Improving care for residents in long term care facilities experiencing an acute change in health status

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dc.contributor.authorMunene, Abraham
dc.contributor.authorLang, Eddy
dc.contributor.authorEwa, Vivian
dc.contributor.authorHair, Heather
dc.contributor.authorCummings, Greta
dc.contributor.authorMcLane, Patrick
dc.contributor.authorSpackman, Eldon
dc.contributor.authorFaris, Peter
dc.contributor.authorZuzic, Nancy
dc.contributor.authorQuail, Patrick B
dc.contributor.authorGeorge, Marian
dc.contributor.authorHeinemeyer, Anne
dc.contributor.authorGrigat, Daniel
dc.contributor.authorMcMillen, Mark
dc.contributor.authorReid, Shawna
dc.contributor.authorHolroyd-Leduc, Jayna
dc.date.accessioned2020-11-29T01:09:36Z
dc.date.available2020-11-29T01:09:36Z
dc.date.issued2020-11-25
dc.date.updated2020-11-29T01:09:36Z
dc.description.abstractAbstract Background Long term care (LTC) facilities provide health services and assist residents with daily care. At times residents may require transfer to emergency departments (ED), depending on the severity of their change in health status, their goals of care, and the ability of the facility to care for medically unstable residents. However, many transfers from LTC to ED are unnecessary, and expose residents to discontinuity in care and iatrogenic harms. This knowledge translation project aims to implement a standardized LTC-ED care and referral pathway for LTC facilities seeking transfer to ED, which optimizes the use of resources both within the LTC facility and surrounding community. Methods/design We will use a quasi-experimental randomized stepped-wedge design in the implementation and evaluation of the pathway within the Calgary zone of Alberta Health Services (AHS), Canada. Specifically, the intervention will be implemented in 38 LTC facilities. The intervention will involve a standardized LTC-ED care and referral pathway, along with targeted INTERACT® tools. The implementation strategies will be adapted to the local context of each facility and to address potential implementation barriers identified through a staff completed barriers assessment tool. The evaluation will use a mixed-methods approach. The primary outcome will be any change in the rate of transfers to ED from LTC facilities adjusted by resident-days. Secondary outcomes will include a post-implementation qualitative assessment of the pathway. Comparative cost-analysis will be undertaken from the perspective of publicly funded health care. Discussion This study will integrate current resources in the LTC-ED pathway in a manner that will better coordinate and optimize the care for LTC residents experiencing an acute change in health status.
dc.identifier.citationBMC Health Services Research. 2020 Nov 25;20(1):1075
dc.identifier.doihttps://doi.org/10.1186/s12913-020-05919-7
dc.identifier.urihttp://hdl.handle.net/1880/112791
dc.language.rfc3066en
dc.rights.holderThe Author(s)
dc.titleImproving care for residents in long term care facilities experiencing an acute change in health status
dc.typeJournal Article
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