Older Persons' Transitions in Care (OPTIC): a study protocol

Changes in health status, triggered by events such as infections, falls, and geriatric syndromes, are common among nursing home (NH) residents and necessitate transitions between NHs and Emergency Departments (EDs). During transitions, residents frequently experience care that is delayed, unnecessar...

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Published inBMC geriatrics Vol. 12; no. 1; p. 75
Main Authors Cummings, Greta G, Reid, R Colin, Estabrooks, Carole A, Norton, Peter G, Cummings, Garnet E, Rowe, Brian H, Abel, Stephanie L, Bissell, Laura, Bottorff, Joan L, Robinson, Carole A, Wagg, Adrian, Lee, Jacques S, Lynch, Susan L, Masaoud, Elmabrok
Format Journal Article
LanguageEnglish
Published England BioMed Central 14.12.2012
BMC
Subjects
Aged
Alberta - epidemiology
British Columbia - epidemiology
Communications
Continuity of Patient Care - standards
Elderly
Emergency Departments
Emergency medical care
Emergency Medical Services
Emergency Service, Hospital - standards
Frailty
Geriatrics
Handovers
Health Personnel - standards
Health sciences
Health services
Homes for the Aged - standards
Hospitalization
Hospitals
Humans
Managers
Measurement
Medical research
Medicine
Nursing
Nursing homes
Nursing Homes - standards
Older people
Patient Care Team - standards
Quality of care
Quality of Health Care - standards
Seniors
Study Protocol
Success
Transitions
Alberta
British Columbia
British Columbia Canada
Canada
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Abstract Changes in health status, triggered by events such as infections, falls, and geriatric syndromes, are common among nursing home (NH) residents and necessitate transitions between NHs and Emergency Departments (EDs). During transitions, residents frequently experience care that is delayed, unnecessary, not evidence-based, potentially unsafe, and fragmented. Furthermore, a high proportion of residents and their family caregivers report substantial unmet needs during transitions. This study is part of a program of research whose overall aim is to improve quality of care for frail older adults who reside in NHs. The purpose of this study is to identify successful transitions from multiple perspectives and to identify organizational and individual factors related to transition success, in order to inform improvements in care for frail elderly NH residents during transitions to and from acute care. Specific objectives are to: 1. define successful and unsuccessful elements of transitions from multiple perspectives; 2. develop and test a practical tool to assess transition success; 3. assess transition processes in a discrete set of transfers in two study sites over a one year period; 4. assess the influence of organizational factors in key practice locations, e.g., NHs, emergency medical services (EMS), and EDs, on transition success; and 5. identify opportunities for evidence-informed management and quality improvement decisions related to the management of NH - ED transitions. This is a mixed-methods observational study incorporating an integrated knowledge translation (IKT) approach. It uses data from multiple levels (facility, care unit, individual) and sources (healthcare providers, residents, health records, and administrative databases). Key to study success is operationalizing the IKT approach by using a partnership model in which the OPTIC governance structure provides for team decision-makers and researchers to participate equally in developing study goals, design, data collection, analysis and implications of findings. As preliminary and ongoing study findings are developed, their implications for practice and policy in study settings will be discussed by the research team and shared with study site administrators and staff. The study is designed to investigate the complexities of transitions and to enhance the potential for successful and sustained improvement of these transitions.
AbstractList Abstract Background Changes in health status, triggered by events such as infections, falls, and geriatric syndromes, are common among nursing home (NH) residents and necessitate transitions between NHs and Emergency Departments (EDs). During transitions, residents frequently experience care that is delayed, unnecessary, not evidence-based, potentially unsafe, and fragmented. Furthermore, a high proportion of residents and their family caregivers report substantial unmet needs during transitions. This study is part of a program of research whose overall aim is to improve quality of care for frail older adults who reside in NHs. The purpose of this study is to identify successful transitions from multiple perspectives and to identify organizational and individual factors related to transition success, in order to inform improvements in care for frail elderly NH residents during transitions to and from acute care. Specific objectives are to: 1. define successful and unsuccessful elements of transitions from multiple perspectives; 2. develop and test a practical tool to assess transition success; 3. assess transition processes in a discrete set of transfers in two study sites over a one year period; 4. assess the influence of organizational factors in key practice locations, e.g., NHs, emergency medical services (EMS), and EDs, on transition success; and 5. identify opportunities for evidence-informed management and quality improvement decisions related to the management of NH – ED transitions. Methods/Design This is a mixed-methods observational study incorporating an integrated knowledge translation (IKT) approach. It uses data from multiple levels (facility, care unit, individual) and sources (healthcare providers, residents, health records, and administrative databases). Discussion Key to study success is operationalizing the IKT approach by using a partnership model in which the OPTIC governance structure provides for team decision-makers and researchers to participate equally in developing study goals, design, data collection, analysis and implications of findings. As preliminary and ongoing study findings are developed, their implications for practice and policy in study settings will be discussed by the research team and shared with study site administrators and staff. The study is designed to investigate the complexities of transitions and to enhance the potential for successful and sustained improvement of these transitions.
