Pub Date : 2023-11-10DOI: 10.1177/10848223231209926
Christofer Rydenfält, Johanna Persson, Roger Larsson, Gerd Johansson, Gudbjörg Erlingsdóttir
Teamwork is considered something positive. While there is much research on teamwork in healthcare, research on teamwork in home care nursing is limited. As the need for home care nursing is likely to increase in the future, it is of great interest to investigate the circumstances associated with the implementation of teamwork in home care nursing. The present study compares the results from a large change initiative intended to foster inter-organizational teamwork between municipal home care nurses and doctors employed by the region, with success factors identified by forerunners and contemporary team theory. Eighteen participants representing the organizations involved in the change initiative, and 6 participants from the forerunners, were interviewed, and 3 success factors were identified: fixed doctors in team, co-location of staff, and a shared team identity. However, for the studied change initiative, few of the success factors were present. Since the success factors are similar to factors associated with effective teamwork in the literature, this is problematic. The results indicate that there was a focus on the division of labor between the municipalities and the region rather than on interdisciplinary cooperation. They also suggest that the change initiative, as it worked in practice, did not always make sense from the perspective of the nurses and doctors involved. Thus, we suggest that measures are taken to ensure that change initiatives, like the 1 studied, also make sense on the local level in the organization where most of the implementation takes place.
{"title":"Inter-Organizational Home Care Nursing Teams: A Comparison of a Region Wide Organizational Change Initiative With Success Factors Identified by Forerunners and Team Theory","authors":"Christofer Rydenfält, Johanna Persson, Roger Larsson, Gerd Johansson, Gudbjörg Erlingsdóttir","doi":"10.1177/10848223231209926","DOIUrl":"https://doi.org/10.1177/10848223231209926","url":null,"abstract":"Teamwork is considered something positive. While there is much research on teamwork in healthcare, research on teamwork in home care nursing is limited. As the need for home care nursing is likely to increase in the future, it is of great interest to investigate the circumstances associated with the implementation of teamwork in home care nursing. The present study compares the results from a large change initiative intended to foster inter-organizational teamwork between municipal home care nurses and doctors employed by the region, with success factors identified by forerunners and contemporary team theory. Eighteen participants representing the organizations involved in the change initiative, and 6 participants from the forerunners, were interviewed, and 3 success factors were identified: fixed doctors in team, co-location of staff, and a shared team identity. However, for the studied change initiative, few of the success factors were present. Since the success factors are similar to factors associated with effective teamwork in the literature, this is problematic. The results indicate that there was a focus on the division of labor between the municipalities and the region rather than on interdisciplinary cooperation. They also suggest that the change initiative, as it worked in practice, did not always make sense from the perspective of the nurses and doctors involved. Thus, we suggest that measures are taken to ensure that change initiatives, like the 1 studied, also make sense on the local level in the organization where most of the implementation takes place.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135092241","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 : 2023-11-06DOI: 10.1177/10848223231209316
Panagiota Naoum, Kostas Athanasakis, Elpida Pavi
Palliative care improves the quality of life for patients; however, its value-for-money is not yet established. The objective of the present study was to identify and critically assess published studies which investigate the cost-effectiveness of palliative care. A defined strategy was applied; the identified records were assessed with specific inclusion-exclusion criteria (PICO). Methodological quality of the included studies was assessed with the Drummond checklist. An electronic search was conducted in PubMed, SCOPUS, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials, from January 2010 up to December 2022. A narrative synthesis approach was used. From a total of 3857 records, 21 studies were included in the analysis. Almost half (n = 10) the studies were conducted along randomized controlled trials, while the most common setting was home-based palliative care (n = 9). Quality of life was the most commonly assessed outcome (n = 14), measured almost exclusively in Quality-Adjusted Life Years (n = 13). In more than half of the included studies (n = 13), palliative care was found to lead to improved outcomes, while 3 studies did not find any difference in outcomes between comparators. Also, palliative care yielded lower costs in 13 studies and increased costs in 5 studies. Overall, 11 studies concluded that palliative care was a cost-effective intervention. The results of the review indicate that palliative care has the potential to be a cost-efficient allocation of healthcare resources or, at least, a cost saving approach. However, the need for a commonly aligned methodological framework still remains.
