with the perspectives of managers. An online questionnaire was used to collect the data. A logistic regression was applied to evaluate factors that shape the prioritisation of groups in access to health care services. The collected data comprehends 400 individuals, aged 18 years old and over living in continental Portugal. The study results reveal that managers and the general public, in the context of limited resources, both agree with the need to prioritise some groups over others in access to health care services. The priority groups would include the elderly, children, and people with chronic conditions. The most outstanding finding is that managers prefer children as their first priority group against the general public who has considered as top priority the elder ones. This study identified which stakeholders are prone to be included in decision-making processes for effective priority-setting models in the health care systems and evaluated their preferences.
{"title":"Setting priorities in health: The managers' perspectives versus general public","authors":"N. Araújo, Ana Maria Reis, A. Borges, J. Neves, Á. Rosa","doi":"10.1177/20534345231191037","DOIUrl":"https://doi.org/10.1177/20534345231191037","url":null,"abstract":"Decision-makers are constantly confronted with the need of balancing limited resources while establishing rationing criteria in health care system. However, there is an emerging trend in involving citizens in rationing debates as mechanism to assuring legitimacy in the decision-making process. This paper aims to explore citizens’ opinions on priority setting in health care access in comparison with the perspectives of managers. An online questionnaire was used to collect the data. A logistic regression was applied to evaluate factors that shape the prioritisation of groups in access to health care services. The collected data comprehends 400 individuals, aged 18 years old and over living in continental Portugal. The study results reveal that managers and the general public, in the context of limited resources, both agree with the need to prioritise some groups over others in access to health care services. The priority groups would include the elderly, children, and people with chronic conditions. The most outstanding finding is that managers prefer children as their first priority group against the general public who has considered as top priority the elder ones. This study identified which stakeholders are prone to be included in decision-making processes for effective priority-setting models in the health care systems and evaluated their preferences.","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46890222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1177/20534345231182882
H. Vrijhoef
Artificial Intelligence (AI) systems have been increasingly used in health care with the potential that such systems may help develop and augment the capacity of humans in diagnostics, therapeutics, and management of patient care and health care systems. It is claimed that AI systems have the capability to transform health care by, for example, improving risk prediction, augmenting patient– care provider relationships, and optimizing operations and resource allocation. Moreover, it is indicated that AI will be helping the complete journey of patients in terms of prehospital alert and in-hospital stay, and eventually, creating a pathway for post-hospital care. In a rapid review covering the evidence base for promising AI application scenarios for nursing care, Seibert et al. found that from a sample of 292 included studies, most (29.8%) describe AI applications in hospital settings. Further, they report that ‘care coordination and communication are frequent topics, which among others, include AI approaches classifying information in nursing documentation, supporting decision-making, and yielding information for coordination and continuity of care’. However, only a few publications went beyond proof-of-concept studies and few studies have assessed the effects of AI on clinical and organizational outcomes. In a perspective piece, London writes that the ability of AI systems to overcome fragmented, uncoordinated, and unwarranted medical practices is frustrated by the degree to which the ecosystems in which AI systems are being developed suffer from these same shortcomings. Moreover, he argues that the current state of AI has the potential to simply add another dimension to unnecessary variation in clinical care. To get a better grip on the value of AI for improving patient care, London points to applying a framework for indicating the level of maturity of AI systems and the level of evidence supporting specific claims to clinical utility. Further, he makes a point for implementation science to play a greater role in structuring and evaluating proposals to implement AI systems in healthcare settings. To stimulate research in this field and to clarify whether, how and when AI lives up to its promise regarding care coordination, the International Journal of Care Coordination will launch a special issue inviting authors to submit relevant work. Please visit the journal’s website for details about the special issue on CoordinAtIon scheduled for early 2024. In the current issue of the International Journal of Care Coordination, Kokorelias et al. present the findings of a scoping review regarding the implementation characteristics of dementia-specific navigation programs to help the integration of care across various settings. Based on 22 studies, mostly from the United States, key factors to the successful implementation of navigation programs for persons living with dementia were identified. With these factors fitting the constructs of the Consolidated Fr