Doc number: 75 Abstract Background: Changes in health status, triggered by events such as infections, falls, and geriatric syndromes, are common among nursing home (NH) residents and necessitate transitions between NHs and Emergency Departments (EDs). During transitions, residents frequently experience care that is delayed, unnecessary, not evidence-based, potentially unsafe, and fragmented. Furthermore, a high proportion of residents and their family caregivers report substantial unmet needs during transitions. This study is part of a program of research whose overall aim is to improve quality of care for frail older adults who reside in NHs. The purpose of this study is to identify successful transitions from multiple perspectives and to identify organizational and individual factors related to transition success, in order to inform improvements in care for frail elderly NH residents during transitions to and from acute care. Specific objectives are to: 1. define successful and unsuccessful elements of transitions from multiple perspectives; 2. develop and test a practical tool to assess transition success; 3. assess transition processes in a discrete set of transfers in two study sites over a one year period; 4. assess the influence of organizational factors in key practice locations, e.g., NHs, emergency medical services (EMS), and EDs, on transition success; and 5. identify opportunities for evidence-informed management and quality improvement decisions related to the management of NH - ED transitions. Methods/Design: This is a mixed-methods observational study incorporating an integrated knowledge translation (IKT) approach. It uses data from multiple levels (facility, care unit, individual) and sources (healthcare providers, residents, health records, and administrative databases). Discussion: Key to study success is operationalizing the IKT approach by using a partnership model in which the OPTIC governance structure provides for team decision-makers and researchers to participate equally in developing study goals, design, data collection, analysis and implications of findings. As preliminary and ongoing study findings are developed, their implications for practice and policy in study settings will be discussed by the research team and shared with study site administrators and staff. The study is designed to investigate the complexities of transitions and to enhance the potential for successful and sustained improvement of these transitions.
BACKGROUNDChanges in health status, triggered by events such as infections, falls, and geriatric syndromes, are common among nursing home (NH) residents and necessitate transitions between NHs and Emergency Departments (EDs). During transitions, residents frequently experience care that is delayed, unnecessary, not evidence-based, potentially unsafe, and fragmented. Furthermore, a high proportion of residents and their family caregivers report substantial unmet needs during transitions. This study is part of a program of research whose overall aim is to improve quality of care for frail older adults who reside in NHs. The purpose of this study is to identify successful transitions from multiple perspectives and to identify organizational and individual factors related to transition success, in order to inform improvements in care for frail elderly NH residents during transitions to and from acute care. Specific objectives are to: 1. define successful and unsuccessful elements of transitions from multiple perspectives; 2. develop and test a practical tool to assess transition success; 3. assess transition processes in a discrete set of transfers in two study sites over a one year period; 4. assess the influence of organizational factors in key practice locations, e.g., NHs, emergency medical services (EMS), and EDs, on transition success; and 5. identify opportunities for evidence-informed management and quality improvement decisions related to the management of NH - ED transitions.METHODS/DESIGNThis is a mixed-methods observational study incorporating an integrated knowledge translation (IKT) approach. It uses data from multiple levels (facility, care unit, individual) and sources (healthcare providers, residents, health records, and administrative databases).DISCUSSIONKey to study success is operationalizing the IKT approach by using a partnership model in which the OPTIC governance structure provides for team decision-makers and researchers to participate equally in developing study goals, design, data collection, analysis and implications of findings. As preliminary and ongoing study findings are developed, their implications for practice and policy in study settings will be discussed by the research team and shared with study site administrators and staff. The study is designed to investigate the complexities of transitions and to enhance the potential for successful and sustained improvement of these transitions.