{"title":"Is Palliative Care Cost-Effective? A Systematic Review of the Literature","authors":"Panagiota Naoum, Kostas Athanasakis, Elpida Pavi","doi":"10.1177/10848223231209316","DOIUrl":"https://doi.org/10.1177/10848223231209316","url":null,"abstract":"Palliative care improves the quality of life for patients; however, its value-for-money is not yet established. The objective of the present study was to identify and critically assess published studies which investigate the cost-effectiveness of palliative care. A defined strategy was applied; the identified records were assessed with specific inclusion-exclusion criteria (PICO). Methodological quality of the included studies was assessed with the Drummond checklist. An electronic search was conducted in PubMed, SCOPUS, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials, from January 2010 up to December 2022. A narrative synthesis approach was used. From a total of 3857 records, 21 studies were included in the analysis. Almost half (n = 10) the studies were conducted along randomized controlled trials, while the most common setting was home-based palliative care (n = 9). Quality of life was the most commonly assessed outcome (n = 14), measured almost exclusively in Quality-Adjusted Life Years (n = 13). In more than half of the included studies (n = 13), palliative care was found to lead to improved outcomes, while 3 studies did not find any difference in outcomes between comparators. Also, palliative care yielded lower costs in 13 studies and increased costs in 5 studies. Overall, 11 studies concluded that palliative care was a cost-effective intervention. The results of the review indicate that palliative care has the potential to be a cost-efficient allocation of healthcare resources or, at least, a cost saving approach. However, the need for a commonly aligned methodological framework still remains.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135682336","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 : 2023-10-31DOI: 10.1177/10848223231208704
William Cabin
Alzheimer’s disease is a major and increasing cause of illness and death in the United States, imposing significant social, economic, and psychological burdens on patients and their caregivers. This article explores the perceptions of Medicare home health nurses as to the impact of Medicare home health requirements on their decisions to admit, treat, cope with, and meet patient care needs of Alzheimer’s disease patients. It presents an exploratory study, which resulted from a gap in the literature review that found only 3 studies and 1 article since 1965. The study is based on interviews of a convenience sample of 37 home care nurses from 5 home health agencies in the New York City metropolitan area. Analysis followed the grounded theory 3-stage coding of interview data: open, axial, and selective coding. This research methodology was used because it was developed for interpreting qualitative data in the absence of a pre-existing theory. Five themes emerged from interviews: (1) Most Medicare home health patients have some level of Alzheimer’s disease (AD). Medicare home care regulations: (2) restrict nurses’ admissions of persons with AD and lack a mandatory evidence-based assessment for AD; (3) restrict the care that nurses can order for persons with AD; (4) do not cover evidence-based non-pharmacological interventions for AD patients ; and (5) nurses use 3 coping strategies to deal with the restrictions: most as conformists, others as innovators, some as rebels. Policymakers are urged to consider legislation expanding coverage of home-based, evidence-based non-pharmacological interventions for persons with Alzheimer’s disease; expanding Medicare home care social work services to allow delivery of appropriate services; requiring an evidence-based Alzheimer’s disease assessment at intake and as part of the OASIS; additional reimbursement for home health agencies treating Medicare homebound persons with Alzheimer’s disease.
