Browsing by Subject "acute care"

Now showing 1 - 4 of 4
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    Discharge planning in acute care rehabilitation: Selecting an appropriate standardized assessment to utilize in evaluation to guide discharge recommendations
    (2025-05-05) Claybon, Anna; Hull, Kristin; Department of Occupational Therapy, School of Health and Human Sciences; Gray, Daniel; Walker, Kasey
    Effective discharge planning in the acute care setting is essential for ensuring patient safety and reducing hospital readmissions. Through a combination of a literature review, needs assessment, and clinical experience, the doctoral capstone student (DCS) identified a lack of cognitive assessment administration as a gap in current practice in the acute care setting. The purpose of this project was to identify effective cognitive assessments that support discharge planning and would allow for growth in the DCS’s understanding and administration of cognitive assessments. Based on current research and resources available, the Mini-Mental State Examination (MMSE) was examined as a tool to assess cognitive status. Through self-reflection, the DCS’s understanding of cognitive assessment administration grew over the course of the capstone experience.
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    Patient Perceptions of Provider and Hospital Factors Associated With New Medication Communication
    (Sage, 2016-09) Bartlett Ellis, Rebecca J.; Haase, Joan E.; Bakoyannis, Giorgos; Boyer, Kiersten; Carpenter, Janet S.; IU School of Nursing
    This research examined provider and hospital factors associated with patients’ perceptions of how often explanations of new medications were “always” given to them, using Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. HCAHPS results were obtained for October 2012 to September 2013, from 3,420 hospitals and combined with a Magnet-designated hospital listing. Multiple regression examined correlates of new medication communication, including health care provider factors (perceptions of nurse and physician communication) and health care system factors (magnet designation, hospital ownership, hospital type, availability of emergency services, and survey numbers). Nurse and physician communication was strongly associated with new medication communication (r = .819, p < .001; r = .722, p < .001, respectively). Multivariable correlates included nurse communication (p < .001), physician communication (p < .001), hospital ownership, availability of emergency services, and survey numbers. There was a significant relationship between patients’ perceptions of nurse and physician communication and the explanations they had received about their new medications during hospitalization.
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    Prime movers: Advanced practice professionals in the role of stroke coordinator
    (Wiley, 2017-06) Rattray, Nicholas A.; Damush, Teresa M.; Luckhurst, Cherie; Bauer-Martinez, Catherine J.; Homoya, Barbara J.; Miech, Edward J.; Anthropology, School of Liberal Arts
    Background and purpose Following a stroke quality improvement clustered randomized trial and a national acute ischemic stroke (AIS) directive in the Veterans Health Administration in 2011, this comparative case study examined the role of advanced practice professionals (APPs) in quality improvement activities among stroke teams. Methods Semistructured interviews were conducted at 11 Veterans Affairs medical centers annually over a 3-year period. A multidisciplinary team analyzed interviews from clinical providers through a mixed-methods, data matrix approach linking APPs (nurse practitioners and physician assistants) with Consolidated Framework for Implementation Research constructs and a group organization measure. Conclusion Five of 11 facilities independently chose to staff stroke coordinator positions with APPs. Analysis indicated that APPs emerged as boundary spanners across services and disciplines who played an important role in coordinating evidence-based, facility-level approaches to AIS care. The presence of APPs was related to engaging in group-based evaluation of performance data, implementing stroke protocols, monitoring care through data audit, convening interprofessional meetings involving planning activities, and providing direct care. Implications for practice The presence of APPs appears to be an influential feature of local context crucial in developing an advanced, facility-wide approach to stroke care because of their boundary spanning capabilities.
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    Redesigning inpatient care: testing the effectiveness of an Accountable Care Team model
    (Wiley, 2015-12) Kara, Areeba; Johnson, Cynthia S.; Nicley, Amy; Niemeier, Michael R.; Hui, Siu L.; Department of Medicine, IU School of Medicine
    BACKGROUND US healthcare underperforms on quality and safety metrics. Inpatient care constitutes an immense opportunity to intervene to improve care. OBJECTIVE Describe a model of inpatient care and measure its impact. DESIGN A quantitative assessment of the implementation of a new model of care. The graded implementation of the model allowed us to follow outcomes and measure their association with the dose of the implementation. SETTING AND PATIENTS Inpatient medical and surgical units in a large academic health center. INTERVENTION Eight interventions rooted in improving interprofessional collaboration (IPC), enabling data-driven decisions, and providing leadership were implemented. MEASUREMENTS Outcome data from August 2012 to December 2013 were analyzed using generalized linear mixed models for associations with the implementation of the model. Length of stay (LOS) index, case-mix index–adjusted variable direct costs (CMI-adjusted VDC), 30-day readmission rates, overall patient satisfaction scores, and provider satisfaction with the model were measured. RESULTS The implementation of the model was associated with decreases in LOS index (P < 0.0001) and CMI-adjusted VDC (P = 0.0006). We did not detect improvements in readmission rates or patient satisfaction scores. Most providers (95.8%, n = 92) agreed that the model had improved the quality and safety of the care delivered. CONCLUSIONS Creating an environment and framework in which IPC is fostered, performance data are transparently available, and leadership is provided may improve value on both medical and surgical units. These interventions appear to be well accepted by front-line staff. Readmission rates and patient satisfaction remain challenging.