{"title":"CoordinAtIon","authors":"H. Vrijhoef","doi":"10.1177/20534345231182882","DOIUrl":"https://doi.org/10.1177/20534345231182882","url":null,"abstract":"Artificial Intelligence (AI) systems have been increasingly used in health care with the potential that such systems may help develop and augment the capacity of humans in diagnostics, therapeutics, and management of patient care and health care systems. It is claimed that AI systems have the capability to transform health care by, for example, improving risk prediction, augmenting patient– care provider relationships, and optimizing operations and resource allocation. Moreover, it is indicated that AI will be helping the complete journey of patients in terms of prehospital alert and in-hospital stay, and eventually, creating a pathway for post-hospital care. In a rapid review covering the evidence base for promising AI application scenarios for nursing care, Seibert et al. found that from a sample of 292 included studies, most (29.8%) describe AI applications in hospital settings. Further, they report that ‘care coordination and communication are frequent topics, which among others, include AI approaches classifying information in nursing documentation, supporting decision-making, and yielding information for coordination and continuity of care’. However, only a few publications went beyond proof-of-concept studies and few studies have assessed the effects of AI on clinical and organizational outcomes. In a perspective piece, London writes that the ability of AI systems to overcome fragmented, uncoordinated, and unwarranted medical practices is frustrated by the degree to which the ecosystems in which AI systems are being developed suffer from these same shortcomings. Moreover, he argues that the current state of AI has the potential to simply add another dimension to unnecessary variation in clinical care. To get a better grip on the value of AI for improving patient care, London points to applying a framework for indicating the level of maturity of AI systems and the level of evidence supporting specific claims to clinical utility. Further, he makes a point for implementation science to play a greater role in structuring and evaluating proposals to implement AI systems in healthcare settings. To stimulate research in this field and to clarify whether, how and when AI lives up to its promise regarding care coordination, the International Journal of Care Coordination will launch a special issue inviting authors to submit relevant work. Please visit the journal’s website for details about the special issue on CoordinAtIon scheduled for early 2024. In the current issue of the International Journal of Care Coordination, Kokorelias et al. present the findings of a scoping review regarding the implementation characteristics of dementia-specific navigation programs to help the integration of care across various settings. Based on 22 studies, mostly from the United States, key factors to the successful implementation of navigation programs for persons living with dementia were identified. With these factors fitting the constructs of the Consolidated Fr","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"26 1","pages":"53 - 54"},"PeriodicalIF":1.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46121147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-01DOI: 10.1177/20534345231153801
Denise M Hynes, Kathleen C Thomas
Current theoretical models intended to guide health services research and evaluation lack care coordination-its features and impacts. These aspects are critical for understanding the role of care coordination in healthcare use, quality, and outcomes. In this Focus article, we briefly review the well-known Andersen individual behavioral model (IBM) of healthcare use and the Donabedian health system and quality model (HSQM) together with recent practice-based evidence. We propose a new integrated theoretical model of healthcare and care coordination. The model can serve as a guide for future research to better understand the variation in care coordination services and delivery and its added value to improving mental health in different real-world settings.
{"title":"Realigning theory with evidence to understand the role of care coordination in mental health services research.","authors":"Denise M Hynes, Kathleen C Thomas","doi":"10.1177/20534345231153801","DOIUrl":"https://doi.org/10.1177/20534345231153801","url":null,"abstract":"<p><p>Current theoretical models intended to guide health services research and evaluation lack care coordination-its features and impacts. These aspects are critical for understanding the role of care coordination in healthcare use, quality, and outcomes. In this Focus article, we briefly review the well-known Andersen individual behavioral model (IBM) of healthcare use and the Donabedian health system and quality model (HSQM) together with recent practice-based evidence. We propose a new integrated theoretical model of healthcare and care coordination. The model can serve as a guide for future research to better understand the variation in care coordination services and delivery and its added value to improving mental health in different real-world settings.</p>","PeriodicalId":43751,"journal":{"name":"International Journal of Care Coordination","volume":"26 2","pages":"55-61"},"PeriodicalIF":1.4,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/a2/10.1177_20534345231153801.PMC10273861.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10291234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-19DOI: 10.1177/20534345231169883
K. Kokorelias, H. Singh, Amanda Knoepfli, Tracey Das Gupta, Naomi Ziegler, S. Hitzig
Introduction Older adults living with complex care needs are often hospitalized due to poor community support. Recommendations for improving patient and family experiences include having a patient navigator to support patients and caregivers in hospital and community settings. This study aimed to report on older adults’ and caregivers’ experiences of receiving services from a hospital-to-home patient navigation program. Methods A qualitative descriptive study was conducted. Telephone interviews were conducted with 14 older adults with complex care needs or their family caregivers in Toronto, Ontario from 2020 to 2021. Data were analyzed using inductive thematic analysis. Results Four themes were identified: (1) Initial Hesitancy; (2) Meeting Evolving Needs; (3) Unexpected Benefits of Patient Navigation; and (4) The Value of Patient Navigation in Sustaining Aging-in-Place. Participants viewed all their interactions with the navigator as positive, and perceived navigators improved their quality of care. Discussion These study findings suggest that patient navigators may be well-positioned to address gaps in services around psychosocial support and care coordination while also encouraging self-management in older adults with complex care needs.
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