{"title":"“They Are Lost Souls”: Medicare Home Care Nurses’ Perceptions of Medicare’s Inadequate Coverage of Homebound Persons With Alzheimer’s Disease","authors":"William Cabin","doi":"10.1177/10848223231208704","DOIUrl":"https://doi.org/10.1177/10848223231208704","url":null,"abstract":"Alzheimer’s disease is a major and increasing cause of illness and death in the United States, imposing significant social, economic, and psychological burdens on patients and their caregivers. This article explores the perceptions of Medicare home health nurses as to the impact of Medicare home health requirements on their decisions to admit, treat, cope with, and meet patient care needs of Alzheimer’s disease patients. It presents an exploratory study, which resulted from a gap in the literature review that found only 3 studies and 1 article since 1965. The study is based on interviews of a convenience sample of 37 home care nurses from 5 home health agencies in the New York City metropolitan area. Analysis followed the grounded theory 3-stage coding of interview data: open, axial, and selective coding. This research methodology was used because it was developed for interpreting qualitative data in the absence of a pre-existing theory. Five themes emerged from interviews: (1) Most Medicare home health patients have some level of Alzheimer’s disease (AD). Medicare home care regulations: (2) restrict nurses’ admissions of persons with AD and lack a mandatory evidence-based assessment for AD; (3) restrict the care that nurses can order for persons with AD; (4) do not cover evidence-based non-pharmacological interventions for AD patients ; and (5) nurses use 3 coping strategies to deal with the restrictions: most as conformists, others as innovators, some as rebels. Policymakers are urged to consider legislation expanding coverage of home-based, evidence-based non-pharmacological interventions for persons with Alzheimer’s disease; expanding Medicare home care social work services to allow delivery of appropriate services; requiring an evidence-based Alzheimer’s disease assessment at intake and as part of the OASIS; additional reimbursement for home health agencies treating Medicare homebound persons with Alzheimer’s disease.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135863151","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 : 2023-10-27DOI: 10.1177/10848223231208025
Lynette Mackenzie, Sanet DuToit, Margaret McGrath, Yihong Fang, Carolyn Loton
To identify the characteristics of the users of the HOME FAST-SR, to explore the common home hazards identified and to determine the opinions of older people about the usefulness of the HOME FAST-SR. Data from completed HOME FAST-SR submissions were downloaded from the website hosting the tool, and data from participants who consented to provide additional anonymized information about themselves were included for analysis (n = 250). A further link to an electronic survey was used to gather data about participants’ experience of using the HOME FAST-SR (n = 27). Data were downloaded into SPSS and analyzed. Participants had a mean of 11.37 hazards which is in the high-risk category for falls. A total of 12 hazards were identified by more than half of the participants, most of which were modifiable. Participants indicated they agreed that HOME FAST-SR was useable across the criteria, and 57.9% of participants rated the HOME FAST-SR at 4 stars and a further 21.1% rated it at 5 stars. The online HOME FAST-SR is a useable tool that provides older people with an evaluation of their home hazards and information about how to modify these hazards. It also provides a way to make home hazard evaluation more accessible for older people living in the community.
{"title":"An Online, Self-Report Version of the Home Falls and Accidents Screening Tool (HOME FAST-SR) to Identify Fall-Related Hazards in the Homes of Older People","authors":"Lynette Mackenzie, Sanet DuToit, Margaret McGrath, Yihong Fang, Carolyn Loton","doi":"10.1177/10848223231208025","DOIUrl":"https://doi.org/10.1177/10848223231208025","url":null,"abstract":"To identify the characteristics of the users of the HOME FAST-SR, to explore the common home hazards identified and to determine the opinions of older people about the usefulness of the HOME FAST-SR. Data from completed HOME FAST-SR submissions were downloaded from the website hosting the tool, and data from participants who consented to provide additional anonymized information about themselves were included for analysis (n = 250). A further link to an electronic survey was used to gather data about participants’ experience of using the HOME FAST-SR (n = 27). Data were downloaded into SPSS and analyzed. Participants had a mean of 11.37 hazards which is in the high-risk category for falls. A total of 12 hazards were identified by more than half of the participants, most of which were modifiable. Participants indicated they agreed that HOME FAST-SR was useable across the criteria, and 57.9% of participants rated the HOME FAST-SR at 4 stars and a further 21.1% rated it at 5 stars. The online HOME FAST-SR is a useable tool that provides older people with an evaluation of their home hazards and information about how to modify these hazards. It also provides a way to make home hazard evaluation more accessible for older people living in the community.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136317533","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 : 2023-10-16DOI: 10.1177/10848223231205200
Fatma Tanrikulu, Yurdanur Dikmen
Home caregivers have a large amount of responsibility, and many have difficulty in fulfilling their care-giving roles. Previous studies have shown that when caregivers are supported socially, psychologically, and culturally, there is a positive improvement in caregivers’ coping skills, quality of live, and a decrease in health problems. The purpose of this study was to evaluate the effect of a family support program based on the nurse-led case management model on home caregivers by measuring quality of life, caregiver burden, and family functionality level. In this study 27 home caregivers were randomly divided into intervention and control groups. The family support program based on a 5-stage nurse-led case management model was administered for the caregivers in the intervention group (n = 13) for 6 months. The caregivers in the control group (n = 14) were monitored by home health services through routine follow-ups. Baseline and postintervention assessments included the Zarit Caregiver Burden Scale, the World Health Organization Quality of Life–Brief Turkish Form, and the Family APGAR Scale. It was found out that there was a statistically significant difference among caregiver burden, quality of life, and family functionality level total scores of caregivers in the intervention and control groups ( p < .05). A family support program based on nurse-led case management model has a supportive role for caregivers, where web-based education and counseling services are available, patients and their relatives are monitored by a multidisciplinary health team, and their educational needs are met.
