کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3466362 1596560 2013 7 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Discharge intervention pilot improves satisfaction for patients and professionals
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی پزشکی و دندانپزشکی (عمومی)
پیش نمایش صفحه اول مقاله
Discharge intervention pilot improves satisfaction for patients and professionals
چکیده انگلیسی


• The use of nurse care managers to improve hospital discharge processes was studied.
• Community- and hospital-based MDs and RNs collaborated to develop the intervention.
• A randomized, controlled, single-blind pilot evaluated feasibility and acceptance.
• Patients and families receiving the intervention reported higher satisfaction.
• Physicians rated discharge information more highly in the intervention group.

BackgroundThe risk of adverse events and information loss following hospital discharge is particularly high for vulnerable multimorbid patients. Poor coordination of care at discharge increases the burden upon patients, caregivers and professionals, and can lead to increased morbidity and costs. Targeted programs can improve efficiency and health outcomes, but the ideal organization of hospital discharge remains to be specified.MethodsThis single-blind, randomized, controlled interprofessional pilot on two internal medicine wards in a teaching hospital in Baden, Switzerland tested a discharge management intervention using nurse care managers. Patients (n = 60) were at high risk for adverse events, fulfilling criteria such as polypharmacy, therapy with anticoagulants or insulin, plus secondary criteria indicating vulnerability. Primary composite endpoint was fulfilled by any of the following: death, rehospitalization, urgent physician visit within five days of discharge or adverse medicine reaction. Secondary endpoints evaluated patient quality-of-life, caregiver burden, adequacy of information provided to primary care physicians and home care nurses, and satisfaction with discharge for all groups. Endpoint evaluation was via telephone interviews on days 5 and 30 post-discharge. Design was critically evaluated in anticipation of a larger trial.ResultsIntervention acceptance was high. In the intervention group, satisfaction was higher among patients (p = 0.027) and caregivers (p = 0.008), and primary care physicians rated discharge information higher (p = 0.031). Primary endpoint showed no significant difference between groups. Necessary design modifications were identified.ConclusionDischarge coordination and follow-up care by nurse care managers significantly improved subjective endpoints. A modified design is planned to test effectiveness in a well-powered study.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: European Journal of Internal Medicine - Volume 24, Issue 8, December 2013, Pages 756–762
نویسندگان
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