Changes in health status, triggered by events such as infections, falls, and geriatric syndromes, are common among nursing home (NH) residents and necessitate transitions between NHs and Emergency Departments (EDs). During transitions, residents frequently experience care that is delayed, unnecessary, not evidence-based, potentially unsafe, and fragmented. Furthermore, a high proportion of residents and their family caregivers report substantial unmet needs during transitions. This study is part of a program of research whose overall aim is to improve quality of care for frail older adults who reside in NHs. The purpose of this study is to identify successful transitions from multiple perspectives and to identify organizational and individual factors related to transition success, in order to inform improvements in care for frail elderly NH residents during transitions to and from acute care. Specific objectives are to: 1. define successful and unsuccessful elements of transitions from multiple perspectives; 2. develop and test a practical tool to assess transition success; 3. assess transition processes in a discrete set of transfers in two study sites over a one year period; 4. assess the influence of organizational factors in key practice locations, e.g., NHs, emergency medical services (EMS), and EDs, on transition success; and 5. identify opportunities for evidence-informed management and quality improvement decisions related to the management of NH - ED transitions. This is a mixed-methods observational study incorporating an integrated knowledge translation (IKT) approach. It uses data from multiple levels (facility, care unit, individual) and sources (healthcare providers, residents, health records, and administrative databases). Key to study success is operationalizing the IKT approach by using a partnership model in which the OPTIC governance structure provides for team decision-makers and researchers to participate equally in developing study goals, design, data collection, analysis and implications of findings. As preliminary and ongoing study findings are developed, their implications for practice and policy in study settings will be discussed by the research team and shared with study site administrators and staff. The study is designed to investigate the complexities of transitions and to enhance the potential for successful and sustained improvement of these transitions.
ArticleNumber 75
Author Lee, Jacques S
Masaoud, Elmabrok
Norton, Peter G
Rowe, Brian H
Reid, R Colin
Abel, Stephanie L
Lynch, Susan L
Robinson, Carole A
Bissell, Laura
Estabrooks, Carole A
Bottorff, Joan L
Cummings, Greta G
Cummings, Garnet E
Wagg, Adrian
AuthorAffiliation 6 Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
2 School of Health and Exercise Sciences, University of British Columbia’s Okanagan campus, Kelowna, BC, Canada
5 School of Nursing, University of British Columbia’s Okanagan campus, Kelowna, BC, Canada
1 Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
4 Department of Emergency Medicine, Faculty of Medicine and Dentistry and School of Public Health, University of Alberta, Edmonton, AB, Canada
7 Department of Emergency Services, Sunnybrook Health Sciences Center, Toronto, ON, Canada
8 Faculty of Nursing, Edmonton Clinic Health Academy, University of Alberta, 11405-87 Ave, Edmonton, AB, T6G 0C1, Canada
3 Department of Family Medicine, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
AuthorAffiliation_xml – name: 1 Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
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– name: 3 Department of Family Medicine, Faculty of Medicine, University of Calgary, Calgary, AB, Canada
– name: 4 Department of Emergency Medicine, Faculty of Medicine and Dentistry and School of Public Health, University of Alberta, Edmonton, AB, Canada
– name: 2 School of Health and Exercise Sciences, University of British Columbia’s Okanagan campus, Kelowna, BC, Canada
– name: 7 Department of Emergency Services, Sunnybrook Health Sciences Center, Toronto, ON, Canada
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  surname: Cummings
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/23241360$$D View this record in MEDLINE/PubMed
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ContentType Journal Article
Copyright 2012 Cummings et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright ©2012 Cummings et al.; licensee BioMed Central Ltd. 2012 Cummings et al.; licensee BioMed Central Ltd.
Copyright_xml – notice: 2012 Cummings et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
– notice: Copyright ©2012 Cummings et al.; licensee BioMed Central Ltd. 2012 Cummings et al.; licensee BioMed Central Ltd.
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Publisher BioMed Central
BMC
Publisher_xml – name: BioMed Central
– name: BMC
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SSID ssj0017826
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Snippet Changes in health status, triggered by events such as infections, falls, and geriatric syndromes, are common among nursing home (NH) residents and necessitate...
Doc number: 75 Abstract Background: Changes in health status, triggered by events such as infections, falls, and geriatric syndromes, are common among nursing...
BACKGROUNDChanges in health status, triggered by events such as infections, falls, and geriatric syndromes, are common among nursing home (NH) residents and...
Abstract Background Changes in health status, triggered by events such as infections, falls, and geriatric syndromes, are common among nursing home (NH)...
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StartPage 75
SubjectTerms Aged
Alberta - epidemiology
British Columbia - epidemiology
Communications
Continuity of Patient Care - standards
Elderly
Emergency Departments
Emergency medical care
Emergency Medical Services
Emergency Service, Hospital - standards
Frailty
Geriatrics
Handovers
Health Personnel - standards
Health sciences
Health services
Homes for the Aged - standards
Hospitalization
Hospitals
Humans
Managers
Measurement
Medical research
Medicine
Nursing
Nursing homes
Nursing Homes - standards
Older people
Patient Care Team - standards
Quality of care
Quality of Health Care - standards
Seniors
Study Protocol
Success
Transitions
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Title Older Persons' Transitions in Care (OPTIC): a study protocol
URI https://www.ncbi.nlm.nih.gov/pubmed/23241360
https://www.proquest.com/docview/1286701339
https://search.proquest.com/docview/1287887263
https://pubmed.ncbi.nlm.nih.gov/PMC3570479
https://doaj.org/article/c5d933eeb1374c18b157f174e301bdf9
Volume 12
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