{"title":"The Effect on Home Caregivers of a Family Support Program Based on a Nurse-Led Case Management Model: A Randomized Controlled Pilot Trial","authors":"Fatma Tanrikulu, Yurdanur Dikmen","doi":"10.1177/10848223231205200","DOIUrl":"https://doi.org/10.1177/10848223231205200","url":null,"abstract":"Home caregivers have a large amount of responsibility, and many have difficulty in fulfilling their care-giving roles. Previous studies have shown that when caregivers are supported socially, psychologically, and culturally, there is a positive improvement in caregivers’ coping skills, quality of live, and a decrease in health problems. The purpose of this study was to evaluate the effect of a family support program based on the nurse-led case management model on home caregivers by measuring quality of life, caregiver burden, and family functionality level. In this study 27 home caregivers were randomly divided into intervention and control groups. The family support program based on a 5-stage nurse-led case management model was administered for the caregivers in the intervention group (n = 13) for 6 months. The caregivers in the control group (n = 14) were monitored by home health services through routine follow-ups. Baseline and postintervention assessments included the Zarit Caregiver Burden Scale, the World Health Organization Quality of Life–Brief Turkish Form, and the Family APGAR Scale. It was found out that there was a statistically significant difference among caregiver burden, quality of life, and family functionality level total scores of caregivers in the intervention and control groups ( p < .05). A family support program based on nurse-led case management model has a supportive role for caregivers, where web-based education and counseling services are available, patients and their relatives are monitored by a multidisciplinary health team, and their educational needs are met.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136114459","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 : 2023-09-30DOI: 10.1177/10848223231196301
Pallavi Gupta, Sonali Randhawa, Sunil Nandraj
India is currently experiencing a demographic and epidemiological transition characterized by an aging population and an increase in chronic diseases, resulting in a greater demand for home healthcare services. Despite the critical nature and expansion of this area, home healthcare delivery in India remains under-researched. There is a dearth of information about the services, providers and organizations that offer services at home. There are various concerns in the provision of home healthcare services. These relate to accessibility and availability, information on providers, regulatory issues, standards of care, costs, safety concerns, and grievance redressal mechanisms for providers and users, which are among the topics discussed in this article. The article concludes that there is a need to recognize the “home” as a place for providing healthcare and as a “workplace” of care providers, develop standardized processes and guidelines for delivering care for different conditions at home, adopt standard human resource practices in deployment of care providers, bring transparency in the calculation of the cost of services and regulation of costs, and establish grievance redressal mechanisms for users, providers, and organizations. Further research is recommended on aspects such as user and provider perspective, training and supervision of providers, and financing, accreditation, and quality of services.
{"title":"The Home Healthcare Boom: Opportunities and Obstacles in India’s Changing Healthcare Landscape","authors":"Pallavi Gupta, Sonali Randhawa, Sunil Nandraj","doi":"10.1177/10848223231196301","DOIUrl":"https://doi.org/10.1177/10848223231196301","url":null,"abstract":"India is currently experiencing a demographic and epidemiological transition characterized by an aging population and an increase in chronic diseases, resulting in a greater demand for home healthcare services. Despite the critical nature and expansion of this area, home healthcare delivery in India remains under-researched. There is a dearth of information about the services, providers and organizations that offer services at home. There are various concerns in the provision of home healthcare services. These relate to accessibility and availability, information on providers, regulatory issues, standards of care, costs, safety concerns, and grievance redressal mechanisms for providers and users, which are among the topics discussed in this article. The article concludes that there is a need to recognize the “home” as a place for providing healthcare and as a “workplace” of care providers, develop standardized processes and guidelines for delivering care for different conditions at home, adopt standard human resource practices in deployment of care providers, bring transparency in the calculation of the cost of services and regulation of costs, and establish grievance redressal mechanisms for users, providers, and organizations. Further research is recommended on aspects such as user and provider perspective, training and supervision of providers, and financing, accreditation, and quality of services.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136341458","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 : 2023-08-30DOI: 10.1177/10848223231196585
Elizabeth S Knaster, Marcail Moody-Burks, C. Dent, Sahar Banijamali
This study assessed the prevalence of Adverse Childhood Experiences (ACEs) among Home Care Aides (HCAs) and explored the relationship between ACEs and mental health. A 2017 survey of 424 HCAs assessed childhood trauma using the CDC-BRFSS ACE module. Approximately 27% of HCAs had a high ACE score (between 4 and 10). There were no associations found between ACE score and respondent demographic characteristics. HCAs with high ACE scores reported lower rates of social and emotional support and higher rates of past-month hopelessness compared with those with no or limited experience of adverse childhood events. This research suggests that HCAs have higher than average rates of ACEs, known to be linked to various negative physical and mental health outcomes.
