Evaluation of a Hospital
| Autor: | Colleen Delaney, Diahann Wilcox, Sheila L. Molony, Paula S McCauley |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Program evaluation medicine.medical_specialty Community partnership Leadership and Management MEDLINE Motivational interviewing Guidelines as Topic Assessment and Diagnosis Medicare Patient Readmission 01 natural sciences Health administration 03 medical and health sciences 0302 clinical medicine Hospital Administration Phone medicine Humans 030212 general & internal medicine 0101 mathematics Care Planning Aged Quality of Health Care Retrospective Studies Aged 80 and over business.industry Health Policy 010102 general mathematics Fee-for-Service Plans Retrospective cohort study Middle Aged Patient Discharge United States Connecticut Family medicine General partnership Female business Program Evaluation |
| Zdroj: | Professional Case Management. 23:327-341 |
| ISSN: | 1932-8087 |
| Popis: | Purpose To evaluate the ComPass program by (1) effectiveness in reducing 30-day hospital readmissions, (2) reach of program into target population, and (3) implementation of key program elements. Primary practice setting An academic hospital in New England (John Dempsey Hospital). Methodology and sample Retrospective analysis of Medicare fee-for-service (FFS) beneficiaries hospitalized at John Dempsey Hospital between May 1, 2012, and November 30, 2014. Results The program reached 34% of eligible Medicare FFS beneficiaries (n = 832; 61% female, mean age = 79 years). The unadjusted 30-day all-cause readmission rate decreased from 21% to 16.2% (p = .03). Implementation was high for postdischarge phone calls (89%) but low for home visits (34%). The mean change in patient activation scores following completion of the program was 0.15 (SD = 4.79), with no change in patient activation level, χ (6) = 3.82, p = .70. Implications for case management practice The ComPass program was consistent with the philosophy and standards of case management practice. Case managers will want to utilize an evidence-based instrument with real-time information to identify patients at risk for 30-day readmission. A physical presence of ComPass coaches within the hospital enabled a strong hospital-community-based organization (CBO) partnership, facilitating the coordination, communication, and collaboration. Case managers will want to advocate for policy incentivizing hospital-CBO partnerships. Patient activation is essential; case managers may benefit from training in motivational interviewing to improve patient activation and outcomes. Additional research is needed to further elucidate and mitigate barriers to posttransition home visits and patient activation. |
| Databáze: | OpenAIRE |
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