Effect of interprofessional and intraprofessional clinical collaboration on patient related outcomes in multimorbid older patients - a retrospective cohort study on the Intensive Collaboration Ward.

Autor: de Gans ST; Jeroen Bosch Hospital, Jeroen Bosch Academy, PO BOX 90153, 5200, ME, 'S-Hertogenbosch, the Netherlands. s.d.gans@jbz.nl., Maessen GC; University Medical Center Utrecht, CRU + Master Program, Utrecht, the Netherlands., van de Pol MHJ; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands., van Apeldoorn MJ; Department of Internal Medicine, Jeroen Bosch Hospital, 'S-Hertogenbosch, the Netherlands., van Ingen-Stokbroekx MAL; Jeroen Bosch Hospital, Intensive Collaboration Ward, 'S-Hertogenbosch, the Netherlands., van der Sloot N; Department of Pulmonary Medicine, Jeroen Bosch Hospital, 'S-Hertogenbosch, the Netherlands., Keijsers CJPW; Department of Geriatric Medicine, Department of Clinical Pharmacology, Jeroen Bosch Hospital, 'S-Hertogenbosch, the Netherlands., van der Zwaard BC; Department of Orthopedics, Jeroen Bosch Hospital, 'S-Hertogenbosch, the Netherlands.
Jazyk: angličtina
Zdroj: BMC geriatrics [BMC Geriatr] 2023 Aug 26; Vol. 23 (1), pp. 519. Date of Electronic Publication: 2023 Aug 26.
DOI: 10.1186/s12877-023-04232-2
Abstrakt: Background: The management and care of older patients with multiple health problems is demanding and complex. Interprofessional and intraprofessional collaboration has the potential to improve both the efficiency and the quality of care for these patients. However, it has proven difficult to demonstrate the efficacy of this approach in terms of objective patient-related outcomes. Recently, a care model with interprofessional and intraprofessional care was started, the Intensive Collaboration Ward (ICW). This ward combines interprofessional care and intraprofessional care for older patients with multiple health problems. The aim of this study was to evaluate the effects of ICW care in older patients with multiple health problems.
Methods: This retrospective cohort study evaluated the effects on patients outcomes. This was done by comparing patients of the new model, the ICW (ICW group), to a historical cohort of comparable patients who would have been eligible for the ICW (control group). Outcomes were medical consultations, allied health professional consultations, radiological procedures, waiting time for radiological procedures, change in primary treating specialty, length of hospital stay, readmission rate, and mortality rate. Linear and logistic regression analyses were performed, adjusted for baseline differences.
Results: The ICW group required significantly fewer medical consultations than the control group. Calls to specialists from the emergency room decreased significantly, but there was no change in in-person consultations on the ER. 51% of control patients had ≥ 1 in-hospital consultation compared to 21% of ICW patients (p < 0.05). Patients in the ICW group received significantly more consultations with allied health professionals and more often had a change in primary treating specialty.
Conclusions: Interprofessional and intraprofessional clinical collaboration on the ICW reduced in-hospital consultations and increased allied health professionals' consultations. This approach may decrease fragmentation of care and provide more integrated, efficient and patient centered care. This may improve the overall care of older patients with multiple health problems.
(© 2023. BioMed Central Ltd., part of Springer Nature.)
Databáze: MEDLINE
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