{"title":"Adverse Childhood Experiences and Mental Health Among Home Care Aides in Washington State","authors":"Elizabeth S Knaster, Marcail Moody-Burks, C. Dent, Sahar Banijamali","doi":"10.1177/10848223231196585","DOIUrl":"https://doi.org/10.1177/10848223231196585","url":null,"abstract":"This study assessed the prevalence of Adverse Childhood Experiences (ACEs) among Home Care Aides (HCAs) and explored the relationship between ACEs and mental health. A 2017 survey of 424 HCAs assessed childhood trauma using the CDC-BRFSS ACE module. Approximately 27% of HCAs had a high ACE score (between 4 and 10). There were no associations found between ACE score and respondent demographic characteristics. HCAs with high ACE scores reported lower rates of social and emotional support and higher rates of past-month hopelessness compared with those with no or limited experience of adverse childhood events. This research suggests that HCAs have higher than average rates of ACEs, known to be linked to various negative physical and mental health outcomes.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76491167","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: 10.1177/10848223231195638
Widya Ratna Wulan, Evina Widianawati, Ika Pantiawati, F. Wulandari
National data showed that the majority of deaths due to COVID-19 are elderly people with comorbidities such as diabetes, hypertension, and kidney failure who have a 3.5-fold risk of dying compared to non-elderly people. With an increasing number of elderly and a high prevalence of chronic diseases, home healthcare is important to enable people to be in their own homes rather than hospitals by taking advantage of telemedicine within limited distances. A cross-sectional quantitative study was conducted with 157 elderly respondents of the Chronic Disease Management Program (Prolanis) at Primary Healthcare Facilities participants in Semarang Regency by a validated questionnaire. Analyzed by SPSS version 21 and a chi-square test. The respondent knowledge level with fewer telemedicine-related categories is about 47.1%. The attitude regarding the development of telemedicine in Prolanis was positive (79.0%), and positively perceived the development of telemedicine by 58.3%. Age ( p = .035; OR = 0.502) and gender ( p = .010; OR = 2.605) were significantly related to respondents’ knowledge. The educational background is significantly related to respondents’ attitudes ( p = .025; OR = 3.080). Health information technology (telemedicine) needs to be developed among elderly users, especially participants in the Prolanis (hypertension and diabetes mellitus type 2) in Health Service Facilities.
{"title":"Telemedicine Homecare Among the Hypertension and Diabetes Mellitus Risk Elderly Group in Indonesian Primary Healthcare: A Technology Acceptance Model","authors":"Widya Ratna Wulan, Evina Widianawati, Ika Pantiawati, F. Wulandari","doi":"10.1177/10848223231195638","DOIUrl":"https://doi.org/10.1177/10848223231195638","url":null,"abstract":"National data showed that the majority of deaths due to COVID-19 are elderly people with comorbidities such as diabetes, hypertension, and kidney failure who have a 3.5-fold risk of dying compared to non-elderly people. With an increasing number of elderly and a high prevalence of chronic diseases, home healthcare is important to enable people to be in their own homes rather than hospitals by taking advantage of telemedicine within limited distances. A cross-sectional quantitative study was conducted with 157 elderly respondents of the Chronic Disease Management Program (Prolanis) at Primary Healthcare Facilities participants in Semarang Regency by a validated questionnaire. Analyzed by SPSS version 21 and a chi-square test. The respondent knowledge level with fewer telemedicine-related categories is about 47.1%. The attitude regarding the development of telemedicine in Prolanis was positive (79.0%), and positively perceived the development of telemedicine by 58.3%. Age ( p = .035; OR = 0.502) and gender ( p = .010; OR = 2.605) were significantly related to respondents’ knowledge. The educational background is significantly related to respondents’ attitudes ( p = .025; OR = 3.080). Health information technology (telemedicine) needs to be developed among elderly users, especially participants in the Prolanis (hypertension and diabetes mellitus type 2) in Health Service Facilities.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75528164","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 : 2023-08-21DOI: 10.1177/10848223231186403
Allison F. Sheppard
This quality improvement project focuses on decreasing laboratory result retrieval times within a 6-month period at a rural home health setting. Prior to implementation, 73% of all laboratory results were not received within 24 hours (72 hours for cultures). Interventions included Lean Six Sigma methodologies (process mapping and process redesign) and Plan-Do-Study-Act to reduce laboratory result retrieval times. Data analysis included descriptive statistics including means, averages, and percentages for the primary outcome of laboratory result retrieval time. 119 participants included all patients who had laboratory specimens collected by home health staff during the project timeline. Laboratory result delays ≥24/72 hours decreased from 73% (29/40) to 14% (11/79). Furthermore, 25% (10/40) of labs were delayed ≥5 days pre-implementation and 0% post-implementation. Abnormal laboratory results with delayed treatment decreased from 28% (11/40) to 5% (4/79). Provider notification within 24 hours of an abnormal laboratory result increased from 0% (0/13) to 75% (6/8). Hospitalization rates within 30 days of an abnormal result was 15% (6/40) pre-implementation and decreased to 5% (4/79) post-implementation.
{"title":"Improving Laboratory Result Retrieval Times Within the Home Health Setting","authors":"Allison F. Sheppard","doi":"10.1177/10848223231186403","DOIUrl":"https://doi.org/10.1177/10848223231186403","url":null,"abstract":"This quality improvement project focuses on decreasing laboratory result retrieval times within a 6-month period at a rural home health setting. Prior to implementation, 73% of all laboratory results were not received within 24 hours (72 hours for cultures). Interventions included Lean Six Sigma methodologies (process mapping and process redesign) and Plan-Do-Study-Act to reduce laboratory result retrieval times. Data analysis included descriptive statistics including means, averages, and percentages for the primary outcome of laboratory result retrieval time. 119 participants included all patients who had laboratory specimens collected by home health staff during the project timeline. Laboratory result delays ≥24/72 hours decreased from 73% (29/40) to 14% (11/79). Furthermore, 25% (10/40) of labs were delayed ≥5 days pre-implementation and 0% post-implementation. Abnormal laboratory results with delayed treatment decreased from 28% (11/40) to 5% (4/79). Provider notification within 24 hours of an abnormal laboratory result increased from 0% (0/13) to 75% (6/8). Hospitalization rates within 30 days of an abnormal result was 15% (6/40) pre-implementation and decreased to 5% (4/79) post-implementation.","PeriodicalId":45762,"journal":{"name":"Home Health Care Management and Practice","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78126614","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: 10.1177/10848223231176843
Thirunavukkarasu Murugappan, Rajeev Raut
In recent years, telemonitoring solutions have gained prominence for monitoring patients at home. However, patient and clinician enthusiasm, as well as adherence rates, have been inconsistent. This article presents a primary care evaluation of an autonomous foot-measuring home device, designed to monitor physiological changes in medium to high-risk chronic heart failure patients at risk of decompensation. The Heartfelt device garnered positive reception among the 13 participating patients. Remarkably, in 77% of cases (10 patients), the device captured and transmitted patient data on more than half of the days each month, while only 8% (one patient) managed to provide equivalent daily measurements using weighing scales. These results indicate that the Heartfelt device holds promise as an effective telemonitoring solution for patients who face adherence challenges with traditional telemonitoring systems, and self-management checks more generally. By adopting this technology, healthcare providers may be better equipped to proactively manage chronic heart failure patients and improve overall patient outcomes.
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